The legislation may pass — either Friday or over the weekend. (It almost certainly won’t pass without changes.) But House Republicans had to be feeling a sense of deja vu as it became clear Thursday that despite the efforts of President Trump and Speaker Paul D. Ryan, the votes simply weren’t there to pass the legislation.

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Republicans — led by then-Speaker John A. Boehner — failed time and time again to rally votes behind proposals, from the fiscal cliff in 2012 to the farm bill in 2013 to the debt ceiling in 2014. Each time, the conservative wing of the conference — now organized under the House Freedom Caucus — withheld their votes, insisting that the legislation offered by Boehner was an abandonment of principles.

The inability to appease the party’s conservative wing while also keeping the centrists within the party — yes, they still exist — on board is what drove Boehner into a surprisingly early retirement.

That was then, this is now, Republicans argued in the run-up to the planned health-care vote. Ryan was someone, unlike Boehner, who the House Freedom Caucus liked and trusted. And with Trump in the White House and Republicans with a large House majority and a clear Senate majority, the problems of the last five years were a thing of the past.

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Except not. As Republicans have learned over the past few weeks — and especially in the last few days — having a majority of House and Senate seats as well as the White House ensures you nothing in terms of legislation.

The problem for House Republicans today is the same problem they had in 2012 and 2013 and 2014 and 2015 and 2016. The conference — split, broadly speaking, between activist conservatives and establishment conservatives — simply cannot be consistently led. The House Freedom Caucus not only believes compromise is capitulation but also views Trump’s election last fall as evidence of how unapologetic conservatism can win. The establishment wing of the party — which represents the bulk of competitive seats in swing areas of the country like the Midwest — frets that caving to conservative interests within the GOP could cost them their jobs in the next election.

Since he began running for president, Trump has portrayed himself as a person uniquely able to bring warring sides to the table and cut good deals. That’s why getting some sort of health-care deal matters so much to him.