Now that Paul Ryan is the presumptive new leader of the House of Representatives, what happens next? The single biggest domestic policy issue the country faces is Obamacare. So far, Republicans in Congress haven’t done anything very useful in addressing it. The House has voted 54 times to repeal some or all of Obamacare – knowing all the while that none of these votes would go anywhere. Yet neither the House nor the Senate has held a single serious hearing on the worse defects in the health reform law.