The document discusses the Affordable Care Act (ACA) and efforts by Republicans to repeal or replace it. It notes that Republicans prioritize reducing costs and smaller government over improving health and equity, while Democrats prioritize the latter goals over reducing costs. There were many Republican attempts to repeal the ACA during the Obama administration that were unsuccessful. Efforts to repeal the ACA could be detrimental to peoples' health by reducing access to care and disadvantaging those with pre-existing conditions. The document also discusses how legislators' decisions are often driven more by getting re-elected than serving citizens' needs.