NEW YORK ( MainStreet) — The problem with reforming the Patient Protection and Affordable Care Act, also known as Obamacare, is that there is not yet a consensus that the program should survive.

Repeal efforts continue.

As National Journal columnist Ron Brownstein recently wrote, "Congress can't wield a scalpel while Republicans are still clamoring for the guillotine ."

Also See: Uninsured Who Passed on Obamacare Said It Was Because of Cost

The latest budget from House Republican budget committee chair Paul Ryan is a guillotine . Proposals from Gov. Bobby Jindal of Louisiana are a guillotine.

What might a scalpel look like?

One thing that might go with a scalpel, writes Joe Deaux at TheStreet, is the employer mandate , the requirement that employers with more than 50 employees buy health insurance for their workers .

Employers buy health insurance, because they're deductible expenses but not counted as salary. If your salary is $50,000 and your employer pays $10,000 a year for your health insurance, in other words, they have $60,000 in expenses, lowering the profit they pay taxes on, while you pay taxes on just $50,000 – the $10,000 in health insurance isn't counted in your income.

Edward Kleinbard of the University of Southern California, former chief of staff for Congress's Joint Committee on Taxation, estimates the tax cost of this policy at $250 billion per year . That's 6.5% of 2014's $3.8 trillion federal budget – more than we're spending on housing, education, and the environment combined.

So if employers want to forego this tax benefit, the reasoning goes, let them. The subsidies in the ACA are designed to replace the tax benefits for workers who buy their own health insurance.

The employer mandate has already been put off twice. It starts next year for employers with 100 employees, and a year later for those with 50 or more. The penalty for failure to comply is also modest, just $2,000 for each employee after the first 30.

As a result, Republicans who don't want to count employees working 30-40 hours per week as full-time are getting some support from Democrats. http://thehill.com/blogs/healthwatch/health-reform-implementation/202636... Why make employers take subsidies they obviously don't want?

Giving employees the subsidies their bosses were getting to buy health insurance is one compromise. What about lowering the cost of insurance more directly?

Sen. Mark Warner of Virginia has offered the Expanded Consumer Choice Act to do just that.

It creates a "copper plan," paying only 50% of health care costs, reducing insurance premiums by 20%. Current "bronze" plans pay 60% of costs, silver plans pay 70%. The copper plans would enjoy the same subsidies as other plans – those with incomes of up to 263% of the poverty line would get subsidies .