Fred Bauer writes at National Review Online about prospects for federal health care reform in the wake of the American Health Care Act fiasco.

The death of the American Health Care Act has been greatly exaggerated — not because it is likely to be revived (at least in its current form) but because it might never have really been alive in the first place.

Many of the provisions of the bill were unlikely to survive contact with the Senate, and there was a very strong chance that the bill that was released from a House–Senate conference would radically differ from the AHCA. Perhaps realizing the limits of the AHCA, some defenders of the AHCA supported the measure principally as a way of getting to conference. However, there is no reason to believe that the tensions that pulled down the AHCA on Friday would not similarly undo the resulting House–Senate conference bill. Some Republicans would still be upset that the conference bill was not a full repeal of the Affordable Care Act, and moderates (along with some populists) would be pulled into a tug-of-war with budget-cutters over the size of Medicaid cuts.

Matthew Continetti has observed that the American Health Care Act allowed procedure to dictate policy. Because the bill was designed to be passed through reconciliation, it focused on the government financing of health care. When at the eleventh hour Utah senator Mike Lee suggested that the Senate parliamentarian might allow certain regulations to be changed, regulatory changes were quickly added to the bill. But that was all too late and too fast. Moreover, the fact that the AHCA was essentially a tax- and entitlement-reform bill caused it to accentuate tensions between populists and other factions of the GOP.

There is no inherent reason, though, why the main Republican effort at health-care reform has to be done through reconciliation. In fact, there are some ways in which trying to pass health-care reform through reconciliation is worse in terms of policy and political outcomes.