“Why, why, why... ?”

In a speech Monday at the National Press Club, US Health and Human Services Secretary Sylvia Mathews Burwell puzzled over the GOP’s plan to repeal the Affordable Care Act without having replacement legislation at the ready. “Why do you want to want to repeal it without telling what we’re going to do?” she said. “That’s not what we owe the American people.”

Her question—and her whole speech—are part of a coordinated campaign by the outgoing Administration to protect the signature healthcare legislation from Republican leaders, who are already abuzz with plans for a swift repeal once President-elect Donald Trump takes office January 20.

Instead of proposing replacement legislation, GOP leaders are planning on delaying the implementation of the repeal—perhaps by several years—so that they can come up with their own healthcare plan.

Burwell and President Barack Obama called that dangerous.

“This approach of ‘repeal first and replace later’ is, simply put, irresponsible—and could slowly bleed the health care system that all of us depend on,” Obama wrote in an editorial in the New England Journal of Medicine, published Friday.

In her speech, Burwell noted that insurance companies have until mid-2017 to decide whether they’ll participate in 2018 marketplaces and how they will price their plans. Uncertainty about what will happen with the ACA may cause insurance companies to raise prices or pull out of marketplaces altogether. Hospitals may cut back on services, not knowing if they’ll be compensated. Employers may struggle to make hiring and compensation decisions if they don’t know how their healthcare costs will change. And millions of Americans, particularly those with pre-existing conditions who gained affordable coverage under the ACA, fear losing their coverage, Burwell said.

Around 20 million Americans gained coverage under the law. So far, 8.8 million people—a record high—have already signed up for 2017 plans through healthcare.gov during this enrollment period, which ends January 31. Burwell noted that polls of those covered suggest that people are generally happy with their plans. And a new scientific study, published Monday in the journal Cancer, suggests that the law is measurably improving access to cancer prevention services. The study also reports increased cancer screening among those in low socioeconomic brackets—groups that generally miss out on critical preventative services.

The Cancer study found that, after the ACA reduced out-of-pocket costs for mammograms, there were across-the-board upticks in screenings across the country, including among lower-income patients. The researchers also looked at colonoscopies, but didn’t see an uptick there. They speculate that other barriers—such as perceived discomfort, the need to prepare beforehand, and loopholes that allow for out-of-pocket costs—may have held down access.

Still, the study is a positive sign that the ACA is doing what the Obama Administration intended, which is to improve access, quality, and affordability of healthcare.

“Are there things that need to be improved... yes,” Burwell said in her speech. But a repeal and limbo are not the way forward, she argued.

So far, the GOP has been largely unmoved by Democrats pleas to preserve the ACA or at least pass legislation that maintains current coverage and gains—such as barring insurance companies from discriminating against those with preexisting conditions, setting minimum standards for coverage, and allowing children to stay on their parents plans until they turn 26.

In a Monday opinion piece on Fox News, Senate Majority Leader Mitch McConnell (R-Ky.) wrote:

We’re acting quickly because ObamaCare is collapsing under its own weight, and things will continue to get worse otherwise. That doesn’t mean the law will end overnight. There will be a stable transition period, and once repeal is passed, we will turn to replacement policies that cost less and work better than what we have now.

Yet, some members of the party are nervous about the delayed replacement, including Tom Cotton (R-Ark.), Bob Corker (R-Tenn.), Rand Paul (R-Ky.), and—most notably—President-elect Trump.

Earlier today, Sen. Paul reported that Trump called him Friday to say he agreed that “we should vote on Obamacare replacement at the same time” as repeal. Paul said he is now rushing to get the President-elect replacement plans.