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Story highlights

There's a lot of talk on the Hill about whether health care efforts have actually died

In short, this gets real when the moderates say it's real

"It appears the White House has realized President Trump doesn't like losing"

(CNN) —  

There are plenty of Republicans across Capitol Hill that see the GOP plans to repeal and replace Obamacare as a settled issue at least for the moment, but behind the scenes several key players are not letting the issue go..

An impasse between conservatives and moderate Republicans last month led House Speaker Paul Ryan to pull the bill and tell his fellow members that GOP leaders were “moving on” with their agenda.

Since then, there’s been a small but growing and steady stream of indicators that if nothing else, Republicans – from President Donald Trump, new golfing partner Sen. Rand Paul and several freshmen congressmen – are still looking for a deal.

And Monday night, Vice President Mike Pence spoke to the House Freedom Caucus – the group of conservatives that helped sink the health care bill last month.

Here’s the latest state of play of health care efforts on the Hill:

What are the changes being discussed?

Conversations on a pathway forward have continued to pick up over the last week, and they have focused almost entirely on picking up members of the House Freedom Caucus – the chamber’s most conservative wing of the GOP.

The two key issues: repeal of Essential Health Benefits and repeal of the existing community ratings provision.

A straight repeal of those two items remains an almost impossible sell to the broader conference (the moderate Tuesday Group was fleeing in large numbers when EHBs was put on the table two weeks ago), so they’re trying to figure out a way to massage it in a way to appease both poles of the conference.

One idea being kicked around is to provide more authority to the Health and Human Services secretary to give states the ability to make these changes on their own.

After meeting Pence, Freedom Caucus Chairman Mark Meadows said his group was “intrigued” by the idea of giving give states more flexibility to opt out of Obamacare regulations using a waiver process, but Meadows wouldn’t promise the Freedom Caucus would be on board in the end.

“No one made any definitive changes in terms of moving from ‘no’ to ‘yes’ primarily because there is not enough detail to do so,” Meadows said. “But I can tell you all the ‘no’s,’ every one of the ‘no’s,’ expressed a willingness to look at this in a very detailed manner.”

Paul, who has urged the Freedom Caucus to hold together in opposition to the original bill, said after a meeting with members of the group Monday that they still weren’t zeroing in on a final deal. He said that the insurance regulations, known in shorthand as “Title One” regulations after their place in the Affordable Care Act, remain the problem they have been to compromise for weeks, labeling them as “a big sticking point.”

“I think there still is an opportunity for compromise on this, but I think it still needs more time,” Paul told reporters outside of his office.

Where is the White House?

The White House blitz right now is real, and it is clearly taking the lead on the effort.

Pence has taken and increasingly large role in the process, according to several lawmakers and aides involved in the process. That is being received well for the moment – and the efforts are growing.

Pence met with several moderate members at the White House on Monday and then swung by the Freedom Caucus later on. Why?

“It appears the White House has realized President Trump doesn’t like losing,” was the way one GOP aide characterized the clear shift in position.

It was only 11 days ago, as everything collapsed around them, that the President instructed his team – and House leaders – to drop the issue entirely and move on to tax reform.

Those instructions are now being viewed as premature by everyone involved, but the core issues – and central problems that plagued and eventually sank the original bill – remain unchanged.

Is there a deadline?

There remains significant skepticism about whether something can come of the talks among top GOP aides – or what kind of timeline any deal would work under.

House Ways and Means Chairman Kevin Brady, one of the authors of the health care bill, has made clear that his committee has moved onto tax reform, as was requested by the President and announced by Ryan the day health care collapsed.