Ryan says Trump playing constructive role on healthcare

The American Health Care Act, the House GOP bill to overhaul the United States healthcare system, passed the House Budget Committee on Thursday, but Republicans may have gotten a preview of the worries to come.

But the ObamaCare replacement plan still faces opposition from both moderate Republicans and the party's more conservative factions. It would cut Medicaid, repeal the law's tax increases on higher earning Americans and allow 30 percent higher premiums for consumers who let coverage lapse.

In this March 8, 2017, photo, House Speaker Paul Ryan of Wis. speaks during a news conference at the Republican National Committee Headquarters on Capitol Hill in Washington.

Cotton's stance on the legislation reflects realities on the ground in his state, where health advocates credit the Affordable Care Act with cutting how much hospitals are spending on care for uninsured patients and for a dramatic drop in the state's uninsured rate. A majority of the committee's 36 members supported the bill.

Ryan, the top House of Representatives Republican, also continued to champion the legislation, saying on cable news he was open to making "improvements and refinements", but adding, "The major components are staying intact". But even if those changes occur, some say they still would worry this bill is destined to die in the Senate anyway - something Senate Republicans themselves have been predicting will happen.

Hoping to secure support, Trump was meeting with a group of House conservatives at the Oval Office.

Republicans in the Budget Committee pushed nonbinding proposals to phase out the Medicaid expansion more rapidly, help low-income people more with tax credits and require able-bodied Medicaid recipients to meet work requirements. Moving up the end of Medicaid expansion from 2020 to 2018 is a "nonstarter", said Representative Charlie Dent of Pennsylvania, a co-chairman of a group of House moderates.

Without providing any substantive details, Trump said he was able to achieve commitments of support, and declared Obamacare 'dead'. It was agreed then to allow this in the states that wanted it and places like OH actually benefited. Rand Paul (R-Ky.) refuse to vote for the bill, he said. Sen.

Health and Human Services Secretary Tom Price told House Republicans that one of the changes being considered is allowing states to impose work requirements for Medicaid recipients, an adjustment that could win over some conservatives, The Hill reported. Trump did not want to alarm those in favor of the original bill, as he claimed...

"We made certain changes but frankly very little", he said.

The CBO analysis reportedly shook members of Congress, as many were already on the fence regarding the American Health Care Act before the CBO did any sort of analysis. Centrist Republicans remained wary of a bill they fear will yank many constituents from coverage. This is why President Trump had to talk of changes, which may help to sway people back on the side of passing the bill through. Virginia Republican Rep. David Brat, a Freedom Caucus board member, said Wednesday he would vote no in committee.

House Republicans from swing districts aren't interested in taking a risky vote on legislation that may be dead on arrival in the Senate. Medicaid covers more than 70 million people, and its future is expected to be a central issue in the Senate. It's also become a big personal test for Ryan as speaker; his non-stop media blitz to defend the bill in recent days has only further entwined his reputation with its fate. While Democrats won't back it, Republican Senators would need to if it were to get to the 52 number needed to pass to President Trump.

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