McConnell juggles conservative, moderate tensions in effort to replace Obamacare

Sen. Ted Cruz speaks to reporters on Capitol Hill

AHIP: Cruz proposal would destabilize the ACA exchanges

The overall measure represents the Senate GOP's attempt to deliver on the party's promise to repeal President Barack Obama's health care law, which they've been pledging to do since its 2010 enactment. This is America. The government should never force people to buy insurance they don't want or can't afford.

"Republican lawmakers, the health insurance lobby, and tens of millions of voters would all be invested in making it work - and Democrats nearly never say no to more taxpayer dollars for health care", Cannon wrote. "It shouldn't be the government dictating what insurance you can buy". This could lead to more people with low healthcare costs giving up their coverage.

On its face, this reads like an implicit admission that the latest version of the BCRA would allow insurers to sell policies of such low quality that, even for purposes of the GOP's own bill, can't really be considered insurance.

However, Sen. Mike Lee, the Utah Republican who was working on the amendment with Cruz, tweeted later that what he was crafting with Cruz was not in the bill, although "something based on it has" been added to the legislation. How would you describe the process, and whether we should, as American consumers of politics...be able to accept an end result of a process that looks this kind of lousy, to be honest?

People with preexisting conditions - even if they don't now require medical care - may also end up on these plans because cheaper off-exchange plans would likely bar them from signing up. This proposal would allow insurers in every state to sell health plans that don't contain any of the basic protections now in place under the ACA (including the requirement to provide coverage at the same rates to Americans with preexisting conditions) - as long as they continue to offer at least one plan that keeps the ACA's protections. To address that free-rider problem, the bill needed some sort of incentive to get people who don't receive health insurance coverage as a benefit tied to employment, and who aren't covered by a government plan such as Medicare or Medicaid, to go out and buy policies on the open market.

Trumpcare 4.0 offers an extra $70 billion to help insurers shoulder these people's costs, for a total of $182 billion over 10 years.

People can retain everything Obamacare does or change to a real market plan at reasonable cost, now paid with tax-exempt savings, another long-favored conservative option.

"It is simply unworkable in any form", the letter said. She predicted skyrocketing costs for taxpayers also, stuck with the bill for sicker patients.

A proposal to let Obamacare insurers sell skimpier coverage will be the wildcard in efforts to pass the revised Republican health care bill that's expected to be unveiled on Thursday. How about repealing the individual and employer mandate? The value of workplace insurance is tax-free for employees and tax-deductible for employers. Because young and healthy people would opt for the cheap, skinny, noncompliant plans, the risk pools for Affordable Care Act-compliant plans would fall out of balance, and premiums could spiral out of control as only the sickest people signed up for them.

There is only one way non-subsidized health insurance products can be sold in the individual health insurance market for low prices. "People with opioid and other drug problems have other health issues, from HIV, to hepatitis, health and liver problems, mental health, depression and on and on".

McConnell kept some of the Obama-era tax increases used by Democrats to finance expanded coverage.

Insurers in the Affordable Care Act, or "Obamacare", marketplaces earned an average of almost $300 per member in the first quarter of 2017, more than double what they earned in a similar period in the marketplaces' previous three years, The Washington Post reported. Perhaps more significantly, it would limit future federal funding for the overall program.

The office estimated that McConnell's initial bill would have caused 22 million additional people to be uninsured.

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