Paul Ryan is stuck with a woofer of a health-care bill that his own party’s senators fear and loathe. Photo: Justin Sullivan/Getty Images

Like a doomed college basketball team with key injuries, a coach on the “hot seat,” and players at each other’s throats lurching into the abattoir of March Madness, the GOP effort to enact the American Health Care Act moved forward in the House today. The Budget Committee cleared the legislation narrowly despite three conservative Republican defections. Now it goes to the Rules Committee, where Speaker Paul Ryan will try to put together a “manager’s amendment” to fix the bill in ways that will get him over the threshold of 218 votes.

That will be quite the task, since the key objections of Republican AHCA opponents (the Washington Post counted 37 GOP House members publicly expressing grave concerns as of yesterday) are all but mutually exclusive (some want a more generous bill, others think it’s far too generous already), and Ryan cannot lose more than 21 votes. Worse yet, he cannot perform some sort of con job on his members, since the Congressional Budget Office— the very entity that exposed AHCA’s problems earlier this week — will again “score” the amendment. With deadlines almost sure to slip, the prospect of this wretched legislation following GOP members of one or both chambers home for the long Easter recess grow higher each day.

It is reasonably clear that Ryan’s obsessive goal now is to somehow get the bill through the House so that the whole steaming mess can be sent across the Capitol to the Senate, where the factional problems are even worse and the elephants are even less disciplined. That is why Republican senators, according to the Hill, are hoping the bill dies an early death:

Support for the House legislation has “disintegrated” in the Senate, according one Republican senator who requested anonymity to discuss internal conference politics.



It will require substantial revisions to win the support of moderate Republicans in the upper chamber — something that will likely make it unacceptable to conservatives.



Given what looks like an unbridgeable divide in the Senate GOP conference, some are saying that it would be better if the bill dies in the House.

It is not a good sign when the internal party debate over must-pass legislation shifts from the hows and the wherefores to the apportionment of blame. And make no mistake, Republicans understand “the base” is going to be furious with them for what will look like the failure to pull off a one-car funeral:

Another Republican senator who requested anonymity to discuss the House bill candidly said, “There are no good options.”



The lawmaker acknowledged that not fulfilling the party’s campaign promise to repeal and replace ­ObamaCare would be politically painful in the short-term but worried that voting for bad policy could have negative reverberations for the GOP over the next decade.



“The best thing may be to kill it early so it doesn’t come over here,” the GOP senator said.

In understanding the consequences of this situation, it is important to recall that both the tea-party movement and the Trump uprising were fed heavily by the frustration of Republican voters with a party that could not find a way to impose its will on Barack Obama. Now they control the federal government entirely and still cannot repeal the hated health-care law they voted to kill 52 times when it did not matter.

Yet the certain wrath they will thereby incur is not worse than voting for this woofer of a bill, it seems. And the only plan B most of them can imagine is to somehow fix the AHCA’s many problems via a second bill that would require eight Democratic votes in the Senate along with every Republican.

If there is a way out of this quagmire for Republicans, it is not obvious. Might their president somehow save them? Hardly: It’s not like he commands that much personal loyalty in Congress, and the substantive dilemmas won’t be resolved by turning them over to someone who probably does not begin to understand them. It’s more likely that Donald Trump, with Stephen Bannon and other anti-Establishmentarians whispering in his ear, blames Ryan for the fiasco, or even backs a coup to get rid of him.

But these are early days for that kind of speculation. First, Republicans in both the Legislative and Executive branches must play out the string and listen to the death agonies of a health-care plan with fewer friends than Christian Laettner at a Kentucky basketball banquet.

March madness indeed.