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On health care, Republicans find themselves lost without a map

Last week, Paul Ryan guaranteed that his health care reform bill would pass. This week is a very different story.
The dome of the U.S. Capitol Building is reflected in a puddle on a rainy morning in Washington.
The dome of the U.S. Capitol Building is reflected in a puddle on a rainy morning in Washington.
By Steve Benen, Steve Benen
Imagine being a House Republican right now. You hate the Affordable Care Act -- at least, that's what you've told your constituents -- and you're inclined to stick with your party leadership, but you've also seen a striking rise in progressive activism in your district. You're probably a little more concerned about next year's campaign cycle than you might otherwise would be.And then the Congressional Budget Office releases a devastating report that says your party's health care plan would push tens of millions of Americans into the ranks of the uninsured.Given these circumstances, how inclined would you be to follow House Speaker Paul Ryan's lead and vote for the American Health Care Act ("Trumpcare")?Sen. Tom Cotton (R-Ark.), a critic of the House GOP legislation, had an interesting conversation with ABC News' George Stephanopoulos over the weekend. This exchange, in particular, stood out for me:

STEPHANOPOULOS:  So you're saying House Republicans if they vote for this bill are going to pay the price without getting any benefit?COTTON:  I'm afraid that if they vote for this bill, they're going to put the House majority at risk next year.... And I don't want to see the House majority put at risk on a bill that is not going to pass the Senate.

And this is why I see the American Health Care Act on life-support. House Republicans are being told they have to support a bad bill that would produce bad outcomes. They can't expect much in the way of cover from the White House given Trump's unpopularity and ongoing scandals. They know that if they vote for the bill, the Democratic attack ads will be both brutal and accurate.And they know that if the House passes the bill, it'll die in the Senate, which means they'll have taken the political hit for no reason.What we're left with is a divided party with awful legislation, being pursued for reasons party leaders are struggling to explain. The president recently said, "Nobody knew that health care could be so complicated," but it's a safe bet Trump knows it now.Last week, Paul Ryan boasted to reporters, with uncharacteristic bravado, "We will have 218 votes. This is the beginning of the legislative process. We'll have 218 when this thing comes to the floor. I can guarantee you that."Raise your hand if you think the Speaker would make that same guarantee today.