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Donald Trump’s first six months in office have been a spectacular failure.

Friday marks his sixth month in office. The White House had planned a week devoted to products that were Made in America (somewhat ironic given the First Family’s penchant for making things abroad), but Senators Mike Lee and Jerry Moran scuttled that Monday evening when they announced that they were not going to vote for Mitch McConnell’s health care bill, effectively derailing it. It was yet another bitter reminder that Trump has yet to pass a major piece of legislation, but Moran and Lee didn’t seem to care about that at all. The White House apparently didn’t even receive a courtesy call.

It’s a fitting way to crown Trump’s first six months, since the health care bill’s sputtering progress has been a reflection of his presidency as a whole. He has barely been engaged in the process, preferring to lead from behind and tweet about the morning shows. He has seemingly learned nothing about the policy details, and instead has tried to turn the fate of health care in America into a purely partisan exercise. It all comes down to loyalty.

Even when there has been success, as when the House passed its version of the bill back in May, Trump has shown that he doesn’t understand the politics of either chamber. His bizarre and jubilant Rose Garden press conference following the House vote is perhaps best understood as an attempt at putting political pressure on the Senate to act (it didn’t work). And, only a few weeks after that press conference, Trump turned viciously on that bill, which he called “mean.” It’s no wonder that Lee and Moran didn’t bother reaching out, given the relationship between Congress and the White House.

In health care, we have witnessed Trump’s disengagement from the political process; his abandonment of his campaign promises; and his lack of impact in the White House. Above all else, the bill and the president have made each other less popular in a mutually reinforcing pattern. The main takeaway from Trump’s first six months in office is that he doesn’t know what he’s doing and he isn’t learning—and that has been best encapsulated by his inept struggle to repeal and replace Obamacare.