State leaders are positioning themselves to have a key voice in a potential rewrite of ObamaCare next year.

With the election of Donald Trump, Republican leaders in Congress have promised a dramatic overhaul of President Obama’s signature policy.

The National Governors Association (NGA), a proudly bipartisan group representing every state, is now eyeing a more public — and more aggressive — role alongside GOP leaders as they attempt to gut the massive federal program.

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It is vital that the new Administration, Congress, and state officials orchestrate a smooth and methodical transition for the repeal of Obamacare. For this smooth transition to take place, Congress should act immediately to initiate repeal and the Administration should take aggressive administrative actions to stabilize the private market for the upcoming 2018 plan cycle. The Administration, Congress, and the states should then coordinate efforts to begin the process to have a set of reforms in place for the 2019 plan cycle.

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With Republicans controlling the White House and Congress in January, they’re faced with delivering on their long-time promise to repeal and replace the ACA. Because Republicans will control the Senate by just 52-48, the Senate will have to navigate the complex reconciliation rules processes to avoid filibusters, which require 60 votes to end. Their key policy challenge is to protect the millions of people receiving coverage under the law and convince insurers to continue to offer coverage.

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The election of Donald Trump as president, along with the Republican Party’s retention of both houses of Congress, sets the stage for the long-promised repeal and replacement of the Affordable Care Act (ACA), popularly known as Obamacare. Obamacare boosters warn that repeal would throw 20 million Americans who have gained health insurance coverage through the law back into the ranks of the uninsured overnight. The truth is more complex. Nearly half of the coverage gains made during Obama’s presidency had nothing to do with ACA provisions and will survive repeal. Many other newly insured people will keep their coverage—if changes are made to health-care financing, and if two popular ACA provisions President-elect Trump has spoken favorably of are retained.

Repealing most of the ACA, retaining a few provisions, and replacing programs in 2018 will rid the country of one the most contentious, complex, and wasteful pieces of social engineering ever enacted—and set the stage for a more efficient, consumer-centered health-care system.

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Thanks to all of the issues with our vast and complicated healthcare system, any attempts at reform will require massive amounts of effort, political capital, cooperation from various public and private entities and, likely, luck. So while Donald Trump ran on a platform of “repealing and replacing Obamacare”, it might be wise to start with some small changes to the Affordable Care Act (ACA) that could still have large benefits.

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Donald Trump and Republicans in Congress are vowing to repeal and replace the Affordable Care Act, the signature health care overhaul of President Obama.

Trump has offered a few ideas of where he’d like to see a health care overhaul go, such as a greater reliance on health savings accounts, but he hasn’t provided a detailed proposal.

The absence of specifics on health care from the president-elect makes the 37-page plan that Speaker of the House Paul Ryan has released the fullest outline of what Republicans would like to replace Obamacare.

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The GOP Congress and incoming Trump administration will need to make some decisions in the coming weeks on how to proceed with a legislative agenda in 2017. The course they choose to take is likely to define the rest of the Trump presidency, just as decisions President-elect Obama made in late 2008 and early 2009 — to do a large stimulus bill first, followed by a sweeping health care law, and then Dodd-Frank — came to define his presidency.

Based on press reports, it seems the GOP is about to choose a path that will haunt them for years to come.

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Repeal of the 2010 health care law is a top priority as soon as Donald Trump takes office in January, Vice President-elect Mike Pence said in a Sunday television interview.

“Decisions have been made, that, by the president-elect, that he wants to focus out of the gate on repealing Obamacare and beginning the process of replacing Obamacare with the kind of free-market solutions that he campaigned on,” Pence said on “Fox News Sunday.”

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Congressional Republicans are itching to dismantle Obamacare, but a group of conservatives say the current plan to take down key parts of the law is not quick enough, and is already pushing for alternatives that completely and immediately repeal it entirely.

Republicans in the House and Senate have pointed to a repeal bill that was approved last year through a procedural move called reconciliation as a means to quickly gut the law after Trump assumes office in January. Reconciliation bills require only a simple 51-vote majority as opposed to 60 votes to break a filibuster, which means they’re a way to quickly pass a proposal in the Senate.

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The House Speaker wants Obamacare dead. The House Budget Chairman — a leading candidate for HHS secretary — wants Medicare reform. But all the focus on Republicans’ health strategies is ignoring the biggest elephant in the room: Donald Trump, a president-elect who’s spent more than a year bucking congressional Republicans — and may not share their priorities, two leading conservative thinkers tell POLITICO’s “Pulse Check” podcast.

“For all the times that the president-elect has expressed his desire to repeal and replace Obamacare … [he] campaigned on universal coverage,” said Avik Roy of the Foundation for Research on Equal Opportunity. “That’s a very different set of principles … than you might expect from a generic Republican president-elect.”

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