The acknowledgment comes just days out from an expected House vote on the GOP legislation to gut Obamacare, and puts further pressure on undecided conservatives to take an official stance on their party's landmark proposal.
Conservative senators hoping for changes to the Republican health care bill emerged from a meeting at the White House Monday afternoon disappointed, with Sen. Mike Lee describing the meeting as "terribly frustrating."
President Donald Trump, GOP leaders and White House officials have been working furiously to try to win over dissatisfied lawmakers in recent days, and even made some last-minute legislative concessions to move the bill to the right. The effective conclusion of negotiations means that it is now time for House Republicans to get in line — or vote against a bill that has the President's seal of approval.
House Freedom Caucus Chairman Mark Meadows will be voting against the bill, his spokesman Ben Williamson told CNN.
"We've gotten the vibe that the negotiations have closed," Williamson said.
Meadows told reporters Monday that the caucus will not take "official positions" on the health care vote -- which could signal that leadership is picking off some votes from members of the conservative group.
But after a meeting with the group Monday night, Meadows insisted there were enough "no" votes to sink the bill.
"I'm confident that we have still enough concerns that a vote of 216 votes in the House would not happen today," Meadows said.
GOP Rep. Raul Labrador said that now that leaders and the White House are indicating that no major changes will be added to the bill, "it means the bill is going to fail." Asked if he was confident it couldn't pass on Thursday, he responded: "I'm confident."
"We don't believe that they have 216 votes in fact we know that they don't have 216 votes," Labrador said flatly.
Lee, a Utah Republican, and other conservatives were making a last-minute pitch to Trump officials and House leaders to revise the bill. But the White House made it clear the bill is closed, a Lee aide said.
Thursday's vote to repeal and replace Obamacare will be one of the most consequential moments for the GOP this year — as well as for Trump's first months in the White House.
Trump will personally rally the troops Tuesday morning, attending a closed-door House GOP conference meeting on Capitol Hill to make a final pitch to his colleagues.
Final changes from House Republican leaders are expected to be unveiled Monday night.
Counting the votes
The GOP leadership's most urgent priority: Make sure they have the votes, changing the bill if necessary.
The whip count operation is now in "full motion," a senior GOP aide told CNN Monday morning.
In the final days leading up to the vote, leaders are hashing out adjustments to the bill that they unveiled two weeks ago. These modifications are a crucial aspect of the whipping process -- possible concessions are being carefully considered to try to win over lawmakers who are still on the fence.
One change that a senior GOP source said is likely to be included: language that would immediately prevent states from expanding Medicaid.
Under the first version of the legislation, enhanced funding for Medicaid would be repealed as of January 1, 2020. But senior Republicans are now preparing to include language that would explicitly prevent states from expanding the program before that time -- a concession to conservative lawmakers.
Another change that's being worked on: Expanding tax credits to older Americans. The details are still unclear, but it is an effort to calm worried GOP lawmakers who fear that the GOP health care bill would result in a spike of premiums for their constituents in their 50s and early 60s.
Last week, the White House also announced after Trump's meeting with members of the conservative Republican Study Committee that they had agreed to include in the House legislation optional Medicaid work requirements as well as the choice for states to block grant the program.
These changes are expected to be included in a package of amendments to be considered before the House Rules Committee on Wednesday.
Over the weekend, HHS Secretary Tom Price acknowledged
the challenge House GOP leaders are confronting in getting the majority of their conference behind the health care bill.
"It's a fine needle that needs to be thread. There's no doubt about it," he said.