Speaker Paul Ryan’s Obamacare Lite replacement bill appears heading for defeat in the face of opposition from members of the House Freedom Caucus, as well as from many conservatives, calling his control over the House into question.

Pennsylvania Representative Lou Barletta, a conservative representing an area in the eastern part of the state that heavily supported President Donald Trump, announced his opposition to Speaker Paul Ryan’s Obamacare replacement bill, dubbed “Obamacare Lite” and “Ryancare” by its detractors.

“The monstrosity of a health care law failed the American people by throwing them off their preferred plans, eliminating access to their favorite doctors, and sending premiums and deductibles through the roof,” Barletta said. “In fact, the average premium in Pennsylvania increased by 32 percent this year, and in some corners premiums rose as much as 53 percent.”

“That level of cost increase is unsustainable.”

Barletta, who has taken a leading role in advocating for tighter immigration control and securing the border, indicated a provision in Ryan’s bill that leaves open the possibility of illegal immigrants participating in the healthcare system was a non-starter.

“Unfortunately, after evaluating the text of the American Health Care Act, I cannot support the bill in its current form. I am concerned that the bill lacks sufficient safeguards for verifying whether or not an individual applying for health care tax credits is lawfully in this country and eligible to receive them,” he said.

“Under Obamacare, a half a million people received a total of $750 million in health care subsidies, even though the recipients could not prove their lawful presence in the United States,” he added. “I cannot vote for a replacement plan that fails to address this problem.”

A measure aimed at addressing Barletta’s concerns was removed from the bill after the Senate Parliamentarian determined that the Senate Finance Committee, which is responsible for tax credits under the bill, does not have purview over the Department of Homeland Security.

Barletta joins most of the nearly 29 members of the House Freedom Caucus, as well as non-caucus members Representative Ted Budd of North Carolina and Thomas Massie of Kentucky, in opposing the bill, raising the prospect of Speaker Ryan losing in a landslide.

Kentucky Senator Rand Paul, a vocal opponent of the bill, indicated he believes there are at least 35 House Republicans set to oppose the bill when it comes up for final passage on Thursday.

“I think there’s easily 35 no votes right now so unless something happens in the next 24 hours, I would predict they pull the bill and start over. I think if conservatives stick together, they will have earned a seat at the table where real negotiation to make this bill an acceptable bill will happen,” he said during an interview with Breitbart

In the House, all 193 Democrats are expected to oppose the bill. Without support from House Democrats, Republican leadership can not afford more than 21 defections, or else the bill would fail to reach the 216 votes necessary to constitute a majority.

Such a defeat, spearheaded by the same faction of the Republican caucus that forced his predecessor John Boehner to resign, would heavily damage Speaker Ryan’s control of the House.

“You have to be careful when you go all-in with a full-court press that we are seeing from leadership,” said North Carolina Representative Mark Walker, chairman of the conservative Republican Study Committee. “If you’re putting all your chips in the middle of the table and don’t win, it can come back to bite you.”

“If his powers of persuasion come up short, it will be Mr. Ryan’s most high-profile stumble as speaker and a sign that the fractious House GOP conference is beyond his control,” reported the Wall Street Journal.

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