The parliamentarian made several rejections related to student aid and health coverage that were announced Thursday, including a key Medicaid provision on provider taxes.

The bill carrying much of President Trump’s domestic agenda is facing examination by the Senate parliamentarian, a nonpartisan official who enforces the chamber’s complex rules — and who can effectively strip out parts of the bill that don’t comply.

Republicans will be able to push the tax and entitlement package through with a simple Senate majority, avoiding a Democratic filibuster, as long as it complies with the “Byrd Rule,” which has governed the budget reconciliation process they are using since the 1980s. Under the rule, each of the bill’s provisions:

  • Must produce a non-incidental change to the federal budget. In other words, it must primarily be a change to spending or revenue. Provisions with no or minimal budgetary impact, or that are mostly there for policy reasons, are supposed to be struck, but the decision can be subjective.

  • May not increase the deficit outside of the budget window. In this case, provisions can’t add to deficits past 2034.

  • May not make changes to Social Security.

The process of review is known informally in the Senate as the “Byrd bath.” So far, the parliamentarian, Elizabeth MacDonough, has determined that dozens of provisions do not pass muster to be included in the megabill, in most cases because they represent policy changes with only incidental effects on the budget.

Republican committee leaders have said they plan to rewrite some of the struck provisions to make them compliant.

Rejected provisions

Most of the struck provisions would have had a small effect on the bill’s bottom line, but there are a handful that would have saved hundreds of billions of dollars as written. Some provisions were policy priorities for some Republicans, and their removal could make those lawmakers less enthusiastic about supporting the bill. What is likely to be the most consequential ruling, on whether Republicans may use a budget maneuver to exclude the cost of tax cut extensions, is still outstanding.

We’ve highlighted instances where Republicans have said they have made or are working on adjustments to the offending portions.

Health care

Provider tax restrictions

Lower the maximum rates of taxes that states can charge health care providers for states that have expanded Medicaid under Obamacare, and freeze current tax rates for states that have not. States often use such taxes to boost federal matching payments. This provision was expected to generate significant savings in the bill.

Republicans are working to make the provision compliant.

Gender transition care

Ban the use of Medicaid funds for gender-affirming medical care for transgender minors and adults

Medicaid eligibility for immigrants

Revoke eligibility for certain noncitizens

Medicare coverage for immigrants

Revoke eligibility for certain noncitizens

Obamacare tax credits for immigrants

Revoke eligibility for certain noncitizens

Eliminate a Medicaid grace period for immigrants

Prevent states from enrolling people in Medicaid until their citizenship status can be confirmed

Obamacare tax credits for immigrants ineligible for Medicaid

Prevent immigrants who are poor but haven’t been in the country for five years from accessing tax credits to buy private insurance

Spread pricing

Ban a practice sometimes used by pharmacy benefit managers in pricing drugs for Medicaid

Reduce federal funding for certain states

States that use their own funds to provide health insurance outside of Medicaid to undocumented immigrants would pay a higher share for Medicaid expansion beneficiaries

Obamacare cost-sharing reductions

Fund payments to insurance companies to lower Obamacare deductibles and co-payments for low-income purchasers, a technical change that will paradoxically raise prices for many Obamacare plans

Abortion restrictions for cost-sharing reduction payments

Restrict coverage of abortions in many Obamacare plans

Student aid

Student loan repayment

Limit on income-driven repayment options. The parliamentarian ruled that the limited repayment options may not be applied to current borrowers.

Student loan eligibility for immigrants

Revoke eligibility for certain noncitizens

Public Service Loan Forgiveness

Prohibit loan payments made while students are in medical or dental internships or residencies from counting toward forgiveness

Pell Grant expansion

Allow grants for short-term professional training certificates

Food benefits

SNAP state matching funds

After the provision was rejected, Republicans said they had revised the language to comply with the rules. Democrats will have the opportunity to review the change and challenge it.

SNAP eligibility for certain immigrants

Limit food aid benefits to citizens or lawful permanent residents, with certain exceptions

This provision was rewritten. Republicans have not announced whether the parliamentarian has approved this change.

Permanent price support authority

A legislative mechanism usually addressed in the Farm Bill to prevent old agricultural laws from taking effect

Immigration and justice

State and local immigration enforcement

Funding for states to conduct border security and immigration enforcement

Republicans submitted a revised version of this provision that states that nothing in the section “shall authorize any state or local government to exercise immigration or border security authorities reserved exclusively to the federal government.” They have not announced whether the parliamentarian has approved this change.

State and local law enforcement grant eligibility

Limit eligibility for grants for “sanctuary” jurisdictions, or if the attorney general disagrees with how states and localities enforce immigration policies

State and local authority to arrest noncitizens

Authority for state and local officials to arrest noncitizens suspected of being unlawfully present in the U.S.

Limitation on lawsuits against the federal government

Limit on preliminary injunctions or temporary restraining orders by requiring litigants to post potentially large bonds. This provision could have limited those seeking to block President Trump’s executive actions.

Limitation on the ability of the government to settle with third parties

Energy and environment

Repeal of green energy and emissions reduction programs

The parliamentarian ruled that the bill may take away funding from Inflation Reduction Act programs, but it may not repeal their authorization, so Congress could provide funding to them in the future.

This provision was rewritten. Republicans have not announced whether the parliamentarian has approved this change.

Repeal of E.P.A. tailpipe emissions rule

Repeal of an E.P.A. regulation limiting vehicle emissions

Environmental reviews

A provision would have allowed project sponsors to expedite environmental reviews and avoid judicial scrutiny for a fee. The judicial review portion was found to violate the rules.

This provision was rewritten. Republicans have not announced whether the parliamentarian has approved this change.

Environmental compliance

Automatic compliance with the National Environmental Policy Act for oil and gas lease sales

Geothermal leasing and royalties

Requirement for annual geothermal lease sales and changes to geothermal royalties

Mining road in Alaska

Approval for construction of the Ambler Road

Natural gas exports and imports

Fee for natural gas exporters to have their project “deemed to be in the public interest” and approved

Offshore oil and gas leasing

Requirement that leases be issued within 90 days of a sale

Public land sales

Mandatory sales of Bureau of Land Management and U.S. Forest Service land to allow for more housing

Renewable energy fees

Removal of the Interior secretary’s discretion to reduce fees for solar and wind projects on public land

Banking and financial regulation

Elimination of Consumer Financial Protection Bureau funding

This provision was rewritten. Republicans have not announced whether the parliamentarian has approved this change.

Elimination of the Office of Financial Research funding

The office is an independent bureau that is supposed to monitor risk on Wall Street

Elimination of the Public Company Accounting Oversight Board

The board is an auditing watchdog created after the 2001 Enron scandal

Reduction in pay of some Federal Reserve employees

Federal workers and government

Limits on agency rulemaking

A version of the REINS Act, which would give Congress more power over federal agency rules

Agency reorganization

Authorization for the executive branch to reorganize federal agencies

Retirement contributions and worker protections

Increase in the rate of required contributions to the federal retirement system for those who do not give up some civil service protections

Cost-cutter bonuses

Incentive program for federal employees to identify expenditures to cut

Worker complaints

Requirement that workers and former workers pay filing fees when they make complaints

Electric U.S.P.S. vehicles

Requirement that electric vehicles used by the Postal Service are sold

Fees for unions

New fee for federal worker unions’ use of agency resources

Other

Defense spending plan enforcement

Reduction in appropriations if Defense Department spending plans are not submitted on time

Coast Guard station repair

The section in violation would apply to a specific damaged station on South Padre Island, Texas

NASA space vehicle transfer

Transfer of space shuttle to a nonprofit in Houston from the Smithsonian’s National Air and Space Museum

This provision was rewritten. Republicans have not announced whether the parliamentarian has approved this change.