Of all the promises that Donald Trump made on the campaign trail, those regarding health care were the most absurd. Unless you’re sitting on blueprints for an army of robot doctors who run on carbon dioxide and tap water, you can’t simultaneously have lower premiums, lower deductibles, lower taxes, and lower numbers of Americans without health care. Either rich and healthy Americans overpay in order to cover poor and unhealthy Americans, or poor and unhealthy Americans go without coverage.

After a close vote in the House on Thursday, we’re going with option B, and that’s not surprising. Tax cuts to Republicans are like eucalyptus leaves to the koala—the very food of life, even if they’re poisonous to other animals. And Trump will falsely claim—as he has already started to do—that the repeal and replacement of Obamacare passed by the House will make health care better for everyone. That’s not surprising either. It’s what he does.

Populists are noticing that Trump has done very little to promote his heresies and a lot to promote Republican establishment priorities. Of course, that’s partly because he’s Donald Trump, the talker and not the deliverer, but it’s also because he has little choice. Trump simply doesn’t have a populist army inside Washington, and his deplorables no longer seem to scare lawmakers as they once did. So he has nowhere to go with his rebellious ideas: a tougher line on Wall Street, negotiating prices with drug companies, spending on the poor, trade barriers, non-interventionism in foreign policy, improved relations with Russia, a border wall, and strict immigration control. What he can deliver on is the stuff that the establishment wants: tax cuts, defense spending, business-friendly judges, a business-friendly Department of Labor, rollbacks of environmental protections, and maybe a few missile strikes here and there. So he’s delivering.

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Life is perhaps too short to point out political hypocrisy, and partisan venting gets tiresome, but Paul Ryan and the House Republicans are still a spectacular bunch, heirs to a tradition who have taken it to a higher level. That Ryan could once state his opposition to passing “bills that we haven’t read, that we don’t know what they cost” only to push through a giant bill that almost no one has had time to read (a violation of yet another Republican pledge) with a cost not yet calculated by the Congressional Budget Office—well, we can all learn from that. Life is short, so brazen it out and enjoy yourself. Don’t be a loser.

Now the bill goes to the Senate and into a conference committee, where it might wither away. Nancy Pelosi is among those who predict this fate. “You’re walking the plank—for what? A bill that will not be accepted by the U.S. Senate,” she warned Republicans on the floor of the House today. “But you have every provision of this bill tattooed on your forehead. You will glow in the dark with this one.”

Maybe, but maybe not. The filibuster will not apply, because reconciliation will be the mechanism for passing it. To put it another way, 50 votes (plus Mike Pence) would do the trick, and the Senate has 52 Republicans. While no one seems that excited to take possession of the hideous baby birthed by the House, Republicans know, again, that tax cuts, big tax cuts, become possible if Washington yanks away health subsidies for the poor. That should prove hard to resist.

If you believe that poverty and ill-health are to a large extent the product of bad luck—that only some people are fortunate enough to be born with distinctive talents, hearty constitutions, and nurturing families—then you tend to be supportive of Obamacare in theory. But if you think we ought to keep what we’ve got, and we’ve got it because we’re great, then odds are good you’re in the donor class of the Republican Party, which for the most part still is the Republican Party. No wonder beer-filled celebrations are underway at the Capitol. Santé!