Health Care Has G.O.P. Down. Tax Cuts May Be the Cure.

Americans for Prosperity, the Koch group that will be most involved in the push, says it has spent nearly $1 million so far on lobbying and advertising efforts, including more than 500 meetings with lawmakers and their staff members on Capitol Hill and ads directed at Republicans on the Senate and House committees responsible for tax policy. By the time debate begins on a tax bill, expected later this year, the group will most likely have spent several million dollars more, its strategists said.

The American Action Network, another conservative policy group, expects to invest more than $20 million in an advertising campaign promoting tax changes, more than it spent pushing for the health care bill.

“The American Action Network spent $15 million on health care reform since Jan. 1,” said Corry Bliss, the group’s executive director. “Looking ahead to the tax initiative that we’re all waiting for,” he added, “$15 million from our perspective is the starting point.”

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An ad for Americans for Prosperity, which has spent nearly $1 million lobbying for tax reform. Credit Americans for Prosperity

Underlying this kind of spending — on a policy, no less, that was once expected to be a relatively easy lift for Republicans — is a rising sense of urgency. Republicans fear they could be looking at a worst-of-two-worlds scenario in which they have a historically unpopular president dogged by persistent legal and ethical questions, at the same time they remain unable to restore a semblance of functionality to Capitol Hill.

Watching efforts to repeal and replace the Affordable Care Act fall apart was more than just a setback for conservatives who disliked the law, which expanded the government’s role in health care and created an expensive new entitlement program. For some, it was a demoralizing glimpse into a future in which Republicans have all the power in Washington but they are powerless to do anything with it.

“Anytime a party is given this kind of opportunity, you’re judged by the product you produce,” said Josh Holmes, a Republican strategist and former aide to Mitch McConnell, the Senate majority leader.

The inability to produce is especially problematic for the Republican Party, which portrays itself as more capable and efficient when it comes to running an unwieldy federal bureaucracy. “Where Republicans have their biggest problem,” Mr. Holmes said, “is when all of a sudden they look like they don’t have their hand on the wheel.”

In that sense it is competence — and not the accusations of corruption or collusion that have led to various investigations into the Trump campaign’s ties to Russia — that most worries many Republicans.

A perception of ineptitude could be especially damaging for President Trump, who portrays himself as a master problem-solver and deal maker who promised voters that the country under his leadership would be run so competently, “You’re going to be so sick and tired of winning.”

Many conservatives brushed aside doubts about Mr. Trump’s readiness to be president — and his true commitment to conservatism — and voted for him because he represented their best shot at pursuing an agenda that would begin rolling back what they saw as an egregious expansion of government under President Barack Obama.

And while conservatives have much to cheer under Mr. Trump’s presidency so far — a decidedly conservative new Supreme Court justice, a rollback of regulations on business, and plans to withdraw from the Paris climate pact — he has yet to fulfill some of his biggest campaign promises.

Planned Parenthood has retained its federal funding, despite Mr. Trump’s repeated vows to cut the group off, a promise that has died, for now, with the health care bill. Just this week, Mr. Trump recertified the international agreement with Iran that curtails its nuclear program, despite having repeatedly said it was “the worst deal ever” and that he would renegotiate it. And construction of the wall he promised along the country’s southern border has not begun.

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David H. Koch, above, and his brother Charles G. Koch are financing a network of groups pressing for tax reform. Credit Phelan M. Ebenhack/Associated Press

“The governing party has to govern,” said John Shadegg, a Republican former congressman from Arizona. “And especially when you make the case for eight years that you can do it: ‘Give us the House; we can fix this. Give us the Senate; we can fix this. Give us the White House and we can fix this.’ ”

“You cannot make a promise for eight years,” he continued, “and simply say, ‘Eh, when push came to shove, our promises turned out to be wrong or too difficult.’ ”

Mr. Trump’s supporters have demonstrated a tendency to forgive. But Republican lawmakers may find voters far less sympathetic. And as conservatives digested news on Tuesday of the failed health care effort, their disgust was evident.

“We may well be witnessing one of the greatest political whiffs of our time,” said Rich Lowry, editor of National Review.

In an editorial on Wednesday, The Wall Street Journal described the week’s events as “one of the great political failures in recent U.S. history,” going as far as endorsing efforts to unseat the disloyal senators. “If the Obamacare Republicans now get primary opponents, they have earned them,” the paper said.

As the radio host Hugh Hewitt took calls from irate listeners, he predicted political ruin for Republican senators like Dean Heller of Nevada who had opposed the bill. “Boy are people mad,” he said. “They are mad as hell.”

But banking on a tax overhaul as a springboard for a dispirited Republican Party may not be a sure thing. The issue does not have the potency and emotion of the Affordable Care Act, which also had an easily demonized antagonist in Mr. Obama. Democrats will be waiting to pounce with criticisms that the Republican plan is a big giveaway to the rich. And the conservative grass roots may find the policy lacking in populist appeal.

Either way, said Levi Russell, director of public affairs for Americans for Prosperity, Republicans need to move in unison on this issue.

“Clearly that’s what we lacked during the health care debate,” he added. “Republicans were not unified around a solution.”

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