Replacing a repealed ACA is a more daunting and complicated challenge than most legislators and policy makers can imagine. How can you preserve, for example, such very popular provisions as banning insurers from denying coverage based on pre-existing conditions and keeping children on parents’ plans until age 26? How can you protect Medicare from higher spending, which will lead to higher premiums, deductibles, and cost sharing for beneficiaries? (10) Without the ACA’s guarantees, how can you preserve the ability for about 52 million adults to gain coverage on individual plans? (11) Moreover, how can you assure an adequate safety net for the 20 million more uninsured and lower-income Americans as Medicaid cuts allow states to restrict eligibility and benefits with less accountability?