Conservatives kept up their barrage against the American Health Care Act on Wednesday, as FreedomWorks, one of the grass-roots organizations brought to meet President Trump last week, went ahead with a “Day of Action” against the bill it calls “Ryancare,” after House Speaker Paul D. Ryan (R-Wis.), its chief proponent. Braving 28-degree weather and biting winds, hundreds of them grabbed red “Storm Congress” baseball caps and cheered for Republican members of Congress as they promised them a fight.

But the group’s rally on the Hill, joined by Congress’s most prominent Republican opponents of the Ryan plan, revealed the divisions inside the conservative opposition. Republicans such as Sen. Rand Paul (R-Ky.), who introduced his own Affordable Care Act replacement in January, are committed to voting down anything less than a full repeal. Republicans such as Sen. Ted Cruz (R-Tex.), joined by FreedomWorks itself, are trying to tweak the bill into one they can support.

Cruz, who pointedly did not appear at a previous conservative rally against the Ryan plan, told activists at Wednesday’s event that they could help him — and the president — shape the plan into one they could support.

“The leaders you’re hearing from are working to take the House plan — which has a lot of problems — and try to make it a real repeal that lowers premiums, that gives you control over your health care,” said Cruz. “I believe we can get it done. I can tell ya, the last week, four days, I’ve been at the White House meeting with the president, with the vice president, saying, ‘We’ve got to get it done.’ ”

President Trump’s name frequently earned cheers from the crowd; Cruz was not the only speaker suggesting that the president, who has repeatedly endorsed the AHCA, would be an ally in getting Ryan to change it.

“Failure is not an option,” said Cruz. “If Republicans take this opportunity and blow it, we will rightly be considered a laughingstock.”

In a memo obtained by The Washington Post and intended for the White House and members of Congress, FreedomWorks itself suggested that the Ryan bill could be amended in ways that made it worth conservative votes. In public, FreedomWorks has been running a campaign denouncing AHCA as “Ryancare,” with Web ads that show the speaker hugging former president Barack Obama. In the memo, FreedomWorks offered praise for sections of the bill, calling the expansion of Health Savings Accounts “a positive reform that we support.”

FreedomWorks can get to ‘yes’ on the bill if House Republican leaders would:
• Lessen the fiscal impact of the tax credit by making it nonrefundable or partially refundable
• Immediately freeze Medicaid expansion enrollment and add work requirements to the program
• Repeal ObamaCare’s essential health benefits mandates
• Strike the continuous coverage language

Those demands butt up against the changes that many Senate Republicans say they favor. But while the White House has repeatedly claimed that the president favors the AHCA as it is, conservative holdouts increasingly say that the president is their partner in dealmaking. Before he headed onstage at Wednesday’s rally, Rep. Mark Meadows (R-N.C.), the leader of the House Freedom Caucus, told reporters that the president was clearly leaving options open.

“He is looking for amendments to be made, to make it better,” said Meadows. “Ultimately it’s going to have to be amended to get enough support for passage on the House floor. We see some of the things we’re recommending needing to be adjudicated in the Senate.”

Onstage, Meadows struck a more combative tone, telling activists that his fellow Republicans needed to be ready to lose reelection if it meant keeping their repeal promise.

“We’ll be judged on one thing,” said Meadows. “It is not a CBO score. It is not even on keeping our word — even though we will be judged on that. It will be if premiums are coming down. That’s the number that matters.”

To the cheering members of the audience, who braved hours of cold to hear their leaders promise a fight, this was manna. Jane Bilello, the leader of the tea party group in Asheville, N.C., brought a Meadows for Congress sign to the rally — after redistricting, he became her representative — and said she, too, trusted that Trump wanted Republicans to keep their promise, while Ryan was undermining it.

“He’s a John A. Boehner clone,” said Bilello, mentioning the former House Speaker. “We need a motion to vacate the chair, get rid of him.”

Democrats, lacking the votes to block any Republican plan, looked at the protests with bemusement. At a morning news conference, Rep. Joseph Crowley (D-N.Y.) said that the Freedom Caucus die-hards were more likely to get their changes into the bill than the holdout members of the Senate, who are asking for more generous tax credits and the extension of Medicaid expansion.

“I think the likelihood of them trying to massage moderate Republicans is a dream at this point,” said Crowley. “They’re more likely to try to massage the right-wing members of the caucus, the Freedom Caucus. I’d suggest: Keep trying, keep working on ways to moderate this bill, so that it works in ways that the Affordable Care Act is already working.”

That talk was anathema to FreedomWorks members, whether they trusted that “Ryancare” could be amended or whether they wanted it blocked. The only speaker at Wednesday’s rally with a reception as warm as Cruz’s was Paul, who has pledged to oppose any bill short of the 2015 repeal package Republicans passed knowing that Obama would veto it.

“Tell the weak-kneed Republicans we were not out there campaigning for Obamacare Lite,” said Paul.