The day after unveiling their new bill to replace Obamacare, the Republican authors of the Affordable Health Care Act find themselves in a bind. 
 
 Even if the new bill has the votes in the House, it will also have to pass the Senate. Because this legislation is moving forward through the budget reconciliation process, which only requires 51 votes, the 52 Republicans in the Senate can only afford two defections and still pass the bill (assuming Vice President Mike Pence would break a tie in their favor). A third defection would doom the Obamacare replacement package. 
 
 And, already, four Senate Republicans have already criticized Speaker Paul Ryan’s first proposal, saying it doesn’t do enough to protect Medicaid beneficiaries. That group consists of Rob Portman (R-OH), Sen. Shelley Moore Capito (R-WV), Sen. Cory Gardner (R-CO) and Sen. Lisa Murkowski (R-AK). Assuming Democrats stick together in opposition, that moderate bloc of Republicans could torpedo the bill on their own. 
 
 But appeasing moderates could carry risk for Republican leadership as well: Conservative senators could defect in protest of a bill they think is too far to the left. The most conservative senators are already blasting the first draft as not doing nearly enough to slow entitlement spending, with Sen. Ted Cruz (R-TX), Sen. Rand Paul (R-KY), and Sen. Mike Lee (R-UT) echoing the arch-conservatives in the House Freedom Caucus who say that the bill amounts to “Obamacare-lite” and leaves too much of Obama’s law intact, including the expansion to Medicaid in place until 2020 and the “Cadillac tax” on health care plans for those with high incomes. 
 
 National Review’s John Fund points out the difficult spot that Republican leadership is in on Twitter: 
 
 Biggest obstacle to House health bill: 7 GOP senators on fence - 4 who said didn’t adequately protect Medicaid, 3 who say bill too generous — John Fund (@johnfund) March 7, 2017 
 
 If anything, Fund’s tweet undersells the challenge leading Republicans face in building the coalition to get to the 51 votes they’ll need at a minimum to get Trumpcare through reconciliation. 
 
 It’s not just the fight over Medicaid. Sen. Bill Cassidy (R-LA), for instance, has said that the bill has to cover the same number of people as Obamacare. Sen. Bob Corker (R-TN) wants it to be neutral, meaning it doesn’t add to the deficit. 
 
 "I'm going to be very anxious to hear how we'll get to 51 votes and [how] the House gets to 218," said Sen. Roy Blunt (R-MO). 
 
 The Congressional Budget Office hasn’t yet estimated how many people the bill will cover or how much it will cost, key to Cassidy and Corker’s support. But the challenge is obvious from a mile away. 
 
 Meanwhile, Sen. Susan Collins (R-ME) and Sen. Murkowski say the House health bill should be stripped of its provisions to defund Planned Parenthood. 
 
 “If you go too far and have too many drastic cuts, you lose the moderate four,” says Josh Huder, a congressional scholar at the Government Affairs Institute at Georgetown University, citing Portman, Caputo, Gardner, and Murkowski. “And if you don’t go far enough, you lose the conservatives.” Republicans need both to get to 51 votes. 
 
 It’s perfectly possible either or both factions of Republicans are bluffing, simply hoping to pull the negotiations as far to their side as possible. “There's a high probability of that,” Huder says. That’s what happened during the debate over Obamacare. 
 
 In 2010, it looked like then-Majority Leader Harry Reid didn’t have the votes for the Affordable Care Act. Two versions of the bill were shot down after passing separate committees, Democrats like Joe Lieberman threatened to withhold support, and the future of health care reform seemed to be in danger. 
 
 Then the bill was reworked — and Reid had the votes. “All of a sudden, Harry Reid dropped a bill on the Senate floor that found the right mixture of people, and then the House swallowed the pill,” Huder says. “It looked like Obamacare was dead in the water — and then all of a sudden it sprang back to life.” 
 
 But even if some Republicans are bluffing because they hope to influence what the final bill looks like, the balancing act between conservatives and moderates is a real challenge. 
 
 “It’s going to be really, really hard for them to do this,” Huder says. “It’s the key question: Can they find a way to thread the needle here between the moderates and the conservatives in the Senate? There’s no way forward if not.” 
 
 Tara Golshan contributed reporting. ||||| White House press secretary Sean Spicer said that what the House GOP released last night is the Obamacare repeal that everyone’s been waiting for. 
 
 And while Vice President Mike Pence said today that the White House is “open to improvements,” it’s already getting an icy reception from many on the right. The bill has received criticism from Heritage Action and National Review, and several Republican legislators — including Mike Lee and Rand Paul — have already voiced their concerns. 
 
 Ann Coulter isn’t too happy about it either, saying the following on Twitter today: 
 
 Page 3 of the Obamacare repeal makes ABSOLUTELY CLEAR no abortionists get funding. We’re dying under O-care! You got to give it a rest, GOP. — Ann Coulter (@AnnCoulter) March 7, 2017 
 
 Millions of ppl are stuck with Uganda-educated doctors or being impoverished by Obamacare and the GOP has to show off on abortion. — Ann Coulter (@AnnCoulter) March 7, 2017 
 
 The “free market” part of Obamacare repeal sends all control back to the most corrupt entities in the U.S.: State Insurance Commissions. — Ann Coulter (@AnnCoulter) March 7, 2017 
 
 Can anybody find the part of the Obamacare repeal where we can buy insurance across state lines? That’s the Holy Grail of health reform. — Ann Coulter (@AnnCoulter) March 7, 2017 
 
 Hey @RepDaveBrat! You were an economics professor. Can you explain the devilishly complicated idea of the free market to your colleagues? — Ann Coulter (@AnnCoulter) March 7, 2017 
 
 I think we should keep Obamacare but just for members of Congress (who exempted themselves!) — Ann Coulter (@AnnCoulter) March 7, 2017 
 
 And the 500k uninsured were mostly immigrants. https://t.co/8Fo1LcJ6yA — Ann Coulter (@AnnCoulter) March 7, 2017 
 
 Who wrote this piece of crap Obamacare replacement bill? Please be specific. — Ann Coulter (@AnnCoulter) March 7, 2017 
 
 I have to give full identifying info as each health ins co goes bankrupt. What are names of the brain trust that wrote this piece of crap? — Ann Coulter (@AnnCoulter) March 7, 2017 
 
 Also, I would like every person involved in the writing of this Obamacare replacement POS to take a ten-minute IQ test. Transparency! — Ann Coulter (@AnnCoulter) March 7, 2017 
 
 [image via screengrab] 
 
 —— 
 
 Follow Josh Feldman on Twitter: @feldmaniac 
 
 Have a tip we should know? tips@mediaite.com ||||| CLOSE Over the strong objections of key conservatives and Democrats, House Republican leaders are forging ahead with a health care plan that scraps major parts of the Obama-era overhaul. (March 7) AP 
 
 Do we stay with Obamacare and the unsustainable status quo, or do we repeal it and replace it with something better? 
 
 House Speaker Paul Ryan (Photo: J. Scott Applewhite, AP) 
 
 When I took the speaker’s gavel, I told my colleagues that it’s no longer good enough to just say what we’re against. We had to show what we’re for. That’s why last year we released a complete policy agenda — tracking closely with ideas from our presidential nominee, Donald Trump — to tackle all of the big challenges facing this country. The truth is, we have solutions to all of the many problems that Barack Obama left behind. 
 
 And there is no more urgent problem than Obamacare. 
 
 The collapsing law is driving up health care costs and driving out choices for American families. This year alone, premiums have gone up by double digits in 31 states. Choices have dwindled to the point that one out of every three counties in America has just one insurer to choose from. 
 
 Not too long ago, Bill Clinton called Obamacare “the craziest thing in the world.” He is on to something there. 
 
 That’s why we must end this law — repealing it once and for all. But rather than going back to the way things were, we must move to a better system that embraces competition and choice and actually lowers costs for patients and taxpayers. 
 
 
 
 Introduced this week, the American Health Care Act keeps our promise to repeal and replace Obamacare. I hope you will read the bill online at readthebill.gop. 
 
 Our goal is to give every American access to quality, affordable health care. For families, that means lower costs, more choices and greater control. Let me walk you through how our plan will help get us there. 
 
 For starters, our bill repeals Obamacare. We cannot rebuild the American health care system on such a flawed foundation, and that’s why we eliminate Obamacare’s taxes, mandates and spending. 
 
 Next, and this is important, our plan ensures there will be a stable transition. As we move from a Washington-driven system to a more vibrant market, we will make sure no one has the rug pulled out from under them. This also means we will ensure vital protections for patients with pre-existing conditions and allow young adults to stay on their parents’ plan. 
 
 We will also give states more funding and flexibility to support high-risk pools and reinsurance programs. Where Obamacare was built on mandates and coercion that make coverage more expensive, our plan takes care of those in need without driving up costs for everyone else. 
 
 Next, while Obamacare just added people to a broken Medicaid system, we will strengthen Medicaid so that states have the tools they need to take care of their poor and most vulnerable populations at a lower cost. Our plan represents the most significant entitlement reform in more than 50 years. 
 
 Republicans have long said that we have to empower patients as consumers to spur competition and bring down costs. That’s why we will also nearly double the amount of money you can contribute to health savings accounts to pay for out-of-pocket expenses. This will end Obamacare’s limits on how you save and spend your health care dollars. 
 
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 Ultimately, we need a real marketplace for health insurance. Currently, the tax code discriminates against those who don't get coverage through their employer. To level the playing field, our plan offers an advanceable, refundable tax credit to those who don’t get insurance from work or a government program. Instead of mandates forcing you to buy what the government wants, you will have real choices. Available to those under a certain income level, this tax credit will be age-based and portable so that you can take it with you from job to job. 
 
 
 
 And to help more people buy the kind of plan that fits their needs, we will get rid of costly insurance mandates and regulations. 
 
 
 
 In the weeks ahead, the House will consider this plan through an open and transparent process, including legislation to allow people to purchase health care across state lines. As we do, I encourage you to read the bill so you can see the changes we are proposing. 
 
 Here is the choice we face: Do we stay with Obamacare and the unsustainable status quo, or do we repeal it and replace it with something better? 
 
 
 
 The American Health Care Act offers a better way. It keeps our promise, begins to clean up the mess Obamacare has made, and builds a better system for all Americans. Now we must deliver. 
 
 Rep. Paul Ryan, R-Wis., is speaker of the House of Representatives. 
 
 You can read diverse opinions from our Board of Contributors and other writers on the Opinion front page, on Twitter @USATOpinion and in our daily Opinion newsletter. To submit a letter, comment or column, check our submission guidelines. 
 
 Read or Share this story: http://usat.ly/2nbKQrx ||||| poster="http://v.politico.com/images/1155968404/201703/1220/1155968404_5351163412001_5351156359001-vs.jpg?pubId=1155968404" true Ryan disappoints his friends with Obamacare replacement bill Close allies in conservative policies circles found little to love with the GOP's health care proposal. 
 
 House Speaker Paul Ryan has long been the darling of conservative policy wonks. But on one of the biggest days of his political career, when House Republicans released their much-anticipated Obamacare replacement, many of Ryan's closest friends in the conservative intelligentsia expressed disappointment — if not outright dismay — with the legislation bearing the speaker's imprimatur. 
 
 Indeed, virtually every prominent conservative health care expert — precisely the sort of ideological allies who have backed Ryan in the past — panned this legislation. 
 
 Story Continued Below 
 
 The Cato Institute’s Michael Cannon called it “a train wreck waiting to happen.” The American Enterprise Institute’s Jim Capretta told POLITICO the GOP’s decision to do away with a cap on tax credits for employer-based health insurance reflected a reluctance to “deal with reality.” Forbes’ Avik Roy, widely considered one of the pre-eminent health care policy experts on the right, predicted the legislation would make insurance unaffordable for millions of the nation’s poor and offered an analysis with subsections titled, “The Good,” “The Bad” and “The Terrible.” The Wall Street Journal editorial board was the lone dissenter, calling the bill "the most consequential GOP social-policy reform since the welfare overhaul of 1996." 
 
 “It is remarkable that they’ve produced a bill that is so out of touch with ACA opponents,” Cannon said. “The first rule in these situations is you want to dance with the gal that brung ya. You don’t want to walk away from your base.” 
 
 Paul Ryan's spokesperson, AshLee Strong, took issue with that characterization. 
 
 "The bill is a compilation of reforms conservatives have fought for over many years including Medicaid block grants, HSA expansion, equalized tax treatment for health benefits, and repeal of Obamacare to the full extent reconciliation allows," she said. 
 
 Conservatives have never seen eye to eye on just how to go about repealing and replacing the Affordable Care Act, and, over time, right-leaning Obamacare critics have fallen into two camps: those who favor scrapping Obamacare without providing alternative coverage for its beneficiaries and those who favor replacing Obamacare’s subsidies with a tax credit, either flat or adjusted for the wealth and income of beneficiaries. 
 
 The origins of the current debate stretch back to June 2016, when Ryan rolled out his own health care plan as part of a broader policy vision he dubbed “A Better Way.” The plan itself was the result of dozens of conversations with conservative think tankers over the years, and in it, Ryan planted his stake firmly in the camp of those who support replacing the current subsidies with a flat tax credit. 
 
 But the Republican-controlled House never voted on the plan and the tensions and disagreements that would normally have surrounded it receded into the background in the midst of the election season. 
 
 “There was never a vote or a poll taken on it,” Roy said. In Congress, “people just kind of kept their mouths shut, they didn’t complain about it and didn’t endorse it, they just kind of left it alone.” 
 
 Though Ryan's plan sprang from conservative circles — and served as a framework for the current bill — the legislation unveiled on Monday night includes many compromises Ryan's blueprint did not. 
 
 As a result, the current GOP bill has managed to rile all three major conservative camps. And a debate that as recently as a year ago was taking place in think tank board rooms and congressional offices is now unfolding on the national stage. 
 
 House and Senate leaders seemed tacitly to acknowledge the precarious position they’re in, vowing to push forward as quickly as possible, without a debate in Congress and despite the fact that the Congressional Budget Office hasn't given the bill an official price tag. Senate Majority Leader Mitch McConnell on Tuesday promised a vote on a health care bill by the end of April. 
 
 Though few conservative policy wonks harbored the illusion that an Obamacare replacement would not reflect some painful bargaining, they are by and large surprised to see the initial volley riddled with so many compromises, leaving one prominent conservative to lament: “This bill has no friends.” 
 
 Perhaps the biggest flash point in the legislation is the 30 percent surcharge on those who allow their insurance coverage to lapse, which has led experts to warn the bill will entrench and exacerbate problems introduced by Obamacare. Roy speculated that origins of the provision lie in reports from several insurance companies, on earnings calls and elsewhere, that those who enroll in Obamacare exchanges outside the regular enrollment period are on average 30 percent costlier to ensure. 
 
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 “Once you create that rule, you create a different incentive structure — people who are healthy have an incentive to stay uninsured, and people who are very sick have an incentive to pay the 30 percent penalty,” said Roy, who called it a “recipe for adverse selection death spirals.” 
 
 It’s that prospect that has onetime Ryan allies warning that what should be a high point for the Republican majority could cost them at the ballot box if they continue down the same path. 
 
 Cannon predicted Republican House members would be “hammered” by their constituents who see their health care deteriorate. 
 
 “I think if they actually enacted the House bill, they would create a mess in 2017, 2018 and 2019,” Capretta said. 
 
 He demurred, though, when asked about the chances that the legislation would make it to the president’s desk. “Normally, leaders of Congress don’t proceed unless they think they have a pretty good chance of success,” he said. “It looks daunting to me but, you know …” ||||| Myth #1: This Amendment does not cover pre-existing conditions. 
 
 FACT: The MacArthur Amendment explicitly maintains protections for pre-existing conditions. NO STATE, under ANY circumstances, may ever obtain a waiver for guaranteed issue of coverage, guaranteed renewability of coverage, or the prohibition on denying coverage due to pre-existing conditions. The amendment specifically clarifies that its provisions cannot be construed as allowing insurers to limit coverage for those with pre-existing conditions. All of these protections will remain the law. 
 
 Myth #2: This Amendment will price those with pre-existing conditions out of the market, making health care unaffordable for them. 
 
 FACT: The amendment’s limited waiver for health rating requires states to set up a program for high-risk individuals or premium stabilization, or to participate in the federal invisible risk sharing program. No state may obtain a waiver for health status unless it has taken these efforts to protect those who might be affected. In states with a waiver, individuals who maintain continuous coverage could not be rated based on health status. 
 
 Myth #3: High-risk pools have traditionally been underfunded by states and the federal government, resulting in poor coverage and high costs for those who need insurance the most. 
 
 FACT: The AHCA sets aside $100 billion over ten years to help states with high-risk pools and other innovations. It sets aside an additional $15 billion specifically for maternity care, mental health care, and substance abuse treatment. And it sets aside an ADDITIONAL $15 billion for a federal invisible risk-sharing program -- another innovative way to help people access affordable coverage. 
 
 Myth #4: Under this amendment, States do not have to cover essential health benefits. 
 
 FACT: This amendment ensures essential health benefits are the federal law of the land and maintains other important protections. States have the option to obtain a waiver regarding federal essential health benefits, but the state must publicly attest its purpose for doing so (to reduce the cost of health care coverage, increase the number of people with health care coverage, etc.) and it must specify the benefits it will require instead of the federal standard. NO STATE, under ANY circumstances, may ever obtain a waiver for pre-existing condition protection, prohibition on gender discrimination, for guaranteed issue and renewability, or for the right of dependents to stay on a family plan up to age 26. 
 
 Myth #5: 129 Million Americans have pre-existing conditions and could be denied coverage. 
 
 FACT: This legislation addresses the 7% of Americans on the individual market, and those in the small group market. Anyone with employer-provided coverage or government coverage (Medicare, Medicaid, Tricare, VA benefits, etc.) would not be affected. Again, this amendment would not allow any state to deny coverage to those with pre-existing conditions, and would require the extensive protections described above for those with riskier health profiles. It is also worth noting that many states required insurers to offer coverage to those with pre-existing conditions before Obamacare was implemented. ||||| Washington (CNN) President Donald Trump warned House Republicans Tuesday if they can't pass health care legislation after seven years of promises it could be a "bloodbath" in the 2018 midterm election, according to one member present in the meeting. 
 
 Trump vowed to throw his full support behind the effort to repeal and replace the Affordable Care Act during a meeting with House GOP leadership, saying he is "proud" to support a GOP-authored plan to replace Obamacare and told members behind closed doors that he would support it "100%," according to sources in the room. 
 
 But he warned lawmakers of the high-stakes nature of the effort, citing a potential electoral "bloodbath," a member present said. 
 
 "He said he hopes members understand that," the source said. 
 
 Despite early opposition from conservative groups and some members of Congress, there was a lot of optimism among the House leadership members charged with passing the legislation that members would come around. 
 
 Trump promised House Republicans in the meeting he would use the power of the bully pulpit -- calling and meeting with members -- to get conservatives and moderates in line and pass the bill. 
 
 "I'm proud to support the replacement plan released by the House of Representatives and encouraged by members of both parties," Trump said during brief remarks captured by the press pool. 
 
 Republicans first unveiled their legislation, which would eliminate the individual mandate to obtain health insurance contained in Obamacare and include tax incentives meant to encourage Americans to purchase coverage, Monday night. 
 
 The gathered lawmakers told the President they faced obstacles ahead without any expectation of Democratic support for their plan, nor any idea of where some conservatives might land. The House GOP vote-counters told Trump they planned to move forward with a whip count later this week 
 
 "We don't have it today, but I think we'll get it," a source in the room told CNN. 
 
 Trump's remarks during the roughly 30-minute meeting with members in the East Room of the White House reflected the most explicit administration endorsement yet of the replacement health care plan. 
 
 "I cannot comment on the discussions in closed door meetings," said Lindsay Walters, a White House spokeswoman, when asked about Trump's comments about the political pitfalls of failing to pass a replacement plan. 
 
 Trump had not yet weighed in overtly on the Republican plan until Tuesday afternoon. Earlier, he tweeted support for the bill but also suggested there were elements of the measure that could be changed. 
 
 JUST WATCHED Spicer compares healthcare bills by size Replay More Videos ... MUST WATCH Spicer compares healthcare bills by size 01:23 
 
 "Our wonderful new Healthcare Bill is now out for review and negotiation," he wrote Tuesday morning. 
 
 Sources in the room told CNN that Trump did not explicitly call out any member or group opposed to the bill, but did emphasize the importance of getting the job done and working together to do it. 
 
 "We cannot toss this out and start all over. We are too far down the road for that," the source said. 
 
 The whip strategy going forward appears to be to remind members again and again that voting against the House's bill is the same as voting against their President, and handing a victory to Senate Minority Leader Chuck Schumer and House Democratic Leader Nancy Pelosi. The strategy is to remind members there is no second chance to get this right. 
 
 Vice President Mike Pence also joined the meeting and was feeling hopeful about the legislation's prospects in the Senate, sources said, despite the fact that two senators have already come out with deep concerns about the House legislation. 
 
 While Trump said he was committed to the bill, he did indicate he was open to making changes. Sources in the room, however, said that the changes would have to win broad support and be passed through the amendment process, making it difficult to amend the contours of the legislation in any meaningful way. 
 
 "This is a guy who knows how to close a deal, and he thinks we are at the point were we need to close," the source said. 
 
 Trump took to Twitter Tuesday evening to reach out to one of the bill's most vocal conservative opponents. 
 
 "I feel sure that my friend @RandPaul will come along with the new and great health care program because he knows Obamacare is a disaster!" Trump tweeted, just as an interview with Sen. Rand Paul was about to air on CNN's Erin Burnett "OutFront." 
 
 I feel sure that my friend @RandPaul will come along with the new and great health care program because he knows Obamacare is a disaster! — Donald J. Trump (@realDonaldTrump) March 8, 2017 
 
 In that interview taped prior to Trump's tweet, the Kentucky Senator said he met with Trump and didn't believe the two were "that far off" from each other on how to proceed. Paul said they both want to repeal Obamacare, and the disagreement came over how exactly to replace it -- and whether or not that replacement should be combined with the repeal in one bill. 
 
 "I did express with the President that I think separating repeal from replacement will get it done, and I think that's maybe the only vehicle for getting that done," Paul said. ||||| Photo: Mandel Ngan/AFP/Getty Images 
 
 Following the unveiling of the House Republican plan to shrink Obamacare dramatically, two surprising things happened. The first is that the conservative-movement apparatus has lined up rapidly against the bill. The major right-wing pressure groups — Freedom­Works, the Club for Growth, Americans for Prosperity, and Heritage Action for America — all announced opposition, and were quickly echoed by the most right-wing members of Congress, like House Freedom Caucus chair Jim Jordan and Senator Rand Paul. The second surprising thing is that Senate Majority Leader Mitch McConnell announced his intention to jam the House bill through the Senate quickly. Rather than develop its own bills through committees and the normal debate process, McConnell declared he plans to bring it directly to the Senate floor. Neither of these decisions makes a great deal of sense on their own, and they make even less sense in conjunction with each other. 
 
 The grounds for the right’s opposition is that the House bill would replace Obamacare with a “new entitlement,” albeit one funded almost entirely through cuts to an old entitlement (Medicaid) and which would provide such meager benefits as to be useless to large numbers of its purported beneficiaries. 
 
 What makes this revolt so confounding to the party leadership is that the House bill, while too liberal for the party’s right flank, is also almost certainly too conservative to pass the Senate. Senators Lisa Murkowski, Cory Gardner, Rob Portman, and Shelly Moore Capito signed a letter yesterday opposing the bill’s repeal of the Medicaid expansion. A fifth, Dean Heller, has raised concerns about protecting Medicaid. Susan Collins and Bill Cassidy have proposed a much more moderate replacement bill, which has also been co-sponsored by Capito and Johnny Isakson. Additionally, Lamar Alexander, Jeff Flake, and Lindsey Graham have urged caution and deliberation — all of which run counter to the leadership’s strategy of ramming a bill through as quickly as possible in order to enable the passage of a big tax cut later in the year. 
 
 That makes 11 Republican senators who have, in some form or fashion, expressed reservations about the party leadership’s preferred health care strategy. Even assuming the three senators who object to the law from the right — Ted Cruz, Rand Paul, and Mike Lee — can be corralled, Trumpcare seems to be very far from corralling the necessary 50 Senate votes. And this is before the Congressional Budget Office produces its score, which will probably show millions and millions of people losing coverage, and may possibly also show the deficit blowing up. 
 
 While McConnell’s plan might be necessary in order to keep the party’s legislative strategy on track, it is highly and even delusionally optimistic, given the state of his vote count. It also runs counter to the Senate’s institutional culture. Senators cherish their power to shape and control legislation. A strategy of photocopying the House bill and ramming it through seems almost designed to violate the Senatorial ego. 
 
 This raises a question: Is it designed to violate the Senatorial ego? And thus to fail? Neither the conservative revolt nor McConnell’s plan make a lot of sense if you view them as strategies designed to yield the most right-wing health-care policy that is attainable. They do make sense as a strategy designed to insulate Republicans from failure. 
 
 Republicans have made two promises that can’t be reconciled. They promised to repeal Obamacare, and to replace it with a terrific law that would take care of everybody. As the House Republican ad put it, they promised, “more choices and better care, at lower costs. … peace of mind to people with preexisting conditions … without disrupting existing coverage.” Those things cannot be reconciled. If Republicans repeal Obamacare, they will put in place something that not only fails to provide the better, cheaper care they have promised the country, but does not meet even the minimal threshold of access to basic care for people who currently receive it. 
 
 From that standpoint, the winning play for the GOP might be to try to repeal and replace Obamacare but fail. If they are seen trying and failing to repeal the law, it might upset the base, but most Republican lawmakers will have their opposition to Obamacare on the record. And if it is to fail, it should fail quickly, so they can move on to cutting taxes. 
 
 This may all be wrong. It is never safe to assume rational thought on the part of public actors, especially in the reality-distortion field of Trump’s Washington. Maybe ultra-conservatives think they are using their leverage to push the bill to the right. Or maybe McConnell believes he can whip his caucus into line. Whatever the explanation, the strategy behind the bill is almost as incompetent as the bill itself.
– House Republicans have laid out their alternative for ObamaCare, and it continues to take heat from both moderates and conservatives. A look at the latest coverage: How many might lose coverage under the new plan? The Congressional Budget Office has not weighed in yet, but Standard & Poor's estimates up to 10 million people. Of those, 2 million to 4 million would drop from the ObamaCare individual markets, while the rest are currently covered by Medicaid, per CNBC. People in their 50s and 60s are particularly vulnerable because the age-related tax credits aren't as generous for them as the subsidies they'd replace, explains the New York Times. President Trump said he is "proud to support the replacement plan," and he warned GOP lawmakers behind closed doors that they face an electoral "bloodbath" if they fail to come through, reports CNN. Vox thinks this tweet is telling: "Biggest obstacle to House health bill: 7 GOP senators on fence—4 who said didn’t adequately protect Medicaid, 3 who say bill too generous." Its assessment of the criticism from both sides is here. Paul Ryan makes his case in a USA Today op-ed that this is the smartest approach. He cites rising premiums under the "collapsing" current law. Ryan's problem, though, is that virtually all conservative health care experts hate the plan. Politico has details. (Another prominent voice on the right, Ann Coulter, wants to know who wrote this "piece of crap," per Mediaite.) Bustle lays out the next steps for the legislation here, while Jonathan Chait at New York can't understand why Mitch McConnell is rushing a bill "everybody hates." Here is the plan itself.