House Speaker Paul D. Ryan (R-Wis.) reads from a list of states with increasing health insurance premiums during his weekly news conference at the Capitol on Jan. 12. (Chip Somodevilla/Getty Images)

Republicans are heading toward a bitter fight over two competing cornerstones of modern conservative ethos: the read-the-bill, take-our-time, Schoolhouse Rock mantra that fueled this decade’s tea party revolution, and their utter hatred for the Affordable Care Act.

Back in 2009, as Democrats slogged through the final stages of passing the massive health-care law, Republicans took then-Speaker Nancy Pelosi’s statement that Congress would “have to pass the bill so that you can find out what is in it” as an admission that discussion and scrutiny had intentionally been thwarted. They vowed never again to allow laws of such enormous import to pass under such circumstances.

But the sheer Republican antipathy toward Obamacare has also prompted many conservatives to believe that, if fully in power, Republicans would and should instantly abolish the law. “Obamacare should be repealed root and branch,” Senate Majority Leader Mitch McConnell (R-Ky.) promised back in 2013.

Those competing visions landed Thursday at House Speaker Paul D. Ryan’s feet as he touted the early-morning passage of a Senate resolution that starts the process of repealing the health-care law. In a 13-minute news conference, Ryan (R-Wis.) veered back and forth between the ways Republicans were going to meet both goals.

“We’re going to do this the right way, we’re going to do this the way it was designed to do, through the congressional committee system,” he said, denouncing the way Democrats handled the ACA negotiations and passage seven years ago.

(Jenny Starrs/The Washington Post)

In the next breath — literally, four seconds later — Ryan added this caveat: “Of course, our goal, though, is to deliver relief as soon as possible, because this is just not a matter of us keeping our promise to the American people. This is a rescue mission.”

It’s hard to reconcile these two visions, particularly now that President-elect Donald Trump has thrown his allegiance in with lawmakers who want to replace the health-care law at almost the exact same time that it is formally repealed. “It will be essentially simultaneous,” Trump said, “the same day or the same week.” With no replacement plan in view, that means it won’t be right away.

And it sets up a continuing battle that the GOP will play out for much of the year. It can be summed up as regular order vs. the aforementioned rescue mission.

The regular order that Ryan and other Republicans have clamored for is long and complex, not allowing for the instant gratification that the president-elect wants.

Take the ACA. For all the criticism Democrats endured over the sometimes-ugly process of passing it, they did go through regular order. Two committees in the Senate and three committees in the House marked up various portions of the law in their respective committees, and long negotiations were held with holdouts (moderate Republicans in the Senate, conservative Democrats in the House). Then the bills were merged, and the House and Senate each passed their own version of the law by the end of 2009.

It took another three months of ups and downs to put together a final bill and make sure every box was checked, including some controversial side deals. The effort was complicated by the Democrats losing a critical special election to fill the seat of the late senator Edward M. Kennedy.

All told, it took 15 months to get a set of bills to President Obama’s desk for his signature.

That’s not exactly the pace of a rescue mission.

Even at the end of that long process, Republicans accused Democrats of moving too quickly, leading to chants of “read the bill” by conservative activists protesting outside the Capitol.

It became such a mantra that after Republicans won the House in a dramatic 63-seat pickup in the 2010 midterms, GOP leaders instituted a formal rule that set up a three-day process before a final vote could take place on legislation — something that is still in place.

And now they must live with it.

Sen. Lamar Alexander (R-Tenn.), chairman of the health committee, wants a three-step process to establish a timeline for repealing the law, making small changes and then allowing for Trump administration officials to take some regulatory steps that will help “bridge” to the new law. Then Alexander wants a long period to write several more laws to replace Obamacare.

“We will first send in a rescue crew to repair temporarily a collapsing health-care market so no one else is hurt,” Alexander said during Senate debate. “Then, step by step, we will build better systems that give Americans access to truly affordable health care.”

That’s a far cry from the “same day, same week” timeline that Trump touted during a news conference Wednesday — although, admittedly, Trump has also cautioned Hill Republicans not to repeal without a replacement ready to go.The president-elect’s rhetoric is more in line with Sen. Rand Paul (R-Ky.), who voted against the initial resolution because there’s no certainty of when the replacement legislation will happen.

House Republicans across the ideological spectrum are also voicing concerns about what they’re scheduled to vote on Friday — a nonbinding Jan. 27 deadline for committees to craft legislation to repeal the ACA without any deadline for a replacement.

Then there is Ryan, who repeatedly professed to be in “complete sync” with Trump and Vice President-elect Mike Pence on the pacing of how to proceed.

Yet even Ryan’s own words ran into contradictions. His briefing began with a pledge for a “thoughtful, step-by-step process” and a promise that Republicans would “not jam some bill through” Congress. By the end, he sounded like he was ordering in paratroopers to save the health-care industry.

“The reason we need to act, and act quickly as possible, using the process the way it was supposed to be designed, is because we are on a rescue mission to prevent Obamacare from making things even worse,” he said.

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