Republicans have reached a gut check moment: After spending more than six years vowing to fix the flagging patient that is Obamacare, it's the GOP's own repeal effort that's on life support.

Undoing the health care law despised by conservatives seemed to be a straightforward proposition for the party after it won the White House and retained control of both chambers of Congress. Instead, Republicans are sniping over how much of the law to scrap, what to replace it with and when. At this moment, it's far from a sure thing any plan could get through Congress.

Consider Paul Ryan's feel-good meeting with Senate Republicans on Tuesday. The House speaker trekked across the Capitol to reassure senators that lawmakers are making more progress toward repealing the health care law than the media are reporting.

But not everyone was buying it. Sen. Rand Paul (R-Ky.) left before it was over, having heard enough of a conversation that he says centers around keeping Obamacare's Medicaid expansion intact and creating tax credits that he called a "new entitlement program," though a Republican in the room rebutted the notion that the topic of Medicaid expansion came up in the Tuesday meeting with Ryan.

"I hear things that are unacceptable to me," Paul said in an interview afterward. "If they don't seem to care what conservatives think about complete repeal of Obamacare, they're going to be shocked when they count the votes."

Ryan's efforts precede Wednesday's visit by newly confirmed Health and Human Services Secretary Tom Price, who will attend lunch with Senate Republicans, ostensibly to articulate President Donald Trump's position. In addition, Republicans are pressing Price to do as much as he can through executive actions to buy them time to come to a consensus this spring.