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ASHINGTON — The Senate parliamentarian added a new complication to Republican hopes for their floundering health care bill, ruling the GOP would need to win an all-but-impossible 60 votes to retain anti-abortion provisions in the measure, Democrats said late Friday.

Democrats said the parliamentarian decided another provision providing Medicaid savings for upstate New York counties would also need 60 votes to survive. Democrats said they believed that means other bill language benefiting Alaska and other states — which Senate Majority Leader Mitch McConnell put into the legislation to try winning support from those states’ senators — is in jeopardy.

Republicans contested Democrats’ description, saying the parliamentarian’s views were guidance only. They said the legislation’s wording was subject to change as leaders work behind the scenes to win over GOP senators, and said efforts would continue to craft the provisions in ways that would pass parliamentary muster.

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Republicans have a 52-48 Senate majority, and at least one Republican said late Friday that the GOP is short of the votes to move ahead with Sen. John McCain in Arizona dealing with brain cancer.

“Without John McCain, we don’t have 50 people to take that vote,” Sen. James Lankford of Oklahoma said at the Western Conservative Summit in Denver.

Democrats have been unified in opposing the GOP repeal effort. Few Democrats would be expected to join them to retain anti-abortion provisions, and none would likely side with the GOP to retain the state-specific language. That means it seems certain Republicans would fall short of reaching 60 votes.

Republicans have said they plan to begin voting on their health care legislation Tuesday. That might be delayed if McConnell, R-Ky., is still hunting GOP votes.

“The parliamentarian’s guidance helps inform us as we write legislation before going to the floor,” said Eric Ueland, Republican staff director of the Senate Budget Committee. “We look forward to continued preparations for votes next week.”

One abortion provision in jeopardy would block federal payments to Planned Parenthood for a year. Another would forbid individuals and small businesses from using the bill’s health care tax credits to buy policies that cover abortion.

The abortion provisions are important for conservatives. It is unclear what they would do if that language was removed from the bill.

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Senate Minority Leader Chuck Schumer, D-N.Y., said the ruling on the New York language “will greatly tie the majority leader’s hands as he tries to win over reluctant Republicans with state-specific provisions. We will challenge every one of them.”

Sen. Bernie Sanders, I-Vt., said the way Republicans wrote the bill is “a disaster,” adding, “It is time for the Republican leadership to junk this bill.”

Republicans are using special procedures for the health care bill that bar Democrats from using a filibuster to kill it. Filibusters require 60 votes to end.

But under those rules, provisions must have a budget-related impact and cannot be driven primarily by making a policy change.

When a bill is being debated on the Senate floor, any senator can claim that a provision violates that rule.

The parliamentarian, Elizabeth MacDonough, tells the chamber’s presiding senator her advice on that challenge and it is generally announced by the presiding senator. If another senator challenges that ruling, it takes 60 votes to override her ruling.

Associated Press writer Nicholas Riccardi in Denver contributed to this report.

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    • Or that the GOP is in favor of killing 20 – 30 millions of already born citizens to get their way!! (Congressional Budget Office estimates)

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