The reconciliation process lets Republicans push the bill through the Senate—where they have a 53-47 majority—on a simple majority vote. But the process comes with strings attached, and those limits are known as the Byrd Rule, for the late Sen. Robert Byrd (D., W.Va.).

Senate Republicans on Monday proposed steeper Medicaid cuts than those included in the House-passed version of President Donald Trump’s signature policy bill—making the bill’s passage by the July 4 deadline set by Congressional Republicans even more uncertain as Medicaid cuts have been a major sticking point for some in the GOP.