Mark Meadows's constituents are celebrating the Freedom Caucus chairman's holdout over health care, and the inspector general is probing HHS's decision to kill some Obamacare outreach and ads.

But first: Fallout from the American Health Care Act's failure roiled Washington this weekend.

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OBAMACARE REPEAL IS DEAD. LONG LIVE OBAMACARE? — The stunning collapse of Republicans' health reform efforts on Friday, along with House Speaker Paul Ryan's declaration that "Obamacare is the law of the land," is a radical U-turn for conservative policymakers after seven years of resistance to the ACA.

It also forces a series of hard questions for Republicans, as they look for lessons from the past few weeks and chart a path for the months ahead.

KEY QUESTION #1: WHY DIDN'T THE PRESIDENT CARE MORE ABOUT HEALTH CARE? — Despite hitting repeal hard in the final days of the campaign and promising to get rid of the ACA "on day 1," the president didn't take direct ownership of the repeal effort and didn't passionately sell the bill until it was too late. And rather than simply delay the vote or instruct leaders to write new legislation, Trump decided to move the party forward to tax reform.

POLITICO's Annie Karni has a look at how unengaged Trump was in the health care debate. A conservative policy wonk told PULSE over the weekend that when it came to Trump getting enmeshed in health care policy details, "it was always clear he was too [intellectually] lazy to actually bother."

All that bodes poorly for future efforts to do large-scale health reforms under Trump, the policy experts told us — if he even tries. "Why would he want to touch health care again?" said one.

… POLITICO's Josh Dawsey reported that Trump was less upset about the death of the health bill than he had been about the crowd size controversy at his inauguration, according to White House officials.

… Trump also alienated some Freedom Caucus members when he met with them last Thursday, trying to finally close the deal by urging them to ignore the bill's details and focus on the possible political victory.

"Forget about the little shit," said Trump, multiple sources in the room told POLITICO's Tim Alberta. "Let's focus on the big picture here."

Rather than come on board, Freedom Caucus members were disturbed by Trump's dismissiveness; they cared a whole lot about policies like essential health benefits. Trump picked up no votes from the last-ditch meeting. Much more from inside the Freedom Caucus.

… By Friday, Trump came to the conclusion — after spending weeks asking aides, "Is this a good bill?" — that it was time to move on, White House officials said.

"After all the pushback the bill had gotten, he’d come to realize that it might not be the right piece of legislation after all," POLITICO's Alex Isenstadt reports.

KEY QUESTION #2: WHAT NEXT FOR OBAMACARE? — Pro's Adam Cancryn, Jen Haberkorn and Rachana Pradhan reviewed five possible scenarios for Republicans, and here's a quick takeaway.

1) 'Let it explode.' That's what Trump has warned multiple times, a theme he returned to on Friday, and Republicans have a variety of tactics to force the law's demise. For instance, they could effectively halt the exchanges' cost-sharing subsidies, which would likely prompt insurers to flee the individual insurance market, or ramp up other efforts to undermine enrollment.

But any overt strategy to damage the ACA could backfire on Republicans, as patients affected by the law's possible collapse look for someone to blame.

2) Claim ownership and fix it. Now that it’s on the GOP’s watch — and voters may hold them accountable for its problems — Republicans could decide grudgingly to work to shore up the individual insurance market that even Obamacare supporters acknowledge need fixes.

3) Turn the program red. Republicans could use regulatory authority to push the ACA to have a more conservative tinge, such as rewriting coverage rules and allowing states to impose work requirements on low-income Americans covered under Obamacare’s Medicaid expansion.

4) Try for straight repeal again. Conservatives could eye a measure like the one House Republicans passed in 2015. Once that goal is fulfilled, they say, they can start in on a separate replacement measure.

“Sometimes you’ve got to take a couple shots at something to get it,” said Rep. Scott Perry (R-Pa.), a member of the Freedom Caucus, before Ryan pulled the bill. “I’m confident that what I’m going to do is do everything I can to repeal and replace the ACA.”

5) Work with Democrats — and push choices to the states. It doesn't seem likely right now, given the divisions between the parties. But Trump himself told the Washington Post Friday afternoon that he wanted to work with Democrats — right after he ranted about Obamacare’s implosion. "When it explodes they [Dems] come to us and we make one beautiful deal,” he said.

KEY QUESTION #3: WILL REPUBLICANS SUFFER FOR BREAKING THEIR PROMISE? — After years of GOP pledges to repeal the law, it's not clear yet how much voters will punish Republicans for failing to do so at the first opportunity.

Many GOP supporters had inflated expectations because the party's promise was more than just getting rid of the ACA, Anthony Wright of Health Access California said. "Speaker Ryan keeps talking about what they promised — but they promised not just to repeal but in the very same breath to replace, with something that would provide better coverage," Wright pointed out.

… The Washington Examiner's Philip Klein thinks it's the "biggest broken promise in political history."

Klein runs through the four election cycles where the GOP promised to repeal and replace, pointing out that the backlash to the law in 2010 helped propel Republicans to the House majority and the botched rollout of the ACA's exchanges in 2013 helped them win the Senate the following year.

"Here's the bottom line: Republicans didn't want to repeal Obamacare that badly," Klein writes. Their opposition was more about convenient politics than policy, he adds; "Obamacare was a useful tool for them."

** A message from PhRMA: Did you know 4 former FDA Commissioners, both from Republican and Democratic administrations, sent a letter to Congress warning about the dangers of drug importation? “[W]e believe … importation represents a complex and risky approach—one that … is likely to harm patients and consumers … .” http://politi.co/2mZxGgO **

KEY QUESTION #4: WHO GETS THE BLAME? — The GOP finger-pointing is in full thrust, and — predictably — the Freedom Caucus has been taking the brunt of other Republicans' criticism.

"If this bill goes down,” warned Rep. Michael Burgess (R-Texas) before the vote was pulled, “that's our chance. Then we've got Obamacare forever. And that'll be on them.” Trump also took a high-profile shot at the group on Twitter. “Democrats are smiling in D.C. that the Freedom Caucus, with the help of Club For Growth and Heritage, have saved Planned Parenthood & Ocare!” the president tweeted on Sunday.

Meanwhile, Rep. Ted Poe (R-Texas) resigned from the Freedom Caucus over the group's opposition to the Republican plan to repeal and replace Obamacare. POLITICO's Kyle Cheney and John Bresnahan have more on the party's infighting.

But Mark Meadows returned home to a hero's welcome. Yes, the Freedom Caucus chairman embarrassed the White House and forced his fellow Republicans to turn tail on a seven-year pledge to tear down Obamacare. But his constituents are throwing him a party, Pro's Adam Cancryn reports from western North Carolina.

“This is the face of leadership!” declares a flyer posted by the local tea party in Highlands, N.C., urging supporters to turn out for a rally celebrating the three-term congressman. “Thank Mark and all those who gave us an opportunity to get health care right.”

… The support for Meadows' principles is echoed all over the town, Adam reports, and it strikes at the heart of the dilemma facing Republican leaders — how to enact big complex legislation without compromising the ideological purity they nurtured for years among lawmakers and voters alike.

Especially because the 30-member-plus Freedom Caucus is big enough to derail any Republican bill deemed insufficiently conservative — and it’s backed by voters eager to reward them, even if it means bringing down still more of the GOP hierarchy. More for Pros.

Other Republicans also taking heat. Ryan's been widely attacked in public, and Trump privately has questioned Ryan's strategy to make health care his first legislative priority. HHS Secretary Tom Price also has been criticized by conservatives who say he didn't do enough to fully repeal the ACA or win Capitol Hill lawmakers — his former colleagues — to his side.

Several more top officials are taking behind-the-scenes flak, including:

— Gary Cohn. The director of the National Economic Council and longtime Democrat has been targeted by Steve Bannon, Trump’s populist-minded chief strategist, who's charged that Cohn was too willing to make concessions to mainstream Republicans that repelled the hard-line House Freedom Caucus, Alex Isenstadt reported. More.

— Reince Priebus. The former RNC chairman was elevated to his current role because he was seen as a savvy Washington operator who could help the newcomer Trump — but fellow White House officials said the health bill's failings revealed the limits of his reach.

THIS IS MONDAY PULSE — Where the entire health reform debate came and went with nary a sign of Trump's own health plan — despite, as Harvard's David Cutler notes, Trump repeatedly saying he was nearly done with it.

This writer knows: It's never a good sign if you keep promising that you're just about to file. But if you end up finding Trump's plan, or anything else, tip ddiamond@politico.com or @ddiamond on Twitter.

With help from Jen Haberkorn (@JenHab)

MORE ON OBAMACARE

OIG probing administration's decision to kill ads, outreach at the end of the enrollment season. The news broke on Friday, just as the bill was getting pulled — and less than an hour after Ryan said that the ACA was "the law of the land."

"We will conduct a fact-finding review of … the timeline, decision-making process, and factors considered by HHS, including any analyses of implications for enrollment," Inspector General Daniel Levinson wrote in a letter to Sens. Elizabeth Warren (D-Mass.) and Patty Murray (D-Wash.), who requested the review.

The senators said the review is necessary following the Trump administration’s early moves to weaken the Affordable Care Act. Enrollment in the ACA exchanges this year fell for the first time since the marketplaces launched in 2013.

IN CONGRESS

Bernie Sanders to introduce Medicare-for-all plan. “I'm going to introduce a Medicare-for-all single-payer program," Sanders told anchor Dana Bash on CNN's "State of the Union." The Vermont senator, who has repeatedly stated his support for such a plan in the past, said he hoped to garner bipartisan support for the plan. More.

AT THE WHITE HOUSE

Jared Kushner to lead ‘Office of American Innovation.’ The president’s son-in-law and senior adviser will lead the new effort, which will report directly to Trump, the Washington Post reports.

“Viewed internally as a SWAT team of strategic consultants, the office will be staffed by former business executives and is designed to infuse fresh thinking into Washington, float above the daily political grind and create a lasting legacy for a president still searching for signature achievements,” WaPo’s Ashley Parker and Philip Rucker write. More.

Two early priorities for the office:

- Tackling VA health care. “The team plans to focus its attention on reimagining Veterans Affairs,” Rucker and Parker write.
- Combatting opioid abuse, with Chris Christie in key role. Christie, who’s been working on the issue with Kushner for several weeks, will chair an official commission.

For context: Other presidents have pursued similar initiatives. While it’s not mentioned in the piece, the Reagan and Clinton administrations set up commissions and attempted to import business ideas into government, too.

Former President Barack Obama went even further — using the same SWAT team language — by tapping ex-business executives like Jeff Zients, former CEO of the Advisory Board Company, to fill new roles like Chief Performance Officer. Unlike Kushner's role, those jobs were subject to Senate confirmation.

NAMES IN THE NEWS

Merrill Goozner to retire as Modern Healthcare editor. The well-regarded health care and business journalist, whose decades-long career includes a stop at the Chicago Tribune and the book "The $800 Million Pill," will continue to write. "One of the smartest people I have met!" tweeted Rulon Stacey, a former hospital CEO.

WHAT WE'RE READING

A Heritage Foundation alum who's been critical of transgender rights will lead the civil rights office at HHS, ProPublica's Charles Ornstein reports. More.

WSJ’s Louise Radnofsky details how ex-Obama administration officials like Leslie Dach and Andy Slavitt — often working behind the scenes — aided in the demise of the Republican health bill. More.

Speaking of Slavitt, the ex-CMS administrator — who’s newly installed at the Bipartisan Policy Center — lays out a bipartisan path forward on health care in USA TODAY. More.

The real national security threat is deadly disease, but the Trump administration isn’t prioritizing it enough, epidemiologist Michael Osterholm and documentarian Mark Olshaker warn in the New York Times. More.

In Modern Healthcare, Steven Ross Johnson details how the opioid crisis increasingly is hitting the nation's middle-class suburbs. More.

Deadspin rounds up the various pro-GOP ads that aired on Friday night — after the AHCA had been pulled — erroneously congratulating Republicans on "keeping their promise" and replacing Obamacare. More. Some of the ads, which were pre-paid for by the American Action Network, praised congressmen who ultimately said they wouldn't vote for the bill.

Harold Pollack argues simply and forcefully: The Republicans' health effort failed because Speaker Paul Ryan's health plan was awful. More.

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