(CNN) President Donald Trump touted progress as top House Republicans may be nearing a significant breakthrough on efforts to repeal and replace Obamacare, one month after a Republican health care bill was pulled from the House floor. 
 
 The leader of the conservative House Freedom Caucus, North Carolina Rep. Mark Meadows, and the head of the moderate Tuesday Group, New Jersey Rep. Tom MacArthur, are working toward a deal that could bring 18 to 20 new "Yes" votes from the conference's conservative wing, according to a source familiar with the talks. But it's not clear there would be enough votes in the broader GOP House conference to pass the bill. 
 
 The White House and GOP leadership have been involved in the talks and are aware of the latest progress, the source added. 
 
 A White House official confirmed to CNN the administration is aiming to circulate legislative text on a health care replacement plan by Friday or Saturday, though exact timing is still fluid. 
 
 During a news conference Thursday, Trump said "we're doing very well on health care," that the legislative effort is "evolving" and that "there was never a give-up." 
 
 "I want to get both. Are you shocked?," he said in reference to health care and passing a continuing resolution to fund the government next week. 
 
 There will be a House GOP conference call on Saturday to discuss the upcoming legislative agenda following the Easter recess, according to a Republican lawmaker, where health care is expected to come up. 
 
 GOP Rep. Tom Cole of Oklahoma, who supported the Republican health care legislation known as the American Health Care Act, has been in touch with his colleagues in the House as well as the White House about health care over Congress' two-week recess, which wraps next week. His big-picture takeaway on the discussions: "Differences have narrowed and this thing is very much alive." 
 
 But in a phone interview with CNN Thursday morning, Cole also cautioned that there are a lot of mixed feelings across the conference among members and aides on whether this effort could be any more successful than the first time. Much of the concern continues to center on gutting Obamacare's protections for those with pre-existing conditions. 
 
 "It's amazing the diverse things you hear from different people," Cole said, noting the responses range from "'it's hopeless' to 'Oh, it's going to get there.'" 
 
 The colleagues he has spoken with appear "cautiously optimistic," Cole added. "Some of the folks in leadership -- they've been burned so many times they're afraid to be optimistic," he said. 
 
 As of now, the broader conference is not aware of what the new health care blueprint is, suggesting that things are very much in the air. "I think only the people directly involved in the talks have a very clear idea of what's happening," Cole said. 
 
 A Republican member familiar with the negotiations expressed some skepticism that the Freedom Caucus can actually deliver the votes they are promising. 
 
 "They have yet another agreement in principle, but no final legislative language," the member told CNN. "We have no idea if this nets us votes or can pass the Byrd Rule," a reference to whether the current bill would be eligible to pass via reconciliation, which would only need a simple majority to pass in the Senate, as oppose to needing to clear 60-vote threshold. 
 
 The member added, "I would say we are skeptical at best." 
 
 In a speech in London on Wednesday, House Speaker Paul Ryan said that "health care is not dead." 
 
 Ryan said he and others are working on "finishing touches" to their repeal and replace legislation, though he also acknowledged that this work is "difficult." 
 
 In the past few weeks, the White House has been making a strong push to take one more stab on health care, particularly as Trump approaches his 100-day mark in office. 
 
 But there are significant obstacles. 
 
 The focus next week will be to passing a bill to avoid a government shutdown, so it is unclear how much members will be able to focus on getting another health care vote in the House. 
 
 And there are serious philosophical divides between the House's more moderate and conservative members. 
 
 Meadows and his colleagues on the Freedom Caucus want to get rid of as many of Obamacare's insurance reforms, known as Title One for their section in the Affordable Care Act, as possible. These measures contain the main protections for those with pre-existing conditions, as well as more general consumer protections that ensure enrollees get comprehensive benefits and limit their financial liability if they get sick. 
 
 The original bill ran aground last month after Freedom Caucus members pushed at the last minute to scale back or eliminate these protections, which they argue is the only way to lower premiums. But moderates, including the Tuesday Group, balked, saying that this could severely harm the care of those with pre-existing conditions -- one of the most popular parts of Obamacare. 
 
 The talks between Meadows and MacArthur have continued to focus on three areas identified before the congressional recess: essential health benefits , which requires insurers to provide 10 services, including maternity, substance abuse and prescription drugs, in all plans; community rating, which bans insurers from charging more to people based on health history or gender, and guaranteed issue, which mandates insurers cover everyone regardless of their medical status, according to sources. 
 
 Lawmakers are looking at allowing states to obtain waivers to opt out of some of these protections, but requiring states to attest that the waiver's goal is to reduce the cost of health care or increase the number of insured. Under the so-called MacArthur Amendment, states could never allow insurers to price plans based on gender or to turn away people because of pre-existing conditions. 
 
 Members are also discussing providing extra money to help defer states and insurers' costs for caring for the sick through high-risk pools or other mechanisms. The current deal-making has centered on what triggers would allow states to opt out and how much additional funding would be provided. Any states that allow insurers to charge consumers more based on health status would also have to set up a high-risk pool to assist those affected. 
 
 In addition to concerns about those with pre-existing conditions, some moderate Republicans were also upset that the House bill would severely cut back funding for Medicaid, which provides health coverage for many opioid addicts. Several GOP governors in states that expanded Medicaid to low-income adults were pushing representatives to revise these provisions in the House bill. 
 
 The Congressional Budget Office estimated that 24 million fewer people would be covered under an early version of the Republican bill, which did not include all these changes to insurance reforms. Much of the coverage loss stemmed from the reductions to Medicaid. 
 
 Americans have not embraced the House bill that was pulled last month. Only 17% of voters approved of the plan, according to a Quinnipiac poll released last month 
 
 A new Quinnipiac poll found that only 36% of American voters say Republicans in Congress should try again to repeal and replace Obamacare, while 60% say the Republicans should "move on." 
 
 Voters disapprove by a 65% to 29% margin of the way Trump is handling health care. 
 
 The March Quinnipiac poll was conducted March 16-21, and consisted of 1,056 respondents and had a margin of error of plus or minus 3 percentage points. The new poll was conducted April 12-18 among 1,062 respondents in the US and has a margin of error of plus or minus 3 percentage points. ||||| (The Washington Post) 
 
 President Trump is pushing Congress toward another dramatic showdown over the Affordable Care Act, despite big outstanding obstacles to a beleaguered revision plan and a high-stakes deadline next week to keep the government running. 
 
 The fresh pressure from the White House to pass a revision was met with skepticism by some Capitol Hill Republicans and their aides, who were recently humiliated when their bill failed to reach the House floor for a vote and who worry now that little has changed to suggest a new revision would fare any better. 
 
 The effort reflects Trump’s sense of urgency to score a victory on Obamacare replacement and move on to other legislative objectives, notably tax restructuring. Passing an Affordable Care Act revision would also allow the president to show progress toward a major campaign promise as he completes his first 100 days in office. 
 
 “The plan gets better and better and better, and it’s gotten really good, and a lot of people are liking it a lot,” Trump said at a news conference Thursday. “We have a good chance of getting it soon. I’d like to say next week, but we will get it.” 
 
 Congressional Republicans also worry that they must attract Democratic support to fund the government past the month’s end — a step they must take by midnight April 28 to avoid a shutdown. That could become difficult if Democrats grow alienated by the effort to alter former president Barack Obama’s key domestic policy achievement, which some White House officials said they hope will come up for a vote as early as Wednesday. 
 
 (Reuters) 
 
 Several congressional GOP aides, who spoke on the condition of anonymity to talk openly about the ongoing negotiations, said they worry that the rushed process threatens to create another embarrassing public failure over health care. The schedule would also make it nearly impossible for lawmakers to finish their work in time for official scorekeepers to provide a clear estimate of how much the legislation would cost or how it would affect coverage numbers. 
 
 House GOP aides in Washington worked furiously to scale back expectations for a quick vote on the legislation, citing the fact that lawmakers have not been fully briefed on the discussions. There was no deadline for finishing the legislation as of Thursday evening, and GOP leaders have not committed to plans for a Wednesday vote, according to one House GOP leadership aide. 
 
 The fresh hopes for resuscitating the American Health Care Act are pegged to an amendment being offered by Rep. Tom MacArthur (R-N.J.) that aims to attract enough conservatives and moderates that the measure can pass in the House. White House officials said language would be circulated among members in the next few days, and the modifications will be discussed Saturday in a conference-wide call as Republicans prepare to return to Washington next week. 
 
 The MacArthur amendment would allow states to obtain permission from the federal government to write their own list of essential health benefits and allow insurers to charge people with preexisting conditions higher premiums, as long as they also make a high-risk pool available to those patients — a change conservatives have demanded. 
 
 As a concession to moderates, the amendment would also add back federal requirements for essential health benefits, which the measure’s current version instead leaves up to states. 
 
 House leadership and committees are taking a secondary role in the negotiations, which are being largely carried out by MacArthur, head of the moderate Tuesday Group, and Rep. Mark Meadows (R-N.C.), chairman of the conservative House Freedom Caucus. Members from both groups had balked at voting for the bill last month, forcing leaders to pull it from the floor at the last minute. 
 
 Meadows was silent Thursday on whether he supports the proposed changes. 
 
 Apart from the publicly embarrassing struggle to reach consensus on an Affordable Care Act revision, some Republicans are also uncomfortable with refocusing on health care just as they are trying to build goodwill with Democrats to pass a stopgap budget plan to keep the government open past April 28. 
 
 Republican leaders have already admitted that they are unable to craft a spending bill that can appease the far-right flank of the GOP, and they have turned to Democrats to deliver votes instead. Democrats have so far been willing to work with Republicans to avoid a government shutdown, but any effort to schedule a vote to repeal the Affordable Care Act could destroy those talks and threaten a government shutdown that Republicans have vowed to avoid. 
 
 “There isn’t going to be a warm, fuzzy feeling,” House Democratic Caucus Chairman Joseph Crowley (D-N.Y.) said of the impact a health-care repeal effort would have on spending talks. 
 
 Congress has five days next week to pass a spending bill, a tight timeline under the most generous of circumstance that would be nearly impossible to meet if House leaders also try to force a vote on the repeal legislation. Several Republican and Democratic aides said there is a chance that both parties could agree to pass a very short-lived spending bill — one that kept the government open one week, for instance — to give negotiators time to carefully complete a broader spending agreement. But Democrats are already warning that they could walk away if GOP leaders push for repeal. 
 
 “It doesn’t really bode well in terms of negotiating with us that they’re going to try to push off the vote on the [spending bill] to accommodate them on a bill we think is disastrous,” Crowley said. 
 
 Asked whether a health-care bill or funding the government should be Congress’s top priority next week, Trump said Thursday that he believes both could get done. 
 
 “I think we want to keep the government open, don’t you agree?” Trump said. “So I think we’ll get both.” 
 
 Trump’s position on a health-care overhaul appears to have shifted in the weeks since the House GOP’s proposal, called the American Health Care Act, failed last month. Then, the president indicated that he was ready to move on to his next priorities, notably tax reform. 
 
 Now, Trump is bringing a new urgency to the task of delivering one of his central campaign promises. Additionally, with the 100-day mark of his presidency approaching, he and his senior aides are eager to show a concrete legislative achievement. 
 
 Trump would like to show progress on health care by Day 100 of his administration but is not overly concerned about the exact day a bill might pass the House, said a senior administration official, who was not authorized to speak publicly and spoke on the condition of anonymity. The official acknowledged that House passage of a bill next week is ambitious and said prospects will be clearer once more members have had an opportunity to review the legislative language. 
 
 The confirmation of Neil M. Gorsuch to the Supreme Court — after Republican senators used a rule change to muscle the nomination through — remains Trump’s sole major accomplishment on Capitol Hill as the 100-day mark nears. 
 
 His ambitious legislative agenda has been stalled by divisions within the White House and among Republicans in Congress, despite their control of both chambers. 
 
 As a candidate for president, Trump promised that he would work with Congress to pass legislation that would dramatically cut taxes, spur $1 trillion in infrastructure investments, significantly expand school choice and make it easier to afford child care. And he promised he would get started on all that — and six other pieces of legislation — in his first 100 days, according to a “Contract with the American Voter” released shortly before Election Day. 
 
 The only one of those 10 legislative items introduced to this point is the House health-care bill, which Trump embraced. 
 
 While the Gorsuch confirmation buoyed conservatives both on and off Capitol Hill — providing a taste of victory — the manner in which it was rammed through further poisoned Trump’s relationships with Democrats, whose support he’ll need on many of his other initiatives. 
 
 Meanwhile, White House Office of Management and Budget Director Mick Mulvaney said Thursday that the White House would be open to funding some Democratic priorities — potentially including paying insurance subsidies as part of the Affordable Care Act — if Democrats would agree separately to fund parts of the White House’s agenda in upcoming budget talks. 
 
 Mulvaney’s comments suggested that the White House could try to use the Obamacare subsidy payments as leverage to extract funding to create a wall along the U.S.-Mexico border. 
 
 “This is the first real test of whether the Democrats, specifically in the Senate, are interested in negotiating, interested in compromising,” Mulvaney said. 
 
 Meadows and MacArthur are gauging their members’ support for the proposed changes, according to aides and lobbyists. Moderate Republicans worry about depriving consumers of certain health-care benefits, and some conservatives say they think the GOP plan leaves too much of the Democrats’ health-care law in place. 
 
 Yet some moderates said Thursday that they view the MacArthur amendment as more of a concession to conservatives, as it would allow states to opt out of some of the Affordable Care Act’s insurance regulations they view as crucial. 
 
 “I don’t think the Tuesday Group has discussed, approved or has prior buy-in,” said one senior aide to a moderate Republican House member. “I don’t see how this gets either the Freedom Caucus or the Tuesday Group.” 
 
 [Republicans try to revive health-care effort as leaders seek to temper expectations] 
 
 [Trump delivers ultimatum to House Republicans: Pass health-care measure on Friday or he’ll move on] 
 
 Robert Costa and Damian Paletta contributed to this report. 
 
 Read more at PowerPost ||||| A frantic and impatient White House is pressuring House GOP leaders for another showdown vote on repealing Obamacare next week so it can notch a legislative win before President Donald Trump’s first 100 days in office. 
 
 But while the outlines of a possible deal are starting to come together, it’s far from clear that House Republican leaders have found the sweet spot to pass their embattled alternative health plan. 
 
 Story Continued Below 
 
 The White House does not schedule House floor votes. And while some senior administration officials suggested Thursday that a vote will occur next week, multiple House GOP sources told POLITICO that is unlikely. 
 
 Indeed, the vote is not currently on the calendar. Nor do Republican insiders think it’s even possible, as Congress will reconvene Tuesday after a two-week Easter recess. That would leave them with one day to whip votes — an unlikely time frame for such a heavy legislative lift. 
 
 “The question is whether it can get 216 votes in the House, and the answer isn't clear at this time,” a senior GOP aide said. “There is no legislative text and therefore no agreement to do a whip count on.” 
 
 The conflicting narratives suggest top administration officials and House Republican leaders are either miscommunicating — or, more likely, that White House sources are squeezing Speaker Paul Ryan and his team, telling them to move quickly. Notably, the same senior White House officials who suggested a vote would occur next week also said the text of a new deal will likely be circulated Friday "or by the weekend." 
 
 The claim perplexed some GOP insiders who don’t expect legislative text for a few days, at the earliest. 
 
 The back-and-forth highlights just how impatient Trump is growing with Congress. Administration officials are feeling inordinate pressure to advance the legislation out of the House, fearing that failure to repeal the health care law will dominate coverage of the administration's first 100 days, which end next week, officials say. 
 
 Trump on Thursday predicted that health care legislation would pass "next week or shortly thereafter.” During a joint news conference alongside Italian Prime Minister Paolo Gentiloni, the president also took issue with the characterization that Republicans gave up on health care after they pulled the original House bill. He reminded reporters that Obamacare was roughly a year-and-half-long effort, while he said he’s only had about two months to negotiate a better deal. 
 
 But multiple House GOP insiders say the White House doesn’t understand how Congress works, and just because Trump officials say there will be a vote next week doesn’t make it so. GOP leaders cannot whip votes until legislative text is actually written, and it will be tough to get a good sense of where the conference stands until members return to town on Tuesday. 
 
 GOP leaders have their work cut out for them in the meantime. While the White House believes it is "close" to having the 216 votes needed to get a bill out of the House, one senior official said, others on Capitol Hill aren't nearly as confident. 
 
 Insiders say the deal could probably deliver between 15 to 20 conservative House Freedom Caucus members who were previously "no" votes, so long as the text says exactly what was agreed to. But moderates — and more than a few traditional Republicans — say the deal is bad policy. 
 
 Indeed, several centrist sources were incensed that Tuesday Group co-chair Tom MacArthur, the top negotiator for the moderates, agreed to the changes without getting the backing of his group. They're not sure he can deliver the votes. 
 
 "The amendment doesn't address the things that I had concerns about — the things I think are detrimental to the people I represent," said Rep. Dan Donovan, a centrist New York Republican who is currently a "no" on the bill. 
 
 Donovan said there has been little to no Tuesday Group coordination on the negotiations, and he was skeptical that the deal would move any moderate votes. 
 
 The White House began ramping up pressure on GOP leaders two weeks ago, when top Trump officials called Ryan to the White House and chided the Wisconsin Republican for not delaying recess until a deal was struck. 
 
 Since then, the White House has worked with Freedom Caucus Chairman Mark Meadows (R-N.C.) and MacArthur (R-N.J.) to come up with a deal they hope will pick off enough conservatives and moderate support to pass the House. 
 
 Trump, meanwhile, has asked repeatedly — sometimes several times a day — about the status of the health care law and seems more engaged than during last month's failed effort to get Ryan’s American Health Care Act through the chamber, a senior administration official said. The president believes that it will be difficult to gain momentum on other issues without "getting something done on health care," according to one person who spoke with him. OMB Director Mick Mulvaney separately said Thursday the White House is ready to negotiate with Democrats on adding key Obamacare insurance cost-sharing subsidies to a fiscal 2017 spending bill to keep the government running -- if Democrats agree to pay for some of Trump’s priorities,such as defense and border security money. 
 
 According to a draft of the tentative deal obtained by POLITICO, the latest proposal would allow states to apply for "limited waivers" that would undermine Obamacare's protections for pre-existing conditions. Under these waivers, states could opt out of Obamacare standards setting minimum benefits that health plans must offer and a requirement — called community rating — forbidding insurers from charging different prices to people based on health status. 
 
 Both are provisions that the GOP’s ultraconservatives have pushed to eliminate as part of the repeal effort, contending that these coverage mandates drive up the cost of insurance. States opting out of the community rating rules would be forced to set up an "invisible risk-sharing" program aimed at providing a backstop to health plans while preventing sicker patients from being priced out of the market. The hope is that protecting insurers from the most expensive customers will bring down the costs for the rest of the risk pool. That will allow insurers to lower premiums, which in turn will entice more customers into the individual market. 
 
 At the same time, the deal would allow states the option of maintaining insurance protections, supported by centrist Republicans, including community rating. 
 
 While the changes will likely win over some conservatives, leaders will have a problem with their centrists. MacArthur said in a statement Thursday that he has insisted during the discussions that any compromise have protections for individuals with pre-existing conditions. But many of his like-minded colleagues believe he did not keep that promise under the current agreement. 
 
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 Many centrists don’t approve of MacArthur’s negotiating tactics. While Meadows has made a point of ensuring that any potential changes he negotiates will likely get a green light from his members, some Tuesday Group members do not feel MacArthur has done the same. 
 
 Moderates and a few traditional Republicans believe the legislative changes will hurt people with pre-existing conditions, a population they vowed to protect on the campaign trail. But since GOP leaders are feeling the heat from the White House, they may have to put the changes on the floor regardless. 
 
 House Republicans will likely discuss the latest changes during a Saturday telephone conference call. The call, however, is routine during recess and was actually announced last week — well before the White House, MacArthur and Meadows publicized the new accord. 
 
 The renewed effort also comes just days before the high-stakes deadline over funding the government or shutting it down over contentious issues — including whether Republicans will fund a key Obamacare subsidy program, financing for Trump’s border wall and boosting military spending, among others. 
 
 Trump and some administration officials have threatened to cut off Obamacare cost-sharing subsidies — a decision that would wreak havoc on the Obamacare insurance exchanges — in a bid to get Democrats to negotiate on a replacement plan. 
 
 Those subsidies, which are at the center of a court battle begun under the Obama administration, help lower-income people pay medical bills and insurance deductibles. Taking them away would prompt insurers to either flee the market or severely hike premiums to cover those costs. Despite calls from the health care industry, business groups and Democrats to continue the payments, the White House has yet to tip its hand. 
 
 Paul Demko, Adam Cancryn and Nolan D. McCaskill contributed to this story.
– "This thing is very much alive," Rep. Tom Cole tells CNN regarding the Republican health care proposal that appeared to have died in the House last month. Politico reports the White House is hoping to try a second time to repeal and replace the Affordable Care Act as early as next Wednesday. Sources say President Trump has recently been pestering Paul Ryan about a Republican health care bill—sometimes multiple times a day. Senior White House officials says Trump is worried his failure on health care—he had promised to repeal the ACA on "day one"—will be the big story in retrospectives on his first 100 days in office next week. Ryan says Republicans are adding "finishing touches" to a new health care proposal, and sources say the text of a new bill could be released Friday. The new health care deal is being negotiated by leaders from the conservative House Freedom Caucus and moderate Tuesday Group. According to the Washington Post, it's unclear there's any compromise that could please both moderates and conservatives enough to secure the necessary 216 votes in the House. Even if a new bill passes the House—the White House says it's "close" to having the votes—an even bigger hurdle looms in the Senate.