"The Trump-Upton exchange was the culmination of a dynamic that plagued Republicans throughout their push to move legislation through the House. White House officials, including chief of staff Reince Priebus, constantly pestered Ryan to hold a vote on the bill, which they felt wasn’t moving fast enough. Their prodding enraged House GOP leaders, who say their decision to hold back stemmed from their knowledge of how the Hill works.
Leadership had to strike a delicate balance between conservatives who helped sink an earlier draft of the bill they dubbed “Obamacare lite” and moderates who could lose their seats — and possibly the House majority — if they backed the legislation.
“They kept saying, ‘You need to vote! You need to call the vote!’ But we were trying to give this space and time to develop as opposed to a pressure cooker,” said one House Republican aide. “We needed to let this play out a little bit. But the White House just couldn’t let this go.”