The Republican Study Committee (RSC) is sending up a warning flare to Senate Republicans over changes to the ObamaCare repeal-and-replace bill, warning that the alterations “may jeopardize final passage in the House.”

The RSC, which the largest bloc of conservatives in Congress, has drafted a letter to Senate Majority Leader Mitch McConnell Addison (Mitch) Mitchell McConnellDemocratic senator to party: 'A little message discipline wouldn't kill us' House to vote on resolution affirming peaceful transition of power Republican lawyers brush off Trump's election comments MORE (R-Ky.) raising “serious concerns” with the direction of the Senate’s healthcare legislation.

The caucus says four elements are critical to keep in the healthcare legislation. They are:

Ending the extra federal funds for Medicaid expansion by 2020. The Senate is proposing a more gradual phase-out of this money. Leadership has proposed a three-year transition, beginning in 2020. More moderate senators are pushing for a longer, seven-year phase-out. Keeping a waiver that lets states opt out of ObamaCare insurance regulations. The Senate might do away with a provision in the House bill that would allow states to let insurers charge consumers more based on their health status. Repealing ObamaCare’s taxes “in the most expeditious manner possible.” The Senate is eying keeping some taxes around for longer. Defunding Planned Parenthood for one year and preventing tax credits from going to plans that cover abortion. At least two senators have expressed concerns over defunding Planned Parenthood, and the Senate parliamentarian has warned the tax credit measure may run afoul of reconciliation rules.

“As the Senate continues its deliberative process, we urge you to carefully evaluate the American Health Care Act and consider the important role these specific policies played in building consensus in the House,” the letter states.

ADVERTISEMENT

The RSC plans to send the letter soon, and non-RSC members can sign onto it if they so choose.

The Hill obtained a draft of the letter, which was first reported by The Independent Journal Review.

The House passed a healthcare bill in May only after the legislation was amended to win votes from conservatives. Until those changes were made, the legislation lacked the support to pass.

But the Senate is now looking to soften some of those same provisions, which could prove problematic in the House.

The House bill won the support of RSC Chairman Mark Walker (R-N.C.) after states were given two new options: adding work requirements to their Medicaid programs and-block granting Medicaid.

Separately, the bill, which is known as the American Health Care Act, netted the support of the Freedom Caucus with the addition of waivers letting states opt out of community rating and essential health benefits.