Following the 2004 Election, former President George W. Bush famously declared he had earned "political capital, and now I intend to spend it."

His focus was on overhauling Social Security by giving younger workers the option of diverting money to personal accounts. Bush's sales pitch was on the merits of his plan and how much better the future would be. But in the eyes of most Americans, it was a solution in search of a problem because there was no impending insolvency of Social Security. Rarely does anything get done in Washington without a looming crisis.

The Republicans now face a similar situation on healthcare. As the Republican Senate struggles to cobble together 50 votes from the conservative and moderate wings of their party to repeal and replace Obamacare – barely getting enough votes to even proceed to considering it – what is again noticeably absent is an aggressive and coordinated pitch to the American people of why this needs to happen now.

The trouble with the GOP's healthcare reform effort can be traced back to November 8, 2016. No one expected Trump to win the White House, and so they weren't ready to move on real reforms that would be signed into law. In addition, there seems to be a conventional wisdom that the electorate gave Republicans a mandate during the 2010, 2014, and 2016 elections to eliminate Obamacare; however, stump speeches and campaign ads make for lousy legislative language.

Republicans missed an opportunity to hold hearings, consult experts, and build coalitions and consensus early in the process. Instead, they wasted time on a public internal battle for the soul of the party. The result in the House and recently in the Senate was repeated efforts to rush legislation constructed behind closed doors, without CBO scores, to the floor. Leadership and the White House's expectation was that they could force a vote on the rank-and-file to fulfill a campaign pledge. Now, Sen. Mitch McConnell is going off-script again, moving on a freewheeling process that saw its first version of the bill go down, and could create more chaos on the Senate floor. We will see how this strategy plays out, but in the process, Republicans have only managed to energize the opposition.

The Democrats and the mainstream media have seized on the opportunity, selling only the bad part of the Republican proposals - continued premium increases, fewer insured, tax cuts for wealthy, and leaving the most vulnerable at greater risk. And since Republicans hadn't articulated the unsustainable nature of Obamacare that would jeopardize everyone's care, they were saddled with only playing defense when they should have been on offense. The result? Only 17 percent of Americans approve of their alternative.

As the Senate stumbles forward, they may be missing an opportunity for GOP members to get home and make the case for reform by cutting the August district work period short. This only furthers the narrative that they are afraid and unprepared to answer angry constituents.

The president, who claims this is a priority, has shown no leadership and no depth of understanding on the actual reforms. He instead continues to threaten Republicans who oppose the effort. In fact, Trump's investment in this issue is summed up in one recent quote: "I'm waiting for the bill to come to my desk. I hope they do it. They have been promising it for years." So much for teamwork, and so much for the power of the bully pulpit.

Voters are not prepared to buy into another major reform of the tumultuous healthcare insurance system without understanding what is in the bill and why it needs to happen. They fell for that once before when Nancy Pelosi regrettably said, "We have to pass the bill, so that you can find out what is in it."

Republicans should focus on defining the crisis and confidently justifying their plan. If they cannot, then like Bush, the Congress and President Trump should move on to something they can sell – like tax reform for economic growth or fixing America's infrastructure.

Mark Dion is a Founding Partner of Revolution Agency, a leading public affairs and advocacy firm known for its innovative national advertising and marketing campaigns for top issue groups, Super PACs, and Fortune 500 companies

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