Overview

• Elizabeth MacDonough has ruled that proposed caps on federal Medicaid funding and changes to student loan repayment violate Senate reconciliation rules
• Some Republican senators have publicly challenged her nonbinding decisions and are debating rare steps to override or even dismiss her
• Reconciliation bills require a simple majority but must comply with the Byrd Rule, which the parliamentarian enforces to bar extraneous measures
• Her latest rulings risk delaying final passage of the 1,000-page “big, beautiful bill” beyond the party’s self-imposed July 4 deadline
• Appointed in 2012 and retained by both parties’ leaders, MacDonough’s guidance has repeatedly shaped major legislation without partisan favoritism