I’ve always been for a clean repeal especially in light of the fact that the GOP seem to think bailing out insurers and ocare exchanges is what we voted for them to do. If they want to do that crap then put it in a separate bill after the repeal. The reason they don’t is simple. They know it would never fly even though Democrats should back such measures.
What they should have done is followed through on what they, including Trump, all ran on:
Repeal as just the start of further federal regulation repeal so as to restore the free market to medicine such as we haven’t had since the 1940s.
Then Trump and his team should have used the bully pulpit from day one to make the case for that to Congress’s various constituencies across the country.
If somehow they came up short, they could have at least got Obamacare repealed, as well as the tax deductibility of employer-provided insurance. That is a biggie, but it should have been coupled with major tax cuts such that those who would owe more tax for the change would also have had the difference made up for with lower income taxes.
The third major repeal that should have been done up front is repeal of the McCarran-Ferguson Act, which took away interstate competition for health insurance: https://www.americanactionforum.org/research/primer-interstate-sale-of-health-insurance/
Those three repeals, plus the coupling with tax cuts to make the repeal of employer deductibility palatable, should have been Trump and the GOP’s position out of the gate.