The newest ‘Trumpcare’ vote may already be in trouble — for the exact opposite reason as last time

Paul RyanHouse Speaker Paul Ryan.AP

After drawing conservative Republicans on board to the American Health Care Act, Republican leadership appears set to try to bring back the American Health Care Act to the House floor for a vote.

But the fate of the legislation appeared to be in doubt Thursday as leaders raced to get the support of moderate Republican lawmakers.

An amendment released Tuesday night, authored by moderate Rep. Tom MacArthur, appeared to placate conservatives who did not think the original AHCA went far enough in its repeal of Obamacare.

The amendment would allow states to apply for a waiver that would exempt their insurance markets from certain regulations created by the Affordable Care Act, or Obamacare, if they can prove it would bring down costs.

The waiver, health policy experts argue, could have negative consequences for people with preexisting conditions and allow insurers to offer plans that cover fewer health needs.

(Read more about the amendment here»)

The tweak was enough to get the conservative House Freedom Caucus officially on board with the bill, which could mean support from roughly 20 members who were against the original AHCA.

But the amendment may have alienated more moderate members of the Republican caucus and could leave the AHCA short of the votes it needs to pass. Only 22 GOP members can vote against the bill for it pass through the Republican-controlled chamber.

MacArthur, the author of the amendment and a co-chair of the Tuesday Group, admitted to reporters Thursday that the Republican conference does not currently have enough votes.

Members of the House GOP conference that originally said they would vote “yes” have now expressed doubts over the amendment. Rep. Mario Diaz-Balart said “there are a lot of red flags” in the legislation and that he was undecided on Thursday — he was a yes on the first version of the AHCA.According to The Hill, other newly undecided members include Reps. Brain Babin, Mike Coffman, and Ryan Costello.

While the House GOP conference attempts to wrangle votes, the White House has also sought to apply pressure ahead of the 100-day mark in President Donald Trump’s administration. Mick Mulvaney, the Office of and Management and Budget director, told CNBC that he was “still holding out” for a vote on Saturday, while other reports suggested a vote could come Friday.

Pushing back on any timeline, House Speaker Paul Ryan has repeatedly said leadership will not bring the legislation to the floor until “we have the votes.”

Passing the AHCA through the House represent a significant hurdle cleared, but it would also lead to new challenges.

Several Republican senators have expressed serious doubts about the AHCA. And since Republicans are attempting to move the healthcare bill through the budget reconciliation process, there have been questions whether the bill would even qualify under the Senate rules.

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