Campaign Action Because the Republican Congress had to pass their Obamacare repeal and "replacement" bill with just Republican votes, they had to resort to budget reconciliation, a process that allows for passage with just 51 votes. But there's a catch in that—the Byrd Rule, which means basically the provisions of the bill have to have a direct impact on either spending or revenue to be ruled in order. The person who determines if the bill's provisions past muster is Elizabeth MacDonough, the Senate parliamentarian, in what's colloquially known as the "Byrd Bath," and in the case of Trumpcare she's decided big chunks of it don't.