Since Congress failed to pass a bill repealing and replacing the Affordable Care Act (ACA), Republican lawmakers have been in a quandary.  Because they have been predicting for so long that the ACA was going to fail, some Republicans seemed to be determined to make that happen. However, others realize that the part of the law they can sabotage – the subsidized marketplace for private insurance – is critically important for millions of Americans and also a centrist approach for increasing access to health care.