President Trump is putting the entire weight of the presidency behind the American Healthcare Act being pushed in the House by Speaker Paul Ryan. Fighting stiff opposition from conservative factions within the House and Senate, Trump seems bent on getting this particular bill passed, and passed quickly.

Report from CNBC:

Time for talk running out, President Donald Trump on Tuesday warned wavering House Republicans that their jobs were on the line in next year’s elections if they failed to back a GOP bill that would upend Barack Obama’s Affordable Care Act.

The countdown quickened toward an expected vote Thursday on legislation undoing much of the law that has provided coverage to some 20 million Americans. Trump huddled behind closed doors with rank-and-file Republicans just hours after GOP leaders unveiled changes intended to pick up votes by doling out concessions to centrists and hardliners alike.

“If we fail to get it done, fail to (meet) the promises made by all of us, including the president, then it could have a very detrimental effect to Republicans in `18 who are running for re-election,” said Rep. Mike Conaway, R-Texas. “If it fails, then there will be a lot of people looking for work in 2018.”

Trump’s message to Republicans: “If you don’t pass the bill there could be political costs,” said Rep. Walter Jones, R-N.C.

The truth is that there will be political costs no matter what bill gets passed or doesn’t pass. If nothing passes, the GOP risks looking like weak at best, and liars at worst, since they spent years running on a promise to repeal ObamaCare, including during the 2016 cycle. However, the argument from conservatives is that this particular bill doesn’t repeal all of ObamaCare, just certain parts, which is why they oppose it.

If they do manage to pass something, it will inevitably lead to more people uninsured than current numbers since it will no longer be a requirement to buy health insurance. President Trump seems fine with the outcome, so long as he can claim the mantle of “getting things done” in Washington, which I think is what is truly motivating him here. This is the first big test of his ability to steer his agenda through congress, so he has a lot riding on this and at this point, he’s all in.

As for the voters, the base of the GOP wants to do away with ObamaCare and will surely punish some members of Congress if they fail to meet that promise. On the other hand, if they do repeal it, will Democratic voters, and perhaps some moderates, punish the GOP worse than their base will?

This is what is called a “tough decision,” but that’s what these politicians are sent to Washington for, to make the tough decisions.