Whenever Republicans and Democrats clash on health care, Republicans are almost always on the defensive and they almost always lose the debate.

But first, their track record. Republicans have done three things that help liberate people from the burdens of Obamacare. They have (1) effectively eliminated the individual mandate, (2) allowed the purchase of short-term insurance, which is not subject to Obamacare’s regulations, and (3) allowed association health plans, which are also less rigorously regulated than Obamacare individual market plans.

In support of these changes, a recent report by the Council of Economic Advisers (CEA), Deregulating Health Insurance Markets, finds that the people who benefit from these changes will experience a gain worth $45 billion a year. The CEA concedes that as healthier people exit the (Obamacare) exchanges for less expensive alternatives, premiums will rise for middle-income enrollees with health care problems. But it concludes that the benefits to those who gain far outweigh the costs to those who lose.

For economists, that might settle the issue. But Democrats believe they recaptured the House of Representatives because of health care. In a recent congressional hearing, they argued that Republican reforms weaken the protections of Obamacare. Although only about 5% of people with private insurance are buying individual plans, just about everyone with employer-provided insurance views the individual market as the market of last resort. It’s where they would turn, should they become too sick to continue working.