WATCH | House Republicans have unveiled their long-awaited bill to replace the Affordable Care Act and some Congressional Republicans are... not thrilled. Now it's up to leadership to wrangle Republicans on the far right and even some moderates in the Senate who aren't on board with the plan.
Hard-right conservatives say the House's "American Health Care Act" leaves too much of Obamacare in tact, and have branded it "Obamacare lite" and "Obamacare 2.0."
They argue the plan sets up a new form of entitlement program with tax credits for patients based on their age. Many would have preferred tax deductions instead of credits.
The House leadership Obamacare Lite plan has many problems. We should be stopping mandates, taxes and entitlements not keeping them.— Senator Rand Paul (@RandPaul) March 7, 2017
Still a mandate?
Conservatives also say the House plan doesn't really get rid of penalties for people who don't get health insurance, also known as the individual mandate.
Instead, they say the plan would just shift the mandate from the government to the insurance companies because the bill allows insurers to increase rates by 30 percent for people who go longer than two months without health care.
A group of conservatives opposed to the House bill on Tuesday announced they would introduce their own repeal plan on Wednesday that will likely resemble a bill Republicans voted on in 2015 but was vetoed by Obama.
"We think you have to get rid of Obamacare completely, so tomorrow I will introduce the bill that every single Republican voted on just 15 months ago, the bill that actually repeals Obamacare," Rep. Jim Jordan of Ohio told reporters.
The House Freedom Caucus, a group of hard-line conservatives, is set to meet Tuesday night to discuss the bill and draft a list of demands to give to GOP leadership on healthcare.
Moderates worried about Medicaid
In the Senate, several more moderate Republicans have concerns about changes the House bill makes to Medicaid.
Republicans Sens. Rob Portman (Ohio), Shelley Moore Capito (West Virginia), Cory Gardner (Colorado), and Lisa Murkowski (Alaska) sent a letter to Senate Majority Leader Mitch McConnell this week, saying they would oppose any bill that "does not include stability for Medicaid expansion populations or flexibility for states."
A fight over women's healthcare
There will definitely be a battle over women's healthcare in the Senate. The House bill includes language that would defund Planned Parenthood and other clinics that provide abortions for one year.
Murkowski said earlier this month that she would not support a bill that defunds Planned Parenthood and Sen. Susan Collins (R-Maine) opposed that provision in the 2015 GOP healthcare bill.
Moving too fast
Both hard line conservatives and moderates say the bill is being pushed through too quickly. The House Ways and Means and Energy and Commerce committees introduced the plan on Monday and will hold votes on the bill this week.
The Congressional Budget Office has yet to release a score for the bill to predict how much it would cost to implement and how many people would gain or lose coverage.
It's just the first step
But experts on the plan and architects of the bill say this is just the first step in a long process to replace Obamacare.
"I think there's going to be a lot of wiggle room on almost any issue you can think of," said John Hart, editor-in-chief of Opportunity Lives and an adviser to the One Nation Health Coalition.
"It's a mixture of posturing, it's a mixture of principled disagreement," said Hart, a former staffer for Republican Rep. Tom Coburn.
Hart added that some of the disgruntled lawmakers are trying to save face ahead of midterm elections.
"There's been some dysfunction on our side for the past few years. What I call the RINOs or the rebels in name only, who always play conservative one-upsmanship with everybody. It's the 'please don't primary me' caucus. They're afraid that if they're not sufficiently conservative they're going to have somebody run against them on the right.
The road ahead
It will take a lot of jockeying on the part of GOP leaders to get the caucus on board with their plan, and a lot of compromise.
If Republicans lose more than 21 votes in the House or more than 2 in the Senate, the bill won't pass. Democrats are showing no signs of support.
House Speaker Paul Ryan on Tuesday told reporters he is confident that the bill will have the 218 votes it needs to pass when it goes to the House floor.
President Trump supports the House plan and is sure Paul and others will "come along" to it.