The risk of Paul Ryan’s top-down approach to the health care bill

House Speaker Paul Ryan is calling the shots on the Republican plan to replace Obamacare.

The bill was drafted in his office, it was pushed through committee after committee, after committee per his request, and on Monday night — three days before the House of Representatives is scheduled to vote on the bill — he submitted a manager’s amendment to the bill, a package of changes to be considered in the Rules committee on Wednesday, one day before the floor vote.

In theory, this...


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