US Senate Republicans on Thursday unveiled a revamped health care bill aimed at fulfilling President Donald Trump's pledge to repeal significant parts of Obamacare, as Democrats rallied block the controversial measure.
The bill appears to be a less austere version of the one that passed the House of Representatives last month which, according to a forecast by the non-partisan Congressional Budget Office (CBO), would leave 23 million fewer people insured than under current law.
The Senate version delays cuts to the Medicaid program and maintains tax credits included in Obama's signature Affordable Care Act to help lower income Americans purchase health insurance for at least two years.
Majority Leader Mitch McConnell unveiled the bill, drafted in secret by a handful of lawmakers and aides, at a closed-door session with party faithful.
"I came away more positive than I thought I'd be," Senator Lindsey Graham told reporters.
Graham said he feels "comfortable" that the Senate bill will not deny insurance coverage to people with pre-existing medical conditions, a point of contention in the House measure.
"For the next couple years, the ACA regime will continue, but then it will transfer to a different set of tax credits," Senator Bill Cassidy said.
So-called stabilization funds would meanwhile bridge the gap for people to ease the insurance cost burden. Cassidy said such a plan would be funded at $50 billion over five years.
But Cassidy said he remained "undecided" about the bill.
"I haven't read the text yet," he said.
Republicans hold 52 out of 100 seats in the Senate and the latest bill is designed to thread the needle to find an agreement between the party's conservative and more moderate wings.
They can afford only two defections; in that case, Vice President Mike Pence would be brought in to break a 50-50 tie.
Lawmakers were racing back to their offices to digest the new text.
Many will be "looking to see if there are things that we can do to refine it, and make it more acceptable to more members in our conference, to get to 50," Senator John Thune said.
"I think right now the challenge is how do we get to 50."
Trump, who campaigned heavily on a pledge to dismantle his predecessor's landmark health care reforms, offered a brief reaction to the bill's release.
"It's going to be very good," the president said. "Little negotiation, but it's going to be very good."
McConnell said in the chamber that a fresh CBO score on the new bill was expected next week, and there will be "robust debate" on the floor.
Democrats "can choose to keep standing by as their failing law continues to collapse and hurt more Americans, but I hope they will join us instead to bring relief to the families who've struggled under Obamacare for far too long," McConnell said.
He also said there would be an open amendment process to allow changes. He wants a final vote by the end of the month.
Graham called the bill "a starting point."
"This is a proposal from the leadership that is expected to change," he said.
The draft appears to seek to reduce the impact on Americans who stood to lose the most under the House version.
But it also reconfigures subsidies and gives states wider abilities to opt out of regulations and waive essential benefits that are mandatory in insurance plans under current law.
Top Senate Democrat Chuck Schumer blasted the new bill as "heartless," warning it would eventually cut Medicaid even more steeply than the House legislation.
"This is a bill designed to strip away health care benefits and protections from Americans who need it most in order to give a tax break to the folks who need it least," Schumer said.
The new legislation would eliminate federal funding for Planned Parenthood, a non-profit health organization that Trump's administration has targeted for cuts because it provides abortion services.
Democrats have railed against the secretive drafting process and vowed an all-out fight to stop the measure.
If three Republicans join a united Democratic front, the legislation will be blocked.
Any new Senate bill would have to be reconciled with the House version.