One of the obvious mistakes Republicans made during Donald Trump ’s first term was to frame their first large budget-reconciliation package as an effort to “repeal and replace” Obamacare . There were two big problems with that approach. The first was that Obamacare (usually understood as including both the expanded Medicaid eligibility and the subsidized private health-insurance marketplace created by the Affordable Care Act) had become quite popular in the years since it was first rolled out to mixed reviews. The second is that the “replace” part of “repeal and replace” was never quite clear aside from the manifest determination of Republicans to let insurance companies resume discrimination against people with expensive health problems.

This second problem hasn’t been solved, of c

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