A realistic viable replacement can not be passed using reconciliation. The reason for the bill that failed was to repeal Obamacare and allow the House and Senate to go to committee and develop a viable replacement. Reconciliation can only be used for taxing and spending, any major constructive changes need to be passed with 60 votes. This is where the bipartisanship and coming together would have taken place. This is were Right and Left ideas are hashed over and compromises are made. The point being Obamacare, has to be repealed before any Democrat is going to negotiate on a somewhat level playing field.