Senate Republicans are feeling pressure to pass a health care bill to repeal parts of the Affordable Care Act, and leaders say they are getting closer. This means that the bill can now proceed to the upper chamber for consideration.

And while Republicans sounded more optimistic about the bill's chances coming out of the lunch meeting than going into it, many said they still had a long ways to go.

"I am stunned that that is what Leader McConnell would call regular order, which he sanctimoniously said would be the order of the day when the Republicans took the Senate over". "I'm very encouraged, very encouraged". "I just want them to pass a bill".

Under current matching rules, Nevada would pay $113 million a year to cover those who received Medicaid under the expansion in 2021.

"The House bill has kind of an abrupt cutoff, and we're having a good productive discussion about a glide path to help states get to a point where they can get back to [the lower funding levels] without an abrupt cutoff", Barrasso said. That expansion extended coverage to 11 to 12 million people in 31 states including Ohio, West Virginia, and Nevada. Pushing for a more moderate bill to appease Sens.

But House Appropriations Chairman Cameron Henry, a Metairie Republican who handles the budget in the House, said he won't agree to any deal that involves spending every dollar available as the Senate wants.

GOP leaders told fellow Republicans this week they favor keeping Obamacare's protections against denial of coverage for people with preexisting medical conditions.

McCaskill corrected the senior Senator from Utah, saying she was referring to the bill the Republican Senate is drafting in response to the House's TrumpCare legislation that passed last month.

"It's become painfully clear that Obamacare is failing to live up to its promises", said Senate Majority Leader Mitch McConnell, R-Ky.

He was non-committal about when that would happen. In the event of a 50-50 vote, Vice President Mike Pence would cast the tiebreaker.

For instance, "moderate" Republican senators like Nevada's Dean Heller, Ohio's Rob Portman, and West Virginia's Shelley Moore Capito all claimed they would not support the House's plan to end the Medicaid expansion, but all three of them now support a proposal to phase out Medicaid expansion that shifts the date until after they are re-elected.

Senators are reportedly weighing details about how to address people with pre-existing conditions, how best to phaseout the Medicaid expansion and how to stabilize the insurance market in the first few years of a new law. Rep. Joe Pitre, R-Framingham, said he worries about the potential fallout if the House torpedoes the budget again. Their most prominent spokesman is none other than President Donald Trump, who has roiled the insurance exchanges established under the ACA by hinting that his administration will neither continue to make the subsidy payments insurers have come to depend on nor enforce the individual mandate that requires most Americans, including the youngest, healthiest adults, to buy health insurance.

Uncertainty over the funding is making it hard for insurers to forecast their premiums for next year and some carriers are leaving the industry altogether. They plan no public hearings on the legislation.

"The important thing is, we made sure pre-existing conditions are covered", Yoho said as he chewed a piece of pizza. "The last statewide insurer in the great state of OH is leaving", Trump said.

In that case, he is ready to let the bill fail, bring the health care debate to a definitive end, and get over it.

And so, the CBO could do serious damage to any such GOP tactic by releasing a score of the Senate bill (when it is done) that shines a harsh light on what the bill would actually do.

But even as GOP members attempted to portray Anthem's departure as yet another example of the failure of the health care law, the difficulty Republicans face in overhauling it on a strictly partisan basis was still on full display.