Much of the commentary following the disastrous failure of “TrumpCare” focuses on the role of the ideological fissures in the Republican Party, the failure of Paul Ryan to understand the dynamics of his caucus, or the lack of policy expertise of Trump and the White house. All of these factors played a minor role, but they ignore the three truly important factors that made it impossible for the GOP to cram “TrumpCare” – or “RyanCare” – or ACA “repeal and replace” — down the throats of Congress and the American people. Factor #1.