President Trump will survive the GOP's health-care debacle. Will Paul Ryan?

President Trump can draw some hope, ironically, from Hillary Clinton

Fans of irony might appreciate the fact that President Trump's first big probable legislative defeat will be remarkably similar to Hillary Clinton's.

On Thursday afternoon, House Republicans had to delay their planned vote on the American Health Care Act — timed to coincide with the seventh anniversary of the day former President Barack Obama had signed the Affordable Care Act, which the AHCA seeks to topple — due to a lack of "yes" votes. Trump had spent the morning trying to convince the far-right House Freedom Caucus to support the bill, and the afternoon cajoling the more centrist Tuesday Group to fall in line.

When that didn't seal the deal, Trump sent senior strategist Stephen Bannon and White House budget director Mick Mulvaney to Capitol Hill with an order and an ultimatum: This bill is the final deal, and it will be voted on Friday; if Republicans don't pass it, ObamaCare lives. As of early Friday, it still isn't clear what is even in the bill. "We're going to vote and we'll see," Bannon told reporters after a late-Thursday meeting with lawmakers and top administration officials. "Let's vote."

Nobody can be sure how that vote will turn out, but the prospects aren't very rosy — and Trump is reportedly privately regretting pushing health-care reform as his first big legislative initiative. If House Republicans twist enough arms or cut enough sweetheart deals to pass the bill, it faces an even dicier future in the Senate. If the House kills the bill on Friday, that will be a humiliating defeat for the man famous for artistic dealmaking.

And it could be even worse.

How much worse? If Republicans fail to pass the bill on Friday, said Rep. Matt Gaetz (R-Fla.), "we'll have the opportunity to watch a unified Democratic caucus impeach Donald Trump in two years when we lose the majority." That's actually not impossible, or even as improbable as it sounds. If Democrats soar back to a congressional majority in the 2018 midterms, their first order of business might well be impeaching Trump.

And that takes us back to the Clintons.

When Democrats were putting together ObamaCare in 2009 and 2010, they were careful to avoid the mistake former President Bill Clinton made when he tried to reform health care in 1993 and 1994, the cornerstone of his first term. He put his wife, first lady Hillary Clinton, in charge of a task force to compile a viable plan. Bill Clinton didn't start his public push for the plan until September 1993, but the effort faced immediate and effective pushback from conservative groups and the insurance industry.

Clinton's Democratic Party controlled both houses of Congress, like Trump's Republicans do now, but then-Senate Majority Leader George Mitchell (D-Maine) officially declared the Clinton effort DOA in September 1994. The Democrats were routed in the midterm elections a few weeks later, and Republicans took control of both houses for the first time since 1954. The success of the "Republican revolution" of 1994 was driven at least in part by the Clintons' ill-fated health-care reform effort, and it's safe to say that Clinton's presidency would have turned out much differently if his party had held on to at least one house of Congress. He would not, for example, have been impeached.

So yes, obviously, this health-care mess is not particularly good for President Trump. But the real loser of this health-care debacle is House Speaker Paul Ryan, who came up with the strategy of passing health care first because it would allow him to cut taxes deeper and more permanently later in the year.

This health-care fight has given new power to the House Freedom Caucus, a group that played an instrumental role in ousting Ryan's predecessor, John Boehner. The caucus already spent the week negotiating directly with Trump, bypassing Ryan and his leadership team. Ryan isn't winning any love from the rest of his caucus, either, by asking them to take a potentially career-ending vote.

Trump and Ryan have never been very close, and if Ryan embarrasses Trump with a loss on health care, he'll face certain fury from the White House. Dan Rather argued Thursday that the word "Trump fears being called more than any other" is "loser," and if the health-care bill he's thrown his support behind goes down, he'll be seen as "a loser president," unlike the presidents "with bold agendas that they quickly put in place" like Obama and Ronald Reagan.

Already, Trump's top advisers — Bannon, Gary Cohn, son-in-law Jared Kushner — have reportedly decided backing Ryan's bill was a mistake, and Vice President Mike Pence suggested earlier this month that Trump start emphasizing that the bill is Ryan's baby, keeping his distance from the increasingly unpopular legislation. Ryan has already tried to share credit for the bill with Trump, but as The Daily Show's Trevor Noah joked last week, you can't throw Trump under the bus "because Trump is the bus." He added: "So Paul Ryan, I hope you've got good health care, because that bus is coming."

Trump will live to fight another day. Consider the HillaryCare debacle, which hardly destroyed the Clintons. Bill Clinton was re-elected in 1996, and Hillary Clinton went on to win two Senate elections and become the first female presidential nominee from a major party. Furthermore, even though the Clintons' health-care bill died, they were still able to enact smaller changes, like the State Children's Health Insurance Program (SCHIP) in 1997, which extended health coverage to millions of low-income children.

Trump will still be able to chip away at ObamaCare if he chooses to expend energy and political capital on the fight, even if he loses on Friday or whenever Ryan holds the vote, or in the Senate. And if Republicans lose one or both houses of Congress in 2018, Trump might actually benefit from having a Democratic foil to fight — as Bill Clinton did with the GOP Congress (impeachment proceedings notwithstanding...).

Trump is rolling the dice with Friday's vote, but as any former casino owner knows, the house always wins — even if, in this case, House Republicans don't.


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