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Republican leaders are considering a legislative effort to roll back major provisions of the health law, but the plan they’re considering would keep the current system in place for at least two and possibly three more years. The nickname for the plan is repeal and delay, and the assumption underlying it is that the current system will be sustainable for as long as it takes Congress to pass and the White House to install a new health plan. The plan might be better described as “zombification.” It is not at all clear that Republicans can easily time the expiration date of the Obamacare markets. Insurance experts say the resulting zombie market — not dead, but not alive either — would suffer from many of the maladies of the existing system, and quite a few more. (Margot Sanger-Katz, 12/7)

The Urban Institute released a new analysis yesterday of the impact of a bill that Congress passed last year to repeal large parts of the Affordable Care Act (ACA). Urban’s analysis is based on many uncertain assumptions, including the implausible one that the incoming Trump administration and Congress, despite numerous campaign promises, will not provide any flexibility for people to purchase non-ACA-compliant products after repeal. Urban’s projections should be treated with significant skepticism because of the large uncertainty about its assumptions as well as substantial mistakes Urban has made in the past about the impact of the ACA. (Brian Blase, 12/7)

Republicans who think their “repeal and delay” strategy for Obamacare won’t cause serious and immediate insurance disruptions should read a new report that came out early Wednesday morning. The report, from the nonpartisan Urban Institute, predicts that state insurance markets will start to unravel almost immediately and that, as early as next year, the ranks of the uninsured will begin swelling. And if Republicans can’t come up with a replacement, the report says, the number of people without insurance could eventually rise by 20 million to 30 million people. (Jonathan Cohn, 12/7)

If there weren’t so much at stake, one would be amused at the spectacle of Republican politicians writhing as they try to make good on their ideological promise to “repeal and replace” Obamacare without ruining the lives of millions of their own constituents. ... Not only are they conceding that conjuring up a replacement for the ACA will take much longer than they promised—years, even—but they’re also talking about reinstating provisions of the law that they undermined during their six-year campaign to hobble it. They’re forced to acknowledge that America’s pre-ACA system of health insurance for individuals was so awful that they can’t justify returning to it. (Michael Hiltzik, 12/7)

The belief among Democrats that a Republican could never win another presidential election was apparently so firm that they’re still in a state of shock. They’re even more stunned that Donald Trump has dared to name an ObamaCare critic as his health-care point man—which makes for an instructive moment. ... Now Democrats are assailing Mr. Price for proposing alternatives to the mess they created. The Republican, who took over the House Budget Committee from Paul Ryan, is a thoughtful and well-informed problem solver. Unlike many of his colleagues, Mr. Price hasn’t dodged details and specifics. He proposed an alternative to ObamaCare during the 2009-10 debate and in the years since he’s put flesh on the bones, including with legislative language. (12/7)

It is also clear that certain parts of the ACA have not worked as well as intended, particularly for individuals who buy health insurance on their own. As the new administration and lawmakers develop specific proposals to repeal and transition, it is imperative that they understand: Changes can either begin a stable transition to a better approach, or they can bring about even more uncertainty and instability. ...The best approach to keep insurance affordable and markets stable would be to fund temporary, transitional programs. These would include maintaining subsidies for low- and moderate-income individuals to purchase insurance and financial help for plans that enroll high-cost individuals, through at least Jan. 1, 2019. (Marilyn Tavenner, 12/7)

Congress should pass a repeal bill that goes into effect in three years. But if they fail to come up with a replacement measure in that time, Obamacare would remain in effect. A further three-year extension could be written into the bill that would give legislators another bite at the apple. But if they fail again, Obamacare would stay the law of the land. (Michael Cohen, 12/7)

Much of the repeal-and-replace rhetoric of ACA critics depicts the pre-Obamacare health insurance landscape as a sort of nirvana in which consumers had almost unlimited options to fashion the coverage they wanted, without government interference. So it’s proper to recall what that marketplace was like. A useful reminder comes from Georgetown University’s Center on Health Insurance Reforms, which compiled a list of the conditions that insurance buyers in Illinois had to report when applying for coverage. The list included serious conditions such as heart attacks, emphysema and cirrhosis, but also common maladies such as hay fever, hives, sinusitis and acne. Any of these gave insurers an incentive to deny coverage to applicants or offer it at inflated prices or with exclusions. (Michael Hiltzik, 12/7)

It is important to recognize that for more than 30 years Americans have expressed dissatisfaction with the nation’s health care system. And yet at no time during that period have they ended up supporting a major health care reform bill once it was actually presented. Americans may be unified in their dissatisfaction, but their differing political values and preferences lead them to oppose specific remedies to the problems they cite. (Robert J. Blendon, 12/7)

The emerging GOP plan to repeal Obamacare on a delayed schedule — and then maybe kinda sorta replace it later — has raised a big question: Will Democrats help Republicans pass a replacement that is far less generous and comprehensive than the health law is, allowing Republicans an escape from the political fallout from repeal? In an interview with me, Senate minority leader Chuck Schumer answered this question with a resounding No. Under no circumstances, he vowed, would Democrats throw Republicans such a political lifeline. (Greg Sargent, 12/7)