Paul Ryan's false choice

House Speaker Paul Ryan says the nation has just two options. It can accept his repeal and replace bill or it can keep the mess it already has. "It really comes down to a binary choice," he said, trying to whip recalcitrant conservatives into line behind the American Health Care Act. "This is the closest we will ever get to repealing and replacing Obamacare."

Many House Republicans are persuaded. So are some conservative commentators and activists. But they are mistaken because Ryan's logic is faulty.

Our friends at the Wall Street Journal editorial page endorsed the AHCA on Wednesday, focusing mostly on the tax cuts in the bill. Tax cuts are indeed an attractive feature of the legislation, but voters delivered neither House and Senate majorities to the GOP nor President Trump's stunning victory so that united government could deliver a narrow victory of lower tax rates for big corporations. Nor were lower taxes on capital gains and medical devices what ignited voters' support for Republicans. They wanted something bigger and more sweeping than that.

The journal argued that conservative critics of the House repeal and replace bill are "missing the larger and rarer opportunity," and added, "ObamaCare was designed to expand over time … If conservatives fumble this repeal-and-replace moment, they won't get another chance."

This is true as far as it goes, but just because the time is right to repeal and replace does not mean Ryan's bill is the right way to do it. His premise of "a binary choice" is not true.