The AHCA fiasco comes from a flaw buried deep in the foundation of the conservative movement, which has become an uneasy coalition of populist demagogues and fiscal conservatives. The fiscal conservatives have a coherent ideology about small government and individual responsibility operating with a framework of largely unregulated markets. The great problem is that the living standards it creates for a majority of Americans have not been satisfactory and the cheerful optimism of the Reagan era has faded.
Against this backdrop, conservative talk radio has rallied large numbers of America's discontented, focusing their frustration on superficial social changes in the role of women, blacks and Mexican immigrants. Their skillful oratory has energized a powerful voter group but their plans are really just vague but exciting fantasy panaceas.
Into this chaos comes a narcissistic billionaire opportunist whose policies are those his class but whose rhetoric is that of TEA Party populism. Neither his experience on TV nor the eight year long "just say 'no'" strategy of the GOP in Congress has prepared him for the complex task of putting together an administration and working up a program that would bridge the gap between his big business base and the Freedom Caucus fiscal conservatives whose vote is necessary to pass bills. "Nobody knew it was going to be so complicated!" At least Donald Trump had no idea how complicated actually governing through the fractured Republican Party was going to be. He is beginning to find out.