Rep. David Valadao, who runs the centrist-oriented Republican Governance Group, has spent the last several weeks in near-constant communication with his leadership, including in weekly meetings with the chairs of key ideological caucuses across the GOP conference.

That clash — with the White House on one side and GOP hard-liners in Congress on the other — is now playing out in closed-door meetings and in the hallways of Capitol Hill as the party rushes to write the megabill and potentially cut more than a half-trillion dollars from the safety-net health program over the coming decade.