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Congressional Republicans have long boasted that once they claim the reins of power, they will act quickly and decisively to roll back what they view as the most onerous piece of President Obama’s domestic agenda: the Affordable Care Act. But their actions starting Tuesday to end Obamacare will be far less sweeping, at least initially, than a full-blown repeal of the law. Democratic opposition and complex Senate rules mean that core pieces of the 2010 health-care overhaul are likely to remain, including the legal framework for the individual mandate and pieces of the state exchanges the law created. (Snell and DeBonis, 1/2)

The Affordable Care Act is in extreme peril .... But the transformation of American health care that has occurred over the last eight years — touching every aspect of the system, down to a knee replacement in the nation’s heartland — has a momentum that could prove impossible to stop. Expanding insurance coverage to more than 20 million Americans is among Mr. Obama’s proudest accomplishments, but the changes he has pushed go deeper. They have had an impact on every level of care. (Goodnough and Pear, 1/3)

The decision last year by some of the nation’s most powerful insurance companies to pull out of the health exchanges left consumers with fewer choices. Premiums and deductibles are up for 2017 coverage, both on and off the exchanges. And taxpayers are facing a bigger bill to help cover people eligible for subsidies. The insurer exits, premium hikes and dwindling choices prompted critics to declare doom for the law known as Obamacare by opponents and some supporters. But the Obama administration has rejected any doomsday talk and has vigorously defended the benefits of the bill that has brought uninsured rates to historic lows. (Liss, 12/31)

Insurers and providers were counting on continuing to add paying customers under the ACA's premium subsidy framework, with more states expanding Medicaid to low-income adults. But after the surprise presidential victory of Republican Donald Trump, industry groups have no clear idea what the new framework will be if Trump and the Republican Congress make good on their pledge to repeal and replace Obamacare. Beyond that, there's great uncertainty whether and at what level Republicans will fund a wide range of health programs, including medical research, mental health and addiction services, public health, community health centers and the Children's Health Insurance Program. Trump's picks for cabinet-level posts, notably Rep. Mick Mulvaney (R-S.C.) at the Office of Management and Budget, are no fans of government social spending. (Meyer, 12/31)

Congressional Republicans, determined to repeal the Affordable Care Act and replace it with an as-yet undefined alternative, are likely to find themselves wandering through a minefield of difficult policy problems when they return to Washington for the next Congress. These range from the fundamental question of what actually constitutes “health insurance coverage” to thorny questions about whether refundable tax credits would actually create the necessary incentive to encourage the uninsured to purchase coverage. (Garver, 1/3)

Congressional Republicans have a new fear when it comes to their two-year-old health care lawsuit against the Obama administration: They might win. ... That could lead to chaos in the insurance market and spur a political backlash just as Republicans gain full control of the government. (Hulse, 12/31)