Rural areas have been the first to lose options. In this year’s open-enrollment period, one-third of all counties -- including all of Alaska, Wyoming, Oklahoma, Alabama and South Carolina -- had just one insurer. More densely populated counties, especially where the marketplace is run by states, have more insurance options, according to data compiled by Bloomberg from Obamacare marketplaces.

Insurers, who say eliminating the tax on their industry will bring down premiums, will now ask the Senate to boost financial assistance to entice younger, healthier people and help older Americans maintain coverage. They’re also seeking more Medicaid funding and are concerned a new formula for the federal-state program might fall short.

Shares of hospital companies, such as Tenet Healthcare Corp. and Community Health Systems Inc., are expected to be hit by the bill’s phase-out of the Medicaid expansion. Before Obamacare, hospitals had to provide more uncompensated care, a funding gap that had been narrowing as more people had coverage.

Tax Overhaul

The House also sought to move quickly for legislative reasons. Republicans intend for the repeal of Obamacare taxes to give them a lower baseline to cut individual and corporate rate in the tax overhaul they promised voters later this year.

“It’s quite obvious that this bill was written by Republicans that didn’t care about health care and wanted to move on to tax reform,” said Michael Cannon, director of health-policy studies at the conservative Cato Institute.

The bill will need major surgery in the Senate to become law, even though Republicans who control the chamber 52-48 are using a procedure that would bar a Democratic filibuster and allow the GOP to enact the measure with a simple majority vote.

Senators including Shelley Moore Capito of West Virginia and Rob Portman of Ohio are demanding changes to Medicaid provisions to protect states like theirs that chose to expand the program for low-income people under Obamacare.

Republican Concerns

Senators Susan Collins of Maine, Bill Cassidy of Louisiana, Tom Cotton of Arkansas, Lisa Murkowski of Alaska and Cory Gardner of Colorado are among those who have expressed concern or outright opposition to the House bill.