WASHINGTON — House Republican leaders, facing a revolt among conservatives and moderates in their ranks, pulled legislation to repeal the Affordable Care Act from consideration on the House floor Friday in a major defeat for President Trump on the first legislative showdown of his presidency.
“We’re going to be living with Obamacare for the foreseeable future,” the House speaker, Paul D. Ryan, conceded.
The failure of the Republicans’ three-month blitz to repeal President Barack Obama’s signature domestic achievement exposed deep divisions in the Republican Party that the election of a Republican president could not mask. It cast a long shadow over the ambitious agenda that Mr. Trump and Republican leaders had promised to enact once their party assumed power at both ends of Pennsylvania Avenue.
And it was the biggest defeat of Mr. Trump’s young presidency, which has suffered many. His travel ban has been blocked by the courts. Allegations of questionable ties to the Russian government forced out his national security adviser, Michael T. Flynn. Tensions with key allies such as Germany, Britain and Australia are high, and Mr. Trump’s approval ratings are at historic lows.
Republican leaders were willing to tolerate Mr. Trump’s foibles with the promise that he would sign into law their conservative agenda. The collective defeat of the health care effort could strain that tolerance.
“Obamacare unfortunately will explode,” Mr. Trump said later. “It’s going to have a very bad year.” At some point, he said, after another round of big premium increases, “Democrats will come to us and say, ‘Look, let’s get together and get a great health care bill or plan that’s really great for the people of our country.’”
Mr. Trump expressed weariness with the effort, though its failure took a fraction of the time that Democrats devoted to enacting the Affordable Care Act in 2009 and 2010. “It’s enough already,” the president said.
A major reason for the bill’s demise was the opposition of members of the conservative House Freedom Caucus, which wanted more aggressive steps to lower insurance costs and to dismantle federal regulation of insurance products.
In a day of high drama, Mr. Ryan rushed to the White House shortly after noon on Friday to tell Mr. Trump he did not have the votes for a repeal bill that had been promised for seven years — since Mr. Obama signed the landmark health care law. During a 3 p.m. phone call, the two men decided to withdraw the bill rather than watch its defeat on the House floor.
Mr. Trump later told journalists in the Oval Office that Republicans were 10 to 15 votes short of what they needed to pass the repeal bill.
The effort to win passage had been relentless, and hardly hidden. Vice President Mike Pence and Tom Price, the health secretary, visited Capitol Hill on Friday for a late appeal to House conservatives, but their pleas fell on deaf ears.
“Obamacare is the law of the land,” Mr. Ryan said. “It’s going to remain the law of the land until it’s replaced.”
Whatever success Mr. Trump had in making business deals, he utterly failed in his first effort at cutting a deal at the pinnacle of power in Washington, Democrats said.
“This is not the art of the deal,” said Representative Lloyd Doggett, Democrat of Texas, alluding to Mr. Trump’s best-selling book. “It is the art of the steal, of taking away insurance coverage from families that really need it to provide tax breaks for those at the very top.”
Rejection of the repeal bill may prompt Republicans to reconsider the political strategy they were planning to use for the next few years.
“We have to do some soul-searching internally to determine whether or not we are even capable of functioning as a governing body,” said Representative Kevin Cramer, Republican of North Dakota. “If ‘no’ is your goal, it’s the easiest goal in the world to reach.”
Representative Robert Pittenger, Republican of North Carolina, offered this advice to hard-line conservatives who helped sink the bill: “Follow the example of Ronald Reagan. He was a master; he built consensus. He would say, ‘I’ll take 80 percent and come back for the other 20 percent later.’”
Failure of the House effort leaves the Affordable Care Act in place, with all the features Republicans detest.
“We tried our hardest,” said Representative Michael C. Burgess of Texas, chairman of the Energy and Commerce subcommittee on health. “There were people who were not interested in solving the problem. They win today.”
“The Freedom Caucus wins,” he added. “They get Obamacare forever.”