left right U.S. House Speaker Paul Ryan speaks about healthcare at his weekly press briefing on Capitol Hill in Washington, U.S, April 27, 2017. REUTERS/Yuri Gripas 1/7 left right U.S. Senator Patty Murray (D-WA) speaks at a news conference on U.S. President Trump's administration's first 100 days and healthcare, on Capitol Hill in Washington, U.S., April 26, 2017. REUTERS/Yuri Gripas 2/7 left right U.S. Senators Patty Murray (D-WA) and Ron Wyden (D-OR), (L), and Representative Frank Pallone (D-NJ) arrive at a news conference on U.S. President Trump's administration's first 100 days and healthcare, on Capitol Hill in Washington, U.S., April 26, 2017. REUTERS/Yuri Gripas 3/7 left right U.S. House Speaker Paul Ryan greets children of members of the press during 'Take Our Daughters and Sons to Work Day' on Capitol Hill in Washington, U.S, April 27, 2017. REUTERS/Yuri Gripas 4/7 left right U.S. Representative Mark Meadows (R-NC), Chairman of the Freedom Caucus, walks to a vote on Capitol Hill in Washington, U.S., April 26, 2017. REUTERS/Aaron P. Bernstein 5/7 left right U.S. Senator Ron Wyden (D-OR) speaks at a news conference on U.S. President Trump's administration's first 100 days and healthcare, on Capitol Hill in Washington, U.S., April 26, 2017. REUTERS/Yuri Gripas 6/7 left right House Speaker Paul Ryan (R-WI) speaks with the media following a conference meeting on Capitol Hill in Washington, U.S., April 26, 2017. REUTERS/Aaron P. Bernstein 7/7 By Susan Cornwell | WASHINGTON
WASHINGTON Prospects for U.S. House passage of a healthcare system overhaul before President Donald Trump's 100th day in office dimmed on Thursday as Republicans struggled to find the needed votes, lawmakers and aides said.
Advocates of the amended healthcare proposal said earlier on Thursday that they were cautiously optimistic that they would be able to push it through the House of Representatives in the near future, after a group of hard-line Republican conservatives endorsed it a day earlier.
But late in the day there were few apparent new converts to the legislation among the Republican moderates whose backing is also needed for passage.
"I think they (House leadership) are still whipping to try to see if there's enough votes … apparently, they're not there yet," Representative Mark Meadows of North Carolina said at midafternoon.
Meadows is the leader of the conservative Freedom Caucus group that backed the amended healthcare bill on Wednesday, after having helped to sink the original version last month.
The Republican healthcare bill would replace Obamacare's income-based tax credit with an age-based credit, roll back an expansion of the Medicaid government health insurance program for the poor and repeal most Obamacare taxes.
The nonpartisan Congressional Budget Office had estimated 24 million fewer people would have insurance under the original version.
The new amendment that has won over some conservatives, drafted by Representative Tom MacArthur, would allow states to seek waivers to opt out of some of the law's provisions. That includes a provision mandating that insurers charge those with pre-existing conditions the same as healthy consumers, and that insurers cover so-called essential health benefits, such as maternity care.
The failed effort in March was a major setback for Trump, who had campaigned heavily on the promise to repeal the Affordable Care Act, commonly known as Obamacare.
The recent Freedom Caucus endorsement set off a flurry of activity by House leaders to see if they could find enough votes to get the legislation passed as early as this week – in time for President Donald Trump's 100th day in office on Saturday.
But it remained unclear whether the amended bill could attract the 216 votes needed to pass the House, given the united Democratic opposition. Some outside groups like the American Medical Association weighed in against the legislation, saying it would cost millions their health care coverage. The bill's future is further clouded in the Senate.
"The mood is still guardedly optimistic," said Representative Chris Collins, a moderate and Trump ally who supports the bill. "There are, I’m going to say, still some 'lean no's' that we’ve just got to get over the hurdle …"
"We're going to go (to the floor) when we have the votes," House Speaker Paul Ryan said on Thursday morning. "We're making very good progress."
Republicans in Congress have made repealing and replacing Obamacare a central promise since the law passed in 2010.
But House Republicans are not keen to repeat last month's debacle, when their leaders acquiesced to Trump's demand for a floor vote on the bill, only to unceremoniously yank the measure after determining it could not pass.
Some centrists say the changes do not address their worries that the bill would hurt poor Americans in the Medicaid program. Others, including Republican Representative Dan Donovan of New York, said the loosening of protections for people with pre-existing medical conditions was a major problem.
"It's going to cost people with pre-existing conditions even more money to have coverage … It's something that we shouldn't be doing," Donovan told CNN.
House Democratic Leader Nancy Pelosi said Trump was making Republicans "walk the plank" on a healthcare bill that was "wildly unpopular."
(Reporting by Susan Cornwell and Susan Heavey; Additional reporting by Amanda Becker and Will Dunham; Editing by Julia Edwards Ainsley and Diane Craft)