The chairman of the House Freedom Caucus told reporters Tuesday that despite a phone call with President Donald J. Trump, he is not voting for the American Health Care Act, crafted by Speaker Paul Ryan (R.-WI) as an alternative to the clean repeal of the 2010 Patient Protection and Affordable Care Act, Obamacare.

North Carolina Republican Rep. Mark Meadows, who took over the House Freedom Caucus at the beginning of this session of Congress, said that he and the president agree that the most important thing national health care policy can accomplish is to lower insurance premiums.

“I know the president wants to lower premiums,” Meadows said.

“Both he and I both agree that premiums need to be lower and if they’re not, both he and I will be judged that we didn’t do our jobs,” he said. Meadows also attended a private meeting with Vice President Mike Pence.

Earlier in the day, Meadows told Breitbart News that negotiations with leadership had come to a halt and that leadership had moved as far as it could with the amendments that were introduced as manager’s amendments. These amendments included, a work requirement for Medicaid, eliminated the RyanCare tax credits for abortions and changed the formula New York State uses to take money from counties outside of New York City to finance Medicaid in the Big Apple.

Meadows called the sop to upstate New York the “Buffalo Buyout,” and said he was not comfortable with leadership giving each state its own special deal, and he does not see the special arrangement as affecting the vote significantly.

House leadership may have thought it was doing a clever thing helping out non-New York City areas of the Empire State, that tend to be Republican. But, they forgot that Rep. Dan Donovan (R.-NY) represents one of the most Republican districts in the country, Staten Island, which is one of the five boroughs of New York City. Although, Donovan was leaning towards voting for the bill, he is now firmly undecided.

The former district attorney said four hospitals in his district would suffer severely under the new rules the speaker’s team designed to win over the upstate New Yorkers.

Donovan was supposed to be a solid Yes. He and roughly a dozen other members of the moderate Tuesday Group went to the White House for a meeting with the president in the Oval Office.

“The president would like people to get to yes, but he listens, more than he tells,” he said about the meeting, where Trump sat among the congressman, not at his desk.

Texas Republican Rep. Kevin Brady (R.-TX), the man, who succeeded Ryan as the chairman of the Ways and Means Committee, said that he was convinced that the bill would pass without any further amendments, but there could be changes in the Senate.

Former South Carolina GOP governor Rep. Mark Sanford surprised reporters when he said that he is a No trying to get to Yes. Sanford is the House sponsor of the alternative health care bill he developed with Sen. Rand Paul (R-KY) that was endorsed by the House Freedom Caucus.

Another member of the House Freedom Caucus with Sanford is Rep. Dave Brat (R.-VA), who said he was confused about the way the RyanCare bill was written and how it has been managed, which leads him to believe that the solvency of the insurance companies could be at stake.

“I think at a minimum that American people are learning that we have an insurance problem on our hands, because they’re seeing the solution, and it doesn’t square with common sense,” he said.

The former economics professor said he is furthered confused about why the House Republican leadership is telling members that many of the fixes would be done administratively, but they will not specific a single one. “Why the delay there?”

Secretary of Health and Human Services Tom Price was the chairman of Brat’s Budget Committee and he has a great rapport with the House Republicans, Brat said it does not make sense to him that Price is not sharing his administrative fixes to Obamacare.

“The vote is coming up Thursday, you’d think they’d say: ‘OK, here’s the regs. Here, guys, this is what we’re going to get rid of.'” he said.

It is strange that leadership keeps hyping administrative changes without committing to anything at all, he said.

Even if he was promised by Price that all the rules would be gone, the congressman would still be a No for RyanCare, because all administrative fixes can be reversed, if the actual Patient Protection and Affordable Care Act is not repealed, he said.

Another No for RyanCare is Rep. Trent Franks (R.-AZ).

“Let me put it this way,” Franks said. “There are a couple of changes that would get me to an unqualified, exuberant, happy, lighthearted Yes.”

Franks two conditions for his vote are the removal of the Individual Mandate, which RyanCare keeps and the ending of the Essential Benefits, another piece of the Obamacare regime preserved by Speaker Ryan and his team.

“If we could do away with those two things, then I believe this thing has a chance,” he said.

Meadows maintained his discipline about not talking about his own whip count, even as he laughed at the idea that if his members were not holding, the president, vice-president, as well as, both the GOP’s Whip Rep. Steve Scalise (R.-LA) and his Deputy Whip Rep. Bill Flores (R.-TX) would be spending so much time with him.

With five vacancies, it now takes 216 votes for a bill to pass in the House and Ryan goes into Thursday’s vote with 237 House Republicans. If the speaker loses more than 22 votes, he loses, because the 193 House Democrats are not looking to help him out. Breitbart reporting pegs the House Freedom Caucus bloc voting No as north of 25. This is not counting the other unaffiliated conservatives joining the HFC to stop RyanCare.

One of the difficulties facing the speaker and his whip team is that for the past six sessions of Congress, the House Republican leadership has refused to deal with House conservatives, preferring instead to cut a deal with President Barack Obama and the Democrats.

Now that House Democrats are not available to save RyanCare, the speaker and his whip team are having to ask conservatives to break their campaign promise to repeal Obamacare based on a sense of trust and teamwork that simply does not exist between the conservatives and leadership. Conservatives do not believe the promises and the threats are dismissed out of hand, because most conservatives have already learned how to deal with leadership meddling in their district.