On Thursday, several Republicans reacted strongly to Senate Parliamentarian Elizabeth MacDonough rejected provisions deemed by Republicans to be integral to the bill's success and future tax cuts—including one measure affiliated with Medicaid that would be stricter with states that have developed methods to obtain more federal Medicaid funding.

Senate Parliamentarian Elizabeth MacDonough on Thursday rejected limiting states' use of healthcare provider taxes to obtain more funding for Medicaid services, along with other provisions in the 2026 budget bill.

Many Republican senators dismissed the idea of overruling the Senate parliamentarian after she rejected key Medicaid provisions in Trump's tax and immigration bill Thursday, which dealt a blow to Republicans' plan to slash costs in the budget package.