The U.S. House of Representatives is expected to vote Thursday on a bill to repeal and replace the Affordable Care Act, the health care law commonly known as Obamacare.

House Majority Leader Kevin McCarthy expressed confidence that there is enough support for the measure among Republicans, who have a majority in both the House and Senate, after a similar push failed in dramatic fashion in late March.

“We will pass this bill,” McCarthy said.

Republican leaders, including President Donald Trump, have been working for days to convince lawmakers to vote for party’s health care legislation.

Two prominent moderate Republicans, Representatives Fred Upton and Billy Long, said Wednesday they would support the bill after negotiating an amendment with the White House.The amendment adds to the proposal $8 billion over five years to help people with pre-existing conditions afford coverage. 

Upton, the author of several Obamacare repeal bills since that program was passed in 2010, said their amendment would put “downward pressure” on premium costs. 

Pre-existing conditions

Not allowing insurance companies to deny coverage based on pre-existing conditions was a major part of Obama’s health care program, which brought insurance to about 20 million Americans who previously lacked coverage.Republicans staunchly oppose the program, saying it is too expensive and unfairly forces people to purchase coverage or face a tax penalty.

House Democratic Leader Nancy Pelosi said despite the addition of money to help those with pre-existing conditions, the bill “will make it impossible for millions of Americans to afford the health coverage that they need.”

An analysis by the non-partisan Congressional Budget Office of the original Republican bill estimated 24 million more Americans would be uninsured by 2026, including 14 million by next year.

Pelosi said going ahead with a vote on the current version without a new CBO report on its effects shows Republicans are “terrified of the public learning the full consequences of their plan.”

The Republican bill is called the American Health Care Act, and would repeal most Obamacare taxes, including the penalty for not having coverage, while also slashing funding for the Medicaid program that provides insurance for the poor.

McCarthy’s office says AHCA reforms will bring more competition to insurance markets, making coverage more affordable while giving people more choices.

Republican leaders can absorb a maximum of only 22 “no” votes from their party and still win approval. About 20 congressmen, mostly moderates, are publicly opposed to the bill. Even more lawmakers have said they are still undecided.

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