The health care bill has been resurrected.
Now, its fate rests in the hands of moderate House Republicans, whose ultimate decision to support or reject the newest version of the bill could not only affect the future of health care but could irrevocably reshape moderates' bargaining power throughout Donald Trump's presidency.
Before the recess, all eyes were on the conservative House Freedom Caucus, whose coalition of more than 30 members had stood united against House leadership's health care bill. Now, however, with a new amendment that gives states broader ability to opt out of Obamacare regulations and roll back protections for individuals with pre-existing conditions, the House Freedom Caucus is on board and moderates are the ones taking the heat.
Rep. Charlie Dent, a moderate Republican from Pennsylvania, called it "an exercise in blame shifting."
The amendment was negotiated between Tuesday Group leader Rep. Tom MacArthur, a moderate Republican from New Jersey, and House Freedom Caucus Chairman Mark Meadows, with consultation from the White House and House leadership. It has caused a lot of heartburn among moderates, with many arguing that they had explicitly asked their leadership not to negotiate with the Freedom Caucus.
In an interview with reporters Wednesday, MacArthur defended his amendment.
"The latest proposal I made was just trying to bridge this divide between people that are holding two important views: people that are saying 'we're not going to fix health care unless we bring the cost down, which means we have to give the states some flexibility,' and people that are saying 'we can't pull the rug out from under people that are vulnerable," MacArthur said.
"And I agree with both of those. They are both right positions, and my amendment was just meant to bridge the divide between those two."
But the thinking among moderates now is if they get rolled on health care -- if the more conservative version of this bill passes -- the GOP leadership and White House will looking to the conservative Freedom Caucus, not moderates, in the days ahead.
There is still plenty of uncertainty, however, about whether or not the amendment gets the conference to the 216 votes that are still needed to repeal and replace Obamacare.
One GOP leadership aide told CNN that "the conversations are going well, things are moving in the right direction, and we're going to continue working toward a good vote."
But Republicans have been close before.
Still, leadership is setting the groundwork to move quickly if it becomes clear they can pass the bill. The Republican whip operation is well underway with the focus on the moderate members who voted "no" before, and the House Rules Committee has posted the language of the MacArthur amendment to the health care bill on its website
Two congressional sources say the language was posted because members wanted to see it for themselves and no hearing or vote was scheduled as of Wednesday evening, but posting the amendment does make it easier to move quickly if needed.
Also posted on the Rules website late Wednesday was legislation to undo an exemption that would keep members of Congress from being subject to the same waivers that could affect other consumers.
That loophole has caused consternation within the conference as members faced questions about why --if the new changes were so good -- members had exempted themselves. Leadership had promised earlier in the day that they would fix the loophole.
