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U.S. Speaker of the House Paul Ryan departs after delivering remarks and taking questions at a press conference at the U.S. Capitol after President Trump's health-care bill was pulled from the floor of the House of Representatives March 24, 2017 in Washington, DC.Win McNamee/Getty Images

Donald Trump was forced to back down from scrapping Obamacare Friday after the Republican-controlled Congress failed to agree on a repeal and replace bill, a blow to one of the party's largest campaign promises and a setback for the President's agenda.

Getting rid of former president Barack Obama's Affordable Care Act was a GOP rallying cry for seven years. But when push came to shove, the party's moderates and hardliners split on the legislation and the U.S. President's frantic, last-minute efforts to broker a compromise came up short.

Mr. Trump and Speaker Paul Ryan decided to pull the proposal, the American Health Care Act, on Friday afternoon shortly before it was to come to a vote in the House of Representatives. The Republicans hold a comfortable majority of seats, but more than twenty of their own caucus planned to vote against the proposed law.

Read more: Trumpcare (or Ryancare) is dead, for now. Who killed it?

Speaking with reporters in the Oval Office, Mr. Trump labelled the Democrats "losers" and tried to blame them for killing his bill, even though his own party controls the House. He also declared that "Obamacare … soon will explode," and said cryptically that he had "learned a lot about loyalty" from the debacle.

"We were very close. It was a very, very tight margin. We had no Democratic support," Mr. Trump said. "We all learned a lot. We learned a lot about loyalty."

Backing down on health care augers poorly for Mr. Trump's ability to push through legislation, a particular problem when other items – including a promised tax cut, funding for his planned wall on the Mexican border and a renegotiated North American free-trade agreement – will need Congress's approval. It is the latest block to a presidential policy, coming a little more than a week after his temporary ban on refugees and a freeze on all immigrants from six Muslim-majority countries was suspended by the courts.

It is also troubling for the GOP which, despite controlling the White House and both houses of Congress, failed to get a core campaign promise beyond an early hurdle in the legislative process.

The climbdown capped a dramatic 48 hours, in which legislators rushed between the White House and the Capitol as Mr. Trump and Mr. Ryan tried to reach an agreement to save the bill. Mr. Trump issued an ultimatum: If the House failed to vote on the bill Friday, he would abandon the project and move on to other things. Shortly before the scheduled 3.30 p.m. vote, after Mr. Ryan told the President there was not enough support to pass it, the pair agreed to instead pull the legislation.

"I will not sugarcoat this: This is a disappointing day for us. Doing big things is hard," Mr. Ryan told reporters as he announced that the legislation would be taken off the table. "This all kind of comes down to a choice: Are all of us willing to give a little to get something done? Are we willing to say 'yes' to the good, to the very good, even if it's not perfect?"

He blamed the failure on the party's "growing pains" as it tries to learn how to govern after years in opposition.

Part of the problem was the sheer complexity of the U.S.'s private health-care system. Obamacare used a combination of new regulations on the insurance industry and subsidies for low-income people to expand health-care insurance coverage to 20 million people who previously did not have it. The drawback was that it caused premiums to rise for some people who were already insured.

The AHCA, crafted by Mr. Ryan and other congressional leaders and backed by Mr. Trump, rolled back parts of Obamacare while leaving others intact. For instance, it did away with some of the subsidies and ended a rule that obliged people to have insurance, but kept a law that compelled insurers to cover people with pre-existing conditions.

The result was that the Freedom Caucus, a group of hard-right GOP House members, refused to back the repeal bill, arguing it did not repeal enough of Obamacare. Mr. Trump met repeatedly with the hardliners seeking a compromise, but refused to back a full repeal, which would have turned moderate Republicans against him. As it was, the non-partisan Congressional Budget Office estimated that the AHCA would cause 24 million fewer people to have health insurance by 2026 than if Obamacare were retained. A poll this week from Quinnipiac University found just 17 per cent of respondents supported the AHCA. Mr. Trump's failure will also embolden the Democrats, whose caucus solidarity – in contrast with that of their GOP rivals – could help thwart the other pieces of Mr. Trump's agenda that require Congressional approval.

Nancy Pelosi, the Democratic leader in the House, crowed that public pressure kept the GOP from repealing the bill and also said the party had botched its attempt at repeal by trying to rush it through with minimal consultation. Republican lawmakers have been bombarded with anger from constituents at town halls since the repeal bill was unveiled.

"The reason that they lost was because of actions they took or did not take. But it was also because the American people weighed in. Our phone lines were deluged," she said. "Let's breathe a sigh of relief for the American people that the Affordable Care Act was not repealed."