In the background of the White House’s bedlam, congressional Republicans have been quietly chipping away at the Affordable Care Act, threatening its efficacy. Health care experts warn that the changes are tantamount to a partial repeal of President Barack Obama’s signature act, with more dire consequences than the conservative caucus’s failed 2017 effort to ditch the public health insurance system. “The net effect of the changes they are making is a partial repeal of the ACA,” Larry Levitt,