Regulations from the Executive in Need of Scrutiny Act of 20 23 or the REINS Act of 2023 This bill revises provisions relating to congressional review of agency rulemaking. Specifically, the bill establishes a congressional approval process for a major rule. A major rule may only take effect if Congress approves of the rule. A major rule is a rule that has resulted in or is likely to result in (1) an annual effect on the economy of $100 million or more; (2) a major increase in costs or prices for consumers, individual industries, government agencies, or geographic regions; (3) significant adverse effects on competition, employment, investment, productivity, innovation, or the ability of U.S.-based enterprises to compete with foreign-based enterprises; or (4) an increase in mandatory vaccinations. The bill also provides for the designation, review, and approval of at least 20% of agency rules currently in effect.