Many sayings are attributed to Sam Rayburn, the longest serving Speaker of the House in American history. One seems particularly helpful in understanding the current situation: ‘Any jackass can kick over a barn, but it takes a skilled carpenter to build one’. Repealing the Affordable Care Act (AKA Obamacare) was always going to be the easy part. Replacing it with something else is considerably more difficult.

As I have mentioned before the Republican Party under Trump is far from unified in philosophical terms, still less when it comes to the specifics of policy. It was one thing when President Obama was in office and the troops could be reliably rallied in opposition to his agenda, but now that the GOP finds itself alone in a room with a blank piece of paper the cracks are well and truly forming.

The House, under the leadership of Speaker Ryan, has released its proposed replacement to Affordable Care Act, cementing Ryan’s position as the man with the most thankless task in American politics. Reviews have not been good.

To Conservatives this bill still contains many of the objectionable parts of the original act. Direct subsidies will in many cases be replaced with tax refunds, but this is still the Federal government writing cheques to people to pay for healthcare. It is not the kind of free-market, consumer driven healthcare system they want. Worse still from their perspective is the inclusion of the tax hikes used to pay for the ACA, which will annoy both Republican donors and the Tea Party anti-tax crowd.  As if to demonstrate the truth of the old adage that ‘you reap what you sow’ the phrase ‘Obamacare-Lite’ has even been bandied about by some of the more adventurous souls on the right wing. They like the removal of the individual mandate, but that is nowhere near enough metaphorical sugar to make the medicine go down. This is not a cohort schooled in compromise.

All of that would be much less of a problem if Liberals were in favor of the bill. Even with the overwhelming loathing they feel for Trump and his administration, it may have been possible to chip off enough votes from the Democrats to pass the thing. We seem to be witnessing one of those rare moments of bipartisan consensus. Unfortunately for Trump it is against the bill, rather than for it.

Democrats loathe almost everything about it. Not only is there no mechanism to fund the rebates after the old tax increases are grandfathered out, but the removal of the mandate makes the whole thing unworkable. If insurance companies are being asked to pay more that money will either come from higher premiums or more government subsidy. They are understandably skeptical of protestations that neither will occur. To them, it ammounts to throwing out everything worth having in the messy and compromised ACA and throwing the very Americans it was designed to help under the bus. Senators from left to right have come out in opposition to this bill, and it seems certain that it would not pass even if a filibuster is avoided.

The bigger problem for the GOP is that ‘Obamacare’ is having a bit of a renaissance as far as public opinion is concerned. Public support for the provisions of the bill has increased substantially over the last few months, and it seems quite clear that a repeal without a salable replacement would be politically risky at best. And so they must try and reconcile the irreconcilable.

It must have no mandates for coverage, but cover pre-existing conditions. It must have no subsidy, but not increase premiums. It must lead to better coverage for more people without providing more money to fund that coverage. These circles cannot be squared. But as with so much in Washington the question isn’t whether you will do it or not, but how exactly you are going to not do it, and who exactly you can afford to alienate.

In any case, those who wondered if the entire edifice of the Republican party would meekly fall in behind Trump and whatever he proposed have their answer. As we watch this bill die, either drowned in amendments or suffocated quietly in some committee, spare a though for Paul Ryan. This isn’t the first time he has had to be in charge of the sacrificial lamb, and it certainly won’t be the last.