Axios

I'm struck by how many people in D.C. health care circles are predicting the same outcome for the Obamacare repeal battles: Trump and congressional Republicans will end up with a program that's built on the framework of Obamacare, but modified to reflect Republican principles, like:

• More choices of health coverage
• An alternative to the individual mandate
• More flexibility for states to try different approaches

In other words, the repeal will really be a rebranding of Obamacare, and Republicans will have to sell the hell out of it. Always Be Closing!

When Obamacare passed Congress, Democrats tried to balance competing interests and minimize winners and losers. Once it's repealed, Republicans will have to do the same thing.

It's not clear that they can.

They'll try, but unless their replacement covers as many newly insured people as Obamacare, everyone who benefits from more paying customers will be hurt — and hospitals and other health care providers are bracing for the biggest hit.

John Cornyn, the #2 Senate Republican, after meeting with some GOP governors, said no one who is currently on Medicaid will lose their coverage. How that squares with repealing Obamacare's Medicaid expansion along with most of the rest of the law is unclear.

When asked if pro-expansion state governors, including Ohio Gov. John Kasich, expressed concern over their constituents losing coverage, Cornyn said: "We're all concerned, but it ain't gonna happen."

What's next: That's a big promise, but it also seems like the only way out of the political mess repealing Medicaid expansion would create. Now the question is how to make good on that promise.

As of tomorrow, the Centers for Medicare and Medicaid Services, the agency that runs the implementation of Obamacare, will have a new acting director. It's Patrick Conway, currently the head of the Center for Medicare and Medicaid Innovation, the office that runs the cost-savings experiments under Obamacare that have drawn so much ire from physicians — and from Congress.

Andy Slavitt, the current chief of the Centers for Medicare and Medicaid Services, will step down tomorrow when President Obama leaves office. In a series of tweets Thursday, he praised Conway and said the agency will be in good hands:

Conway will have the responsibility of closing out the last week and a half of Obamacare enrollment, which ends on Jan. 31.

One striking moment in Tom Price's testimony: The part where he wondered aloud why so many Americans still don't have health insurance, even under Obamacare, and what can be done to help them get it. He might start by reading this Kaiser Family Foundation analysis of the 27 million people who are still uninsured.

Republicans on the Hill are taking a close look at an idea they believe could actually expand health coverage: just enroll everyone in a health plan unless they opt out.