Paul Ryan and Donald Trump, aka "the closer," have lost this battle.
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WASHINGTON ― With conservatives unable to find a deal and leadership unable to find the votes, House Republicans pulled their health care bill from the floor and delayed a vote that had been scheduled for Thursday.

“No vote tonight,” a GOP leadership aide said.

Conservatives have teetered between strongly opposing the GOP health care bill and looming support. The House Freedom Caucus has negotiated with the White House on potentially eliminating Essential Health Benefits and some unknown provisions in Title I of the Affordable Care Act. That expansive section of the 2010 health care law Republicans are trying to repeal includes provisions requiring coverage for people with pre-existing conditions and allowing young adults to remain on a parent’s plan until they’re 26 years old. 

The last-minute renegotiation of the bill spooked moderates, whose trickle of opposition became a steady stream throughout Thursday. Rep. Charlie Dent (R-Pa.) ― the head of the Tuesday Group, which is made up of roughly 50 moderate House Republicans ― announced his own opposition.

The delay also comes one day after White House press secretary Sean Spicer agreed with chief deputy whip Patrick McHenry (R-N.C.)’s assessment that President Donald Trump is “the closer.” 

The vote delay, while not the floor defeat that the Freedom Caucus and reluctant moderates had been promising, is still a huge loss for congressional leaders like House Speaker Paul Ryan (R-Wis.) and House Majority Leader Kevin McCarthy (R-Calif.), as well as for Trump.

Trump has come to own the American Health Care Act, even making a direct pitch during a closed-door meeting with House Republicans on Tuesday. The continued opposition to the bill may be the first signal that Trump’s political capital doesn’t run very deep in the House GOP conference, and that Republicans, particularly conservative ones, aren’t afraid to cross the president.

Trump’s vaunted dealmaking skills have failed him so far, however. He didn’t pick up any new support by offering to eliminate Essential Health Benefits from the bill, but instead lost a wave of moderates and made the measure more politically toxic than it had been.

Lawmakers emerging from an evening caucus with leaders and Trump administration figures said it was still unclear if there would be the votes on Friday, but they intended to push ahead anyway.

The compromise that emerged was said to be a take-it-or-leave-it final offer from the White House that would let conservatives eliminate certain essential benefits from insurance requirements, such as maternity care and mental illness treatment. To appease moderates concerned too many people will be tossed from the health insurance rolls, the deal includes keeping a 0.9 percent Medicare surcharge tax from the Affordable Care Act on high-income earners for six years. That would add about $15 billion to a fund to help states defray costs.

“We didn’t even discuss votes,” said Rep. Chris Collins (R-N.Y.), one of the biggest boosters for the repeal. “This was a plea one-on-one-on-one for the entire conference to come together as a team, to look in the mirror, understand we are the governing body.”

A procedural vote was expected at 10 a.m. Friday, followed by a vote on passage of the bill in the afternoon.

Some lawmakers were pushing to hold a vote on the bill itself as soon as possible, regardless of whether too many of their colleagues were publicly opposed. Ryan can afford to lose 21 or 22 members, depending on how many lawmakers are present, and still succeed. The Huffington Post’s count has him losing well more than that.

“Some of them that are at least indicating to y’all that they’re going to vote no are going to vote yes,” Rep. Bradley Byrne (R-Ala.) told reporters outside of Ryan’s offices, arguing that the longer past midnight Thursday the vote goes, the less likely it will succeed.

“Time to make a decision, gentleman and ladies,” Byrne said. “And this is one of those moments where you’ve got to say who you are deep inside of you. Are you for President Trump and repealing and replacing Obamacare, or are you against President Trump, and you are against repealing and replacing Obamacare? It’s that simple.”

After House leaders delayed the vote, the Congressional Budget Office released a fresh analysis of the bill, which had already been revised once.

The budget scorekeeper’s assessment found the revised bill would save less money than the original but have similar poor outcomes. As with the original version, 24 million fewer people would have health insurance by 2026. Premiums would also rise 10 percent to 15 percent in 2018 and 2019 ― then wind up 10 percent lower by 2026, after high prices drove older customers from the market. The new version of the bill would cut just $150 billion from the deficit over 10 years, while the original legislation would have cut $337 billion.

The new CBO estimates did not include the new potential changes that are currently being discussed in an effort to win over conservatives, such as eliminating portions of the Affordable Care Act that require insurers to sell plans covering a set of basic benefits.

This article has been updated with the evening caucus of House Republicans with Trump administration figures. 

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Before You Go

Health Care Reform Efforts In U.S. History
1912(01 of17)
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Former President Theodore Roosevelt champions national health insurance as he unsuccessfully tries to ride his progressive Bull Moose Party back to the White House. (credit:Topical Press Agency/Getty Images)
1935(02 of17)
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President Franklin D. Roosevelt favors creating national health insurance amid the Great Depression but decides to push for Social Security first. (credit:Keystone/Getty Images)
1942(03 of17)
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Roosevelt establishes wage and price controls during World War II. Businesses can't attract workers with higher pay so they compete through added benefits, including health insurance, which grows into a workplace perk. (credit:Hulton Archive/Getty Images)
1945(04 of17)
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President Harry Truman calls on Congress to create a national insurance program for those who pay voluntary fees. The American Medical Association denounces the idea as "socialized medicine" and it goes nowhere. (credit:Keystone/Getty Images)
1960(05 of17)
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John F. Kennedy makes health care a major campaign issue but as president can't get a plan for the elderly through Congress. (credit:Keystone/Getty Images)
1965 (06 of17)
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President Lyndon B. Johnson's legendary arm-twisting and a Congress dominated by his fellow Democrats lead to creation of two landmark government health programs: Medicare for the elderly and Medicaid for the poor. (credit:AFP/Getty Images)
1974(07 of17)
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President Richard Nixon wants to require employers to cover their workers and create federal subsidies to help everyone else buy private insurance. The Watergate scandal intervenes. (credit:Keystone/Getty Images)
1976(08 of17)
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President Jimmy Carter pushes a mandatory national health plan, but economic recession helps push it aside. (credit:Central Press/Getty Images)
1986(09 of17)
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President Ronald Reagan signs COBRA, a requirement that employers let former workers stay on the company health plan for 18 months after leaving a job, with workers bearing the cost. (credit:MIKE SARGENT/AFP/Getty Images)
1988(10 of17)
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Congress expands Medicare by adding a prescription drug benefit and catastrophic care coverage. It doesn't last long. Barraged by protests from older Americans upset about paying a tax to finance the additional coverage, Congress repeals the law the next year. (credit:TIM SLOAN/AFP/Getty Images)
1993(11 of17)
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President Bill Clinton puts first lady Hillary Rodham Clinton in charge of developing what becomes a 1,300-page plan for universal coverage. It requires businesses to cover their workers and mandates that everyone have health insurance. The plan meets Republican opposition, divides Democrats and comes under a firestorm of lobbying from businesses and the health care industry. It dies in the Senate. (credit:PAUL J. RICHARDS/AFP/Getty Images)
1997(12 of17)
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Clinton signs bipartisan legislation creating a state-federal program to provide coverage for millions of children in families of modest means whose incomes are too high to qualify for Medicaid. (credit:JAMAL A. WILSON/AFP/Getty Images)
2003(13 of17)
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President George W. Bush persuades Congress to add prescription drug coverage to Medicare in a major expansion of the program for older people. (credit:STEPHEN JAFFE/AFP/Getty Images)
2008(14 of17)
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Hillary Clinton promotes a sweeping health care plan in her bid for the Democratic presidential nomination. She loses to Barack Obama, who has a less comprehensive plan. (credit:PAUL RICHARDS/AFP/Getty Images)
2009(15 of17)
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President Barack Obama and the Democratic-controlled Congress spend an intense year ironing out legislation to require most companies to cover their workers; mandate that everyone have coverage or pay a fine; require insurance companies to accept all comers, regardless of any pre-existing conditions; and assist people who can't afford insurance. (credit:Alex Wong/Getty Images)
2010(16 of17)
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With no Republican support, Congress passes the measure, designed to extend health care coverage to more than 30 million uninsured people. Republican opponents scorned the law as "Obamacare." (credit:Mark Wilson/Getty Images)
2012(17 of17)
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On a campaign tour in the Midwest, Obama himself embraces the term "Obamacare" and says the law shows "I do care." (credit:BRENDAN SMIALOWSKI/AFP/Getty Images)