“The latest proposal I made was just trying to bridge this divide between people that are holding two important views: people that are saying ‘we’re not going to fix health care unless we bring the cost down, which means we have to give the states some flexibility, ‘” he said.

House Freedom Caucus Chairman Mark Meadows (R-N.C.) told reporters Wednesday that the caucus supports the American Health Care Act pursuant to an agreement on an amendment that is created to contain health insurance premiums.

The change would allow states to scrap what the caucus described as the “cost driving aspects” of Obamacare. In this case, the changes that have been made to appease the conservatives in the House Freedom Caucus may end up being too much for the GOP moderates represented by the Tuesday Morning Group and other informal groups of Republicans. Even with Republicans in control of both chambers of Congress and the White House, the Trump administration is learning that Democrats retain significant leverage when their votes are needed on must-pass legislation.

Formally known as the Affordable Care Act, Obamacare included a provision requiring members of Congress and their staffs to buy their coverage on an Obamacare marketplace; they now get coverage through a Washington, D.C., exchange aimed at small business coverage, where they also get a significant employer contribution from the federal government.

A spokesperson for Rep. Tom MacArthur (R-N.J.) who authored this amendment confirmed this was the case: members of Congress and their staff would get the guarantee of keeping these Obamacare regulations.

For example, a state could choose to drop the maternity coverage section of the extended health benefits included in Obamacare, and an insurer could then charge more for this service, as they would be allowed to do with pre-existing conditions.

House Republicans are closer to passing a health bill than they’ve ever been – but it’s still not certain they can rack up enough votes for a win.

Charlie Dent also says he believes that moderates who have opposed the Republican health overhaul haven’t changed their minds, despite proposed changes.

Their wavering comes as more hardline Republicans in the House Freedom Caucus have suddenly thrown their support behind the legislation.

“This is the same bill that would cause 24 million Americans to lose health insurance”.

The choice moderates face is to stand against President Donald Trump and congressional leaders, or to potentially go back on their promises to protect people with pre-existing conditions. Mo Brooks, R-Ala., said he’d already chose to switch to backing the revamped bill on Wednesday before he got two phone calls from Pence, who on the second call handed the phone to Trump. Many of his members have already said no to or are being silent about the bill, perhaps hopeful they will not have to take a public position. “It’s simply bad policy that will cut a lifeline of health care for millions of Americans”, Siegel’s statement said.

An official Freedom Caucus endorsement requires support from 80 percent of its members. But Ryan told reporters that “we’re not doing that”.

He and other Republicans, however, stopped short of saying they had enough votes to pass the measure in the House.

The dispute with Democrats, in particular Pelosi, threatened to hold up the $1 trillion-plus spending bill.

“I have always campaigned on making sure that no one is denied coverage based on pre-existing condition”, said Rep. Leonard Lance, R-N.J., who said he remained opposed to the legislation.

Republican Rep. Chris Collins, R-N.Y., summed it up more succinctly, speaking to reporters off the House floor. Since many moderates were still publicly unclear or undecided, it’s unknown exactly how many votes GOP leadership had been deprived from the moderate wing in order to mount them to 216 votes.

In March, Washington state’s most elusive representative, Dave Reichert (Auburn), only considered pulling his support from the AHCA once Ryan & Co. started gutting protections to appease the Freedom Caucus.