Well during the nearly 50 attempts to eliminate the ACA the Republicans did not even try to deal with the possibility of simply making changes.  It was easier to pass something they new would never get signed, then to deal with changes that might have been agreed to. The GOP was more interested in making big talking points, repeal the ACA, than actually providing the alternatives that could have improved. Gaining congressional  seats is more important than anything else for the Republicans.  Now they have the opportunity to repeal and replace but they have no replacement available and need three years to put a plan together according to their Speaker.