Senate Parliamentarian Elizabeth MacDonough has delivered a crushing blow to President Donald Trump’s domestic policy agenda, forcing Senate Republicans to strip 47 provisions from the president’s comprehensive legislative package.
The unelected official’s rulings have effectively gutted major portions of what Trump has called his “one big, beautiful” bill.
MacDonough advised Senate Republicans that significant Medicaid reforms must be removed from the landmark legislation to comply with strict budget reconciliation rules.
The parliamentarian’s decisions have forced GOP lawmakers back to the drawing board to rewrite substantial sections of their proposal.
The scope of MacDonough’s intervention represents an unprecedented challenge to Republican legislative priorities.
Her rulings have touched virtually every aspect of the bill, from healthcare provisions to immigration enforcement measures that formed the cornerstone of Trump’s campaign promises.
Among the healthcare provisions MacDonough struck from the bill are measures prohibiting federal Medicaid funding for sex change procedures.
The parliamentarian also eliminated language that would have denied federal Medicaid funding to states providing coverage for certain noncitizens.
Additional provisions removed include reducing federal Medicaid expenditures for the Obamacare expansion population in states offering free healthcare to illegal immigrants.
These cuts represented core conservative priorities that Republicans had fought to include in the