The Republican healthcare plan looks really and truly dead - but that doesn't mean Obamacare is safe

• The GOP effort to repeal Obamacare appears dead for now.
• One GOP senator says the party is "too divided" for a restart right now on healthcare.
• The Trump administration could seek to weaken Obamacare through a number of executive measures.

After numerous resurrections, false starts, and missteps, the Republican attempt to repeal and replace Obamacare on a straight party-line basis looks like it is truly dead.

The defeat of the attempted "skinny repeal" of Obamacare on Thursday appears to be enough to put the idea to rest for now. GOP lawmakers expressed doubts that another bill would come up, and the brutal stretch of must-pass legislation ahead on the calendar likely puts the GOP Obamacare effort on the back burner.

Nevertheless, the White House has attempted to revive the push by getting behind a plan advanced by Republican Sens. Bill Cassidy, Lindsey Graham, and Dean Heller. The plan would have shifted the funding for Medicaid and other healthcare needs to the states in a block-grant form.

According to reports, the trio met with President Donald Trump regarding the plan and brought in Rep. Mark Meadows, the head of the conservative House Freedom Caucus.

Trump used the bully pulpit of Twitter over the weekend to lay into Republicans for failing to pass a repeal and replace bill, even going so far as to call GOP senators "quitters" and threaten the healthcare of members of Congress.

But many Republican leaders have simply moved on.

Senate Majority Leader Mitch McConnell said it was "time to move on" after last week's healthcare bill failure and focus on other priorities before the Senate recesses in mid-August.

Sen. Orrin Hatch, the head of the Finance Committee, told Reuters that the Republican conference was too far apart on the issue to sustain another attempt on repeal and replace.

"There's just too much animosity and we're too divided on healthcare," Hatch said.

And Sen. John Thune - the third-highest ranking GOP senator - told Politico's Burgess Everett and Jennifer Haberkorn that the healthcare effort is off the table.

"Until somebody shows us a way to get that elusive 50th vote, I think it's over," Thune told Politico. "Maybe lightning will strike and something will come together but I'm not holding my breath."

Additionally, the math makes any sort of revival for the repeal and replace bill nearly impossible. With Sen. John McCain gone through August for treatment on brain cancer, McConnell could only lose a single Republican vote to pass a bill. Sens. Susan Collins and Lisa Murkowski, who voted against every GOP healthcare measure, are enough to sink any push.

There's still work to be done

The US healthcare system could still see some adjustments throughout the rest of the year.

For instance, there have been repeated calls from both sides of the aisle to work on a bill that would stabilize the individual marketplace - in other words, what people think of as the Obamacare exchanges. Ideas include guaranteeing critical cost-sharing subsidies via congressional appropriation, setting up a stability fund for states to try to bring down premiums, and rolling back parts of the employer mandate.

Those could happen in separate legislation or as part of the Children's Health Insurance Program (CHIP) reauthorization, which must be passed by the end of September.

While the end of GOP-overhaul efforts could mean fixes to the Obamacare markets, it does not mean the law is free of danger.

The White House and the Department of Health and Human Services could use a variety of tactics to stir up trouble in the Obamacare markets and cause its "collapse," including yanking the cost-sharing payments, halting the enforcement of the individual mandate, and cutting off funding for key programs designed to get people into the markets.

Complicating all of this is a jam-packed schedule for Congress in the back half of the year. Before the end of September alone, Congress needs to pass legislation to avoid a shutdown, raise the debt ceiling, and reauthorize several government programs.

Throw on top of that the GOP's pivot to tax reform, which the White House wants done by the end of 2017.

A revived health bill would "take time," said Greg Valliere, chief strategist at Horizon Investments. "Lots and lots of time."

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