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The repair language was discussed by Republicans during their closed-door policy retreat in Philadelphia last week as a better way to brand their strategy. Some of that discussion flowed from views that Republicans may not be headed toward a total replacement.

So why are they doing this?

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    When one of your questions gets deleted, please don't repost it without changes. I made the required changes to your question which changes it from an opinion piece to an answerable question. – Philipp Feb 3 '17 at 9:30
  • Thank you for the edits. I still want to know why they suddenly sound like Clinton. As for the other post, I made the changes you suggested then waited a couple of days and nothing happened, (it stayed deleted and I was unable to undelete).. btw, a comment would have been enough to get me to make those changes. But taking that post out of play gave me no other option than to put up the question again. I still want to know the answer. The establishment (both D & R) seem to be holding together against the president. – SDsolar Feb 3 '17 at 19:56
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    Just an opinion: it would appear 'repeal' was a better campaigning slogan for their target demographic, but 'repair' is simply a more pragmatic policy. – user1530 Feb 3 '17 at 20:19
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    @SDsolar There is always the possibility that Republican legislators have come to the conclusion the president has proposed a policy that has not been well thought through and is therefore likely to fail, similar to his actions on immigration. – phoog Feb 3 '17 at 20:50
  • Because they never knew it could be so complicated. – userLTK Mar 21 '17 at 5:23
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It's partly semantics and partly implementation strategy.

Context

The ACA isn't a single provision, it's a maze of interlocking pieces that has hooks in every aspect of life in the US. It can't simply be terminated or replaced overnight because it would be like trying to unscramble an egg. When all is said and done, there will be a system in place with differences from the ACA. As the ACA, itself, demonstrated, trying to implement change of this scope and complexity in a single step leads to unanticipated problems.

What does replacement really mean?

Any legislation dealing with the subject will have massive overlap with the ACA, and the objective has always been to retain certain beneficial features, like providing for pre-existing conditions and allowing young people to stay on their parents' plan. So even a complete replacement will have certain similarities.

Implementation

No change can be implemented overnight because of the lead times required to implement them. No matter how change is accomplished, the result will be a blur of old and new that will stretch over a period of more than a year.

In the meantime, changes need to be made because the ACA is crumbling under it's own weight. Some things in the current plan need "repair" to survive until more permanent structural changes are in effect.

Beyond that, it is simply good business practice to implement change incrementally to the extent practical. Some structural elements have dependencies that require concurrent implementation. Other pieces that have turned out to be problematic can be individually fixed, at least temporarily. There is also a balancing act of implementing changes in a deliberative, and to the extent possible, incremental manner, vs. having a stable and predictable environment for all of the players.

The reality

Getting to the finish line will be a combination of immediate patches and fundamental changes. The election changed the landscape for what can be changed and how that change can be accomplished. Given that, efforts have been refocused to reflect that new reality. That includes both the "what" and the "how".

The objective for the end result is fundamentally unchanged, although the political realities may allow minor differences from what was contemplated during the Obama administration. Now that Republicans are in a position to actually implement substantive change, one of the first steps is to figure out the best way to accomplish that. Strategy details have moved from campaign rhetoric to implementation plans, so refinement is to be expected.

There is also an element of encouraging bi-partisan participation, so terminology like "repair" is more palatable to Democrats. And I suspect that current calls for "repeal" by some Republicans is part of the posturing and negotiating dance.

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    "not anybody's literal plan" as the house voted on this numerous times (10, 20? I lost track) I'd say this is a demonstrably false claim. – user1530 Feb 3 '17 at 20:42
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    @blip, the house voted on what, exactly, and when? Once the ACA was fully implemented, I'm not aware of any serious efforts to simply repeal it. Regardless, I modified the wording. – user11810 Feb 3 '17 at 20:46
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    They voted to repeal Obamacare. Over 50 times. Over the past several years: thinkprogress.org/… – user1530 Feb 4 '17 at 0:49
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I think your linked article already mentions the relevant point.

As the article notes, 75% of Americans do not want to repeal the Affordable Care Act, at least not without a proper replacement:

Using the word repair “captures exactly what the large majority of the American people want,” said Frank Luntz[.]

While the ACA in its current form is rather disliked, polls show that people do not want to repeal it altogether, but instead improve it. This isn't really a new development either, see for example this poll from 2014 (30% for repeal, 52% for improvements). The main reason for this is likely that people do not want to lose the benefits gained under the ACA (no exclusion for pre-existing conditions, larger coverage, etc).

Another reason may be that Republicans do not have an actual replacement plan. The ideas they do have will likely be rejected by most other Republicans and have been described as unworkable.

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    This is a good answer as to why they're now saying "Repair", but it doesn't address why they started out with "Repeal". As the poll you linked shows, people's opinions haven't changed recently. – Bobson Feb 3 '17 at 13:40
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    I'd be interested to see if there are any opinion polls on people thoughts on repealing/replacing Obamocare against the ACA, despite the fact they are the same thing – SGR Feb 3 '17 at 13:59
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    @SGR there was some polling on that question. Here's a link to an article from 2013. – Kryten Feb 3 '17 at 14:14
  • @Bobson They may have needed time to adapt to the changing public opinion. It's also always easier to call for the complete repeal of something when you don't actually have the power to repeal it and thus do not have to face the consequences or come up with a replacement. – tim Feb 3 '17 at 14:35
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    @SDsolar Trump has stated that, but that's not 'a plan'. That's just him saying that. As for Healthcare providers, of course they were better off. They don't make as much money insuring those that actually need insurance. That's a red herring as that's part of the problem with health care in general. As for your 'free market' complaint, you need to really dive into health care history in this US. The free market is a big reason why we needed the ACA. – user1530 Feb 3 '17 at 20:16
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Three factors plus political calculus lead to the change in strategy.

The factors
  1. The Democrats politically own the ACA.
  2. The ACA is unpopular (46% unfavorable vs 43% favorable according to this poll).
  3. Most Americans support repair over repeal.
The calculus

If the GOP were to repeal the ACA, they would politically own the result. A repair strategy is less risky than a repeal strategy because the GOP will not own the defects in the system (as they would after a repeal) and, instead, they can continue repairing the ACA into future election cycles.

  • Upvote, because I see your logic that if they did repeal it, the result could end up being called Trumpcare, and I doubt even he wants that. Or Ryancare. I still like Trump's idea of letting it be like auto insurance. I remember the days when I could only get GEICO because I was a government employee then they deregulated that and it has gone on to be a great company with good rates for everybody. – SDsolar Feb 3 '17 at 22:07

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