By Susan Heavey and Susan Cornwell
WASHINGTON (Reuters) - President Donald Trump and congressional leaders are weighing changes to their effort to dismantle the Obamacare health law, a White House spokesman said Tuesday, as Republicans defended their plan following an estimate that it would cause 14 million Americans to lose insurance next year.
Press Secretary Sean Spicer said White House officials and leaders in the Republican-controlled U.S. House of Representatives were considering whether they could tweak the plan, which faces growing doubts within party ranks.
The effort to bolster support came a day after the nonpartisan U.S. Congressional Budget Office (CBO) estimated that by 2026, the plan would boost the number of people without health insurance by 24 million.
The findings make it harder for Republicans to sell the Republican president's first major piece of legislation and deliver on a longtime pledge to undo Democratic former President Barack Obama's signature domestic policy achievement.
Trump was set to speak by phone to House Speaker Paul Ryan and Majority Leader Kevin McCarthy, and he has met with numerous Republican lawmakers in recent weeks. He spoke to managed care company Anthem Inc Chief Executive Joseph Swedish earlier on Tuesday.
"Part of the reason we are engaging with these individuals is to hear their ideas," Spicer said. "We are obviously in talks with House leadership about the contents."
Republicans' plan to replace the 2010 Affordable Care Act, popularly known as Obamacare, would repeal a requirement that every American have health insurance and slash spending on the Medicaid program for the poor and disabled.
It would also revamp tax subsidies that help people buy insurance if they do not get it from work. The amounts would be based on age, not income.
Democrats say the Republican plan would hurt the elderly, the poor and working families but give tax cuts to the rich. Doctors, hospitals and advocates for patients and senior citizens also have panned it.
Spicer said the plan would give Americans more choice in insurance. He said the CBO struggles to estimate insurance coverage. Before the 2010 law passed, the office projected many more people would buy individual insurance plans through new online marketplaces than actually did.
The White House has, however, promoted the CBO's estimate of the plan's effect on federal deficits. The report said it would cause deficits to fall by $337 billion between 2017 and 2026.
Still, Trump's administration must heal divisions in his own party. Moderates, particularly in the U.S. Senate, worry about causing people to lose coverage, while conservatives do not think the bill goes far enough in undoing Obamacare.
House leaders have resisted a conservative push to bring a quicker end to Obamacare's expansion of Medicaid. But they are considering changes to tax credits to help older, lower-income Americans.
The CBO said that group would see higher insurance premiums under the Republican plan, which would let insurers charge older enrollees more than they can under Obamacare.
"We're examining different options for how we can improve that," Representative Kevin Brady, a Republican who heads a key tax-writing committee, said on Tuesday. He did not give details.
Republican senators held a lunch on Capitol Hill with Vice President Mike Pence and Health and Human Services Secretary Tom Price to discuss possible changes.
Senate Majority Leader Mitch McConnell said the bill could be amended in the Republican-controlled Senate.
“The first step is in the House. We're hopeful and optimistic they're going to send us over something. It will be open for amendment,” he said.
Shares of hospitals and health insurers slipped, partly on worries the plan would mean fewer insured patients.
Among insurer stocks, UnitedHealth Group Inc closed down 0.7 percent, and Aetna Inc and Humana Inc each dipped 0.5 percent.
“It looks like it's going to be the dismantling of the individual insurance market, which again means lower revenues and the loss of the individual market for the most part for the insurers,” said Vishnu Lekraj, an equity analyst at Morningstar.
Hospital shares were also lower. Tenet Healthcare Corp finished down 3.3 percent and HCA Holdings Inc ended down 1.5 percent.
Overall, CBO projected that 52 million people would be uninsured by 2026 if the bill becomes law, compared with 28 million who would not have coverage that year if Obamacare remained unchanged.
(Additional reporting by Caroline Humer, Alistair Bell, David Morgan, Mike Erman and Natalie Grover; Writing by Emily Stephenson; Editing by Jeffrey Benkoe and Jonathan Oatis)