WASHINGTON — On Thursday, Republicans were met with a new hurdle in their quest to pass President Trump’s anticipated “big beautiful bill.” The Senate parliamentarian decided that several proposed health care spending reforms would require 60 votes to pass, instead of the 51 votes targeted by the GOP. This ruling significantly jeopardizes the prospects of achieving the anticipated savings of hundreds of billions of dollars.

Senate Parliamentarian Elizabeth MacDonough concluded that certain Medicaid-related elements of the massive bill, such as adjustments to federal financial support for states concerning health care provider taxes, did not qualify for passage through reconciliation, which allows for a simple majority vote.

Additional provisions that were rejected involved reducing Medicaid eligibility for non-citizen adults and children and decreasing the Federal Medical Assistance Percentage (FMAP) funding for those states that permit non-citizens to access health care coverage, cutting it from 90% to 80%.

Still another section that failed to pass muster with MacDonough blocked federal funding for Medicaid and the Children’s Health Insurance Program (CHIP) to provide gender-transition medical care.

“The WOKE Senate Parliamentarian, who was appointed by Harry Reid and advised Al Gore, just STRUCK DOWN a provision BANNING illegals from stealing Medicaid from American citizens,” erupted Sen. Tommy Tuberville (R-Ala.). “This is a perfect example of why Americans hate THE SWAMP.”

“Unelected bureaucrats think they know better than U.S. Congressmen who are elected BY THE PEOPLE,” he added. “Her job is not to push a woke agenda. THE SENATE PARLIAMENTARIAN SHOULD BE FIRED ASAP.”

“How is it that an unelected swamp bureaucrat, who was appointed by Harry Reid over a decade ago, gets to decide what can and cannot go in President Trump’s One Big Beautiful Bill?” griped Rep. Greg Steube (R-Fla.).

“It is time for our elected leaders to take back control. [Vice President JD Vance] should overrule the Parliamentarian and let the will of the people, not some staffer hiding behind Senate procedure, determine the future of this country.”

The Congressional Budget Office (CBO) determined that the House-passed version of the One Big Beautiful Bill Act, which the Senate has been revising, would add up to $3 trillion to the federal deficit over the next decade.

House Republicans had previously boasted that as much as $1.6 trillion in spending cuts were included in their version of the tax-and-spending package.

Senate Majority Leader John Thune (R-SD) described MacDonough’s ruling as a “speed bump” in the bill’s progress.

Thune, 64, has indicated in the past that ignoring the parliamentarian would be tantamount to abolishing the 60-vote filibuster, a feature that sets the upper chamber apart from the lower and provides a check for the party out of power.

Vance, though president of the Senate, can’t overrule the parliamentarian’s decision outright either, but would need a vote by the full chamber.

Sen. Jeff Merkley of Oregon, the top Democrat on the Senate Budget Committee, celebrated the ruling in a statement, sharing other provisions that had been struck down by the upper chamber’s referee.

“Democrats are continuing to make the case against every provision in this Big, Beautiful Betrayal of a bill that violates Senate rules and hurts families and workers,” Merkley (D-Ore.) said.

“Democrats are fighting back against Republicans’ plans to gut Medicaid, dismantle the Affordable Care Act, and kick kids, veterans, seniors, and folks with disabilities off of their health insurance – all to fund tax breaks for billionaires.”

Reconciliation legislation is subject to parliamentary scrutiny under the so-called “Byrd Rule” — named for former Senate Majority Leader Robert Byrd — which requires bills to focus strictly on fiscal issues.