U.S. healthcare executives say Obamacare is likely here to stay, despite repeated calls from Republican lawmakers for repeal of the 2010 law aimed at providing health coverage for millions of uninsured Americans.

Top executives who gathered in San Francisco this week for the annual J.P. Morgan Healthcare conference, say that while President Obama’s signature domestic policy achievement may well be tweaked, it is too entrenched to be removed.

The Obama administration said in November that it aims to have over 9 million people enrolled in government-backed federal and state health insurance marketplaces in 2015, their second year of operation. Another 10 million have enrolled for coverage under an expansion of the Medicaid program for the poor.

Opponents of the law in the newly-elected Congress, now dominated by Republicans, seek to replace Obama’s Affordable Care Act with their own healthcare reforms. Some are betting that the U.S. Supreme Court strikes down the federal tax subsidies helping the uninsured buy coverage in 36 states.

For private health insurers and hospitals, the addition of millions of new covered patients has helped buoy their profits. Drugmakers have benefited from the increase in the number of patients eligible for reimbursement of prescription medications.

Repeal of the Affordable Care Act “is not a possibility,” George Scangos, chief executive officer at biotechnology company Biogen Idec Inc, said in an interview. “They would somehow have to explain to millions of people that they will lose health insurance.”

Aetna Inc, the third biggest health insurer, said it is talking to Republicans and Democrats about a possible “grand bargain” to salvage Obamacare if the Supreme Court up-ends the healthcare law later this year.

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Jeffrey R. Ungvary President