Congress’s last-ditch attempt to pass a “skinny” bill to kill a few pieces of the health law — many of which Trump could have abolished himself with an executive order — collapsed.

In the intervening six months, Republicans were bedeviled by an enormous backlash from a public that suddenly decided it likes the health care law, cold feet over stripping health care coverage from millions of Americans, damaging intraparty squabbling and a White House that threw bombs at their efforts. Ultimately, an old truth held: Once politicians bestow social benefits, it’s almost impossible to take them away.

. . .

It was the most dramatic night in the United States Senate in recent history. Just ask the senators who witnessed it. A seven-year quest to undo the Affordable Care Act collapsed—at least for now—as Sen. John McCain kept his colleagues and the press corps in suspense over a little more than two hours late Thursday into early Friday. Not since September 2008, when the House of Representatives rejected the Troubled Asset Relief Program—causing the Dow Jones industrial average to plunge nearly 800 points in a single afternoon—had such an unexpected vote caused such a striking twist.

. . .

“Repeal and replace” made Republicans electoral Supermen, but “pre-existing conditions” were their kryptonite. Senate Republicans played out the final scene of their legislative tragedy in the early hours of Friday morning when they formally laid to rest their seven-year effort to repeal the law. Through four election cycles, Obamacare’s rising premiums, burdensome cost-sharing, narrow networks, and plan cancellations helped fuel GOP electoral victories at every level of government. The failure suggests why the political consequences are likely to be deep and long-lasting.

. . .

The GOP cannot simply “move on” and give up on health care. Health care is the biggest driver of our debt and deficit, the biggest driver of growth in government, and one of the biggest drivers of economic insecurity for those in the middle class and below. Take some time to reflect, yes. Come up with a better strategy, yes. But to give up on health-care reform is to give up on everything conservatives stand for.

. . .

It’s pretty hard to get a head start on President Trump in trying to shift blame onto others for the late night culmination of massive political failure in the presumptively Republican Senate. But let’s provide a short report from the medical examiner on the causes of death to the once soaring rhetoric and more recently depressing reality of “repeal and replace.”

  • Yes, the procedural minefield through budget reconciliation was narrow, murky, and treacherous. But even the entire inventory of legislative tricks, gimmicks, and sidesteps attempted still needed to be anchored to a larger commitment than just avoiding political-party embarrassment.
  • Republicans in Washington never met the challenge of offering a sufficiently unifying message to constituents that all the uncertainties and sacrifices immediately ahead from disruptive changes were aimed at actually making their lives BETTER eventually, rather than just not quite as bad as a host of maladies and calamities attributed to Obamacare…

. . .

Senators who walked off the floor around 2 a.m. Friday after the stunning defeat of the latest GOP ObamaCare repeal effort face tough questions on how to move forward.

GOP leaders sounded pessimistic notes that the failure would lead to compromise or bipartisan work on healthcare, though some members said they hoped it would spur leaders to start a more formal process of committee work after months on Senate bills being drawn up behind closed doors.

“We’re not adverse to that,” said Sen. John Thune, the No. 3 Republican leader. “I just don’t have high hopes that we’re going to get anything that really solves the problems that we think exist with ObamaCare today.”

. . .

Shortly before 1:30 a.m. Friday, McCain strode to the well of the Senate, and gestured his hand downward to vote “no.” Stunned gasps echoed throughout the chamber.

“I thought it was the right vote,” McCain told reporters as he left the Capitol. “I do my job as a senator.”

It was a shocking — yet fitting — coda for the Senate’s health care battle, starring the veteran senator with a well-polished maverick streak. Within days he went from Obamacare repeal’s savior to its executioner.

. . .

The Senate voted 45-55 Wednesday not to repeal ObamaCare with a two-year delay to replace it, and the only consolation for Republicans is the clarity of seeing who voted to preserve and protect rather than repeal and replace.

Congress had passed and sent to Barack Obama’s desk a similar measure in 2015, with support from every current Senate Republican except Susan Collins of Maine. This time seven voted no, including Rob Portman of Ohio and Shelley Moore Capito of West Virginia, who aren’t up for re-election until 2022 and 2020, respectively. If you’re going to renege on your political promises, better to do it early, we suppose.

. . .

Obamacare gave the federal government a heretofore unprecedented power: the power to force us to buy health insurance irrespective of our desire to do so. Republicans, for both moral and economic reasons, oppose this mandate. The framers of the Constitution never envisioned granting Congress the power to force people to buy a privately delivered financial service. There are also important economic reasons to oppose Obamacare’s mandate. Gross premiums for individually purchased coverage have doubled over the past four years under Obamacare. But the authors of Obamacare don’t need to care about whether they’ve made coverage costlier, because they’re forcing you to buy it anyway. Without a mandate, insurers would have to do what businesses have to do in every other sector of the economy: design products that you voluntarily want to buy because they represent a good value for you. Under Obamacare, they don’t have to.

. . .

Yesterday, Senate Majority Leader Mitch McConnell did the seemingly impossible and got the votes he needed to proceed to consideration of the House-passed plan for repealing and replacing the Affordable Care Act (ACA). At this point, it’s hard to tell what exactly will happen in the coming days, but there is one thing that is fairly certain: if the current Republican effort succeeds in passing a bill, the legislation will make the individual insurance market less stable than it is under current law.

The problem for Senate Republicans is that their principal policy goal is incompatible with the process they are using — budget reconciliation — to pass their legislation.

. . .