Republicans bet the future on health care bill

“This is all a mess, it’s going to stay a mess, it’s a huge undertaking. They have allowed themselves to be trapped by two Washington swamp institutions — reconciliation, as defined by the parliamentarian, and the Congressional Budget Office. It’s very hard to defend Trumpism if you let the swamp define the rules of the game,” said former House Speaker Newt Gingrich, the leader of 1994’s so-called Republican Revolution. “Health is an immensely difficult area, ten times more complicated than national security. We’re going to have to muddle through for a while.”

His party, he said, could risk a serious midterm blowback if the health plan isn’t through within the year: “By next Spring, they have to have a health solution clear enough — and implemented enough — that people feel comfortable.”

Outside Washington, GOP governors — many of them elected as part of the Class of 2010 — sense the danger as well. Despite agreeing in principle with the idea of repealing and replacing Obamacare, few have been willing to vigorously support the American Health Care Act. The GOP will be especially exposed at the state level over the next two years — 27 of 38 Republican-held governors mansions will be be up for election in 2017 and 2018. A handful of them will be in blue states where phasing out Medicaid coverage will be extremely unpopular.

A central concern among Republican officials both in Washington and in the states is that the health care debate could spiral out of their control, overwhelming the legislative agenda before the party can pass anything else.