Ryan's Legacy As Speaker On Line With Health Care Vote

WASHINGTON (AP) — The vote on the Republican health care bill is a defining moment for House Speaker Paul Ryan that could boost his aggressive agenda to overhaul the tax code and remake the federal government. The bill to repeal major parts of Barack Obama's Affordable Care Act, cap future funding for Medicaid and reverse tax increases on the wealthy is the kind of high-impact legislation that has become rare in a Congress that sometimes struggles with the routine like keeping the government open. Trump warned GOP lawmakers that they could lose their majorities in the House and Senate in the 2018 midterm elections if they renege on promises to repeal and replace Obama's signature health law. Ryan, his party's vice presidential nominee in 2012 and perhaps a future White House hopeful, understands the stakes, calling the vote "a rendezvous with destiny." The political marriage of Ryan and Trump is an odd pairing as the speaker only reluctantly backed Trump last year and distanced himself from the presidential nominee after the audio emerged in October of Trump boasting about groping women. Under Ryan, the House has passed significant legislation, including a financial rescue package for Puerto Rico, ending a ban on crude oil exports and passing a law to deal with opioid addiction. Over time, 24 million fewer people would have health insurance under the GOP plan, according to the non-partisan Congressional Budget Office.