A spokeswoman for the House Freedom Caucus told Breitbart News the technical and Medicare-related changes to the RyanCare bill up for a House floor vote Thursday will not save the bill from defeat.

“The amendments offered by Republican leadership do little to address the serious concerns of House conservatives,” said Alyssa Farah, the caucus communications director.

“At this time, the bill does not have the votes to pass,” she said. “The Freedom Caucus will continue to work with House colleagues, the Senate, and the White House to find a path forward that works for the American people.”

Speaker of the House Paul Ryan (R.-WI) posted changes to his American Health Care Act bill late Monday night that were made to the RyanCare bill by the House Rules Committee, hours before President Donald Trump visits the Capitol to save the speaker’s plan to save the Obamacare program created by the 2010 Patient Protection and Affordable Care Act.

Trump’s visit is significant, because taken at face value, it demonstrates the president’s commitment to Ryan’s plan, but it could also be read as Trump’s attempt to inoculate himself from the charge that he did not do enough to help the speaker if RyanCare is defeated.

The changes are both technical and substantive amendments. The speaker said the technical amendments were necessary to ensure that the bill survives the “Byrd Bath,” the process by which senators allow parliamentarians to strip away parts of a House budget bill that violate the Byrd Rule. The Byrd Rule states that the only bills that are allowed to use the Senate’s privileged budget reconciliation track and remain exempt from filibusters are bills that deal purely with revenues and spending.

.@freedomcaucus has suggested multiple alternatives to unite Rs & earn support among Ds, but GOP leaders have so far rejected major changes. https://t.co/x9uPKjrMRi — Justin Amash (@justinamash) March 20, 2017

The significant amendments to the bill include closing the provision in the RyanCare bill that allowed an abortion tax credit, cutting back the expansion of Health Savings Accounts, and adding new restrictions on Medicaid.

Under the new amendments, rules would discourage New York State from forcing non-New York City counties to subsidize the Big Apple’s Medicaid bill. The amendment would require able-bodied adults without dependents to have a job before they apply for Medicaid benefits. The Empire State provisions apply only to that state.

“I want to thank the White House and members from all parts of our conference who have helped make this the strongest legislation it can be,” Ryan said. “With this amendment, we accelerate tax relief, give states additional options to spend health care dollars how they choose, strengthen what were already substantial pro-life protections, and ensure there are necessary resources to help older Americans and the disabled.”

“The American Health Care Act is the result of a long, member-driven process, and these improvements are an extension of that inclusive approach,” said the speaker, whose bill was crafted privately by working groups made up of insurance industry representatives, congressional staffers, and selected members of Congress.

Capitol Hill conservatives are incensed and frustrated by Ryan’s handling of what was supposed to be a repeal-and-replace of Obamacare but was hijacked by the speaker. House Republicans were told behind closed doors that the RyanCare was precisely worded to unwind features of the Obamacare program that destabilized insurance markets. As the bill progressed through the Ways and Means, Energy and Commerce, and Budget Committees, Republicans did not offer amendments, and amendments by Democrats were ruled out of order, followed by appeals of those rulings, which the Republicans voted to table.

The text of the RyanCare bill was first released March 6 at 6:00 p.m., as congressmen and senators were still arriving back into Washington after a weekend recess.

Until Monday’s night’s changes, the text of the RyanCare bill was exactly as it was the night it was first made public.

An important part of how the speaker is managing his bill is his need to preserve the trappings of “regular order.” Regular order is the routine process, by which measures are developed in committees and subcommittee with hearings and an open amendment process. While the RyanCare bill continued step-by-step through the committees, the speaker was able to tout his returning to regular order — one of his pledges — when he first ran for speaker to block a conservative from succeeding Speaker John Boehner (R.-OH).

While Republicans are content to go-along-to-get-along within their respective committees, the RyanCare bill is heading for defeat on the House floor. There are 237 Republicans and 193 Democrats. The five vacant seats mean that Ryan needs 216 votes, a target beyond his grasp if 21 members of the House Freedom Caucus hold the line. Reporting by Breitbart News puts the HFC bloc against RyanCare north of 25.

Under the House rules, that is regular order; the bill is now awaiting consideration by the Rules Committee, chaired by Rep. Pete Sessions (R.-TX). Sessions was himself a contender to replace Boehner, but he chose instead to back Ryan. Although Sessions is the chairman of the committee, the committee is in practice the speaker’s instrument to control legislation. Called the “Speaker’s Commitee,” the Rules Committee has extraordinary power to change legislation and set the terms of debate and the degree to which a bill would be subject to amendments on the floor.

Conservatives are still waiting to see if the House Republican leadership instructs the Rules Committee to allow an open amendment process on the floor.