One ma­jor flaw with the polit­ics of Obama­care was that it cre­ated win­ners and losers, re­dis­trib­ut­ing health care be­ne­fits to those who had been un­in­sured while rais­ing rates for the middle class (on the in­di­vidu­al ex­changes) and in­ef­fect­ively man­aging in­creased de­mand for over­taxed med­ic­al pro­viders. Past en­ti­tle­ment pro­grams con­ferred an over­all be­ne­fit to every­one; Obama’s law ef­fect­ively re­dis­trib­uted be­ne­fits from one group to an­oth­er.

Giv­en that real­ity, re­vers­ing it in­ev­it­ably will cre­ate an­oth­er set of win­ners and losers. That doesn’t mean any re­place­ment pro­pos­al should be his­tor­ic­ally un­pop­u­lar. If Re­pub­lic­ans tried to make the case that gov­ern­ment spend­ing on health care was crowding out re­sources for oth­er pub­lic pri­or­it­ies, they might have a cap­tive audi­ence. If they made the case that health care out­comes for those on Medi­caid aren’t good, and it’s prefer­able to have more re­cip­i­ents on private in­sur­ance, they’d be mak­ing a cred­ible case. If they even made the simple ar­gu­ment that the taxes and man­dates on busi­nesses from Obama­care are slow­ing eco­nom­ic growth, they’d have a re­cept­ive con­stitu­ency.