It is hard to overestimate the damage the Freedom Caucus has done to the fledgling presidency of Donald Trump, and to the country. By blocking the American Health Care Act of 2017, the conservative group has guaranteed that Americans will struggle forward under the burden of Obamacare. In the next few months insurers will announce their premium hikes for the coming year; chances are, given the continuing withdrawal of major companies from the marketplaces and the ongoing failure of the bill to attract enough young and healthy participants, the new rates will not be pretty. Last year premiums went up 25%; it’s likely the increases will be higher this year.

Republicans will own those higher rates. Their failure to repeal the financial underpinnings of Obamacare and start replacing that failing program with an approach that encourages competition and that embodies numerous other common sense reforms will mean that families hit by ever-higher costs will blame the GOP. Voters elected Donald Trump and a GOP Congress to get this job done – the number one promise of every Republican campaign since 2010.

Now the Republican Party inherits the Sisyphean task of managing Obamacare’s inevitable decline. They are no longer critics; they are now the producers of the show. It is unlikely that House Speaker Paul Ryan or Trump will have the political will and patience to return to the drawing board and attempt to craft a brand new bill. They have made other commitments to voters, and so Obamacare, as a defeated Paul Ryan admitted after withdrawing the AHCA, is the law of the land. Live with it.

Of course, the damage is not limited to healthcare reform. The undermining of the House leadership is profound and clouds prospects of tax reform, infrastructure spending and other important jobs to be done. If Ryan cannot be counted on to herd the cats on healthcare, how do we know he can round up votes on tax reform?

It is the young Trump presidency, however, that takes the biggest hit here. Trump was elected because people across the political spectrum thought he could fix some of our problems. He was the businessman who could import common sense to Washington, and the deal maker who could bring people together. He made big promises; a country tired of stalemate and disappointment believed that he could bring back jobs, reduce our debt, build the wall, find a better healthcare solution.

His credibility and credentials now lie in tatters. All that optimism that has stoked the stock market and boosted investment plans – all that may fade.