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An 11th-hour White House push to give President Trump a major legislative victory in his first 100 days in office broke down late Thursday as House Republican leaders failed to round up enough votes for their bill to repeal the Affordable Care Act. ... [S]eesawing commitments and the reservations from numerous lawmakers throughout Thursday laid bare the difficulty that Republican leaders faced in trying to push through a repeal bill. (Kaplan and Pear, 4/27)

The House won't vote on a reworked health care overhaul until at least next week, Majority Leader Kevin McCarthy, R-Calif., told reporters late Thursday. Party leaders made that decision after spending all day pressuring moderate GOP lawmakers to back that bill, but fell short of the votes they'd need to prevail. "As soon as we have the votes, we'll vote on it," McCarthy said after leaving a nearly two-hour meeting of the House GOP leadership. (Fram, 4/28)

"We've been educating people on health care," McCarthy said. "It's not tomorrow. I never said it was going to be tomorrow. ... We are not voting on health care tomorrow." When asked about Saturday, he said, "No. We never put it out there." He didn't make any further comments about timing. (Mershon and McPherson, 4/27)

White House officials, after striking a deal with conservatives, had publicly raised expectations that the vote would occur this week. And they privately pushed Ryan (R-Wis.) to hand Trump something he could tout as a major legislative victory before Saturday, his 100th day in office. (Cheney, Bade and Bresnahan, 4/27)

Outside of the Freedom Caucus, Republicans who had opposed the American Health Care Act grappled with the revised text. Most were still opposed or undecided on Thursday. “We’re taking a trillion bucks out and saying, ‘Good luck, states,’” said Rep. Mark Amodei (R-Nev.), whose district covers Reno and most of rural Nevada. “That may provide money to do tax reform, but what you leave in my state is that when the legislature meets, it’s got about a quarter-of-a-billion-dollar shortfall.” (Eilperin and Weigel, 4/27)

As many as 15 or so House Republicans have publicly said they will not support the latest GOP proposal, which was crafted among the White House, the hard-line House Freedom Caucus and a leading moderate lawmaker. That leaves House Speaker Paul D. Ryan (R-Wis.) and the White House an incredibly narrow path for passage. The speaker can lose only 22 Republicans on a health-care vote because Democrats have fiercely opposed any attempt to repeal the ACA. (Snell and Kane, 4/27)

The latest version of Obamacare repeal and replace would leave it up to the states on how much insurers can charge older customers beginning next year. In 2020, it would allow states to apply for a waiver to change the 10 essential health benefits now required to be part of nearly all health insurance plans. The goal of any of these changes, according to the bill's authors, is to reduce healthcare premiums for the majority of customers. (4/27)

[S]everal moderate Republicans are visibly frustrated about the renewed push to pass the bill after leaders made changes aimed at winning over conservatives. "We’ve been through this before,” Republican Representative Charlie Dent of Pennsylvania said Thursday. "The business model around here is to load the bill up, make it as conservative as possible, send it to the Senate and have the Senate clean it up and send it back, and the very people who are placated on the first launch won’t be there on the final. And that dog ain’t hunting anymore." (Edgerton and House, 4/27)

The budget scorekeeper for Congress is apparently a few weeks away from releasing an analysis of the GOP's revised ObamaCare repeal-and-replace bill.  The nonpartisan Congressional Budget Office (CBO) told House Minority Leader Nancy Pelosi's (D-Calif.) office Thursday that a score of the bill would not be ready this week or next. (Hellmann, 4/27)

House Speaker Paul D. Ryan fired warning shots to his fellow Republicans on Thursday that not repealing the 2010 health care law could have significant political consequences in the midterm elections. The comments come as leadership attempts to corral support for legislation (HR 1628) that would remove large portions of the health law. While a scheduled vote on the bill was pulled last month amid infighting between conservative and moderate Republicans, the effort has gained new momentum in recent days due in large part to an amendment from GOP Reps. Tom MacArthur of New Jersey and Mark Meadows of North Carolina that would allow states to apply for exemptions from key mandates in the law. (Williams, 4/27)

House Republicans are mounting yet another effort to tear down Obamacare and remake the health care system — but the path to delivering on one of the GOP's longest-standing priorities remains complicated and fraught with uncertainty. (Cancryn, 4/27)

Nearly two-thirds of the 14 Republicans in the California congressional delegation are still reviewing changes to the GOP healthcare plan, and only four have taken a firm position on it. (Wire, 4/27)

The lone Georgia Republican congressman to reject an earlier iteration of the GOP’s Obamacare replacement plan said he’s now on board after conservatives struck a deal with a moderate leader. Rep. Jody Hice, R-Monroe, said he’ll support the GOP’s American Health Care Act, or AHCA, after the chairman of the House Freedom Caucus and moderate New Jersey Republican Tom MacArthur negotiated changes to the legislation that would allow states to opt out Obamacare’s basic coverage requirements as long as they first get a waiver. (Hallerman, 4/27)

Even if House Republicans manage to get enough members of their party on board with the latest version of their health care bill, they will face another battle in the Senate: whether the bill complies with the chamber’s arcane budget rules. But experts say that’s one battle Democrats have a chance of winning — unless the Senate pulls another “nuclear option.” (Reid, 4/27)