Obamacare replacement bill runs into Republican trouble
Senate Republicans have released their long-awaited bill to dismantle much of Barack Obama's healthcare law but ran into trouble as four GOP senators said they opposed it.
The bill would provide less-generous tax credits to help people buy insurance and let states get waivers to ignore some coverage standards that Obamacare requires of insurers.
It would also end the tax penalties under Mr Obama's law on people who do not buy insurance - the so-called individual mandate - and on larger firms that do not offer coverage to their employees.
The measure represents the Senate GOP's effort to achieve a top-tier priority for President Donald Trump and virtually all Republican members of Congress.
Senate majority leader Mitch McConnell hopes to push it through his chamber next week but solid Democratic opposition - and complaints from at least six Republicans - have left its fate unclear.
"We have to act," Mr McConnell said on the Senate floor. "Because Obamacare is a direct attack on the middle class and American families deserve better than its failing status quo."
Some Republican senators, as well as all the Senate's Democrats, have complained about Mr McConnell's proposal, the secrecy with which he drafted it and the speed with which he would like to move it to passage.
Mr McConnell has only a thin margin of error: The bill would fail if just three of the Senate's 52 GOP senators oppose it.
Democrats gathered on the Senate floor and defended Mr Obama's 2010 overhaul.
They said GOP characterisations of the law as failing are wrong and claimed the Republican plan would boot millions off coverage and leave others facing higher out-of-pocket costs.
"We live in the wealthiest country on earth. Surely we can do better than what the Republican healthcare bill promises," said Senate minority leader Chuck Schumer.
Four GOP conservative senators - Ted Cruz of Texas, Mike Lee of Utah, Kentucky's Rand Paul and Ron Johnson of Wisconsin - said the bill falls short of GOP promises to erase Mr Obama's law and lower people's costs.
However, they said they were "open to negotiation and obtaining more information".
The House approved its version of the bill last month.
Though he lauded its passage in a rose garden ceremony, Mr Trump last week privately called the House measure "mean" and called on senators to make their version more "generous".
At the White House on Thursday, Mr Trump expressed hope for quick action.
"We'll hopefully get something done and it will be something with heart and very meaningful," he said.
The bill would phase out the extra money Mr Obama's law provides to states that have expanded coverage under the federal-state Medicaid program for low-income people.
The additional funds would continue through 2020 and be gradually reduced until they are entirely eliminated in 2024.
Ending Mr Obama's expansion has been a major problem for some GOP senators.
Some from states that have expanded the programme have battled to prolong the phase-out while conservative Republicans have sought to halt the funds quickly.
Beginning in 2020, the Senate measure would also limit the federal funds states get each year for Medicaid.
The program currently gives states all the money needed to cover eligible recipients and procedures.