The flaws of the bill, then, can be understood as a symptom of the flaws of the Republican Party, which has for decades maintained a myopic focus on tax cuts at the expense of nearly all else. Too often, it is a party of people who seem to confuse governing with cutting taxes.

The health care bill is a policy mess, but as politics, it’s even worse. A poll published in March showed the bill with an approval rating below 20 percent. It’s likely to be heavily rewritten in the Senate. It wouldn’t fulfill President Trump’s campaign promises to provide coverage for everyone or to reduce premiums and deductibles. It doesn’t even fulfill the Republican Party’s goal of fully repealing Obamacare: It leaves many key insurance regulations in place at the federal level. (States would have the option to apply for a waiver of these rules.)

Republicans have consistently had difficulty making the case for the bill on health policy merits. It’s not even clear that most House Republican lawmakers know what’s in the legislation. “I don’t think any individual has read the whole bill,” Representative Tom Garrett of Virginia said. Why then did House Republicans push so hard to pass this health care bill?

Because it cuts taxes — especially for the top 20 percent of earners — and so sets up the broader tax reform legislation Republicans hope to pass later in the year.