It showed that Republicans — now in control of the House, the Senate and the presidency — couldn’t band together on a major priority. It suggests that the divides among Republicans, a theme of the Obama years, remain a problem for the party. In fact, those divides could be even wider in the Trump era: In the health care debate, not only did the deeply conservative House Freedom Caucus break with party leadership, as it often has (arguing the legislation was not conservative enough), but a bloc of more centrist members emerged from the other side of the political spectrum, arguing that the bill was too conservative. And Trump, who has cast himself as a master negotiator, couldn’t get fellow Republicans behind him, making him look ineffectual in comparison to his three predecessors as president, who all got their first legislative priority through Congress in their first year in office. [...]
Broadly, there were four blocs of GOP members opposed to the legislation: those from the conservative and anti-establishment House Freedom Caucus; those in districts that Hillary Clinton won or almost won in 2016, putting them in some political peril if they backed a bill that is very unpopular; those associated with the Tuesday Group of more centrist House Republicans; and a few who are kind of mavericks, sometimes voting against the position of GOP congressional leaders and Trump. But there were some “no’s” outside of those four blocs, and many members within those four blocs who said that they supported the AHCA. (Some members fall into in more than one of these groups.) [...]
With this defeat, Trump avoids two potentially negative outcomes: getting mired in the details of health care policy for months and months, as he and the congressional Republicans try to write a bill the party can agree on; and secondly, dealing with the political fallout of pushing through an unpopular bill. Former President Barack Obama signed the Affordable Care Act into law on March 23, 2010, after spending close to a year working on it. And the ACA vote was a major factor in Democrats losing a bunch of congressional seats in the midterm elections later that year.
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