This is the legislative bargain that Republicans have struck, and it's looking like a predictable mess. In exchange for supporting Trump and turning a blind eye to his controversial behavior, the GOP hoped to reap the benefits of a negotiator in the Oval Office who could help them get things done while they controlled the presidency and both chambers of Congress. Instead, they got a highly inconsistent partner with a fleeting set of priorities and apparently very little interest in policy details. They also got a president who occasionally talks about exacting retribution against those who vote against him, but has also had several bluffs called and doesn't seem to be striking fear in the hearts of many Republicans in Congress.
And the size of the mess is difficult to overstate. Yet again, the GOP's health-care efforts have earned opposition from both sides of the party — from conservatives worried it doesn't undo Obamacare enough to moderates worried about people losing insurance and cutting Medicaid. That leaves any resolution seeming almost impossible. They're also in a situation now in which House Republicans took a very difficult vote on a very unpopular health-care bill, apparently for naught.
Look, passing health-care reform is difficult. It took Democrats months and months and months in 2009 and 2010 — even when they had a far bigger Senate majority than the GOP does now. And perhaps this effort will eventually succeed in some way.
But the lack of a steady hand at the top is proving a real hindrance. Trump has never really been forceful about what exactly he wants in this bill — if he even knows what he wants — and that gives Republicans very little reason to stick their necks out and vote for something specific that they don't love. Trump seems to be perpetually acknowledging that if this one fails, they'll just try something else. Is it any wonder Republicans in Congress have taken the same approach?
Trump is watching out for his own brand here, and he doesn't want this failure to be laid at his feet; that's why he's always talking about alternatives. But at some point, Republican senators are going to have to vote for something they don't love out of fear, either of the president, of voters or of Obamacare continuing in perpetuity.
Thus far, the negotiator in chief hasn't given them an offer they can't refuse, because he's always negotiating in his own mind and often negotiating the next deal before the current one's even dead. This has led Republicans to rightly believe that they don't need to support the current bill. At some point, they'll need to be relieved of that notion if something is ever going to pass.