WASHINGTON -- Sen. Mitch McConnell, the Republican leader, gambled on health care policy and Senate politics this week -- and lost big when efforts to influence both failed.
The defeat of Sen. Luther Strange, the Alabama Republican who was defending the Senate seat he was appointed to, and the implosion of the party's last-ditch attempt to repeal the Patient Protection and Affordable Care Act marked twin setbacks for McConnell, who has struggled to govern with an already slim majority.
Now the majority leader, celebrated for years as a brilliant tactician, looks vulnerable to dissent within his Senate conference and to insurgents from President Donald Trump's populist wing of the party, who want to storm the Senate in 2018.
"We have to deliver on tax reform," said Sen. John Thune, R-S.D., who is a member of the party's leadership. "I don't think failure is an option."
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Strange lost his primary runoff to Roy Moore, the former chief justice of Alabama, who made attacking McConnell a central feature of his campaign. Allies of McConnell poured money into the primary contest, painting Strange as a reliable Trump loyalist and Moore as a lifelong, untrustworthy politician.
But that story line never broke through. In fact, the race spotlighted growing divisions between establishment Republicans personified by McConnell and his allies and Trump Republicans, even though it was Strange who had the president's endorsement.
The gap was so wide that when Trump campaigned for Strange, he tried to distance Strange from McConnell.
"They say he's friendly with Mitch -- he doesn't even know Mitch McConnell," Trump told a crowd of several thousand people.
That wasn't quite true, because the Senate Leadership Fund, a political action committee that McConnell helped found, spent nearly $9 million trying to elect Strange, said Steven Law, its president and chief executive officer.
Strange's defeat raised questions about McConnell's leadership.
"I'd hate to think about where we would be without Sen. McConnell's efforts. But I think we'll learn from it, and we'll adjust," McConnell's No. 2, Sen. John Cornyn of Texas, said of Moore's victory. "We're all listening and watching very closely and trying to understand the message that's being sent."
To some conservative campaign operatives, there was little question about that message.
"Alabama was a rejection of Mitch McConnell and the entire Republican establishment that he represents," said Andy Surabian, senior adviser to the pro-Trump group Great America Alliance, which spent more than $150,000 on Moore's behalf.
McConnell did get a vote of confidence from Trump, who told reporters asking whether he had confidence in the majority leader: "I do have confidence in him, yes. I do have confidence. But it's really not up to me, it's up to the Senate, but I do have confidence in him. I will say they used him in the race, and I was very honored by the way I was treated in the race, but they used him in the race."
With Democrats across the country energized by the election of Trump, some analysts said Democrats now have an outside chance to pick up the seat -- even in a deeply conservative state like Alabama. But if Moore wins, he will almost certainly be a wild card in the Senate, where McConnell is already struggling to keep his majority of 52 Republicans in line.
"The stakes here are high," said Scott Jennings, a Republican strategist who is close to McConnell. "His majority of 52 is slim, and it's even slimmer when you consider at any given time there are four to six of them who are contrarians. So if you take out a Luther, who is not a contrarian, and you throw in a Roy Moore, who's going to be a contrarian, that makes the majority even less effective and productive."
And it could get worse. Buoyed by Moore's victory, conservatives like former Trump strategist Steve Bannon and Sarah Palin, the former governor of Alaska, now speak of separating "Trumpism" from Trump, and they are throwing themselves behind insurgent populists around the country.
Already, "Trumpist" candidates have emerged to challenge Sens. Dean Heller of Nevada and Jeff Flake of Arizona in Republican primaries next year. Bannon is courting another firebrand, state Sen. Chris McDaniel, to challenge Sen. Roger Wicker of Mississippi, who embodies low-key country-club Republicanism.
And Bannon and allies are looking for a populist candidate to run for the Tennessee U.S. Senate seat that opened up Tuesday when Sen. Bob Corker, a Republican, announced that he would not run for re-election.
Victories by such candidates would remake the Senate and threaten McConnell's leadership.
"Today, every conservative in America wishes they had a Roy Moore running for the Senate in their state," said Richard Viguerie, the conservative direct mail pioneer. He called Moore's victory "a stunning rejection of Mitch McConnell's corrupt and incompetent leadership."
In the Senate, McConnell has a deep well of support within his caucus, in part because he is effective at raising money to re-elect people. Even so, Republicans are clearly frustrated by the legislative gridlock that has gripped the chamber, especially the on-again, off-again effort to repeal the Affordable Care Act. The latest effort ended Tuesday when McConnell concluded that he did not have the votes to pass the so-called Graham-Cassidy bill, which would have taken money spent under the law and given it to the states in the form of block grants.
"I wasn't sent up here to sit around and talk," complained Sen. John Kennedy, a freshman Republican from Louisiana. "I was sent up here to make ordinary Americans' lives better."
But Kennedy said he did not blame McConnell for being unable to muster the 50 votes necessary to pass the bill by Saturday, when a special rule allowing passage with a simple majority will expire. "This is not a Mitch McConnell problem," he said. "He's got a lot more patience than I would have had."
Information for this article was contributed by Sheryl Gay Stolberg of The New York Times and by Erica Werner of The Associated Press.
A Section on 09/28/2017