Those who know the ins and outs of health care policy will quickly tell you that the replacement plan is the hard part and that it can't be devised, debated, or passed quickly. We have seven years of no GOP replacement plans as Exhibit A for why it's so hard. So if you're a GOP member of Congress now saying you want to see a replacement plan along with a repeal plan, then you're essentially saying, intentionally or not, that you want to push off repeal for a while.
Steven Dennis at Bloomberg reports this very telling exchange with an unnamed GOP senator:
A Republican senator on condition of anonymity said the details of the repeal bill remain very uncertain. Originally, Republicans were planning to simply bring back the bill they put on Obama’s desk last year for his veto.
But that bill was written knowing it wouldn’t become law, and now some Republicans want to make tweaks to soften the blow of repeal.
"Even people who voted for this before are, ‘Wait a minute, wait a minute, we knew that wasn’t going to happen,’" said the senator. "There were no consequences." He said there’s a growing sense among some of his colleagues that they need to have a replacement for Obamacare ready soon "because we’re going to own this."
The key element here is time. Coming up with a replacement takes time. Pushing off repeal for long risks not having the political juice down the road to take it up again, or having to do so on less favorable terms. Doing health care policy right isn't a matter of good political messaging and well-applied bandaids to obscure what you're really doing. It's slow-going, and Republicans have boxed themselves in with promises of immediate repeal. Some of them seem to be figuring that out.
It's important not to read too much into early signs of squeamishness from backbenchers in the House and from GOP senators. But then again this is the central legislative priority of Republicans on the Hill and soon to be in the White House. This has been their great white whale for seven years. So nothing is casual or inadvertent in this political/legislative process.