The Trump administration has been attempting to persuade ultra-conservatives to support the planned reforms
The future of Donald Trump's healthcare plans remains uncertain today ahead of a key vote on proposed legislation.
The American Health Care Act (AHCA) is the culmination of senior Republicans' efforts to fulfill their party's pledge to 'repeal and replace' the Affordable Care Act, also known as Obamacare.
The bill retains some popular aspects of Obamacare - such as requiring health insurance companies to offer coverage to individuals with pre-existing conditions.
However, it also makes radical changes to the existing legislation, such as decreasing subsidies for lower-income people and removing the penalty tax on people who do not have a health insurance plan.
Proponents - which include President Trump and House leader Paul Ryan - argue the AHCA would cut premiums and benefit businesses.
The legislation is, however, vehemently opposed by Democrats and others. They argue it would benefit high income & healthy people while adversely affecting sick & poorer people.
The nonpartisan Congressional Budget Office has suggested the controversial legislation would result in 24 million losing insurance by 2026.
An analysis by the Urban Institute, meanwhile, has estimated that a average family with an income of less than $10,000 in 2022 would be $1,420 worse off under the AHCA. In contrast, a family earning more than $200,000 would be $5,640 better off.
Trump, meanwhile, has insisted the bill is 'wonderful', arguing: "ObamaCare is a complete and total disaster - is imploding fast!"
A vote on the AHCA was due to take place on Thursday - the 7th anniversary of Barack Obama signing his signature healthcare legislation - but that was delayed until Friday amid frantic efforts to secure enough congressional votes for it to pass.
While Republicans have a majority in the US House of Representatives, the bill has caused disquiet in the party. If 23 or more of the party's 237 congresspeople vote against the bill, it will not pass.
A small number of moderate Republicans are concerned that the bill will negatively impact many of their constituents, but the real uncertainty for party leaders involves the ultra-conservative Freedom Caucus.
The 29 member group has opposed the bill on the grounds that does not go far enough in terms of repealing and replacing down Obamacare.
Members of the caucus were at the White House for intense and high-level meetings yesterday as the Trump administration attempted to persuade them to vote in favour of the legislation.
The New York Times reports that the conservative group secured a key concession in negotiations yesterday when the White House agreed to remove a clause requiring insurers to cover 'essential health benefits' in areas such as maternity care, emergency services, mental health care and addiction treatment.
However, that and other concessions did not win over members, and also risked alienating moderate Republicans who were already uneasy about the bill.
According to CNN, the White House last night issued an ultimatum to Republicans that they would be 'stuck with Obamacare' if the bill does not pass Friday's vote.
The vote is being seen as an important test of whether Donald Trump's much-vaunted 'art of the deal' philosophy can be carried over from the business world to the political one. Passing the AHCA would also be an important victory for his embattled administration.
Freedom Caucus chairman Mark Meadows suggested an agreement would eventually be reached, but admitted: "We have not gotten enough of our members to get to a 'yes' at this point."
Paul Ryan, meanwhile, simply told reporters they were 'proceeding' with the vote without offering any insight into its prospects.
Democrats, meanwhile, have remained steadfast in their opposition to the bill, with house minority leader Nancy Pelosi describing it as a "moral monstrosity".
"Apparently they still do not have the votes to pass the bill, and are working to make it even worse," she said in a statement yesterday.
Even if the bill successfully passes through the House of Representatives, it must still pass through the Senate.
Any amendments added by senators would have to be considered by committee. The revised bill would then have to pass through both houses before President Trump would be able to sign it into law.