True, the GOP didn’t replace it.
All they did was repeal the universal coverage mandate. But think through the implications.
Now we are back to where if you don’t have insurance, and get your head cracked open in a motorcycle accident (no helmet needed where I live), you get a couple million dollars in free care. (Or, if you prefer, care that is free except for having to take calls from bill collectors and/or file for bankruptcy.)
To me, the Affordable Care Act was mostly about saying that if you could afford it, you needed to contribute to the cost of your care. No more freeloading.
I realize that this is not how it was framed politically. It was framed as liberals helping people, and Republicans wanting to hold down costs. The problem with this framing is that US hospitals are required to treat everyone with an urgent condition, even if they openly admit unwillingness to pay. It’s true they can try claiming cancer isn’t urgent, but a high proportion of US health care expenses are at end of life, and they can’t avoid that, just like they can’t ignore chest pain. Then the hospitals pass on the cost, of treating freeloaders, to people who do have insurance. Actually, EMTALA (see my link above), plus no insurance mandate, more clearly equates to socialized medicine than does a requirement to buy a private insurance plan.
I realize that other aspects of the Affordable Care Act remain, such as the marketplace plans. But I don’t see how they can remain Affordable for long now that only people with high health care needs have a strong incentive to buy them.
As for the rule against pre-existing condition limitations, yes, that is still on the books. That’s why people will risk waiting to get insurance until they are sick, destroying the Affordable Care Act financial structure.
I should also acknowledge that Massachusetts, AKA Romneycare, has its own insurance mandate, so the exchange plans there are unlikely to collapse.