Congressional Republicans have promised to “repeal and replace” President Obama’s health care reform law, but they still have not agreed on what that should look like. Today, Speaker John Boehner said every part of Obamacare needs to be removed:

“We voted to fully repeal the president’s healthcare law as one of our first acts as a new House majority, and our plan remains to repeal the law in its entirety,” Boehner said to reporters. “Anything short of that is unacceptable.”

But Republicans have yet to offer a viable alternative that would that would fill the void left by the law and provide coverage to the 30 million Americans who would lose insurance without Obamacare. Politico reported this morning that GOP leaders have quietly begun to float a piecemeal plan that may provide limited insurance coverage to a small portion of the uninsured. Republicans have said they would preserve the most popular provisions, like allowing young adults to stay on their parents’ health insurance until age 26, without the individual mandate that helps pay for the regulations.

But the GOP’s internal disagreement and unwillingness to offer a unified comprehensive plan suggests that they consider health care a low legislative priority. For instance, Rep. Paul Ryan (R-WI) — the GOP’s spokesman on economic issues — told the Washington Examiner on Thursday that the party will “articulate our vision” to replace the law, but wouldn’t necessarily offer a legislative solution.

This approach contrasts sharply from Republican’s pledge to “replace” reform as soon as it became law in 2010. Boehner promised in 2010 to “replace it with common-sense reforms,” and Ryan said in a 2011 speech that Republicans can’t stop at simply repealing the law and “have a responsibility to fix the broken network of government policies that have made such a mess of health care.”

But now that their strategy looks like nothing more than tossing out a law that helps expand access to health insurance while controlling costs, Republicans are telling the uninsured and those worried about rising health care costs that they are not concerned about fixing their problems.

Republicans are absolutely gleeful about the possibility that the Supreme Court may strike down the Affordable Care Act, despite the fact that doing so would increase premiums, cause millions to lose health insurance, and ultimately raise health care spending.

Now, several health experts are warning of another unintended consequence: Medicare might not be able to function properly, potentially putting patient care and payments to doctors at risk. As some experts told NPR, the program could be thrown into complete chaos:

“The Affordable Care Act has become part and parcel of the Medicare system, encouraging providers to deliver better, more integrated, better coordinated care, at lower cost,” says Judy Feder, a public policy professor at Georgetown University and former Clinton administration health official. “To all of a sudden eliminate that would be highly disruptive.”

Sara Rosenbaum, a professor of health law and policy at George Washington University, puts it a bit more bluntly: “We could find ourselves at kind of a grand stopping point for the entire health care system.”

And it’s not just Democrats warning of potential problems. Gail Wilensky, who ran Medicare and Medicaid under President George H.W. Bush, says she doesn’t think it’s likely that the court will strike down the entire health law. But if it does, she says, “it seems like it takes everything with it, including those aspects that are only very peripherally related to the expansion of coverage.”

As Rosenbaum noted, if the law is ruled unconstitutional, “Hospitals might not get paid. Nursing homes might not get paid. Doctors might not get paid. Changes in coverage that have begun to take effect for the elderly, closing the doughnut hole might not happen. We don’t know.”

This uncertainty is already spilling over into the market: the ratings service Moody’s reported earlier this month that for-profit hospitals could be hit particularly hard if the law is overturned. As the report said, “Uninsured patients enter the health care system through the emergency room and often wind up admitted and accumulating bills they don’t have the means to pay. The continued rise in uncompensated care costs would limit operators’ revenue growth and profit margins and constrain cash flow.”

-Zachary Bernstein

Rep. Michele Bachmann (R-MN)

Today is the two-year anniversary of President Barack Obama signing the Affordable Care Act, which, once fully implemented will cover 30 million Americans and begin to lower the rate of growth in health care spending. Since reform passed, however, Republicans have voted to repeal or defund the law at least 25 times and Senate Minority Leader Mitch McConnell (R-KY) is preparing to focus largely on health care as he charts “a course for a Republican Senate in 2013 and what could be a bruising reelection bid in 2014.”

During the nearly 10-month legislative battle that preceded passage and in the years after, the GOP characterized the bill as a “socialist” “government takeover” and warned Americans that the bill would destroy lives and American society, hurling apocalyptic warnings that seem downright satirical two years later:

Below are some of their most outrageous claims:

– REP. JOHN BOEHNER (R-OH): Passage of health reform is “Armageddon” because the law will “ruin our country.” [3/20/2010]

– FRMR. SEN. RICK SANTORUM (R-PA): Health reform “will destroy the country” because, “in the next year or so,” America will have to “dramatically cut the military because we can’t pay for it.” [10/23/2010]

– SEN. TOM COBURN (R-OK): “There will be no insurance industry left in three years.” [10/12/2010]

– REP. MICHELE BACHMANN (R-MN): “On page 16, you can read for yourself that no new health insurance policies can be written once this federal plan comes into effect.” [7/17/2009]

– GLENN BECK: “This is the end of prosperity in America forever … the end of America as you know it.” [11/19/2009]

– SEAN HANNITY: “If we get nationalized health care, it’s over; this is socialism.” [11/2/2009]

– REP. PAUL BROUN (R-GA): “That’s exactly what’s going on in Canada and Great Britain today…and a lot of people are going to die.” [7/10/2009]

– REP. LOUIE GOHMERT (R-TX): “I would hate to think that among five women, one of ‘em is gonna die because we go to socialized care.” [7/15/2009]

– REP. VIRGINIA FOXX (R-NC): “The Republican plan will] make sure we bring down the cost of health care for all Americans and that ensures affordable access for all Americans and is pro-life because it will not put seniors in a position of being put to death by their government.” [7/28/2009]

– SEN. TOM COBURN (R-OK): “I have a message for you: you’re going to die soon…When you restrict the ability of the primary care givers int his country to do what is best for their senior patients, what you are doing is limiting their life expectancy.” [12/1/2009]

– REP. MICHELE BACHMANN (R-MN): “Socialized medicine is the crown jewel of socialism. This will change our country forever.” [11/3/2009]

– HERMAN CAIN: “If ObamaCare had been fully implemented when I caught cancer, I’d be dead.” [8/18/2011]

– NEWT GINGRICH (R): “I think it is a disaster. I think, candidly, Governor Palin got attacked unfairly for describing what would, in effect, be death panels.” [10/11/2011]

– RICK SANTORUM (R): “What got me into this race was Obamacare…I believe, final death knell will be to America of having government control that very critical aspect of our life, which is access to the care that we need to stay alive.” [12/13/2011]

Tea Party firebrand Rep. Joe Walsh (R-IL) is apparently unsatisfied with the number of meaningless symbolic votes Speaker John Boehner (R-OH) is holding, saying in a recent interview that he would prefer to repeatedly waste the House of Representatives’ time by voting to repeal the Affordable Care Act every single month. He told Accuracy in Media for an upcoming documentary:

WALSH: If I were the Speaker, starting last year, every month we would have voted to repeal ObamaCare. I would have pulled ObamaCare up on the floor of the House yesterday.

Watch it:

Walsh’s scheme is an exercise in both redundancy and futility several times over, because no matter how many times the House passes a repeal (it only takes one time to matter), the Senate, controlled by Democrats, is not going to do the same. And even if they did, President Obama would certainly veto a bill killing his signature legislative accomplishment.

Meanwhile, Walsh would continue to enjoy his government healthcare while wasting everyone else’s time.