WASHINGTON • US Senate Republicans have unveiled a revamped healthcare plan aimed at fulfilling President Donald Trump's pledge to repeal Obamacare, but a revolt within their ranks put the Bill in instant jeopardy.
Democrats formed a united front against the controversial measure that was drafted in secret, criticising it as a "war on Medicaid", the healthcare programme for lower-income Americans, and calling it a worse plan than one that passed the House of Representatives last month.
For the past seven years, Republicans have worked to repeal the landmark health reforms of Mr Trump's Democratic predecessor Barack Obama. Members from both parties agree the repeal effort has never been closer to fruition.
Senate Republicans are painting the new plan as less austere than the House Bill which, according to a forecast by the non-partisan Congressional Budget Office (CBO), would leave 23 million fewer people insured than under current law.
But the 142-page draft would allow states to drop several benefits which are now mandated, such as maternity care and hospital services, and would also abolish the requirement for most Americans to have health insurance.
It, however, delays cuts to the Medicaid programme and maintains for two years the tax credits included in the Affordable Care Act - commonly known as Obamacare - to help lower-income Americans purchase coverage.
"I am very supportive of the Senate #HealthcareBill," Mr Trump tweeted. "Remember, ObamaCare is dead." Senate Majority Leader Mitch McConnell unveiled the Bill at a closed-door session with party faithful on Thursday.
Four Republicans quickly came out in opposition - Mr Ted Cruz, Mr Mike Lee, Mr Ron Johnson and Dr Rand Paul - while at least three more Republicans have openly expressed serious concerns.
That poses a problem for the party leadership. Republicans hold 52 out of 100 Senate seats, so they can afford only two defections; in that case, Vice-President Mike Pence would be brought in to break a 50-50 tie.
Yet Mr Trump remained confident, although he acknowledged that a "negotiation" might be needed to get the Bill passed.
However Mr Obama, whose best-known domestic policy achievement stands to crumble, offered a scathing critique of the new Bill just hours after its release.
He called it "a massive transfer of wealth from middle-class and poor families" to the very rich that would raise costs, reduce coverage, roll back protections and "ruin Medicaid as we know it". Even if the measure is ultimately tweaked through amendments in Congress, it "cannot change the fundamental meanness at the core of this legislation", the former president warned in a Facebook post.
Mr McConnell said a fresh CBO score was expected next week, and there will be "robust debate" on the floor. He said there would be an open amendment process to allow changes, adding that he wants a final vote by the end of the month.
Top Senate Democrat Chuck Schumer called the new Bill "heartless", warning it would eventually cut Medicaid even more steeply than the House legislation, which slashes it by US$800 billion (S$1.1 trillion) over a decade.
The new legislation would eliminate federal funding for Planned Parenthood, a non-profit health organisation that Mr Trump's administration has targeted for cuts because it provides abortion services. But it preserves a key element of Obamacare, which allows parents to cover children under their plan until age 26.