GOP tax bill faces major setback as Senate parliamentarian strikes down key Medicaid measures

John Wilkerson is a Washington correspondent for STAT who writes about the politics of health care. He is also the author of the twice-weekly D.C. Diagnosis newsletter.

Daniel Payne reports on how the health industry and Washington influence and impact each other. He joined STAT in 2025 after covering health care at POLITICO. You can reach Daniel on Signal at danielp.100.

The Senate parliamentarian struck down several major health care measures in Republicans’ tax bill, including Medicaid changes that the GOP was counting on to help pay for President Trump’s tax cuts. 

The parliamentarian’s decision is a major challenge to Republicans’ plans to reap savings from the Medicaid program and could lead lawmakers to look for new savings across federal programs. It may make it more difficult for them to pass the bill ahead of Trump’s July 4 deadline.

The ruling further complicates disagreements among Republicans over how deep cuts to the Medicaid program should be, and analysts believe it will force Republicans to regroup. The parliamentarian rejected a contentious provision restricting provider taxes, which states use to increase federal funding to their Medicaid programs, as well as several measures related to health care for immigrants.