The House Ways and Means Committee on Thursday advanced GOP legislation to repeal and replace ObamaCare on a party line vote, moving the process forward even as the bill faces headwinds. 
 
 Republican leaders are pushing forward with the process on a fast timetable, even as many conservatives strongly object to the bill, known as the American Health Care Act, and centrists harbor their own reservations. 
 
 The committee markup lasted over 16 hours, stretching until after 4 a.m. Thursday before the measure was approved, 23-16. Republicans blamed Democrats for purposely dragging the process out with a range of amendments. The measure now goes to the House Budget Committee, with plans for a vote in the full House within weeks. 
 
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 Democrats said Republicans were wrongly advancing the bill in the middle of the night. The House Energy and Commerce Committee, meanwhile, was still going, working through the night. 
 
 “Here were are at almost 2 o’clock in the morning taking a vote when the American people have gone to sleep,” said Rep. Richard Neal (D-Mass.), the Ways and Means Committee’s top Democrat. 
 
 Democrats were generally more vocal, denouncing a range of measures in the bill, while Republicans voted down amendment after amendment. 
 
 The committee called a markup without a score from the Congressional Budget Office (CBO), meaning lawmakers voted without an analysis of how much the bill will cost or how many people would lose coverage. 
 
 Democrats argued that Republicans wanted to move forward without a score because it would cast a bad light on their healthcare plan. 
 
 "You’re fearful the CBO will provide answers to questions that you don’t like," said Rep. Sandy Levin (D-Mich.). 
 
 House Ways and Means Committee Chairman Kevin Brady Kevin Patrick BradyTrump gets recommendation for steep curbs on imported steel, risking trade war Business groups pressing for repeal of ObamaCare employer mandate Watchdog: IRS issued bonuses to employees with conduct issues MORE (R-Texas) pushed back on Democratic concerns about the markup occurring without a CBO score. 
 
 "We expect CBO to have a thoughtful, thorough, comprehensive score to us before this recommendation goes to the Budget Committee, comes to the House floor," he said. 
 
 Republicans also pushed aside a Democratic amendment aimed at highlighting the "Trump promise" that everyone would have health insurance under a GOP plan. 
 
 The amendment from Rep. Earl Blumenauer Earl BlumenauerSessions' war on marijuana a handout for illegal operators Fox's Wallace: 'It's a mistake' for Dems to boycott State of the Union WHIP LIST: Dems boycotting Trump’s State of the Union MORE (D-Ore.) would have prevented the GOP ObamaCare replacement bill from taking effect until the CBO ensured that the bill would provide health insurance for "all taxpayers and their dependents." 
 
 The amendment was an attempt to draw attention to President Trump's comment in January to The Washington Post that a GOP plan should provide "insurance for everybody." 
 
 Republicans acknowledge that their bill will cover fewer people than ObamaCare but say that it is not trying to compete with the health law, which includes a mandate requiring coverage. 
 
 Republicans sidelined the amendment on parliamentary grounds, saying that it was not germane, as they did with a range of other Democratic amendments. Blumenauer said lawmakers should "give the American people the 'Trump guarantee.'" 
 
 Later, Rep. Lloyd Doggett (D-Texas) held up Trump’s quotation on a poster. 
 
 Republicans blamed Democrats for dragging out the process with off-topic amendments. 
 
 Democrats denounced Republicans for repealing a pair of ObamaCare taxes on high-income people. Levin asked “how this isn’t a boondoggle for the very wealthy while really assaulting the interests of typical middle class families.” 
 
 Rep. Peter Roskam (R-Ill.) defended the repeal of one of the taxes, on investment income. “If investment is good, then why are we raising taxes on investment?” he said. 
 
 Democrats noted that the repeal of the higher Medicare taxes on high earners is projected to reduce the expected solvency of the Medicare trust fund by three years. 
 
 More broadly, Brady praised repealing all of the ObamaCare taxes. “Do you want all these taxes on people, or do you want affordable healthcare?” he said. 
 
 Levin also criticized the new Republican tax credit for failing to give enough help to low-income people, citing a Kaiser Family Foundation study that found the new credit would provide an average of 36 percent less help than the assistance under ObamaCare. 
 
 Democrats offered a range of other amendments, including to prevent enactment of the bill if it was found to raise out of pocket health costs and to allow states to choose to keep ObamaCare, among other issues. 
 
 Doggett unsuccessfully offered a motion to delay the Ways and Means markup until next week, arguing that the bill is a "legislative surprise package" released just two days before the committee vote. 
 
 "If you have nothing to hide, a week will not impair your effort," he said. ||||| (The Washington Post) 
 
 President Trump is pushing Congress toward another dramatic showdown over the Affordable Care Act, despite big outstanding obstacles to a beleaguered revision plan and a high-stakes deadline next week to keep the government running. 
 
 The fresh pressure from the White House to pass a revision was met with skepticism by some Capitol Hill Republicans and their aides, who were recently humiliated when their bill failed to reach the House floor for a vote and who worry now that little has changed to suggest a new revision would fare any better. 
 
 The effort reflects Trump’s sense of urgency to score a victory on Obamacare replacement and move on to other legislative objectives, notably tax restructuring. Passing an Affordable Care Act revision would also allow the president to show progress toward a major campaign promise as he completes his first 100 days in office. 
 
 “The plan gets better and better and better, and it’s gotten really good, and a lot of people are liking it a lot,” Trump said at a news conference Thursday. “We have a good chance of getting it soon. I’d like to say next week, but we will get it.” 
 
 Congressional Republicans also worry that they must attract Democratic support to fund the government past the month’s end — a step they must take by midnight April 28 to avoid a shutdown. That could become difficult if Democrats grow alienated by the effort to alter former president Barack Obama’s key domestic policy achievement, which some White House officials said they hope will come up for a vote as early as Wednesday. 
 
 (Reuters) 
 
 Several congressional GOP aides, who spoke on the condition of anonymity to talk openly about the ongoing negotiations, said they worry that the rushed process threatens to create another embarrassing public failure over health care. The schedule would also make it nearly impossible for lawmakers to finish their work in time for official scorekeepers to provide a clear estimate of how much the legislation would cost or how it would affect coverage numbers. 
 
 House GOP aides in Washington worked furiously to scale back expectations for a quick vote on the legislation, citing the fact that lawmakers have not been fully briefed on the discussions. There was no deadline for finishing the legislation as of Thursday evening, and GOP leaders have not committed to plans for a Wednesday vote, according to one House GOP leadership aide. 
 
 The fresh hopes for resuscitating the American Health Care Act are pegged to an amendment being offered by Rep. Tom MacArthur (R-N.J.) that aims to attract enough conservatives and moderates that the measure can pass in the House. White House officials said language would be circulated among members in the next few days, and the modifications will be discussed Saturday in a conference-wide call as Republicans prepare to return to Washington next week. 
 
 The MacArthur amendment would allow states to obtain permission from the federal government to write their own list of essential health benefits and allow insurers to charge people with preexisting conditions higher premiums, as long as they also make a high-risk pool available to those patients — a change conservatives have demanded. 
 
 As a concession to moderates, the amendment would also add back federal requirements for essential health benefits, which the measure’s current version instead leaves up to states. 
 
 House leadership and committees are taking a secondary role in the negotiations, which are being largely carried out by MacArthur, head of the moderate Tuesday Group, and Rep. Mark Meadows (R-N.C.), chairman of the conservative House Freedom Caucus. Members from both groups had balked at voting for the bill last month, forcing leaders to pull it from the floor at the last minute. 
 
 Meadows was silent Thursday on whether he supports the proposed changes. 
 
 Apart from the publicly embarrassing struggle to reach consensus on an Affordable Care Act revision, some Republicans are also uncomfortable with refocusing on health care just as they are trying to build goodwill with Democrats to pass a stopgap budget plan to keep the government open past April 28. 
 
 Republican leaders have already admitted that they are unable to craft a spending bill that can appease the far-right flank of the GOP, and they have turned to Democrats to deliver votes instead. Democrats have so far been willing to work with Republicans to avoid a government shutdown, but any effort to schedule a vote to repeal the Affordable Care Act could destroy those talks and threaten a government shutdown that Republicans have vowed to avoid. 
 
 “There isn’t going to be a warm, fuzzy feeling,” House Democratic Caucus Chairman Joseph Crowley (D-N.Y.) said of the impact a health-care repeal effort would have on spending talks. 
 
 Congress has five days next week to pass a spending bill, a tight timeline under the most generous of circumstance that would be nearly impossible to meet if House leaders also try to force a vote on the repeal legislation. Several Republican and Democratic aides said there is a chance that both parties could agree to pass a very short-lived spending bill — one that kept the government open one week, for instance — to give negotiators time to carefully complete a broader spending agreement. But Democrats are already warning that they could walk away if GOP leaders push for repeal. 
 
 “It doesn’t really bode well in terms of negotiating with us that they’re going to try to push off the vote on the [spending bill] to accommodate them on a bill we think is disastrous,” Crowley said. 
 
 Asked whether a health-care bill or funding the government should be Congress’s top priority next week, Trump said Thursday that he believes both could get done. 
 
 “I think we want to keep the government open, don’t you agree?” Trump said. “So I think we’ll get both.” 
 
 Trump’s position on a health-care overhaul appears to have shifted in the weeks since the House GOP’s proposal, called the American Health Care Act, failed last month. Then, the president indicated that he was ready to move on to his next priorities, notably tax reform. 
 
 Now, Trump is bringing a new urgency to the task of delivering one of his central campaign promises. Additionally, with the 100-day mark of his presidency approaching, he and his senior aides are eager to show a concrete legislative achievement. 
 
 Trump would like to show progress on health care by Day 100 of his administration but is not overly concerned about the exact day a bill might pass the House, said a senior administration official, who was not authorized to speak publicly and spoke on the condition of anonymity. The official acknowledged that House passage of a bill next week is ambitious and said prospects will be clearer once more members have had an opportunity to review the legislative language. 
 
 The confirmation of Neil M. Gorsuch to the Supreme Court — after Republican senators used a rule change to muscle the nomination through — remains Trump’s sole major accomplishment on Capitol Hill as the 100-day mark nears. 
 
 His ambitious legislative agenda has been stalled by divisions within the White House and among Republicans in Congress, despite their control of both chambers. 
 
 As a candidate for president, Trump promised that he would work with Congress to pass legislation that would dramatically cut taxes, spur $1 trillion in infrastructure investments, significantly expand school choice and make it easier to afford child care. And he promised he would get started on all that — and six other pieces of legislation — in his first 100 days, according to a “Contract with the American Voter” released shortly before Election Day. 
 
 The only one of those 10 legislative items introduced to this point is the House health-care bill, which Trump embraced. 
 
 While the Gorsuch confirmation buoyed conservatives both on and off Capitol Hill — providing a taste of victory — the manner in which it was rammed through further poisoned Trump’s relationships with Democrats, whose support he’ll need on many of his other initiatives. 
 
 Meanwhile, White House Office of Management and Budget Director Mick Mulvaney said Thursday that the White House would be open to funding some Democratic priorities — potentially including paying insurance subsidies as part of the Affordable Care Act — if Democrats would agree separately to fund parts of the White House’s agenda in upcoming budget talks. 
 
 Mulvaney’s comments suggested that the White House could try to use the Obamacare subsidy payments as leverage to extract funding to create a wall along the U.S.-Mexico border. 
 
 “This is the first real test of whether the Democrats, specifically in the Senate, are interested in negotiating, interested in compromising,” Mulvaney said. 
 
 Meadows and MacArthur are gauging their members’ support for the proposed changes, according to aides and lobbyists. Moderate Republicans worry about depriving consumers of certain health-care benefits, and some conservatives say they think the GOP plan leaves too much of the Democrats’ health-care law in place. 
 
 Yet some moderates said Thursday that they view the MacArthur amendment as more of a concession to conservatives, as it would allow states to opt out of some of the Affordable Care Act’s insurance regulations they view as crucial. 
 
 “I don’t think the Tuesday Group has discussed, approved or has prior buy-in,” said one senior aide to a moderate Republican House member. “I don’t see how this gets either the Freedom Caucus or the Tuesday Group.” 
 
 [Republicans try to revive health-care effort as leaders seek to temper expectations] 
 
 [Trump delivers ultimatum to House Republicans: Pass health-care measure on Friday or he’ll move on] 
 
 Robert Costa and Damian Paletta contributed to this report. 
 
 Read more at PowerPost ||||| Senate Republican leaders on Thursday unveiled a revised version of their bill to repeal and replace ObamaCare as they race toward a high-stakes vote next week. 
 
 
 
 The measure includes changes intended to win over additional votes, with leadership making concessions aimed at bringing both conservatives and moderates on board. (READ THE BILL HERE.) 
 
 
 
 But Senate Majority Leader Mitch McConnell Addison (Mitch) Mitchell McConnellTrump dismissed warnings from GOP leaders that party could lose House: report Gender and race shouldn't define your politics Trump’s budget chief talks spending clawback with key chairman MORE (R-Ky.) is facing a tough task in finding enough votes to pass the bill. Sens. Susan Collins Susan Margaret CollinsHow long must women wait? Senators hope Trump's next VA pick will be less controversial GOP moves to cut debate time for Trump nominees MORE (R-Maine) and Rand Paul Randal (Rand) Howard PaulPompeo vote won’t guarantee Democrats a win in November Overnight Defense: Uncertainty for VA after Trump pick withdraws | Veterans groups hope for more input | Pompeo confirmed as secretary of State | Mattis defends Iran deal as Trump deadline nears Overnight Cybersecurity: DHS chief eyes new ways to bolster cyber workforce | Dems grill Diamond and Silk | Senate panel approves bill to protect Mueller | Two-thirds of agencies using email fraud tool MORE (R-Ky.) appear to be firmly against the measure, and one other defection would kill the bill. 
 
 
 
 
 
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 Overall, McConnell appears to have shifted the revised bill more toward the conservatives than the moderates.Importantly, the bill largely keeps the Medicaid sections the same, meaning that deeper cuts to the program will still begin in 2025, and the funds for ObamaCare’s expansion of Medicaid will still end in 2024.The changes to Medicaid have emerged as a top concern for moderates such as Sens.(R-Ohio),(R-W.Va.) and(R-Alaska).The Congressional Budget Office (CBO) found that those Medicaid changes in the original bill would result in 15 million fewer people being enrolled in the program and cut spending by $772 billion over 10 years. 
 
 Collins said she still plans to vote against a motion to proceed to the bill, adding that the legislation should move through the normal committee process. 
 
 "My strong inclination and current intention is to vote no on the motion to proceed," Collins told reporters after leaving a briefing on the legislation. 
 
 "The only way I'd change my mind is if there's something in the new bill that wasn't discussed or that I didn't fully understand or the CBO estimate comes out and says they fixed the Medicaid cuts, which I don't think that's going to happen." 
 
 
 
 For the conservatives, the measure includes a version of an amendment from Sens. Ted Cruz Rafael (Ted) Edward CruzBritish toddler at center of legal battle dies after taken off life support Kushner expected to attend opening of Jerusalem embassy: CNN Handholding with South Korea aside, North Korea still has its nukes MORE (R-Texas) and Mike Lee Michael (Mike) Shumway LeeOvernight Cybersecurity: DHS chief eyes new ways to bolster cyber workforce | Dems grill Diamond and Silk | Senate panel approves bill to protect Mueller | Two-thirds of agencies using email fraud tool The Hill's 12:30 Report Senate panel approves bill to protect special counsel MORE (R-Utah) aimed at allowing insurers to offer plans that do not meet all of ObamaCare’s regulations, including those protecting people with pre-existing conditions and mandating that plans cover certain services, such as maternity care and mental healthcare. 
 
 
 
 Conservatives argue the change would allow healthier people to buy cheaper plans, but moderates and many healthcare experts warn that premiums would spike for the sick people remaining in the more generous insurance plans. 
 
 Cruz said he will support the bill so long as the provisions he sees as a priority are not changed in amendment votes on the floor. 
 
 "If this is the bill, I will support this bill," Cruz told reporters after a meeting of GOP senators. "Now, if it’s amended and we lose the protections that lower premiums, my view could well change." 
 
 Senate Republicans had vowed to not change the ObamaCare protections for people from being charged more based on their health in their bill, which is why the debate over the Cruz-Lee amendment has been heated. 
 
 A Senate GOP aide said Thursday it is possible that the Cruz amendment would not be analyzed by the CBO in time for the vote next week. It is possible the Department of Health and Human Services could provide an alternative analysis. 
 
 Lee cautioned that he was not involved in the changes to the proposal, including the amendment, and would have to review the new language before deciding whether to support it. 
 
 The bill does include new funding, $70 billion over seven years, aimed at easing costs for those sick people remaining in the ObamaCare plans. 
 
 However, the new measure does not boost the generosity of the tax credits, as some moderates wanted. It still replaces ObamaCare’s tax credits to help people afford insurance with a smaller, scaled-down tax credit that provides less assistance. 
 
 The Kaiser Family Foundation found premium costs would increase an average of 74 percent for the most popular healthcare plan, given the reduced assistance in the GOP bill. 
 
 The new measure will leave in place two ObamaCare taxes on the wealthy, in a departure from the initial bill. 
 
 That original measure lacked the support to pass, as more moderate members pointed to the CBO's finding that 22 million fewer people would have insurance over a decade. 
 
 Senate Republicans are now awaiting a new score of the revised legislation from the CBO, which could come early next week. 
 
 The new bill does include $45 billion to fight opioid addiction, but moderates such as Capito and Portman who hail from states where the problem is rampant have said they also want changes to the Medicaid portion of the legislation. 
 
 Portman said his position on the bill had not changed, but he did not give a clear answer on whether he'd back his party on the procedural vote. 
 
 “I'm the same position I've been in. I'm looking at the language,” he said. 
 
 Capito also said she doesn’t know whether she’ll vote to proceed to the bill. 
 
 “We have another meeting this afternoon on the Medicaid cuts,” she told reporters. “I need to really look at it, look at the score; I still have concerns.” 
 
 Asked if she would vote for the motion to proceed next week, she said, “Wait and see.” 
 
 In a change that could appeal to Murkowski, the bill sets aside 1 percent of the stability funds for states with costs that are 75 percent above the national average, which would benefit high-cost states like Alaska. 
 
 — This story was updated at 3:15 p.m. Alexander Bolton contributed. ||||| WASHINGTON (Reuters) - The top U.S. doctors’ organization and several hospital groups came out strongly on Wednesday against a Republican plan backed by President Donald Trump to overhaul America’s healthcare system, as Democrats mounted a fierce battle to thwart the bill. 
 
 Two House of Representatives committees debated the plan late into the night, two days after the proposals were unveiled by Republican leaders. The legislation aims to repeal and replace the Obamacare law, which Republicans call a government overreach that has ruined healthcare in the United States. 
 
 Trump and fellow Republicans in Congress campaigned last year on a promise to dismantle the signature domestic policy achievement of Democratic former President Barack Obama. 
 
 However, they face resistance from conservatives in their own party who have condemned the bill as too similar to the law it is meant to supplant. Democrats, meanwhile, have denounced it as a gift to the wealthy that will take insurance away from millions of people. 
 
 “What they’re doing is very destructive. ... It represents the biggest shift of money to the wealthiest people in our country, the top 1 percent, at the cost of working families,” House Democratic leader Nancy Pelosi told reporters. 
 
 Doctors and other providers said the bill would probably cause many patients to lose insurance and raise healthcare costs. The American Medical Association urged senior lawmakers in a letter to reconsider drastic changes to Medicaid, the government health insurance program for the poor. 
 
 The AMA, which supported Obamacare, said the replacement of income-based subsidies with age-based tax credits to help people buy insurance would make coverage more expensive, if not out of reach, for poor and sick Americans. 
 
 Obamacare, formally called the Affordable Care Act, enabled 20 million previously uninsured people to obtain coverage, about half through a Medicaid expansion the new bill would end. 
 
 Insurers are worried about the affordability of the tax structure and proposed major changes in Medicaid financing. 
 
 In a letter to Congress, America’s Health Insurance Plans, which represents Anthem Inc and others, indicated that was still a concern, despite many aspects of the draft that would help stabilize the individual insurance market. 
 
 Seven hospital groups, including the American Hospital Association, America’s Essential Hospitals and the Catholic Health Association of the United States, also voiced opposition. They wrote in a letter to lawmakers that the proposal could lead to “tremendous instability” for people seeking affordable medical coverage, including children, the elderly and disabled. 
 
 Republicans control both chambers of Congress and the White House for the first time in a decade. But the bill’s fate is far from certain, with a number of Republican conservatives saying it is not a full repeal and sets up new entitlement programs. 
 
 Speaker of the House Paul Ryan (R-WI) and House Majority Leader Kevin McCarthy (R-CA) speak about the American Health Care Act, the Republican replacement to Obamacare, at the Republican National Committee in Washington, U.S., March 8, 2017. REUTERS/Joshua Roberts 
 
 Trump and Vice President Mike Pence met leaders of conservative groups who have concerns about the bill. 
 
 “I’m encouraged that the president indicated they are pushing to make changes,” David McIntosh from one of those groups, Club for Growth, told reporters after the meeting. 
 
 A White House official said Trump and Pence were “open to constructive improvements that maintain the core principles and get the bill over the goal.” 
 
 “CONSERVATIVE WISH LIST” 
 
 The House Ways and Means Committee, with jurisdiction over taxes, and the House Energy and Commerce Committee, which oversees health issues, kicked off what could become marathon sessions working on the legislation. 
 
 The plan would scrap the Obamacare requirement that most Americans obtain medical insurance and would replace its income-based subsidies with a system of fixed tax credits to coax people to buy private insurance on the open market. 
 
 Trying to mollify skeptics in his party, House Speaker Paul Ryan, an architect of the plan, touted it as “a conservative wish list” and “monumental, exciting conservative reform.” 
 
 Representative Mark Walker, head of the Republican Study Committee (RSC), the largest group of conservatives in Congress, said RSC leaders might support the bill if two changes are made. 
 
 The first, proposed by Representative Joe Barton in the Energy and Commerce Committee, would bring forward the end of enrollment in Medicaid expansion by two years to January 2018. The second would make age-based tax credits for purchasing health insurance partially rather than fully refundable. 
 
 With those changes, “we’d be a hard ‘yes’,” Walker told reporters. 
 
 Democrats were using every procedural maneuver possible to delay the committee work, including demanding votes to adjourn on the House floor. The top Energy and Commerce Committee Democrat, Representative Frank Pallone, called the Republican plan “a prescription for disaster” and said not a single hearing had been held to develop the bill. 
 
 Republicans insisted on committee action even though the nonpartisan Congressional Budget Office (CBO) had not yet done its customary assessment of the cost of the measure and how many people it would cover. 
 
 Slideshow (8 Images) 
 
 White House spokesman Sean Spicer said: “If you’re looking at the CBO for accuracy, you’re looking in the wrong place.” 
 
 Ways and Means Democrats raised questions over the bill’s proposed tax break for insurance company executives, with Representative Lloyd Doggett calling it a “$400 million windfall” for insurance company executives. 
 
 Hospital stocks clawed back some of Tuesday’s losses after the bill’s unveiling. Community Health Systems Inc rose 4.5 percent and Tenet Healthcare Corp gained 1.5 percent. Health insurer shares, including WellCare Health Plans Inc and Aetna Inc, closed moderately higher.
– The GOP's replacement plan for ObamaCare isn't getting a universal thumbs-up, but it cleared one of its first hurdles early Thursday, the Hill reports. In a session that lasted more than 16 hours and went past 4am, the House Ways and Means Committee approved the measure in a 23-16 vote, with Republicans shooting down "off-topic" amendments proposed by Democrats, who in turn accused Republicans of trying to push the bill through while people were asleep and without a Congressional Budget Office analysis of the measure. "You're fearful the CBO will provide answers to questions that you don't like," such as bill costs or revealing who'd lose coverage, Michigan Rep. Sandy Levin said. One of the many bones of contention in the bill: a proposal to cut nearly $1 billion in CDC funding, per CNN. Committee Chair Kevin Brady said a "thoughtful, thorough comprehensive score" was expected before the bill ends up with the House Budget Committee, the next step in advancing the bill. Also pushing back on the controversial measure: groups representing retirees, hospitals, and medical professionals, the New York Times reports. The AARP and American Medical Association spurned the bill Tuesday, and on Wednesday, the American Nurses Association and lobbyist groups for hospitals and other health systems joined in, with the latter also mentioning the CBO's absence as an issue. "We are very concerned" the proposal "could lead to tremendous instability for those seeking affordable coverage," read a letter from the American Hospital Association and others. ABC News looks at the numbers needed to pass the legislation.