text: The Ryan bill failed because it was plainly a plan to repeal the surtaxes on the wealthy at any cost and to finally pass his plan to end Medicaid as an entitlement. He was too clever by half. Of course, the Trump Executive Order which stopped the IRS from collecting the mandate has effectively killed it, but in a way that will eventually lead to insurance company bankruptcy and a single-payer workout. Neither Ryan nor Trump can shoot straight.