With Democrats expected to vote as a bloc against the legislation, Republicans can afford to lose only 21 votes to pass the bill through the House.
House Speaker Paul D. Ryan waved aside complaints that the process is messy, saying "this is legislating", and he praised President Trump for staying engaged. "This isn't going to get any easier the longer we leave it hanging out there".
"If we make no changes to it, I would say that it will not pass the House". "Slow down, get it right".
Under the rules, there are few changes that can be made in the Budget Committee. At an all-hands meeting Wednesday evening of House GOP lawmakers, Vice President Mike Pence and party leaders urged their rank-and-file to unite behind the legislation. A handful of Budget panel members, including Reps.
Republican Reps. Mark Sanford, Dave Brat and Gary Palmer, who are members of the conservative House Freedom Caucus, joined Democratic committee members in voting against the measure. A majority of House members must vote for the bill to send it to the Senate.
Rep. John Yarmouth of Kentucky, the committee's ranking Democrat, argued strongly against it, describing the proposal as "Robin Hood in reverse, but far worse".
But Ryan is open to tinkering around the edges of some of these policies, such as adding a work requirement for Medicaid or changing the timeline for phasing out the expansion, according to the aide, who spoke on condition of anonymity.
Trump held a campaign-style rally in Nashville and Tom Price, secretary of Health and Human Services, appeared on a CNN Town Hall, to promote the effort.
Many conservatives say what is on paper now smacks too much of Obamacare itself, and doesn't do enough to cut Medicaid and other costs. And though he's been one of Trump's unwavering supporters, including using his position on the Armed Services Committee to defend the president over Russian Federation, he's not ready to fall in line yet, especially given the mixed signals Trump has sent on whether he actually supports the bill as-is.
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Whatever they propose, however, could scare off centrist votes, who say the bill is already too draconian.
The House GOP bill is the party's attempt, with control of both chambers of Congress and the White House, to finally make good on seven years' worth of promises to repeal and replace Obama's health care law.
Among those accepting the agreement was Rep. Mark Walker, R-N.C., leader of the Republican Study Committee, a large group of House conservatives.
"For every action it creates an equal and opposite reaction sure some of that is going to be able to be moved back and forth".
Representative Charlie Dent, following a meeting of moderate Republicans with Pence, told reporters that speeding up the termination of the Medicaid expansion was a "non-starter".
"Given how narrowly we've threaded this needle", said Representative Kevin Cramer of North Dakota, "any abrupt change would probably be - could be a deal killer".
Obamacare expanded insurance to about 20 million Americans but the nonpartisan Congressional Budget Office said on Monday that 14 million Americans would lose medical insurance by next year under the Republican plan.
Ryan told reporters that he and the other Republican leaders could now make "some necessary improvements and refinements" to the legislation, reflecting an urgency to buttress support. That's because 216 backers will be needed for passage if all 430 now sitting House members show up and vote on the bill. That left House members angry over being asked to take a politically risky vote for legislation likely to be altered. And combined with opposition from Republicans of all stripes, the president's flexible stance suggested final passage of the bill could be delayed, potentially exposing the legislation to the same kind of extended public backlash undermining former President Barack Obama's Affordable Care Act from the start.