The 2016 elections created an irreconcilable contradiction that now threatens to paralyze the GOP. The Republican Party in Congress is dominated by conservative lawmakers, many of whom won their seats in the tea party-led wave midterm elections of 2010 and 2014. Donald Trump, however, ran for and won the White House by campaigning against ideology. He marketed himself as a fixer married only to what works and suspicious of the rigid partisan divides that had crippled Washington. When Trump was elected to the White House, he was also selected to lead the Republican Party—a party that remains a congeries of committed conservatives. This contradiction was bound to lead to conflict someday. That day is today.

As of this writing, the fate of the GOP’s health care overhaul legislation is in doubt. Not only is it unclear if the bill can pass, it’s not at all obvious that it will ever be put up for a vote. At least, not in its present iteration. What remains most intriguing about the events of this week is the revolt of a familiar cast of mutinous conservative lawmakers—many of whom are members of the libertarian-leaning House Freedom Caucus—and the so-called “establishment wing” of the GOP. Remarkably, neither Donald Trump nor his staunchest defenders appear to think that the president belongs to either of these two camps. In their imaginations, he presides over the chaos from some Olympian remove. They believe him to be immune from this fight’s effects and dispassionate about the outcome. That is delusional.

Donald Trump is the leader of the Republican Party. He is the President of the United States. His party controls both chambers of Congress. He is, by definition, the Republican “establishment.” Whether Trump’s most self-indulgent supporters refuse to recognize that fact or not is irrelevant. The president certainly does. He spent the last two and a half weeks unreservedly wrapping his arms around the GOP’s health care reform bill. He had no choice.

Trump’s political strategy was to transform the vote on the health care bill into a referendum on his presidency. Only by turning the bill into a proxy vote of support for his administration could he impose a cost on conservative lawmakers in dark red districts who do not fear crossing Speaker Paul Ryan but are apprehensive about making an enemy out of Trump. He stumped for the bill at rallies, spoke to the House GOP conference in its defense, and dispatched his advisors—including Steve Bannon—to compel the surrender of recalcitrant House conservatives. Trump went all in.

Despite this dramatic display, neither the Speaker nor the President could convince principled conservatives to abandon their antipathy toward the bill. Its failure reflects poorly on everyone involved, House GOP leadership not least among them. It is a terrible setback for the GOP’s governing agenda. But Trump defenders who seem to believe that the president can simply wash his hands of the affair and, as Trump said, “move on” to other items are  kidding themselves.

First, no one is “moving on” from health care. America’s broken insurance model and ObamaCare’s intrusion into daily life has been the subject of intense congressional debate and myriad votes for the last seven years. Every time a continuing resolution or a budget comes up for a vote, the ACA’s taxes will be part of that debate. Further, the ongoing implosion of Obama’s health-care overhaul ensures no one will be able to run from it forever.

Second, this strange idea that Donald Trump is somehow shielded from the costs of failure here is wishful thinking. This is the first major piece of legislation Trump has vocally supported. For a new president’s first big ask of Congress to be denied, and at the hands of his fellow party-members, is almost unheard of. It will damage his presidency.

The president’s defenders would do well to take off their red caps for a moment and consider the positions they occupy. They are no longer plucky insurgents railing against the powers that be. They are the powers that be. Republicans who harbor some antipathy toward Paul Ryan may believe that, by humiliating him, they can have him removed from the speakership in favor of some ill-defined populist figure that exists only in their imaginations. They underestimate how easy it is to unite the House GOP conference behind one leader. Further, they make no accounting for the fact that Ryan’s humiliation will badly damage Trump’s administration and the Republican Party he leads. The prospects for a successful Trump presidency will be substantially reduced in this scenario, and he will still have at least three and a half painful years left in his term.

Trump’s allies don’t seem to have internalized the fact that the president and Paul Ryan are on the same team—at least, not like Donald Trump and Paul Ryan appear to have. Their fates are intertwined. Trump supporters do the president no favors by pretending he is an island and the rules of political gravity do not apply to him. The revolt of House conservatives demonstrates that they quite clearly do.

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