Republicans are scurrying to get the 216 votes needed to pass the American Health Care Act in a vote expected later today that could drag out for days.
GOP leaders met until late Wednesday night and continued debate Thursday.
They have yet to count on the 216 votes needed in the House for the bill to repeal and replace the Affordable Care Act to pass.
Conservative Republicans in the Freedom Caucus threaten to veto the bill they call 'Obamacare Lite' if it includes the essential benefits of the ACA, and moderates might walk if the benefits are removed.
Freedom Caucus members said Wednesday essential health benefits are in play, according to ABC News.
But GOP Rep. Charlie Dent, a moderate leader, said Wednesday, "After careful deliberation, I cannot support the bill and will oppose it. I believe this bill, in its current form, will lead to the loss of coverage and make insurance unaffordable for too many Americans, particularly for low-to-moderate income and older individuals. We have an important opportunity to enact reforms that will result in real health care transformation--bringing down costs and improving health outcomes. This legislation misses the mark."
The essential benefits provision of the Affordable Care Act is supported by providers and those who say that without it, insurers could cherry-pick healthy, young consumers in a move that would undermine the industry.
"Their latest concession - eliminating common sense requirements that private plans provide a minimum package of essential benefits - would make this damaging bill even worse," said Bruce Siegel, MD, CEO of America's Essential Hospitals. "It could leave countless people with too little coverage to meet their health care needs and drive higher rates of uncompensated care at hospitals already struggling to cover their costs."
Advocates of getting rid of the provision say having to provide essential benefits drives up the cost of insurance, and some of its benefits, such as maternity care, are useless to many beneficiaries.
Insurers are currently required to offer essential benefits to cover basic services such as prescription drugs, maternity, substance abuse, mental health, laboratory and diagnostic tests, preventative care, and dental and vision services for children.
The final vote on the American Health Care Act is expected Thursday but could be delayed until House Speaker Paul Ryan knows he has the votes. The bill could also be pulled if he can reach no compromise with members of his party.
Ryan and his top deputies reportedly huddled with a group of moderate Republicans in the Speaker's office Wednesday night, according to ABC.
Meanwhile, the Koch brothers have promised funding the advertising campaigns of Republicans, when they come up for reelection, who vote against the bill.
Charles G. Koch and David H. Koch are brothers with Koch Industries and are affiliated with the Koch family foundations and the nonprofit Americans for Prosperity and Freedom Partners.
President Trump tweet on the @POTUS account Thursday, "You were given many lies with #Obamacare! Go with our plan! Call your Rep & let them know you're behind #AHCA."
Trump and Ryan must get 216 Republicans on board for the bill to pass by simple majority in the House of 237 Republicans and 193 Democrats.