President Trump’s campaign enemies are looming large as he tries to win passage of a bill to repeal and replace Obamacare and finds himself needing to woo many of the very same people he ran against and defeated for the Republican nomination last year.

Meanwhile, Mr. Trump has hitched his wagon to yet another nemesis from the campaign, House Speaker Paul D. Ryan, Wisconsin Republican, who was brutal in assessing candidate Trump but now has forged a partnership as they try to win over reluctant conservatives.

“I am very pleased and very excited, and I’ve got to tell you, it’s something I hadn’t seen in along time,” Mr. Ryan told reporters Thursday. “This president is getting deeply involved. He is helping us bridge gaps in our conference.”

 

The Ryan-Trump tag team, though, has little margin for error. Without the help of Democrats, they stand to lose about 20 Republican votes in the House and two votes in the Senate on this first go-around.

That means buy-in from most of Mr. Trump’s rivals from the Republican presidential race Sens. Rand Paul of Kentucky and Lindsey Graham of South Carolina, whom Mr. Trump branded as “lightweights”; Sen. Marco Rubio of Florida, dubbed “little Marco”; and Sen. Ted Cruz of Texas, whom he named “Lyin’ Ted.”

While Mr. Rubio has said he is open to the bill that Mr. Ryan and Mr. Trump have crafted, Mr. Cruz, Mr. Graham and Mr. Paul have all been skeptical.

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