A better Republican strategy would be designed around Ryan’s stated goal. It would begin with the understanding that Obamacare’s worst features are its overregulation of health insurance and its centralization of regulation in Washington, D.C. The way Obamacare regulates insurers’ treatment of people with preexisting conditions, the benefits they have to offer, and the difference between what they can charge the young and the old have raised premiums and deductibles, resulted in insurance policies that are not attractive to the young and healthy, and so made the exchanges shaky at best in much of the country even with the help of the individual mandate.
Republicans already have a set of legislative ideas (if not yet actual legislation) that builds on that insight. The main Republican alternative to Obamacare — advanced in different forms by Senators Bill Cassidy, Orrin Hatch, Richard Burr, and Marco Rubio, by the House Republicans, and by Tom Price, Trump’s nominee to be secretary of health and human services — is to create a much less regulated market.