House Speaker Paul Ryan will not hold a floor vote on the American Health Care Act on Thursday as planned, according to multiple reports citing GOP sources, after President Donald Trump held meetings with conservative and moderate Republican caucuses in hopes of coming to a deal.

The announcement strikes a blow to Republicans, who seem unable to come to a consensus on the repeal bill for the Affordable Care Act.

Members of the conservative Freedom Caucus have said they won't vote for the plan because it includes too many mandates on insurance companies, including the ACA provision that payers cover essential health benefits. Sean Spicer on Thursday suggested they may strip those provisions from the bill.

House Freedom Caucus Chairman Mark Meadows told the Boston Globe that "progress is being made" on adding items from the conservative's wish list to the bill.

But removing essential benefits threatens to cause more moderate members of the party to abandon the bill. It also would lower the probability that the Senate approves the bill.

Meanwhile, the Koch brothers have promised to fund the advertising campaigns of Republicans, when they come up for reelection, who vote against the bill.

The House can lose no more than 21 votes for the bill to pass, but there could be more than 25 members of the Freedom Caucus who plan to vote "no."

President Trump, addition to holding those meetings, on Thursday delivered several messages on his Twitter channels asking the public to call their representatives to voice support for the bill.

Supporters of the bill, including Ryan, Trump and Health and Human Services Secretary Tom Price, have said the GOP bill would give consumers more choice, lower premiums and eliminate the government's mandate that Americans must be insured.

"When it comes to #healthcare, DC doesn't know best. @POTUS & @HHSGov are working to put #patients & doctors in charge of medical decisions," Price tweeted Thursday.

But despite that claim, few healthcare organizations are supporting the bill. The American Medical Association and the American Hospital Association both oppose the bill.

While the announcement about the vote signals an embarrassing loss for Ryan and Trump, Rep. Nancy Pelosi appeared to revel in the party infighting.

"Rookie's error, Donald Trump, you may be a great negotiator, rookie's error for bringing this up on a day when clearly you're not ready," she said Thursday.

Former President Barack Obama, whose signature legislation is at the heart of the debate, issued a statement Thursday defending the ACA and imploring Americans to stand up for the law.

"So if Republicans are serious about lowering costs while expanding coverage to those who need it, and if they're prepared to work with Democrats and objective evaluators in finding solutions that accomplish those goals – that's something we all should welcome. But we should start from the baseline that any changes will make our health care system better, not worse for hardworking Americans. That should always be our priority," he said.

A Quinnipiac poll released Thursday found that 56 percent of those surveyed disapprove of the Republican plan.

This story will be updated.

Twitter: @HenryPowderly
Contact the author: henry.powderly@himssmedia.com