Senate Majority Leader John Thune, R-S.D., center, accompanied by Sen. John Barrasso, R-Wyo., left, and Sen. Shelley Moore Capito, R-W.Va., right,  speaks to reporters following a weekly Republican policy luncheon at the U.S. Capitol on Feb. 19, 2025 in Washington, D.C. (Photo by Andrew Harnik/Getty Images)

WASHINGTON — Republicans in the U.S. Senate will spend the next couple weeks defending the party’s “big beautiful bill” against Democratic criticisms and attempting to pass a final version that can win 51 votes.

Reconciliation, the name for the process under which the massive bill is being considered, comes with a lot of rules in the Senate, including that every proposal in the bill addresses federal revenue, spending, or the debt limit. And language addressing the first two cannot be deemed “merely incidental,” or it gets kicked to the curb.

Reconciliation is also favorable for the party in power, in this case Republicans, since the bill is not subject to the legislative filibuster. That means the GOP will need no more than a simple majority for passage.

As you watch and read about Senate action during the coming weeks, here are the answers to five questions about reconciliation and other ways in which Congress sets a budget and allocates taxpayer money:

Q: Where does reconciliation fit in with everything else that’s happening, like the president’s budget request, the budget resolution Congress approved earlier this year, the appropriations bills and rescissions?

A: Yeah, they really don’t make this easy.

The president’s budget request is a proposal that serves as the starting point for lawmakers’ work on a variety of fronts, including the annual appropriations bills. Nothing in the president’s budget request becomes real unless Congress takes action.

Congress’ budget resolution is separate from that request. It is a tax and spending blueprint that lawmakers are supposed to use to plan the country’s financial future for the next decade.

It is not a bill and cannot become law, but when the House and Senate adopt a budget resolution with reconciliation instructions it unlocks the process Republicans are now using to pass their “big beautiful bill” — reconciliation.

Reconciliation bills move through Congress similar to how a regular bill becomes a law. However, in the Senate, the political party using the process must defend its work to the parliamentarian, who ensures the legislation complies with the Byrd rule, which is actually a law.

In a process separate from this are the dozen annual appropriations bills, which is how Congress, with its power of the purse, funds the departments, agencies and programs that most people picture when they think about the federal government.

Those bills account for about one-third of federal spending. The other two-thirds comes from mandatory programs like Medicare, Medicaid and Social Security that lawmakers designed to run outside of the annual appropriations process.

Congress is supposed to approve the appropriations bills by the start of the fiscal year on Oct. 1, but lawmakers rarely complete the work before their deadline and typically have to use a stopgap spending bill to give themselves more time to negotiate full-year government funding bills.

This is why there could still be a partial government shutdown later this year, even though Congress has already adopted a budget resolution and will likely pass a budget reconciliation package in the months ahead.

Yet another process related to government spending is a rescissions request, which Trump sent to Capitol Hill earlier this month. It asks lawmakers to claw back funding approved in an earlier appropriations bill.

Just making the request allows the White House budget office to freeze funding for 45 days while the House and Senate debate the proposal. Senate approval of a rescissions bill is not subject to the chamber’s 60-vote legislative filibuster, so Democratic opposition won’t stop it from becoming a reality if the vast majority of GOP senators vote to cut the previously approved spending.

Q: What are the rules for budget reconciliation bills?

A: Again, remember that in general, this type of legislation must address revenue, spending, or the debt limit. Neither political party can use the process to change policies unless they have a significant impact on federal coffers.

For example, Democrats had to remove a provision that would have raised the federal minimum wage from a reconciliation bill they passed during the Biden administration because the parliamentarian ruled it was “merely incidental.”

Q: Why didn’t the bill have to go through all these extra steps in the House?

A: Congress established the reconciliation process in a 1974 budget act and passed its first reconciliation bill in 1980. But it wasn’t until 1985 and 1986 that the Senate put extra guardrails in place.

The Byrd rule got its name from West Virginia Democratic Sen. Robert C. Byrd, who argued that the reconciliation process needed to be more focused on budgetary issues. The Byrd rule evolved a bit over the years before being made a statute in 1990.

The Byrd rule requires each provision to change revenue or spending in a way not deemed “merely incidental.” Also, committees that receive reconciliation instructions in the budget resolution can only write bills within their jurisdiction and those committees must work within their reconciliation instructions’ fiscal targets.

In addition, proposals cannot increase the deficit outside the 10-year budget window and the package cannot change Social Security.

Q: What is a vote-a-rama?

A: Senate floor debate on a reconciliation package is much different than in the House, where GOP leaders were able to block any amendment debate.

The Senate is required to hold floor votes on reconciliation amendments and this usually leads to a vote-a-rama, where lawmakers debate dozens of amendments overnight and sometimes well after sunrise.

Democrats are likely to focus their amendments on proposals in the reconciliation bill that at least four GOP senators do not support, since that’s the minimum number Democrats would need for any of their amendments to be adopted. Republicans control the chamber with 53 votes and a tie-breaking vote from Vice President J.D. Vance.

GOP senators are likely to call for votes on their own amendments, though typically leaders try to work out many of the final details before the bill comes to the floor, to avoid potentially divisive votes.

Q: How often does Congress use this process to approve legislation?

A: Congress has approved 27 reconciliation bills since 1980, with 23 of those becoming law. Former President Bill Clinton vetoed three and former President Barack Obama vetoed one, according to a report from the nonpartisan Congressional Research Service.

During the last decade, Congress approved three reconciliation bills — Republicans’ 2017 tax law; a $1.9 trillion coronavirus relief package Democrats passed in 2021; and Democrats’ signature climate change, health care and tax package, known as the Inflation Reduction Act, in 2022.

If you’re interested in reading more about budget reconciliation, here is another explainer from earlier this year. 

National Institutes of Health Director Jayanta Bhattacharya speaks at his confirmation hearing before the Senate Committee on Health, Education, Labor, and Pensions on Capitol Hill on March 5, 2025 in Washington, DC. (Photo by Andrew Harnik/Getty Images)

WASHINGTON — National Institutes of Health Director Jay Bhattacharya testified Tuesday that he will work with Congress to potentially reverse a steep cut to the agency’s funding the White House proposed earlier this year in its budget request.

Bhattacharya told highly critical Republicans and Democrats on the Senate panel that writes the NIH’s annual spending bill that he’s “happy” to work with lawmakers to find a funding level that everyone can support in the months ahead.

“This is my first time through this budget fight and so I’m still learning. But I’ll tell you, what I understand is that the budget is a collaborative effort between Congress and the administration,” Bhattacharya said. “I look forward to working with you all to advance the real health needs — not just the folks here in the room who represent Alzheimer’s patients, but also the health needs of all Americans.”

Senate Appropriations Chair Susan Collins, R-Maine, said it was “disturbing” that the president’s budget request suggested lawmakers cut NIH funding by about $18 billion, or 40%, in the upcoming spending bill.

“It would undo years of congressional investment in NIH,” Collins said. “And it would delay or stop effective treatments and cures from being developed for diseases like Alzheimer’s, cancer, type one diabetes. I could go on and on.

“We also risk falling behind China and other countries that are increasing their investment in biomedical research.”

Collins said the committee planned to work with Bhattacharya “to remedy these problems and the deficiencies” in the budget request in the months ahead as the committee writes the annual government funding bills.

Collins also rebuked Bhattacharya for seeking to reduce how much the NIH pays grantees for facilities and administrative costs, which go toward paying bills that aren’t directly associated with just one research project.

NIH efforts to cap those indirect costs at 15% are on hold as lawsuits from Democratic attorneys general, the Association of American Medical Colleges and the Association of American Universities work through the federal court system.

“This proposed cap is so poorly conceived,” Collins said. “And I have seen firsthand how harmful it is. It is leading to scientists leaving the United States for opportunities in other countries. It’s causing clinical trials to be halted and promising medical research to be abandoned. It’s also against federal law. Since 2018, we in Congress have specifically included language to prevent NIH from arbitrarily imposing such a cap.”

Collins told Bhattacharya to talk with Kelvin K. Droegemeier, who worked as President Donald Trump’s science adviser during his first term. Droegemeier is chairman of a group put together by the Association of Public and Land Grant Universities to propose changes to the indirect costs model.

‘Frankly, catastrophic’

Washington state Democratic Sen. Patty Murray, ranking member on the Appropriations Committee, pressed Bhattacharya to defend the actions he’s taken so far and those proposed in the budget request.

“What the Trump administration is doing to NIH right now is, frankly, catastrophic,” Murray said. “Over the past few months, this administration has fired and pushed out nearly 5,000 critical employees across NIH, prevented nearly $3 billion in grant funding from being awarded and terminated nearly 2,500 grants totaling almost $5 billion for life-saving research that is ongoing that includes clinical trials for HIV and Alzheimer’s disease.”

Murray added that no one in America wants less research into treatments and cures for cancer, or Alzheimer’s disease.

West Virginia Republican Sen. Shelley Moore Capito, chairwoman of the Labor-HHS-Education Appropriations subcommittee that held the hearing, expressed concern about NIH’s proposed budget cuts, saying they have raised alarms at numerous research universities.

“These institutions are the reason America has kept the edge in biomedical research and innovation,” Capito said. “As with many changes in leadership, there seems to be a heightened set of concern and confusion that diverting resources from research will result in a less healthy America.”

Capito emphasized she expects NIH to continue to focus research efforts on Alzheimer’s, a disease that affects more than 7 million Americans.

“For almost a decade, this committee has supported research towards the goals of finding treatments and a cure for Alzheimer’s disease,” Capito said. “This goal is very personal to me, as you know, since both of my parents lived with and eventually succumbed to this disease. And I could look out behind you and see in the audience that many folks here are extremely interested in that area of research.”

Delayed funding in the states

Wisconsin Democratic Sen. Tammy Baldwin, ranking member on the subcommittee, also reprimanded Bhattacharya for cutting off funding for projects looking into Alzheimer’s and several other illnesses.

“NIH has delayed $65 million in funding for 14 Alzheimer’s disease research centers in nine states, including at the University of Wisconsin-Madison,” Baldwin said. “It has delayed $47 million in cancer center support grants at nine cancer centers in eight states, it has delayed $55 million for 11 rare disease clinical research network grants in eight states.

“Let that sink in: This administration is making a conscious choice not to fund research into Alzheimer’s disease, cancer and rare diseases. And NIH has terminated grants for maternal morbidity and mortality centers, a grant developing new digital imaging techniques for cervical cancer screening and a clinical trial studying a potential cure for infants born with HIV, just to name a few.”

Alabama Republican Sen. Katie Britt called on Bhattacharya to ensure NIH refocuses on maternal health research and ways to decrease the country’s high maternal mortality rate.

“Look, far too many women in this country are dying from pregnancy-related causes,” Britt said. “You look at Alabama, we have one of the highest maternal mortality rates in the nation. It disproportionately affects Black women, Native American women, those women in rural areas.”

U.S. Senate Majority Leader Sen. John Thune, R-S.D., left, listens as Sen. Mike Crapo, R-Idaho, center, speaks to reporters outside of the West Wing of the White House on June4, 2025 in Washington, D.C.  (Photo by Anna Moneymaker/Getty Images)

WASHINGTON — U.S. Senate Republican Leader John Thune will spend a crucial next few weeks working behind the scenes with other top GOP senators to reshape the party’s “big beautiful bill” — a balancing test accompanied in recent days by incendiary exchanges between President Donald Trump and billionaire Elon Musk over whether the current proposals are so bad that Congress should just go back to the drawing board.

South Dakota’s Thune will need to gain support from deficit hawks, who want to see the mega-bill cut at least $2 trillion in spending, and moderates, who are closely monitoring how less federal funding for safety net programs like Medicaid and food assistance could harm their constituents and home-state institutions like rural hospitals.

Interviews by States Newsroom with Republican senators in early June showed many major elements of the package could change, including provisions that would put states on the hook for unanticipated costs. Arkansas Sen. John Boozman, for example, indicated the Senate may rewrite a proposal in the House-passed bill that would shift some of the cost of the Supplemental Nutrition Assistance Program, which provides food aid to low-income people, to state governments.

“We can do whatever we want to do,” the Agriculture, Nutrition and Forestry Committee chairman said when asked by States Newsroom about amending that policy.

The final deal — intended to extend the 2017 tax cuts — cannot lose more than three GOP senators and still make it back across the Capitol to the House for final approval, since all Democrats are expected to oppose the bill. Thune only needs a majority vote in the Senate for the special process being used by Republicans.

Internal debates about just how to rework the Trump-backed tax and spending cuts measure began in the first week of June during meetings on Capitol Hill and at the White House, as GOP senators began critiquing the House-passed package line-by-line to ensure it complies with their strict rules for the complex reconciliation process and their policy goals.

Republicans said during interviews that several provisions in the House version likely won’t comply with the chamber’s Byrd rule, which could force lawmakers to toss out some provisions.

Complicating all of it was the very public back-and-forth between not just Trump but GOP leaders and former White House adviser Musk over the bill, which Musk on social media labeled “a disgusting abomination” and a “big, ugly spending bill” for its effect on the deficit and debt limit. “KILL the BILL,” Musk said on X, the platform he owns. Senate leaders so far have dismissed Musk’s criticisms.

Fragile House coalition

The talks, and whatever the legislation looks like after a marathon amendment voting session expected in late June, have already raised deep concerns among House GOP lawmakers, who will have to vote on the bill again in order to send it to Trump.

The extremely narrow majorities mean House Republican leaders cannot lose more than four of their own members if all the lawmakers in that chamber vote on the party-line bill.

Any changes the Senate makes could unbalance the fragile coalition of votes Speaker Mike Johnson, R-La., cobbled together last month for a 215-214 vote. But GOP senators are adamant they will amend the legislation.

Complicating matters is a new report from the nonpartisan Congressional Budget Office that shows the proposed changes to tax law, Medicaid, the Supplemental Nutrition Assistance Program and higher education aid wouldn’t actually help to reduce deficits during the next decade but raise them by more than $2.4 trillion.

The numbers are the exact opposite for what Republicans hoped their sweeping tax and spending cuts package would accomplish.

Scrutiny begins

The first stop for the House-passed reconciliation package in the Senate appears to be the parliamentarian’s office, where staff have begun evaluating whether each provision in the current version of the bill complies with the upper chamber’s strict rules.

Boozman said staff on his panel have already begun meeting with the parliamentarian to go over the House provisions within its jurisdiction.

He expects that section of the package will have to change to comply with the strict rules that govern the reconciliation process in the Senate and to better fit that chamber’s policy goals.

“We can’t really decide exactly what we want to use in the House version until we know what’s eligible,” Boozman said. “We’ve got some other ideas too that we asked them about. But we need to know, of the ideas that we have, what would be viable options as far as being Byrd eligible.”

The Byrd rule, which is actually a law, requires reconciliation bills to address federal revenue, spending, or the debt limit. This generally bars lawmakers from using the special budget process to change policies that don’t have a significant impact on those three areas.

Alabama Sen. Tommy Tuberville, who is campaigning to become his home state’s next governor, said pushing some of the cost of the nutrition program to states may be problematic.

“We’re trying to send more costs to the states. Most states can’t afford that, so we want to take care of people, but we need people to go back to work,” Tuberville said. “It’s not a forever entitlement. It’s for part-time, you know, take care of yourself until you get a job, go back to work and let people that need it really, really get it.”

Rural hospitals on edge

Senate GOP leaders will have to navigate how best to reduce federal spending on Medicaid, the state-federal health program for lower-income people and some with disabilities, that is relied on by tens of millions of Americans, many of whom are loyal Republican voters.

The nonpartisan Congressional Budget Office projects that 7.8 million people would lose access to Medicaid during the next decade if the House’s policy changes are implemented as written.

There are also concerns among GOP lawmakers about how losing the revenue that comes with treating Medicaid patients would impact rural health care access and hospitals.

Missouri Sen. Josh Hawley said under no circumstances would he vote for a bill that cuts benefits to Medicaid recipients and is worried about how provisions in the House package would affect rural hospitals.

“They’re very concerned about it, rightly so,” Hawley said, referring to conversations he’s had with health care systems in his home state.

“This is something that we need to work on. I don’t know why we would penalize rural hospitals,” he added. “If you want to reduce health care spending, then cap the price of prescription drugs. I mean, that’s the way to do it. If you want to get major savings in the health care sector, don’t close rural hospitals, don’t take away benefits from working people. Cap the costs, cap the price that (the Centers for Medicare & Medicaid Services) is going to pay for prescription drugs.”

West Virginia Sen. Shelley Moore Capito said she’s not yet come to a decision about whether to keep, amend, or completely scrap some of the House changes to Medicaid.

“I talked to a lot of our hospitals when I was home to see what the impacts would be, because we have a very high Medicaid population,” Capito said. “I want to see it work and be preserved, but I want it to be there for future generations. And it’s just getting way out of control on the spend side. So right now, we’re looking at everything.”

Louisiana Sen. Bill Cassidy — chairman of the Health, Education, Labor and Pensions Committee — said he doesn’t expect all of the health care provisions in the House bill make it through the “Byrd bath” with the parliamentarian. But he declined to go into detail.

“Some of it is more regulatory, that’s all I can say,” Cassidy said.

West Virginia’s Sen. Jim Justice said he is in favor of requiring some Medicaid enrollees to work, participate in community service, or attend an educational program at least 80 hours a month to stay on the program, a sentiment shared by many of his GOP colleagues.

“I’m good with every bit of that,” he said. 

But Justice expects the Senate will make its own changes to the package and that it will be “proud of their own pond.”

“Any frog that’s not proud of your own pond’s not much of a frog,” Justice said.

He did not go into detail on what those changes would entail.

SALT shakers

The state and local tax deduction, or SALT, represents another tightrope  for Thune, who is no fan of the changes made in the House. But he has said repeatedly this week he understands altering that language too much could mean a Senate-amended version of the bill never makes it back through the House to actually become law.

Thune said outside the White House following a June 4 meeting with Trump and others that there will very likely be changes to SALT.

“There isn’t a single Republican senator who cares much about the SALT issue,” Thune said. “It’s just not an issue that plays.” States that are most affected generally don’t elect Republicans to the Senate.

The House tax-writing panel originally proposed raising the SALT cap from $10,000 to $30,000, but Johnson had to raise that to $40,000 in order to secure votes from House Republicans who represent higher tax states like California, New Jersey and New York. The revised cap would benefit more high-income taxpayers in their states.

“In 2017, that was one of the best reforms we had in the bill,” Thune said. “But we understand it’s about 51 and 218. So we will work with our House counterparts and with the White House to try to get that issue in a place where we can deliver the votes and get the bill across the finish line.”

Republicans hold 53 seats in the Senate, but can rely on Vice President J.D. Vance to break a tied vote if necessary.

At least 218 House lawmakers must vote to pass bills when all 435 seats are filled. But with three vacancies at the moment, legislation can move through that chamber with 216 votes. The GOP has 220 seats at the moment, meaning Johnson can afford four defections on party-line bills.

North Dakota Sen. John Hoeven told reporters this week that he’d like to see GOP senators rework the SALT section of the bill, even if that causes challenges for Speaker Johnson’s ability to pass a final version.

“Let’s talk about SALT, for example. The House has a very large SALT number. The Senate is probably going to take a look at that,” Hoeven said. “There’ll be a lot of areas we can look at. There’ll be other things we’re going to look at. We’d like to get to $2 trillion in savings.”

Ohio Sen. Bernie Moreno joined in putting his House colleagues on notice that they likely won’t get the agreement they struck with the speaker in the final version of the bill.

“I think we’re going to make common-sense changes. For example, the SALT cap, by the way, something that definitely helps very wealthy people in blue states,” Moreno said. “I think that cap, the 400% increase, is too much, so we’re going to work on tweaking that.”

Hawley, of Missouri, speaking more generally about the tax provisions, said he would like the Senate to make sure middle-class Americans benefit from the tax changes, just as much as companies.

“I want to be clear, I’m in favor of additional tax relief for working people. So my view is this corporate tax rate, which they lowered in 2017, they made that permanent back then. I know some workers that would like permanent tax relief,” Hawley said. “So I think it’s imperative that we do some addition to tax relief for workers. So I think that’s important.”

A new $4 trillion debt limit

Deficit hawks in the Senate have also voiced objections to raising the nation’s debt limit by $4 trillion, arguing that GOP leaders haven’t done enough to assuage their concerns about the nation’s fiscal trajectory.

Kentucky Sen. Rand Paul argued that the debt limit increase is more about next year’s midterm elections than good governance.

“​​This is really about avoiding having to talk about the debt during election times because people like to go home and talk to the Rotary or the Lions Club and tell them how they’re fiscally conservative and they’re against debt,” Paul said. “It’s embarrassing to them to have to vote to keep raising the debt. But they’re unwilling to have the courage to actually look at all spending.”

Paul suggested that House Republicans created problems by inflating some of the spending levels in their package, including to continue construction of a wall along the U.S.-Mexico border. Paul is chairman of the Homeland Security and Governmental Affairs Committee.

“The $46.5 billion for the wall is eight times higher than the current cost of the wall. If you’re going to do 1,000 miles, you can actually do it for $6.5 billion. They want $46.5 billion,” Paul said. “We can’t be fiscally conservative until it comes to the border, and then we’re no longer fiscally conservative.”

The border wall has been a constant focus for Trump, who made it a central part of his 2016 presidential campaign, when he said repeatedly that the United States would build it and Mexico would pay for it.

South Carolina’s Lindsey Graham, chairman of the Budget Committee, hinted during a brief interview that Congress can only cut so much spending without going near programs like Social Security, which accounted for $1.5 trillion in expenditures last year, or Medicare, which spent $865 billion. Both are normally considered untouchable.

“I think we’re going to make some changes to try to find more spending reductions. I think that’s a fair criticism of the bill, but you can’t do Social Security by law,” Graham said, referring to one of the many rules that govern the reconciliation process. “Nobody’s proposed anything in the Medicare area.”

Graham added that “trying to make the bill more fiscally responsible is a good thing, but we need to pass it.”