Seven years of Republican promises to replace Obamacare will be kept alive or dealt a potential death blow Thursday in a dramatic House vote on an embattled health bill, with big political risks for President Donald Trump and Speaker Paul Ryan.

House leaders and administration officials expressed confidence Wednesday night that they have just enough votes to pass the measure, which is set for an early-afternoon vote in Washington. But with a number of GOP moderates still voicing reservations about the bill, Ryan and other party leaders have a razor-thin margin of error.

“Would you have confidence? We’re going to pass it,” House Majority Leader Kevin McCarthy of California told reporters Wednesday night.

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