Even the Amendment barring alcohol was only repealed. It didn’t require a replacement. There is nothing written in stone that PPACA has to be replaced at all. It began as a lie and a false dream of entitlement no stipulated in the Constitution. There is no reason for it to be “replaced.”
The “replace” would be proper solutions to the actual problems which ACA did a horrible job of solving.
1. Allow interstate commerce in health insurance. That it was prohibited was insane.
2. Address the problems with “pre-existing conditions”. Shouldn’t lose coverage for a legitimate payout reason just because a check got lost in the mail.
3. Stifle tort law abuse. Doctors shouldn’t have to buy insane insurance just because complex procedures sometimes do, naturally, go wrong.
etc.
There were legitimate problems with heath insurance laws pre-Obamacare. Fix them as they should be fixed: individually, narrowly, objectively. Get stupid/problematic regulations out of the way, fix broken laws, expand the marketplace, correct systemic defects.
“Constitution”
The general Constitutionality of the PPACA comes from:
“to lay and collect taxes on incomes” [The mandate is actually a fine, but Congress easily could have written it as a tax like the Dutch legislature did]
“To regulate commerce...” [(the payment by insurance companies for) expensive drugs]
“To promote the progress of science...by securing for limited times to
...inventors the exclusive right to their...discoveries [the patents that allow drugs to be really expensive]
“all treaties made...under the authority of the United States shall be the supreme law of the land” [a treaty enshrines the patent system and costly drug patents]
Pre-existing condition exclusions are generally for those conditions that can often require long-term mental hospitalization or expensive drugs.
Insurance companies don’t want to pay for expensive patented (and other federally exclusive) drugs.
Insurer pre-existing condition exclusions are the health insurance companies’ counters to the exclusive rights of drug inventors.
People don’t want to pay for insurance that costs several times their actual risk, so they exclude health insurance companies (and drug inventors) by not buying coverage.
Every time a useful new drug is invented, the Article I Section 8 “for carrying to execution” factor gets triggered and the Democratic Congress got a legal opportunity to try to band-aid the health insurance system.
The University of California at San Francisco is a leading drug discovery and development center. San Francisco is home to many rich drug barons. San Francisco’s Nancy Pelosi rammed the PPACA through the House.