It's sad when the Republicans take Kathleen Sebelius' resignation as a "victory." From what I understand the Secretary of Health and Human Services was ready to leave at the end of the first term but stayed for the launch of the insurance exchanges. As a result, she became the prime target for the Republican "oversight committee," which held her personally accountable for the "failed" launch of the exchanges. To Sebelius' credit, she gutted out the launch, but was given a less than heroic endorsement for her efforts to resolve the website debacle. It seemed the Obama administration had already tendered her resignation behind closed doors.
"Obamacare" has been a work in progress from day one, withstanding blistering attacks from all sides. The Republican House voted no less than 50 times to repeal the historic act, and has voted to defund it in all the budgets it has presented. Four years later, there appears to be no sign the Republicans will relent in their assault. They have chosen to make it the centerpiece of the midterm elections, as they did in 2010. Only problem now is that Americans have come to accept the ACA to a much larger degree.
The Republicans have had to rethink their strategy given that the exchanges yielded over 7 million enrollees. It wasn't the unmitigated disaster they had imagined. The program reached its revised goal after the poor roll out. Medicaid expansion further added to the final enrollment count, reducing the total number of uninsured Americans to its lowest level since 2009. Now, the GOP'ers are busily trying to cobble together an alternative health insurance program, which they can present to voters.
Their front man appears to be Bobby Jindal, who unveiled his plan after the close of the exchanges. It seems to build on that proposed earlier by Republican Congressmen, who more or less cherry-picked from the ACA, taking those parts which they regarded as the least offensive, and added a few sour cherries of their own. The only problem is that the ACA has been held up in the Supreme Court and is the law of the land, so unless the Republicans can turn over the Senate there is not much chance they will be able to enact their new health care vision. It would take 60 votes in the Senate to overturn the Affordable Care Act, which would mean they would have to win virtually every seat, a Promethean task to say the least.
In the meantime, the Republicans will try to block the administration's nominee, Sylvia Matthews Burwell, to replace Sebelius as HHS Secretary. I assume the "nuclear option" is still in effect and all the Democrats need is a straight up vote on her nomination. But, I'm sure the Republicans will use the opportunity to vent their ire for voter consumption.