Washington (AFP) - Donald Trump has thrown his full weight behind a contested plan to replace Obamacare, battling to overcome resistance from his Republican Party's right wing and meet a key campaign pledge 50 days into his presidency.
With Democrats united against the new health care plan, Trump can ill afford defections from within as he seeks to drive home the top legislative priority of his new administration.
While the bill winds its way through Congress this month, Trump is using his bully pulpit, powers of persuasion, and deal-making savvy in a bid to salvage the controversial plan.
He met Friday with senior congressional Republicans to discuss the way forward on the repeal and replacement of Barack Obama's signature health care law.
"We must act now to save Americans from the imploding Obamacare disaster," Trump said as he sat down with the lawmakers. "This is the time we're going to get it done."
The president has spent much of the week huddling with key health care players, including Republicans who support and oppose the bill, known as the American Health Care Act.
On Wednesday, he hosted several conservative groups that have expressed concerns about how the plan to use tax credits for people to buy insurance on the free market is too similar to the subsidies in Obamacare.
Trump will send Vice President Mike Pence to talk up the bill Saturday in Kentucky -- an arm-twisting gesture of sorts as Kentucky's Senator Rand Paul is one of the plan's chief Republican critics.
With some conservatives like Paul warning that the bill will not pass Congress without significant changes, the president has signalled his openness to "negotiation."
At the heart of the debate, Trump wants to repeal Obama's landmark reforms and remove the federal government from its role as health care architect, while maintaining the high levels of coverage for Americans entitled to Obamacare.
Trump has stated he ultimately wants a plan in place that allows for "insurance for everybody."
- 'Binary choice' -
The chief champion of the plan in Congress, House Speaker Paul Ryan, claimed that millions of US taxpayers would benefit from a rollback of Obamacare's subsidy system.
In a rolled-up-sleeves presentation Thursday, Ryan also sounded a clear warning to Republicans who are considering defying the president.
"This is the closest we will ever get to repealing and replacing Obamacare," the charismatic 47-year-old said, describing the path forward as "a binary choice" between reform and the status quo.
House Republican Steve Scalise reiterated the us-versus-them approach Friday on CNN.
"Members are going to have to pick a side: (House Democratic leader) Nancy Pelosi or President Trump," Scalise said.
Polls show that Obama's Affordable Care Act, which helped 20 million Americans gain coverage, remains popular. About half of those people are covered through Obamacare's expansion of Medicaid, the insurance program for the poor.
Under the new plan, that expansion will be phased out by 2020. Some conservatives have said they want a quicker rollback of the expansion, which they view as an unnecessary government entitlement.
The administration is treading carefully on the delicate issue, given that 31 of the 50 states, including several with Republican governors, accepted federal funds to expand Medicaid.
Trump is "willing to listen" to different options, White House spokesman Sean Spicer said.
Several health-related interest groups, including the American Medical Association, are opposed to the Republican substitute, fearing millions could lose their coverage.
According to The Washington Post, citing figures from New York University research, the plan would strip away vital drug addiction or mental health treatment benefits from up to 1.3 million people.
- How much will it cost? -
The new legislation's cost remains a major unknown. Next week the Congressional Budget Office is expected to release its "score" on the bill's costs and the estimate on how many people who could lose or gain coverage.
A preliminary analysis by Standard & Poor's estimated that between six million and 10 million people could lose coverage under the Republican plan.
With Ryan urging his foot soldiers in Congress to gird for battle, some Republicans are warning against taking a page out of Obama's playbook to ram health policy through with no bipartisan support.
Ohio Governor John Kasich, who challenged Trump for the Republican presidential nomination, said it was time to end the "partisan warfare" on health care.
"True and lasting reform of the health insurance system must be accomplished by bringing the two sides together, not by replacing one divisive wedge with another," Kasich wrote in Friday's New York Times.