Senate Republicans deal with challenges with tax and health provisions
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Democrats slam bill as benefiting wealthy Americans

Rural health centers warn of negative impact from provider tax cuts

By Bo Erickson, David Morgan and Andy Sullivan

WASHINGTON, June 26 (Reuters) - Republicans in the U.S. Congress scrambled on Thursday to solve nettlesome tax and health care arrangements in their sweeping tax-cut and spending expense on Thursday as President Donald Trump pressed them to pass it by a July 4 due date.

Trump prepares to promote the $2.4 trillion bundle at an afternoon White House event that will feature truck drivers, firefighters, ranchers and other workers who say they would gain from the costs.

But Senate Republicans have yet to produce their variation of their legislation ahead of a possible weekend vote, and the overall shape of the expense appeared more uncertain after a nonpartisan referee ruled that a number of healthcare provisions broke the complicated procedure Republicans are conjuring up to bypass Democratic opposition.

Those elements jointly represented more than $250 billion in healthcare cuts, according to Democratic Senator Ron Wyden of Oregon. Democrats have actually lined up against the costs, depicting it as an inefficient free gift to the most affluent Americans.

It was uncertain whether Republicans could decide to rework the expense to adhere to the complex budget rules, as they have actually currently finished with some elements, or seek to override the decision by the Senate parliamentarian.

The costs includes much of Trump's domestic program. It would extend his 2017 tax cuts, increase immigration enforcement, no out green-energy incentives and tighten food and health safety-net programs.

Republicans who control both chambers of Congress broadly support the bundle, and have currently passed it out of the House of Representatives. But they can manage to lose no greater than 3 votes in either chamber, and they stay at odds over several provisions-- notably a proposed tax break for state and regional tax payments and a tax on health care suppliers that some states use to increase the federal government's contribution to the Medicaid health insurance.

The expense would limit those "company taxes," which nonpartisan guard dogs depict as an accounting technique that drives up Medicaid costs. But rural medical facilities and other health service providers alert that those cuts might force them to downsize operations or go out of service. (Writing by Andy Sullivan