Collins has adopted a similar stance. While she hasn’t ruled out voting for a package that defunds Planned Parenthood, she said in January she was “not happy” that House Speaker Paul Ryan had decided to make it part of the leadership’s plan to repeal Obamacare. A group of moderates in the House is also wary about targeting the organization, which operates about 700 health centers nationwide and provides a range of services to women beyond abortion. At a GOP policy retreat in January, freshman Representative John Faso of New York urged leaders to separate out the issue from Obamacare, warning that they would be “walking into a gigantic political trap” by taking on the two contentious topics together, according to a secret tape reported by The Washington Post.

Yet conservatives are equally adamant that the bill defund Planned Parenthood, arguing that even though federal law already forbids taxpayer funding for abortion, the reimbursements that the organization receive through Medicaid helps to subsidize a procedure they consider morally unconscionable. Representative Trent Franks of Arizona is one of the most passionate abortion foes in the House. When I asked him last week what would happen if Republicans tried to repeal Obamacare without defunding Planned Parenthood, he replied: “It would be easier to light the Capitol on fire.”

Abortion is in some ways a microcosm of the GOP’s broader struggle on healthcare. The party has a majority in both chambers of Congress but not, it seems, for any one approach to replacing Obamacare; its majority in opposition to abortion appears smaller still. If Republican leaders move to the right on Planned Parenthood, they risk losing the support of moderates, but postponing the fight to future legislation could doom the repeal effort with the far larger group of conservatives (if it isn’t already).

On this issue, President Trump seems to be in the middle. As a candidate, he at one point suggesting women should face criminal punishment if they had an abortion. Yet he was one of the few Republican candidates who spoke up in support of Planned Parenthood—even as he backed cutting off its federal funding. “Millions of millions of women —cervical cancer, breast cancer—are helped by Planned Parenthood,” Trump said during a primary debate a little over a year ago. “I would defund it because I'm pro-life, but millions of women are helped by Planned Parenthood.”

The New York Times reported Monday that the White House, recognizing the political controversy surrounding the organization, had offered Planned Parenthood a deal: It could keep its federal funding if it stopped performing abortions, which by its own analysis constitutes just 3 percent of the services it provides to women. The answer was no. In a statement, Planned Parenthood’s president, Cecile Richards, said in part:

The White House proposal that Planned Parenthood stop providing abortion is the same demand opponents of women’s health have been pushing for decades, as a part of their long-standing effort to end women’s access to safe, legal abortion. Planned Parenthood has always stood strong against these attacks on our patients and their ability to access the full range of reproductive health care. We are glad that the White House understands that taking away the preventive care Planned Parenthood provides is deeply unpopular and would be a disaster for women’s health care.

In a briefing at the White House on Tuesday, the secretary of health and human services, Tom Price, would not make a definitive statement about the administration’s position on Planned Parenthood other than to say legislation should allow people to purchase insurance that respects their “conscience.” “We think it’s important that the legislature work its will on this process ,” Price said.