After campaigning on repealing the health care law and voting to gut it, an Iowa Republican is cautioning constituents fearful of losing coverage that the House GOP replacement is just “a tweak of Obamacare” that would have gone further had he had his way.

Two-term Rep. Rod Blum, who represents a swing district that includes Dubuque and Cedar Rapids, is among the conservative House Republicans who campaigned angrily against then-President Barack Obama’s signature health law for two years, only to accept a bill they say did not undo enough of the 2010 law. And in so doing, Blum and others are understating the impact of the bill that, if enacted, could drop millions from their insurance by next year.

“Only about 10 percent of Obamacare was changed with this bill that we passed in the House, only 10 percent,” Blum told about 200 people at a community college in central Iowa on Thursday. “When we leave 90 percent of the language in the bill, I would not call that personally a repeal.”

A week ago, the House narrowly approved a bill that would cut the Medicaid program for low-income people, eliminate the fines for people who don’t buy insurance, cut taxes for wealthy Americans and provide generally skimpier subsidies for many who need help to buy insurance. The bill also would allow insurers to charge seriously ill customers higher rates if they let their coverage lapse.

Congressional analysts estimate that 24 million more Americans would be uninsured by 2026, including 14 million by next year.

“I don’t see how he can say this won’t affect people on Medicaid,” Mike Poe, a 62-year-old Marshalltown farmer, said after the Blum event. “People like me, not yet eligible for Medicare, are the ones who are vulnerable.”

President Donald Trump and dozens of House Republicans celebrated the bill’s passage in a Rose Garden ceremony. Back home in their congressional districts, many of those Republicans have had to explain their vote.

Blum, a businessman, former high school basketball coach and onetime real estate developer, won his seat in the Republican wave of 2014 on the promise of repeal.

“Quite frankly, this bill is a tweak of Obamacare,” Blum said Tuesday in Dubuque before the first of four meetings across his district, which spans central Iowa to the Mississippi River.

Blum insisted people would not lose Medicaid coverage, if they don’t let their coverage lapse. “If you’re on Medicaid, nothing’s going to change,” he told the audience in Marshalltown, which broke into a chorus of loud objections.

However, some people typically enter and leave Medicaid coverage due to temporary employment, making the change in the bill potentially harmful to people who change jobs frequently.

Blum was among the roughly 30 conservative House Freedom Caucus members responsible for scuttling the earlier version of the bill. He said he grudgingly supported the revised measure because it allows states to opt not to abide by the Obama law’s requirement on essential benefits and coverage for those with pre-existing conditions. Even that was a hard choice to make, he said.

“You can’t get what you want all the time,” Blum told the group in Marshalltown. “So in the end I compromised.”

It was an unusual statement from a member of the typically unyielding Freedom Caucus. Blum, on the first day of his term, was one of 25 Republicans in January 2015 who refused to back the more pragmatic John Boehner for House speaker. Months later, in September, the Freedom Caucus hastened Boehner’s departure.

While the Senate works on its version of the health care bill, the House measure continues to face strong public opposition, according to a Quinnipiac University poll released Thursday.

The poll found that only 21 percent of voters approve of the House-passed bill, while 56 percent disapprove.

With the exception of Republicans, majorities of people disapproved across demographic groups. That included 81 percent of Democrats and 60 percent of independents, 54 percent of men and 58 percent of women.

“There’s a moral obligation to protect people’s health. I just think he sees it only in terms of money,” 65-year-old retired teacher Anne Michael of nearby Tama said after the Blum event.

Blum also cast doubt on a consensus bill emerging from the Senate, where Republicans hold a narrower majority than in the House, and have tea party conservatives Rand Paul, Ted Cruz and Mike Lee, along with moderate Susan Collins.

“Getting something done this year for Iowans I think is going to be a heavy lift,” Blum later told The Associated Press.

A fellow Iowa Republican, Sen. Chuck Grassley, said Senate Republicans were not “going to go through the public relations problems that the House of representatives had for a month.”

Speaking during a taping for C-SPAN’s “Newsmakers” program, Grassley was referring to House GOP leadership’s call for a vote in April when there weren’t enough votes to pass the original bill, and members complained they hadn’t had time to review it.

(AP)