Paul Ryan's ego and reputation for one thing, if he cannot leverage Trumpcare Bill to Passage then he looks like an impotent schnook after years and years of big talk about "repeal and replace".
If it passes though, (and passage in the Senate still sounds doubtful) Congress will be willfully creating a native class of lumpen unisured "refugees" and if that doesn't spark some form of mass consciousness at the polls then this country is surely doomed.
If it doesn't pass then we are faced with a far more dangerous and ambiguous situation (those two words are the very crux of "Brand Trump"), a brutish hostile US Congress and President are compelled to administer a law they've sworn up and down to repeal....I doubt the administration will waste any time to make sure the ACA is badly enforced and a burden in extremis to all and sundry.
Under those circumstances repeal is oddly enough the better option for Us Liberals, we can then self transition completely to the "single payer" option (the same one all of Congress Has to this day) having tried a private sector centric approach.
Keeping ACA on the books yet badly administered muddies the waters policy wise, I am assuming here that no matter what healthcare is going to become a very controversial issue over the intermediate terms costs and burdens will rise services will be restricted.
On the other hand it'll just be fun to watch Ryan try to spin an abject defeat today....he has it coming to him believe me.
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