WASHINGTON _ Moderate Republicans will determine whether the bill to repeal Obamacare makes it out of the House of Representatives in the coming days, as skeptical conservatives are now on board with a health care bill that failed moments before a scheduled vote last month.
An amendment offered earlier this week by New Jersey Republican Rep. Tom MacArthur, a moderate and former insurance executive, gives states the ability to seek waivers that would weaken key parts of Obamacare, including measures that protect people with pre-existing conditions.
The amendment received the backing of the conservative Freedom Caucus, which did not support the bill in March. But moderate Republicans still have reservations.
Florida Rep. Mario Diaz-Balart said the new bill has "lots of red flags." He voted to send the first version of the bill out of the House Budget Committee in March, but isn't sure he'll vote for the current one.
"I'm trying to figure out how this makes the legislation better," Diaz-Balart said. "We're back to square one as far as I'm concerned."
Other Republicans such as Pennsylvania Rep. Charlie Dent, Florida Rep. Ileana Ros-Lehtinen and California Rep. Jeff Denham plan to vote no on the current legislation.
MacArthur acknowledged that his amendment, negotiated with conservative Rep. Mark Meadows of North Carolina, has moved some Republicans from no to yes but has not brought the necessary 216 GOP votes.
"If so, we would have already voted," MacArthur said when asked whether the bill has enough support to pass. "On this particular bill it's going to be an all-Republican effort, and so I see looking at which Republicans we can get to support a compromise that is helpful to move along health care reform, which is desperately needed."
House Speaker Paul Ryan, R-Wis., said Thursday that MacArthur's amendment was a key factor in getting conservative votes.
"I would argue this is a bill that moderates are more likely to support," Ryan said. "Tom MacArthur is a leading moderate in Congress; it's his amendment. It gets to where we all want to go. We want to bring down costs, we want to preserve protections for pre-existing conditions and we want to respect the fact that states have different issues and different health care marketplaces."
A slew of hard-line conservatives such as Meadows and Texas Rep. Louie Gohmert support the current bill.
But at least 18 Republicans are on record opposing the current bill with the amendment as of Thursday afternoon, according to a whip count from The Hill, and dozens more are silent or undecided over the proposal. If 22 Republicans vote against the bill, it will fail.
MacArthur, a co-chairman of the moderate Tuesday Group, made a point of saying that his negotiations with conservative Republicans were done on his own and not on behalf of the coalition of moderates.
"I would never want to put anyone in a difficult spot. That's not my intention, but legislation can be a messy process, as we're seeing," MacArthur said. "I'm not looking at this through a political lens. We have a health care crisis in our country. My home state had six health insurers 18 months ago; now we have two."
Fellow Tuesday Group member Chris Collins of New York, a supporter of President Donald Trump and the Obamacare repeal effort, acknowledged that MacArthur's amendment likely angered some moderates.
"It's probably moved some members from lean yes to lean no," Collins said. "I don't know if it's moved some lean noes to a no."
Collins said Ryan had told members that the bill wouldn't come to the floor until he had the votes. As for a rumored attempt to hold the vote on Saturday _ Trump's 100th day in office _ Collins said members had been "advised to keep ourselves flexible."
He said MacArthur was not speaking for the Tuesday Group and acknowledged there had been "some frustration" over his efforts.
Ryan hedged against the argument that some moderates won't vote for an Obamacare repeal bill because it could hurt their chances of re-election in 2018.
"I think people's seats are at risk if we don't do what we said we would do," Ryan said. "We all campaigned on repealing and replacing this law that has collapsed. If you violate your promise, if you commit the sin of hypocrisy in politics, that's the greater risk for a person's seat."
