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In a bid to get votes, House Republicans prepare changes to their bill rolling back Obamacare

Health and Human Services Secretary Tom Price, second from left, and senior House Republicans discuss the party’s plans to advance legislation to repeal the Affordable Care Act. (Associated Press)

Scrambling to round up votes to roll back the Affordable Care Act, House Republican leaders were making a series of last-minute changes late Monday to their Obamacare repeal bill ahead of this week’s vote.

The changes, which senior GOP leaders hope will sway wary conservative and moderate lawmakers, are aimed at building momentum for House passage while punting even more substantive fixes to the Senate.

President Trump planned to come to Capitol Hill on Tuesday morning to rally House Republicans to close the deal.

“I’m optimistic the legislation not only passes the House in a strong way, passes the Senate, gets to the president’s desk soon,” Rep. Kevin Brady (R-Texas), one of the bill’s authors, said ahead of Thursday’s vote.

Details of the amended bill were expected to be formally unveiled Monday night.

To win over conservatives, the changes are expected to give states added flexibility to limit who qualifies for Medicaid, the government health plan for the poor, and impose work requirements for some aide recipients.

And to appeal to moderates, Republican leaders were looking at providing additional assistance for Americans nearing retirement who rely on insurance marketplaces created through Obamacare, as the healthcare law is often called.

These 50- and 60-year-old consumers were scheduled to see huge premium increases under the original Republican plan, which independent analyses concluded would force many to go without coverage.

House Speaker Paul D. Ryan (R-Wis.) said over the weekend that “we have to have more assistance” for those Americans.

“We’re exploring different options and listening to members about how best to help that population,” Brady said. “There’ll be a partnership with the Senate going forward on this.”

Republican leaders worked frantically over the weekend and Monday to tweak the plan to gain broader support.

But as they did, parallel negotiations were underway at Mar-a-Largo, the president’s estate in Florida, where Sen. Ted Cruz (R-Texas) and a small group of conservatives, including the House Freedom Caucus’ Rep. Mark Meadows (R-N.C.), huddled with administration officials.

Cruz also met Monday afternoon at the White House with other Republican senators.

The competing efforts showed the difficulty facing Ryan and Senate Majority Leader Mitch McConnell (R-Ky.) as they try to unite Republican factions around an alternative healthcare plan.

Potentially adding to the challenge, a group of 87 leading physician and patient groups — including the American Lung Assn., March of Dimes and American Academy of Pediatrics — on Monday sent a letter to Ryan and McConnell warning that the Medicaid changes in the House legislation “would leave millions without the healthcare they rely on.”

It was unclear whether the changes being discussed would be enough to satisfy conservatives still angry that the repeal legislation preserves major parts of Obamacare or the growing number of centrist GOP lawmakers who have voiced concerns about how many people are scheduled to lose coverage.

“While I’ve been in Congress, I can’t recall a more universally detested piece of legislation than this GOP healthcare bill,” tweeted Rep. Justin Amash (R-Mich.).

Also unclear is the effect of the changes on patients, as the nonpartisan Congressional Budget Office hasn’t completed an analysis of the amended GOP plan. Leaders expected an update from the budget office before Thursday’s vote.

Wavering lawmakers were also hit with stern warnings from leaders that their votes would be noted by powerful conservative interest groups such as the National Right to Life Committee and the National Retail Federation.

“These next few days could define us for years to come,” wrote GOP Whip Steve Scalise (R-La.) in a memo to his team responsible for rounding up votes.

The original House GOP bill was projected to nearly double the number of people without health coverage over the next decade, increasing the ranks of the uninsured by 24 million.

Millions of consumers would also see skimpier health coverage and higher deductibles under the Republican plan, the budget office projected.

And although average premiums for those who buy their own insurance are projected to be lower after 2020 than under Obamacare — partly because plans will cover less — many consumers will pay more over the next few years than they would under the current law.

Hardest hit in the long run would be lower-income Americans and those nearing retirement, according to the budget office, which estimates that over the next decade, the GOP legislation would cut about $1 trillion in federal healthcare assistance to low- and moderate-income Americans.

Obamacare is credited with extending coverage to more than 20 million previously uninsured Americans and driving the nation’s uninsured rate to the lowest levels ever recorded.

House Republican leaders have been looking for ways to relieve the burden on older consumers by increasing subsidies, Ryan said Sunday on Fox News.