Thanks, Katz. You know well my opposition to Donald Trump - but on this issue he's not that far off the mark.
I will be very frank with you, Jazz.
I don't think that any of us know what Trump fully has in mind on this topic (including Trump!).
I will say this, and it isn't limited to this topic alone, what everyone needs to understand is that Trump, Cruz, Kasich, Carson, etc. are primarily engaged with winning a nomination at this point. Then, whichever one of them succeeds in that, will then be focused on winning the general election. This is true for everyone of them, perhaps more so for some than others. That is why I pretty much take everything that all of them say in this mode, with a large grain of salt!
The following is my predication, regarding how Trump (or most any of them) would handle it, if he succeeds at winning the general election.
1. He will hire subject matter experts to fill advisory roles.
2. He will engage legislative liaisons that will manage the give and take with the (majority & minority) leaders of both chambers.
3. At some point, it will be determined how the repeal of ACA will be handled in both chambers (if it will indeed be possible).
4. Concurrently they will be drafting replacement legislation. Again, cabinet heads, top staff, subject matter experts, and presidential advisers will all be engaged. And of course, the non-governmetal interests will all be clamoring for their place at the table.
5. At some point (perhaps a lot later than many may expect!) the repeal vote and replacement votes will be held.
What will the replacement legislation look like in the end? I have no clue. I hope that it will be better than what it replaces. I hope that it will be as close to a free market-based solution as possible,
given the realities of America 2017. I hope that it includes some of the items that Trump has talked about thus far: opening up health insurance markets across state lines; health care savings accounts (though I really dislike social engineering in the tax code!); cutting out a large part of the fraud and waste endemic in Medicare, Medicaid, CHIPS; negotiating better pricing with providers for the government run programs, etc.
Is it likely to be everything that I would hope for? Probably not. Will it be worse than the ACA? Probably not.
That is why, I am very interested to read the opinion of folks like yourself, that appear to have studied this topic for some time. Because I am not really sure what indeed is
possible and preferable with any replacement legislation.