First, they could keep negotiating with themselves on a repeal and replacement bill, but the difficulties this week make it increasingly clear just how hard it is to write legislation that would bring together a coalition of Freedom Caucus conservatives and moderates in politically vulnerable districts.

Alternatively, they could use executive powers to starve Obamacare by denying funding, while pushing regulatory buttons that unravel it. People would lose coverage, and the whole thing could collapse.

The other option is a more modest “repair” bill that keeps the foundation of Obamacare — such as the online marketplaces, the subsidies and Medicaid expansion — while addressing weaker parts of the law. That effort might even attract some Democrats, but it would be politically risky for a Republican Congress — and president — who campaigned for four election cycles on repealing Obamacare.