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THURSDAY, March 23, 2017 (HealthDay News) -- Efforts to pass a bill repealing the Affordable Care Act stalled on Thursday, with House leaders and the White House saying a vote could still come early Friday.
President Donald Trump and Republican leaders continued to work furiously on Thursday, seeking to garner enough support to begin dismantling the landmark health care reform law.
However, key conservative House lawmakers -- mainly members of a group known as the Freedom Caucus -- continued to say they could not support the repeal bill, dubbed the American Health Care Act, according to the Washington Post.
The Post reported that House Republicans plan a closed-door meeting later Thursday, and members of the House have been told to be available on Friday should a vote become likely at that point.
White House Deputy Press Secretary Sarah Huckabee Sanders confirmed the delay, the Post said. She added that more debate on the bill is expected Thursday night and a vote could occur early Friday.
"We're very confident that the bill will pass tomorrow morning," Huckabee Sanders said.
The delay comes after conservative House Republicans rejected an offer by Trump on Thursday to remove certain coverage mandates from the Affordable Care Act, raising uncertainty as to whether House Speaker Paul Ryan could get enough votes to pass the latest version of the bill.
Earlier in the day, a vote on Thursday had seemed possible, but lawmakers confirmed with the Post that action has been delayed.
Pressure to pass the repeal bill first came from Trump personally on Tuesday, who met privately with House Republicans to convince defiant party members to keep their promise to repeal the Affordable Care Act.
Those meetings were part of a full-out effort by House Speaker Paul Ryan and other Republican leaders to secure the 216 votes needed to pass the bill in the lower chamber before sending it to the Senate for consideration.
"President Trump was here to do what he does best, and that is to close the deal," Ryan said after the Tuesday meeting.
Ryan's plan, known as the American Health Care Act, is a budget "reconciliation" bill that rolls back major tax and spending provisions of the ACA. It is the first step in the process to replace the historic health law, signed by President Barack Obama seven years ago on March 23, 2010.
Although key House committees have signed off on the bill, the legislation faces sharp opposition, even within the Republican party.
GOP leaders unveiled changes late Monday that were aimed at winning over party skeptics.
The amended legislation accelerates the repeal of various taxes under the ACA, and imposes an immediate ban on state Medicaid expansions.
It also allows the federal government to make "block grants" to states to fund Medicaid. Under the ACA, Medicaid expansion provides benefits to all who qualify, while block grants would give states a lump sum of money to spend as they see fit.
In addition, the amended bill gives states the option to implement a work requirement in Medicaid for certain able-bodied adults.
Some of the changes are a response to a backlash by the Republican party's conservative wing, whose members have complained that the proposal doesn't go far enough to peel back Obamacare.
Some moderate Republicans have also expressed concern that the bill would adversely affect their constituents, particularly older Americans.
A Congressional Budget Office (CBO) analysis of the GOP's American Health Care Act found that older adults who buy individual health insurance would face sharply higher health insurance premiums.
A 64-year-old making $26,500 a year would see annual premiums rise from $1,700 under current law to $14,600 under the Republican plan, according to the CBO.
Ryan's proposal maintains popular aspects of Obamacare, namely the ban on exclusions of people with pre-existing conditions and the ability to keep young adults on parents' health insurance until age 26.
However, it would also eliminate Obamacare's controversial individual and employer health insurance mandates.
The GOP plan also advances a so-called continuous coverage provision. Insurers would be allowed to impose a 30 percent surcharge on health plan premiums for a year if consumers let their insurance lapse.
America's Health Insurance Plans, the nation's largest health insurance lobby, issued a statement Tuesday commending the House for supporting the continuous coverage provision.
"A strong, stable individual market can deliver more choices at lower costs for more consumers," the insurance group said.
However, another group took issue with the bill.
Twila Brase, president and co-founder of Citizens' Council for Health Freedom, said the GOP bill fails to live up to the promise of an Obamacare repeal. The council advocates for health freedom and affordability.
"We are concerned that it's just exchanging one federal program for another federal program," Brase said.
Instead, the council is calling for recreation of an individual insurance marketplace where consumers may buy "catastrophic" coverage to cover major health events.
"Insurance is not to pay for every little thing that happens to you at the doctor's office," Brase explained. But because it has evolved that way, "it is exceedingly expensive, because everything has to go through the health plan."
But many House Republicans insist the legislation is their best chance to finally make good on campaign promises to repeal the ACA.
Copyright © 2017 HealthDay. All rights reserved.
SOURCES: ABC News; Washington Post; American Health Care Act and amendments (speaker.gov); March 13, 2017, Congressional Budget Office, Washington, D.C.; March 21, 2017, news releases, America's Health Insurance Plans and American Action Network, Washington, D.C.; Twila Brase, president and co-founder, Citizens' Council for Health Freedom, St. Paul, Minn.