The Republican-led Congress is poised to adjourn for the two-week Easter recess without fulfilling the party's top campaign promise to repeal and replace Obamacare.
Despite weeks of talks, hours of hearings and a last-minute push by the White House, it's all but certain GOP lawmakers will go home without the big win on healthcare reform that seemed all but assured after Republicans won control of the White House and Congress in November.
The House is set to leave town on Thursday and the Senate will likely complete business by Friday after it confirms Judge Neil Gorsuch to the Supreme Court, after changing Senate rules to get him through by a simple majority.
A vote to repeal and replace Obamacare isn't on either the House or Senate agendas this week, even though House Speaker Paul Ryan, R-Wis., had promised earlier this year it would be finished in April.
"Getting this done by tomorrow, I think that's tough," Majority Leader Kevin McCarthy, R-Calif., said Wednesday.
With the GOP's number one campaign promise in limbo, some Republicans fear the chance to repeal and replace Obamacare has slipped away and will not return until after the critical midterm elections, because Congress and the White House are eager to tackle tax reform and a deal on an infrastructure plan.
"If we don't get this done in short order, we are looking at 2019," said Rep. Chris Collins, R-N.Y., a member of the House GOP whip team. "We are not going to do it in a midterm election year."
Rep. Mark Meadows, R-N.C., a key negotiator who heads the conservative House Freedom Caucus, acknowledged Wednesday that prospects for a last-minute deal had dimmed, but said Republicans would keep working over the recess and would communicate in conference calls on the bill.
"I think what we would do is hopefully negotiate and find an agreement," Meadows told the Washington Examiner. "And come back and vote."
An eleventh-hour push by the Trump administration to secure enough House GOP votes to pass a bill to repeal and replace Obamacare by this week fell apart Tuesday night, and by Wednesday, momentum for an agreement was gone as Republicans planned their Thursday exit.
McCarthy sat in on a late-night negotiation session Wednesday between Vice President Mike Pence and House conservatives that failed to yield an agreement.
Pence, who had earlier held meetings with moderates, presented a proposal that significantly modified a pitch he made to the conservative House Freedom Caucus on Monday that would have allowed states to apply for waivers for many of the Obamacare mandates that HFC members want to eliminate.
Pence's revised offer narrowed the waiver allowance to include only Obamacare's essential health benefits and age rating, which prohibits insurers from charging too much for insurance for elderly customers. The other mandates would remain law.
The change was made to appease more moderate Republicans, but it cost the support of critical conservatives, thwarting a deal that could have produced the 216 GOP votes needed to pass it.
The disagreement has created a bit of a rift between the conservatives, who feel they have been wrongly blamed for blocking passage of a repeal and replace bill, and the moderates, who are refusing to back the more conservative proposal.
"It's an issue of trying to craft a bill that keeps everybody on board," said Rep. Morgan Griffith, R-Va. "And it's not easy."
Republican leaders and the White House have maintained optimism and said talks are continuing and even progressing. White House legislative affairs director Marc Short told reporters on Wednesday that the GOP had formed consensus "conceptually" around a bill.
But when Republicans return in two weeks, they must focus most of their attention on passing a critical government spending bill ahead of an April 28 deadline. That won't give them any time that week to deal with Obamacare.
"I'd like to have this done," Rep. Steve King," R-Iowa, said of the failed healthcare reform deal.
Rep. Tom Reed, R-N.Y., said despite failure this week to achieve a deal, the GOP won't give up on passing a bill.
"Hopefully we'll take these two weeks, take a deep breath, and come back and work on it," Reed said.
Reed is among the House GOP lawmakers who opposed the broad waiver plan first pitched to the House Freedom Caucus in a private meeting with Pence on Monday.
"To me, that was moving the ball way too far," Reed said. "More openness, more transparency will lead to a better outcome."
Meadows said Wednesday he still held out some hope that before leaving town, moderate and conservative Republicans could strike a deal.
"What I'd like to do is put us in a room and say don't come out without an agreement," Meadows said. "Understanding that both sides have to give."
Al Weaver contributed to this report