Bill Frist, a Republican who was once the Senate majority leader, is urging House Republicans to drop their effort to repeal the health care law.

A heart surgeon turned politician, Frist is leading a project at the Bipartisan Policy Center, along with another former Senate majority leader, Democrat Tom Daschle, to help implement the new law in the states.

Frist takes a mend-it-don’t-end it approach to the new law. It seemed a far cry from the days when he threatened to use the “nuclear option” to steamroll over Senate Democrats to end their filibusters of President George W. Bush’s judicial picks.

At a Tuesday event at the Bipartisan Center, he said:

As all of you know, the Affordable Care Act, not just for me but for the — more American people than not, is not the bill that they would have written.  It’s not the bill that I would have drafted.  But it is the law of the land, and it is the platform, the fundamental platform, upon which all future efforts to make this system better for that patient, for that family, for that community, will be based…

… I know the discussion in Washington is the repeal, and … and it’s going to be the focus here in Washington…

In truth, the law contains many elements — on the front page of the Washington Post today — nobody’s going to say take that away.  Or if they said take it away, it will be put right back in, because it has many strong elements.

And those elements — well, whatever happens — need to be preserved, need to be cuddled, need to be snuggled, need to be promoted and need to be implemented…

I mean, what came out of Washington, D.C., the vision, the construct, the policy, is beautiful on paper…

Frist allowed that the question of the whether it’s constitutional for the federal government to mandate that people buy a service they might not otherwise purchase.

But he said the implementation of the law in the states could run on a separate track from the federal lawsuit challenging the law that’s been joined by attorney generals in 19 states and counting.

Frist said:

And I’ll just add that there is a constitutional question.  I mean, the idea you can — the federal — or a government can regulate one’s choice not to participate in coverage is a legitimate question…

… I don’t know how it’s going to be decided and, you know, we don’t know…  Regardless of what happens in Washington, the idea of having a marketplace at a large enough level, like the state, the idea of state exchanges, is supported broadly by governors Republican and Democrat alike.

The attorney general’s court system constitutional question is not inextricably linked to state exchanges. In fact, I would argue it is totally separate and there is a general bipartisan commitment to state exchanges.

How quickly?  Where’s the money going to come from?  The actuaries, the infrastructure?  All legitimate questions, which will be checked, maybe even slowed down.  But it’s two separate issues.