This fight reveals the problem of strength. Because our federal system gives greater weight to less densely populated area where the Republicans are strong, they are an electoral heavyweight. They control both Houses of Congress, and their strength in the states is so great that political journalists at least feel forced to explain that the GOP can’t quite pass constitutional amendments on their own. But the party is also shaped by the extremely high number of safe seats that are either features of our regionalized politics or expansive gerrymandering. A party with so many safe seats and comfortable majorities sure has a hard time governing.
Trump ran his campaign almost entirely as himself rather than as a normal Republican. He stayed away from policy details on health care, promising only that it would be terrific and take care of everyone. Republicans in the House and Senate felt no need to rally to his ideas and so campaigned on their own or none.
That has left the new Republican-dominated government divided in a few ways. The most juicy divide is the one between the populists like Bannon and the tax-cutting wonks like Ryan. But there are other fissures that will make governing difficult.