Keen to score his first major legislative win since taking office in January, Trump has been personally engaged this week in trying to cement support among fellow Republicans in the House of Representatives for an effort that has twice before collapsed in confusion.

The bill has been changed several times as Republican leaders try to balance demands by conservatives seeking a maximum rollback of the Affordable Care Act with the concerns of moderates worried about angering voters who value parts of it.

The moderates, speaking to reporters outside the White House, said Trump has endorsed their plan to add $8 billion over five years to help cover the cost for people with pre-existing illnesses who could otherwise be priced out of insurance markets.

Representative Fred Upton said it now seemed likely the bill would pass the House, although a moderate colleague, Representative Billy Long, said Republicans still seemed short of the votes needed.

“There’s still work to be done on the votes,” he said.

Aides said Trump has been working the phones furiously in an effort to drum up support and score a victory on one of his key priorities, which is to overhaul Democratic former President Barack Obama’s signature domestic legislation. The effort to push through a healthcare bill is showing Trump the challenge of placating various Republican factions.

An initial attempt foundered in the House and was withdrawn by Republican leaders in March, a defeat that cast a shadow over Trump’s first 100 days in office. Republicans renewed negotiations last month at the White House’s urging, but failed to round up enough support for a vote before a two-week recess in April. Republicans are now hoping to get something passed before they leave for another recess on Thursday evening.

Health insurers such as Anthem Inc, UnitedHealth Group, Aetna Inc and Cigna Corp have faced months of uncertainty over the future of the country’s healthcare system.

Millions more Americans got healthcare coverage under Obamacare, which was passed in 2010, but Republicans have long sought to overturn it, seeing it as government overreach and complaining it drives up costs.

House Democrats rejected the latest proposed change to the Republican legislation on Wednesday, saying it appears to protect patients with pre-existing conditions, but some could still be pushed off their insurance in certain states and face higher costs.

“This is deadly,” House Democratic Leader Nancy Pelosi told a news conference. “No band-aid will fix it.”

-REUTERS