JUDY WOODRUFF: The battle over the Affordable Care Act, or Obamacare, is now joined in earnest. Republicans in the House of Representatives pressed forward today, in the face of resistance from Democrats and from inside their own party.
Lisa Desjardins reports from Capitol Hill.
LISA DESJARDINS: It was day one of Republicans’ push to sell their long-awaited replacement plan for the Affordable Care Act, or Obamacare.
Greg Walden chairs the Energy and Commerce Committee and helped author the bill.
REP. GREG WALDEN, R-Ore.: Introduction of this bill is just the first step in helping American families across the country obtain truly affordable health care and we’re eager to get started.
MAN: I encourage you to read the bill.
LISA DESJARDINS: Named the American Health Care Act, Republicans are keeping some and changing some of the Affordable Care Act. The first big change? Medicaid. Obamacare expanded Medicaid to include roughly 12 million more people, lower-income adults. Republicans would end that expansion in 2020, but allow those enrolled at that time to stay on Medicaid.
For the rest of Medicaid, some 55 million people, there is potentially sweeping change. Republicans would move from paying for all health care costs now to setting a limit on spending per person.
Democrats like Kentucky Congressman John Yarmuth are outraged, saying that will cut benefits to millions.
REP. JOHN YARMUTH, D-Ky.: Over the long term, what it’s going to mean is, the people who need the care the most, people who are working hard and need the coverage, will get less of it, and the states will have to shoulder more of the burden.
LISA DESJARDINS: But Republican leaders mounted an all-out offensive, with Vice President Mike Pence visiting senators at the Capitol, and President Trump meeting with House leaders at the White House.
PRESIDENT DONALD TRUMP: I think, really, we’re going to have something that’s much more understood and much more popular than people can even imagine.
LISA DESJARDINS: The largest issue for the Republican bill is what we don’t know. We don’t yet know if this bill will mean fewer people with health insurance. We also don’t know how much anything will cost, including new tax credits.
Those tax credits are another big issue and change. The Affordable Care Act gives direct tax subsidies for low- and middle-income Americans. Republicans would instead give refundable tax credits and rework who gets them. Individuals making under $75,000 would get a full credit based on age, $2,000 dollars for the youngest, increasing to $4,000 for those over 60.
But those tax credits are raising concern from the right. Republican Congressman Dave Brat says the credits are more massive government spending.
REP. DAVE BRAT, R-Va.: Where is it coming from? It’s coming from the federal government. And it’s a new entitlement program. And so for the folks out there, they may not know — go Google it — we have a $100 trillion entitlement problem.
LISA DESJARDINS: He’s not alone. Republican Congressman Justin Amash called the bill Obamacare 2.0 in a tweet. And Kentucky Senator Rand Paul and other Republicans held a news conference to push back.
SEN. RAND PAUL, R-Ky.: We are united on repeal. But we are divided on replacement.
LISA DESJARDINS: That could be a serious issue in the Senate, where the GOP can afford to lose only two votes and still pass their bill without help from Democrats.
But, as some raised doubts, others in the party moved to Answer them, like Health and Human Services Secretary Tom Price.
TOM PRICE, U.S. Health and Human Services Secretary: This is all about patients, and in order to provide that transition and in order to make it so that nobody falls through the cracks, we have got to have a system that allows for individuals to gain the kind of coverage that they want.
LISA DESJARDINS: And House Speaker Paul Ryan insisted that the bill will get the votes it needs in the House.
REP. PAUL RYAN, R-Wis., Speaker of the House: We will have 218 when this comes to the floor. I can guarantee you that.
LISA DESJARDINS: Tomorrow, day two, may be more important, as the bill heads to possible committee votes.
For the PBS NewsHour, I’m Lisa Desjardins at the Capitol.