Axios

Cases of Hepatitis C have almost tripled in the past few years, according to the Center for Disease Control and Prevention — an effect of the opioid crisis and the unsanitary use of needles by drug users. There were 2,436 reported cases of the liver disease in 2015, up from 853 cases in 2010.

House Speaker Paul Ryan's press secretary, Doug Andres, told Axios Wednesday that despite the bipartisan push behind the Alexander-Murray health bill, "The speaker does not see anything that changes his view that the Senate should keep its focus on repeal and replace of Obamacare."

Why it matters: This is a huge setback for the bill. Even if the measure can get 60 votes in the Senate, it still needs to pass the House. With Ryan against it, the odds of it passing aren't looking good.

Go deeper: Sen. Alexander told Mike Allen Trump "engineered" his health bill. Minutes later, Trump said he'd never support bailing out insurance companies.

Sen. Lamar Alexander (R-Tenn.) sat down with Mike Allen immediately after getting off the phone with President Trump, who called to encourage him about the bipartisan health care bill he announced yesterday with Sen. Patty Murray (D-Wash.). Trump told Alexander that he supports the effort, is glad they're trying, but still needs to review the deal to "reserve his options."

Alexander's bottom line: "Trump completely engineered the plan that we announced yesterday," by calling me repeatedly and asking Sen. Murray to be a part of it. "He wanted a bipartisan bill for the short term."

Yes, but: Minutes later, Trump tweeted: "I am supportive of Lamar as a person & also of the process, but I can never support bailing out ins co's who have made a fortune w/ O'Care."

Sen. Tim Kaine (D-Va.) told Axios' Mike Allen Wednesday that he predicts the bipartisan Alexander-Murray health care bill "will pass as some part of a must-pass piece of legislation," but not as a stand-alone bill. Kaine said he expects it will move forward with the federal spending bill in December.

His bottom line: Kaine admitted that anything modest that's bipartisan on health care "will be a good sign" to the American people.