House Speaker Paul Ryan talks about getting past the failure to pass a health care overhaul bill and rebuilding unity in the Republican Conference, Tuesday, March 28. | AP Photo White House aides clash with GOP leaders over flailing Obamacare push The job security of Speaker Paul Ryan as well as GOP lawmakers and White House staff was a topic of discussion.

A Wednesday evening meeting between top aides to President Donald Trump and House Republican leaders turned heated when the White House officials exhorted Speaker Paul Ryan to show immediate progress on the GOP's stalled plan to repeal and replace Obamacare.

The meeting was tense. At one point, according to three sources briefed on the meeting, White House chief of staff Reince Priebus suggested it could be detrimental to Ryan’s speakership if Republicans fail to pass a bill. Others disputed that characterization, saying the comments were not aimed specifically at Ryan but more broadly, as in: All Republican lawmakers' jobs are in jeopardy if they don't deliver.


"It was really bad," said one person familiar with the meeting. "They were in total meltdown, total chaos mode."

Multiple White House and Hill sources familiar with the meeting said Vice President Mike Pence and Priebus leaned on Ryan to accept a series of changes they floated to conservatives, but which House leaders and moderate Republicans have rejected. Aides sparred over the inability to advance a new bill, saying it should have been done weeks ago.

Trump officials present — who also included Trump’s chief strategist, Steve Bannon; Jared Kushner; legislative liaison Marc Short; and Pence’s chief of staff, Josh Pitcock — urged Ryan to hold a vote on the bill this week before the House leaves for a two-week recess. GOP leaders responded that a bill was not ready.

The two sides settled on agreeing to hold an emergency Rules Committee hearing Thursday before members leave Washington.

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Hill GOP insiders say the White House, desperate to show progress on one of Trump’s signature campaign promises, has lashed out at House GOP leaders in recent days. White House staff members are worried their jobs will be in jeopardy if a health care bill is not approved, sources say.

White House aides vocalized those fears during the meeting, indicating that they were under pressure — including at risk of losing their jobs — because of the issue, according to two sources.

That’s why the White House is cranking up pressure on Ryan, who spoke separately with Trump after the meeting.

“The president and the speaker had a very good, long conversation last night, and they remain fully on the same page on the path ahead,” said AshLee Strong, a spokeswoman for Ryan.

White House officials and top GOP leaders also disagreed over whether concessions that Pence floated to conservatives would actually improve the chances of passage and should be considered. Pence, Priebus and budget director Mick Mulvaney on Monday told the House Freedom Caucus they could potentially offer states waivers from major Obamacare regulations.

The group of three dozen hard-liners, who’ve dubbed the Republican effort “Obamacare lite,” banded together to block the votes for the earlier bill, forcing Ryan to pull it from the floor two weeks ago.

But the White House, led by Pence, sought to woo the far right this week in a last-ditch effort before the recess. Pence and Priebus floated a new provision allowing states to opt out of Obamacare regulations that bar insurance companies from charging sick people more than healthy people.

The next day, however, leadership and moderates pushed back on the White House’s pitch. They say those regulations make up the foundation of protections for people with pre-existing conditions. And they argue that Trump and GOP leaders ran on a platform of keeping those popular safeguards for the nation’s sickest.

John Bresnahan and Jake Sherman contributed to this report.

