The rationale heard repeatedly in Congress from Minnesota Rep. Jason Lewis and others during the debate over the Republican health reform plan boiled down to this: We should vote for this bill because we made a campaign promise to repeal Obamacare.

What Lewis and his party need to grasp, especially in the wake of the GOP plan's recent failure, is that voters' judgments are going to be based far more on pragmatic metrics than political ones. Primarily, did Republicans now controlling Congress help friends, family and neighbors better afford quality care and coverage?

In our view, the Republican plan, known as the American Health Care Act (AHCA), would have made health insurance more affordable for some — the young and wealthy — but with unacceptable trade-offs, such as dramatic premiums increases for older people, the loss of coverage for 24 million people and cuts to long-term care funding. Ongoing Republican arguments for this plan are moot. They don't have the numbers to pass it.

Those with an eye toward re-election in 2018 and beyond should see the current situation as an opportunity not a setback. While President Trump has said accurately, if belatedly, that health care is "hard," fixing the Obama health reform law's flaws need not be. There is widespread consensus in health policy circles on what should be done. Those doing political calculations should also factor in that fixing what's in place vs. starting over with something brand-new is an easier sell to voters. That's why the 2010 Obama law has broad support, while polls showed that fewer than 20 percent supported the AHCA.

A message from congressional leadership saying that pragmatic fixes are the strategy, even for the short-term, would help stabilize the individual health insurance market right now. This market, where about 5 percent of Minnesotans buy coverage, is where consumers buy plans if they don't get insurance through employers or public programs such as Medicare. Uncertainty over congressional action has made insurers leery. The result: fewer choices and higher-priced premiums to cover their risk.

More specific strategies for improving competition and affordability shouldn't be a heavy lift, either. Congress should revive the Obama law's temporary financial-risk protection programs for insurers. These funds were put in place to help insurers adjust to an individual market that reformers knew would be made volatile by new consumer protections and better access to coverage. But a 2015 measure backed by Sen. Marco Rubio, R-Fla., undercut one of these aid programs, a move that led to rising premiums.

Expanding and extending another one of these financial risk programs — "reinsurance" — is also worthwhile. Reinsurance offsets medical care costs for consumers with expensive medical needs. Just a few of these patients can sharply drive up premiums. Minnesota legislators have passed a reinsurance measure this session, but continuing that level of state funding is daunting.

Congress also should back away from its efforts to derail the Obama law's "cost-sharing" provisions, which helped consumers meet deductibles. In addition, the Trump administration should signal that it will vigorously enforce the individual mandate to buy insurance. That would enlarge the insurance "risk pool" and help drive down premium costs for everyone.

The brash real-estate developer in the White House might also consider going beyond incremental improvements. Allowing Americans 55 and older to buy into Medicare, the federally run program for those 65 and up, would likely have broad voter appeal and reset the health debate.

Launching a Medicare buy-in would be more complex than it first appears, but backing it would allow Trump to rebrand himself as a health care innovator. That could be a boost for an administration struggling to find its footing.