washington u.s. house republicans work change healthcare overhaul bill provide generous tax credit old americans add work requirement medicaid program poor house speaker paul ryan say sunday ryan say republican leaders still plan bring healthcare bill vote house representatives floor thursday speak fox news sunday television program say leaders work address concern raise rank-and-file republicans legislation republicans remain deeply divide healthcare overhaul president donald trump first major legislative initiative aim fulfill campaign pledge repeal replace affordable care act popularly know obamacare signature healthcare program democratic predecessor barack obama democrats say republican plan could throw millions health insurance hurt elderly poor work families give tax cut rich think offer even assistance bill currently lower-income people age 50 64 ryan top republican congress say tax credit health insurance propose legislation ryan also say republicans work change would allow federal block grant state medicaid permit state impose work requirement able-bodied medicaid recipients trump tell reporters brief conversation aboard air force one meet healthcare reform florida weekend effort sell proposal go well woo lawmakers vote bill back dozen conservative lawmakers friday oval office meet president endorse work requirement block-grant option medicaid trump set meet ezekiel emanuel health policy special adviser obama help shape affordable care acton white house monday along ryan health human service secretary tom price block grant would give state set amount money cover people medicaid program provide flexibility spend decisions however guarantee fund would keep future demand ryan say felt good health bill prospect house lead conservative lawmaker representative mark meadows tell c-span newsmakers program currently 40 republican vote house republicans hold majority chamber afford 21 defections measure pass meadows two republican opponents bill senators mike lee utah ted cruz texas meet trump mar-a-lago estate florida saturday negotiate president team try fix bill cruz tell cbs face nation north carolina republican meadows say change consider medicaid program would go far enough leave state decide whether put place work requirement price acknowledge tough negotiations tell abc week fine needle need thread doubt it healthcare bill would face significant challenge senate even pass house senator tom cotton conservative arkansas republican say bill would reduce premiums people private insurance market fixable go take lot work cotton say cnn state union moderate republicans also express concern bill worry often conservatives speak nbc meet press republican senator susan collins maine worry bill would harm old americans shift medicaid cost state something critics say block-grant approach would make bad collins say coverage issue must also deal cite report congressional budget office say 14 million people would lose health coverage house bill next year 24 million next decade affordability one big concern insurers hospital group raise legislation extent change tax credit make healthcare affordable people insurers hospitals could stand benefit bluecross blueshield association emphasize need replacement affordable draft healthcare bill release early month association represent bcbs insurers cover vast majority roughly 10 million people enrol 2017 obamacare plan republicans revamp u.s. health bill boost benefit old americans