How Trump's plan for an 'easy' Obamacare repeal collapsed

"You're going to have such great healthcare at a tiny fraction of the cost. And it's going to be so easy." The words of Donald Trump on 25 October, 2016, at an election rally in Florida. Just over half a year later, it's all gone wrong.

Healthcare has been a divisive issue in the US for decades, but when Trump announced he was running for president, one of his priorities was to get rid of the Affordable Care Act, known colloquially as Obamacare.

It was the flagship legacy that Barack Obama left behind after eight years in the White House, but Trump wanted rid of it. In fact, many Republicans wanted rid of it, too. Members of Congress on the right-hand side of the House and Senate had long bemoaned the cost and scale of the healthcare act. It was an issue that was popular with both Trump and GOP supporters.

But exactly six months on from Trump signing an executive order to repeal and replace it, the new Republican healthcare bill has collapsed.

So, what went wrong and what happens next?

On 20 January, Trump signed the order to begin the gradual take down of Obamacare and to kickstart the process of finding a replacement.

Trump had been in the job for just a few hours, and he had made it the very first piece of legislation he was enacting. Travel bans, a wall, Nafta; these issues were looked at later. Obamacare was the priority.

Traditionally, the sweetest moment for a new administration is the first six months. Between the January inauguration and the summer recess, a president often carries their highest levels of support as well as strong backing from their own party in Congress.

Repeal and replace should have been "easy". But no sooner had the ball stared rolling did politicians on the Hill realise that it wasn't going to be easy at all. Republicans needed to come together to have any hope of passing their new healthcare bill. Democrats were staunchly opposed to much of what the GOP package had to offer.

Especially when the first score from the Congressional Budget Office (CBO) came in. The CBO report, which analysed the potential impact of Trump's healthcare policy, suggested that premiums on health insurance would rise by 20-25%, and those people who were uninsured would also rise by around 32 million people by 2026.

A vote was scrapped at the last minute when it became clear that the votes weren't in the GOP's favour. But eventually, after some careful backroom deals from House leader Paul Ryan, the first stage was passed. It was time to move onto the Senate.

Trump gave a big speech in the Rose Garden of the White House. Flanked by GOP congressmen, beaming, he lauded the landmark vote, "confident" that the Senate would swiftly pass the bill.

As the weeks progressed, it was clear that senators from across the country were nervous. To pass a vote, Republicans could only afford to lose two of their own. Before it even landed on the desks of senators, around half a dozen had raised the alarm.

The GOP was split. Those on the left of the party, who had concerns about the numbers of Americans who would lose coverage, and those on the right, who thought the reforms weren't radical enough.

The left-leaning senators were the most worried. With mid-term elections in just over a year, a number of those set for re-election come from Obamacare-heavy districts, and couldn't afford to see cuts to those now insured.

Without an agreement in sight, some, including Trump himself called for the replacement to be put on hold and to instead focus on simply repealing Obamacare.

This was just as divisive, and quickly a signed letter from around a dozen Republicans led by the former presidential candidate John Kasich said that they would not back the idea. As all hope looked lost, Trump brought Republicans to the White House for 11th hour talks to unite the party to gather around repeal.

But even Trump's stance was confusing. Over 36 hours, Trump had three different opinions, he urged senators on Twitter to "repeal failing Obamacare". A day later, he said "let Obamacare fail."

And on the 19 July he said that the healthcare bill will "get better". Republicans then managed to assemble the votes to begin a debate on repealing and replacing Obamacare thanks to the dramatic return of John McCain.

His vote had tipped the scales into the favour of those trying to repeal Obamacare, just days after he had undergone treatment for brain cancer. The start of three days of debates triggered a Washington vote-o-rama, which collapsed as Republicans suggested various amendments to the plans.

Then on the 27 July, the latest attempt to reform healthcare was killed off.

In a startling volte-face, John McCain, who had been heralded by Trump as an American hero just days earlier, voted against the majority of his Republican colleagues, and sparking a mixture of both gasps and cheers from inside the Senate chamber.

Once again, McCain was able to tip the scale. The "skinny" repeal was the Republicans' best chance of any progress, but McCain's shock vote has forced the GOP to take a fresh look at the state of their party.

Trump was naturally unhappy with the loss. He tweeted: "3 Republicans and 48 Democrats let the American people down. As I said from the beginning, let ObamaCare implode, then deal. Watch!"

At the end of the day, the Republicans control the House, Senate and the White House, and despite around seven years of criticising Obamacare, when it mattered most, they failed.

Any hope of reform will now require bipartisan work. The Democrats are happy to tweak Obamacare in certain areas, but so far have been forced out of the GOP's plans. Only by working together can the Republicans get healthcare back on the legislative table.

Until then, the Republicans will take a long hard look at themselves and will now begin to move on.

The budget, tax reform, and infrastructure are all areas lined up on the agenda, and will need time to work on. Major tax reforms are planned, and aren't something that can be passed in a few days.

The last major tax reform took two years to complete under Ronald Reagan. There is just a year and a half until the Democrats have a possibility of taking control of the House. To avoid losses at the polls, Republicans need to start winning in Congress.