After a dramatic day on Capitol Hill, Ryan rushed from the White House to Capitol Hill to tell Trump he did not have the votes to pass the measure, the culmination of seven years of Republican efforts to eradicate President Barack Obama‘s proudest domestic achievement.

As Ryan presented the dire vote totals in his meeting with Trump, he explicitly recommended the President pull the bill, according to a senior GOP official. The decision was ultimately Trump‘s. Trump made the call at 3 p.m., as the rest of House leadership was gathering in Ryan‘s office.