Andrew Harnik / AP

For all of the talk that this might finally be House Republicans' chance to repeal and replace the Affordable Care Act, the big picture is that there's still a bitter divide within the party — though it's now separating the moderates from everyone else — and the whole effort is still wildly unpopular.

They're closer to the goal of fulfilling a campaign promise, but they're about to take a vote that will be perceived, rightly or wrongly, as abandoning sick people.

  • The new amendment by Rep. Tom MacArthur, a leader of the moderate Tuesday Group, has shifted the health care bill substantially to the right. It's not everything conservatives wanted on loosening the ACA's insurance mandates, but there's more in it for them than for moderates.
  • The endorsement of the conservative Freedom Caucus was big step forward for Republicans, since they were some of the main holdouts. That may be bringing Republicans closer to 216 votes. "Making progress," one leadership aide said last night.
  • But it's not bringing any moderate Republicans on board. It may even be losing some: Rep. Mike Coffman, a supporter of the original bill, is now undecided, according to multiple reports. (The Hill has a good whip list.)
  • A Friday vote is looking less likely now, but not impossible.
  • The Rules Committee posted the amendment text last night, along with another amendment to make sure Congress isn't exempted — cleaning up what would have been a huge political embarrassment. But as of this morning, the committee hadn't scheduled a meeting yet.
  • Moderates are mad at MacArthur for negotiating the deal and mad at the Freedom Caucus, who they think are trying to turn the spotlight to them. "It's an exercise in blame-shifting," Rep. Charlie Dent said, per the Washington Post.
  • They're not going to get a lot of sympathy from conservatives, who point out that the moderates ran on repealing the ACA.
  • If the House schedules a vote soon, it's not going to have any analysis from the Congressional Budget Office to look at. So it won't have any idea how many states might apply for waivers from the required benefits or the ban on charging higher rates to sick people, or how many people might be affected.

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