President Donald Trump on Tuesday said he was "proud to endorse" a plan to replace Obamacare backed by Republican leaders in Congress, and called for its quick passage even as opposition to the bill hardened among conservatives.
The divisions in the Republican ranks greatly complicate GOP efforts to fulfill the promise by members of Congress and Trump to swiftly gut the Affordable Care Act, and replace it with new health-care legislation.
Those efforts already face staunch opposition from the Democratic minority in both chambers of Congress.
"We will do something important and really good for the American people," Trump said of the GOP leaders' proposal. "I hope it's going to go quickly."
"Obamacare is collapsing, and it's bad shape, and we're going to start acting," Trump said at the White House. "There's going to be no slowing down, and there's not going to be any more excuses by anybody."
"It's a great bill," Trump said of the American Health Care Act. "I really believe we're going to have tremendous support."
"I"m proud to endorse the replacement plan."
But just before Trump spoke, a group of conservative Republicans in Congress stood outside the Capitol and criticized the GOP leadership's plan.
And they expressed hope that the bill is not set in stone, but open to being changed through negotiation.
"What's been introduced in the House in the last 24 hours is not the Obamacare replacement plan, is not the Obamacare repeal plan that we've been hoping for," said Sen. Mike Lee, R-Utah.
"If anything, it's a step in the wrong direction," Lee said.
Rep. Jim Jordan, R-Ohio, said of the bill, "As I look through it [the bill], it is Obamacare in a different form."
And Sen. Rand Paul, R-Ky., said he would introduce a bill Tuesday in the Senate calling for "complete repeal, a clean repeal" of Obamacare, which he wants to be voted on before Congress tackles legislation that would replace the Affordable Care Act.
Paul said the question of whether Obamacare should be repealed "doesn't divide us, it brings us to together.
"We are divided, we have to admit, we are divided on replacement," Paul said.
Trump later tweeted that he thought Paul would eventually support the bill.
The bill introduced by GOP leaders would kill Obamacare's requirement that most Americans have some form of health coverage or pay a fine, and would replace its current system of subsidies for most customers of insurance exchanges with a system of tax credits that could be used to pay for plans on or outside of those markets.
Many conservatives in Congress opposed the tax credits, which they consider to be entitlements. And they also blanch at the fact that the new bill does not immediately roll back Obamacare's expansion of Medicaid eligibility to nearly all poor adults in more than 30 states that have adopted expansion.
Instead, the bill would freeze expansion effective in 2020, after which no people could sign up under expanded eligibility standards. The bill also would change federal funding of state Medicaid programs to a block grant system.
If enough conservatives, along with Democrats in the House, vote against the bill, it could fail to pass in that chamber.
The Republican leadership, even before introducing the bill early Monday evening, was warned by four GOP senators that they would oppose legislation if it threatened the stability of people now enrolled in Medicaid, or the flexibility of states to meet the needs of Medicaid beneficiaries.
The GOP leadership plan as presented Monday is seen as a step toward reducing federal spending on Medicaid, a move to having fewer people enrolled in the program.
Republicans hold just 52 Senate seats. If three GOP senators oppose replacement legislation, and the Democrats vote in a bloc to oppose it as well, the bill would die.
Also Tuesday, a health-care expert from the Heritage Foundation wrote that the House bill's "key problem ... is that it fails to correct the features of Obamacare that drove up health insurance costs."
"Instead, it mainly tweaks Obamacare's financing and subsidy structure," wrote the analyst, Edmund Haislmaier.
"Basically, the bill focuses on protecting those who gained subsidized coverage through the law's exchange subsidies and Medicaid expansion, while failing to correct Obamacare's misguided insurance regulations that drove up premiums for Americans buying coverage without government subsidies," he wrote.
