Nonprofit organizations with healthcare missions, as well as nonprofits concerned about social justice, have a limited but intense opportunity to make their voices heard.
Trump later criticized the House bill privately as "mean" and this week called for a health plan "with heart". I said, "If you can take repeal off the table, sit down, and talk about fix, and fixing what we have, and how to make it better, I'm in with you".
The Senate bill resembles legislation the House approved last month.
Under special rules McConnell is using that will block Democrats from using a filibuster to kill the bill, the legislation can not include provisions that make policy changes that don't primarily affect the budget.
Senators are likely to have only a handful of days to decide whether to support or vote against the 142-page bill, which was unveiled on Thursday.
The Senate bill has faced significant blowback from Democrats as well as some Republicans.
One of the most controversial aspects of the senate bill is its treatment of Medicaid.
Congressional budget analysts plan to issue their projections as early as Monday on the legislation's effect on the federal deficit and the number of Americans whose insurance coverage it will impact. "Not one. And if it were the greatest bill ever proposed in mankind, we wouldn't get a vote." he said.
Unless those holdouts can be swayed, their numbers are more than enough to torpedo the measure developed in private by Senate Majority Leader Mitch McConnell, R-Ky., and deliver a bitter defeat for the president. It also gives him the opportunity to use the amendment to reward or punish specific senators and their interests.
Sandoval said the Senate bill "is something that needs to change". A few senators drafted the new bill in secret.
"The Republicans that wrote this bill don't want you to understand the damage it will cause before they vote on it", said Wolf, a Democrat.
Since there are differences between the House-passed AHCA and the Senate's BCRA, those differences would have to be negotiated in a conference committee of House and Senate members. But she said it will be "extremely difficult" for the White House to be able to find a narrow path to attract both conservatives and moderates.
President Trump has not yet signaled support or opposition to the BCRA.
While getting people under the poverty level covered by insurance would be a good thing, it should be done by expanding Medicaid, said Sabrina Corlette, who studies the individual insurance market as research professor at Georgetown University's Health Policy Institute. Dean Heller and Susan Collins have also withheld support. This keeps them from being surprised by amendments they oppose to bills they support (or vice versa). People would "have to be more disabled before they qualify for Medicaid assistance".
Some pundits believe that McConnell is engineering the process in such a way that the ACA repeal-and-replace effort will ultimately fail in such a way as to leave Senate Republicans with the lesser share of the blame.
This is really an interesting question because I actually am a big believer in bipartisanship, in large part because I don't think our country deserves to go through the back-and-forth of changing our health care system every election cycle.
Again, nonprofit organizations have a limited, but intense, opportunity to make their voices heard.