By Jonathan D. Salant | NJ Advance Media for NJ.com

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On the 101st day of his presidency, President Donald Trump took to Twitter and the airwaves to discuss his so-far unsuccessful efforts to repeal and replace the Affordable Care Act with legislation that could leave 24 million more Americans without health insurance by 2026.

Trump, who promised during the presidential campaign that he would provide health care for everyone and would not cut Medicaid, broke both pledges in pushing for the House Republican alternative.

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House Speaker Paul Ryan (R-Wis.) pulled the bill from the floor due to lack of support from both the most moderate and the most conservative members of the Republican conference.

Then Rep. Tom MacArthur (R-3rd Dist.) kept hope alive by offering a proposal that won the support of the Freedom Caucus, the conservative group.

As for the party's moderate wing, many of them, including three from New Jersey, remain opposed to the GOP bill.

MacArthur's amendment was designed to lower insurance premiums by allowing states to request waivers from the list of benefits all insurers must offer policyholders and, if they set up high-risk pools, from the requirement that companies cannot charge more for customers with pre-existing conditions.

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'Obamacare is dead'

In a pair of early-morning tweets, Trump continued to insist that the Affordable Care Act was dying.

That assertion was contradicted by the Congressional Budget Office and independent health care experts, who said that the health care law was working well for most Americans and a few changes were all that were necessary to spur competition in areas where there was none.

You can't compare anything to ObamaCare because ObamaCare is dead. Dems want billions to go to Insurance Companies to bail out donors....New — Donald J. Trump (@realDonaldTrump) April 30, 2017

...healthcare plan is on its way. Will have much lower premiums & deductibles while at the same time taking care of pre-existing conditions! — Donald J. Trump (@realDonaldTrump) April 30, 2017

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Misrepresenting payments to insurance companies

The president also misrepresented the payments to insurance companies. The federal government provides funding to cover the out-of-pocket costs, such as deductibles and co-pays, for poorer Americans, and Trump has agreed to continue those payments.

America's Health Insurance Plans, American Academy of

Family Physicians, American Benefits Council, American Hospital Association, American Medical Association, Blue Cross Blue Shield Association, Federation of American Hospitals, and U.S. Chamber of Commerce together issued the following statement in response to recent remarks made by Congressional leaders and the Administration on cost-sharing reduction (CSR) payments, which go for the direct benefit of health care consumers.

“Without these funds, consumers’ access to care is jeopardized, their premiums will increase dramatically, and they will be left with even fewer coverage options," according to a statement by associations representing health insurers, hospitals and doctors.

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The bail out

Trump continues to insist that the Democrats want to bail out their insurance donors. But the political action committees of the top five health insurers, as identified by Forbes, gave 58 percent of their $3.5 million in 2016 campaign contributions to Republicans and just 42 percent to Democrats, according to Center for Responsive Politics data compiled by NJ Advance Media.

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'Pre-existing conditions are in the bill'

Trump said Sunday on CBS's "Face the Nation" that the latest version of the Republican health care bill would cover Americans with cancer, diabetes and other pre-existing conditions.

"Pre-existing conditions are in the bill," Trump said. "And I mandate it. I said, 'Has to be.'"

Rep. MacArthur has maintained that his amendment does protect those with pre-existing conditions. But others disagree.

New Jersey Policy Perspective, a progressive research group, said 3.8 million Garden State residents with pre-existing conditions could lose their ability to get adequate coverage. That's on top of the 500,000 fewer state residents who would have insurance under the GOP alternative.

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The newest #TrumpCare change would return us to the days when insurance companies could charge more for pre-existing conditions. pic.twitter.com/oXneYFLE9J — Energy and Commerce Committee (@EnergyCommerce) April 27, 2017

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'We've made many changes to the bill'

Trump said the latest version of the American Health Care Act is much improved.

"We've made many changes to the bill," Trump told CBS. "You know, this bill is very much different than it was three weeks ago."

There have been no additional changes to the bill since MacArthur's changes were embraced by the Freedom Caucus, spokeswoman Camille Gallo said.

That means the pre-existing clause hasn't changed either.

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The proposed AHCA amendment requires insurers to cover pre-existing conditions, but lets states waive limits on how much sick people pay. — Larry Levitt (@larry_levitt) April 30, 2017

States do not have to set up high-risk pools to waive community rating. They can also use a federal invisible risk-sharing program. — Larry Levitt (@larry_levitt) April 30, 2017

The invisible risk-sharing program is funded with $15 billion over 10 years, chump change given the cost of pre-existing conditions. — Larry Levitt (@larry_levitt) April 30, 2017

Unless there's been a change, states do not have to set up high-risk pools guaranteeing affordable coverage for pre-existing conditions. — Larry Levitt (@larry_levitt) April 30, 2017

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In this April 9, 2017, file photo, President Donald Trump gives a thumbs-up as he walks across the South Lawn of the White House. (AP Photo | Pablo Martinez Monsivais)

'The concept of Medicare, I'm not touching'

Trump promised during the campaign not to cut Medicaid, the federal/state health care program for the elderly, disabled and poor, or Medicare, the federal health program for the elderly.

House Republicans under Ryan previously voted to end traditional Medicare, choosing instead to give seniors vouchers to buy private health insurance or allow them to continue in the federal program with a limit on expenditures.

Trump said he won't support such a plan.

"I'm not going to touch it, because I said it," Trump said on CBS. "Now, waste, fraud and abuse, I'm going to touch. If there's something in Medicare that's been abused, I will touch that."

He said the same thing about Medicaid during the campaign, but broke part of that promise when he embraced the Republican health care bill. That legislation cut Medicaid spending by almost $840 billion over 10 years by fundamentally changing the program. No longer would the federal government guarantee funding for every American eligible for Medicaid but instead would give states a fixed sum.

Furthermore, the GOP measure would cap Medicaid expansion under the Affordable Care Act, prevent states like New Jersey from getting extra federal funding to provide health coverage to new recipients after 2020.

The savings from those cuts would fund tax cuts for corporations and wealthy Americans.

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'We didn't have a failure on the bill'

"We didn't have a failure on the bill.," Trump said on CBS. "You know, it was reported like a failure. Now, the one thing I wouldn't have done again is put a timeline. That's why on the second iteration, I didn't put a timeline."

The House speaker pulled the bill from the floor because he doesn't have the votes to pass it. That was a major defeat for the House GOP and for Trump.

As for the "second iteration," CNN reported that White House chief of staff Reince Priebus pushed for a vote on the revised GOP bill before the end of Trump's first 100 days in office.

Ryan refused. "We're going to go when we have the votes," he said last week.

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Trying to shift blame on health care

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The Democrats, without a leader, have become the party of obstruction.They are only interested in themselves and not in what's best for U.S. — Donald J. Trump (@realDonaldTrump) April 30, 2017

Though House Republicans decided to use a parliamentary maneuver so they could avoid a filibuster and pass their health care bill without any Democratic input, Trump blamed the minority party for the bill's failure.

Senate Democratic Leader Chuck Schumer (D-N.Y.) wasn't buying it.

"He tries to blame the Democrats, but he didn't need a single Democratic vote to pass it in the House," Schumer said on "Fox News Sunday." "We've said over and over again, if he backs off repeal, we'll sit down and work with him to improve Obamacare."

Under Senate rules, the repeal bill cannot include a key element of Trump's repeal plan, allowing insurers to sell policies across state lines in an attempt to increase competition. That would go in separate legislation requiring 60 votes for passage in the Senate.

"What's going to happen is the competition is going to drive down the premiums, in my opinion, much, much more than people understand," Trump said on CBS.

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Christie backs up Trump

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Gov. Chris Christie speaks about the need for federal funding for the Gateway Tunnel. (Aristide Economopoulos | NJ Advance Media for NJ.com)

In an interview Sunday on the Fox News Channel, Christie agreed with Trump that the private insurance market under the Affordable Care Act was collapsing

"It's just been a failure," Christie said. "The rates have gone up. Less people are having access to the private insurance market. It succeeded on the Medicaid side to some measure but not the private sector side."

The Congressional Budget Office, however, said that the federal subsidies insulated most Affordable Care Act recipients from the higher premiums. The combination of the subsidies and the requirement that all Americans have health coverage will "cause sufficient demand" for insurance market "to be stable," the CBO said.

The Republicans, though, would cut the subsidies, especially for those aged 50 to 64, and would eliminate the requirement that all Americans have health insurance or pay a penalty.

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Trump makes insurers 'very nervous'

Larry Levitt, senior vice president of the Kaiser Family Foundation, which studies health care, said Trump's comments, not the current provisions of the Affordable Care Act, could lead to less competition or higher premiums.

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These payments compensate insurers, who are required to provider lower deductibles and copays to low-income people.https://t.co/rIyzI73zKa — Larry Levitt (@larry_levitt) April 30, 2017

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Read more about the fight over health care

Has revamped Obamacare repeal bill swayed N.J. Republican lawmakers?

Could 4M N.J. residents lose affordable health care?

What Americans think of Trump's efforts to repeal Obamacare

How MacArthur's Obamacare plan deals with pre-existing conditions

Can this N.J. lawmaker save Trump's Obamacare repeal effort?

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Jonathan D. Salant may be reached at jsalant@njadvancemedia.com. Follow him on Twitter @JDSalant or on Facebook. Find NJ.com Politics on Facebook.