Trump's new health care opportunity: Our view

President Trump says he has a new strategy to address problems with the Affordable Care Act. He is going to wait "to let Obamacare explode" and then wait some more to let the Democrats "come to us" so we can "make one beautiful deal for the people."

But that is not a new strategy. It is waiting that created Friday's legislative disaster in which Trump and House Speaker Paul Ryan poured all their political capital into a failed effort to repeal the 7-year-old law, only to have to abort the mission at the last minute.

When Democrats united to pass the Affordable Care Act in 2010, Republicans united in opposition but did not rush to come up with a plan of their own. Since taking control of the House 2011 and Senate in 2014, they have voted to repeal, weaken or delay the ACA dozens of times. But still they did not rush to come up with an alternative plan. When Trump rallied voters to win the presidency last year, he united them with vows to "repeal and replace" Obamacare. And neither he nor his transition team rushed to come up with an alternative. Trump and Ryan's American Health Care Act was 18 days old when House Republicans killed it.

"The beauty," Trump says of waiting for an explosion, "is that (the Democrats) own Obamacare." Except it is Republicans who now own the federal government — the House of Representatives and the Senate and the White House — while they ask the American public to wait yet again for Republicans to come up with something, anything, that they are actually for.

There is an alternative: Reach out to Democrats now. Drop the repeal-and-replace rhetoric. Try repair and rebrand instead.

Some of President Trump’s rhetoric presaged just this approach, particularly his promises to get terrific health care for everybody and his vow to leave nobody worse off. He now has a ready-made opportunity to swoop in and “save” Obamacare. He should start working on that now.

He will have plenty of allies. The House Freedom Caucus, an all-or-nothing, my-way-or-the-highway group that has been a force for disruption since the birth of the Tea Party movement, got most of the ink and pixels during the GOP’s march to doom. But one of the most welcome revelations was the size and clout of the House forces of moderation. This group has the potential to grow in districts in which conservative voters have seen or experienced the value of insurance coverage made possible by the Affordable Care Act.

Obamacare lives, but for how long?: Other views

Democrats are no more eager than Republicans to see insurers quit markets and leave people in the lurch, or raise premiums and deductibles so high people can’t afford them. It would be nice if Republicans were equally enthused to expand coverage. Short of that, they should at least be interested in making sure existing coverage doesn’t erode. How best to achieve that?

There is plenty for Republicans and Democrats to discuss if both parties can focus on repair.

For a start, Congress could restore some of the protections the ACA initially provided and Republicans have challenged, such as money meant to help people cope with high deductibles (“cost sharing reductions”). It also means more states expanding Medicaid, which leads to lower rates for private plans. It could mean more states creating reinsurance pools, which lower premiums by saving insurance companies money. It could mean finding a way to lower prescription drug prices and requiring transparent pricing of medical services. It does not mean repealing the tax increases and decimating Medicaid in order to cut taxes for wealthy Americans.

Insurance companies and the country at large will be looking for signals from Trump, Ryan and Tom Price, the secretary of Health and Human Services. Will they stand by and wait for Obamacare to explode? Will they intervene and make sure it does? Or will they work with a structure that is serving millions well and could be fixed for those it is hurting? A structure that originated with the conservative Heritage Foundation, came to fruition under Republican Gov. Mitt Romney in Massachusetts, and was so successful that Democrats used it as a model for national coverage?

Only option 3 will serve the country well. The sooner Trump stops waiting and starts working with Democrats and Republican moderates, the healthier the insurance markets — and Americans — will be.

USA TODAY's editorial opinions are decided by its Editorial Board, separate from the news staff. Most editorials are coupled with an opposing view — a unique USA TODAY feature.

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