The Trump administration has suffered a heavy setback in its healthcare reform agenda. The so-called repeal and replace bill, which includes significant changes to the Affordable Care Act, is, as of this week, unlikely to make it through the U.S. Senate.

In May, the House of Representatives narrowly passed a repeal of the ACA. This Senate bill is the continuation of that push. In the last two weeks the bill has experienced a series of unfortunate events and is now no longer viable in its current form.

Multiple Republican Senators, each holding a key vote, have decided to oppose the bill. Senator Rand Paul, for instance, voiced his opposition this weekend on the simple basis that it did not repeal the ACA in its entirety.

On Monday night, Republican Senators Mike Lee and Jerry Moran announced that they would oppose, each citing concerns that the bill would not do enough to eliminate what they view as some of the most unacceptable parts of the ACA.

The loss of these two votes spells disaster for the measure, which still had a glimmer of hope going into this week. In response, president Donald Trump expressed his disappointment and went to Twitter, urging Republicans toward cooperation on repealing and replacing the ACA.

The bill already faced a difficult situation in the Senate. More conservative Republicans were likely to withdraw their support from any measure that fell short of their expectations. Moderate Republicans were likely to reject any formulation that went too far to please conservatives.

The failure of this effort is thoroughly embarrassing for the administration. It also serves to weaken many of its future plans for policy reform. The fact that Trump himself has appeared less and less interested in the increasingly difficult healthcare battle does not reflect well on his consistency as a leader. Months ago his approach was radically different as he claimed that the fight would be easy provided that an acceptable alternative to the ACA were presented to the legislature.

It seems clear that, as Trump has become more accustomed to the realities of the American political landscape, he has come to more fully understand the naïve simplicity of many of his early promises. Furthermore, if this healthcare misadventure indicates anything about the future success or failure of the Trump administrations other agenda items, the president is certainly in for more frustration.

Democrats are elated at the news and have cited Republican disunity as evidence of the ultimate weakness and untenability of the repeal and replace effort. For now, the Affordable Care Act is safe. President Trump and other Republicans are no doubt anxious to move on to another arena where perhaps they will find more success.


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