A US Representative from Kansas has apologised for his remarks that poor people do not want healthcare, a statement that has echoes in the White House.
In an interview about healthcare with Stat News, Obstetrician Roger Marshall argued that the Affordable Care Act could not be structured to only benefit those with low incomes.
"Just like Jesus said, ‘The poor will always be with us.’ … There is a group of people that just don’t want health care and aren’t going to take care of themselves," he told the publication.
"Just, like, homeless people. … I think just morally, spiritually, socially, (some people) just don’t want health care," Mr Marshall continued. "The Medicaid population, which is (on) a free credit card, as a group, do probably the least preventive medicine and taking care of themselves and eating healthy and exercising.
"And I’m not judging, I’m just saying socially that’s where they are. So there’s a group of people that even with unlimited access to health care are only going to use the emergency room when their arm is chopped off or when their pneumonia is so bad they get brought (into) the ER."
The Affordable Care Act was used to cover low-income people and disabled people in the state.
Kansas is one of 19 states that have not expanded healthcare insurance programs to cover people who make too much money to receive Medicaid but earn too little to access the federal health care exchange.
His comments quickly gained national attention. Mr Marshall said on Wednesday that he regrets "trying to address several issues with a singular response" and that he wanted to emphasise that "we cannot build a national healthcare policy around any one segment of the population."
The remarks may appear outlandish as many Republicans, including House Speaker Paul Ryan, insisted the new American Health Care Act would serve all Americans.
"This is what good, Conservative, health care reform looks like," he insisted.
In a country of more than 300 million people where one in six children are estimated to live in food-insecure households and more than 43 million survive on food stamps, critics say the Republican healthcare replacement plan would not protect the most vulnerable citizens.
But the sentiment of Mr Marshall is shared more widely than might be presumed.
At a White House press conference on Wednesday, Press Secretary Sean Spicer also appeared to blame low-income people.
"The issue [with Obamacare] was, in an attempt to solve a problem that affected a very specified, fine group of people, that affected the whole healthcare market."
Jason Chaffetz, the Chairman of the House Committee of Oversight and Government Reform, also told CNN that low-income people needed to make choices about their finances.
"So rather than getting that new iPhone that they just love and want to go spend hundreds of dollars on that, maybe they should invest in their own health care," he said. "They've got to make those decisions themselves."
He has since walked those comments back.
Tom Price, Heath and Human Service Secretary, responded to a Chaffetz-related question that Americans are already "having to sacrifice in order to purchase coverage".
Yet the new plan maintains a penalty for people that choose not to buy healthcare coverage, and they pay that penalty to the insurance company instead of the government.
Medicaid expansion is maintained until 2020, and a cap on state spending will be instituted thereafter.
The income-based tax credit system will be changed to an age and income-based plan, meaning older citizens will be potentially left unprotected.
People will not be discriminated against for pre-existing conditions under the new plan, but if someone has a coverage gap for more than 63 days, they will pay a premium surcharge of 30 per cent for 12 months.
There has been no public statement yet on whether the new plan will provide coverage for contraception.
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