What do you think are the odds that they will work to amend it and stop wasting time and tax payer money trying to scrap it? Also, thoughts on what the 1st change to the ACA should be?
The ACA was never meant to be a final product. The key was laying a foundation on which to build and taking a somewhat scattershot approach, trying lots of different ideas at once. But implicit in the notion of trying lots of things or fostering different approaches is that you're going to evolve and learn from them.
Most of this happens in the states, so they're the ones with the primary responsibility for evaluating what is and isn't working and making the necessary course corrections. Some changes in the federal framework can be made without Congress, in places like the CMS Innovation Center or other pieces of the executive branch. But there may also be places where Congress will need to step in and act as we see what is and isn't working.
At the moment, it's not entirely clear the degree to which Congress is up to the challenge. For instance, the ACA authorized grants for states to help them get to work retooling their tort laws. Like much of the rest of the law, the philosophy was that letting 50 flowers bloom would reveal the best paths forward (though the idea of tort reform grants was actually borrowed from Republican legislation). To date I don't believe the House has actually appropriated the funds to make those grants happen so no state tort laws have yet been impacted. So if they're not even willing to start the experiments where their actions are still needed--even in areas they ostensibly support, like tort reform--that doesn't bode well for the chances of them building on the successes and correcting the failures of other ongoing experiments.
It's going to be a pretty wild decade. But a fascinating one.