WASHINGTON — Republicans are rarely as exercised as when they are fighting with themselves.

And as the House debates how to best dismantle the Affordable Care Act, a familiar array of interest groups with deep pockets, incensed talk radio hosts and online agitators is again assuming its posture of aggression toward the House Republican leadership.

“Swampcare,” the writer and radio personality Erick Erickson scoffed at the new American Health Care Act, the culmination of seven years of promises to repeal and replace President Barack Obama’s signature domestic achievement. “Obamacare 2.0,” declared Breitbart.com. “RINOCARE,” Mark Levin wrote on Twitter, using the acronym for Republican in Name Only.

Political groups backed by the billionaire brothers Charles and David Koch and other powerful players on the right, such as Club for Growth and Heritage Action for America, have come out quickly and strongly against the bill. Some have threatened to punish lawmakers by docking their conservative ratings on the influential “scorecards” they distribute to voters. Activists are already swarming Capitol Hill and demanding that Congress take a harder line and pass a repeal measure that would leave no trace of the Affordable Care Act.

“I feel lied to,” said Anna Beavon Gravely, the deputy state director of the North Carolina chapter of Americans for Prosperity, a Koch-backed group that is funding a grass-roots push against Republicans in Congress who want to stop short of an outright repeal.