What price, if any, Republicans will pay for this setback will be revealed over the coming months. Perhaps they will be able to move quickly on other priorities - a tax bill being the most appealing now, although not necessarily a slam dunk - and wash away the bitter taste of the healthcare debate. That might be the best they can hope for, but there are no guarantees.
The failed promise to repeal and replace Obamacare surely will affect the mood and enthusiasm of the Republican base heading toward 2018.
When the Gallup organisation asked Americans about the future of the Affordable Care Act recently, 30 per cent overall said they favoured "repeal and replace," but 70 per cent of Republicans supported that option.
GOP lawmakers will have left them empty-handed, perhaps disillusioned. That will energise Democrats even more in their quest to take control of the House in 2018.
The breakdown that has been on display over the past weeks also cannot help but bring more attention to divisions inside a Republican Party whose coalition has been reshaped by the rising voice of white working-class voters who helped put Trump in the Oval Office.
All parties have divisions, but what Republicans must reckon with is not simply a conflict between conservatives and moderate-conservatives, but differences rooted in potentially incompatible perceptions of government and Washington.
The President spent today tweeting his frustrations, blaming Democrats and "a few Republicans" for what happened in the Senate.
"We will return!" he said in one tweet. "Stay tuned!" he said in another. Let Obamacare fail, he proclaimed.
Those are standard exhortations by the President, meant to shore up his supporters, but they carry no particular force with those in his party who have been doing the heavy legislative lifting.
Instead, those tweets underscored the futility of trying to make what happened on healthcare anything other than what it was: A self-inflicted wound by a party that succumbed to easy appeal of campaign slogans without doing the hard work of policymaking over the past seven years.
William Galston of the Brookings Institution noted that the healthcare debate showed anew that Republicans have not bridged the gap between campaigning and governing.
This has been a longtime problem for a party that is at best ambivalent about the federal government and at worst openly anti-government, at least rhetorically. This condition existed before Trump came on the scene. It has worsened because of his political success.
Trump's rise and his victory in the presidential campaign intensified a point of internal conflict for the Republicans, one that pits hardline, anti-government conservatives against many of those working-class voters who believe in the federal programmes that deliver services to them and don't want them eliminated.
"The Republican Party is grappling with the fact that conservative orthodoxy is one thing and populism is another," Galston said. "Populists are not anti-government. Populists are in favour of government that helps people like them."
The President's embrace of the Republican promise to repeal and replace the Affordable Care Act was and is incompatible with political views he often stated as a candidate.
He adopted the rhetoric of repeal and replace, but whenever he talked about healthcare policy, he did not sound like a conservative Republican. He wanted coverage for everyone. He didn't want to hurt people. He didn't want to make cuts to entitlement programmes, whether Medicare, Medicaid or Social Security.
What Trump espoused clashed with what conservative, small-government Republicans long had been preaching. In office, his ambivalence has been evident at virtually every turn in the debate. He complained about the House bill as too mean after publicly praising it. He wanted repeal and replace without any pain. He wanted a victory but could not engineer it.
Republicans have experienced two well-known lessons. Tackling big issues on a partisan basis is fraught with political risk. And once government benefits are extended to tens of millions of Americans, taking them away is as risky politically as it is substantively difficult.
After seven years of the Affordable Care Act, despite its flaws and weaknesses, Republicans were forced to concede that parts of the law were extremely popular. Trying to keep the good while fulfilling a promise to get rid of the measure called for legislative and policy gymnastics beyond their capability.
