Trump's health-care bill won over the Freedom Caucus -- but risks losing everyone else

The AHCA didn’t fail in March solely because of Freedom Caucus opposition. As I noted at the time, the most conservative members of the Republican House caucus were no more likely to oppose the bill than your average GOP representative. Instead, two groups of Republicans were most likely to oppose the AHCA: moderate GOP representatives and anti-establishment GOP representatives.

You can see both blocs on the chart below, which shows the two dimensions of DW-Nominate scores, which measures each member’s ideology based on roll call votes from previous congresses. GOP House members on the left of the chart are more moderate (as seen through lower DW-Nominate first dimension scores), while those on the bottom half are more anti-establishment (as seen through negative DW-Nominate second dimension scores). Among the 49 House Republicans who were identified as leaning “no” on the AHCA earlier this month,2 a little more than half were more moderate than the average House Republican.

Because Trump and House Speaker Paul Ryan can afford only 22 Republican defections for the bill to pass, every single conservative House member previously opposed to the bill could vote “yes” and it would still not be on track to make it out of the House. Instead, the AHCA would probably need somewhere in the neighborhood of five to 15 moderate Republicans who opposed the AHCA the first time around to jump on board (depending how many previously opposed conservative members do).