Paul Ryan

Speaker Paul Ryan announced Sunday he would be willing to make major changes to the Republican health care bill this week, but not push back the scheduled vote Thursday.

He’s considering those changes in response to division among party members over the bill in its current form: conservatives say they won’t vote for it because it’s “Obamacare-lite,” while moderates are spooked by the Congressional Budget Office’s assessment that 24 million Americans stand to lose coverage if it passes, among other warning signs.

He told Chris Wallace Sunday that unspecified changes would “help bring market freedom and regulatory relief to the insurance markets to dramatically lower the price of the plan for the 50- and 60-year-olds.”

Other changes under discussion would impose work requirements for people receiving Medicaid benefits and increase tax credits for older Americans.

But Ryan wants members of Congress to vote on the updated bill before they know what its impact on constituents will be.

The House will still vote on Thursday, before the CBO has a chance to make another assessment.

Ryan is not historically a skeptic of CBO’s findings: he asked that nonpartisan body for an assessment of his “Path to Prosperity” budget plan in 2012, although he pre-supposed an outcome to get the numbers he was hoping for.

He has relied on the office’s findings to bolster support for other of his measures. Back in 2009, Ryan himself requested CBO score the Affordable Care Act even before markup.

House Republicans selected Keith Hall, a deeply conservative economist who served in the Bush administration, as CBO director in 2015.

Current Trump appointee Tom Price, then chairman of the House Budget Committee, praised Hall’s “impressive level of economic expertise and experience” at the time of the announcement.

Speaker Ryan will be asking members to vote on a piece of legislation that impacts a fifth of the economy before members are able to understand its budget impact, its effects on their constituents, or any of the other outcomes typically assessed by a CBO report.

Still, Ryan says he is confident it will pass, despite his own admission that major components are still under construction.

“The reason I feel so good about this is because the president has become a great closer. He’s the one who has helped negotiate changes to this bill with members from all over our caucus.”

Democratic Leader Nancy Pelosi wrote Ryan last week and demanded he give the CBO an opportunity to analyze the changes health care bill before any floor vote.

“Republicans are terrified the American people will see the reality of their disastrous TrumpCare bill. If the GOP are afraid of the public having the facts about their bill, they shouldn’t be voting on it,” Pelosi said in a statement released Sunday after Republicans announced they will not wait for the CBO.