FUCCKFUCKFUCKFUCKFUCKFUCK
It'll still be tough to get this incarnation of the AHCA through the Senate. I'm not sure how much of it can be passed through reconciliation, and some Senators, especially those facing tough reelection challenges (like Heller in Nevada, Corker in Tennessee, or Collins in Maine, maybe even Ted Cruz (!), though he's enough of an ideologue that he might not care) may be very reluctant to vote for it even when it only has a 50-vote (plus Pence's tiebreaker) threshold. And if it needs 60, forget it. They might not even bring it to a vote, so that those vulnerable Senators don't have to go on the record as supporting or opposing it.
Ryan just needed to pass
something so that he could say that he did his best to repeal the ACA. If it fails now, that's on McConnell.
EDIT: More detailed breakdown.
The AHCA has passed the House of Representatives by a vote of 217-213.
20 Republicans joined 193 Democrats in voting against; all 217 votes for were Republicans. 1 Republican did not vote. Speaker Ryan elected to vote.
Republicans voting against: Biggs (AR-5th), Coffman (CO-6th), Comstock (VA-10th), Costello (PA-6th), Dent (PA-15th), Donovan (NY-11th), Fitzpatrick (PA-8th), Herrera Beutler (WA-3rd), Hurd (TX-23rd), Jones (NC-3rd), Joyce (OH-14th), Katko (NY-24th), Lance (NJ-7th), LoBiondo (NJ-2nd), Massie (KY-4th), Meehan (PA-7th), Reichert (WA-8th), Ros-Lehtinen (FL-27th), Smith (NJ-4th), Turner (OH-10th).
Not voting: Newhouse (R-WA-4th)
EDIT #2:
Apparently, the big stumbling blocks in the Senate are two provisions in the House bill.
First, defunding Planned Parenthood. Both Sens. Collins and Murkowski have said they will not vote for any bill that includes that provision.
Second, eliminating the Medicaid expansion. Sen. Portman has said that he will not vote for any bill that eliminates Ohio's Medicaid expansion.
That takes them to 49 on the House bill right there, and means that any compromise between the House and the Senate will have to retain either the Medicaid expansion or the funding for Planned Parenthood, and even then vulnerable Senators like Heller and Corker might feel too much heat from their constituents to vote for it.