22 March 2017 - For the House Republicans who have never served under a Republican president — roughly two-thirds of them — the vote scheduled for Thursday on a measure to replace President Barack Obama’s health care law is a legislative fantasia, the culmination of seven years of campaign promises impeded by Mr. Obama’s veto pen.

But weeks of back-room machinations to bring a disparate group of lawmakers on board have left many Republicans with an excruciating choice: Pass a bill with an extremely limited constituency that could well wreak havoc with their own voters, and with Republicans’ re-election prospects, or vote it down, undermining President Trump’s agenda.

Speaker Paul D. Ryan said Wednesday that he was confident the House would pass the bill. But as of late Wednesday, roughly 30 Republicans had said they either would vote against the measure or had not made up their minds. That left the bill’s sponsors short of the 216 votes needed, and on Wednesday night Mr. Ryan scheduled a meeting in the Capitol to try to win over skeptics.

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