The effects of a repeal of ACA

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Here is why the Republicans want to abolish Obamacare:

Despite characterizing themselves as the party of fiscal conservatism, Republicans are planning on pushing through a legislative agenda under President-elect Donald Trump that will cause the deficit to balloon. These include an important method for repealing the Affordable Care Act, namely a budget resolution that will add $9 trillion to the debt by 2026. The actual Affordable Care Act repeal will eliminate more than $1 trillion in revenue that had been acquired through taxes included in the bill in order to maintain a balanced budget. Finally, Republicans are considering passage of a spending bill in excess of $1 trillion to complete unfinished Cabinet budgets, one that is expected to include allocations for expensive Trump proposals like a wall on the U.S.-Mexican border. “One of the things that we’re focusing on is getting people back to work, is economic growth,” House Speaker Paul Ryan said to reporters on Tuesday. “You can’t ever balance the budget if you don’t get this economy growing.” In 2011, though, Ryan had said, “The country’s biggest challenge, domestically speaking, no doubt about it, is a debt crisis.”

Deficits don’t matter (again)! Paul Ryan promotes Congress’ upcoming spending binge - Salon.com

It's simple

The Affordable Care Act (ACA), which President-elect Donald Trump and the Republican-controlled Congress have vowed to repeal, was crafted to overcome two basic problems in the provision of health care in the United States. First, the costs are incredibly skewed, with just 10 percent of patients accounting for almost two thirds of the nation’s healthcare spending. The other problem is asymmetric information: Patients have far more knowledge about the state of their own health than insurers do. This means that the people with the largest costs are the ones most likely to sign up for insurance. These two problems make it impossible to get to universal coverage under a purely market-based system.

The Economics of the Affordable Care Act

If you want to cover these people you will often have to subsidize them as many simply can't afford to buy the healthcare in a market based system as insurers will devise all kinds of methods to keep them out, limit spending on them or charge huge premiums. 

Obamacare did this by:

• Ending discrimination by insurers so they can't keep sick people out, limit spending on them or charge them hugely higher rates
  
• To limit the adverse selection problem (only sick people insuring themselves), the individual mandate was set, everybody needs to buy insurance
  
• But not everybody can afford it, hence the subsidies. 
  

It's the latter which so riles Republicans, as it's redistribution to which they have an ideologically (and financier) driven objection.