The American Health Care Act is in trouble, with House Speaker Paul D. Ryan, R-Wis., admitting Wednesday that the bill must change to make it through Congress. The reason? The Republican right and the Republican center want different things, and the rules under which the proposed Obamacare replacement can pass the Senate by a simple majority make it extremely hard to satisfy both sides. But the apparently difficult problems of policy reforms are just that: “apparent.” With some outside-the-box thinking, some dealmaking and a little humility, the AHCA can be saved.

The right wants to gut “essen...