After the collapse of health care reform legislation in the House on Friday, Republicans in the Congress and President Donald Trump now must decide what's next on their respective agendas, as the GOP tries to pick up the pieces from a very public legislative failure over an issue that had been their central political focus for the last seven years.
Here's the look from Capitol Hill.
1. The first big setback for the Trump agenda. You can try to downplay what happened, but there was little positive to take from this health care debacle in the House. "I will not sugarcoat this; this is a disappointing day for us," said House Speaker Paul Ryan after the vote was canceled. President Trump tried to blame Democrats, but that rang hollow since the White House had done no serious outreach to the other party. With this setback, it's even more apparent how little has been done so far by the GOP Congress with respect to the Trump Agenda. Other than approving a series of plans to reverse specific regulations of the Obama Administration, no bills of any import have been passed. Infrastructure, jobs bills, tax cuts, cutting government - all of that sounds good - but so far, no action.
2. Trump allies turn their sights on Speaker Ryan. It wasn't hard to hear the low rumbling of some supporters of President Trump, as they used the Friday health care debacle to immediately try to make Speaker Ryan the scapegoat. Ann Coulter bluntly said, "Ryan is not on Trump's side." Pro-Trump websites like InfoWars and Breitbart immediately attacked Ryan as well, with some conservatives urging the House Freedom Caucus to help dump Ryan, arguing that he is the perfect illustration of the Republican Establishment that needs to be excised from Swamp of Washington, D.C.
3. Full repeal of Obamacare needs 60 votes in the Senate. If Republicans couldn't muster a majority in the House - how are they going to get 60 votes in the Senate to really change the bulk of the Obama health law? The answer - they're not going to do that any time soon. But full repeal was still the mantra from a number of Republicans as the House GOP health care bill went down the tubes on Friday. "I remain committed to repealing Obamacare and replacing it with conservative reforms," said Rep. Jim Banks (R-IN). "Congress should take its time and pass a good bill that actually repeals ObamaCare," said Rep. Ron DeSantis (R-FL). But the truth is, unless Republicans get 60 votes in the 2018 elections, an Obama health law repeal bill faces a difficult road in the Congress. It also could be described as a promise that can't be kept in the short term.
4. This fight on health care is already over? It seems hard to believe that Republicans are just going to drop the issue of health care reform, especially after making it such a central part of their political message in recent years. But President Trump seemed to send the signal that he is going to focus his political capital on other issues, like tax reform. "That one is going to be fun," the President said earlier this week, as his Treasury Secretary predicted a final tax bill would on the President's desk by early August. The last time Congress approved major tax reform was 1986. There's a reason it hasn't happened in over 30 years. It is not easy. And the lobbyists of Gucci Gulch will be ready.
5. This wasn't really much of an effort. The White House said the President "left everything on the field" to get a health care bill. But it doesn't look like that at all. Go back eight years, and Democrats were just launching their 13 month effort to forge what would become known as Obamacare. It went through the spring, summer, fall, winter, and then into the next spring of 2010, before being achieved. By contrast, the GOP introduced its health care bill on March 6 and gave up on March 24. Back in 2009 and 2010, Democrats struggled to keep their side together, but managed to get 60 votes for their package in the Senate. The GOP couldn't even get a majority in the House. There is still time to go back to the drawing board. But it takes more than 18 days of work.
6. Let the Republican finger pointing begin. One of the biggest immediate targets for Republicans in the House was the Freedom Caucus, the group of more conservative lawmakers which for years has been very good at holding out against the GOP leadership, but has done almost nothing in the way of substantive legislating. Some of that ire was aimed at Rep. Mark Meadows (R-NC), the head of the Freedom Caucus. "Mark Meadows is more interested in being on the TV than solving problems," fumed Rep. Austin Scott (R-GA), who then aimed some more barbs at Meadows and pointedly made sure to tell one reporter - "You can quote me on that."
7. Don't downplay the importance of this setback. Yes, it's just one bill. Yes, it's not the end of the world. But this failure was a big deal. Republicans have been talking for years about how they would repeal and replace the Obama health law. Donald Trump said he would do it right away. But for years, I have been reporting - and taking flak for saying - that while the GOP had lots of ideas, they didn't have consensus on any plan. And that was obvious as they desperately tried to stitch together deals at the last minute to keep the bill moving. It's pretty easy to lob verbal grenades at the other party - it's a little different to offer substantive legislation and pass it.
8. This was not a good week for President Trump. It started Monday with the FBI Director publicly confirming that not only was there an investigation of how Russia meddled in last year's election, but also a probe of any links between the Trump Campaign and Moscow. The FBI chief also made clear there was no evidence to back up Trump's claim that he had been wiretapped in 2016. And the NSA shot down talk that British Intelligence had helped with surveillance on Trump Tower. Meanwhile, the Trump travel and refugee ban stayed on hold the courts, despite Mr. Trump's declaration that judges were overstepping their authority. Then the week ended with a health care thud.