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WASHINGTON — The House Budget Committee voted narrowly Thursday to advance the troubled Republican health care bill, with defections by three GOP conservatives underscoring the obstacles party leaders face in maneuvering to avoid a stinging setback to their showpiece legislation.

The vote was 19-17, with Democrats unanimously voting no. Had one more Republican joined them, the measure would have failed in what would have been a damaging, embarrassing — but not fatal — blow to the measure, despite its backing by President Donald Trump.

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