NEW YORK (AP) -- Republicans are expressing embarrassment, fear and frustration as party leaders concede that their years-long promise to erase much of Barack Obama's Affordable Care Act is all but dead.
Conservative activists blamed establishment Republicans who control Congress. Establishment Republicans blamed a lack of leadership from their president. And the Republican president blamed "a few Republicans" and all Democrats for blocking his agenda.
The finger-pointing marked a new low for a Republican Party that swept into power in January and has struggled to govern ever since.
"If embarrassment were fatal, we'd all be dead," Republican strategist Rick Tyler said of his party's performance since taking control of the White House and both chambers of Congress. "The American people have given us enormous responsibility and enormous trust and we're blowing it."
President Donald Trump signaled Tuesday that his party was largely giving up after seven years of promising to repeal the law. The move came after four Republican senators objected to the GOP's latest health care plan, which would have caused millions of Americans to lose their health insurance. Conservatives complained that the measure didn't go far enough in repealing the law.
"I think we're probably in that position where we'll just let Obamacare fail," Trump said, downplaying the political consequences. "We're not going to own it. I'm not going to own it."
The extraordinary development intensified Republican divisions from Georgia to Colorado to Texas as conservatives vowed to punish ineffective Republicans in Congress. At the same time, GOP operatives warned of dire political consequences for the party in next year's midterm elections, when control of the House is up for grabs.
"Everyone's ticked off," said Owen Hill, a Republican Colorado state senator challenging six-term GOP Rep. Doug Lamborn. "All we're seeing is failing to make any traction on fulfilling promises to voters."
With the next election season looming, Republican leaders are grasping for evidence they deserve to stay in power.
Many point to the Trump administration's success in rolling back Obama-era regulations and filling a Supreme Court vacancy with conservative Neil Gorsuch. But since taking complete control of Washington, Republicans have failed to enact any major legislative achievements six months into Trump's presidency.
Asked how they would explain their lack of accomplishments to voters, Senate Majority Leader Mitch McConnell said, "Well, we have a new Supreme Court justice."
That's not a good enough for Republican voters, crucial in midterm elections, who repeatedly were promised health care repeal for seven years, according to Republican pollster Frank Luntz, who called this week's health care failure "tremendously significant."
"I don't think voters who expected, and even demanded, Obamacare repeal will forgive the GOP for failing," Luntz said. "It is about keeping your promises. And if you can't achieve your signature legislation, what exactly can you achieve?"
Indeed, conservative activists, along with like-minded groups such as the Senate Conservatives Fund, quickly vowed to recruit challengers for those "Obamacare Republicans." That was already happening on the ground in several states, including Texas, where Houston hospital executive David Balat, a Republican, is running against nine-term GOP Rep. John Culberson.
"There's hesitation for brave leadership and decision-making based on conservative ideology," Balat said in an interview.
It was the same in Georgia, where former Tea Party Express leader Amy Kremer insisted, "These people have got to go."
"You're now going to see a meeting of the minds about who's going to be primaried," said Kremer, who now leads a pro-Trump political action committee.
Like many conservatives across the country, she lashed out at McConnell and House Speaker Paul Ryan for "trying to derail Donald Trump's agenda" on health care. "It's not a failure on Trump's part," Kremer said. "Everybody knows these people didn't want Donald Trump to win."
On the other side of the Republican spectrum, Chicago-based GOP donor Bill Kunkler blamed Trump for failing to lead on what he called sensible Republican reforms, such as rewriting the tax code.
"It's all dysfunctional and self-inflicted," Kunkler said of the White House's political struggles. He said he sees Ryan as the party's de facto leader.
"I think people feel, like me, that the Republican establishment is the refuge from this maelstrom we're in right now," Kunkler said.
Amid intensifying GOP infighting, many Republicans are warning of a rapidly shrinking window to get anything done. Trump on Tuesday, like some Republicans in Congress, indicated he was ready to shift his attention to the nation's tax code or infrastructure. Yet Washington will only become more bogged down by politics as midterm elections draw closer.
"It's critical they show movement," North Carolina Republican Party Chairman Robin Hayes said of his party's leaders in Congress. "They're showing deadlock right now, and that won't cut it" in 2018.
Looking ahead to the next election, Trump offered a simple solution to those frustrated with the performance of the Republican-led government.
"We're going to have to go out and get more Republicans elected in '18," the president said. "And I'll be working very hard for that to happen, OK?"
Beaumont reported from Des Moines, Iowa. Associated Press writer Bill Barrow in Greensboro, North Carolina contributed to this report.