Let me briefly try to answer this question: how did Republicans fail to repeal and replace the Affordable Care Act? In no order, and off the top of my addled mind at the end of a crushing week:

• They hated Obamacare but they never understood the Affordable Care Act.

This is the uber-explanation for much of what follows. Hating Obamacare became just what you did on the Right. It didn’t mean you understood it, beyond maybe getting that it was a government programme and thus paid for by taxes. It certainly — and this turned out to be very important — did not mean you had any ideas about what it did, how it worked or how many people were benefiting from it ... or how to replace it.

• Obamacare created a new baseline.

It’s hard to take away something — in this case, health insurance coverage for more than 20 million people — from which people are benefiting. This relates to the above; because they did not understand the law, they convinced themselves that calibration problems, of which there were many, were fatal. So, when premiums rose sharply in some of the exchanges, they didn’t understand that most exchange recipients would not see anything like those increases, owing to the subsidies that adjusted to meet the higher costs. They didn’t recognise that fewer than 10 per cent of those with coverage get it through that part of the market. Millions more get Obamacare coverage through the Medicaid expansion, and they convinced themselves that this was a terrible part of a programme that no Republican governor or member of Congress would ever want to keep in place.

• They don’t have a policy bench.

From Trump on down, many of today’s conservatives tend be much more skilled at campaigning, opposing pretty much everything, riling up their bases with antipathy towards the other side and getting elected — granted, that last bit is kind of important — than at the qualities that enable governing, such as compromise and fact-based analysis. Of course, there are thoughtful conservatives with cogent ideas about health policy, but clearly they are of little interest to today’s leadership. How do I know that? Because their replacement law — the American Health Care Act — was an incoherent dog’s breakfast of massive tax cuts for the rich and spending cuts for the poor, more a caricature of Republican policy than actual policy. In this regard, credit also goes to the Congressional Budget Office, for quickly and credibly revealing the damage that would be done by the AHCA.

• The one policy Republicans get is tax cuts, and little else motivates/interests them.

This is a variant on the previous entry, but it meant that a real motivation for the repeal was cutting about $1 trillion in taxes, including two ACA taxes paid mostly by the wealthiest Americans. It is axiomatic that when you cut such highly progressive taxes, the benefits go to those at the top of the scale, and it quickly became clear that, for example, almost 50 per cent of the cuts went to millionaire households. The 400 richest taxpayers, with average income above $300 million, would get a tax break averaging $7 million. Couple that with the sharp cuts in Medicaid and the predicted premium increases for low-income elderly people in their AHCA plan, and even in Washington, the extent of this Robin Hood-in-reverse play was too much for moderate Republicans, many of whom have ACA beneficiaries in their districts from whom they were hearing.

• They’re ungovernable.

It caught my attention when former House Leader John A. Boehner, predicted what just happened a few weeks ago. Part of this was a variation of the “no bench” point earlier: “In the 25 years I served in the United States Congress, Republicans never, ever, one time, agreed on what a healthcare proposal should look like. Not once.” But part was an impossible political Sudoku problem that House Speaker Paul Ryan could not solve: if you try to please the moderates, you lose the hard Right. Boehner learnt that lesson in must-pass votes, like raising the debt ceiling, that he passed with votes from Democrats, which was not going to happen here.

• president Donald Trump wasn’t much help.

When I worked for Obama during his first administration, I vividly recall two challenges in moving legislation: Republicans and Democrats. From Day 1, the Republicans were never with us, but we also quickly learnt that it would take a ton of work to woo our own caucus. I don’t think team Trump is there yet by a long shot. Moreover, he has got some unique problems of his own making: people are learning his “art of the deal” shtick, so they know that what he says on Monday may well be totally different from where he is on Tuesday.

• Their version of reality did not allow for the ACA gaining public support.

Various polls show public support for the ACA hitting its highest level on record, with 54 per cent approval and 43 per cent disapproval.

Their bubble also seems to have kept them from realising that their replacement Bill was in terrible shape re public support. Before they pulled the vote last Friday, former Republican House Speaker Newt Gingrich, of all people, was compelled to tweet out the following: “Why would you schedule a vote on a bill that is at 17 per cent approval? Have we forgotten everything Reagan taught us?”

Readers of this column know my extremely negative take on their replacement Bill, so of course I am very glad about this outcome. But we’re not out of the woods, in part because the ACA is far from perfect and I don’t expect this government to provide it with the maintenance it needs.

Also, while I know that Trump said that if this vote fails, there will be no trips back to this well, recall what I said above about the veracity of such announcements: no one should believe them.

But at least so far, I was wrong when I bemoaned late on the night of November 8: “There goes the ACA.” It’s still standing, and for millions of Americans with affordable coverage, that is a very good thing.

•Joe Bernstein, a former chief economist to former vice-president Joe Biden, is a senior fellow at the Centre on Budget and Policy Priorities, and author of the new book The Reconnection Agenda: Reuniting Growth and Prosperity