I figure Ryan And ultra right conversatives
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And ultra right conversatives have 1 chance. If the process chosen doesn't work. I figure Ryan is done and Trump will move with moderate Republican and Democates to get a fix or replacement to Obamacare.
I don't think you can have affordable healthcare without tort law reform or the US government being a underwriter for catastrophic care. Meaning over a certain $$ amount the government kicks in on coverage. That would also require capping premiums.