REPEAL-ISH AND REPLACE-ISH: GOP leaders unveil changes to healthcare bill.

The changes include two measures that conservative Republican Study Committee members won at the White House on Friday: allowing states to require Medicaid recipients to work and allowing states to choose a Medicaid block grant over the cap system in the current bill.

The revisions also include a change targeted at New York state that is expected to bring on board several wavering Empire State Republicans. That change would cut off federal Medicaid reimbursement for county contributions to Medicaid.

It is in doubt whether this range of changes will be enough to win the 216 votes needed for the bill to pass on Thursday. Rep. Mark Meadows (R-N.C.), the chairman of the conservative House Freedom Caucus, said Monday night that given his understanding of the changes, not enough was altered to bring him and his colleagues on board.

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Here’s what Meadows told Axios early Monday evening:

After investing hours and hours and hours of trying to find common ground between our moderate members and conservative members, and believing, because of the White House’s engagement in the process, that we could find common ground; I’ve now reached a conclusion that our leadership is going to put forth a bill that does not address any of the concerns in a meaningful way and will dare us to vote against it.

Why this matters: If the White House loses most of the Freedom Caucus members they can’t pass this bill. Meadows was only speaking for himself tonight, but his is a voice to move votes. The caucus will meet tonight, and whether to collectively oppose the bill or not will certainly be discussed.

What a trainwreck.