Paul Ryan has a major math problem.

The House speaker and his leadership team can lose only 22 Republicans and still pass their Obamacare repeal bill. But roughly 20 GOP members are on record in opposition, and at least another two dozen are undecided.

The situation has gotten only uglier this week, as two leadership-aligned congressmen, Fred Upton (R-Mich.) and Billy Long (R-Mo.), came out against the plan.

Leaders have won over all but a few members of the House Freedom Caucus and at least one big-name moderate who opposed the earlier Republican proposal. But the path to 216 votes is exceedingly thin.