The latest Senate attempt to repeal Obamacare is dead. The votes aren’t there, even among Republican senators.

It’s a blow to President Trump, who still has yet to secure a major legislative victory. The last four presidents, both Republican and Democrat, achieved a big legislative win by the end of their first summer in the White House.

President Obama had the economic stimulus package by Feb. 19.

President George W. Bush had his tax cuts by June 7.

President Bill Clinton had signed the Deficit Reduction Act by Aug. 10.

President Ronald Reagan had his first tax cut by Aug. 13.

Trump’s dilemma now is whether to stick with health care or ditch that for now and move on to something else. On Monday night, a furious Trump took to Twitter to lash out at senators, calling some disloyal.

“Republicans should just REPEAL failing ObamaCare now & work on a new Healthcare Plan that will start from a clean slate,” he tweeted. He followed that up with more tweets Tuesday morning, claiming the "Dems control Senate," even though members of his own party were the ones who ultimately doomed the latest health bill.

Trump keeps pushing health care, but many top economic advisers from his 2016 campaign are shouting in his ear: move to tax cuts.

“President Trump and Republican leaders in Congress must act with much more urgency and decisiveness on tax cuts,” wrote Steve Forbes, Larry Kudlow, Arthur Laffer and Stephen Moore in an op-ed in Investor’s Business Daily on Friday.

They urge a tax cut by Labor Day, calling it the best chance for Republicans to win in the 2018 mid-term elections.

The trouble with a "pivot" -- the term du jour in Washington-speak -- is that if you pivot too many times, you're just turning in a circle. Since Trump took office, his administration has vacillated between health care and tax reform, switching its focus every time one initiative hit a setback.

Still, Trump's campaign advisers are alarmed that tax reform has “stalled out,” and they say it is negatively impacting the stock market and economy. In reality, the U.S. stock market continues to hit all-time highs, although they are right that confidence in the Trump economic agenda is starting to decline.

“We hear that a tax plan from the White House may not come until the fall and may not even pass Congress until 2018 – if at all,” they write. Goldman Sachs, the investment bank with many alums in the White House, has been giving clients the same warning since the spring not to expect any action on taxes until 2018.

But many on Wall Street see a fresh opening to lobby the White House for action on its top priority. Compass Point, a research and trading firm, put it bluntly in its morning note to clients on Tuesday:"Failing to pass health care legislation dramatically increases the sense of urgency surrounding the tax reform conversation," wrote Isaac Boltansky and Lukas Davaz.

This isn’t the first time this group of former Trump economic advisers has pushed this message. They started advancing the idea of doing tax cuts first in April in a New York Times op-ed. But their message has become more urgent, arguing getting something done is far better than doing nothing at all. They are advocating a “Just Do It” mentality, even though their tax proposal would add $3 trillion to the debt.

“Revenue neutrality is an inside-the-Beltway trap and will prevent passage of a strong tax cut,” they argue. They push for reducing the business tax rate to 15 percent, a tax holiday for business to bring back capital from overseas and doubling the standard deduction (so going from $6,500 to $13,000 for individuals and $13,000 to $25,000 for couples).

Tax cuts are usually high on a Republican agenda, but nothing is simple with this Congress. Moderates in the Senate have shown they won’t sign on to anything that guts programs for seniors and the poor too much. Meanwhile, the House's most conservative bloc, the Freedom Caucus, won’t vote for anything that substantially increases America’s $20 trillion debt.

The House Republicans released their “Building A Better America” budget first thing on Tuesday morning. Its top goal is to balance the budget.

“Without significant spending restraint, future generations of Americans will face a sovereign debt crisis that will cripple our economy and adversely affect every American family,” the budget says.

The tax cuts that Forbes and company propose would add trillions to the deficit. House Republicans don’t sound interested at all, unless those tax cuts are accompanied with reductions elsewhere. The House budget is far bolder in scope — and more controversial.

All of this makes it that much harder for the White House to figure out which big priority can realistically get done soon.