Representative Paul Ryan explaining the Republican health care plan on Capitol Hill.
Credit Gabriella Demczuk/The New York Times

It has long been obvious to anyone following health policy that Republicans would never devise a workable replacement for Obamacare. But the bill unveiled this week is worse than even the cynics expected; its awfulness is almost surreal. And the process by which it came to be tells you a lot about the state of the G.O.P.

Given the rhetoric Republicans have used over the past seven years to attack health reform, you might have expected them to do away with the whole structure of the Affordable Care Act — deregulate, de-subsidize and let the magic of the free market do its thing. This would have been devastating for the 20 million Americans who gained coverage thanks to the act, but at least it would have been ideologically consistent.

But Republican leaders weren’t willing to bite that bullet. What they came up with instead was a […]

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