U.S. Rep. Mike Coffman, an Aurora Republican, said Thursday morning that he “cannot support” GOP-sponsored health care reform legislation scheduled for an afternoon vote in the House of Representatives.

Coffman, considered a key swing vote on the revamped American Health Care Act, said in a statement that he doesn’t believe the bill adequately protects Americans with pre-existing conditions. He also said he isn’t going to vote on such sweeping legislation until it’s been scored by the Congressional Budget Office and its cost is better understood.

“At this time, I cannot support the AHCA with the MacArthur amendment because I’m concerned that a small percentage of those with preexisting conditions may still not be protected,” Coffman said.

He added that he’s still committed to replacing the Affordable Care Act, known as Obamacare. Thursday’s planned vote is the third time House Republicans have

“This does not take away from the fact that the Affordable Care Act is failing and American families are hurting. In my conversations with House leadership and the administration over the last 72 hours, I made it clear that additional language was necessary to protect this vulnerable group. And I’m sympathetic to leadership’s challenge — getting 216 votes in this highly polarized political environment isn’t easy. Also, as I have stated in the past, I’m certainly not going to vote on a bill of this magnitude that hasn’t been fully scored by the Congressional Budget Office and whose estimated price tag is unknown,” Coffman said.

The MacArthur Amendment — championed by members of the conservative House Freedom Caucus, many of whom balked at supporting earlier versions of the legislation — would let states drop certain Obamacare provisions, including a requirement that insurers cover designated “essential benefits.”

House Republicans can only afford 21 defections, but leadership expressed confidence Thursday morning that they had the votes.

The CBO score of the first AHCA bill estimated 24 million people would lose their health care coverage over a decade. Republican leaders were pressing ahead with a vote Thursday despite note having an updated analysis from the budget office.

On Wednesday, Coffman said in a statement that the bill’s architects needed to work to strengthen protection for people with preexisting conditions, although he took issue with the bill’s opponents who argue it “dooms” those patients.

“[W]e need to tighten some protections for those with preexisting conditions,” Coffman said. “The critics of the House bill are being totally disingenuous when they say the bill dooms those with preexisting ailments. Individuals with preexisting conditions are guaranteed coverage under the House bill, and I like the idea of giving the states flexibility to meet that requirement. But I worry that, under the current language, a small percentage of those with preexisting conditions may not be adequately protected.”

A day before the scheduled vote, Coffman said he was open to supporting the bill if its authors addressed his concerns but was happy to start over if they didn’t.

“If House Leadership will work to tighten protections for those with preexisting conditions, I’m a yes on sending this bill to the Senate for further consideration,” he said. “If not, I’m a no, and we’ll go back to the drawing board to clean up the mess created by the Affordable Care Act.”

— ernest@coloradostatesman.com