The House GOP’s bill to reform health care is hardly a surprise: Its key elements were part of the “Better Way” agenda championed last year by Speaker Paul Ryan. Republican lawmakers discussed the principles in several special conference meetings. The legislation was then written from the bottom up by the appropriate committees instead of being imposed from the top down.

The bill would repeal much of President Obama’s framework for government-run, highly prescriptive, one-size-fits-all health care. In its place would stand conservative reforms to unleash market forces, give consumers choice, and return power to the states.

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Leaders of conservative groups that oppose the House Republicans’ health-care bill met with President Trump at the White House on Wednesday night, part of a high-profile effort to quiet anger from the right. In the process, the conservatives heard the president and his team express some openness to tweaks to the bill that go further than House or Senate leaders might accept.

Trump and his team did not outright reject changes on at least three components of the GOP’s American Health Care Act, said some of the meeting’s attendees, speaking on the condition of anonymity. One idea was accelerating the timetable for key changes to Medicaid under the House GOP plan from 2020 to 2018.

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On Monday evening, House Republican leaders unveiled their long-awaited Obamacare replacement, entitled the American Health Care Act. The plan was swiftly panned by observers from all over the ideological spectrum. But there was one group whose complaints made the least sense: GOP hard-liners who believe that any attempt to provide financial assistance to the uninsured amounts to “Obamacare Lite.”

It was a phrase we heard over and over on Tuesday. “This is Obamacare Lite,” said Sen. Rand Paul (Ky.). FreedomWorks, a conservative activist group, used the same epithet. Rep. Justin Amash (Mich.) called the AHCA “Obamacare 2.0.”

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After an 18-hour session, the House Ways and Means Committee has become the first to approve the Republicans’ Obamacare repeal bill.

White House and Republican congressional leaders had sought to fast track the legislation through Congress. Democrats made clear it wouldn’t be easy — dragging out a grueling day of committee sessions well into the early morning hours. The House Energy and Commerce Committee is still debating.

Opposition to the Republican health care bill had strengthened Wednesday, as key industry groups that had supported Obamacare said the replacement backed by President Donald Trump could harm vulnerable Americans.

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The Republican House health-insurance reform bill would replace Obamacare with a more consumer-driven system. Rather than having many provisions take effect in 2020, Congress should pass it soon and make it effective next year. But it is getting attacked from both the right and the left. What’s missing from the news coverage is improvements in the new bill. Here are six:

1. No employer mandate.

2. Refundable tax credits to buy health insurance.

3. Expansion of HSAs and FSAs.

4. Move Medicaid patients to regular coverage.

5. Lower costs for the young.

6. Incentives to keep coverage.

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Galen Institute President Grace-Marie Turner is a veteran of Washington health-care debates and was a fierce opponent of the Clinton health-care reform effort in the 1990s and Obamacare since 2009. She is encouraged by what she sees in the American Health Care Act and says the realities on Capitol Hill force this kind of legislation.

“It’s a first step. They’re pushing as far as they can with the process they have to go through. They do not expect any Democrats, in the House or the Senate, to vote for this. That means they have to do this through a particularly difficult process called reconciliation that limits the kinds of things you can repeal,” Turner told WND and Radio America.

“They can’t repeal everything in the law through this process, because it has to have direct spending and budget implications. They’re doing as much as they can and they have plans to go forward with other pieces of legislation, for example, that will allow people to purchase health insurance across state lines. That’s not possible through this particular pathway.”

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The do-or-die moment for the Trump Administration and the GOP Congress arrived on Monday, as House Republicans rolled out their ObamaCare repeal-and-replace bill. The question now is whether they can deliver on their reform promises and govern to improve the lives of American voters.

The American Health Care Act would be the most consequential GOP social-policy reform since the welfare overhaul of 1996. Not only does the bill repair the failures of the Affordable Care Act, it starts to correct many of the government-created dysfunctions that have bedeviled U.S. health care for decades.

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House Republicans released on Monday legislation to repeal and replace the Affordable Care Act, also known as Obamacare.

It fundamentally changes how health care is financed for people who do not have insurance through work, and it eliminates the mandate requiring most Americans to have health insurance, a centerpiece of the Affordable Care Act.

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Progressives are lining up to assail the GOP’s health-care bill, though many on the political right seem to be even more unhappy. A little internal division is inevitable in any reform campaign worth fighting for, but the alternative strategies these conservative critics are suggesting are less than persuasive.

To repeal and replace ObamaCare, Republicans must manage a mix of policy, political and procedural variables that are more complicated than usual. Compromises are necessary to earn 218 votes in the House and then a simple majority among the 52-member Senate GOP conference under the budget reconciliation process, which can bypass the filibuster but limits the scope of what the bill can contain. Call it the art of the deal.

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The Affordable Care Act (ACA) has substantially increased the number of Americans with public and private health insurance coverage. The Assistant Secretary for Planning and Evaluation (ASPE) at the US Department of Health and Human Services estimates that the ACA has resulted in 20 million additional nonelderly adults gaining coverage between the law’s enactment and February 2016. This estimate is likely overstated. Government surveys’ estimates of the number of people who gained coverage between December 2013 and December 2015 vary by 20 percent. Moreover, while the ASPE estimates that the ACA increased the number of young adult dependents with insurance coverage between 2010 and 2013 by 2.3 million, data from government surveys indicate that 1.2 million fewer dependent children had private coverage in 2013 than in 2010, offsetting half the gain in coverage among older dependents. Coverage gains have nonetheless been significant, with most of the increase coming from enrollment surges in Medicaid and the Children’s Health Insurance programs. But a substantial proportion of those who have enrolled in these public programs since 2014 met eligibility standards that predated the ACA. This increase in public coverage may have crowded out private coverage, although further study is needed to determine the existence and magnitude of this effect.

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