It's difficult to express sympathy for Republicans' political imperative to destroy healthcare coverage when the only thing that stands between it and people dying is... a Republican promise that they will expand healthcare coverage with a secret plan.

> Democrats don't want to attempt reform.

The top two Democratic presidential contenders as well as many of the Democrats in Congress campaigned on specific reforms to healthcare. The thing is, Democrats and Republicans have nearly diametrixally opposed goals in reform.

I'm coming at it from the other angle. Republicans know they're stuck with an intractable problem. You can't cover people with large costs without raising the costs for everyone. The problem for Repubs at this point is that those with large costs have already been granted access. It's much easier for them to deny those with pre-existing conditions access than it is for them to now take that away. Futhermore, Repubs can repeal ACA without Dems help but can't pass a new bill without Dems. I believe the goal at this point is to repeal ACA without Dems then push a hyper-partisan ACA replacement which the Dems will not vote for. Then Repubs can successfully lay the blame at Democrats feet for not coming to the table and passing the replacement.

> It is a political imperative for Republicans to repeal the ACA now, and worry about replacing it after the positive PR.

The positive PR of... 20 million people losing health insurance?