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For the six years they ran the House before President Donald Trump arrived on the scene, Republicans voted repeatedly -- more than 50 times -- to either fully repeal, defund or in some way undermine Obamacare. On Capitol Hill or back home, they railed against the law, pledging to gut it -- if voters would only hand them the fillet knife.

And then, after some convincing, voters did.

The simple promise, launched years ago, to "repeal Obamacare" was the first, crucial error. Not because it wasn't a winning message, but because it was, in a way, too good. It was simple and clear. But there was no open reckoning with the downside and little apparent planning for the day it became possible. Clawing back welfare programs is never politically popular. For those who insist on trying, common sense says plowing ahead without a stress-tested alternative will only complicate matters.

A look back at recent comments from Republican officials on the front lines of the fight offers some telling suggestions. At the root is a very simple matter of conservative orthodoxy and the possibility that Republicans, newly empowered by Trump's election, appear to have read into his win a broader mandate than voters actually offered. That shouldn't come as a shock. Both parties tend to make too much of their presidential fortunes.

But Republicans on Capitol Hill set to work in 2017 with little more than a series of talking points -- the kind that seemed more in line with Reagan-style convervatism than Trumpism. Right off the bat, the idea of providing better access to medical care, which would be shifted back in the direction of the open market, emerged as a central theme of their pitch.

Health and Human Services Secretary Tom Price, during his confirmation hearings in January, telegraphed the strategy. Skirting skeptical Democrats' cross-examinations, he promised to work with Congress to assure "every single American has access to affordable coverage." During an earlier round he said all Americans should "have the opportunity to gain access" to it.

But access does not equal coverage. Asked on CBS's "Face the Nation" how many people might lose coverage under the House plan, Speaker Paul Ryan said the number of uninsured would likely rise, but sought to frame it as a symptom of well-exercised "individual freedom."

Facing pressure from both moderates jolted by a fierce opposition and hardliners who still preferred full repeal, Ryan pulled the initial bill. A tweaked version designed to convert Republican holdouts would pass, narrowly, about a month later.

Over time, Republicans began to back off the "access" proposition, but never seemed to agree on a new direction.

Senate Republicans promptly trashed the House legislation and set about writing their own.

But there was another problem brewing. Congressional GOP messaging about what the final product would deliver ran up most rudely not against Democrats' objections, or protesters at town hall meetings, but the most powerful Republican of them all: the President. Throughout his campaign, Trump promised, vaguely but consistently, that his health care plan would cover more people and -- crucially now -- not mess with Medicaid.

"That ought to be the goal -- repair, replace, whatever the words are people use today," he said. "The question is, (is) there something that can be done, and I await that conclusion."

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Why the Republican health care message is floundering - CNN International