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demon­strates that cam­paign­ing and leg­is­lat­ing are two dif­fer­ent things,” said Jim Man­ley, once a top aide to for­mer Demo­cratic se­nate ma­jor­ity leader Harry Reid.

Rep­re­sen­ta­tive Joe Bar­ton of Texas blamed the fail­ure on Repub­li­cans — who con­trol the White House, Se­nate and the House — still learn­ing how to gov­ern af­ter eight years of Obama.

“Some­times you’re play­ing fan­tasy foot­ball and some­times you’re in the real game,” Bar­ton said.

Rep­re­sen­ta­tive Mario Di­azBalart of Florida called it “a big blow” for the Repub­li­can agenda.

Trump’s ef­forts to en­gage the bill’s op­po­nents at times seemed to muddy the process fur­ther, as he largely cut Ryan out of ne­go­ti­a­tions. (Ryan didn’t seem to mind, call­ing Trump a “great closer.”)

But even as Trump of­fered con­ces­sions, con­ser­va­tives did not budge and mod­er­ates were an­gered.

Stu­art Di­a­mond, a pro­fes­sor who teaches ne­go­ti­a­tion at the Whar­ton School at the Univer­sity of Penn­syl­va­nia, said Trump’s strong-arm tac­tics back­fired.

“Threats don’t work in gen­eral. They cause dam­age to re­la­tion­ships. They def­i­nitely don’t work in a sit­u­a­tion with a lot of dif­fer­ent stake­hold­ers, where the power is dis­trib­uted.”

Af­ter the bill was re­vised along Trump’s spec­i­fi­ca­tions, the Con­gres­sional Bud­get Of­fice, which analy­ses the fi­nan­cial im­pact of pro­posed leg­is­la­tion, de­ter­mined that the bill would de­prive 24 mil­lion Amer­i­cans of health in­sur­ance over the next decade and slice US$150 bil­lion (RM664 bil­lion) off the bud­get deficit.

The CBO said the bill would not af­fect the num­ber of unin­sured, but it would re­duce the bud­get deficit sig­nif­i­cantly less than the orig­i­nal bill, trou­bling fis­cal hawks.

Rep­re­sen­ta­tive Bill Huizenga, a Michi­gan Repub­li­can who is also a small-busi­ness owner, said Trump was still get­ting used to gov­ern­ing.

“There are par­al­lels be­tween gov­ern­ment and busi­ness, but they are not ex­actly the same.”

The les­son from the de­ba­cle, said John Fee­hery, a Repub­li­can strate­gist who was an aide to for­mer House speaker Den­nis Hastert, was that the White House need to take a firmer hand in craft­ing leg­isla­tive strat­egy. On health­care, Trump largely de­ferred to Ryan’s of­fice, which drafted the bill in se­cret, sow­ing mis­trust among con­ser­va­tives.

Congress now faces ar­guably an even tougher leg­isla­tive re­form: over­haul­ing the tax code, which has not been done since 1986 and in­volves nav­i­gat­ing a snake pit of com­pet­ing spe­cial in­ter­ests. Like Trump’s health­care pro­posal, it could strug­gle against pub­lic opin­ion, with Democrats likely to cast it as a Repub­li­can give­away to the rich. Repub­li­cans now have to hope vot­ers will not pun­ish them for fail­ing to de­liver on a prom­ise they had been mak­ing since Oba­macare was passed in 2010, and that they will still be­lieve this pres­i­dent when he says he can strike a deal.

“This is a prom­ise the Repub­li­cans made to vot­ers. They need to get it right,” said Rachel Bo­vard, a pol­icy an­a­lyst at the con­ser­va­tive Her­itage Foun­da­tion.

She urged Repub­li­cans to “start over”.

It is un­clear when that could hap­pen. Reuters


US Pres­i­dent Don­ald Trump at the Oval Of­fice of the White House in Wash­ing­ton on Fri­day.

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