WASHINGTON • After seven years of waiting longingly to annul President Barack Obama's signature healthcare law, Republican leaders faced a sudden revolt from the right that threatened their proposal to remake the United States healthcare system.
The much-anticipated House plan to repeal the Affordable Care Act also drew scepticism from some of the party's more moderate members, whose constituents have benefited from expanded coverage in recent years.
The criticism on Tuesday came even before lawmakers knew the cost of the replacement plan and how many people might lose their healthcare if it were enacted.
House Republicans were rushing the legislation through two powerful committees - Ways and Means, and Energy and Commerce - with the hope of a full House vote next week.
It is an extraordinarily compressed time frame given that the legislation affects many parts of the US economy and could alter the healthcare of millions.
This is not the Obamacare repeal Bill we've been waiting for. It is a missed opportunity and a step in the wrong direction. We promised the American people we would drain the swamp and end business as usual in Washington. This Bill does not do that.
REPUBLICAN SENATOR MIKE LEE
PROMISE OF CHANGE
Doing big things is never easy. The nightmare of Obamacare is about to end.
HOUSE SPEAKER PAUL RYAN
House Republicans are rushing the legislation through two powerful committees - Ways and Means, and Energy and Commerce - with the hope of a full House vote next week.
But the swift opposition from fellow Republicans signalled that they might have to drastically reconsider their approach.
If more than a dozen House Republicans defect, the Bill will be in jeopardy, with Democrats almost certainly united as a bloc.
"Doing big things is never easy," House Speaker Paul Ryan conceded at a news conference after absorbing broad-based criticism of the Bill.
Still, he guaranteed he would drum up the 218 votes needed for passage, saying: "The nightmare of Obamacare is about to end."
Some White House officials say President Donald Trump will be directly engaged in persuading lawmakers to back the Bill.
But many factions that provided financial and political support to back Republicans who vowed to wipe out the Affordable Care Act are nowhere near satisfied with the option rolled out on Monday.
These powerful conservative groups include the Club for Growth, Heritage Action for America and Charles G. and David H. Koch's Americans for Prosperity.
"This is not the Obamacare repeal Bill we've been waiting for," said Republican Senator Mike Lee. "It is a missed opportunity and a step in the wrong direction. We promised the American people we would drain the swamp and end business as usual in Washington. This Bill does not do that."
The Republican Bill would scrap the mandated coverage in Mr Obama's Affordable Care Act in favour of tax incentives to coax people to purchase healthcare.
However, the legislation maintains many of the Act's mandates and basic benefits, including prohibiting insurance companies from denying policies for pre-existing conditions or capping benefits in a year or a lifetime.
Some conservatives have labelled the House plan "Obamacare lite", saying it is nearly as intrusive in the insurance market as the law it would replace.
Republicans have been counting on Mr Trump to use his influence to persuade wavering members to support the plan.
But despite his characterisation of the Bill as "tremendous" on Tuesday, others in his administration seemed to concede that changes, perhaps major ones, were likely.