text: Speaker of the House Paul Ryan (R.-WI) cancelled the anticipated vote on the American Health Care Act—RyanCare—the latest sign that the bill is in a death spiral.
  
  Progress bringing the bill to the floor was stalled out when a compromise reached in principle between President Donald Trump and the chamber’s conservative bloc, the House Freedom Caucus, late Wednesday was not included in to the bill as a manager’s amendment. Manager’s amendments are privilege’s of relevant committee chairmen, who can change the language in a bill without going back to the full committee.
  
  The HFC members accept that the RyanCare bill is not the repeal-and-replace of the 2010 Patient Protection and Affordable Care Act that created Obamacare, but they insist that the speaker’s Obamacare rescue bill eliminate the Essential Health Benefits provision that requires a minimum of services in insurance policies, and they want to eliminate the Individual Mandate that RyanCare preserves as a program managed by the insurance companies, not the IRS.
  
  As conservatives gain concessions in the RyanCare negotiations, more liberal Republicans have been dropping out, especially over cuts to Medicaid and a new promise by the president to keep illegal aliens from participating in RyanCare health plans.
  
  The delay was announced at or around 3:30 p.m., which was also the time Ryan was supposed to hold a press conference about the bill. The press conference was originally scheduled for 11:30 a.m., which shows you what kind of day Ryan is having.
  
  Shortly after he decided not to call the RyanCare bill for a floor vote, the Speaker ended a meeting with Rep. Cathy McMorris Rodgers (R.-WA), the chairwoman of the House Republican Conference. After the meeting, McMorris Rodgers sent a blast email to all House Republicans telling them there would be a conference meeting at 7 p.m.
  
  Texas Republican Rep. John Ratcliffe told reporters after receiving the email about the 7 p.m. meeting that he still could see the RyanCare bill coming up for a vote. To Ratcliffe’s point, there are procedural votes scheduled for the House floor beginning at 8 p.m.
  
  Before the bill comes to the floor, the House Rules Committee must approve a rule with the bill’s most recent text. The committee has not yet approved the rule and as of publication of this story, the official language of the RyanCare bill stands at where it was Monday after certain manager’s amendments.