This is being read as a signal to House conservatives to stay strong before Thursday’s big vote. Probably right, especially since Americans for Prosperity also came out against the bill this afternoon. But there’s a wrinkle.

What’s the wrinkle? Well, like Ed said here, the more confident conservatives in the House are that the Senate will end up killing the bill, the freer they might feel to pass the damned thing in the expectation that the other chamber will euthanize it. Lee’s opposition, which increases the odds that the bill will fail given the GOP’s narrow Senate majority, might paradoxically bolster the case for voting for it in the House. But there’s a wrinkle to the wrinkle: Other House Republicans might conclude that there’s no point casting a tough vote for an unpopular bill that’s headed for the trash bin in the Senate. It’s one thing to hold your nose and vote for something that actually succeeds in unseating ObamaCare, it’s another thing to take the plunge for Trump and then have Mike Lee and the conservatives in the Senate make it all for naught. If you’re a House GOPer expecting some tough health-care attack ads from Democrats in 2018 if you vote yes, why would you vote yes unless you’re confident of success in the Senate too?

It’s a difficult calculation for the House. Here’s Tom Cotton making it even more difficult:

“Despite the proposed amendments, I still cannot support the House health-care bill, nor would it pass the Senate. The amendments improve the Medicaid reforms in the original bill, but do little to address the core problem of Obamacare: rising premiums and deductibles, which are making insurance unaffordable for too many Arkansans. The House should continue its work on this bill. It’s more important to finally get health-care reform right than to get it fast.”

That’s 50 yays to start with, the bare minimum McConnell needs. If Rand Paul is also a no, as is almost certainly the case, the GOP will begin this process shy of a majority. The important caveat here is that both the White House and McConnell are reportedly expecting (and maybe even encouraging) changes to the House bill in the Senate. It doesn’t matter that Lee and Cotton won’t vote for the House bill as is, since no one’s asking them to. They can fix it — in theory. In practice, they face the same dilemma they’ve faced all along, somehow threading a needle in which conservatives like Lee want “full repeal” while moderates like Susan Collins and Bill Cassidy want something that keeps the ObamaCare exchanges in place for blue states and maybe increases the tax credits under the bill to help make premiums more affordable. There’s no reason right now to believe that circle can be squared. Said Sean Trende of the Lee/Paul conservative opposition that may doom the bill, “I cannot adequately put into words how hilarious I think it is that Tea Partiers will be keeping Obamacare alive.”

Rep. Chris Collins, who was the Trump campaign’s liaison to House Republicans, thinks Ryan does have the votes to get the bill to the Senate — but he’ll do it with the bare minimum:

No one wants to vote for the bill, but 216 might bite the bullet just to keep Trump off their backs. This is a rare moment, in fact, when Trump’s tweeting habit might be helping him as president rather than hurting. Normally, those Republicans would be worried about Democrats attacking them in 2018 for voting yes; as it is, they may be more worried about Trump attacking them on social media for voting no. If you come from a red district that voted for Trump overwhelmingly, from whom would you think you had more to fear? On the other hand, a Freedom Caucus source tells CNBC that they’ve got 25 firm nays and two leaners, more than enough to sink the bill in the House. Someone’s bluffing. My guess is it’s the conservatives but we’ll know in 48 hours.

In lieu of an exit question, read this piece on private polling by the GOP that allegedly shows Republican voters want swift action in replacing ObamaCare. That’s good news for the House bill, but beware the famously fickle American electorate

It’s easy to imagine “pass something now!” transforming into “you passed this crap?” very quickly. Good luck, Paul Ryan!

Update: This sure sounds like a no from Paul. That puts McConnell at 49 to start, one shy of what he needs.

Update: Make that 48. Ron Johnson doesn’t say he’s definitively voting no here, but read between the lines.