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"The president wanted us to get it going", Ryan said.

U.S. House Speaker Paul Ryan, R-Wis.: Obamacare "is in what the actuaries call a death spiral". So is every other Republican faction. That wasn't well thought out because of the complexity of the health insurance industry.

From the view of Republicans, Rep. Charlie Dent, R-Pa., said: "If we want to have durable, sustainable reforms in this country, whether tax reform, health care or anything else, it will need to be done on a bipartisan basis". Counties pay about 13 percent of the state Medicaid bill, the amount they pay having been capped by state legislation several years ago.

"So if you look at the cross section of the conference they have similar positions about similar provisions - preexisting condition, guarantee issue and medical underwriting are components of that", McHenry added.

Efforts to replace the Affordable Care Act have caused worry for insurers, who aren't sure about the law's future or what would replace it.

Gallup said this week that the law gained majority approval for the first time, with 55 percent supporting it and 41 percent disapproving.

Republicans have yet to heal from the events of March 24, when Ryan abruptly canceled a House vote on the health care bill because opposition from both wings of the party would have sunk it.

"What are they going to tell their constituents in six months or next year?"

'We don't want to shut down, but we say this all the time - we should fight for what we promised the American people, ' he said. Nobody winds up implementing everything that they pledged, but the pledges are a useful focusing device and serve as a starting point. But playing the blame game and pointing fingers does little to advance the ball.

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Now, the holdouts are pondering the changes.

Leadership announced a last-minute Rules Committee meeting on an amendment to the American Health Care Act - put forward by House Freedom Caucus members Gary Palmer of Alabama and David Schweikert of Arizona - allowing them to go back to their districts with the message they are making progress on the bill.

"We believe more freedom to the states would certainly be something that we would encourage", Meadows said after meeting with other GOP House leaders and Vice President Mike Pence earlier this week. The congressional recess could drain more momentum from the repeal drive although many Republicans say individually they're not giving up.

"There's no suggestion we should be changing our flights", moderate Rep. Chris Collins, R-N.Y., said Wednesday afternoon, a day before lawmakers were slated to leave Washington for their two-week recess. Their four-page amendment would give the Health and Human Services Department wide latitude over how to disperse the $15 billion to insurers, including which patients would be covered. In theory, this would help stabilize the individual insurance market for those without coverage through an employer or government program like Medicare. Republicans said those claims were exaggerated.

"While we still have work to do to get all the way there, we have made some real progress this week". We talk and we don't even shake hands.

"The White House is going to need its own clear direction, or it's going to need to defer to Congress, but saying that your plan is forthcoming and then not producing a plan kind of puts everything in stasis", said Alan Cole, an economist at the conservative Tax Foundation.

"The Freedom Caucus will hurt the entire Republican agenda if they don't get on the team, & fast". "I don't know that it's a probability, but it's always a possibility". That is what happened in 2006 for Democrats and 2010 for Republicans.

"There was no vetting at all, no process whatsoever". "High-risk pools" are a mechanism to subsidize more expensive insurance coverage for those who are seriously ill.

Perry said he was prepared to vote against the bill because it didn't accomplish his primary goals: removing the federal government from health care decisions and lowering prices. "It isn't at this level". Please support our efforts.


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