u.s. president donald trump use barnstorm strategy wednesday try build momentum first legislative initiative healthcare overhaul hold massive rally nashville tennessee reminiscent campaign events back capitol hill republican leaders negotiate behind close doors hold media conferences give cable-news interview try push forward plan dismantle affordable care act commonly call obamacare republican house speaker paul ryan unveil new plan last week fault line appear within party conservatives say go far enough others reject entirely trump use campaign-like language wednesday night speech pledge repeal replace horrible disastrous obamacare speak reporters aboard presidential plane air force one rally trump express optimism plan chance congress go come something always say republicans control congress white house first time decade overhaul still face political battle fight president new govern white house spokesman sean spic tell reporters rally trump administration talk ryan congressional leaders flood media interview administration officials help advance plan ryan top republican house representatives also continue champion legislation say cable news open make improvements refinements also add major components stay intact tell news conference late even house would hold vote repeal replace obamacare refuse provide timetable two house committees approve bill provision change last week budget committee try thursday unify plan single bill consideration house floor republicans afford lose three rank committee pass three committee republicans members hardline conservative house freedom caucus sign emerge wednesday white house win reluctant conservatives initially question legislation ground closely resemble obamacare signature domestic policy achievement former president barack obama administration indicate open revisit plan treatment medicaid government health insurance program poor meet conservative wing party specifically conservatives want obamacare expansion medicaid end sooner propose ryan plan want introduce medicaid work requirements able-bodied adults without children state governments run medicaid reimbursements federal government obamacare expand eligibility increase fund enable 10 million previously uninsured americans obtain medical insurance vice president mike pence advocate plan early wednesday behind close doors republican study committee large group house conservatives republican representative phil roe say pence meet bill would probably change move end medicaid expansion one year 2019. conservative group members close sign legislation leader representative mark walker tell reporters speak cnn ryan mention give state good chance flexibility medicaid provide detail party conservatives begin express optimism proposal fortunes republican moderate raise concern tax credit currently bill intend help people buy health insurance sufficient representative charlie dent follow meet moderate republicans pence tell reporters speed termination medicaid expansion non-starter senate republicans also voice rise unease write house bill would pass senate believe fix senator ted cruz tell reporters republican senator lindsey graham tell nbc today show mortally wound conservative advocacy group freedomworks hold rally amid snow flurry frigid wind outside capitol several house senate republicans include cruz senator rand paul voice dissatisfaction bill paul late tell reporters white house much open negotiation house leaders libertarian paul post op-ed breitbart news website late wednesday call ryan plan obamacare lite suggest smash smithereens u.s. department health human service release data show enrollment individual insurance plan create obamacare decline 12.2 million americans enrollment individual insurance plan 500,000 people 2016 end january say 1.6 million people short obama goal 2017 sign-ups government say trump barnstorm push healthcare plan sign conservative support