Lose-lose. Win-win.

This is working out badly for the GOP.

Blame cable news and cell phone videos.   And thank Sarah Palin.  Yes, Sarah Palin.

The president needs a win, even a Pyrrhic one, where his prize is to get what Obama got with the ACA, an unpopular law and political suicide.

The House needs to look like it isn't dysfunctional, even though the only real governing majority in the House is not the fractious Republicans, but rather a coalition of Democrats and a few dozen Republicans who want to get things done.

The GOP discovered that, actually, on reflection, people do not consider healthcare is a luxury item like a smart phone or a vacation.   They think people should have it, or at least some of it, as a right.   A right to life.

There has been a fundamental change in American thinking.  Some of it is the ACA and people getting accustomed to a benefit.  Some of it is cable news and Youtube and Facebook.    People can see the faces of the victims   Voters might be still be comfortable denying coverage to an undocumented adult male with dark skin, but certainly not an undocumented child of any race.   The Right to Life idea has some traction and it is spreading from the fetus to the living.  

No politician in America says that a blonde child who needs liver or heart surgery should die on the steps of the hospital for reasons of thrift and holding the parents accountable for failing to have the hundreds of thousands of dollars they should have saved.  There simply is no constituency for this.  Sad cases are too human, too relatable.  

A mess either way.

We can blame Sarah Palin, too.  She used the phrase "death panels" to condemn a feature of the ACA that allowed physicians to bill their time for explaining palliative care options to very sick, elderly patients.  She called it a death panel and the charge was misdirected but it had power.   There was revulsion against the idea of government death panels.  She helped change attitudes because she named and stigmatized the notion of that no one connected with the government has the right to limit health treatment for the sick.  The clearest case of this would be allowing people to die of untreated disease.  

The House will either pass this or not, and i expect it to pass.  

House members will have opened themselves for criticism for their heartlessness because it would remove people from Medicaid eligibility and it would limit access for people with pre-existing conditions.  Some House members campaigned saying just the opposite.

Their ace in the hole is that it will fail in the Senate and the effects of the law will be theoretical and arguable, not certain.   Democrats can pray that Senators will once again over-ride the filibuster rule and pass it narrowly on a party line vote.  Then the proposed, potential horror stories will be real ones, with real victims, real hard luck stories, real examples of people whose health insurance became unaffordable and the working poor kicked off Medicaid, hospitals in trouble, state governments furious,  

But this will be win-win either way for Democrats.   Either the Senate Republicans reject the Trump-House healthcare bill, helping define the House as heartlessly ideological as they strip healthcare access from the poor and the sick, or the Senate gives Trump the win, and the country has a year to experience it.    A Republican strategy would be to delay putting the law into effect, so that they can claim it solves problems before voters see how it actually effects people.  (It would be a smart, cynical strategy and I expect it.)   

Either way, this is turning into a loser for Republicans since they are visibly taking responsibility for health care in America and it is bound to be expensive and complicated and full of problems.  Damned if you do, damned if you don't. 

Why is this happening?   A confluence of two things.  Trump is a competitor.  He wants to win something, even if he doesn't really care about it.   This is about Trump-the-winner.  

It is also about how the House of Representatives and state legislatures turned Republican in 2010.  They ran against Obamacare.  They convinced people that they would repeal it and replace it with something great.   It was great politics.  

If only Hillary had won, they could keep right on going with a winning strategy.  Instead the won and discovered people expecteactually did want something great.