Trump does not have a conservative alternative to the Affordable Care Act; the Affordable Care Act itself is the conservative alternative to a single payer plan that would insure everyone (Medicare for all.)  What came to be known as the Affordable Care Act, or colloquially, Obamacare, was percolating at least since the early 1970s when President Nixon proposed, and Sen. Edward Kennedy opposed, a plan that was very much like the ACA.  Trump and his allies in Congress will likely be able to repeal large parts of the ACA -- but obviously they have nothing with which to replace it; they never did. The result will be that millions of people will have no health insurance.  As a result, the rate and number of abortions will increase -- no matter who Trump appoints to the bench or what legislation is passed or what executive actions Trump takes or rescinds.  The 'pro-life' folks bought a pig in a poke.