Here are some things the GOP could productively do on healthcare, that have little or nothing to do with repealing the ACA:
1. Price transparency and consistency. Require all providers (hospitals, doctors, etc..) to clearly publish their prices by service and by diagnosis in advance, physically and electronically, in both human and machine-readable formats.
2. Stop gouging the uninsured. Require that providers give people who are paying out of their own pocket “most favored nation” status – giving them the best price that the provider offers to any private insurer.
3. Easier approval for generics in the US – to create more price competition in drugs and devices, and bring prices down.
4. FDA drug approval reciprocity with Europe. Once a drug is approved in Europe or the US, it defaults to an approved state across the Atlantic.
5. Tort reform. Cap pain and suffering awards. Reduce some of the drive for defensive medicine.
6. *Increase* medical R&D from the NIH and elsewhere (instead of decreasing it, as the Trump budget proposed). And specifically fund R&D into more cost-effective treatments that can bring the cost of healthcare down.
7. Allow cross-state exchanges.
8. Slowly phase out the employer health care tax credit – the single thing that most ties health insurance to one’s job, and which significantly distorts insurance markets.
All of these are compatible with both market-oriented viewpoints and the ACA. If the GOP cares about improving healthcare, and wants to use market-oriented and innovation-oriented approaches to do so, all of these are paths towards that.