Former House Speaker John Boehner said Thursday that he believes Republicans in Congress must marry any efforts to replace the Affordable Care Act with efforts to repeal it.

Related: Pence gives ACA attack update

Opponents of the ACA can probably succeed at making the ACA system more flexible, and giving states the ability to choose whether they want to operate ACA exchanges, or how they want to regulate the commercial coverage sold to their residents, Boehner said.

But "most of the Affordable Care Act is going to stay," Boehner said.

Popular ACA features, such as the subsidies that help low-income working people pay for coverage and restrictions on health insurers' ability to consider people's health when selling them coverage, are likely to stay, Boehner predicted.

Boehner, a Republican, represented Ohio in the House from 1991 through 2015.

Boehner said Republicans need to combine efforts to replace the ACA with efforts to repeal it because coming up with a replacement will be too difficult.

"Perfectly has always been the enemy of the good," he said.

If Republicans repeal much or all of the ACA without replacing it, "anything that happens is your fault," Boehner said. "You broke it."

Boehner talked about the ACA in Orlando, Florida, at the HIMSS17 conference, which was organized by the Healthcare Information and Management Systems Society.

Matthew Eccles posted a video of the HIMSS17 on YouTube, and this article was based on a viewing of Eccles' video.

The HIMSS17 session also featured Ed Rendell, a Democrat, who was the governor of Pennsylvania from 2003 through 2011.

Rendell said the real solution is for Republicans and Democrats to come together to improve the ACA in a bipartisan basis.

Current replacement proposals keep expensive ACA provisions but kill the provisions, such as the individual coverage mandate and ACA taxes, that help pay for the provisions, Rendell said.

In related news, the Pew Research Center reported that only 17 percent of the U.S. adults who participated in a telephone survey it sponsored earlier this month said they support full ACA repeal. Fifty-four percent of the participants said they approve of the law, according to a summary of the results.

Only 10 percent of the Republicans surveyed said they approve of the ACA, but just 44 percent of the Republicans said they favor full ACA repeal. Forty-two percent of the Republicans who participated said they want to see the ACA modified, rather than eliminated.

Fifty-three percent of the independents said they approve of the ACA. Fifteen percent of the independents said they want the law eliminated, and 29 percent of the independents said they want the law changed.

Instant Insights /

Former GOP House speaker thinks ACA system will stay

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