Why the Republican health care bill is doomed to fail -- even if it passes

In some ways, Republicans are in a more precarious position with the Bizarro bill than Democrats were in 2009. Obama, at least, managed to cobble together support from insurers and providers, which muted some of the criticism when premiums started to rise. Trump and Paul Ryan, the House speaker, haven’t even tried to assemble a coalition.

You have to remember, too, that Republicans are playing with something here that neither party has ever attempted on such a scale before: a rollback of benefits the public already has. It’s one thing to ram through a program with lots of subsidies and new rights attached. It’s an untested proposition to unilaterally take that stuff away.

Here’s what we do know: With a policy area as complicated as this one, and as reliant on theories about how the markets and consumers will respond to various incentives, you’re never going to pass one law and be done with it. Responsible governing in Washington — if we can still conceive of such a thing — means being able and willing to reassess and adjust to reality as time goes on.

Democrats were never going to be able to do that because of the dubious ways in which they sold and enacted their law. And Republicans won’t have that option, either, even if they manage to come up with something that satisfies their dueling factions.