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J Scott Applewhite / AP

If you've been watching House Speaker Paul Ryan over the years, you understand why he has more riding on the success or failure of the Obamacare replacement bill than just about any other Republican: because it's his baby.

  • He's the one who pulled together the "Better Way" plan on which it was based — along with his former House colleague, Health and Human Services secretary Tom Price — and he's been working on Republican health care ideas since the days of the Obamacare debate in 2009.
  • All of that helps explain why he pulled out the PowerPoint at yesterday's weekly press conference and spent half an hour lecturing reporters on health care terms ("what is a death spiral?") and how the bill is supposed to work.
  • It also explains why he spent so much time insisting he's not about to get outflanked on the right on health care reform. "These are long-standing conservative principles that those of us who've been working in health care for about 20 years have been fighting for," Ryan said. (He even threw in a Reagan reference, about how the conservative icon wanted to give states more control over Medicaid.)
  • And it explains why he was so adamant that conservatives shouldn't miss the moment: "This is something that we, as conservatives, have been dreaming about for decades. This is the chance, and the best and only chance we're going to get."

What he thinks the problem is: Ryan thinks the conservatives are objecting to the bill mainly because they don't understand the limits of the budget "reconciliation" process, which prevent them from doing some of the things they want to do, like letting health insurers sell plans across state lines. He's taking care of that by assuring them those bills will move separately.

Why it matters: Anyone who has this much pride of authorship could have a harder time dealing with other conservatives who disagree on some of the basic solutions, like refundable tax credits or how to end Medicaid expansion. In the meantime, Trump met with Freedom Caucus members on Thursday and signaled he's open to changes.

And Ryan is about to face weeks of negotiations with Republicans who disagree with him. A gentle reminder from Senate Finance Committee chairman Orrin Hatch in a floor speech yesterday: "We have two chambers in Congress for a reason."

Key quote: "What we hear from the White House is, this is a work in progress," said Freedom Caucus member Mark Sanford, per the Washington Post. "Then we hear from leadership, take it or leave it."

Go deeper

Updated 3 hours ago - Politics & Policy

Giuliani associate Lev Parnas convicted of campaign finance crimes

Lev Parnas, a former associate of then-President Donald Trump’s personal lawyer Rudy Giuliani. Photo: Stefani Reynolds/Bloomberg via Getty Images

Florida businessman Lev Parnas was convicted Friday on charges of conspiracy to make foreign contributions to political campaigns, according to multiple outlets.

Why it matters: Prosecutors said Parnas, then an associate of former President Donald Trump's personal lawyer Rudy Giuliani, funneled over $150,000 from a Russian businessman into U.S. campaigns as part of an effort to land licenses in the U.S.'s legal cannabis industry.

Supreme Court agrees to hear challenges to Texas abortion law

Photo: Saul Loeb/AFP via Getty Images

The Supreme Court on Friday agreed to hear two cases challenging Texas' abortion law, which bans the procedure as soon as six weeks into pregnancy, but left the law in place in the meantime.

Why it matters: The court is moving extraordinarily fast on the Texas cases, compressing into just a few days a process that normally takes months. And that schedule means the court will take up Texas' ban a month before it hears another major abortion case — a challenge to Mississippi's own 2018 ban on abortions after 15 weeks.

Officials warn 5 key tech sectors will determine whether China overtakes U.S.

Illustration: Aïda Amer/Axios

U.S. intelligence officials responsible for protecting advanced technologies have narrowed their focus to five key sectors: artificial intelligence, quantum computing, biotechnology, semiconductors and autonomous systems.

Why it matters: China and Russia are employing a variety of legal and illegal methods to undermine and overtake U.S. dominance in these critical industries, officials warned in a new paper. Their success will determine "whether America remains the world’s leading superpower or is eclipsed by strategic competitors."