Mark the gerund which is used as a noun:

     President Donald Trump’s main healthcare policy initiative has been working to fulfill his campaign promise to repeal and replace the Patient Protection and Affordable Care Act(ACA), commonly known as Obamacare. He expressed his support for the House and Senate bills that proposed modifying parts of the ACA. The House passed its bill — the American Health Care Act of 2017 — but members of the Senate have been unable to agree on a final replacement plan, leaving most of the provisions of the ACA in place. Republicans did take one step towards changing the ACA by eliminating the law's individual mandate, which took effect in January 2019. In October 2017, the Trump administration took actions to modify the ACA. Trump issued an executive order directing members of his Cabinet to create rules that would allow small businesses to collectively buy health insurance through association health plans, expand shortterm health coverage, and expand the use of Health Reimbursement Arrangements (HRAs). The order did not make direct changes to existing health insurance rules; instead, it directed agencies to consider new rules that would be subject to a notice and comment period. Trump said that he is still committed to passing a bill to repeal and replace the ACA. Before signing the executive order on October 12, 2017, Trump said, “Today is only the beginning. In the coming months, we plan to take new measures to provide our people with even more relief and more freedom. (…) And we’re going to also pressure Congress very strongly to finish the repeal and the replace of Obamacare once and for all. We will have great healthcare in our country..”.

(Available in: https://ballotpedia.org. Adapted.)