Republicans are poised to use their control of the presidency and both houses of Congress to repeal major parts of the Affordable Care Act. But a careful review reveals that significant parts of the ACA are actually working. Specifically, it has allowed for significant expansion of insurance coverage and it is accelerating the move from a financing system that pays for the volume of services provided to one that rewards care providers for delivering higher-quality care. For these reasons, the Republicans should try to improve the ACA, not largely abandon it.