Republicans have to tread carefully with Trump on Medicare, though. The president-elect has emphasized that he does not want to overhaul the entitlement program, which cuts out some maneuvering room on mitigating the effects of total repeal. Price’s EFPS bill exists in legislative language now and could be enacted fairly quickly, at least those portions of it that could qualify under reconciliation, but its changes to Medicare would accelerate its coming insolvency by a few years. If Trump felt that he was getting trapped into working on broader entitlement reform, he might just balk at the whole project, leaving Republicans – and insurers — in limbo on Obamacare.

The alternative would be to unwind parts of Obamacare immediately through a partial repeal, but leave its Medicare components in place for a later date. That would take a more surgical approach, while Price could cut into the vast regulatory expansion created under the ACA by his two predecessors. It would take more time but would provide a better landing arc for the demolition of the program. …

With 10 Senate Democrats looking at defending their seats in 2018 for states that Trump won in 2016, obvious incentives to play along exist. But that only works if Republicans can repeal Obamacare up front, at least those portions that don’t impact Medicare.