WASHINGTON ― Just hours before an expected Thursday vote in the House, congressional Republicans are considering massive changes to insurance coverage without even a basic idea of what those changes mean. According to House Freedom Caucus members, the conservatives group is negotiating directly with President Donald Trump and the White House on an amendment to the Republican health care bill, seemingly cutting out GOP leadership from the conversation as Speaker Paul Ryan (R-Wis.) and his deputies work to corral votes for a bill that is, in these latest provisions, a mystery to even them. The re-opening of negotiations is an admission that the bill as constructed by Ryan does not have the votes to pass on Thursday.