Nobody knew health care could be so complicated.

Many Republicans in Congress ran on repealing the Affordable Care Act, popularly known as Obamacare.

For years, the House regularly took symbolic repeal votes, knowing the legislation was unlikely to get through the Senate and knowing that if it did would be vetoed by then-President Barack Obama. And while many Republicans wanted the government completely out of health care — a straight repeal of the Affordable Care Act — others wanted to keep some of the more popular aspects.

Now the Republicans control both houses of Congress and the presidency. And repeal is proving more difficult than they claimed it would be.

When the House passed its version of a new health care law, the Congressional Budget Office estimated that up to 23 million Americans would lose health insurance. Insurers would be able to charge older customers up to five times more than they charge younger customers. States could change this ratio if they wanted, allowing them to charge more, or less. States could allow insurers to increase someone’s premiums based on their pre-existing conditions if they had a break in coverage, and states would run high-risk pools to cover the sickest residents. The federal government would have its own $8 billion fund to help cover sick people’s high premiums within the individual market.

When the House passed the bill, the House GOP and President Donald Trump held a Rose Garden celebration. A few weeks later, when talking with the Senate Republicans, Trump called the House bill he had celebrated “mean.”

The Senate Republican leadership decided that 13 senators would negotiate its version of bill in secret before revealing it to the full Senate. Their product, revealed Thursday, tries to walk a fine line between Obamacare and the House’s American Health Care Act. It does address some of the most controversial parts of the House bill. Senate Majority Leader Mitch McConnell has vowed to bring the bill to a vote before the July 4 recess. But it is uncertain that there are enough votes to pass the bill, and McConnell has suggested that it’s open to change — but not from Democrats.

Who knows where the Senate bill will end up. As of this writing, the CBO has not weighed in on the costs of the bill or how many people will lose health coverage. And polling indicates that the Republican approach to health care is even more unpopular than Obamacare, which was blamed (or credited) for the 2010 “wave” election that knocked the Democrats out of the House majority.

It is clear however, that the GOP Congress and the president are determined to pass something. The way millions of people get health care is soon going to change.

Congressional Republicans have discovered that health care is complicated, but they have also discovered that keeping the Affordable Care Act after railing against it for seven years would make it complicated for them to keep their base voters in the upcoming election. At this point it isn’t about better health care. It’s about keeping potential primary challengers at bay.

— Mankato Free Press, June 24