Don't worry: congressional Republicans all understand the world of hurt they are in for if they ask their supporters to re-elect them without having repealed Obamacare.  There is going to be major health care reform, but working out the details turns out to be (surprise!) complicated, and turning over the new plan to Paul Ryan was a mistake, as was the strategy of narrowly tailoring the law to reconciliation with 51 Senate votes.

Meanwhile, tax reform can't wait.  That is how we get the economy moving and improve people's lives before they vote in November 2018.  

Donald Trump knows that you always have to be prepared to walk away from the deal, or in the current case, the House vote.  The need to make a deal, any deal, hands leverage to the other side.  He said so in The Art of the Deal, and besides, every competent negotiator knows it.  

Now, both caucuses of the House and both parties need to face up to the slow-motion collapse of Obamacare, as premiums continue to soar and insurers vanish from entire state markets.  There will be sob stories aplenty.

Democrats just could not help themselves, rejoicing on camera over the humiliation of the Republicans.  They are celebrating the disaster that will unfold, and those clips will live on in GOP video ads.  They reiterated their continuing ownership of Obamacare with this celebration.

If the GOP plays it smart, a continuing campaign highlighting the disasters of Obamacare, complete with victims, would lead up to a real plan for reform resting on a systemic, not incremental change, and market forces replacing entire bureaucracies.  Radical simplicity can replace the byzantine system of third-party payers and regulations – universal catastrophic care combined with medical savings accounts to pay for routine expenses, for instance.  For poor people, let the government put in a thousand dollars per year; that's cheaper than what we have now.

If not this approach, find other ways of getting money to people who can make their own decisions on what to buy in the way of medical care, and let the vendors compete openly on price and other factors.

Force the Democrats to tell the American people that this plan is not for them.  Especially if there is the prospect of a thousand bucks a year landing in their account that they get to spend, Americans just might like an approach that puts the power in their own hands.