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Donald Trump and Republicans in Congress have one thing in common: After years of trashing Obamacare, they don’t have a clue how to craft anything better. So the president is now saying that repealing and replacing the Affordable Care Act — which he promised to do instantly when he took office — may not happen until next year. Why? Because it’s next to impossible to devise a system based on private insurers that is cheaper, covers as many Americans and provides better medical outcomes than the ACA. (2/10)

The GOP strategy on quickly repealing the Affordable Care Act and enacting tax reform that seemed to be so creative and smart when it was first revealed right after the election may soon become the prime source of legislative hell for House and Senate Republicans. Knowing that a Senate filibuster was virtually certain on ACA repeal and highly probable on tax reform, the GOP plan was to use the reconciliation process -- which prevents filibusters -- to pass them both. (Stan Collender, 2/12)

The Post reports on the confirmation of Rep. Tom Price (R-Ga.) as secretary of the Department of Health and Human Services. ... This is the sole development to date on the Obamacare front that could be characterized as a win for Republicans, who promised voters they’d repeal every word of the Affordable Care Act — and replace with a system that offers lower costs, more flexibility, better care and repeal of ACA-related taxes. So far, the effort has been semi-disastrous, raising questions about whether Republicans can manage to devise and agree upon a replacement that will attract the eight Democratic senators needed for cloture. Republicans would be well-advised to abide by a number of simple rules. (Jennifer Rubin, 2/10)

M.J. Lee of CNN has flagged a great moment at a town hall meeting with GOP Rep. Diane Black that has gone viral because it shows a constituent making an impassioned case for, of all things, the Affordable Care Act’s individual mandate. As some immediately pointed out, Democrats could learn from this kind of messaging. But the moment is notable for another reason, too: The answer offered by Rep. Black shows how much the debate over the health care law has shifted, in favor of the health law. (Greg Sargent, 2/10)

Medicaid is a highly complex program that provides vital care for a broad array of individuals. There are no easy solutions when it comes to reducing its costs. Changing Medicaid, just like reforming health care, is at best an incremental process, particularly when one considers the new populations now covered by the program as a result of the ACA, such as families in which an adult is employed but in a lower-income job. It has often been said that there are two ways to lower Medicaid costs: reduce eligibility to the program or cut the services provided. Neither are attractive options. Turning the program into block grants firmly delegates decisions on that dilemma to the states. (Gerard Vitti, 2/10)

Moda Health, a small Oregon health insurer, just won a $214-million judgment against the federal government. Normally that wouldn’t be worth reporting, except that in awarding Moda the money, the federal judge in the case dismantled the most cynical attack on the Affordable Care Act that Congressional Republicans had devised.The issue was the ACA’s risk corridor program, which was devised to shelter insurers from unexpected losses in covering ACA customers from 2014 through 2016. To encourage insurers to enter an entirely novel market, the program aimed to balance risks by taking profits from insurers that turned out to be unexpectedly profitable and use the funds to cushion others’ losses. (Michael Hiltzik, 2/10)

The debate about what to do with the Affordable Care Act feels overwhelming to a lot of people. Repeal. Don’t repeal. Replace. With what? What does all this uncertainty mean to us in Florida? As healthcare professionals at Florida’s largest public hospital — Jackson Health System — I and many of my colleagues are frankly terrified by the possibilities. (Martha Baker, 2/10)

In a Jan. 6 letter to Republican representatives in Congress, Gov. Matt Bevin asked them to throw out the Affordable Care Act, saying regulation of health insurance should be given back to individual states. Bevin is advocating sending us back to the time when individuals with chronic medical conditions and disabilities had to beg legislators to get even minimal coverage for their conditions, when insurance-industry lobbyists decided what they could tolerate and then strongly encouraged legislators as to how to vote. (Wendy Wheeler-Mullins, 2/10)