The effort to convert candidate Barack Obama’s health policy platform into what became Obamacare began just days after the 2008 election, with the release of a detailed white paper written by Senate Finance Committee chairman Max Baucus that bears remarkable resemblance to the Patient Protection and Affordable Care Act, which became law nearly a year and a half later.

Everything that happened in between—dozens of public hearings, hundreds of private ones, countless Congressional Budget Office cost estimates, White House negotiations and agreements with industry and consumer stakeholders—had an impact on the final bill, but the process began with a remarkable degree of Democratic consensus, reflected in the similarities between the initial and final products.

We know from this recent history what a successful legislative effort to reform the health care system looks like. The GOP effort to repeal and replace Obamacare looks nothing like it.

Republican leaders emerged victorious from the 2016 election with no intra-party health care consensus of any kind, and thus, no basis upon which to introduce a blueprint in advance. Without a starting point in mind, nor a single goal, the path has become nearly impossible to trace, as has any sense of what victory would look like to them. As time goes on, their legislative shenanigans look less like the considered advances of parliamentary masters and increasingly resemble defensive maneuvers meant to delay their admission of defeat—and to avoid blame when that day comes.

After weeks of infighting, House Republicans on Monday unveiled a bill that would repeal and replace Obamacare, in the hope that setting events in motion will impel members of Congress to set aside their reservations and pass it. That bill has reportedly undergone several changes, big and small, in recent days—based on both internal ideological dissension and private indications from CBO that their ideas will result in a significant increase in the rate of uninsurance.

