And Sen. Tom Cotton (R-Ark.) on ABC: “I'm afraid that if they vote for this bill, they're going to put the House majority at risk next year. … I’m worried it could make it worse in some ways.”

And Sen. Dean Heller (R-Nev.) in an audio recording unearthed by Politico: “They’re talking about [getting rid of the Medicaid expansion by] 2020, now they’re talking about making the changes in 2018. That’s not enough time for Nevada to adjust.”

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That's three very reluctant senators, two of whom spoke publicly about serious reservations. And none of them are even among the four GOP senators who have said they won't vote for anything that leaves millions uninsured. (We're still waiting for a Congressional Budget Office score that is very likely to show such a projection.)

Republican leaders, including House Speaker Paul D. Ryan (Wis.) and President Trump, have expressed confidence that the bill will pass and warned of the dire consequences of not passing it. But it's clear from many Republicans' public comments that these words are falling on deaf ears. As The Fix's Amber Phillips notes, there are enough skeptical Republicans in both the Senate and the House to kill the bill right now, and many of them have spoken in quite strong terms, just like Paul and Cotton.

Ryan dismissed the rhetoric last week, suggesting it's the remnants of being a longtime minority party in Washington. “We’re going through the growing pains of being an opposition party with Barack Obama to actually being a governing party with a Republican President Donald Trump,” he told Hugh Hewitt.

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But there is a difference between expressing a few reservations and the kinds of lines in the sand that are being drawn by the senators above. There is certainly something to be said for withholding support until you get something you want; these statements strongly suggest no adjustments — either moving the bill to the right to appeal to conservatives such as Paul and Cotton, or to the left to appeal to Heller and the group of four senators — are going to check the boxes for enough senators.

It's hard to overstate just how significant and wide-ranging the reservations are. Conservatives want the Medicaid expansion to be reined in sooner and the “Cadillac tax” to be cut. Middle-of-the-road senators, meanwhile, want the Medicaid expansion kept for a long time — if not permanently — and say they aren't going to abide by a decline in the insurance rate.

Satisfying either of those camps comes at the expense of the other. If the Medicaid expansion were ended sooner, how could Heller explain voting for it? And if it were extended, how would conservatives explain their hard-line rhetoric?