Boehner still wants to repeal Obamacare. Or not.

Here’s a sign of how tenuous a hold House Speaker John A. Boehner (R-Ohio) has on his fellow Republicans: Seemingly every time he sounds a note of pragmatism, he has to follow up his remarks a few hours later to clarify that he’s not conceding a thing.

A good example comes in my colleague Lisa Mascaro’s story about an interview Boehner gave ABC News’ Diane Sawyer on Thursday. In addition to reiterating his opposition to higher tax rates, Boehner weighed in on the fate of the 2010 Patient Protection and Affordable Care Act, better known as Obamacare.

Noting that Republicans had pledged to repeal the law in 2013 if Mitt Romney was elected president, Sawyer asked, “Is that still your mission?” Boehner replied: “I think the election changes that. It’s pretty clear, the president was reelected. Obamacare is the law of the land.”

He went on to say that parts of the law “are going to be very difficult to implement and very expensive,” and as the government looks for ways to cut the deficit, “everything has to be on the table.” But when Sawyer said, “But you won’t be spending the time next year trying to repeal Obamacare,” the speaker did not disagree. Instead, he said: “There certainly may be parts of it that we believe need to be changed; we may do that. No decisions at this point.”

There’s no mystery here: Boehner was just acknowledging reality. Without a Republican president in 2013, there will be no repeal of the Affordable Care Act. Yes, it’s expensive. But once the insurance protections and subsidies go into full effect in 2014, enabling tens of millions of uninsured Americans to obtain coverage, it’s hard to imagine a future Congress turning back.

Nevertheless, not long after ABC News posted a story about the interview, Boehner felt compelled to walk his comments back. He tweeted: “ObamaCare is law of the land, but it is raising costs & threatening jobs. Our goal has been, and will remain, #fullrepeal.”

Election or no election, the fight goes on. In another news flash, Rep. Ron Paul (R-Texas) continues his quest to end the Federal Reserve. And Donald Trump redoubles his search for President Obama’s college transcripts.

Why do Republicans keep shaking their fists at the moon about the Affordable Care Act? No one has ever pretended that the measure was the ne plus ultra in healthcare reform. Even supporters knew that Congress was going to have to do more work to ensure that the goals of the law were met, particularly on cost containment. As long as Republicans insisted on dumping the entire thing, none of that work was possible.

I know, I know, Obamacare is unpopular, and many conservatives believe it will make the system more expensive and inefficient, not less. But polls have long shown that the public likes most of the law’s provisions, even if they say they dislike the measure as a whole. And there should be no disagreement about the underlying concept of the law, which is that healthcare should be more accessible, affordable and effective.

Now that the GOP’s hopes of winning the White House and a majority of both chambers of Congress have been dashed, it’s time for Republicans to set a new goal for healthcare reform -- something closer to Boeher’s initial remarks than his subsequent tweet. It’s no longer about repealing or even replacing the Affordable Care Act. It’s about making the law work, so that more Americans obtain coverage and rising healthcare costs don’t bankrupt the country.

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Follow Jon Healey on Twitter @jcahealey