Republican leaders are relying on the Medicaid provider tax change to save billions of dollars in the GOP package to offset the cost of trillions of dollars in tax cuts that are their top

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.