US President Donald Trump's health care plan failed Friday in the House of Representatives, as his own conservative Republican Party was too divided to pass the measure.
House Speaker Paul Ryan announced that he had pulled the legislation without a vote, after advising Trump that it lacked the support to pass.
"We came up short," Ryan said. "We just didn't quite get consensus."
He called the failure to pass the legislation "growing pains" as the conservative Republican Party adjust to holding power with Trump in the White House, after Democrat Barack Obama's eight-year presidency.
Trump had vigorously backed the health care plan proposed by Republican congressional leaders.
The cancelled vote would have been the first major legislative test for Trump, who has used mostly executive orders to implement a right-wing populist agenda during his first two months in office.
The measure, introduced in early March by Republican congressional leaders, sought to overhaul Obama's signature legislative achievement, the 2010 Affordable Care Act, which installed a system of incentives and subsidies to make health insurance more widely available.
The programme has been a target of Republican ire since it passed, and Trump in his campaign railed against so-called Obamacare as a "disaster."
Democrats said that the Republican replacement would have sharply raised the cost of insurance and left tens of millions more people without coverage.
Hard-line Republicans who refused to support the now-failed measure said it left too many government-imposed requirements for health insurance coverage and gave consumers too few choices.
US President Donald Trump is blaming Democrats for the failure of proposed health care reforms in Congress, while voicing willingness to craft a "bipartisan" alternative with the left-leaning opposition.
After his Republicans, who hold majorities in Congress, withdrew their own legislation because of fractures within the conservative party, he said that Democrats "weren't going to give us a single vote."
Flanked by Vice President Mike Pence and Health and Human Services Secretary Tom Price, Trump appeared in front of reporters at his desk in the Oval Office, saying that the legislation was "very close" to passage.
He complained that Democrats "weren't going to give us a single vote," and said they were now responsible for the "exploding" Obamacare, amid reported large increases in insurance costs in some states.
Trump called the dissident Republicans his "friends," but that "We learned a lot about loyalty" in his first major legislative initiative in office. He invited Democrats to help forge a "bipartisan" health care reform that could be "even better" that the failed effort.
Nancy Pelosi, leader of the minority Democrats in the House, said that Friday's events were a "very clear" message to Republicans that people across the United States still support Obamacare.
"What happened on the floor is a victory for the American people," she said.
The 2010 law has assured access to affordable, quality health care for most Americans, Pelosi said.
Even if it had cleared the House, the legislation appeared to lack the votes to pass the Senate, where Republicans hold a narrower majority.