Weary Republicans in Washington may be ready to move on from health care, but conservatives across the United States are warning the GOP-led Congress not to abandon its pledge to repeal the Obama-era health law — or risk a political nightmare in next year's elections.
The Senate's failure to pass repeal legislation has outraged the Republican base and triggered a new wave of fear. The stunning collapse has exposed a party so paralyzed by ideological division that it could not deliver on its top campaign pledge.
After devoting months to the debate and seven years to promising to kill the Affordable Care Act, Senate Majority Leader Mitch McConnell, R-Ky., simply said: "It's time to move on."
But that's simply not an option for a conservative base energized by its opposition to the health law. Local party leaders, activists and political operatives are predicting payback for Republicans lawmakers if they don't revive the fight.
"This is an epic fail for Republicans," said Tim Phillips, president of Americans For Prosperity, the political arm of the conservative Koch Brothers' network. "Their failure to keep their promise will hurt them. It will."
To the American Conservative Union, the three Republican senators who blocked the stripped-down repeal bill that failed in the wee hours Friday are "sellouts." A Trump-sanctioned super political action committee did not rule out running ads against uncooperative Republicans, which it did recently against Sen. Dean Heller, R-Nev.
There are limited options for directly punishing the renegade senators — John McCain of Arizona, Lisa Murkowski of Alaska and Susan Collins of Maine. None of the three is up for re-election next fall. McCain, whose dramatic "no" vote killed the bill, was just re-elected to a 6-year term and has probably faced his last election, has brain cancer and is hardly moved by electoral threats.
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Still, broad disillusionment among conservative voters could have an impact beyond just a few senators. Primary election challenges or a low turnout could mean trouble for all Republicans. Democrats need to flip 24 seats to take control of the House of Representatives, a shift that would dramatically re-shape the last two years of Trump's first term.
"If you look at competitive districts, swing districts, or districts where Republicans could face primary challenges, this is something that will be a potent electoral issue," Republican pollster Chris Wilson said of his party's health care failure. "I don't think this is something voters are going to forget."
One such challenger has emerged. Conservative activist Shak Hill, a former Air Force pilot, plans to run against second-term GOP Rep. Barbara Comstock in a competitive northern Virginia district.
Hill told The Associated Press that Comstock, who voted against a GOP House health care repeal bill in May, "has failed the moral test of her time in Congress."
The leaders of other groups, such as Women Vote Trump, have begun to court primary challengers to punish those members of Congress deemed insufficiently committed to President Donald Trump's agenda.
"I expect that we will get involved in primaries," said the group's co-founder, Amy Kremer. "You cannot continue to elect the same people over and over again and expect different results."
On Capitol Hill, some Republicans insist their health care overhaul could be saved in the short term. Yet party leaders — backed by outside groups — are signaling that they would probably move on to taxes. Republicans hoped the issue would bring some party unity, even as realists in Washington view the a tax overhaul — something that hasn't happened in more than 30 years — as one of the most complex legislative projects possible.
The Trump administration has become engulfed in internal drama over personnel and personalities. Trump on Friday ousted his chief of staff, Reince Priebus, and replacing him with Home Security Secretary John Kelly. The president did not appear to share conservatives' outrage about the Senate's vote, but repeated his promises to remake the health system.
"You can't have everything," Trump said, adding: "We'll get it done. We're going to get it."
Around the country, Republican voters continue to support efforts to repeal former President Barack Obama's health law, even if there is little agreement on an alternative.
A CNN poll released last week found that 83 percent of Republicans favor some form of repeal, while only 11 percent of Republicans want the party to abandon the repeal effort. Among all adults, 52 percent of voters favor some sort of repeal, with 34 percent favored repeal only if replacement could be enacted at the same time.
"The political pressure on something like this is real," said GOP strategist Mike Shields. "I don't think this is over."
Like others Republican operatives, Shields said the party's ability to enact the rest of Trump's agenda — taxes, infrastructure and the border wall — could help "mitigate how upset people will be" about health care.
"If this is part of a general trend," he said of the GOP's governing struggles, "I think that can be pretty disastrous for 2018."
Republicans will be held responsible for any negative economic fallout from the current health system's failure, said Paul Shumaker, a North Carolina Republican pollster and senior adviser to Sen. Richard Burr, R-N.C.
As early as October, voters are likely to see increased costs as insurance companies notify people about their new rates. By next October, it will be too late to unlink Republicans from the problem, Shumaker said.
For now at least, many Trump supporters blame the Republican Party's problems on its leaders in Congress.
"They certainly didn't have their house in order," said Larry Wood of Waynesboro, Virginia, who voted for Trump only after supporting Ohio Gov. John Kasich in the 2016 GOP primary. The 69-year-old retired homebuilder says the failure falls at the feet of Congress.
Trump seems content to let the current system collapse.
"As I said from the beginning, let ObamaCare implode, then deal. Watch!" he said in a tweet.
Associated Press writer Bill Barrow in Atlanta contributed to this report.