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U.S. House Speaker Paul Ryan, a Republican from Wisconsin, speaks during a news conference after a House Republican conference meeting with U.S. President Donald Trump, not pictured, at the U.S. Capitol in Washington, D.C., U.S., on Tuesday, March 21, 2017. Trump warned House Republicans at the closed-door meeting that many of them could lose their seats in the 2018 elections if they don't pass their bill to replace Obamacare. Photographer: Andrew Harrer/Bloomberg via Getty Images