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Republicans who have opposed Obamacare with every breath since it passed in 2010 are in an uncomfortable position. How do they fix the problems their constituents are seeing without helping a policy they always hated? So far, they haven't come up with a clear answer. The Hill outlines how Republican members of Congress are trying to answer it — for which there are four options.

Fix it.

A poll from CNN last month suggested that most Americans thought it was too soon to call the policy a failure and that it would be fixed. As The Hill notes, that's almost certainly why Republicans have suddenly started offering fixes — though sometimes then backing off of them.

Georgia Rep. Sam Kingston both voted for Rep. Fred Upton's bill delaying policy cancellations and has proposed his own adjustment to the law. He also demonstrates the political risks of doing so.

Kingston, running in a crowded primary for Georgia’s open Senate seat, last week came under fire from conservatives for suggesting the strategy to let the law fail is not “responsible.”

Kingston on Wednesday clarified to The Hill that he meant Republicans should try to “accelerate its demise,” rather than sit back and watch it collapse.

There are two reasons for this. The first is that fixing a bill that a vocal part of the party's base wants to toss is seen as apostasy. And second, the president has actively and repeatedly invited Republicans to offer fixes to the law, both to show that he is willing to make changes but also to give them some ownership over it. For some Republicans, anything Obama likes is necessarily a bad thing.

Rep. Tom Cotton, running for the Senate in Arkansas, is in the same bind as Kingston. "[R]epeal is always going to be hard," he told The Hill. "Therefore, I think we have a duty as elected leaders to try to do as much as possible to protect our constituents from the harm of the law."

Repeal it.

Ever since the Republicans took control of the House in 2011, they attempted to repeal the law in full or in part. The latter attempts mostly focused on cutting funding for the legislation, culminating in the politically disastrous government shutdown as an attempt to block any funding.

Smaller defunding efforts are still in the works, and House Majority Leader Eric Cantor told the paper that full repeal is "only way to completely stop the terrible harm being inflicted on families and individuals." But as Brian Beutler argued at Salon earlier this week, repeal is quickly becoming much more difficult, as more people sign up for coverage. After January 1 in particular, he wrote, "a vote to repeal the law would transform from an abstraction into an attempt to snatch health insurance away from as many as several million people."

At least, the full repeal Cantor advocates. The distinction between "fixes" and "partial repeals" is a semantic distinction (as Kingston figured out), but any changes would still need to go through President Obama, who's unlikely to "fix" anything that cripples the program.

Replace it.

Democrats have consistently suggested that the Republicans have no alternative proposal to help uninsured Americans or reduce healthcare costs. As The Hill notes, the party even created a site,, which contrasts Obamacare's provisions with blank spaces representing Republicans' ideas.

There have been replacement proposals. On Thursday, Rep. Tom Price of Georgia introduced the Empowering Patients First Act, which tackles some of those issues. And, his site trumpets, would save the government trillions of dollars over the next decade. It's not entirely comprehensive, but that's not the real stumbling block: Obama would never sign it into law.

Even if the Republican Party proposed a replacement, that holds true. Obamacare will not be replaced until Obama is replaced, in 2017. By which, to Beutler's point, the poliyc proposals become much trickier.

Ignore it.

Leaving Republican members of Congress to do what they would probably have done had the roll-out not been such a debacle — complain in general terms about the law's provisions until they have the political capital or White House they want. Blowing on the embers of voter dissatisfaction, after all, may help them with the latter goal over the long term.

This article is from the archive of our partner The Wire.

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