Today the American people, especially Republican voters, realize that the GOP exists only to peddle red meat ideas to their base in order to gain access to Washington, and then dump those promises immediately upon joining the Swamp.
"Repeal and replace Obamacare" is not some vague platitude like "defend the Constitution" or "fight for the rights of the unborn". It's a concrete policy target whose success or failure cannot be spun in the way the other red meat promises can be. And their effort failed, big-league, despite controlling all branches of government.
It was all just a lie to elect more of their party into the Congress for their own sake, and to raise boatloads of donor money on the theme.
Trump went to bat for the GOP Congress -- not zealously, but at least holding pow-wows, threatening unwilling Congressmen, and refraining from advocating his own longstanding single-payer goals. He used their slogan on the campaign trail, "repeal and replace". He did not appear to be at war with his own party in Congress, or even neutral.
The public will probably link Trump with the healthcare bill failure, just as they did when Trump's approval ratings took a nosedive right after the House's first failed attempt back in March. Trump had nothing to do with the creation of that bill or the dynamics of its failure, but unless he was vocally against it, Republican voters assume he was roughly on the same page as them idea-wise, and part of the same team effort to pass it mechanics-wise.
So they blamed him for being part of the losing team: maybe he didn't do enough to put good ideas in it, or didn't do enough to cajole the hold-outs by using his supreme office and bully pulpit.
Now that the GOP brand has been cemented as being cynical liars and spineless do-nothings, the Trump faction must distance itself from the GOP. The plan was for the bold, fresh Trump movement to stage a hostile takeover of the GOP and subject it to a major brand rehabilitation, to keep it viable and even thriving long-term.
But so far, the GOP is dead-set against adapting itself to the Trump movement, other than giving in somewhat on re-industrialization. They are determined to ride it till the wheels fall off. They'll all either have golden parachutes, to mix metaphors, or they'll have their brains rotted out by tumors anyway.
We'll see if the new RNC Chairwoman, Ronna McDaniel, can right the ship or not. It means making a decisive break with the failed conservatism of the past several decades, orienting toward populism and nationalism, and fielding candidates who are sincere rather than feckless or outright deceitful.
The temptation will be the status quo because there's simply far too much donor money and influence with power groups (Pentagon, Big Pharma, Wall Street, media, etc.) from sticking with what has failed.
The elites and their power groups are degenerate, clueless, wasteful, and dangerous. They must be ignored, and the general public appealed to. In other times, when we had an elite that was stewardship-minded, you could just rely on them and not so much on public outreach. But now that the elite is so infested with parasites, they cannot be relied on to produce results, let alone guide something as large as one of the two national parties toward long-term sustainability.
Trump won with the people, not the elites or any of their power groups -- indeed, against their constant and hysterical objections. The GOP can either imitate the successful, or go extinct.
If Trump tries to advance his big plans through Congress rather than the executive branch, and especially if he plans on only working with the GOP, his winning ideas will inevitably become corrupted by the losing Republican Establishment. His momentum will tumble off a cliff, and after perhaps limping into re-election, the movement will get cut off from top power after that.
That leaves three paths:
1) Advance the agenda through executive branch parallels of legislative functions, like Obama did, by getting creative if necessary. Works best for things that the public is not too interested in, or won't mobilize over. E.g., ending support for jihadist militias in Syria.
2) Go through Congressional GOP, but against their failed orthodoxy, and daring them in public to defy him and the tens of millions of voters who finally delivered the White House to a Republican. He must back this up with a threat to sic his mob of rabid supporters on anyone who defies the majority of citizens. E.g., deporting at least half the illegal population by the end of his term, de facto end to labor-related visas, etc.
3) Go through Congress on a topic with bipartisan appeal, like infrastructure.
The common theme in those paths is that they don't require a lot of political capital, since Trump has effectively zero or negative capital among DC Swamp dwellers. Something that everyone loves, like rebuilding roads and airports, doesn't require Trump to give them anything beyond his signature at the end. Something that the GOP opposes, but that the Trump mob demands, can be gotten by appealing to those with whom he has immense capital (citizens). And executive actions are unilateral, although making sure they are enforced is another question.
After six months of failing at their own topics rather than pursuing and achieving the Trump agenda, it's pretty clear that the GOP will never consider Trump's political debt paid off, after he burned their party and brand to the ground during the primary and general. So even if he does build up a modicum of capital with them over four years, they will not consider it enough to put him in positive territory, and they will therefore never do him any big favors in good faith. They won't even call off the Deep State coup, and they control all branches of government.
The natural first step would be for Trump to re-adopt his campaign trail tone about how he's not a conservative, how he wants to convert Democrats and Independents, while also detailing what a disaster the other major party is too. Everybody already sees how much the Democrats suck, though: they don't control anything because no one trusts them. The Democrats are a thoroughly defeated non-entity in contemporary politics.
What matters now is distancing himself from the GOP, which people actually do trust, but which consistently disappoints and outright betrays them. Whether that eventually leads to forming a new second party to supplant the GOP, or whether enough pressure causes the GOP to finally relent and let the Trump movement take over, remains to be seen. But we can't tolerate any more typical Republican bullshit, or the stench and disease will rub off on the Trump movement as well.