Republicans have been promising to “repeal and replace” the Affordable Care Act ever since it was passed. There were votes in the House over the last few years, but they were largely symbolic. They addressed repealing the current legislation, but they didn’t propose a replacement. And everyone knew that the repeal bills would fail in the Senate or be vetoed by the President. An actual proposal wasn’t necessary. Vague promises that the replacement would be “terrific” were enough.
Now Republicans have a majority in both houses of Congress and a President who says he’ll sign their bill. Their time has come. Elections really do have consequences.