There’s a much simpler way to look at this. Think like an online gamer for a minute.
There’s a set of interests in this country who have used a combination of emotional appeals, distraction by social issues, and good old disinformation to get a large set of voters to vote for policies and candidates who are just plain against the economic interests of that set of voters. In gaming terms, I see this as an “exploit”, that is, doing something the game’s designers clearly did not intend (read the Federalist papers), but against which no rule is enforced.
Those interests (think “Dark Money” today, but the same interests were aligned with the other color party 100 years ago) have a particular outcome they want in the health care arena.
Trump is brilliant at ratings and audience, and realized over decade ago that he could hijack this exploit to win a presidential election. However, knowing his audience well, he fully understood that taking the ability to get health care away from a large group of them would not play well in ratings, so committed to the contrary during the campaign.
The divergence of these two positions, one that health care is a thing one buys, and can only buy to the extent of one’s resources, and the other that a basic level of health care is a human right, is not reconcilable without crossing the aisle.
The game, now between the exploiter and the one who hijacked that exploit, has deadlocked.