The Republican Party of "no" for Democrat Barack Obama's eight years is having a hard time getting to "yes" in the early Donald Trump era.
The unmitigated failure of the GOP bill to replace Obamacare underscored that Republicans are a party of upstart firebrands, old-guard conservatives and moderates in Democratic-leaning districts. Despite the GOP monopoly on Washington, they are pitted against one another and struggling for a way to govern.
The divisions cost the party its best chance to fulfill a seven-year promise to undo Obama's Affordable Care Act and cast doubt on whether the Republican-led Congress can do the monumental — the first overhaul of the nation's tax system in more than 30 years — as well as the basics — keeping the government open at the end of next month, raising the nation's borrowing authority later this year and passing the 12 spending bills for federal agencies and departments.
While the anti-establishment bloc that grew out of the tea party's rise helped the Republicans win majorities in Congress in 2010 and 2014, the internal divide, complicated further by Trump's independence, threatens the GOP's ability to deliver on other promises.
"I think we have to do some soul-searching internally to determine whether or not we are even capable as a governing body," said Rep. Kevin Cramer of North Dakota in the bitter aftermath of the health care debacle.
Despite a commanding majority in the House, an advantage in the Senate and Trump in the White House, Republicans hardly seem to be on the same team.
"There are some folks in the Republican House caucus who have yet to make the pivot from complaining to governing," said Republican pollster Whit Ayres. "And this is a White House controlled by a politician who is not really trying to lead a party."
Trump took aim at members of his own party Sunday, saying on Twitter that "Democrats were smiling in D.C. that the Freedom Caucus," a group of conservative House members whose opposition to the bill, had "saved" Obama's health care law.
White House Budget Director Mick Mulvaney said the Trump White House wondered how a Republican Congress and president could not come together. "We're asking the same questions. We really are," Mulvaney said while appearing on NBC's "Meet the Press." ''Is the Republican Party capable of governing?"
The GOP health care bill exposed philosophical fissures masked by years of rejecting and resisting all things Obama. The legislation's provision to repeal essential health benefits such as maternity care and emergency services was designed to appeal to hard-line conservatives who don't think the government should be in the health care business.
That unnerved GOP moderates, especially those in districts won by Democrat Hillary Clinton last year, who were worried about tens of thousands of constituents losing Medicaid or older voters being forced to pay more. The irony of the outsider president is both the health care debate and Trump's proposed budget cuts to domestic programs from Appalachia to the inner cities reminded many Americans that government can do some good.
Pulling the bill on Friday cleared out Washington, giving House Republicans a chance to cool off back home this weekend. Still, some seethed while others couldn't hide their frustration, hardly a combination for unity and success.
Michigan Rep. Justin Amash said he and his conservative colleagues wanted a full-blown departure from the Obama law, rather than what Speaker Paul Ryan, R-Wis., was offering, but were given little voice.
"From the beginning of the process, I think the way it was set up did not bring the disparate parts of the conference together," Amash said.
New York Rep. Chris Collins, an early Trump backer in the campaign, echoed the bill's supporters in chiding opponents for not seizing the opportunity to deliver on the perennial campaign promise.
"I can tell you right now there's bitterness within our conference, it's going to take time to heal that," Collins said.
That sentiment spilled out in Texas Rep. Ted Poe's resignation Sunday from the Freedom Caucus, roughly 30 conservative House Republicans whose opposition helped kill the health care bill. "Saying no is easy, leading is hard but that is what we were elected to do," Poe, who supported the bill, said in a statement.
Ryan pledged the House would return to its campaign agenda, including legislation aimed at beefing up U.S.-Mexican border security, increasing spending on the military and public works, while also reining in the budget deficit. The GOP has to move beyond the defeat, with midterm elections next year and the historic disadvantage the president's party typically faces in holding seats.
"We were a 10-year opposition party where being against things was easy to do. You just had to be against it," Ryan told reporters after canceling the vote. "And now, in three months' time, we try to go to governing where we actually have to get ... people to agree with each other."
Ryan's toughest opponents were the Freedom Caucus, the hardliners widely expected to be marginalized after Trump won, but instead a bloc that showed its strength. The GOP owes its majority numbers to the brand of conservatism born in opposition to the 2010 health care law, the tea partyers and nonconformists like Sens. Rand Paul of Kentucky and Ted Cruz of Texas.
After all that winning, former Republican National Committee Chairman Haley Barbour cast the GOP as an expansive party with multiple factions. But the former Mississippi governor said Republicans must produce something for the electorate because they "have told the American people from Day One" they would.
For his part, Ryan insisted there is a viable governing path.
"We will get there," he said Friday. "But we weren't there today."