By Pat Loeb

by Pat Loeb

PHILADELPHIA (CBS) — A flurry of activity around the Affordable Care Act in the past week has created uncertainty but, for the moment, nothing has actually changed.

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There are efforts on several fronts to make changes without harming those who get their insurance through the Act.

An executive order Donald Trump signed last week fulfills a campaign pledge to begin repealing the law on his first day, but Republican Senator Susan Collins says it doesn’t actually accomplish anything.

“Until there’s a secretary who can do the rule-making to rescind regulations, it’s very difficult to say what the impact’s going to be,” she said.

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Collins spoke at a news conference where she proposed a replacement for the Act, something that she says her party is more intent on now that it’s paved the way for a repeal.

Meanwhile, state officials warned an appeal could leave more than half a million Pennsylvanians without insurance and cost the state $3 billion, but Drexel law and health policy management professor Rob Field believes that is at least several months away.

“To (repeal the individual mandate) without a replacement plan really would bring chaos to the individual markets and, at this point, Trump would own that chaos and that wouldn’t look very good for him,” Field said.

State Treasurer Joe Torsella says a repeal of the Medicaid expansion would be a mistake.

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“It would be a mistake on the human level, it would be a mistake on the policy level, it would be a mistake on the fiscal level. Beyond that though, it would be an unmitigated disaster to do it without a suitable replacement in place,” Torsella said.