All eyes are on Donald Trump’s promise to “piece together a great healthcare plan” and tax reform, but the fight against funding Planned Parenthood could cause the next big shake-up and could even close down the government.

After the Republican’s American Health Care Act (ACHA) was pulled on Friday, conservatives have been tasked to come up with a new way to replace Obamacare.

The government is running on stopgap funding in fiscal 2017 that expires on 28 April, and the funding extension needs to be approved.

If Speaker of the House Paul Ryan takes out a provision to defund Planned Parenthood, it would diminish his popularity even further amongst certain red-meat Republicans and could lead to a government shut-down, as reported by Axios.

If Mr Ryan leaves the provision in, the bill would still be unlikely to pass even with a Republican-controlled House and Senate, as Democrats would vote in block against it.

The two options are worrying for Mr Ryan. His predecessor John Boehner was forced out of his job in 2015, thanks to the House Freedom Caucus, after he relied on Democrat support to push through bills.

“What is being said, is that Conservatives are saying, ‘We will only approve the extension of government funding if we defund Planned Parenthood’,” said Scott Lucas, professor of American Studies at the University of Birmingham.

“The problem with that is many surveys say that the vast majority of Americans don’t want to defund it, once they understand that federal funds don’t cover abortion, and even if there is a minority [of lawmakers who want to defund it], I’m sceptical as to whether they would do it through blackmail by threatening a government shutdown.”

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The House Freedom Caucus is a loud minority, however. They would need a majority of votes in the House and more than 50 votes in the Senate. The Caucus also successfully worked to block the scrapped healthcare bill.

Planned Parenthood, the network of family planning and health clinics, which also offers abortions, has been a political hot potato for years.

Vice President Mike Pence, who spoke at the annual March for Life in January, is also keen to take away the clinics’ federal funding. Of Mr Pence’s 10 last tweets since 27 January, six of them have been advocating his pro-life stance.

He and his colleagues’ determination comes in spite of the fact that the Hyde Amendment has already scrapped government money for abortion providers.

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Planned Parenthood’s funding is used for other health services like cancer screenings and STI tests for women and men. Around 2.5 million patients, of mostly low incomes, depend on the organisation for basic medical needs.

House Freedom Caucus co-founder Jim Jordan said that a total repeal of Obamacare was still their “top priority” after the ACHA was pulled.

“Now, House Republicans owe it to our constituents to immediately get back to the drawing board and bring forward a bolder effort to replace the failing Obamacare with a plan to reduce costs by increasing choice and competition,” he said.

Meanwhile Planned Parenthood declared the “fight was far from over”.

“They’re going to continue to try to defund Planned Parenthood, continue to try to take away women’s access to health care,” said Planned Parenthood President Cecile Richards, who has promised more grassroots campaigning.