Senate Republicans are facing significant challenges with their large-scale domestic policy bill, as the Senate parliamentarian has warned that several provisions aimed at securing hundreds of billions in budget savings will not be able to pass along party lines. These provisions include contentious Medicaid policy changes, such as measures to control costs by imposing stricter state provider tax rules, which are considered politically explosive. The situation has been underscored in a memo from the Senate Budget Committee, adding to the growing pressure on GOP leaders who are already dealing with internal opposition to these provisions. With the potential impact on the bill’s viability, Republicans are now contemplating rewriting key sections or possibly omitting some of the more controversial policies. The challenges come at a critical time for Senate Majority Leader John Thune and his team, who are grappling with growing concerns over the practical and political ramifications of the proposed changes. The internal dissent among GOP members has intensified, with some advocating for a more moderate approach, such as reverting to a less drastic House plan that would merely freeze existing provider taxes, although the feasibility of such a change under Senate procedural rules remains uncertain.