But it’s also possible that Trump — or his advisors, like Stephen Bannon — are playing a longer game. The AHCA was announced to furious condemnation by many Tea Party-type Republicans for not completely eviscerating the ACA, but instead being “ObamaCare light.” Since then, it’s shored up its support on the right in the House, but come under fire from less-doctrinaire Republicans in the Senate without having won back Cruz and Paul. What are the odds that a bill with that kind of opposition can even pass? Maybe not high. It’s possible that this is fine with the Trump administration, and that in fact they would prefer for the bill to fail.
It would normally be strange for a Republican president to want his own party’s majority to suffer a major black eye like that. But this is Ryan’s bill, and Trump has no love for Ryan. Moreover, inasmuch as Bannon is in competition with Ryan-ally and Chief of Staff Reince Priebus for influence over the White House’s agenda, it’s very much in his interest specifically for Ryan to fail. The collapse of the AHCA would be a massive failure — and would likely invite a leadership challenge.
And if it failed quickly, it would be easy for Trump to blame Ryan for getting it wrong, tinker with ObamaCare around the edges (particularly in ways that could be done without even passing legislation), and then when the exchanges don’t collapse claim he fixed them. After all, the same CBO report that said the AHCA would cost 24 million people their insurance said that the much-heralded death spiral isn’t coming all that soon. Trump could yell at a bunch of insurance executives, watch premiums stabilize, and claim victory.