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The "significance" of it is in question. If you read Frum's column, what you see is that predominately the GOP is planning on using their representation of HCR as a fund raising feature and a GOTV motivator. They don't have an real plans to "repeal and replace". For one thing, as Frum points out, it has features they can't run on, like bringing back the donut hole. They can remove some of the taxes, but that will just increase its cost. That leaves them to defund CHC, remove the mandate, and eliminate the cadillac taxes.
The problem for them is that the cadillac taxes and the mandates were their ideas. Heck, a huge portion of this thing is their idea. So they can try to "repeal" but mostly they'll either be repealing much of what they wanted in the first place, or the more popular parts like pre-existing and lifetime limits. The insurance companies want the unpopular parts kept, and the popular sections repealed. I don't see the GOP bothering to do that, especially considering that they'd need veto proof majorities, or control of the White House to accomplish it.
So it leaves the GOP to basically campaign ON the bill as being against it, but much like campaigning on abortion, there is no real intent on actually doing anything. So it isn't really much of a problem when they don't. But it does give them something to run against for several cycles, and apparently the democrats to run FROM.
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