On Thursday, several Republicans reacted strongly to Senate Parliamentarian Elizabeth MacDonough rejected provisions deemed by Republicans to be integral to the bill's success and future tax cuts—including one measure affiliated with Medicaid that would be stricter with states that have developed methods to obtain more federal Medicaid funding.

The nonpartisan Senate official whose office determines if legislation fits within the rules of the chamber dealt Senate Republicans a blow on proposed changes to Medicaid.

WASHINGTON (AP) — The Senate parliamentarian has advised that a key Medicaid provider tax overhaul that is central to President Donald Trump’s big tax cut and spending bill does not adhere to procedural rules, delivering a crucial blow to Republicans rushing to finish the massive package this week.