The Republican Party’s campaign of maximalist opposition to the Affordable Care Act began almost seven years ago, and has continued through the law’s passage to this very day.

One of the first things Republicans did when they gained control of the House in 2011 was pass legislation to repeal Obamacare. They have supported multiple lawsuits aimed at eliminating or eviscerating the law, discouraged the uninsured from securing its benefits, and shut down the government in protest of the law’s implementation.

At some point along the way—several years ago now—Republican Party leaders accepted that their efforts to sabotage the law needed to be paired with gestures to the idea that the law should be replaced. Their repeated failure to turn those gestures into legislative action quickly became an emblem of the party’s basic indifference to this issue. And now a new development—the Democrats’ ongoing, intra-party argument over the future of American health policy—has thrown the GOP’s indifference into even sharper relief.

Once it became clear that the Affordable Care Act would be implemented, and its benefits would spread, Republican strategists conceded that promising to repeal the law outright, without a plan for displaced beneficiaries, was a recipe for political disaster.

But none of them had any clue how to replace Obamacare, let alone how to unite the party behind a single alternative to it. Indeed, the GOP has never really been able to achieve unanimous agreement that the law should be replaced at all, or on anything other than the certainty that the government is helping to insure too many people.