Just minutes before House lawmakers were scheduled to vote on the Republican healthcare plan, House Speaker Paul Paul Ryan called off the vote. Republicans did not have enough votes to pass the bill, which would have replaced President Obama's Affordable Care Act.
The bill's failure is a huge blow to the GOP agenda, and raises doubts among lawmakers about both President Donald Trump and Ryan's leadership going forward.
Ryan spoke with Trump by phone at 3 p.m., and that the president asked the speaker to pull the bill, a Ryan aide told VICE News. Ryan broke the news to GOP lawmakers at an emergency meeting called around 3:30 p.m., shortly before they were originally scheduled to hold the vote.
"[The Affordable Care Act] is going to remain the law of the land until it's replaced," Ryan said at a press conference shortly after the announcement that the vote was cancelled. "We did not have the votes to replace this law. And so, yeah, we're going to be living with Obamacare for the foreseeable future."
In remarks to reporters in the Oval Office Friday afternoon, Trump put a positive spin on the defeat. "In the end, I think it's going to be an experience that leads to an even better health care plan," he told reporters, adding that the Affordable Care Act would soon "explode."
Trump also repeatedly blamed the Democrats for not giving the bill "a single vote." But he also ominously noted, "We learned a lot about loyalty" — a nod to Republican lawmakers who opposed the bill despite his feverish lobbying efforts.
The House debated the bill for hours Friday, and the partisan divide only got more and more heated as the vote got closer. After each Republican spoke, Democrats would "remind" their colleagues just how many of their constituents stood to lose coverage under the Republican health care plan. (The Congressional Budget Office estimated Thursday that Wednesday amendments to the bill would leave 24 million people uninsured by 2024.)
But ultimately, it was the clash between Republican moderates and ultra-conservatives that ultimately doomed the bill. The conservative House Freedom Caucus met with Trump Thursday, demanding that the president bring down insurance premiums by cutting coverage for what the Affordable Care Act called "essential health benefits," such as maternity care.
The White House agreed, but those last-minute changes then made moderate Republicans turn away from the bill.
Ryan waved away reporters' questions about what the failed bill meant for the rest of the Republican agenda, which he said would now turn to issues like border control and tax reform. "I don't think this is prologue for other future things because members realize that there are other parts of our agenda that people have even more agreement on," he said.
Yet the defeat will send Republicans back to the drawing board on health care reform and make repealing the Affordable Care Act even tougher in the future.
Pulling the bill is significant rebuke for both Ryan and Trump, and raises questions about whether the Republicans — accustomed to being the minority — can find enough common ground on issues to govern.
Ryan got the Trump administration to agree to a legislative strategy that pursued health care reform before turning to the rest of the Republican agenda. The initial bill was also Ryan's blueprint, which he previously described as a "consensus document" that the entire Republican caucus had agreed to. His inability to garner the needed votes raises doubts about whether Ryan will be able to keep an unruly caucus in line on future tough votes.
Trump also put his weight fully behind the bill, telling Republican lawmakers that they needed to pass the bill or risk leaving Affordable Care Act in place. His failure to deliver the needed votes will likely loom over future legislative negotiations, as the "art of the deal" appears to be no match for a handful of House conservatives.
Both Trump and Ryan publicly had kind words for one another in the aftermath. "He worked very, very hard," Trump said of Ryan, while Ryan said, "The president gave his all in this effort."
After learning of Ryan's call, Republican lawmakers left their emergency caucus meeting seeming dazed and unsure of their next steps.
"I don't know what the agenda will be for the next few weeks," said Virginia Republican Rep. Morgan Griffith told VICE News as she left the meeting in the basement of the Capitol.
Kentucky Republican Rep. Andy Barr said it was "time to move on" and "focus on other things." But the bill's failure also scrambles the next step in the GOP's legislative agenda, and the policy that Trump has seemed most eager to pursue: Tax reform. Republicans presumed that the Affordable Care Act's taxes would be repealed, and were crafting their reforms accordingly.
But some members said the botched vote would linger over Ryan. Asked whether the bill's failure raised questions about the Speaker's leadership, Republican North Carolina Rep. Walter Jones said: "Probably so."