The president blames the House Freedom Caucus for the failure of the health care bill.
In a Twitter post, Trump took aim at the Freedom Caucus, a bloc of the most conservative Republicans in the US House of Representatives, indicating he would try to defeat them in next year's congressional elections if they continued to defy him. That would leave just one week to process the as-yet-unfinished spending package through the House and Senate.
Trump's efforts to repeal and replace President Barack Obama's signature health care law fell short last week, after he and House Speaker Paul Ryan failed to convince a number of House lawmakers, including most of the Freedom Caucus, to vote in their favor.
"We just had a major battle on a Republican welfare plan and that has consumed to a large degree my time and mental effort", said Alabama Representative Mo Brooks. Since then, the caucus has acted as its own political party within the GOP, working to shift power away from party leadership toward rank-and-file members and wielding strategies to advance its limited government ideals.
"It's the same old thing with the Freedom Caucus: Don't let the ideal be the enemy of the good", Ellis said.
On Wednesday - about 18 hours before Trump's Twitter attack - senior officials from the White House invited two dozen leaders from conservative groups for a closed-door session to plot a path ahead. On Thursday, he threatened primary challengers in a tweet.
So to sort through what this means for Republicans and the president is NPR political editor Domenico Montanaro.
It's possible that if every single Freedom Caucus member had been prepared to vote for the AHCA it would have passed the House, but that's far from certain.
"Does anybody leave themselves open or vulnerable to a primary challenge?"
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The last government shutdown was orchestrated, in part, by North Carolina Rep. Mark Meadows - who is now the chairman of the House Freedom Caucus. "If they're interesting in having our support, it's kind of on them to come to us".
If they choose to, the Freedom Caucus could make Trump's life hard in upcoming budget and tax debates.
"I would never rule out presidential successes in a Congress controlled by his party, even in the past year of Trump's term", Larry Sabato, director of the University of Virginia's Center for Politics, said Wednesday. "We will continue to do that by ensuring any healthcare reform legislation lives up to the promises we made to the American people".
SHAPIRO: There is another option here, which is that President Trump could try to work with Democrats. The Democrats do not owe the Republicans their cooperation on this piece of legislation.
Kelly Stanger of Lowell, Michigan, argued that conservatives were prevented from contributing to the bill, and said she'd vote again for Rep. Justin Amash who opposed it. "They can only afford about 20 defections".
GEOFF BENNETT, BYLINE: The House Freedom Caucus is resurgent. "This was the first attempt at health care by the Republican leadership, and it did not originate in the White House".
"Ryan said: 'This is what we should have been doing, '" Weber told Reuters.
Ryan said if House Republicans don't get a bill on the president's desk, Democrats will.
And the healthcare legislation performed poorly in opinion polls, so running a candidate against Freedom Caucus members based exclusively on their opposition to the act would be tough, said David Wells, a political science professor at Arizona State University. "For my district, it is not better than the current system", Meadows said. "The federal regulations and mandates prevent you from shopping across state lines, which President Trump campaigned on". Eric Beach, who leads a third nonprofit called Great America Alliance that counts Trump advisers Newt Gingrich and Rudy Giuliani as honorary co-chairmen, said "We all do different things".