House GOP hard-liners fume at Senate parliamentarian’s Medicaid rulings

Hard-line House conservatives are fuming at the Senate parliamentarian’s decision to reject key Medicaid cuts in the upper chamber’s version of the “big, beautiful bill,” urging their GOP colleagues to overrule the Senate referee — which would be a major departure from typical protocol.

Senate parliamentarian Elizabeth MacDonough issued her latest ruling Thursday morning, dealing a blow to major parts of the megabill, including shooting down a proposal to cap states’ use of health care provider taxes to collect more federal Medicaid funding, a provision championed by conservatives that would have generated billions of dollars in savings to pay for President Trump’s tax cuts.

She also struck down an effort to restrict Medicare and Medicaid coverage for immigrants who are not citizens, among other provisions.

Republicans can rework the provisions that were rejected in an attempt to make them compliant with the budget reconciliation rules, a move that could salvage some of the party’s plans.

For now, however, the ruling is reverberating through GOP circles on Capitol Hill: Conservatives are seething, moderates are quietly breathing a sigh of relief, and Senate Majority Leader John Thune (R-S.D.) is rethinking the bill’s path toward passage in the upper chamber.

Thune has said the upper chamber will not move to overrule the parliamentarian — “that would not be a good outcome for getting a bill done,” he told reporters Thursday morning — but conservatives in both chambers are upping the pressure on their colleagues to challenge the referee’s ruling on the floor.

“How is it that an unelected swamp bureaucrat, who was appointed by [former Sen.] Harry Reid [D-Nev.] over a decade ago, gets to decide what can and cannot go in President Trump’s One Big Beautiful Bill?” Rep. Greg Steube (R-Fla.) wrote on social platform X. “The Senate Parliamentarian is not elected. She is not accountable to the American people. Yet she holds veto power over legislation supported by millions of voters.”

“It is time for our elected leaders to take back control. @JDVance should overrule the Parliamentarian and let the will of the people, not some staffer hiding behind Senate procedure, determine the future of this country,” he added.

Rep. Keith Self (R-Texas) was more succinct, writing on X: “The rogue Senate Parliamentarian should be overruled, just like activist judges.”

“Her word isn’t law—just advice,” he added in a separate post. “Senate Republicans: ignore her and deliver on President Trump’s agenda, backed by 77M Americans!”

Rep. Dan Crenshaw (R-Texas) went a step further, saying MacDonough should be fired from her post.

“This is not about partisanship, it is about rule of law. She has failed to apply the rules of reconciliation accurately on multiple occasions. @LeaderJohnThune should fire her NOW,” he added in a post on X.

It is not just House Republicans aiming their anger at the parliamentarian. Sen. Tommy Tuberville (R-Ala.), who is running for governor of Alabama, said “THE SENATE PARLIAMENTARIAN SHOULD BE FIRED ASAP,” calling MacDonough “WOKE.”

Overturning the parliamentarian would require support from at least 51 senators on the floor. The senator presiding over the chamber, known as the chair, could issue a ruling that contrasts with the parliamentarian’s decision, which would have to be sustained with 51 votes to move forward.

Senators in both parties have called for the parliamentarian to be overruled in recent years. In 2022, Democrats tried to overrule the parliamentarian when they were working to pass their marquee bill known as the Inflation Reduction Act.

MacDonough was first appointed Senate parliamentarian in 2012, becoming the first woman to hold the position. Then-Senate Majority Leader Harry Reid (D-Nev.) elevated her to the position.

Thune downplayed her Thursday ruling as small hitches in the party’s path to passing Trump’s megabill.

“These are … short-term setbacks,” he said. “Speed bumps, if you will. We’re focused on the goal.”

Asked if the ruling would change his plans to bring the legislation to the floor for an initial vote Friday, Thune responded: “We’ll see … We’ll see how it all lands.”

Speaker Mike Johnson (R-La.), meanwhile, recognized that the ruling does not help the GOP’s plans to fast-track the package.

“Well it doesn’t make it easier, but you know me, hope springs eternal and we’re gonna work around the clock and try to meet that deadline, because I think that’s the way we should do it,” he told reporters.

The House leader would not say directly if he thinks his Senate GOP colleagues should overrule the parliamentarian’s decision, leaving the high-stakes play call to the upper chamber.

“If only that were our decision,” he said when asked by The Hill if Senate Republicans should overrule the parliamentarian. “The senators have to make that call. I mean, I can make a case for it but no one’s asked me for that.”

Some moderate House Republicans, meanwhile, are privately cheering on the parliamentarian’s ruling, which broke in their direction. Several centrist GOP lawmakers raised concerns about the provider tax provisions, warning that they would not support a product that included the language.

“This moves the bill in a more positive direction and allows us the ability to focus on other areas of the bill we would like to fix,” one moderate House Republican told The Hill.

MacDonough is steadily parsing through the GOP’s “big, beautiful bill” to determine which provisions comply with the budget reconciliation rules. Republicans are looking to use the budget reconciliation process to pass key parts of Trump’s legislative agenda, since the procedure allows GOP senators to circumvent a Democratic filibuster.

If the parliamentarian rules that a provision is not compliant, however, then it requires 60 votes for passage — essentially forcing Republicans to remove it from the sprawling package.

With those strict rules, several hard-line conservatives in the House are torching the parliamentarian’s decision, arguing that MacDonough does not have the authority to dictate the party’s policy decisions.

“An unelected bureaucrat appointed by radical Harry Reid is stripping hard-fought conservative wins from the OBBB. This is politically motivated,” Rep. Andy Biggs (R-Ariz.) wrote on X, referring to the One Big Beautiful Bill Act. “A Senate staffer DOES NOT have the authority to overturn the will of 77 million voters.”

Rep. Scott Perry (R-Pa.), a former chair of the conservative House Freedom Caucus, railed against the parliamentarian’s Medicaid ruling in addition to her decision to strip a provision that sought to make it more difficult for courts to enforce lawsuits against the Trump administration.

“First, rogue judges. Now, the Senate parliamentarian’s allegedly off the rails, getting in the way of the ‘One BBB,’ and slashing the reforms / cuts that 77 million Americans voted for in November,” Perry wrote on X. “Unelected  bureaucrats need to stop meddling in America’s legislative process.”

“[T]he UN-ELECTED Senate Parliamentarian used the Byrd Rule, meaning these Trump agenda priorities, that deliver our campaign promises, need to be stripped out of the One Big Beautiful Bill,” Rep. Marjorie Taylor Greene (R-Ga.) echoed on X. “The UN-ELECTED Deep State bureaucrats, radical far left activist judges, and America LAST Democrats are doing everything they can to destroy President Trump and THE PEOPLE’S agenda!!!”

She later added, “Leader Thune needs to fire the Senate Parliamentarian, which he can!”

Democrats, meanwhile, cheered Thursday morning’s ruling, arguing the decision struck down a provision that would have hurt constituents across the country.

“Major victory!” Rep. Greg Stanton (D-Ariz.) wrote on X. “Republicans tried to gut a key funding source for Medicaid in states like Arizona—the ‘provider tax.’ This would’ve been catastrophic for patients & providers. But today, the nonpartisan Senate Parliamentarian ruled that scheme won’t fly. We’re going to keep fighting this.”

Al Weaver contributed.

This story was updated at 12:41 pm.