Rep. Greg Walden, R-Ore. (Photo: House Energy)

(Bloomberg) — Some House Republicans are pushing back against pressure from the Trump administration to jump aboard its latest version of a GOP health budget bill.

Part of their frustration is with the piecemeal nature of this week’s negotiations, which have been led by the White House and were mostly directed at the conservatives who blocked the American Health Care Act bill last month.

The AHCA bill would change the effects of the Affordable Care Act by modifying or eliminating many ACA tax and spending provisions.

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Jim Renacci, a Republican member of the Ways and Means Committee, had supported the previous version of the bill, which was pulled from a floor vote, despite some reservations about its contents. Now he says he’s withholding support until he sees the outlines of the most recent changes, which were presented to some members Monday night by Vice President Mike Pence.

“I’m a big believer in the process, I’m a big believer in hearings, I’m a big believer in having the authorizing committees to have the opportunities, as well as members from outside, to hear what’s going on, and that process will actually bring a better resolution,” Renacci said. “We have actually broken that process, with no hearings.”

Pence is scheduled to meet Tuesday evening with several Republican lawmakers from moderate and conservative groups to determine the next steps, with some members pushing for a vote this week and others angling for more time to evaluate the latest version.

Republicans are still reeling from the embarrassing collapse of their effort to change the ACA, and the Trump administration is trying to find a path forward after earlier declaring an end to the effort. Lawmakers are scheduled to leave Washington Friday for a two-week recess, and some are expecting to face town halls with concerned constituents.

The new Trump administration version of the health bill would allow states to apply for waivers granting exemptions from some ACA requirements. Those changes could allow states to charge higher rates to sick people, several lawmakers said.

“The president would like to see this done,” White House spokesman Sean Spicer said Tuesday. He said he wasn’t seeking to raise expectations about a possible deal but added, “We feel very optimistic about the tone” of the discussions.

Mark Amodei, a Republican from Nevada, said he would have preferred holding hearings with industry representatives before voting on the bill so that members could better understand how their districts would be impacted. He said he doesn’t even know what to tell his constituents or the insurance commissioner, companies and exchange administrators that operate in his state, because there has been no opportunity to discuss the merits of the bill with experts.

“I’ll look at whatever they come out with,” Amodei said. “I don’t know what the latest iteration of the bill is.”

Republicans, including Mark Meadows of North Carolina, who chairs the conservative House Freedom Caucus, had said they expected to see text of the new bill as early as Tuesday night. But it’s unclear if that timetable will be met.

“I still hope so. I’m getting less optimistic by the hour,” Meadows said.

House Energy and Commerce Chairman Greg Walden of Oregon said lawmakers were still working on the measure.

“We’re trying to distill those discussions down into a little more specificity and we’ll see what that might look like in legislative language but we don’t have all that yet,” he said.

Meadows said that conservatives are trying to get to a yes on the bill, and they are willing to sacrifice part of the upcoming two-week recess if necessary.

“I think for many of us, we’re willing to either come back, or stay in session, if we are close,” said Meadows. “And so hopefully, we’ll get this done so that it doesn’t create any further objections over a long recess.

— Read GOP Seeks Way to Pay Insurers So More Don’t Drop ACA Plans on ThinkAdvisor.

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