Connie Nuss the reason that Ryan and the so called president needed to repeal the ACA immediately was for the tax cuts that destroying Medicaid would give them. Those tax cuts for the uber wealthy would in turn allow even bigger and better tax cuts for the uber wealthy in the upcoming "tax reform" discussion. As it was in the beginning of the ACA is now and ever shall be the primary reason the GOP did not like the ACA is that it taxed the capital gains of those making more than $200,000 in order to pay for the subsidies that allowed tens of millions of Americans to finally be able to buy affordable health insurance. Repealing the ACA was never about freedoms or death panels or any of the other lies conjured up by the primary GOP campaign contributors but always about tax cuts, tax cuts and more tax cuts and the public health and welfare be damned. Once the American people saw that cruelty they rejected it. See Doctor Mitchell's LTE.