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In the end, Republicans relearned a lesson that has bedeviled them since the New Deal: An American entitlement, once established, can almost never be retracted. Since the day the Affordable Care Act passed Congress, Republicans have vowed to overturn it. In the beginning, many voters were with them, handing the Republican Party some of the tools: a sweeping rejection of House Democrats in 2010 — a rejection of government reach — followed by the Senate in 2014. (Steinhauer, 7/17)

It raises a host of questions about the status of the Republican Party, which is led in the White House by a right-wing nationalist who exploited a culture seething at Washington and in Congress by those very Washington establishmentarians. Who is in control? The conservatives from within, though, are not necessarily aligned with Trump. In fact, they have shown they are not afraid of either Trump or McConnell. That could mean big problems ahead for what Republicans can get done. Tax reform is a priority for McConnell and Trump, and Trump would also like to do infrastructure. (Montanaro, 7/18)

Obamacare dogged Democrats for years at the polls, toppling their congressional majorities and stoking partisan fires that still burn in Washington. But if Republicans are ultimately able to pass their own health care plan, they will face their own repercussions — and some will hit at a painful time. Like the 2010 health care law, the GOP bill would not take effect all at once. Many of the most politically tricky provisions are staggered over the coming years and would hit right as a promising group of freshmen Republican senators come up for reelection in 2020. (Cheney and Schor, 7/17)

Republicans offered competing ideas for what to do next on healthcare Monday night, now that the current ObamaCare replacement effort has fallen apart. Senate Majority Leader Mitch McConnell (R-Ky.) acknowledged late Monday that the chamber’s current approach would fail after two more senators announced opposition to the current healthcare draft. (Sullivan, 7/17)

Republican Senator Ron Johnson accused Majority Leader Mitch McConnell of “a real breach of trust” by telling some Republicans privately that long-term cuts conservatives demanded to Medicaid provisions of the party’s embattled health-care bill are unlikely to ever take effect. With two Republicans already opposed to advancing the measure, McConnell can’t afford to lose another senator. Johnson, who had previously said he supported the bill, said other senators told him about McConnell’s comments. (Kapur and Litvan, 7/17)

Donald Trump’s most fervent supporters are less confident of his leadership on health care even though they still overwhelmingly support him as president, the latest Bloomberg National Poll shows. As Trump calls on the U.S. Senate to pass legislation repealing and replacing Obamacare, 60 percent of all poll respondents said they think it’s unrealistic that a bill lowering premiums and covering more people will be passed in the next several years. At the same time, health care ranked as the most important issue facing the country, ahead of jobs, terrorism and immigration. (Mattingly, 7/17)

Twice as many Americans prefer ObamaCare over the GOP's healthcare bill, a new poll released Monday finds. The Washington Post/ABC News poll shows 50 percent prefer ObamaCare, while 24 percent prefer the GOP's plan. Thirteen percent like neither. (Hellmann, 7/17)