It's not 2009. Republicans could've put their plan in to replace what existed before Obamacare. There are a good number of people who've been hurt by Obamacare. They've lost good insurance plans, sometimes more than once, and are now on a much more expensive plan that has such a high deductible that they pay for everything out of pocket. I know. I'm one of those people. I had a great plan for 12 years and it was cancelled when the ACA went into effect. And then my next plan was too.
But we don't count for a lot. Sure, we might have in 2009. If the Democrats had been truthful and told America that 3 million people would lose their health insurance due to the ACA he never would’ve passed it. But they weren't. And a lot of people haven't gotten health insurance through the ACA. And many of those people have gotten cheap insurance. Now none of them would lose their insurance with the Republican plan. (At least that's how it reads. Implementation may mean something else.) The 23 million people who the CBO said wouldn't have health insurance include almost entirely people who don't have it now but the CBO assumes will if Obamacare continues or people who choose to not have it.
That's not what the public believes. Democrats have most everyone believing they'll lose their insurance. Kamala Harris has said 129 million people could lose their coverage. That's reality.
It doesn’t matter that the ACA is unsustainable and that there are better ways of doing it. The Republican plan is less generous with subsidies and is being sold as something that'll take away people's insurance. Once government gives people something you can’t give them less. Republicans need to stop thinking what might be better and understand what the public will accept. They can change the ACA and make it more sustainable and more Republican, as long as people don’t lose their insurance and it doesn’t get pricier. If Republicans pass the current plan, even if it doesn't do what the critics say, they’ll get slammed at the polls in 2018. That's why they can't pass their plan. They can't get the votes to make massive changes. So they either make smaller changes incrementally or they do nothing. At least they can sell small changes at the polls.
I'm not sure that Republicans can avoid big losses in 2018, but so far everything they've done is helping make that happen. They may get slammed by their base if they don't make those massive changes. If they don't take that risk, they'll get slammed by everybody else.