As we look ahead to the 115th Congress, Republicans are likely to take up repeal and replacement of the Affordable Care Act. Repeal and replace is more accurately described as a transition where Republicans design a version of health care reform they will own and defend. In doing so, Republicans must consider three important factors as they look at policy, the first of which is talking to insurers.

The Affordable Care Act has not worked as well as intended. The Congressional Budget Office projected nearly twice as many Americans to be covered by marketplaces as actually have been covered today. In creating the structures of the Affordable Care Act, Democrats made policy decisions that ultimately led to the weakness of the current marketplace.

Republicans believe they can implement policies that provide consumers with market-driven, high-value, cost-efficient health care coverage choices provided by private insurers. In doing so, Republicans must engage insurers as part of that process.

Of course some might claim that engaging insurers is akin to letting the fox guard the hen house, but the stakeholders who provide coverage arguably know their industry best. Much as the Democrats are reaping the consequence of decisions made in 2009, Republicans will face similar consequences if they make decisions that are adverse to the insurance industry.

This post is the second in a series, with the first being published yesterday. In the posts that follow, we will describe additional critical issues that Republicans must tackle as they transition the Affordable Care Act into a version of health care reform that they must own and defend.