March 24, 2017 — Facing the reality of not having enough votes to secure its passage, House leadership withdrew the American Health Care Act (AHCA) from consideration one hour before the final vote was scheduled to begin. House Speaker Paul Ryan (R-Wis.) withdrew the bill on a directive from President Donald Trump, according to the Associated Press, after both men were unable to negotiate a compromise between ultra-conservative and moderate elements within the Republican Party.
The original vote on the AHCA — the legislation drafted by House Republican leadership to repeal and replace the Affordable Care Act (ACA or Obamacare) — was scheduled for Thursday before Ryan ordered a delay on the proceedings to continue working on changes to make the bill acceptable to all sides. While Congressional rules would have allowed the vote to occur anytime through Monday, Trump reportedly insisted on conducting the vote on Friday. He then told Ryan to pull the bill from consideration one hour before the proceedings were to start.
According to The Hill, at least 30 House Republicans planned to vote “no” on the AHCA, with many more leaning that direction.
The most conservative House members, largely represented in the House Freedom Caucus, called for more sweeping repeal of Obamacare provisions such as the Essential Health Benefits, which requires health insurance plans to cover a minimum number of services. More moderate party members are concerned that such changes would result in even more of their constituents losing their insurance coverage.
House leaders did put forward a revised bill on Monday, with these and other changes including conservative reforms to Medicaid and an additional $85 billion directed to help Americans ages 50-64 secure health insurance coverage. A team consisting of Vice President Mike Pence, Health and Human Services Secretary Tom Price and White House Chief of Staff Reince Preibus reportedly spent the early part of Friday meeting with members of the House Freedom Caucus in a last-minute attempt to reach agreement.
A new analysis released Thursday by the Congressional Budget Office showed the changes would not amend the projected number of Americans — 24 million — that would lose coverage by 2026 under the AHCA, according to the Washington Post.
July 29, 2024 
