2018 Dilemma for Republicans: Which Way Now on Obamacare?

“If you’re going to fumble the ball,” he added, “better to do so in the first quarter of a football game.”

Devising health care legislation that could appeal to both wings of the House Republican Conference — the hard-line conservatives and more moderate members — would require a nearly superhuman feat, added Representative Billy Long, Republican of Missouri.

“Not unless Harry Houdini wins a special election to help us,” Mr. Long said about the prospects of cobbling together a coalition that could agree on how to repeal and replace the health care law.

But other longtime Republicans warned that if the party did not address what they have derided as Obamacare, an issue that has been central to their campaigns for the last seven years, they would incur a heavy political price in the midterm elections.

Midterm campaigns have increasingly become akin to parliamentary elections — referendums on the party in power rather than on individual candidates, where turnout by dependable partisan voters is the deciding factor.

“If they fall on their sword on this, they’re going to get slaughtered,” said former Representative Thomas M. Davis III, a Virginia Republican who himself was once at the helm of the House campaign committee.

“Where parties get hurt in midterms is when their base collapses,” Mr. Davis said. “Democrats are going to show up regardless of what you do. If our voters don’t see us fulfilling what we said we were going to do, they’ll get dispirited.”

What troubles many Republican strategists is the specter of the party’s most reliable voters being bombarded by reminders of their leaders’ failure to address the health law. They fear a recurring story line sure to pop up every time insurance premiums increase, providers leave local networks, or, most worrisome, Republicans fund President Barack Obama’s signature achievement.

Conservatives, many of whom opposed the House repeal bill, now warn that it is untenable to stand pat on the issue — and that lawmakers will face retribution if they do not return to the repeal-and-replace effort.

“If people are looking at a situation where there’s no action on this, there are going to be conversations about primaries,” warned Michael A. Needham, the chief executive of Heritage Action for America, the Heritage Foundation’s political arm, which worked to scuttle the Republican health…

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