Speaker of the House Paul Ryan (R-Wis). Photo: Patrick Semansky / AP

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.

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SurveyMonkey poll: Trump improves, but not enough

Trump and Biden during the final debate. Photo: Xinhua/Liu Jie via Getty Images

President Trump's final debate performance exceeded Americans' expectations, but it wasn't enough to shift the dynamics that left him trailing Joe Biden across most measures, according to a new Axios-SurveyMonkey poll.

What they're saying: "Liar" was the word used most by debate watchers to describe Trump's performance, followed by "lies," "strong," "presidential" and "childish." "Presidential" was the word used most to describe Biden's performance, followed by "liar," "weak," "expected" and "honest."

Hunter Biden saga dominates online debate

Data: NewsWhip; Table: Axios Visuals

The mainstream media turned away. But online, President Trump's charges about Hunter Biden were by far the dominant storyline about the final presidential debate, according to exclusive NewsWhip data provided to Axios.

  • Coverage of business dealings by Joe Biden's son — and pre-debate allegations by one of his former business associates, Tony Bobulinski — garnered more than twice as much online activity (likes, comments, shares) as the runner-up.