Under the GOP plan, older people who are not yet eligible for Medicare stand to be the biggest losers. It would shrink the tax credits they use to help buy insurance and it would increase their premiums because the bill allows insurers to charge more as people age and become more susceptible to health problems.
A Congressional Budget Office (CBO) analysis last week said a 64-year-old with income of $26,500 would pay $1,700 out of pocket for insurance under Obama's Affordable Care Act, compared with $14,600 under the GOP plan. It estimated that 24 million people of all ages would lose coverage over 10 years.
On Sunday, Ryan said he believed the CBO analysis was not accurate because Obamacare wouldn't be able to last 10 years. But he allowed the additional assistance was one of several House revisions to be discussed in advance of Thursday's vote, along with possible changes to help low-income people more with tax credits and require able-bodied Medicaid recipients to meet work requirements.
"We think that we should be offering even more assistance than what the bill currently does," he said.
Moderate Republicans are balking over the CBO's findings that millions more people would lack coverage even while premiums in many cases could rise.
In the Senate, where Republicans hold a narrow 52-48 majority, prospects for the GOP bill also were uncertain as both moderates and conservatives criticized it.
Sen. Susan Collins, R-Maine, said she would not vote for the measure without additional changes to provide more aid to older Americans. She also wants an improved proposal that would cover more Americans and offer better Medicaid benefits than the current GOP plan. She joins at least four other GOP senators in opposing the bill after conservative Sen. Ted Cruz of Texas said Sunday he wouldn't vote for it as is. Sens. Dean Heller of Nevada, Mike Lee of Utah and Rand Paul of Kentucky are also opposed.
"I cannot vote for any bill that keeps premiums rising," Cruz said.