RIP, Trumpcare: How the Health Care Bill Crashed and Burned

As Joe Biden might say, this is a big f-cking deal

President Donald Trump, flanked by Health and Human Services Secretary Tom Price, left, and Vice President Mike Pence, meets with members of the media regarding the health care overhaul bill, Friday, March 24, 2017, in the Oval Office of the White House in Washington. Credit: Pablo Martinez Monsivais/AP

Without so much as a vote, the Republican crusade to repeal and replace Obamacare has failed.

The House was supposed to vote Friday afternoon to advance Trumpcare to the Senate – where its fate was dodgy at best. Instead, at a bit after 3:30, Speaker Paul Ryan and President Trump pulled the bill. As Joe Biden might say, this is a big fucking deal.

It's hard to overstate the magnitude of this defeat. For seven years, almost to the day, the Republican Party has made repealing Obamacare the white whale of its legislative agenda. That hunt ended Friday – the whale in clear sight – without launching a single harpoon.

Like Speaker John Boehner before him, Paul Ryan found he could not bridge the ideological gap between the center and the far right of the GOP House. The first presentation of Trumpcare couldn't pass, because it was insufficiently hard-hearted for the far-right members of the Freedom Caucus. But as Trump and Ryan kept tweaking the bill to appease those hardliners – including by stripping away the essential benefit guarantees that health insurance plans in American must now cover – the bill lost supporters at the center, including the chair of the House Appropriations Committee. A winning vote count remained elusive – somewhere between a handful and a dozen votes short.

It did not help that Trumpcare polled at 17 percent support nationally. Nor did the updated score from the Congressional Budget Office forecast that the bill would deprive 24 million Americans of insurance coverage, while only saving the federal government $151 billion. (That latter figure was less than half of the initial projected savings of $337 billion.) Nor that, despite Trump's campaign promises not to touch Medicaid, the bill slashed the program by a quarter: $880 billion over ten years.

Trump had made the House legislation his own from the beginning, calling it "our wonderful new health care bill." And he put his storied reputation as a dealmaker on the line, twisting arms and issuing ultimatums. He told Republicans this was their only shot – that if they did not pass his bill, they would just have to live with Obamacare. He even called out the Freedom Caucus in a tweet Friday morning, trying to wrong-foot the pro-life caucus with their constituents. He framed a vote against Trumpcare as a vote for Planned Parenthood, warning that the caucus "allows P.P. to continue if they stop this plan!"

But throughout the negotiations, the president displayed a stunning lack of interest for the underlying policy, and an artless hand in trying to strike a deal. He seemed desperate to pass something, really – anything. The effort came up empty. Paul Ryan reportedly alerted the White House near mid-day that he lacked the votes to carry the day. The president reportedly insisted that House members walk the plank – and stage a vote for the doomed bill anyway. Even former Speaker Newt Gingrich couldn't refrain from underscoring the idiocy of that plan, tweeting, "Why would you schedule a vote on a bill that is at 17% approval?"

Then, suddenly, the bill was gone. And the House was in recess. And the 20 million Americans who have gained coverage from Obamacare breathed a collective sigh of relief.

For the new president, defeats are now piling up. His centerpiece "Muslim ban" has been tied up, twice, in federal courts. Obamacare repeal is now off the table. And the agenda ahead just keeps getting trickier. "Now [Trump] can turn to something easy like tax reform," snarked never-Trump conservative John Weaver. "All this winning is giving me a headache."

House speaker addresses the nation after health care bill is pulled.