Republican leaders in the U.S. House of Representatives say they have the votes to pass a bill to repeal and replace the Affordable Care Act, former President Barack Obama's signature legislative achievement that extended healthcare coverage to tens of millions of Americans.

U.S. Rep. Kevin McCarthy (R-Calif.), the House Majority Leader, said Wednesday that he will press for a vote today on the new bill touted by President Donald J. Trump, which could force many of those tens of millions back to healthcare insecurity.

"We're going tomorrow, yes we are," McCarthy told CNBC television."We will pass this bill," he said.

House Speaker Paul Ryan (R-Wisc.) told reporters a few days ago that the vote would not go forward if Republicans did not have enough votes to pass it. Ryan is no doubt intent on avoiding a repeat of last month's embarrassing defeat on the House floor when Republicans withdrew an earlier version of the bill for lack of support.

More support?

This time, votes may be easier to come by after Republicans added a provision for $8 billion in federal funding for Americans with serious health conditions who likely would have had to pay sharply increased premiums under the proposed plan. The plan, reflecting promises made by Trump while campaigning in 2016, has become known as Trumpcare.

The bill also makes changes in funding for Medicaid, the federal program that provides health coverage for low-income Americans, and eliminates or reduces taxes imposed to fund Obamacare coverage.

Democrats in opposition

But the leader of the opposition Democrats in the House, Rep. Nancy Pelosi (D-Calif.), complained that Republicans want to vote on a bill without waiting for official analysis by the Congressional Budget Office, which provides estimates of what the ultimate costs and effects of the bill are likely to be.

"Forcing a vote without a CBO score shows that Republicans are terrified of the public learning the full consequences of their plan to push Americans with pre-existing conditions into the cold," Pelosi said.

Republicans are anxious to act on the bill today or tomorrow because the House is scheduled to begin a week-long recess on Monday.

The proposal still is subject to approval by the U.S. Senate, where substantial opposition also is expected before it goes to Trump for final approval.

In its analysis of an earlier version of the Trumpcare legislation, the CBO projected that 24 million people would lose coverage and premiums would spike by as much as 20 percent next year, CNBC said. But Trump and his Republican allies in Congress could do a lot more damage to poor and working class people's healthcare coverage if they wanted to

This probably is just a warmup to the real battle ahead. Conservative Republicans probably have their sights on doing away with the Emergency Medical Treatment & Labor Act of 1986, which requires nearly all hospital emergency rooms to accept indigent patients as a condition of being eligible to receive Medicare reimbursements from the federal government.