washington deeply divide republicans squeeze u.s. healthcare overhaul back president donald trump key house representatives panel thursday despite defections three conservatives consider similar obamacare law intend replace trump first major legislative initiative still face uphill battle full house late senate despite ongoing efforts white house republican leaders satisfy conservative opponents budget committee vote 19 17 republican representatives david brat gary palmer mark sanford members conservative house freedom caucus join panel democrats vote committee bring provision approve last week two panel single bill help pave way late vote house floor republicans control congress white house could afford lose three rank committee pass think anywhere near passage brat say vote note republican conservatives well moderate problems bill 2010 affordable care act signature legislative achievement former president barack obama enable 20 million previously uninsured americans obtain medical coverage half law expansion eligibility increase fund medicaid government health insurance program poor close vote illustrate problems republican leaders may encounter corral enough vote party win passage house floor amid unify democratic opposition measure go rule committee reach house floor congressional budget office nonpartisan congressional agency forecast monday legislation would increase number americans without health insurance 24 million 2026 cut 337 billion federal budget deficits period bill face opposition lead healthcare providers include doctor hospitals track schedule house speaker paul ryan unveil legislation last week chief champion house say committee vote add main part bill go stay exactly republicans make unspecified improvements refinements ryan tell news conference trump deeply involve help bridge gap among republican lawmakers get consensus plan conservatives unmoved natural constituency bill say republican representative raul labrador another freedom caucus member leave really mad right really mad middle really mad far seem constituency one washington insiders people try get something pass get next issue trump administration officials house republican leaders say hope get bill house floor end month go senate lawmakers mid-april recess conservatives want quick end obamacare medicaid expansion bill set 2020 want add work requirements medicaid recipients also call age-based tax credit help people buy insurance open market unwise new entitlement white house say discuss change house republican leaders trump tell fox news interviewer wednesday much bill would still negotiate especially move house senate conservative advocacy group praise republicans vote no club growth president david mcintosh say make sense ryan budget committee chair diane black force republicans walk plank vote bad bill already admit need change black ask fellow republicans doubt cut discussion vote approve legislation panel adopt four non-binding republican recommendations change move house floor include one conservative palmer add work requirements able-bodied childless medicaid recipients recommendations call long encourage people sign insurance medicaid give state flexibility design medicaid program change bill tax credit help lower-income people democrats call republicans plan blow elderly poor give tax cut rich representative john yarmuth committee top democrat say legislation healthcare bill ideological document say bill imagine fantasy land young people get sick apparently grow old either worry price market republicans split conservatives angry healthcare overhaul inch ahead