House Democrats passed new rules Thursday requiring that legislation creating new entitlement programs also include pay cuts or tax increases to prevent an increase in the federal deficit.

The rule's imposition is a loss for some liberals, including Reps. Ro Khanna of California and Alexandria Ocasio-Cortez of New York, and activists on the Left who opposed it on the grounds that it could hinder efforts to introduce new programs, such as expanding Medicare coverage to all age groups or a federal jobs guarantee.

“I just think that it has a difference to do with how we actually pay for these things when you pair it with the fact that dynamic scoring is being removed as well, which I think is completely understandable. You’re not including the macroeconomic impact of 'Medicare for all' or tuition-free public colleges and universities,” said Ocasio-Cortez in a brief interview Thursday.

The new "pay-as-you-go" or "PAYGO" rule is not an impossible hurdle for progressives. House Democrats can elect to waive the rule on future votes. A similar rule is enshrined in federal law, and it too has proved surmountable in cases of major deficit-increasing legislation in past congresses.

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Rep. Jim McGovern, D-Mass., the House Rules Committee chairman who helped write the package, told reporters earlier that he didn’t understand the opposition to it.

“I’ve talked to a number of members about this issue and as I’ve said, I don’t fully understand the controversy as it relates to the rules package,” said McGovern. “If you don’t like PAYGO, and I have some reservations about PAYGO, then you have to change the law.”

Despite the public protests from Ocasio-Cortez and outside progressives, only she, Khanna, and fellow Congressional Progressive Caucus member Rep. Tulsi Gabbard, D-Hawaii, voted against the rules package. Reps. Pramila Jayapal, D-Wash., and Mark Pocan, D-Wis., co-chairmen of the Progressive Caucus, issued a statement on Wednesday decrying the PAYGO rule, but supporting the overall House rules package.

The rules package passed Thursday night also make it easier to increase taxes by eliminating a prior rule requiring a three-fifths majority to raise taxes, considers the debt ceiling raised upon adoption of a new federal budget, and repeals budgetary scoring, known as "dynamic scoring," that factors economic growth into the impact of new legislation on the federal bottom line.

Three Republicans — Reps. Tom Reed and John Katko of New York and Brian Fitzpatrick of Pennsylvania — also voted for the rules package, which includes new rules aimed at making it easier to bring bills with bipartisan support up for a vote. All three are members of the bipartisan Problem Solvers Caucus, which seeks to work across the aisle. Reed and Katko have been especially active on infrastructure policy, which is seen as a potential area of compromise between House Democrats and the Trump administration during this Congress.