John Boehner must be getting ready to give Paul Ryan a consoling call.  By now, the news that Republicans, despite controlling all levers of government, could not repeal a law they have railed against for seven years has spread far and wide.  Boehner, the former Speaker of the House, often battled with the same members that sunk Paul Ryan’s attempt at repealing the law.

Not all the blame can be laid at Paul Ryan’s feet.  Trump took little ownership of the issue and only became involved in the issue late in the game.  He tried to twist arms and get the bill over the hill but in the end his lack of policy expertise, skin in the game, and ideological closeness to Congressional Republicans sunk the bill.  Few Republicans feel like opposing Trump and leadership will cost them (of course I have a slightly differing opinion).

Conservative Republicans (the ones not blinded by pure ideology), now face a quandary that has grave consequences for their party and agenda.  They have a strong electoral base and message that allows them to decisively win elections (even in purple states).  But when it comes to actually governing that base works against them.

Consider the kind of Republicans that shot down the House GOP healthcare bill.  It was not party moderates, though many balked at the number of uninsured caused by the plan and efforts to reform Medicaid, but small government conservatives.  These conservatives, many from the so-called Freedom Caucus, operate under the assumption their constituents really support their small government stances.  As a result, they pound their chests and prevent key legislation from passing unless it is as conservative as it can be made.

The problem with this is that such a strategy and their beliefs simply do not meld well into the current GOP coalition.  I don’t know many conservatives or Republicans who thought Trump campaigned on shrinking government.  They appreciated his talk on limiting harmful regulations and repealing bad laws but Trump also promised building up the military and passing a trillion dollar infrastructure package (not exactly small government).

The problem for the GOP is those bigger government, populist messages resonated with culturally conservative voters.  These voters are not dedicated to small government.  They don’t want small government for ideology’s sake.  They want a government that works for them.  Big or small!

As a result, these voters preferences are different than that of those of the Freedom Caucus.  Due to the size of the Freedom Caucus in the House (over 30 members) and the GOP’s overall majority (21 seats) and Democrat’s lockstep to the GOP agenda the Freedom Caucus can block anything Trump or leadership throws their way.  They derailed the AHCA.  What’ll go off the rails next?

If one wants evidence the GOP’s 2016 coalition and the Freedom Caucus do not meld well just look at a recent poll take on healthcare.  It is pretty much understood no Freedom Caucus member believes the government has an obligation to provide healthcare.  But, it seems a majority of their voters and perhaps their constituents do.

A Pew Research survey taken in January finds that among all Republicans 32 percent favor a governmental role in making sure Americans have health care (not just access).  Most notably, among the group that swung strongest to Trump in 2016, 52 percent of low income whites ($30K or less) favor a governmental role in providing Americans healthcare.

These Republicans were lukewarm to the AHCA.  Recent polls showing the law underwater in popularity found that among Trump supporters it had a meager 60ish percent support level.  That’s because it threatened to shrink Medicaid, take money from Medicaid.  These are both programs that benefit low income whites.

So, House Conservatives jumping up and down about killing the bill are out of step with a significant bloc of their party.  The reasons the Freedom Caucus killed the bill were not the reasons some Republican voters opposed it.

Moving forward this could have significant consequences.  How are Republicans going to manage tax reform when the middle class benefits from significant tax deductions being debated (charitable, mortgage interest, state and local property taxes, etc.)?  Lower income Republicans benefit from the Earned Income Tax Credit and other deductions thought to be on the chopping block.

Making matters worse is Republicans have pledged tax reform will be deficit neutral.  They also need this to push it through the Senate via Budget Reconciliation.   But with Healthcare Reform dead for the time being (at the very least) their margin for error just got smaller.

House conservatives are sure to push for bigger and bigger tax reductions and not want to remove deductions.  They also are unlikely to want a 50/50 split where higher earners might pay more or see deductions capped or limited to lower the taxes of the middle class and lower income Americans (ideology dies hard).  Again, this puts them out of sync with a majority of their own constituents.

Finally, on other big ticket issues, infrastructure, defense spending and entitlements, the Freedom Caucus is sure to be to the right of many in their party.  Even with Trump pushing such efforts as an infrastructure bill will these recalcitrant members move?  Probably not.

The reason being what I stated above.  The GOP has a pretty stable electoral majority (buttressed by geography and redistricting), but many upper-income Republicans (a shrinking wing of the party) still favor the smallest government possible mindset.  Freedom Caucus minded Republicans thus believe they are representing all their constituents when they oppose government growth or new spending on anything but entitlements or tax cuts.

These Republicans may pay a price at the ballot box next year.  But until then they help make the GOP coalition ungovernable.  Ironically, Democrats have the opposite problem.  Their Congressional minorities have not been more ideologically cohesive since the 50’s and as a result they could probably govern if given the chance.  They just cannot win running on more spending, higher taxes, more regulations, etc.  Makes me feel sympathy for Paul Ryan.