Even if Republicans had succeeded in their recent effort to repeal the ACA, “skinny repeal” would have come nowhere close to solving the problems that plague our health-care system, especially rising costs and declining choices. Of course, the ACA also failed to solve those problems and in many ways exacerbated them. Republicans should not give up on reform that would lower costs, improve quality and ensure more widespread adoption of exciting health-care innovations. On the legislative front, there are several rifle-shot provisions that could be attached to must-pass pieces of legislation. Beyond legislation, the Trump administration can improve the ACA through the regulatory process. The Trump administration can also work with states that are interested in taking advantage of the innovation waivers in Section 1332 of the ACA, which allow states to fashion health reforms that suit their citizens best.

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When it comes to providing affordable health care to the people of Maine, Sens. Susan Collins and Angus King are worse than out of touch—they are downright dangerous. After Maine expanded Medicaid to childless adults in 2002 under then-Gov. King, the program nearly bankrupted our state. But now Ms. Collins and Mr. King are pushing to do it again by refusing to reform ObamaCare and prevent the future expansion of Medicaid.

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The repeal and replace effort has failed for now. Republicans will move on to tax reform. It remains to be seen what they accomplish in an effort that is arguably at least as complicated as health reform. Ironically, Senator John McCain, the man whose thumbs down deep-sixed the frantic effort to find a way to get something resembling Obamacare repeal passed in the Senate, long ago offered one of the boldest proposals I have seen in my lifetime as it relates to both health reform and tax reform.

Senator McCain proposed to completely eliminate the tax exclusion for employer-provided health coverage (rather than merely capping it–a half measure designed to mitigate rather than eliminate the distortions caused by the exclusion while doing nearly nothing about its unfairness). As detailed in this Heritage report: His plan “would replace the special tax breaks for employer-based health insurance with a univer­sal system of health care tax credits for the pur­chase of health insurance.

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Senate Republicans couldn’t agree on a way to repeal and replace Obamacare. So now they’re contemplating a totally different approach: Blow it up and let the states sort it out.

The latest attempt to resuscitate the GOP’s repeal bid would reshape the nation’s health care system by sharply curtailing the federal government’s role and placing the future of Obamacare in the hands of governors. But Republican senators will have a hard time overcoming the internal divisions that doomed their three attempts last week to unravel the Affordable Care Act.

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The Federalist: Surely there are some Democratic Senators who want to work on bipartisan fixes to Obamacare. Why are they not coming to the table?

Grace-Marie Turner: That’s actually what Senator Chuck Schumer said in an impassioned speech before Tuesday’s vote on the Senate floor: “Let us work in a bipartisan nature.” But sadly it’s disingenuous. Their bipartisanship means that the ACA stays in place and that you just add more money to it, or you create new regulations to force even more people to purchase coverage they don’t want.

The bipartisanship really is difficult because of the different ideologies we bring to the table. The words sound nice—and the Senate may wind up going there. But at that point “reform” is going to mean minor tweaks around the edges. We would end up having Obamacare forever if they move towards a ‘bipartisan’ process.

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Congress’s last-ditch attempt to pass a “skinny” bill to kill a few pieces of the health law — many of which Trump could have abolished himself with an executive order — collapsed.

In the intervening six months, Republicans were bedeviled by an enormous backlash from a public that suddenly decided it likes the health care law, cold feet over stripping health care coverage from millions of Americans, damaging intraparty squabbling and a White House that threw bombs at their efforts. Ultimately, an old truth held: Once politicians bestow social benefits, it’s almost impossible to take them away.

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It was the most dramatic night in the United States Senate in recent history. Just ask the senators who witnessed it. A seven-year quest to undo the Affordable Care Act collapsed—at least for now—as Sen. John McCain kept his colleagues and the press corps in suspense over a little more than two hours late Thursday into early Friday. Not since September 2008, when the House of Representatives rejected the Troubled Asset Relief Program—causing the Dow Jones industrial average to plunge nearly 800 points in a single afternoon—had such an unexpected vote caused such a striking twist.

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“Repeal and replace” made Republicans electoral Supermen, but “pre-existing conditions” were their kryptonite. Senate Republicans played out the final scene of their legislative tragedy in the early hours of Friday morning when they formally laid to rest their seven-year effort to repeal the law. Through four election cycles, Obamacare’s rising premiums, burdensome cost-sharing, narrow networks, and plan cancellations helped fuel GOP electoral victories at every level of government. The failure suggests why the political consequences are likely to be deep and long-lasting.

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The GOP cannot simply “move on” and give up on health care. Health care is the biggest driver of our debt and deficit, the biggest driver of growth in government, and one of the biggest drivers of economic insecurity for those in the middle class and below. Take some time to reflect, yes. Come up with a better strategy, yes. But to give up on health-care reform is to give up on everything conservatives stand for.

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It’s pretty hard to get a head start on President Trump in trying to shift blame onto others for the late night culmination of massive political failure in the presumptively Republican Senate. But let’s provide a short report from the medical examiner on the causes of death to the once soaring rhetoric and more recently depressing reality of “repeal and replace.”

  • Yes, the procedural minefield through budget reconciliation was narrow, murky, and treacherous. But even the entire inventory of legislative tricks, gimmicks, and sidesteps attempted still needed to be anchored to a larger commitment than just avoiding political-party embarrassment.
  • Republicans in Washington never met the challenge of offering a sufficiently unifying message to constituents that all the uncertainties and sacrifices immediately ahead from disruptive changes were aimed at actually making their lives BETTER eventually, rather than just not quite as bad as a host of maladies and calamities attributed to Obamacare…

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