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The conservative House Freedom Caucus is pushing for quick congressional action to repeal and replace the Affordable Care Act and says the plans it supports will mean better coverage, lower costs and more control for patients.

And House Freedom Caucus Chairman says if Republicans don’t follow through on their promises to repeal and place the law, voters ought to send them packing next year.

“I am confident we can do that, and I am confident that if we don’t do that, everybody should send us home and they would have every right to send us home if we don’t deliver on a real promise to make it affordable,” said Rep. Mark Meadows, R-N.C., who leads the House Freedom Caucus in the current Congress.  “We promised to do that.  We’ve got to deliver.”

Reports vary widely as to how soon Congress may tackle the repeal, with some lawmakers wanting to get it done in President Trump’s first 100 days and others thinking repeal and replacement may not be completed until later this year or even early 2018.

Meadows says the GOP consensus is to get this done quickly, but a debate is brewing about whether to repeal now and replace later or pass the two bills at the same time.

“It’s that replacement plan that really is providing a great anxiety among some of the Republican members, what it should include and what it shouldn’t include.  There’s still some disagreement there but I’m optimistic that we will go ahead in the next 30-45 days and vote on something in the House and the Senate and move this along,” said Meadows.

“If it waits until next year, it won’t get done, so [Americans] need to weigh in with their member of Congress to say, ‘We want them to act now,'” said Meadows.

Meadows also rejects the idea  of allowing the current system to fester for another year as a means of building public demand for repealing and replacing current law.

“I can tell you from a principle standpoint, to suggest that we allow it to continue to spiral down so that more people are hurt is not something that would be prudent,” said Meadows.

But Meadows also dismisses the alarm from Democrats that repealing Obamacare will means tens of millions of Americans will lose their coverage.

“The Affordable Care Act, the way it is now, is not sustainable.  A lot of those people who may have gotten coverage won’t be able to keep their coverage on the current trend,” said Meadows.

Many of those Americans who now have coverage got it through the expansion of Medicaid.  Meadows admits that will be one of the thornier issues to navigate.

“It is a critical component that we have to address in some shape, form, or fashion.  But whether they get this done with block grants on a per capita basis or some other mechanism, I believe that we can come up with a workable solution that doesn’t leave anybody behind and provides an adequate safety net,” said Meadows.

Last week, the House Freedom Caucus threw its support behind legislation from Sen. Rand Paul, R-Ky., that is designed to repeal the current law and simultaneously replace it with legislation that will patients much more freedom in choosing their coverage.  Paul is fiercely urging GOP leaders not to blow a hole in the deficit by repealing the law and only then getting to work on a replacement.

Rep. Mark Sanford, R-S.C., is offering a companion bill in the House that Meadows says goes a step farther than Paul’s approach in the effort to break up monopolies in the insurance market.

Meadows says there are some must-haves for conservatives  in any replacement legislation.

“It’s one of the few plans that is out there that won’t blow a hole in the deficit, actually will bring down costs, and hopefully will not only address the concerns about pre-existing conditions that many of my constituents and people across America have been concerned about, but do it in a way that actually drives the cost of health care down,” said Meadows.

Meadows says the final legislation needs to require insurers to cover people with pre-existing conditions and forbid carriers from cancelling policies when people get sick.  He also wants more flexibility and freedom for people in their Health Savings Accounts, but is shying away from mandating that children be allowed to stay on their parent’s policies until they are 26 years old.

“We think the private sector can actually address that probably better than making it a mandate,” said Meadows, who also strongly endorses a plan from Sen. Paul to provide tax deductions for doctors who work a lot with low income patients.

“They don’t get to write that off now, so this will actually be an incentive to provide health care on a more philanthropic basis,” said Meadows.

Meadows says the cooperation between the White House and Congress has been excellent and that GOP leaders are showing respect for conservative ideas and strategies.  At the same time, Meadows expects an intra-party clash over tax credits.

“Probably the biggest stumbling block right now is the leadership’s desire to use an advanceable, refundable tax credit, where a number of us probably don’t feel that’s the best approach to address it,” said Meadows.

Meadows urges his fellow Republicans to move intelligently but swiftly towards their top legislative priority.  He says lawmakers need to stand on principle and let the political chips fall where they may.

“I think it’s more important that we act now to put forth not only a repeal but a replacement of all of it and make the tough decisions.  As members of Congress, if we make the right decision and it sends us home, so be it,” he said.