The Senate parliamentarian has advised that a Medicaid provider tax overhaul central to President Donald Trump’s tax cut and spending bill doesn’t adhere to the chamber’s procedural rules, delivering a crucial blow as Republicans rush to finish the package this week.

A Senate referee has rejected certain proposed Medicaid cuts including caps on provider taxes. Yet other proposals like work requirements were left untouched.

Colorado could lose more than $10 billion in Medicaid funding over the next five years if a provision of the One Big Beautiful Bill Act becomes law.