Since there were 33 x's, and that many Republicans had been voted out of Congress, they said true.
But in the original picture, many of the X's were reelected, and many weren't even in Congress to begin with.
The author has since retracted the tweet, and admitted it was fake. But Snopes just rephrased the question and left it as true.
https://www.snopes.com/fact-check/gop-obamacare-repeal-elect...