Over the course of Barack Obama’s presidency, House Republicans voted to partially or entirely repeal the Affordable Care Act so many times that watchers lost count at around 60. But it seems the GOP didn’t truly believe it could win the White House in 2016, because they never coalesced around a non-symbolic plan to repeal Obamacare and what, if anything, to replace it with.

Republicans on Capitol Hill today are thus mired in dysfunction. The main impediment to repealing Obamacare is a substantial bloc of GOP lawmakers who won’t vote to repeal the law without a replacement in hand, and the main impediment to replacing Obamacare is a lack of consensus among Republicans about what they should enact in its place.

That consensus eluded Republicans for the entire Obama presidency—long enough to suspect it isn’t going to arise now, magically, in the brief window Republicans have to make good on years’ worth of promises that seem more impossible each day. President Donald Trump invited derision on Monday when he said, “nobody knew health care could be so complicated,” yet he was merely revealing he had been taken in by those very promises.

But the drive to repeal Obamacare has its own momentum. Republicans have staked so much of their credibility on the repeal pledge that they can’t easily walk away from it. Even if President Donald Trump and GOP leaders recognized that they were marching their party into a trap, they are gripped by a collective action problem, wherein nobody wants to be held accountable for failure or surrender.

This has left repeal supporters grasping for tactical maneuvers that might salvage the repeal-and-replace strategy. They’re coalescing around a carrot-and-stick approach that combines a morally obscene sales pitch and an aggressive squeeze play, meant to cow squeamish Republicans and far-right hardliners into submission before the window closes.