In other settings the media normalization of the coming shit storm might be charming or even amusing.

First, we have the “that will never get 60 votes in the Senate” crowd. People, there will be no filibuster when the new Congress convenes in 2017; the only possible hope for a retained filibuster is that Mitch McConnell cynically enjoys power more than actually governing and wants a safety hatch of “someone to blame” (namely: Democrat minority in the Senate) for the outcomes of GOP policy decisions.

Similarly, we have the “what might they do” thought pieces. People, we know what they’ll do. They have an incurious leader that has repeatedly expressed his complete lack of interest in the policy details of even his own policy proposals. Assuming Ryan remains Speaker, we know what he’ll do. He’s been talking about it for years in explicit, legislative terms.
One notable example, “Medicare,” as a name for a program will still exist, but it will be converted to a fixed payment with which program recipients can attempt to go buy insurance on the open market. From Day One of the program, said payment will be insufficient to actually, you know, buy coverage on the market, but you can rest easy in the knowledge that the payment will never increase. But: Medicare is still there, folks! Nothing to see here, and I fully expect it to be reported in exactly those terms, because it’s been reported in exactly those terms every time he’s talked about it. Again, this is not a secret. It’s right there in the Plan for America.

Ryan’s broader proposed budgets actually contains no non-military discretionary spending at all, so the fact that Medicare will at least remain in name only is going to be characterized as a big liberal victory, I guess.

As far as Obamacare (or, really, the ACA): also toast. All the media assurances about “but the GOP will have to do the hard work of coming up with a replacement before repealing coverage” for the ~20M folks that were uninsured pre-ACA: Again, super-funny in other circumstances, media elite. The GOP has had the better part of a decade to suggest a replacement for the ACA and has offered nothing. If anything, they will drop in a high risk pool plan with capped lifetime benefit limits. The more likely outcome is the ACA is replaced with nothing. Is it any wonder that drug company stocks spiked on news of the election?

What a Democratic party should do: there’s no stopping most of it (see: filibuster, lack of), but the better long range strategy is to induce the healthcare death spiral. The community rating and associated benefits of the ACA are extremely popular. With heavy heart the Democrats should offer to gut the unpopular parts of the ACA, namely the mandate and the “Obamacare” portion, which actually subsidizes coverage for people unable to afford it on their own. We need to face the fact that the poors are in for quite the kicking over the next four years, no matter what, and but also work to keep the massively popular parts of ACA in force. The GOP, ever attracted to bad policy like cats to catnip, will be unable to resist, because: hey, popular! And so the Democrats shall have ushered in single payer health care, courtesy of the poison pill; briefly, the community rating forces coverage but eliminating the mandate allows people to buy healthcare only when they really need it, thus slowly burning the medical insurance establishment to the ground. Once there is no functional insurance infrastructure, the only remaining option is single payer. Good thing we still have that Medicare name sitting around and largely going unused.

Mostly, The Democrat needs to be planning based on gaining some seats in 2018, but then creating a wave election in 2020. You’re not going to be in control of any lever of govenment until at least 2018. Plan accordingly. Make small changes around the edges that, longer term, create a death-spiral situations to which your policy provides a positive (and ultimately the only) answer. They’re going to destroy most of the ACA no matter what, you can at least work to keep the popular parts that also happen to inexorably drag our healthcare system towards single payer.

There is zero doubt that this sort of approach creates real pain and suffering in the short term. But we’re going to get that pain and suffering no matter what. May as well make it worth something.