WASHINGTON — Their health care overhaul imperiled from all sides, the White House and top House Republicans acknowledged Wednesday they would make changes to the legislation in hopes of nailing down votes and pushing the party’s showpiece legislation through the chamber soon.
House Speaker Paul Ryan declined to commit to bringing the measure to the House floor next week, a fresh indication of uncertainty. Republican leaders have repeatedly said that was their schedule, but opposition mushroomed after a congressional report concluded this week that the measure would strip 24 million people of coverage in a decade.
Ryan, a Wisconsin Republican, told reporters that GOP leaders could now make ‘‘some necessary improvements and refinements’’ to the legislation, reflecting an urgency to buttress support. The measure would strike down much of former president Barack Obama’s 2010 overhaul and reduce the federal role, including financing, for health care consumers and is opposed uniformly by Democrats.
‘‘We’re going to arbitrate, we’re all going to get together, we’re going to get something done,’’ President Trump promised a crowd at a rally in Nashville.
At an all-hands meeting Wednesday evening of House GOP lawmakers, Vice President Mike Pence and party leaders urged their rank-and-file to rally behind the legislation.
‘‘ ‘It’s our job to get it out of here and get it to the Senate,’ ’’ Pence told the Republicans, according to Representative Dennis Ross of Florida. That would let Trump pressure ‘‘Democrats in these red states to come on board,’’ Ross said, referring to Republican-leaning states where Democratic senators face reelection next year.
Health secretary Tom Price was using phone calls to lobby Republican governors, some of whom — with home-state GOP members of Congress — oppose the bill’s phase out of Obama’s expansion of Medicaid to 11 million additional lower-income Americans.
Amid the maneuvering, a government report said more than 12 million people have signed up for coverage this year under the very statute that Trump and congressional Republicans want to repeal. With Democrats uniformly opposing the Republican bill, that figure underscored the potential political impact of the GOP’s next move.
Pence met repeatedly Wednesday with House Republicans, but GOP rebels still abounded. Conservatives were unhappy the measure doesn’t erase enough of Obama’s law while at the other end of the party’s spectrum, GOP moderates were upset that the Republican bill would strip millions of health coverage.
Conservatives want to end Obama’s expansion of Medicaid to 11 million additional low-income people next year, not 2020 as the Republican bill proposes. They say a GOP proposed tax credit to help people pay medical costs is too generous, and they want to terminate all of Obama’s insurance requirements, including mandatory coverage of specified services like drug counseling.
Underscoring the push-pull problem GOP leaders face in winning votes, moderates feel the tax credits are too stingy, especially for low earners and older people. They oppose accelerating the phaseout of the Medicaid expansion and are unhappy with long-term cuts the measure would inflict on the entire program.
In a new complication, Senator Charles Grassley, an Iowa Republican, said the measure lacked the votes to pass in the Senate, where Republicans hold a precarious 52-48 majority.
That left House moderates angry over being asked to take a politically risky vote for legislation that seems likely to be significantly altered.
Moderates ‘‘don’t like the idea of taking a vote in the House that may go nowhere in the Senate,’’ said Representative Charlie Dent, a Pennsylvania Republican.
Earlier in the day, Pence told House conservatives that the administration was open to changes.
‘‘He gave us a lot of hope,’’ said Representative Mark Walker, a North Carolina Republican who leads the group that met with Pence.
