If you thought that winning both chambers of Congress, the White House, and the most state-level offices in almost 100 years had put the Republican civil war to bed, you thought wrong. The ideological struggle within the Republican Party that typified the 2016 election cycle has subsided, but conservatives, populists, and moderates are still waging a war of ideas. The stakes of the fight are nothing less than dominance within the American right, and the latest battlefield on which that struggle is being waged is the fight over ObamaCare’s replacement. For many on the right, the first draft of the GOP’s bill to replace the Affordable Care Act was a dud. Fearing, perhaps correctly, that whoever took ownership of the bill would one day live to regret it, Donald Trump’s backers in right-leaning media desperately sought to brand the bill “RyanCare.” President Trump isn’t playing along.

At a meeting with members of the House Republican Conference on Tuesday, President Trump made his position on the GOP’s health-care legislation clear: Vote for this bill or face my wrath.

According to reports out of the closed-door meeting on Capitol Hill, Trump told Republican members that they would likely “lose in 2018” if they failed to repeal and replace the Affordable Care Act. He indicated that the recent amendments to the bill designed to satisfy conservative objections should have rendered it a more palatable product. If not, too bad. The time for carrots is over; the president has moved on to sticks.

In a message to the GOP’s recalcitrant conservative members, President Trump singled out Freedom Caucus Chairman Mark Meadows for a jocular but stern admonition. “I think Mark Meadows will get there too,” Trump said. “Mark, I’m coming after you.” It seems Meadows was unmoved by being made an example of, but other Conference members may not be so rigid in the face of such threats. This isn’t the first time Trump extorted Republicans on the Hill. Sources told The Washington Examiner’s David Drucker that, during a White House meeting on the health-care reform bill with the GOP’s whip team, Trump threatened to support primary challengers for those Republicans who balked at supporting the bill.

Trump’s embrace of the health-care bill is slightly more energetic on the Hill than it is at his post-election political rallies. On the stump, the president appears unenthusiastic about the bill and even the project of reforming the nation’s health-care system. He routinely suggests this reform is merely an obstacle to overcome before passing economic legislation that more suits his interests; namely, reforming the nation’s trade deals and overhauling the tax code. But the bill is not popular, and Trump knows he has hitched himself to a drag on his job-approval ratings. It would be easy for him to walk away from the bill and leave his colleagues in Congress hanging out to dry. But Trump isn’t doing that.

All this must come as a terrible let down for right-of-center media outlets that have been trying to create distance between Trump, this legislation, and its chief proponent, Paul Ryan. Breitbart’s Matthew Boyle has suggested in his reporting that Ryan routinely misled Donald Trump about both the nature of his legislation and its prospects for passage.  The typically pro-Trump site has taken to branding the bill “RyanCare.” Tea Party Patriots leader Jenny Beth Martin reportedly sought to drive a wedge between the Speaker and the President in a meeting discussing the health care bill. The Club for Growth announced a $500,000 advertising campaign targeting 10 Republican House members with a spot urging them to reject “RyanCare.”

Will the branding campaign stick? Not with Trump unreservedly embracing the bill. Ryan has done his part by flattering the president. His office has made a point of highlighting how closely they worked with the White House on this bill. “His involvement, his engagement, his listening, and his negotiating skills are bringing people together,” Ryan said last week. “This is a power that we haven’t seen since Ronald Reagan.” On Tuesday, Ryan praised the president’s resolute performance in a closed-door meeting with his colleagues, noting that Trump “was here to do what he does best, and that is to close the deal.”

Ryan’s calculations are correct. While some GOP moderates in Congress think the bill is too conservative, most of the Republicans in Ryan’s conference predisposed to oppose this bill hail from red districts where Trump is popular, but the Speaker is not. Trump needs this bill to pass as much as Ryan does; it would be unheard of for a new president’s first major legislative initiative to fail as a result of opposition from within his own party’s ranks.

Trump’s reported pledge to support primary challenges against Republican holdouts is, in a way, a potent one. Conservative members who balk at voting for a bill their constituents see as too liberal aren’t going to be punished for voting their principles. Voters may be persuaded to abandon their representatives, however, if the issue isn’t the GOP’s health care bill but a litmus test measuring loyalty to President Trump.

That threat only works if the American Health Care Act is seen as a proxy for Trump, and that means the president has to endorse it enthusiastically. He’s done just that. Whether the White House likes it or not, it’s “TrumpCare” from this point forward. Clearly, that’s just how Paul Ryan wanted it.

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