It should not come as a complete surprise to Republicans or anyone else that repealing the Affordable Care Act and replacing it with some alternative plans is not something that can easily be accomplished overnight. When President Obama was in office, of course, Congressional Republicans didn’t have to really worry about the consequences of their vote to repeal the PPACA since it was clear that any such measure would either die in the Senate or be vetoed by the President and it would be impossible to override the veto. Because of that, they were able to vote repeatedly to repeal the PPACA without offering a replacement via votes that were essentially intended to do little more than please the Republican base and as a vehicle for lawmakers to show Republican voters that they were indeed on board with achieving what had become an article of faith among Republican voters. Now that the Republicans hold all of the levers of power, though, they’re finding that the details about repeal and replace are quite complicated and that it could take some time before their goal is achieved, assuming that it ever really does happen.

For example, any attempt to repeal the law has to take into account the fact that millions of people, not to mention the entire health insurance and health care industry, has acted in reliance over the past seven years in reliance on the idea that the rules established by the PPACA and by regulatory agencies charged with its implementation and pulling the rug out from under them suddenly would be highly disruptive and potentially disastrous. For insurers and providers, it would mean having to adjust to new rules in a short period of time, which would no doubt prove costly for everyone involved and which could have devasting consequences for some providers and insurers, which would, in turn, make life difficult for patients. At the consumer level, there are many people who have acted in reliance on the rules that the PPACA put on the system such as the prohibition of denial of coverage for pre-existing conditions, the provisions that allow parents to continue providing coverage for children up to the age of 26, and the end of the lifetime cap on coverage.