The Senate on Sunday moved toward a debate on the embattled Republican tax cuts and domestic policy bill, as G.O.P. leaders toiled to build enough support in their own ranks to push it through before a Fourth of July deadline set by President Trump.
Democrats who are unified against the measure protested its consideration by forcing Senate clerks to read the 940-page bill aloud, a maneuver that delayed the debate and was likely push any major votes to Monday. But even as the endgame drew nearer for the legislation, which would extend tax cuts first enacted in 2017 and exact steep cuts in Medicaid and nutrition assistance programs to help pay for them, continued to change.
The Senate official who enforces the chamber’s rules determined that two last-minute provisions — added on Saturday to benefit Alaska and Hawaii and help secure the vote of Senator Lisa Murkowski, Republican of Alaska — violate Senate rules and would likely need to be dropped from the bill, according to an aide.
Those provisions were crucial to winning the support of Ms. Murkowski on the initial procedural vote that narrowly passed late Saturday night on a 51-49 vote, with two Republicans and all Democrats opposed. It was uncertain whether she would still back the legislation if those sweeteners were dropped.
The ruling by the chamber official, the Senate parliamentarian, involved a special boost to the states’ Medicaid payment rates and one to the prices Medicare pays hospitals in those states for some medical services.
Adding to the uncertainty around the measure were new estimates by the nonpartisan Congressional Budget Office, which showed that it would pile at least $3.3 trillion to the already-bulging national debt over a decade, nearly $1 trillion more than the House-passed version. That could pose big problems for the measure in the House, which must give it final approval and where fiscal hawks have warned that the price tag of the measure must not rise.
The C.B.O. also reported that the Senate measure would result in deeper cuts on federal support for health insurance and more Americans losing coverage than the House measure, underscoring the political risks for Republicans.
The analysis found that the legislation would leave 11.8 million more Americans uninsured by 2034. Federal spending on Medicaid, Medicare and Obamacare would be reduced by more than $1.1 trillion over that period — with more than $1 trillion of those cuts coming from Medicaid alone.
As of 10 a.m. Sunday, Senate clerks had read aloud 630 pages of the 940-page bill and estimates were that they would finish the task by midafternoon. That would start the clock on 20 hours of debate on the legislation, evenly split between the two parties, though Republicans were not anticipating using all of their time. At the end of the debate, members of both parties would have the opportunity to offer more changes and force floor votes on those amendments in an hourslong process known as a vote-a-rama.
The resolution of those amendments could be crucial to determining the fate of the bill when senators cast their final votes.
For instance, Senator Susan Collins, Republican of Maine, wants to offer an amendment to revert the tax rate for the most affluent Americans to the level before the 2017 tax cuts were enacted, generating new revenue. Ms. Collins voted to open the debate on Saturday but told Republican leaders that her vote did not represent a commitment to support the final bill.
A group of hard-right conservatives who held out four hours on Saturday night before agreeing to begin debate also want to win changes to produce greater savings in Medicaid, a proposal that could weaken support from other senators worried about health care cuts in their states.
Democrats are dug in against the proposal.
On CNN’s “State of the Union,” Senator Mark Warner, Democrat of Virginia, warned that 16 million Americans could lose their health care coverage under the bill. The cuts could make health care more expensive and have a “ripple effect to all of us who have traditional health care as well,” he added, setting the total number of uninsured back to “where we were before Obamacare.”
But Senator Katie Britt, Republican of Alabama, appearing on the same program, dismissed recent polls showing a lack of support for the bill. She argued that Americans would greatly benefit and said she was excited about the bill’s potential.
“I think when the American people actually get to see this in fruition, they absolutely are going to be, too,” Ms. Britt said.
Andrew Duehren and Margot Sanger-Katz contributed reporting.
Carl Hulse is the chief Washington correspondent for The Times, primarily writing about Congress and national political races and issues. He has nearly four decades of experience reporting in the nation’s capital.
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