Some more conservative Republicans have pushed to make the bill come into effect faster or say it doesn't do enough to repeal Obamacare. Here is the central prize: "If we lower premiums, and hopefully lower them a lot, that is a victory for the American people". Among the many criticisms levied against the bill, some are concerned that it doesn't do enough to protect seniors and low-income Americans from rising health-care costs. But what we're really talking about is the beginning of Joe Biden's return to the public stage in a promised fight to stop Obamacare opponents from dismantling the health care law that has suddenly become quite popular with a majority of Americans.
The Congressional Budget Office has estimated that under the GOP plan, a 64-year-old with an income of $26,500 would pay $14,600 in yearly out of pocket costs. The effective conclusion of negotiations means that it is now time for House Republicans to get in line - or vote against a bill that has the President's seal of approval.
Lee, a Utah Republican, and other conservatives were making a last-minute pitch to President Trump officials and House leaders to revise the bill.
The GOP bill as now written offers a fixed tax credit for low- and middle-income Americans that rises by age. They also want the bill to be far more aggressive in repealing former President Barack Obama's statute, including its requirement that insurers cover 10 specified types of services. But he acknowledged that the GOP bill would probably have to change.
At the same time, insurance premiums will continue to rise in the near term, especially for older Americans. Analysis by health policy experts have shown this would lead to a signifcant increase in premiums costs compared to the ACA's current tax credits. But he allowed the additional assistance was one of several House revisions to be discussed in advance of Thursday's vote, along with possible changes to help low-income people more with tax credits and require able-bodied Medicaid recipients to meet work requirements.
The GOP leadership's most urgent priority: Make sure they have the votes, changing the bill if necessary.
"They still believe that the conservatives in their caucus don't want Obamacare Lite", he said.
But Ryan expressed confidence that the bill would pass the House this week - and then move to the Senate, where the legislation is facing even sharper doubts and the GOP majority is much narrower.
"We're still having conversations with our members". He cited Trump's hands-on involvement as a key factor is moving the legislation forward.
"I was elected in 2010 right after it came into place, to repeal it", Paul said.
Ryan said he's also impressed with how President Trump is helping the GOP to "close this bill". "We're making fine-tuning improvements to the bill to reflect people's concerns, to reflect peoples' improvements".