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.

Health care providers, physicians, hospital associations and even some GOP lawmakers are sounding the alarm on the impact of the legislation.

But the ruling wasn’t the final word, and Senate Republicans said by Thursday afternoon that they thought some slight tweaks to the wording of some proposed Medicaid cuts would