There’s no way to know how the health care debate in Congress will play out, but there’s a lot of reason to think that the House vote to replace the Affordable Care Act has put Republicans on a risky path heading into next year’s midterm elections.

The midterms were already looking challenging for House Republicans. The president’s party almost always loses big in off-year elections, especially when it has full control of government and a president with weak approval ratings.

And the president’s party has happened to lose particularly badly in several elections that followed a prolonged debate over the national health care system. It’s hard to think of why this particular debate would go much better for the Republicans. The American Health Care Act, passed by 217-213 in the House on Thursday, is extremely unpopular in recent polls — even more unpopular than the Affordable Care Act was when it was passed in 2010.