WASHINGTON – A cornerstone domestic policy initiative championed by Senate Republicans encountered a significant procedural hurdle on Saturday, June 28, 2025, when Senate Parliamentarian Elizabeth MacDonough disqualified several critical provisions within the expansive legislative proposal.
The ruling specifically targeted measures intended to reshape federal funding access for healthcare programs based on immigration status verification and alter state-level taxation mechanisms concerning healthcare providers participating in Medicaid. The setback casts uncertainty over the future of key components within the so-called “megabill” as Republicans navigate complex Senate rules.
Key Provisions Struck Down
Among the most impactful provisions invalidated by the parliamentarian were those designed to prohibit federal funding for both the Medicaid program, which provides healthcare to low-income individuals and families, and the Children’s Health Insurance Program (CHIP). This prohibition would have applied to individuals whose immigration status could not be immediately verified, a measure aimed at tightening eligibility criteria based on citizenship and residency.
Also struck down were proposed changes related to how states can tax Medicaid providers. These provisions, intended to potentially provide states with more flexibility or alter existing revenue streams tied to the federal-state partnership of Medicaid funding, were deemed non-germane or in violation of Senate budgetary rules, likely under the Byrd Rule.
The Role of the Senate Parliamentarian
Elizabeth MacDonough, the nonpartisan referee of Senate rules and procedures, plays a crucial role in determining whether provisions within reconciliation bills adhere to strict guidelines, particularly the Byrd Rule. This rule prevents extraneous matter – provisions unrelated to the budget – from being included in measures considered under the reconciliation process, which allows certain budget-related bills to pass with a simple majority, bypassing the 60-vote threshold usually required in the Senate. The parliamentarian’s rulings are advisory but are almost always followed by the presiding officer.
Her decision on Saturday, June 28, 2025, underscores the technical challenges inherent in crafting large legislative packages under the constraints of the reconciliation process, which Republicans are reportedly seeking to use for this bill.
Republican Reaction and Path Forward
Senate Majority Leader John Thune acknowledged the ruling, describing the development as a “speed bump” for the legislative effort. Despite the setback, Thune indicated that Republican leadership had anticipated potential challenges and possessed contingency plans to address the parliamentarian’s objections. The nature of these plans remains unclear but could involve attempts to modify the offending provisions to comply with the rules, remove them entirely, or potentially challenge the parliamentarian’s ruling, although the latter is rare and typically unsuccessful.
Reaction among other Republican senators varied, highlighting internal divisions or differing perspectives on the path forward. Senator Tommy Tuberville publicly called for the immediate removal of Parliamentarian MacDonough following the decision, expressing frustration with the procedural roadblock. In contrast, Senator Josh Hawley voiced skepticism about the feasibility or likelihood of successfully overruling MacDonough’s determination, acknowledging the difficulty of such a maneuver.
Presidential Involvement and Advocacy
The legislative push also saw public advocacy from former President Donald Trump. President Trump publicly urged congressional Republicans to coalesce behind the bill, which he enthusiastically referred to as the “one big beautiful bill.” His endorsement signaled the administration’s desire to see the legislation enacted, framing it as a comprehensive package of Republican policy priorities.
However, in promoting the bill, President Trump also made a notable factual misstatement, incorrectly asserting that the proposed legislation did not include taxes on social security benefits. The precise contents of the bill regarding social security taxation were a subject of debate and varied depending on specific drafts or interpretations, but Trump’s blanket denial contradicted some analyses and added a layer of confusion to the public discourse surrounding the bill’s provisions.
Outlook for the Megabill
The parliamentarian’s ruling presents a significant challenge to the Republican megabill, particularly impacting provisions central to conservative policy goals regarding healthcare eligibility and state fiscal matters. While Republican leadership has indicated a determination to press forward, the need to revise or remove parts of the bill could alter its scope and impact, potentially complicating efforts to unify the Republican caucus behind the final version. The path ahead for the legislation remains uncertain as lawmakers assess the full implications of the ruling and strategize their next moves on Capitol Hill.