republicans u.s. senate deal another blow effort repeal obamacare friday keeper senate rule say certain provision healthcare bill defunding plan parenthood could include senate parliamentarian determine provision good care reconciliation act violate byrd rule require backers able muster 60 vote accord memo post senate committee budget website republicans control senate slim 52-seat majority unlikely able round many vote key provision bill repeal former president barack obama affordable care act know obamacare affect would provision defund plan parenthood two provision prevent certain tax credit use purchase health insurance cover abortion provision state begin 2020 state long cover essential health benefit medicaid alternative benefit plan provision subject byrd rule accord parliamentarian include provision allow state option impose work requirements medicaid enrollees disable elderly pregnant proposal repeal cost-sharing subsidies provision still review include proposal allow insurers charge old americans young people provision allow small businesses establish association health plan could sell across state line option state receive medicaid block grant lump sum instead per capita cap payments senate majority leader mitch mcconnell seek use procedural rule would allow republicans pass healthcare bill simple majority senate rule deal setback republican healthcare bill