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 (I-Vt.), the ranking member of the Senate Budget Committee.

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 (R-Ky.)

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