Guidance from the parliamentarian is rarely ignored and Republican leaders are now forced to consider difficult options. Republicans were counting on big cuts to Medicaid and other programs to offset trillions of dollars in Trump tax breaks, their top priority.
Additionally, the Senate's chief arbiter of its often complicated rules had advised against various GOP provisions barring certain immigrants from health care programs.
Trump wants the legislation, which includes tax reductions, Medicaid cuts, and border enforcement, passed by July 4.