House Speaker Paul Ryan said today that his healthcare proposal must change to pass the House, marking a significant retreat from his earlier position that the carefully crafted legislation would fail if altered.

The shift came after a private meeting of House Republicans from which Ryan emerged to tell reporters that his proposal to revise the Affordable Care Act would "incorporate feedback" from the rank-and-file.

Ryan attributed the change of strategy to the impact of an analysis issued on Tuesday by the Congressional Budget Office. Among other details that prompted a fresh round of criticism of the proposal was a projection that 14 million fewer Americans would be insured after one year under the Republican plan.

Ryan backed away from his previous rhetoric of calling the measure's fate a "binary choice" for Republican lawmakers.


"Now that we have our score ... we can make some necessary improvements and refinements to the bill," he said, referring to the CBO's estimate of the impact on the number of those covered by health insurance and what the GOP proposal would cost.

Ryan did not detail what changes are under consideration.

Vice President Mike Pence also spoke to House Republicans in the meeting, acknowledging that changes to the legislation - which heads to the House Budget Committee for approval tomorrow - are in the works. President Donald Trump has offered his support for Ryan's measure, while still meeting conservative lawmakers who have expressed serious doubts about the plan.

"This President is ready to put the full weight of his bully pulpit and all of his tools" behind the bill, Pence told Republicans, according to Congressman Kevin Cramer. "It was very important for us to hear that, because there are a lot of people who need that shoring up."

Pence's visit to Capitol Hill - which included meetings with influential blocs of Republicans, as well as individual members - came as part of a White House effort to salvage support for the embattled American Health Care Act, even as Trump's conservative allies told him the bill could be a political trap.