Story highlights Lanhee J. Chen: "Repeal and delay" would bring dramatic uncertainty to the health care system

GOP must seek solutions that will empower governors and state elected officials to address major public policy challenges, he writes

Lanhee J. Chen is the David and Diane Steffy Research Fellow at the Hoover Institution at Stanford University. He served as the policy director for Mitt Romney's 2012 presidential campaign and was a senior aide at the US Department of Health and Human Services during the George W. Bush administration. The views expressed in this commentary are his.

(CNN) The recent collapse of Republican efforts to repeal and replace Obamacare can be blamed on disagreements about policy more than anything else.

For seven years, Republicans at all levels of government were able to articulate the simple message that President Barack Obama's signature health care law had to go, and a set of better, market-based policies needed to replace it.

Lanhee J. Chen

But once the GOP captured control of the White House and both houses of Congress, it became clear that the devil really was in the details. Within their own ranks, Republicans remain divided on fundamental questions of policy -- whether to change how Medicaid is financed, whether there should to be tax credits to help low-income Americans afford private insurance, and how far to go in deregulating the marketplace.

So, what's next? Republicans may soon vote on a bill that will mirror the 2015 legislation they passed (and Obama vetoed) repealing large parts of Obamacare, without an accompanying package of replacement reforms. This approach, dubbed " repeal and delay " because it offsets the repeal of Obamacare by two years, raises significant concerns. It would introduce dramatic uncertainty into the health care system, place the most vulnerable among us at risk of losing the coverage they need, and punt on the important work of replacing Obamacare with reforms that could actually lower costs and expand choices for consumers.

The Congressional Budget Office recently estimated the impact of "repeal-and-delay" and found that, while it would decrease budget deficits significantly, it would also leave 32 million more Americans uninsured in 10 years, as compared to Obamacare. Moreover, a recent survey from the Associated Press and the University of Chicago showed that, by a 2-to-1 margin, those polled believed that Obamacare should not be repealed until a replacement was available.