On Tuesday morning the president was on Capitol Hill, to make his final push to rally support for the bill. He reportedly told Republican lawmakers that a loss was "not acceptable" and went with a traditional carrot-and-stick approach.
Vote yes, and Republicans could pick up as many as 10 Senate seats in the midterm elections next year. Send the legislation down to defeat, however, and their congressional majorities were in peril.
"Many of you came in on the pledge to repeal and replace Obamacare," Mr Trump said. "I honestly think many of you will lose your seats in 2018 if you don't get this done."
If that wasn't clear enough, Mr Trump pointed to Congressman Mark Meadows, leader of the recalcitrant group of libertarian-leaning conservative congressmen known as the Freedom Caucus: "I'm going to come after you, but I know I won't have to, because I know you'll vote 'yes'."
Press Secretary Sean Spicer would later say that Mr Trump meant that as a joke, but in politics a joke is often a threat delivered with a smile.
Mr Meadows, by the way, is still a solid no.
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