Portions of the Republican bill to repeal and replace ObamaCare will require 60 votes for passage, the Senate parliamentarian said Tuesday evening, dealing another blow to the GOP-led effort.

The parliamentarian has advised senators that two provisions could be stripped out, according to a document released Tuesday by Sen. Bernie Sanders Bernie SandersJacobin editor: Primarying Schumer would force him to fight Trump's SCOTUS nominee Trump campaign plays up Biden's skills ahead of Cleveland debate: 'He's actually quite good' Young voters backing Biden by 2:1 margin: poll MORE (I-Vt.), the ranking member of the Senate Budget Committee.

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The provisions in question would allow insurers to charge older people premiums up to five times as high as what they charge younger people — which AARP has called an “age tax” — and would allow small businesses to establish “association health plans” that could be sold across state lines. That aspect has been championed by Sen. Rand Paul Randal (Rand) Howard PaulSecond GOP senator to quarantine after exposure to coronavirus GOP senator to quarantine after coronavirus exposure The Hill's Morning Report - Sponsored by National Industries for the Blind - Trump seeks to flip 'Rage' narrative; Dems block COVID-19 bill MORE (R-Ky.)

The parliamentarian had already told senators late last week that a number of provisions important to conservatives would require 60 votes.

Senate Republican leaders are working frantically to find enough policies that can unite a divided conference, which means any parts of the bill deemed against the rules won’t help their efforts.

Leaders are prepared to offer dozens of amendments to the legislation in order to win over reluctant senators.

Republicans are trying to use the budget reconciliation process to pass their healthcare bill with only a simple majority. The provisions deemed impermissible under that process can be stripped from the bill if a senator on the floor raises an objection.

The ruling from the parliamentarian comes after the Senate narrowly voted to begin debate on the House-passed ObamaCare repeal legislation, relying on Vice President Pence to break a tie.

It’s still not clear what leaders will present as the final bill, but it seems likely to be a “skinny” repeal, designed principally to get senators into a conference with the House.