The bad news for Congressional Republicans came this morning in the form of a long string of rulings from the Senate Parliamentarian absolutely gutting the Medicaid provisions in the Big Beautiful Bill, including “Prohibiting federal financial participation under Medicaid and CHIP for individuals without verified citizenship, nationality or satisfactory immigration status. This section prohibits federal financial participation in Medicaid for adults and kids whose citizenship, nationality, or immigration status cannot be immediately verified, overriding the existing 90-day reasonable opportunity period that currently exists for states to provide coverage as they verify individuals’ immigration status under threat of withholding federal funds. (Section 71109)”

Then “Immigrant Medicaid Eligibility. This section denies federal funding to states for Medicaid coverage for certain immigrants who are not citizens. (Section 71110) Expansion of FMAP for certain states providing payments for health care furnished to certain individuals. This section lowers the Medicaid expansion federal medical assistance percentage from 90 percent to 80 percent for states that choose to provide coverage to people who are undocumented using the state’s own funds. (Section 71111). Prohibiting Federal Medicaid and Children’s Health Insurance Program (CHIP) Funding for Gender Affirming Care. This section prohibits federal Medicaid and CHIP funding for gender-affirming medical care. (Section 71117),” as in a whole shit ton of MAGA culture war priorities on immigration and transgender-relevant healthcare policy.

And the big one: “Provider Taxes. This provision prohibits non-expansion states from increasing the rate of current provider taxes or increasing the base of the tax to a class or items of services that the tax did not previously apply. Beginning in 2027, the hold harmless threshold in expansion states for provider classes other than nursing or intermediate care facilities would be reduced by 0.5 percent annually until the maximum hold harmless threshold reaches 3.5 percent in 2031. Ending states’ ability to tax health care providers would severely limit states’ ability to provide health care to millions of Americans who depend upon Medicaid for their care. (Section 71120),” which is not cultural per se so much as an absolute bunker buster attack on rural healthcare systems for reasons hardcore policy eggheads can explain. The TLDR of it is “Well, we are all going to die.”

All of which was too much for injury-prone home improvement hobbyist Congressman Greg Steube:

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?

The Senate Parliamentarian is not elected. She is not accountable to the American people. Yet she… https://t.co/y2loBAMENc

— Congressman Greg Steube (@RepGregSteube) June 26, 2025

“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,” Steube continued after the cutoff on the embedded tweet above. Worth noting is that Jaydee can’t unilaterally overrule the parliamentarian, but because Steube’s a fucking idiot who doesn’t understand how Congress works he believes that option is available.

One that is possible however is for a simple majority of the chamber to abrogate the rules. That would, once again, effectively end the filibuster and open the door to a future Dem Senate majority bringing a world of pain onto MAGAMerica. John Thune, Mitch McConnell, et al do NOT want that.

“We’re not going there,” Thune told CNN’s Manu Raju on June 2nd, but we’ll see how it shakes out.