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President Donald Trump's remarks conceding defeat on repealing and replacing Obamacare demonstrated why his first big effort failed in the first place.
To begin with, the president remains only loosely attached to his own team. He referred to his Republican allies in Congress as "they," while casting himself passively as "sitting in the Oval Office ... pen in hand, waiting to sign something."
"For seven years, I've been hearing 'repeal and replace' from Congress, and I've been hearing it loud and strong," Trump told reporters at a photo op. "And then when we finally get a chance to repeal and replace, they don't take advantage of it. So, that's disappointing."
Second, Trump continued to display no understanding of health-care issues themselves. He again touted an alternative to Obamacare "with much lower premiums, much lower costs, much better protections."
If such a plan existed, congressional Republicans would have figured it out over the last seven years and passed it this year. Trump's summary assessment — "something will happen, and it will be very good" — showed that he doesn't have one either.
Third, his thinly staffed administration lacks an effective team to develop, push through Congress and implement a new system. As Trump dined at the White House to plot strategy with Senate leaders, he and his aides had no idea that GOP Sens. Mike Lee of Utah and Jerry Moran of Kansas at that moment were sinking their plans.
"I was very surprised when the two folks came out last night, because we thought they were in fairly good shape," the president said. A well-functioning White House staff would not have allowed him to be surprised.
By stunning the world with his election victory over Hillary Clinton last November, Trump earned the right to claim a firmer grasp of the electoral landscape than his critics. But by any conventional standard, his comments on Tuesday about the path forward sounded disconnected from political reality.
Trump faulted Democrats for obstructionism. "We have to get more Republicans elected" to succeed on the issue, he said calling it "impressive by any standard" that he had won over 48 of 52 Republicans.
But since passage is the only legislative standard, 48 votes falls far short of impressive. Republican leaders had arranged a 2017 health-care process that did not require or anticipate Democratic support.
"I think we're going to do very well, actually" in midterm elections, he added, predicting that reinforcements will come soon. But historical patterns, especially for a president with approval ratings as weak as Trump's, suggest a 2018 contest so tilted against him that Democrats might even recapture the House.
"We'll let Obamacare fail and then the Democrats will come to us," he concluded at another point, signaling a strategy that opposes bipartisanship. "We're not going to own it. I'm not going to own it."
That may prove his most unrealistic assessment of all. Trump and his party already "own" what happens in Washington by virtue of controlling both ends of Pennsylvania Avenue – as President Barack Obama and Democrats learned to their chagrin in 2010.
Over the weekend, a Washington Post-ABC News poll showed that just 36 percent of Americans now approve of Trump's performance as president. "Not bad at this time," he responded via Twitter.
In fact, 36 percent is historically bad for a new president in the modern era. And unless Trump and his team begin delivering results soon, there's every reason to expect it will get worse.