The immediate politics of the latest iteration of the Republican healthcare bill make sense for some Republicans, particularly for members of the House Freedom Caucus who would like to not be blamed anymore for the bill's demise.
The conservative House Freedom Caucus came out in support of a reworked USA healthcare overhaul bill even though it would not fully repeal Democratic former President Barack Obama's signature healthcare law, the group said in a statement on Wednesday. These include allowing young people to remain on their parent's health plan until age 26, barring insurers from charging more to people with pre-existing conditions, and requiring that health insurance plans cover mandated essential benefits.
The plan was crafted by Rep. Tom MacArthur, R-N.J., a leader of the moderate House Tuesday Group along with Rep. Mark Meadows, R-N.C., head of the conservative House Freedom Caucus.
But by Thursday evening Republican leaders still had not collected enough votes from moderate Republicans whose backing was also needed for passage in the House, given united Democratic opposition. "We think it's constructive".
House leadership said they will bring AHCA to the floor when they are confident they have the votes for it to pass.
Moderate leader Rep. Charlie Dent, R-Pa., said the changes ignored his concerns that the health care bill would cut too deeply into the Medicaid program for the poor and leave many people unable to afford coverage.
Ryan's answer was an admission that he doesn't have the votes to pass Trump's health care bill. Others, including Republican Representative Dan Donovan of NY, said the loosening of protections for people with pre-existing medical conditions was a major problem.
As of Thursday evening, at least 17 House Republicans were prepared to vote against the amended healthcare bill, according to ABC's whip list.
A Republican lawmaker whose amendment this week has inched Republicans closer to passing their health care bill says the change will protect "vulnerable people" while giving states greater flexibility.
The long-term spending deal is expected to provide more funding for the military and for border security, although President Donald Trump backed off his demand that lawmakers provide money to go toward the wall he wants to build along the border with Mexico.
But the bill may be "going nowhere" in the Senate because the new language would likely run afoul of the Byrd rule, meaning it would require 60 votes in the Senate, said Matt House, a spokesman for Senate Democratic Leader Chuck Schumer of NY. But Ryan told reporters that "we're not doing that".
Brooks also pointed to an amendment introduced by Rep. Gary Palmer, R-Birmingham, that would remove "the most expensive individuals from the market and placing them in a high-risk pool akin to the state of Maine's highly successful model".
Meanwhile, Democrats have maintained unity, leaving Republicans to scramble to find votes within their own caucus.