Gridlock in House stalls Trump's pledge to repeal Obamacare

As a candidate for president, Donald Trump said that "real change begins with immediately repealing and replacing the disaster known as Obamacare."

On March 24, the nation learned that it's not happening immediately. And the road forward isn't clear either.

Capping a frenzied week of negotiations between three House Republican factions -- the party leadership, the hardline conservative House Freedom Caucus, and members of the more moderate, pragmatic wing of the party -- House Speaker Paul Ryan, R-Wis., announced that he would not bring the American Health Care Act to the floor for a vote, as he had planned.

That March 24 announcement came one day after the floor vote had been pushed back to allow for last-minute changes and arm-twisting, and half a day after Trump had issued an ultimatum to House Republicans -- pass the bill or he'll move on.

In the run-up to Ryan's announcement, vote counting by media outlets had concluded that the House GOP would lose too many votes to pass the bill if it tried.

"We came really close today, but we came up short," Ryan said at a press conference. "I will not sugarcoat this. This was a disappointing day for us."

For members on the party's right flank, the American Health Care Act left in place too much of the infrastructure of the Affordable Care Act, President Barack Obama's signature health care law and the target of intense Republican opposition for seven years.

But more moderate Republicans -- especially those serving in Democratic-leaning states and districts -- feared the bill would have taken away insurance from too many Americans. The Congressional Budget Office projected that 24 million more people would be uninsured by 2026 as a result of the bill.

Reconciling the concerns of those two groups proved impossible for Ryan and his team of whips.

Even if the bill had passed the House, it faced rough sledding in the Senate, where several senators were already voicing opposition similar to the House factions. The GOP has only 52 votes in the Senate, meaning that the party could not afford to lose more than two votes either from the right or the center.

It was not immediately clear how congressional Republicans would proceed with efforts to repeal and replace the Affordable Care Act. There is no legislative reason that they could not produce a new bill, but that bill would have to compete with other legislative priorities, such as a tax overhaul or an infrastructure package, for congressional time and attention.

House Minority Leader Nancy Pelosi, D-Calif., called the Republican decision to pull the bill "a victory for the American people." Pelosi was a key player in passing the Affordable Care Act when she served as House Speaker in 2009 and 2010, and her ability to keep a united front among Democrats forced the Republican majority to find enough votes to pass the measure only within its own conference.

As for Trump, he used the bully pulpit to push for the bill, and Ryan thanked him for his efforts as he announced the bill's failure. "The president gave his all in this effort, he did everything he possibly could to help people see the opportunity we had with this bill," Ryan said.

After Ryan's announcement, Trump said from the Oval Office that Obamacare is "exploding now" and he urged Democrats to "get together with us and get a real health care bill." He added that he wants to focus next on tax reform.

Our long-standing policy is to rate promises based on outcomes, not presidential intention. Trump won't be able to repeal Obamacare without direct action from Congress.

With no clear path forward after this major setback, we are moving this promise to Stalled.