House Republican leaders’ embarrassing failure to hold the line against a Medicare-related bill this week raised new questions about whether the rank and file will adopt an every-man-for-himself strategy as the election draws near.

The 355-59 drubbing came despite a personal plea from Minority Leader John Boehner (R-Ohio) to rally his caucus against Democratic attempts to shove the so-called Medicare “doc fix” down the GOP’s throat.

While some argue that the bill was a special case, the vote also symbolized a potential turning point in the GOP leadership’s ability to hold its troops in line, even on politically difficult votes.

It remains to be seen what it could mean for votes on children’s health care legislation and other measures, with Democrats looking to pad the remainder of the House legislative calendar with issues that could reverberate at the polls.

Boehner made an aggressive push to persuade Members to oppose the doc fix bill during Tuesday morning’s weekly GOP Conference meeting — including telling one Member to vote no on the bill if he wanted a choice committee assignment. While aides said later that the comment was made in jest, not everyone in the room took it that way.

Boehner also employed the term “dead asses” in making his pitch, a phrase he used previously when imploring Members to step up their fundraising for the party.

But hours later, 129 Republicans joined with all 226 Democrats present to pass the bill, which would prevent cuts in physician fees under Medicare. Many Republicans switched their vote to yes after it became clear the bill was going to pass overwhelmingly. By that point, Republicans had given up efforts to whip the bill and accepted that they weren’t able to hold their troops in line.

Republican objections to the bill were rooted in the offsets to pay for the fix, which called for spending reductions to Medicare managed-care plans, and their belief that more palatable legislation is being crafted in the Senate.

While leaders tried to convince Members that they would get another chance to vote on a better bill, uncertainty over whether that would actually happen drove many Republicans to vote yes.

“What they should have done was count their votes a little better,” Rep. Mike Simpson (R-Idaho) said. “Members didn’t want to vote against it if it was going to pass.”

Another Republican Member called the decision to try to whip votes against the doc fix an “embarrassment on the minority leadership,” adding that Boehner and Minority Whip Roy Blunt (R-Mo.) misread where the Conference was on the issue.

This Member also expressed the sense that the bill brought to the floor Tuesday was the best bill Members would have an opportunity to vote on — a sentiment that was confirmed by another GOP Member but counter to what leadership was saying.

Highlighting the intensity of Boehner’s push to his Members Tuesday morning was an exchange he had with Rep. Phil Gingrey (R-Ga.), an ob-gyn by profession.

While addressing the group, Gingrey questioned whether leaders understood the significance of asking Members to oppose a measure overwhelmingly supported by doctors and medical providers. If they did, he said, they would need to send Members home for the July Fourth recess with talking points to explain themselves.

In response, Boehner asked Gingrey whether it was true that he wanted to serve on the Energy and Commerce panel. In an interview Wednesday, Gingrey said he replied that he absolutely wanted to be on the committee.

“Then vote no,” Boehner said, to chuckles from the audience.

Gingrey described the comment as tongue-in-cheek and said he wasn’t offended by the exchange. In fact, he said, at times he has wanted leaders to be more forceful in relaying “how strong our leadership feels about something.”

He said Boehner later approached him on the floor and told him to vote his conscience and do what he thought he needed to do, assuring him that it would have no impact on future committee assignments.

Not everyone in the room took Boehner’s comments in jest.

“Some of the Members might have been taken aback by it,” Gingrey conceded.

Other Members privately praised the hard line taken by leadership, even if the effort ultimately failed.

With more sensitive votes expected in July and September, Republican leaders’ ability to hold their rank and file in line will continue to be tested.

Simpson said that the vote could have implications later as Members start thinking about their own re-elections and pay less attention to presidential veto threats.

“The president is going to have less and less say here over the next six months, because frankly, he’s not on the ballot, and we are,” he said.

Leadership aides defended the decision to whip against the bill and acknowledged more difficult votes are to come.

The American Medical Association and pharmaceutical industry mounted an aggressive public relations campaign to build support for the legislation. Members received an outpouring of calls from doctors in their districts prior to the vote.

Republicans sought to put the best face on the defeat, charging that Democrats were seeking to undermine the bipartisan Senate negotiations by bringing the bill up under suspension.

“Our Members wanted to go home having voted for a measure that would ensure that physicians are fairly reimbursed by Medicare,” said Antonia Ferrier, a spokeswoman for Blunt. “Sadly, House Democrats would neither back down nor commit to finding a way to get a reasonable compromise bill to the president’s desk before we leave for recess.”

Rep. Wayne Gilchrest (R-Md.), a moderate who was defeated in a primary earlier this year, said he sees the vote as further evidence that Members are realizing they have to put their own interests above toeing the party line.

“The ship is sinking and somebody yelled ‘every man for himself,’” he said.