Congressional Republicans recrafted their Obamacare replacement bill on Monday in hopes of satisfying critics as US President Donald Trump prepared to promote his first major legislative initiative on Capitol Hill.
In a sign of deepening concern among Republicans about the bill's future, Trump will speak to the party's lawmakers in Congress on Tuesday about the healthcare overhaul, two House Republican aides said.
The Republican leadership proposed a series of amendments that marked major legislative changes, but it was not immediately clear whether they would help win more Republican support amid solid opposition from Democrats.
A leading conservative voice in the House, Representative Jim Jordan of Ohio, is still opposed to the legislation even with the proposed changes, according to an aide.
The administration and House leadership can only afford to lose about 20 votes from Republican ranks. They need to shore up support from moderate Republicans who fear the bill dismantling President Barack Obama's signature Affordable Care Act will hurt millions of Americans enrolled in the program.
However, Trump and Republican leaders must also appeal to hard-right conservatives who believe the original bill did not go far enough in repealing the law, prompting some to dub it "Obamacare Lite".
According to Republican sources who asked not to be identified, House leaders will propose an approximately $85 billion fund for tax credits to help people aged 50-64 get health insurance.
In an unusual move, the House proposed providing the Senate flexibility to offer more help to that age group, which may need a larger tax credit to help cover their healthcare costs - a move aimed at winning over more moderate Republicans. It did not specify how the Senate should do so.
Conservatives have opposed refundable tax credits, calling them another entitlement programme.
One amendment would dismantle most of Obamacare's taxes one year earlier than initially proposed, in 2017 instead of 2018. That includes both the individual mandate that requires everyone to purchase health insurance or else pay a penalty, and the requirement that employers of a certain size provide coverage.
The new language also addresses Medicaid, the federally backed healthcare program for the poor and disabled that is one of the most contentious aspects of the bill.
To appease conservatives, states would have the option of implementing work requirements for able-bodied adults without children or dependents. However, even the Heritage Foundation, a powerful conservative group, has opposed such a provision.
In addition, states could decide whether to take per capita allotments for their Medicaid programmes or block grants for certain populations. Both would drastically reduce federal Medicaid funding from current levels.
Republican leaders hope to move the legislation to the House floor for debate as early as Thursday.