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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. Or send it off the rails. If he fails? "It will be very hard to manage this," the Wisconsin Republican told reporters ahead of Thursday's likely vote. (3/22)

The test for Mr. Ryan is whether he can make the leap from serving as the architect of conservative policy, a role he played for years as the party’s leading budget author, to the more difficult role of guiding legislation into law. The task is much tougher now than when Republicans passed bills with the knowledge that a Democratic president would veto them. “Everybody understands that we’re dealing with live ammo now,” said Sen. Pat Toomey (R., Pa.), a roommate of Mr. Ryan when they served together in the House. (Peterson, 3/21)

The fate of the GOP health-care plan depends largely on whether divided Republicans can decide just how far they want to go in torpedoing the central underpinnings of Affordable Care Act. Conservative Republicans are pressing to swiftly gut most of the law while more moderate GOP members want the federal government to play more of a central role in helping people obtain coverage. (Armour, 3/21)