Not that they’ve asked, but I have some advice for Republicans on handling the chaos in health care that they started creating seven years ago and that now imprisons them.

It’s not about power gamesmanship for party insiders. It’s about policy, practices and governance that directly connect with real people who are concerned about very real consequences — both medical and financial — in the real world.  

When it comes to health care, the American people, especially working Americans with low-income and lower-middle-income jobs, face profound uncertainties about their families’ security because Republican members of Congress are trapped in the deep hole they started digging for themselves in 2010 in the battle against the Patient Protection and Affordable Care Act, aka the ACA, aka Obamacare.

With scare rhetoric about a “loss of freedom” and an outrageous smear-and-fear effort — “death panels,” anyone? — Republicans left little room for maneuvering past the acrimony when the ACA passed the House and Senate with only Democrats voting in favor, even though the bill had had extensive public hearings, discussions, debate and scores of amendments offered by Republicans.

The final Obamacare bill was by no means perfect, but a few modifications could quickly fix some of those imperfections and ease the fears about costs that unsettle families and health insurance markets alike. What stands in the way of Republicans working out those changes with the opposition Democrats are the fears of the Republicans themselves.

And rather than leading their members through the chaos and confusion to relatively simple collaborative Obamacare solutions for the American people, the Republican leadership seems to be doing all it can to stoke the threats that have people so worried in the first place. 

I think there’s a way out of this mess for Republicans, and a few have done it. It takes a clear eye, a clear head and courage to challenge authority in favor of the commitment they’ve made to serve the needs of their constituents. But if the good-faith Republican public servants in Congress don’t claw their way out of the hole and back to sanity at the surface, the American people will be the worse for it.

The first thing Republicans need to do is start ignoring the bizarre humanoid currently appearing in the role of president of the United States. Standing at the edge of the hole, far above the Republicans trying to scramble up and out, Donald Trump tosses down more shovels, and Twitter-screams the equivalent of “Keep digging, you losers!” 

And every now and then, he has one of his cheap flunkies make the lives of Republicans more miserable by dumping a load of garbage into the hole and onto their heads. Last week, a fetid, foul-mouthed personnel shuffle that had nothing to do with health care served the purpose.

Trump has given no indication that he knows or cares what’s been in any of the Republican health care proposals that were considered and rejected by the Senate last week. He seems similarly devoid of interest about what might or should be in a future bill that he keeps haranguing Republicans to come up with.

It doesn’t matter. He will welcome any anti-Obamacare bill that Republicans manage to get to his desk. If that happens, he will sign it, and he will call it beautiful, even if it makes life worse for millions of people who voted for him and millions of others who didn’t. He will declare it a tremendous victory for America, by which he will mean a tremendous victory for him.  Republicans, stop digging. Trump is not on your side. He’s on his side.

The ostensible Republican leaders in the House and Senate keep reminding their members about the “promise”  Republicans have been making to voters since 2010: They will wipe out every trace of Obamacare as soon as possible. With Republicans already controlling both houses of Congress, the death of Obamacare finally became theoretically possible with Trump’s inauguration Jan. 20.

The “promise” is an intimidation ploy. Party leaders say the promise got Republicans elected, and “breaking” the promise would get them unelected next time around. Trump explicitly threatened last week that Republicans exercising their own judgment on this issue could find themselves facing a well-financed Republican challenger in a primary.

Enough is enough. Barack Obama signed the ACA into law on March 23, 2010. That was more than seven years ago. In 21st-century political terms, it might as well have been the Paleozoic Era.

Republicans’ release from the outdated “promise” comes via two words: Things change.

That’s been the approach taken by Lisa Murkowski, one of two Republican senators from Alaska, in her defiance of Trump’s attempted bullying and party leaders during their maniacal and ultimately unsuccessful frenzy last week to kill Obamacare and strip health care from millions of American men, women and children.

Circumstances in Alaska had changed since 2014, Murkowski said simply. It was the year Obamacare coverage first became available to the general public.

Indeed, in Alaska and throughout the country, the overwhelmingly negative opinions about Obamacare shaped by the Republicans’ deceptive early rhetoric began to weaken when people began to experience the provisions of the law for themselves.

There was an undeniable setback when the Obama administration botched the initial rollout of the coverage website, but that, too, smoothed out within a few months. And it turned out that most American families liked what they found:

Subsidized premium rates, the requirement that insurance companies accept people with preexisting conditions without jacking up rates, required minimum packages of benefits, the extension to age 26 of children’s coverage under parents’ policies, the elimination of lifetime coverage limits and certain co-pays, minimum percentages of premiums that insurance companies must spend on benefits, and much more.

Disregarding all that, Trump’s administration is continuing its campaign of sabotage of Obamacare as if it were 2010, pretending that the law is “imploding” because of its flaws when, in fact, it’s Trump’s thumb pressing the button on the explosives.

Republicans and Democrats in Congress can stop him and preserve the many Obamacare provisions that benefit the American people while fixing its problem areas. But Republicans first have to escape from their hole.

They can do it if they really want to.