“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,” the New York Times reports.

“Since the day the Affordable Care Act passed Congress, Republicans have vowed to overturn it…. But in the intervening years, as millions of Americans have become insured under the law that was derisively tagged with President Barack Obama’s name, the health care program has become more and more popular, even with Republican governors.”

“With their bill to repeal and replace the Affordable Care Act in tatters, Senate leaders on Tuesday pushed to vote on a different measure that would repeal major parts of President Obama’s health law without a replacement — but that plan appeared also to collapse,” the New York Times reports.

Sens. Susan Collins (R-ME), Shelley Moore Capito (R-WV) and Lisa Murkowski (R-AK) “immediately declared they could not vote to repeal the Affordable Care Act without a replacement — enough to doom the effort before it could get any momentum.”

“The collapse of the Senate Republican health bill — and the failing struggle to find yet another alternative — highlighted a harsh reality for Senate Republicans: While Republican senators freely assailed the health law while Mr. Obama occupied the White House, they have so far not been able to come up with a workable plan to unwind it that would keep both moderate Republicans and conservatives on board.”

A new Public Policy Polling survey finds that just 20% of voters support the health care bill that was being considered by Congress until last night, to 57% who are opposed to it.

Even among Republicans there’s only very narrow support for it: 35% in favor, 34% opposed, and 31% not sure.

Two Republican senators issued statements opposing the GOP leadership’s effort to repeal the Affordable Care Act without coming up with an immediate replacement.

Sen. Shelley Moore Capito (R-WV):

“I did not come to Washington to hurt people. I have serious concerns about how we continue to provide affordable care to those who have benefited from West Virginia’s decision to expand Medicaid, especially in light of the growing opioid crisis… I cannot vote to repeal Obamacare without a replacement plan.”

Sen. Susan Collins (R-ME):

“I do not think that it’s going to be constructive to repeal a law that at this point is so interwoven within our health care system without having a replacement plan in place. We can’t just hope that we will pass a replacement within the next two years.”

If one more Republican senator opposes the effort, it will be dead.

Jonathan Chait: “In truth, it was never possible to reconcile public standards for a humane health-care system with conservative ideology. In a pure market system, access to medical care will be unaffordable for a huge share of the public. Giving them access to quality care means mobilizing government power to redistribute resources, either through direct tax and transfers or through regulations that raise costs for the healthy and lower them for the sick. Obamacare uses both methods, and both are utterly repugnant and unacceptable to movement conservatives. That commitment to abstract anti-government dogma, without any concern for the practical impact, is the quality that makes the Republican Party unlike right-of-center governing parties in any other democracy. In no other country would a conservative party develop a plan for health care that every major industry stakeholder calls completely unworkable.”

“Every attempt to resolve the contradiction between public demands and conservative ideology has led the party to finesse it instead. That is why Republicans spent years promising their own health-care plan would come out very soon. It is why their first and best option was repeal and delay. And it is why they are returning to that option now.”