If he succeeds, this President will surely be remembered as a political genius. But even as the White House hunkers in the face of criticism, its spokesman Sean Spicer indicated on Tuesday that some of the Trumpcare bill might be negotiable.

And through Tuesday there were reports of simmering rebellion among Trump loyalists, with what The Washington Post described as "a chorus of influential voices suspicious of the proposal" warning Trump to dump it.

Suggesting that the protesters might be getting traction, a White House insider told the Post: "You can't be so blind that you're not seeing the outside noise."

Another was quoted as saying: "We take their views seriously and we're listening."

As analysts and commentators pore over what is hailed as the definitive analysis of the proposed American Health Care Act - a critique by the non-partisan Congressional Budget Office (CBO) - a clearer winners/losers picture is emerging, and incredibly Trump voters feature prominently among the losers.

Consequently it's more than this week's snow that is causing a distinct chill in Washington.

As Republican lawmakers grasp the inequity of it all, a wall of congressional resistance is building faster than Trump's vaunted Mexican border wall.

This was to be the Republicans' brave new world, but their first major bill is being cast as exploding the number of uninsured Americans - seemingly gouging the needy and the vulnerable, either by driving them from the market or by foisting on them cheaper policies under which they'll have to make more out-of-pocket payments because higher deductibles will reduce the scope for them to make claims.

The new bill walks away from Trump's campaign promises not to cut the associated Medicaid scheme for the poor, and of "insurance for everybody"; abandons the Republican Party's explicit promise of relief from steep policy premiums and high deductibles; and breaches its explicit promise that millions would not lose their insurance - all of which, Trump is reportedly being warned by loyalists, would fracture his coalition of working and middle-class voters, many of whom are older and get by on federal aid.

By the CBO analysis, as many as 52 million Americans, or 19 per cent of the population, would be without insurance by 2026 under Trumpcare, compared with about half that number, 10 per cent of the population, if Obamacare were to survive.

In just the first year of Trumpcare, as many as 14 million currently insured Americans would end up without cover, the CBO predicts, and analysts say that many of them would be the poor and near-poor, and rural whites, especially the elderly, in states that voted strongly for Trump.

In an analysis of electoral implications of Trumpcare, in which The Washington Post overlaid the CBO research with that of the Kaiser Family Foundation, a health think tank, Grant County in Nebraska is revealed as a boil that might prove difficult for Trump to lance; with just 700 people, the county voted 93 per cent for Trump, even though as many as 60 per cent of them won tax credits to help buy insurance under Obamacare.

But under Trumpcare, in what the Post describes as a nationwide pattern, many in Grant County now face steep cuts in the tax credits on which they have come to rely because the harshest consequences of the Republican plan would be felt mostly in rural Republican strongholds.

Looking at 25 counties in which Trump won the largest share of votes, the Post finds that, in all but one, people would pay more for health insurance and lose most in tax credits.

Perversely, in a political context, many in liberal areas that voted more than 80 per cent for Hillary Clinton, would benefit under Trumpcare because health costs are lower in urban areas and their Trumpcare tax credits would amount to more money in their pockets.

By the Kaiser Family Foundation calculations, a middle-aged man earning about $US30,000 ($39,000) a year in Grant County would lose $US3670 in tax credits - more than 10 per cent of his Obamacare era income. But in the suburbs of Atlanta, say, the same man would get an extra $US1620 in tax credits under Trumpcare.

Few among Trump's voters would get much of an associated $US600 billion tax cut over the next 10 years - that's reserved for the richest Americans.

And while more young people might get insurance, it will be at the expense of the elderly - under Trumpcare a 21-year-old earning $US68,200 would pay an average $US1450 out of pocket for a year's cover, compared with $5100 under Obamacare. The out-of-pocket spend for a 64-year-old on the same income would be little altered from Obamacare to Trumpcare, but a 64-year-old earning $US26,500 would pay almost half his salary, $US14,600, for coverage under Trumpcare, compared with $US1700 under Obamacare.

By the CBO's estimate, after 10 years of Trumpcare, the portion of Americans aged 50 to 64 and earning less than $US30,000 a year would more than double - from the current 12 per cent to about 30 per cent.

Anticipating only bad news from the CBO, the White House set about discrediting the report in advance of its release on Monday. But the news was mixed, and so Republicans are doing the splits as they spin the report.

White House budget director Mick Mulvaney dismisses it as "deeply flawed", telling reporters: "This is exactly what we thought the CBO would come forward with - they're terrible at counting [insurance] coverage. It's just absurd."

Trump's Health and Human Services Secretary Tom Price agrees, saying: "The CBO report's coverage numbers defy logic."

But House Speaker and author of the bill, Paul Ryan, is seizing on some of its conclusions and language as proof that Americans will have greater freedom to chose to be insured and that, in time, premiums will be less and the national deficit will be reduced by about $US337 billion.

Ryan told Fox News that the bill ushers in "the most fundamental entitlement reform in a generation ??? it's about giving people more choices and better access to a plan they want and can afford. When people have more choices, costs go down. That's what this report shows."

But Republican members of Congress are walking away - either on equity grounds or because the Trumpcare bill doesn't drive sufficient stakes through the heart of Obamacare.

Republican and Freedom Caucus member Jim Jordan: "This bill doesn't repeal Obamacare. This bill doesn't unite Republicans. This bill doesn't bring down the cost of premiums ... There's a reason every major conservative organisation in the country is opposed to this legislation."

Senator Rand Paul: "It is bad law and it can't pass. If House leaders try to do a little less using the same basic framework as the failed Obamacare experiment, then it will fail too."

Maine Senator Susan Collins: "These kinds of estimates are going to cause revisions in the bill, almost certainly. I don't think that the bill that is being considered now is the bill that ultimately will be the one that we vote on in the Senate."

Louisiana Senator and physician Bill Cassidy: "President Trump said that he wants as many people covered as under Obamacare. He said that healthcare should be affordable. If there's 14 million people losing insurance, of course it's concerning. I try to avoid hyperbole and adjectives, but it's concerning."

Arkansas Senator Tom Cotton explaining the range of GOP critics: "They're not just hardline conservatives. Many of them are centrists, or many of them are just being practical-minded about this bill, the way I am. Just from a practical standpoint, I don't think this bill is going to reduce premiums for working Americans. I think it's going to cost coverage for many Americans as the CBO said yesterday."

Virginia House member Rob Wittman announcing his opposition: "I do believe that we can enact meaningful healthcare reforms that put the patient and healthcare provider back at the centre of our healthcare system, but this bill is not the right answer."

The White House baulks at calling this bill Trumpcare - and often it is Ryan who is credited with authorship of the current draft. But Trump has enthusiastically embraced it, so whatever emerges from the congressional sausage-making machine, it will be called Trumpcare.

Americans will debate the shortcomings of Obamacare - "a disaster", as Trump is wont to say. But this President said that the work of his predecessor was broken and he's trying to fix it - ipso facto, Trump owns it.