By Kristina Peterson, Natalie Andrews and Stephanie Armour
WASHINGTON -- Conservative House Republicans said Monday night that they have enough votes to block the GOP's legislation to dismantle the Affordable Care Act, as House leaders proposed changes to the bill in a late effort to draw support.
Rep. Mark Meadows (R., N.C.), chairman of the House Freedom Caucus, a group of conservative lawmakers, said more than 21 members opposed the bill, enough to block passage should House leaders hold the vote as expected on Thursday and all Democrats hold firm in opposing the legislation.
Mr. Meadows spoke after a meeting of House Freedom Caucus, which has 30 to 40 members. By sticking together, the group could force House leaders to alter the bill further to suit conservatives who believe it doesn't go far enough to repeal elements of the Affordable Care Act.
Mr. Meadow's vote count couldn't be verified, but additions to the bill unveiled by House leaders on Monday suggested that they were still working to round up votes to ensure passage.
President Donald Trump prepared to intensify his lobbying effort, with an appearance scheduled for Tuesday morning at the weekly, closed-door meeting of House Republicans. It will be Mr. Trump's first huddle with all House Republicans since his inauguration.
"That's going to be a lot of pressure," said Rep. Raul Labrador (R., Idaho), a member of the conservative group.
"We've spent the last week and weekend listening to our colleagues both from the House and the Senate about ways we can improve this legislation, " said House Ways and Means Committee Chairman Kevin Brady (R., Texas).
The bill repeals much of the 2010 health care law and replaces it with tax credits aimed at helping people afford insurance. House Speaker Paul Ryan (R., Wis.) and other GOP leaders have said they are confident of passage.
The changes to the bill unveiled Monday evening included concessions won by lawmakers who belong to Republican Study Committee, a second and larger group of conservative House members. Some of those lawmakers had met Friday with Mr. Trump at the White House.
To answer their concerns, the bill will be tweaked to permit states to impose a work requirement on Medicaid beneficiaries. The legislation will also be changed to give states more options in how they receive federal Medicaid funding, which also would be curtailed under the House GOP plan.
GOP leaders said the bill would repeal some ACA taxes retroactively to the start of this year, rather than in 2018, as they originally proposed.
To appease a widespread concern among House Republicans, GOP leaders also identified new funding they said they would allow the Senate to offer more generous tax credits to help older Americans, those between the ages of 50 and 65, buy health insurance in the years before the qualify for Medicare. Under the current bill, the tax credits start at $2,000 for those under age 30 and increase up to $4,000 for those 60 and older.
GOP leaders also included a measure sought by New York Republicans intended to stop New York state from raising Medicaid funding through county taxes. Rep. Chris Collins (R., N.Y.) said that change would help win over GOP members of his state's delegation.
The changes weren't enough to satisfy some conservatives, who see the system of tax credits as a new federal benefit.
"Based on what I've been told is in the manager's amendment, and what I've been told tonight, I don't know that it moves anybody or makes a compelling case from where their previous positions were," Mr. Meadows said.
Mr. Labrador pinned the problems with the bill on House leaders. "The White House has been open to negotiations. It's the House leadership that's closed to negotiations," he said.
Mr. Ryan, in a statement, said the changes announced Monday would "accelerate tax relief, give states additional options to spend health care dollars how they choose...and ensure there are necessary resources to help older Americans and the disabled."
GOP Reps. Martha McSally of Arizona, Tom McClintock of California, Thomas MacArthur of New Jersey and Robert Aderholt of Alabama said they would support the bill after leaders unveiled the proposed changes.
The nonpartisan Congressional Budget Office is expected to release an updated projection before Thursday's vote on its budget impact and effect on the number of people with insurance, Mr. Brady said. The office last week estimated that the bill would cause 24 million fewer people to be insured over a decade compared with the ACA.
Write to Kristina Peterson at email@example.com, Natalie Andrews at Natalie.Andrews@wsj.com and Stephanie Armour at firstname.lastname@example.org
(END) Dow Jones Newswires
March 21, 2017 00:35 ET (04:35 GMT)
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