Let's take a moment to really consider the full significance of the Republican's failure to pass a replacement for the ACA.
The Republicans have been unified in their opposition to the ACA since well before it was passed in 2010. They used that opposition to sweep into power on both the federal and state levels in the 2010 midterms. They currently have a strong majority in the House, a strong majority in the Senate, and their party holds the presidency. Their opposition to the ACA has been constant, unrelenting, and vociferous.
Furthermore, they have used their power at the state level to gerrymander as many Congressional districts as possible in order the assure safe Republican seats, meaning there's almost no electoral pressure on most House Republicans.
The Republican party holds all the cards right now--and despite that, their Congressional leadership chose not to bring their replacement bill up for a vote, knowing that it was doomed and thereby avoiding the embarrassment of a quantified failure.
This is not merely a setback. This is an indication of a system so locked up in conflict that it's essentially no longer functioning at all.