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On the ACA, Republicans acknowledge reality, wave the white flag

The GOP has abandoned its “repeal and replace the ACA" agenda. But what does the Republicans' new health care agenda look like?


The first big hint came in February. Sen. Rick Scott, R-Fla., unveiled a controversial policy agenda in February, which touched on practically every issue under the sun, but it didn’t say a word about repealing or replacing the Affordable Care Act.

Soon after, Sen. Ron Johnson briefly suggested he wanted to put ACA repeal back on the table. When Democrats pounced, the Wisconsin Republican scrambled to walk it back.

In the months that followed, as regular readers know, GOP officials — at the state and federal level, up and down the ballot — steered clear of health care altogether. “Obamacare” was a staple of Republican attack ads for years, but in 2022, GOP politicians not only removed the arrow from their rhetorical quiver, they also started editing their websites, erasing their previous criticisms.

When House GOP leaders unveiled their “Commitment to America” blueprint two weeks ago, it too ignored the Affordable Care Act altogether.

Following up on our months of coverage, NBC News confirmed this week that Republicans “are abandoning their long crusade to repeal the Affordable Care Act,” adding some unexpected quotes from key GOP officials.

“I think it’s probably here to stay,” said Sen. John Cornyn, R-Texas, a close ally of Senate Minority Leader Mitch McConnell, R-Ky., and a former chair of the GOP’s campaign arm. ... Rep. Mike Gallagher, R-Wis., a member of the Republican Study Committee, was ... asked whether he expects a new Republican House majority to pursue ACA repeal. “I don’t think that’s on the table,” he said.

As we recently discussed, in the not-too-distant past, this would’ve been tough to predict. Indeed, for those of us who covered the political fight over the Affordable Care Act closely, this day seemed highly implausible. Before Barack Obama signed the reform package into law, Republicans condemned it as an economy-destroying attack on free enterprise and the American way of life. After the ACA became law, Republicans spent years not only denouncing the reforms, but also voting several dozen times to repeal it.

The idea of Cornyn saying on the record that the reform law is “probably here to stay” was a fantasy. And yet, here we are.

But as important as these developments are, this need not end the conversation. There’s a very real chance that Republicans will control at least one chamber of Congress early next year, and whether the party wants to talk about the issue or not, voters deserve to know what the GOP agenda is when it comes to the health care policy.

Aside from vowing to undo Democratic measures to reduce the cost of prescription medications — a top Republican priority — what should American families expect from GOP majorities? The public can take comfort in the fact that “repeal and replace” has been dropped from the Republicans’ to-do list, but has it been replaced by something new?