(Bloomberg) — A last-minute White House bid to win the support of reluctant House conservatives for the GOP Obamacare replacement bill by discussing possible changes risks losing the support of party moderates.
White House press secretary Sean Spicer said Tuesday the administration is talking to lawmakers about possible changes to the GOP leadership measure, but House Speaker Paul Ryan so far is resisting any significant revisions, according to a Republican aide.
Ryan faces a narrow path for getting the controversial measure through the House, particularly after the Congressional Budget Office estimated the measure could add 24 million Americans to the ranks of the uninsured in a decade.
That leaves President Donald Trump with a decision to make about whether to wade into the policy debate or let GOP leaders try to sort it out on their own.
House Republican leaders had hoped to pass their repeal measure in the full House as early as next week and send it to the Senate, where it's facing even stronger skepticism from Republicans. But it's unclear whether they have enough votes to pass it, with several conservatives and moderates announcing they can't back it in its current form.
'In a good place'
Trump spoke with Ryan and other House leaders Tuesday afternoon by telephone, but there were no public statements following the conversation.
"I feel like we're in a good place, but we want to listen to our members," Ryan said on Fox News after the phone call.
He added that he's willing to make changes to the measure, but "we gotta make sure we hit the sweet spot."
The Budget Committee is set to advance the measure Thursday. Efforts to change the bill could come either Thursday or next week as the Rules Committee sets the floor procedure for the measure.
Even with that tight time frame, Trump's administration waded more deeply into the details, with some members of the administration telling different groups they're still open to suggestions. Opponents of the bill upped their criticism after Monday's dire analysis of the Republican plan by the CBO.
The CBO found the GOP measure would cut spending by more than $300 billion over the next decade but would end up resulting in 18 million fewer people holding health insurance by 2018, just as House members all face voters in midterm elections.
Mark Walker says he could live with a richer tax credit for low-income people if a bill winds down the ACA Medicaid expansion program more quickly. (Photo: Walker)
GOP friction
The findings were seized upon by Democrats as evidence Republicans should drop their bill, and they even created internal GOP friction. A senior Republican aide said moderate members are spooked enough by the CBO report that any changes to make the bill repeal Obamacare without elements of a replacement would make it even harder to pass.
Related: Democrats caucus on health care
Rep. Ileana Ros-Lehtinen of Florida, a moderate Republican, announced she couldn't vote for the bill as written because "too many of my constituents will lose insurance and there will be less funds to help the poor and elderly with their health care." Rep. Rob Wittman, a Virginia Republican, also said he decided to opposed the bill because of the CBO's findings.
At the same time, conservatives continued to withhold their backing unless they got changes to the measure.
Medicaid changes
The most significant change they're pushing for is to move up the phase-out date for Obamacare's Medicaid expansion, according to conservatives inside and outside of Congress Tuesday.
The current bill maintains the expansion for participating states until 2020, at which point enrollment would be frozen. Some conservatives are pushing for it to last only until 2018.
