The Senate votes for its leadership, meaning that the GOP's general strategy of starving out Americans until their donors are sufficiently placated is prioritized above the Constitutional duty of the elected Senators. The primary difference between McConnel and Pelosi isn't as much about policy as it is about identity politics, as her demand that all legislation be "budget neutral" is just political speak for do nothing. McConnel is just more "in your face" with his brand of neoliberalism.