Although Donald Trump has tried belatedly to pivot to more conventional Republican Party talking points about economic issues, such as taxes and health care, it’s pretty much anybody’s guess what he would actually do in the Oval Office.

One of the few things that has remained constant in Trump’s speeches on health care is his desire to repeal the Affordable Care Act. What has been much less clear has been what he intends to replace it with.

This statement from nearly a year ago, during a speech, for instance: “Obamacare. We’re going to repel it, we’re going to replace it, get something great. Repeal it, replace it, get something great!”

On occasion, particularly at the beginning of his campaign, he hinted that his appetite for government in health care was just as great, if not greater, than President Obama’s. In one interview he said the “government will pay for it” when asked who would pay for his promise to provide universal coverage.

He has also, in general terms, decried insurance companies, suggesting that he, as a master deal-maker, would be able to force them to offer care for much lower prices.

On other days, particularly recently, the billionaire has read classic conservative proposals on health care from a teleprompter. His website also largely sticks to familiar GOP ideas, such as turning Medicaid into a block grant program, allowing insurance companies to sell policies across state lines and making individual health insurance premiums tax deductible.

At the very least, it appears health care is an issue that Trump is willing to allow be dictated by the GOP establishment. That means that if he is elected, Republicans will expect him to sign an ACA repeal, although that would likely not be possible unless the GOP gains enough seats in the U.S. Senate to break a Democratic filibuster.

The more important question, perhaps, is what Republicans in Congress will do about Obamacare in the likely event that Hillary Clinton is elected president. Will they continue flying the “repeal” banner that they have carried for the past six years?

"There just won't be any credible way to keep talking about repealing the Affordable Care Act," Ron Pollack, executive director of Families USA and a supporter of the law, told the Associated Press.

There have been a number of indications over the past year that some Republicans are losing their interest in fighting against the ACA, especially now that it has become ingrained in the U.S. health care landscape. In the event of another Democratic administration, some Republicans may consider working instead with Democrats to improve the law.

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