Okay, so now it’s crunch time on the Republicans’ Obamacare mantra, “repeal and replace.”

In the wake of federal judge Reed O’Connor’s December 14 ruling that the entirety of Obamacare is unconstitutional, President Trump applauded the decision, saying, “It’s a great ruling for our country.” He added, “We will be able to get great healthcare. We will sit down with the Democrats if the Supreme Court upholds.”

O’Connor’s decision is, indeed, broadly within the range of Trump administration policy; back in June, the Justice Department argued that provisions of Obamacare were unconstitutional.

Still, it’s far from clear how higher courts might rule on the case; the Supreme Court has upheld Obamacare, twice, in 2012 and 2015–although, of course, there are now two Trump appointees, Neil Gorsuch and Brett Kavanaugh, on the court.

Yet as Bloomberg News observes, the voters might get to pass judgment on the case before the judges render a verdict. That is, since the wheels of justice grind slowly, it’s possible that the case won’t be heard until 2020; in other words, Obamacare could be front and center, once again, in the 2020 elections.

In the meantime, the Democrats are in full fury. In the words of House Speaker-to-be Nancy Pelosi, O’Connor’s ruling “exposes the monstrous endgame of Republicans’ all-out assault on people with pre-existing conditions and Americans’ access to affordable healthcare.” Moreover, Sen. Charles Schumer declared that he would seek a vote in the Senate to affirm Obamacare, saying, “It’s an awful, awful ruling, and we’re going to fight this tooth and nail, and the first thing we’re going to do when we get back there in the Senate is urge—put a vote on the floor urging an intervention in the case.”

The ostensible goal of such a vote would be to have the Senate’s lawyers file an amicus brief with the courts on behalf of the Affordable Care Act. The real goal, of course, would be to put Republicans on the spot, yea or nay, on Obamacare.

After all, the Democrats believe that the political wind of healthcare is now at their back. According to a poll conducted by the Kaiser Family Foundation, 53 percent of Americans have a favorable view of Obamacare, while just 40 percent have an unfavorable view. That’s a 13-point advantage for proponents.

This Democratic edge stands in sharp contrast to polling results in the recent past. According to the same Kaiser data, in November 2010, when the Democrats were hammered in the midterm elections, support for Obamacare was 42:40, or a plus of just two points. (That year, of course, was also when Tea Party-intensity was at its peak.) And in November 2014, the favorable/unfavorable rating was 37:46, or minus nine points; so no wonder the Democrats got shellacked, too, in that midterm.

Yet these days, with Obamacare in positive territory, the Democrats are positively emboldened. All through the 2018 elections, Democrats hammered away on healthcare; one study found that a full 45 percent of their campaign ads concerned healthcare. And in the election’s closing days, they hammered even harder.

The 2018 midterm results vindicated the Dems’ strategy. A full 41 percent of voters surveyed in a nationwide exit poll identified healthcare as the most important issue, and on one key sub-issue, protecting the insurance rights of those with pre-existing conditions, 58 percent said Democrats would do a better job, while just 34 percent preferred Republicans. No wonder the donkeys won the nationwide House vote by eight points, giving them a net gain of 40 seats.

The Democrats’ healthcare victory was so pronounced that in the days that followed the election, the GOP quietly abandoned any thoughts of “repeal and replace.”

Such a stance was disappointing to most Republican healthcare experts, still eager to fight their fight on Obamacare. But the truth is, in the eight years since the 44th president signed the Affordable Care Act into law, Republicans have never come up with a common approach that truly repeals and satisfactorily replaces.

That is, it’s easy to find flaws in Obamacare, from rising insurance premiums, to the expanding of bureaucracy, to the funding of abortions and sex-change operations. (To be sure, more digging by journalists and investigators would likely find still more problems with the Obamafied health system, but Republicans should have thought of that before the November 6 elections.)

The bottom line is that Democrats now have a huge advantage, overall, on the healthcare issue. As the Kaiser Family Foundation also documented in October, Democrats hold the winning side on virtually every healthcare topic, including “improving rural healthcare,” where the blues boast an 18-point edge.

Thanks to that greater trust-reservoir, the Democrats could bat back specific accusations against the healthcare status quo. For instance, when Republicans said that Obamacare premiums were rising, Democrats countered that they were rising only because the Trump administration had sabotaged the insurance pools. Is that true? False? It’s hard for ordinary folks to know—all they know is that on healthcare, they trust the Democrats more.

Moreover, on some health issues, Democrats had a colossal advantage, and they made the most of it in the recent election. For example, on the question of protecting the insurance of those with pre-existing conditions, support in polls ranges from 65 percent to 81 percent, and any of those numbers are good enough to win.

Thus in 2018, the Democrats ran hard on the issue, and nobody ran harder than Sen. Joe Manchin of West Virginia. Manchin accused his Republican opponent, the state attorney general, of being one of those who wanted to overturn all of Obamacare, including the pre-existing conditions provision. Manchin, of course, was re-elected by a comfortable margin.

Yet now, Judge O’Connor in Texas has done it: In his ruling that Obamacare, in toto, is unconstitutional, he has forced the GOP to re-engage on the issue. And that includes the matter of pre-existing conditions, as well as other popular aspects of the law, such as the right of children under age 26 to stay on their parents’ policy—that polls at 82 percent positive.

No wonder, then, that Democrats across the nation are cheering at the opportunity to reargue the healthcare issue. (Of course, the judge’s ruling doesn’t immediately kibosh Obamacare, but you’d never know that from the Democrats.) For the Dems, it’s simple: If you have a winning hand, you’ll want to keep playing it, over and over and again.

Of course, if the Democrats have the high cards, then Republicans would be well advised to find a new game—or at least reshuffle the deck with some new issues.

As it happens, this author has been arguing that Republicans should be focusing on medical cures, as opposed to health insurance, since 2009. Yes, it’s true that people want health insurance, but what they really want, even more, is health. And while there will always be plenty to argue about in re: health insurance, there’s a lot less to argue about on health itself, including the benefits of a medical cure. Moreover, if we can make a disease completely go away—as we did with smallpox in 1980—then not only are people healthier and happier, but the system saves money, because not being sick is lot less costly than providing care.

In other words, medical cures are a way of reducing medical costs and improving people’s lives—the essence of a win-win. A win, in fact, that both political parties can celebrate.

By contrast, if the Republican plan on healthcare—make that, health insurance—can be defined as “taking something away” from people, namely, health insurance—well, we’ve seen how that plays out.

In 2017, with those thoughts in mind, this author compared Republican efforts to repeal Obamacare to World War One trench warfare–that is, a lot of bleeding, but not much upside. Also at Breitbart News, this author has argued that what people really want is breakthroughs on medical cures, starting with, say, advances against the dreaded Alzheimer’s Disease. And so a truly MAGA healthcare plan would lead off with medical cures as part of a comprehensive approach to healthcare, of which health-insurance reform is a part, but only a part.

After all, there’s always some dire new medical threat; most recently, we’ve seen an outbreak of a polio-like illness, acute flaccid myelitis, which this year alone has struck down at least 116 Americans. Better treatment, or a cure, or at least a vaccine, would not only be popular, but would also undoubtedly be cheaper, long term, than financing the care for a whole a new group of paralytics.

For reasons we have seen, most Republican politicos didn’t want the healthcare issue to come up again in 2019—they have suffered enough. But now the issue has arisen, and the GOP has no choice but to come up with better answers, lest 2020 look like 2018.

Fortunately, Republicans have some genuine successes to point to—and to learn from. Back in 2016, Sen. Roger Wicker of Mississippi and Rep. Fred Upton of Michigan teamed up to spearhead legislation to accelerate medical research and development, the 21st Century Cures Act. That bill, passed by big majorities in both chambers of Congress and signed into law by President Obama, did much to broaden the GOP’s healthcare message in ’16—and Republicans had a pretty good election that year.

Oddly, the good ideas in The Cures Act—that a cure is better than care, that it’s cheaper to beat than to treat—were neglected in 2017 and 2018, and the recent elections results, of course, speak for themselves.

So now, come 2019, the opportunity exists for Republicans do it again—to go back to a cure strategy as a key part of the pitch. Because, after all, it’s better to win than to lose.