While Republican U.S. Rep. Charles Djou says the recent health care reform act should be repealed, he does not think such action is likely, and Congress should instead work on substantially revising the new law regardless of who wins control of the House in the midterm elections.

State Sen. Colleen Hanabusa, Djou’s Democratic challenger in the 1st Congressional District, remains a steadfast supporter of the act and says Republicans should clearly outline their alternatives rather than simply be obstinate.

The debate over health care reform was renewed last week as provisions of the Patient Protection and Affordable Care Act began to take effect six months after its enactment.

House Republicans, as outlined in their new "Pledge to America," would repeal the legislation, presumably canceling parts that began taking effect Thursday, such as allowing young adults to remain on family health plans until age 26, providing free preventive care and ending denial of coverage to children with pre-existing conditions.

The GOP would instead introduce proposals aimed at making it easier for individuals to find private insurance and to pay for medical care, such as allowing people to buy coverage outside their states, expanding state programs that cover high-risk patients who cannot otherwise get insurance and expanding the use of tax-advantaged savings accounts to cover medical costs.

Djou said the law should be repealed, but adds it is not a realistic goal, since Republicans would have to win a two-thirds’ majority in the House and Senate — enough to override a presidential veto.

"We’re going to have to find a way to work with the president," Djou said. "And I hope the president and the Democrats in Congress would be willing to work with the Republican caucus in finding some sort of reasonable compromise to dramatically reform and fix this wrong legislation."

He suggests seeking middle ground in areas such as reducing some of the bureaucracy created by the new legislation.

Tort reform — enacting changes to the legal system to limit malpractice claims and abuses — is another area where the two sides might be able to reach a compromise, he added.

"The president himself, when he originally started pushing this legislation, made some gestures saying he’s going to work on that issue," Djou said. "I think a Republican Congress should try to take him up on it."

Hanabusa agrees that a repeal is unlikely, and challenged Djou and Republicans to back off the rhetoric.

"It’s like many of the positions that they’ve taken: It’s either their way or no way," Hanabusa said. "They’re going to try to repeal it because it isn’t what they want.

"You want to bring them to the table, but they have to first want to get there versus taking a position of ‘No, it’s our way or no way.’"

The law will be phased in over 10 years, and Hanabusa said the other components yet to kick in are more reason to see it through.

Those include provisions that aim to get 85 percent of money collected from premiums put toward care and improvement of services versus administrative costs, revamping of health care systems to focus on primary care and the closing of the so-called "doughnut hole" for seniors — a coverage gap in the prescription drug plan for some Medicare recipients.

"Those are all necessary components to see us get to the point where we are able to contain health care costs in the future," Hanabusa said.

She said Hawaii, with its prepaid health care act, which exempts the state from the national overhaul bill, should serve as an example of the benefits associated with greater access to health care.

"We may have premiums that are going up, but we’re still the lowest (for premiums) in the nation for the quality of health care that we receive," she said. "So I can’t see how anybody who knows that would want to repeal this health care act, which is going to be making it as available as we can to the rest of the United States.

"We need to join the rest of the industrialized world, in terms of making available health care reform, so that we can at least begin to contain the cost of health care."

The Associated Press contributed to this story.