Paul Ryan's lifelong ambition is to eradicate Medicare, Medicaid, and Social Security.  All his policies reflect this.  If they couldn't get the huge tax break for millionaires through that joke of a healthcare bill, he'll be trying to do it through this tax bill.  I predict that tax reform will not get done until he is removed from his house leadership, or if McConnell somehow wrangles a 50-vote passage, which he is not inclined to do, at least as of now.