House Republicans barely managed to pass their Obamacare repeal bill earlier this month, andthey now face the possibility of having to vote again on theircontroversial health measure.

House Speaker Paul Ryan hasn’t yet sent the bill to the Senatebecause there’s a chance that parts of it may need to be redone,depending on how the Congressional Budget Office estimates itseffects. House leaders want to make sure the bill conformswith Senate rules for reconciliation, a mechanism that allowsSenate Republicans to pass the bill with a simple majority.

Republicans had rushed to vote on the health bill so the Senatecould get a quick start on it, even before the CBO had finishedanalyzing a series of last-minute changes. The CBO is expected torelease an updated estimate next week.

"Unaware," said Representative Jeff Denham of California, withnoticeable surprise Thursday, when advised that his party leadersstill hadn’t sent the bill over to the Senate. Denham was one ofthe House Republicans who ended up voting for the measure, afterearlier in the week opposing it.

"I am on the whip team and we have a lot of conversations, butwe have not had that one. So I am going to look into it," saidDenham, a member of the party’s vote-counting team.

Downplaying concern

One senior GOP aide downplayed any concern over the potentialtrouble from the CBO report, depicting it as hypothetical, andsaying that leaders will cross that bridge if they needto.

According to several aides and other procedural experts, ifRepublicans send the bill to the Senate now and the CBO laterconcludes it doesn’t save at least $2 billion, it would doom thebill and Republicans would have to start their repeal effort allover with a new budget resolution. Congressional rules wouldlikely prevent Republicans from fixing the bill after it’s in theSenate, the aides said.

If Republican leaders hold onto the bill until the CBO report isreleased, then Ryan and his team could still redo it if necessary.That would require at least one more House vote of some sort.

That vote could be cloaked in some kind of arcane proceduralmove, but it would still be depicted as a proxy for yet anothervote on the same bill -- and reluctant Republicans will once againbe forced to decide whether to back it. Only this time, they wouldalso be saddled with the CBO’s latest findings about the bill’scosts and impacts.

Republicans had a sizable deficit reduction cushion -- $150billion -- before several amendments were added to the bill at thelast minute, including changes allowing states to legalize muchskimpier health insurance plans.

Budget assumptions

It’s unclear what assumptions the CBO will make about whatstates will do with that newly created flexibility. If millions ofpeople sign up for much cheaper, minimal insurance, that couldtrigger billions -- and potentially even hundreds of billions -- incosts over a decade because of the House bill’s health insurancetax credits.

"We’ve got to wait for the CBO score," said Greg Walden ofOregon, chairman of the House Energy and Commerce Committee, whichauthored much of the bill. "To prove that you meet thereconciliation test."

But other senior Republicans weren’t aware that leaders had beenholding onto the bill.

"I had no idea," Dennis Ross of Florida, another member of thevote-counting team, said Thursday, adding that the prospect ofanother vote "does concern me."

GOP leaders never said publicly they were planning to hold on tothe bill for two weeks or longer.

Democrats’ criticism

House Minority Whip Steny Hoyer of Maryland said Thursday thatthe delay is further proof that Republicans voted for this bill"before they knew what was in it."

The speaker and other Republicans urgently pushed their May 4floor vote, despite a polarized Republican conference, using thefrantic final hours to win over holdouts. Even so, 20 Republicansstill voted against the bill. After the bill squeaked through, Ryanand other senior Republicans dashed to the White House for anunusual celebration of a one-chamber vote.

That 217-213 tally appeared to be a rare legislative victory forthem and President Donald Trump, even if the vote was a difficultone for some rank-and-file House Republicans, who had qualms. Somehave since been hit with protests in their districts and anger fromconstituents.

Now, two weeks later, the American Health Care Act, H.R. 1628, hasn’tbeen transmitted from the House to the Senate, according to SenateBill Clerk Sara Schwartzman.

"Republicans who argue that this was an open and transparentprocess are misleading the American people," Hoyer said. "If theyhave to amend the bill next week after they are informed of itseffects, then they will have a very difficult time doing so giventhe fierce backlash over Trumpcare that we’ve seen in the dayssince passage."

Drew Hammill, a spokesman for House Minority Leader Nancy Pelosiof California, said in a statement: "As the public heat continuesto rise, more and more members are getting scorched for walking theplank for a bill that has no chance of success in the Senate" ormay have to be amended.

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