Not very.
1) Remember that a single bill can't happen. If Ryan's bill, with all of the concessions that he and Trump made to the Freedom Caucus still couldn't get through the House, then there is nothing that could get both the support of the hardliners in the House and the Senate moderates. That means nothing can pass in a single bill. Piecemeal measures? Sure, but a single replacement? Nope, and since there are more than two votes against repeal in the Senate without a simultaneous replacement, this can't be done in a single bill. This is all posturing.
2) The GOP can't be seen to give up after just a few weeks. That was one of the many stupid aspects of this process. Being the party that fights the never-ending fight against Obamacare doesn't work if you have a plan that is revealed to be an utter failure in a few weeks. Send a few measures to committees. Have lots of hearings. That's what they should have done in the first place. Drag it out. If the point is the fight, Congress is great at dragging things out interminably.
3) The committees should have had a say in this from the beginning anyway. That is where negotiations take place, where the hardliners could duke it out with the moderates, and where they could have figured out from the beginning that a single bill wasn't going to work. Committees are still where they can figure out what can pass.
4) Parties are supposed to make sure that the only stuff that gets anywhere near the floor is the stuff that unifies the majority against the minority. How? You have to know what your party will support. In advance. The committee system, the whip system, all of these can be tools of party leadership, in the right hands. Paul Ryan has never governed before. As a condition for accepting the speakership, Boehner had to raise the debt ceiling first so that Ryan wouldn't have any real work to do before the 2016 election. In the past, I have recommended that everyone read Richard Fenno's Learning to Govern. It is about the mess after the GOP took control after the 1994 election, unexpectedly. Nobody knew what they were doing because nobody in the GOP had ever been in the majority, it having been 40 years since the GOP controlled the House. At least Paul Ryan isn't quite as stupid as Newt Gingrich. Low bar, but still... I expect him to get better.
What does all of this mean for healthcare? In all likelihood, occasional posturing. Maybe a few small measures. A real repeal-and-replace? Fuck no.
