Donald Trump's failure to secure the health bill is deeply damaging – and he knows it

The New York tycoon does not see himself as a 'loser'

Few people are better than Donald Trump at spinning things to their own benefit. From claiming the crowds that turned out to see him on inauguration day were the biggest in history, or else claiming he knows better than military professionals on how to defeat Isis, the New York tycoon has never lacked in braggadocio or swagger.

But as it become clear that for all his efforts – a mixture of charm and threats – the Republicans simply did not have enough votes to pass a healthcare replacement bill, he looked rather pathetic.

“There were things in this bill I didn’t like. Both parties can get together and do real health care, that’s the best thing,” he said. “This means we’re going to have an even better bill.”

But as Trump spoke, through a forced trial, it was pretty clear that he was not even convincing himself. He insisted that he liked House Speaker Paul Ryan, and that he had worked “very hard”. But just a few hours earlier, he had effectively thrown him under the bus, making clear that he should never have gone along with Ryan’s ill-prepared, ideologically-driven assault upon Obamacare.

Some people are already claiming Trump is now a lame duck; that he will not be able to achieve anything else after this setback.

The Democrats and other opponents of Trump may wish that to be the case, but it is not. If the next legislative project he takes on is a planned and coordinated push for more tax cuts or infrastructure investment, the businessman will be able to recover his swagger and claim some easy victories.

But his defeat on Friday, and the recognition that the Affordable Care Act, better known as Obamacare, will for now remain in place, is seriously damaging for a number of reasons. And Trump knows that.

The first 100 days of any presidency are always considered the most crucial, the best chance to push ahead with marquee projects and initiatives for which the new incumbent wants his administration to be forever associated. It’s a time when there is, usually, a degree of goodwill within the country, and among their party there is a readiness to throw themselves behind the mandate the nation’s voters have just delivered.

But 10 weeks into his term, Trump has suffered a defeat that stings him in two ways.

For all his efforts to try to put the blame on Ryan, Trump’s decision to put his shoulder behind the Republicans’ American Health Care Act has meant people can draw two lessons: either he is either not the persuasive “dealmaker” he has always projected himself as, or else his party’s elected politicians are insufficiently scared of him and are more worried about their own supporters, who they need to reelect them in 2018.

“We came very close,” Ryan said afterwards at a press conference.

The Republicans’ bill was always a pretty lousy thing. Hardline conservatives hated it because they believed it provided too many entitlements to people, while moderates feared that millions fewer people – an estimated 14m in 2018 alone – would be able to afford health insurance.

The public also appeared to hate the bill. A recent Quinnipiac University poll suggested that just 17 per cent of the public approved of the measure, while 56 per cent disapproved.

All of which had left close observers of Washington wondering why Trump decided to get behind something neither he or most of his voters care about in the first place.

While he was happy to knock Obamacare on the campaign trail, and while it earned him cheers, Trump was never as obsessed about cutting coverage as Ryan or the members of the hardline “freedom caucus”. Trump’s voters invariably prioritise issues such a job creation, immigration, tax reform and a rebuttal of the Washington establishment that the president just utterly misjudged.

His attempt to blame the House Democrats for what transpired is even more feeble.

He has come away looking hapless, chaotic and ineffective. For a man who campaigned as someone who could be relied on to get things done – even against the toughest odds – that is not a good look.