That Said

As Senate and House Republicans continue down the path of using budget reconciliation to advance President Trump’s legislative agenda, the strategy of putting together a majority vote on the budget becomes more and more complicated.   One key figure in this made-for-TV (or at least CSPAN…) is the Senate Parliamentarian.  Who is the Senate Parliamentarian and what does she do? 

The Role of the Senate Parliamentarian 

The Senate Parliamentarian is an office within the Secretary of the Senate.  The job involves interpreting the complicated rules of the Senate. 

Some of the things the Senate Parliamentarian does include: 

• Advising the Senate’s presiding officer, or Majority Leader, on the appropriate procedure, statements, and responses of the Senate. 

• Offering written guidance on procedural questions. 

• Recommending the referral of measures to relevant committees. 

• Maintaining and publishing procedural rules 

Why is the Senate Parliamentarian Getting So Much Attention? 

The Republican majority is using the budget reconciliation process to accomplish their policy goals.  Using reconciliation does this in two ways:  one, reconciliation speeds up the usually slow and deliberative Senate by avoiding the filibuster; and, two, Republicans can  pass major legislation by simple majority, without Democratic support. 

Big Decisions Ahead 

Republicans want to extend the 2017 tax cuts from the Tax Cuts and Jobs Act (TCJA).  And they are trying to do that as cheaply as possible from a legislative score-keeping perspective. Republicans would like to use a “current policy” budget baseline so they don’t have to offset the $4 trillion or so cost.  

Therefore, enter the Parliamentarian, who decides what whether Republicans do this.  The answers set up or complicate the path forward for Republicans on tax cuts and the rest of the reconciliation bill.  The Parliamentarian also uses the “Byrd Rule” to analyze legislation and makes a determination on whether a provision produces a change in spending or revenues and does not increase the deficit within a set period.  Each provision in the budget bill and the budget reconciliation bill has to save or spend money, and not insignificantly. 

The Senate Parliamentarian has made unpopular rulings to the majority party before.  In 2021, top Senate Democrats were upset by the Parliamentarian’s decision to not include a minimum wage increase in the American Rescue Plan due to an “incidental” impact on the federal budget. 

A majority vote can overrule a Parliamentarian’s ruling but often Senators are creatures of habit and prefer to uphold the rules of the institution of the Senate.   

Is the Parliamentarian Position Partisan? 

The position of the Senate Parliamentarian is strictly non-partisan, and individuals are traditionally appointed to the role from senior staff in the Parliamentarian office. There have only been six Senate Parliamentarians since the position was created in 1935.  Senate Parliamentarians have no defined term length and serve at the pleasure of the Majority Leader.   

Who is the Current Senate Parliamentarian? 

The current Senate Parliamentarian is Elizabeth MacDonough, who was appointed by then-Majority Leader Harry Reid (D-NV) as the first woman to hold the position in 2012.  She previously served as senior assistant parliamentarian for 13 years.  She studied English Literature at George Washington University and attended Vermont Law School. 

Did You Know? 

The Senate Parliamentarian’s salary is $203,700 as of 2022.  For context, Senators earn $174,000 and Senate leaders earn $193,400. 

It’s Not Just the Senate  

The House of Representatives has its own Parliamentarian, too, with a similar salary and responsibilities.  The current House Parliamentarian is Jason Smith (not to be confused with the Chair of the House Ways and Means Committee from Missouri), who was appointed in 2010. 

The Controversy 

The Senate Majority Leader does have the authority to fire the Senate Parliamentarian.  This last happened in 2001, when then-Majority Leader Trent Lott (R-MS) fired then-Parliamentarian Robert Dove after he interpreted Senate rules in way that would have made it difficult to pass then-President George W. Bush’s tax cut proposal through budget reconciliation. 

We aren’t saying Ms. MacDonough will get axed, but the Senate Parliamentarian is a tricky position to have. 

After the confirmation process of former Congressman Dr. Dave Weldon to head the Center for Disease Control and Prevention (CDC) abruptly halted on March, various names were floated to be the new nominee, including former Congressman Dr. Michael Burgess.  The White House announced their new nominee on March 24 is Susan Monarez, PhD.  Who is she?   

Since January, Dr. Monarez has been the acting head of the CDC.  She was brought over to the CDC from ARPA-H, where she has been the Deputy Director since January 2023.  She has a long history in the government, serving under both Democratic and Republican administrations at Health and Human Services (HHS), Homeland Security, the White House (Obama and Trump administrations), and Health Resources and Services Administration (HRSA). Prior to government service, Monarez was a postdoctoral fellow and graduate student, respectively, at Stanford University School of Medicine and the University of Wisconsin – Madison, where she focused on technology development to prevent, diagnose, and treat infectious diseases particularly impacting people living in low- and middle-income countries.  

There are a few interesting facets of her nomination: 

First, she will be the first person ever confirmed by the Senate to run the CDC.  Prior to 2022, CDC directors were appointed; but Congress passed a law that year saying any future CDC heads would be confirmed by the Senate.  Second, if she is confirmed, she will be the first non-medical doctor to run the CDC since 1953.  Prior CDC heads were M.D.s – Dr. Monarez is a Ph.D., not an M.D.  

A key difference between Dr. Monarez and the previous CDC nominee Dave Weldon is her support for vaccines.  In her work at ARPA-H, Dr. Monarez has strongly supported APECx which is an initiative to use artificial intelligence to design antigens that target entire viral families. (She has spoken at public conferences in favor of the program.)  ARPA-H argues the studied viruses (like herpesviruses and flaviviruses, such as Zika and dengue fever) pose serious threats to global health, causing pandemics, cancers, and chronic illnesses.   

Anti-vax groups are concerned about her support for vaccines, but that support will certainly help her nomination chances in the physician-heavy Senate Finance Committee.   

Dr. Monarez is also a strong proponent of the use of AI in health care.  In her career, she has focused on understanding challenges within the health ecosystem and identifying opportunities for innovation to address them through AI, technology, and innovation.   

Critics argue that her extensive background within the federal health bureaucracy and a heavy focus on technology-driven biosecurity suggests a continuation of the status quo rather than the long-overdue “Make America Health Again” reform.  

Thus far, the announcement of her nomination has been well-received, with very little push back.  We do expect her to field pointed questions from Senators regarding CDC actions over the past few weeks, including the cancelling of CDC grant funding and the delayed meeting of vaccine advisors (including for formulating strains for the flu vaccine for the 2025-2026 flu season).  We will continue to watch what happens as her vetting continues.