Did any Republicans in Congress actually want to “repeal Obamacare” on the policy merits? Certainly not the moderates, even though they too had villianized the law. The rank and file are just sheep, willing to vote for whichever bill the leadership tells them to. Obamacare repeal was never an animating spiritual force. It was mostly a bloc of conservatives in both chambers—the Freedom Caucus in the House, and Sens. Mike Lee, Rand Paul, and Ted Cruz in the Senate—who wanted to do away with the policy architecture that Obamacare installed, instead of just reaping the political benefits of opposing it. And that’s just not enough people.

Despite the aura around it, Obamacare, in its individual market reforms, is essentially just the idea that sick people should be able to purchase quality insurance at roughly the same price as healthy people. All of the law’s regulations, carrots, and sticks—guaranteed issue, community rating, essential health benefits, the individual mandate, subsidies, single risk pools, etc.—were put in place to make such a market feasible. To “repeal Obamacare” is to segregate sick people from healthy people, so that the healthy are not subsidizing the sick.