Throughout our recent tumultuous presidential campaign, Donald Trump promised that one of his first acts would be to repeal Obamacare. He adopted that mantra from ideological Republicans in Congress who voted over 60 times (unsuccessfully) to repeal the Affordable Care Act, the centerpiece of President Barack Obama’s administration.

Only a few days after being elected, Trump started backtracking a bit, saying there are parts of the insurance reform package that he likes. Nevertheless, his election has electrified the congressional opponents, who state that repeal is their No. 1 priority and vow to repeal within a few weeks of the new session. And he sealed the deal by appointing a new Health and Human Services secretary who is virulently hostile to the ACA, Rep. Tom Price, an orthopedic surgeon.

In the midst of this chest-pounding, we’ve nevertheless observed other Republicans waffling on Obamacare. Several Republican governors recently petitioned Trump to preserve the expansion of Medicaid services in the ACA because this provision has been so effective in securing health care for their low-income residents. Moreover, a poll from the Kaiser Family Foundation in early December revealed that public support for repeal has decreased substantially since the election, with some of the greatest movement among Republican respondents. Appetite is growing to scale back but not totally eliminate the program.

What are the parts of Obamacare that people find so appealing, confirmed in poll after poll on the national level?

First, the program prevents insurers from denying insurance coverage to individuals with pre-existing conditions.

Second, Obamacare has allowed parents to purchase coverage for their adult children up to age 26, a huge issue in today’s economy where young people have trouble finding jobs with good benefits.

Third, despite the political firestorm surrounding it, the use of federal funds to expand Medicaid to more low-income people is highly supported by the public (80 percent in favor, says a Kaiser Family Foundation poll).

Fourth, Obamacare contains a provision that forbids insurers to require co-pays for preventive services, which certainly makes sense to all of us as consumers.

Fifth, the reform act outlaws lifetime limits on insurance coverage.

To be sure, there are some very unpopular parts of Obamacare as well, most recently the large jump in prices for insurance products in state exchanges. The individual mandate is also thought to be heavy-handed: every individual must demonstrate some form of insurance coverage or pay a tax penalty.

The Obamacare cost increases are indeed worrisome, some say fatal. They are due to several factors: the pent-up demand for medical care among the newly insured, unrealistic pricing policies of the participating insurers, changes in regulations, and escalating costs for pharmaceuticals and high-tech procedures.

Remember though, these are rate increases for individual plans. A very small fraction of insured Americans buy individual policies. Most people will not experience these increases because they receive insurance though their employer or through government insurance such as Medicaid, Medicare, and the Veterans Administration.

Even among those covered by individual policies in Obamacare, most (80 percent) will not feel the heat of those big increases because they get subsidies to help pay for their premiums. Additionally, if they can switch to a cheaper plan in their exchange, they can hold down the out-of-pocket costs they do have to pay.

If, after reading this, you are feeling a little muddled about the pros and cons of Obamacare, then I have made my point. This is a complex program that provides insurance coverage for 30 million people, resulting in record low numbers of uninsured in America. It is not as simple as the politicians would have you believe to repeal a program that has many popular parts.

Neither is it easy to replace it with a smattering of disconnected insurance incentives, such as tax deductions for those paying for insurance, promotion of Health Savings Accounts, or even allowing purchase of insurance across state lines. Tax deductions and HSAs are well beyond the means of the low-income people covered by Obamacare and cross-border sales have shown little promise in states (like Maine) that passed those laws. If the Republicans had a slam-dunk replacement for Obamacare, they would surely have proposed it by now.

That is why we should watch very carefully as Congress and the new Administration move relentlessly toward repeal. If they do not propose a reasonable replacement (or delay replacement), 30 million people could be thrown off health care, 80 percent of those in working families that Trump claims to represent. Our health care delivery system would reel with even more charity care and uncompensated care costs and insurance markets would scramble to re-align in an atmosphere of uncertainty and chaos.

As in prior years, Maine Senators Collins and King will be key players in these votes. Currently, both do not seem to be inclined toward repeal without replacement. If you have skin in this game, make your wishes known soon.

Lisa Miller, of Somerville, is a former legislator who served on the Health and Human Services and Appropriations and Financial Affairs committees.

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