McConnell May Have Been Right: It May Be Too Hard to Replace Obamacare

May 26, 2017 · 379 comments
adara614 (North Coast)
Mitch McConnell is a disgrace to himself, the US Senate, and the USA.
Arne (Bergen, Norway)
So do Mr Trump and Mr McConnell think that lowering corporations' and rich people's taxes will make people forget they are liable to get sick and will need health care?
DTOM (CA)
The GOP is not constitutionally capable as a party to construct a universal healthcare plan for this country. They will not spend the money required. They only want to protect the elite. This is the same party that wants to disband the Education Dept and end publicly funded schooling. They want to destroy the safety net of Medicare and Social Security. They are against women's rights.

Q: What is conservatism?
A: Conservatism is the domination of society by an aristocracy.
Q: What is wrong with conservatism?
A: Conservatism is incompatible with democracy, prosperity, and civilization in general. It is a destructive system of inequality and prejudice that is founded on deception and has no place in the modern world.
James SD (Airport)
It will always come down to the same question: Is our health care system ust another aspect of capital and market driven society, with shareholders at the top of the priority list, or is it a social responsibiity focused on the needs of the sick and injured? Once you answer that question, you can proceed. Currenly it is the former. Despite the fact there is no up front transparency of cost, few choices a consumer can make without harming themselves, no transparent competion, and the drugs and tools are traded on secondary markets with profit margins as the prime goal. Until costs are controlled, the public benefit will not be broad.
richard schumacher (The Benighted States of America)
Republicans should just do the easy thing: Repeal Obamacare, declare victory, then rest on their laurels for the next 18 months and let nature take its course.
sharinlite (Orange, CA)
Let it die its natural death....I think nearly 100% of insurance companies are out, many exchanges failed, states are overwhelmed by the growth of medicaid. Let it die!
And, for all who think this is a right for all, think about the $20+ trillion not to mention the trillions on our back for pensions, and unmet obligations. Taxpayers that gross $200,000 or more pay 62% of taxes. Medicare and Social Security are looking at bankruptcy in the very near future...it is the Progressives in the nation that will literally push their grandmothers over the cliff. So much fraud, so much corruption which has never been addressed and the Progressives don't want touched. We are at a pivotal moment in America's future: continue to be free or become France/Greece/UK......your choice.
MsPea (Seattle)
I'm sick of the topic. The Senate needs to get its act together and either come up with their own healthcare plan, accept the one passed by the House, or leave the subject alone and move on to other items. The truth is that Republicans would love nothing more than to ditch the ACA and not replace it at all. That's their first choice, but they know it's political suicide. So, they provaricate and hesitate and tiptop around making a decision. It's maddening. What a bunch of cowards. Just take a stand, for Pete's sake, and then stand by it, for once in your lives.
Glenn (Florida)
Why should McConnell do anything about Healthcare? It is obvious that Republican strategy is to de-fund, talk down, and collude with Insurance companies to encourage the destruction of the ACA.

Then, as they always do, they will blame Democrats for the failure of healthcare (under their watch). Democrats are defending ACA, while Republicans are intentionally mismanaging, & de-funding it.
Annie Dooley (Georgia)
Please reassign at least three of your reporters from the Russia scandal to the healthcare scandal and publish more op-eds on alternative approaches to universal coverage, highlighting what works well in other countries. Nobody seems to be questioning the dollar costs to businesses of being the main provider of health insurance. That is the big elephant in the room of our so-called "system." Tying affordable, comprehensive health coverage to employment makes American workers little more than indentured servants to companies that can afford to subsidize the premiums, with few or no choices of plans or carriers. Please don't wait for a small cadre of Republican senators to tell us what they want to do to us and our families and let them ram it through in a couple of days.
PAGREN (PA)
I am sure he is right. I mean look at all the ideas coming forth from all the testimony of the experts in the field ... oh wait... there has been none. Obamacare's critical failure is that it contains Obama's name.

Remember, as soon as the House passed that bill, it now their issue.
Geraldine Bryant (Manhattan)
The true reason behind the movement to repeal the ACA is to erase the legacy of America's first African American President. Republicans never meant to replace the ACA and now that they've been forced into creating policy (rather than just winning elections), they've proved just how hollow their pledges are.
Shayladane (Canton, NY)
It seems to me that if the Republicans had any sense at all, they would swallow their foolish pride and establish a bipartisan committee to work on making the ACA better by tweaking the parts they see as bothersome. Inviting the Democrats to work with them could produce a health care bill that would really meet the needs of the American people.

Working with the Democrats would also help heal some of the wounds that Congress has inflicted on itself over the past two or more decades.

I'm not holding my breath, though.
Robert Gween (Canton, OH)
Ayn Rand — 'The question isn't who is going to let me; it's who is going to stop me.'
Robert (<br/>)
Let's be honest about it. For all those who are not rich, in congress or getting subsidized health insurance from their employers, it is called TrumpSCARE.
George (Fairfield CT)
Politicians have turned healthcare into a nightmare. With the current uncertainty, individual/small business health insurance policies are becoming even more expensive and may not even be available in the coming years--all because of political grandstanding and meddling. If the government is to control healthcare, then do it through a single payer system with all the efficiencies that would entail. Otherwise politicians should get out of the way and let the private markets handle it--at least then we know that some coverage would be available at a reasonable price.
Chico (New Hampshire)
I think the real clue as to why the GOP will not be replacing the Affordable Healthcare Act, is that they have to be responsible public servants that want to help the majority of middle class working Americans, working poor, elderly, children and which falls into roughly 90% of the population.

It's been almost 7 years where all we've heard from the Dysfunctional Do Nothing Obstructionist Republican Congress is that they were going to repeal, there main accomplishment in the Congress all of this time was voting about 60 times to repeal it and getting nowhere.

In all this time the incompetent Republican's could have been sitting down and working to craft a really solid improvement or replacement that would gain national support by the overwhelming majority of the citizens, especially the one's that will need to use it; nope, not these Einstein's, spending all of their time whining, talking ACA down, and voting to repeal it.

It's a real embarrassment that all of this time, all we've heard mostly from Paul Ryan himself, about what a deep policy wonk is he was on the subject, that was a joke, he has shown himself to be his own biggest fan, but knows nothing about crafting anything remotely close to a healthcare bill.

Now, we have the Grand Do Nothing, Mitch McConnell who knows even less about healthcare, I'm not sure what his claim to fame is other taken up space and getting his wife a job in the Trump cabinet, but as a Public Servant......Mitch only serves himself!
FrankM2 (Annandale)
News: the Republican undermining strategy is working. The Blues have scaled back, and Republicans have no intention of making the insurance program work. If they delay for a year, and continue to undermine, they will have more reason to claim that Obamacare has failed, while at the same time, more people will be suffering from inadequate health care. If Republicans support our ADD President's wish to do anything immediately, they will of course incur responsibility for the resulting sickness and death. Will the rich donate enough from their huge tax cuts to support enough TV advertising to put lipstick on either side of this pig?
gratis (Colorado)
McConnell admits the GOP has no idea how to govern.
And the GOP mantra of repeal and replace was a lie.
The Party of No, and nothing else.
Back to basics Rob (Nre York)
Any bill should REQUIRE a Senator or Representative to buy their family's health insurance coverage on the exchange that operates in their state or district, and nowhere else. If they choose to go without coverage, bless 'em. Let these "honorable souls" go home and see what their families think of what has happened to them.
Tom (Pa)
Who knew that politics (and governing) could be so difficult? (Especially when trying to gather enough votes to stay in power)
miguel solanes (chile)
Special channels to Russia. Lower public interest benefits for the poor. Tax breaks for the rich. The public interest trumped by mercantile attitudes and selfish winner takes all interests. The risk of external capture of the State and the fact of internal capture of Government. Concentration of power in a single party. Democracy and self-determination seem to be at risk.
frank monaco (Brooklyn NY)
Trump has promised Americans Great Health Care something better than ACA. Well now the Pressure is on. Those videos will be played over and over for the 2018 and 2020 election cycle. It Time for McConnell and Republicans to Produce or they will be sent Home.
What Is Past Is Prologue (U.S.)
The pigs are certainly at the trough.

Tax breaks for the wealthy and no medical insurance for millions. And tax breaks for the wealthy and a consumption tax for everyone else.

Voters have been duped again. When will they wake up?
Sparky (Peru, MA)
McConnell has another problem. In his State of Kentucky Obamacare has been incredibly successful with over 500,000 new enrolled. The Loss of the Medicaid expansion as well as the overall defunding bloc granting of Medicaid that the Republicans are pushing will crush Kentucky. Rand Paul may not worry about throwing hundreds of thousands of his fellow Kentuckians under the bus, but McConnell is not as ideologically driven as Paul. Prediction: Senate punts on Obamacare and McConnell blames Dems. This is who Mitch is anyway, a cake and eat it too politician always playing the angles.
H. Savage (Maine)
Come on, Folks. The GOAL is to provide health insurance to every citizen who needs it at a price they can afford. This bill is so far off that goal, that there is no reason to validate it by discussing it as if it were even aiming there. The lunatics are in charge of the asylum and, though they have the keys, they still can't figure out how to get the door unlocked
northlander (michigan)
It's simple, Mitch, single payer.
Joseph C Bickford (Greensboro, NC)
The Republicans are locked in because of their ideology. If only these......politicians could focus on solving a problem instead of advancing an abstract ideology, our government might actually work. Fix Obamacare or go to single payer, but remember the goal is to solve the problem and provide good health care for EVERY citizen.
Charlotte (Florence, MA)
"McConnell May Have Been Right: It May Be Too Hard to Replace Obamacare"

Doy oy oy.
Scott (Albany)
Republican leadership should man up and geometry and fix it instead of letting it either in those Red States that have tried to kill it outright. I am tired of all these people talking about ACA failures when they have done everything in their power to make it fail. New Mexico has a successful program. It's neighbor Oklahoma has a failed program.
Rose (St. Louis)
Mr. McConnell is less receptive to pressure from the White House? Considering that McConnell's wife is a Trump cabinet officer, I highly doubt this statement. Powerful men often regress to frightened little boys when faced with angry wives and mistresses.
rab (upstate, NY)
Imagine if Canadian doctors had developed a single pill that would not only prevent but would also cure all diseases. In their benevolence and generosity they make the chemical recipe available to the US, adoption contingent upon the approval of Congress. The politicians reject this working solution for disease, preferring to distribute the money needed to a tiny minority of mostly white, wealthy, and healthy donors. Most would consider this decision unethical, immoral, and borderline criminal.

Single payer NOW!
Robert Hall (NJ)
Having sabotaged and vandalized ACA, they are just going to move on? If they are unable to replace ACA, they should have the decency to work with Democrats to rectify the damage they have done.
Christine McM (Massachusetts)
I love the fact that in their zeal to repeal Obamacare they might just returned Healthcare to its prior state.

Wouldn't that be wonderful? our Healthcare System was a big fat mess before the election of President Obama. he made it a core mission of his presidency to expand coverage for those who could not obtain it from employers, whether out of work or the company simply refused to offer it.

So cycle forward nine years , and return to the status quo. 9 years of Health inflation, formerly uninsured people finally able to afford doctor visits, and totally disorganized markets !

Immediately throwing about 20 million off their Healthcare would look really great with absolutely nothing to replace it. in the meantime, the Trump administration is quietly sabotaging the ACA and then claiming it's collapsing. of course it's collapsing as Trump threatens to pull subsidies and Congress dither with a replacement plan that can't be done when you need those government subsidies to fund tax cuts for the rich.

Of course Congress keeps its Cadillac care while stiffing the rest of the country. Gotta keep those politicians healthy!

of course there is a solution thats really pretty easy: Medicare for all.
Anne Villers (Jersey City)
What really scares me is the planned tax code. People like me will truly suffer if they take away deductions like mortgage interest. They are hell bent on giving the rich a tax break but someone like me is going to have to pick up the slack. Of course, the middle class is not the GOP's concern.
drejconsulting (Asheville, NC)
"the tax “blueprint” they released last summer, which represented a dramatic move away from taxing income to a system that basically taxes consumption"

...because there's a physical limit to how much you can spend, but no limit on how much you can make

Let them eat cake, dammit! It's the direction we've been going in ever since Reagan.
Sande (IL)
The sooner they pass it the sooner they're voted out of office.
kjeld hougaard (myanmar)
Ilmar Reepalu, a senior Swedish social democratic politician: “No-one have ever won an election because of their health care policy – but many have lost”
SMB (Savannah)
The bottom line is that one version of the Republican health care bill would cost 24 million Americans their healthcare in 10 years, and 52 million in 20 years.
The other version would cost 23 million Americans their healthcare in 10 years, and 51 million in 20 years with insurance that would exclude essential care like maternity care, pre-existing conditions, etc.

None of the Republican deliberations are about American lives or health: they are about stupid promises to their dwindling base. Which will dwindle all the more if the legislators kill them off.

I don't even care any more. I only care about the responsible Americans that voted against Trump and the Republicans, a party that just endorsed a thug who assaulted a journalist and that elected a serial sexual assaulter, mentally ill and bigoted president who is leaving behind a swath of destruction on the Trump March to the Sea. All of the rest of the Trump voters can enjoy their lack of healthcare, morality and conscience.
Bhaskar (Dallas, TX)
G.O.P. faces divisions over health bill ?
And their problems multiply.
Even as they subtract 23 mil from coverage.
It's time they put 2 and 2 together -- single payer.
It's simple math really, listen to Warren Buffett.
WestSider (NYC)
Washington Post reports seem to add up to the possibility that Jared Kushner is about to be charged with pretty serious crimes. How long will NYT pretend it's not happening?
Richard Mclaughlin (Altoona PA)
That last point is a good one. As it stands right now, Trump couldn't recruit a chimp to primary anyone.
Piggywa (Portsmouth, NH)
Seems fairly easy to understand.
If it may be too hard to replace Obamacare, then stop wrecking it and fix it.
Got it dummies?
robert (reston, VA)
This article tries to mask the big lie that Grand Oblivion Party senators are different from their house buddies. They have the same game plan for destroying the middle class and enriching the 1%. Same difference!
Also note not one of them has really stood up and threaten to resign over the daily lies, possible treason, and non-stop shenanigans of Agent Orange. Same difference!
Deirdre Diamint (New Jersey)
This is your moment Senator McConnell. You have an opportunity to implement single payer healthcare and be remembered for something other than obstructing our first black president

This is your ticket to redemption. Trump will sign anything you put in front of him.
Ozma (Oz)
Can anyone name one good thing that has happened regarding the leadership in our country since January 20, 2017?
Anyone? One itty bitty thing?
Health? No, you suffer or die.
Nature? Sell it. Stuff it. Walk around a mall.
Air? Who cares?
Ethics? Who cares?
Eloquence? What's that?
Learnedness? The dumber the electorate, the better.
Clean water? Buy some. Preferably bottled by a company they have some financial stake in.
Free Press? Shut up or I'll push you down, jail or sue you.
Let's see. I bet a lot of you could come up with a lot more.
And one last thing. Anyone read "The Lottery" by Shirley Jackson?
Those folks shouting that Montana's Greg Gianforte actually did the right thing by knocking that reporter down like villagers gathered round and hurling words instead of stones. Nice. NOT.
Jim (WI)
If the evil republicans have their I wouldn't be forced to own expensive insurance policy that I don't want.
Check Reality vs Tooth Fairy (In the Snow)
The Kochs were looking for an image change and the change that they came up with is to drop off the map...but underneath...

David Koch’s Libertarian Platform 1980

TO BE ABOLISHED:

Department of Energy (DOE)
Environmental Protection Agency (EPA)
Food & Drug Administration (FDA)
Occupational Health & Safety Administration (OSHA)
Federal Communications Commissions (FCC)
Federal Trade Commission (FTC)
National Labor Relations Board (NLRB)
Federal Bureau of Investigation (FBI)
Central Intelligence Agency (CIA)
Federal Reserve
Social Security
Welfare
Public Schools
Taxation
All branches of the military accept the Army

Does this sound at all familiar?

Trump, Ryan, Nunes, Prince, Devos…follow the money…The Kochs
B. Rothman (NYC)
Everything heard about this fabulous bill is that it is a piece of cr-p from start to finish. A sow's ear that stays a sow's ear in order to give the real pigs of the economy, America's corporate elite and inherited wealth piggies, an even bigger mud puddle for them to roll around. Is your resentment soothed yet, all you under-educated voters who Trump loved and left? Because if it's not, you can be sure that your Republican representatives and our Prez who all hate government are going to serve up plenty more garbage for the real pigs of America to feast on. Alas, you voters will just have to watch the big guys eat your lunch as well. Maybe next time you'll vote with your brains instead of your gut. And here's hoping that those of you who thought your vote was pointless, don't sabotage yourselves again by not voting.
JMM (Ballston Lake, NY)
What a colossal failure this administration and Congress are. I mean - will go down in infamy. Lying, cheating, sexual assault, failures in the courts, possible treason, possible impeachment, legislative incompetence, recusals, firings, shoving world leaders, security breaches, conflicts of interest, bombings.

What have I forgotten?
Sophocles (NYC)
The Republican peacocks are flashing their colors, and it's all GREEN, GREEN, and GREEN.
Dry Socket (Illinois)
As their "god" Ayn Rand has meant --- kill the old, the poor, the disenfranchised, the workers, the traitors, to individual rapacious behavior...

Eat all except my beloved Roark...
John Paul (New York)
The campaign for some form of universal government-funded health care has stretched for nearly a century in the US. Health insurance is one of the biggest frauds ever perpetrated on the American public. The industry is a parasite, and it provides no added value whatsoever. However, it is absolutely shameful that the NY Times has failed, along with the mainstream media, and basically ignores, and rarely, if ever, brings up the issue of single payer into the debate. Single payer MUST be included if there is to be a rational, comprehensive discussion about the future of healthcare. This includes education of the public, so that they can make informed decisions. There is a proposed bill, HR 676 (The Expanded and Improved Medicare for All Act) and not a peep from the media, much less most of Congress. There are currently 112 cosponsors for the bill. No less than 7 national studies (GAO & CBO & EPI) spanning the period from 1991 to 2005 as well as 12 individual state studies concluded that single-payer healthcare produces major savings either at the outset or within a few years, including the program’s continued ability to contain costs. And yet there are Democrats who say their efforts must be toward preventing repeal or replacement of the ACA. This is total bovine scatology. Both can be done simultaneously.
Robert Gween (Canton, OH)
This is a toxic law that will legally lynch millions of those who already have desperate and dire medical needs.
It is a medieval attitude that supports such legislation. Hell hath no fury like a Republican scorned.
Slim Pickins (Around)
McConnell suddenly has a brain wave: omg we might be killing not only Americans, but the Republican party! Thinks to self, 'Better make a few compassionate statements to let people know I have a soul!' ugh
Mark (Portland)
You big guys in DC, walking around, pounding your chest, talking about Repeal, Repeal, Repeal.... Pretty easy when there is an election on the line and lying is just much easier than telling the electorate the truth. What a joke the GOP has become. Fix what's broken with Obamacare and move on. Quit lying! It makes you all look so small and foolish.
Michjas (Phoenix)
57% of Americans approve of Obamacare. As a matter of political pressure, that's more than enough to put he Republicans behind the 8 ball. But, considering the widely unpopular Republican proposals, the approval rate of Obamacare is not impressive. Why? Spending on Medicaid patients is about half of spending on the employer-insured. Presumably, Medicaid health care is half as good as what everybody else gets. And with all the attention given to pre-existing conditions, there are only 130,000 enrolled in the PCIP program. And, as for those in the exchanges, they are disproportionately young and healthy and generally pay far more in premiums than they spend on health care. Overall, the greatest benefit is to the many older enrollees in the exchanges. Obamacare certainly has improved their health insurance situation. But the 43% of Americans who do not approve of Obamacare have good reason to feel that way. American health care remains substandard
Nancy (New England)
Regarding corporate income taxes, what is Congress doing about foreign based multinationals operating in the US that pay zero income taxes? Will lowering the tax rate to 15% make a difference? If US profits can be shifted offshore - profits NOT subject to US repatriation if the parent is foreign - even lowering the tax rate to 5% will NOT make a difference. This is why tax inversions are so popular for US based multinationals - move to a foreign country and move away from federal and state income taxes.

The US rate of tax is meaningless if the US tax base is meaningless, a fiction, empty of profits because they have been moved elsewhere. Congress has to fix the tax base before it can fiddle with the tax rate.
Jim in Tucson (Tucson, AZ)
Is it any surprise that the Republicans find it easier to revise the tax code than it is to provide health care? One only requires wholesale giveaways to their wealthy base; the other requires supplying something that everyone needs, but few can afford.
Ted Peters (Northville, Michigan)
The never stated goal of Obamacare was to destory insurance markets so that the only option for the future would be single payer, which would socialize a hugh chunk of the economy and lead to an eventual socialization of the country. If premiums explode in the next year or so... the middle class will be desperate and may well buy the notion that the only way for them to have health care is if it is provided by the government. At that point we may be well on our way to becoming Venezuela.
Jim in Tucson (Tucson, AZ)
Oh, yes. We'd be much better off as Putin's Russia.

By the way, the United States is the only major industrialized nation that doesn't provide basic healthcare to its citizens. We're the only country where the predominant attitude seems to be that sick citizens shouldn't be treated as human beings, but as sheep to be shorn by the healthcare industry.
finder72 (Boston)
It should be common knowledge that the American healthcare system is broken. Efforts to make it work over the past sixty years have not been successful. A central reason for it's inefficiency and cost is that it is based on for-profit American capitalism. It was not always this way. Obamacare was designed to accommodate corporate interests, especially it's profits without performance goals. so it was doomed to fail. Costs are out of control, especially with the cost of drugs. There are no controls. Americans will never afford healthcare the way in function in the U.S. Relying on Republicans that work and function at the behest of corporate interests will never make it right. Keep voting for Republicans no matter what you find appealing in the conservative agenda, and you will never get a healthcare system that works for you.
Sarah O'Leary (Dallas, Texas)
Repeal and Displace will cost them dearly in the next election cycle, even if they don't pass anything at all.

The Democrats will point out that Trump did everything in his power to make the Affordable Care Act fail (which also destabilized the individual commercial marketplace), and Congress did nothing to stop him.
Kathy White (GA)
If not clear by now, there was never a "replace" in the slogan "repeal and replace". The intention has been to eliminate investment in the American people and paths to opportunities that would give people a chance for a better life.
Republicans are telling us we should no longer be compassionate toward the poor, the elderly, the disabled, and children, but direct our sympathies toward those who must pay taxes to support healthcare and other programs for Americans. This is counterintuitive to most normal people.
Robert (Boston)
McConnell not only has a very narrow path to achieve the passage of a health bill but, also, a very narrow time frame to get it done. Campaigns for GOP-held House and Senate seats up for re-election begin right after summer 2017. Tick-tock.

Republicans know very well, from their town halls during the last recess, that the current House health bill is highly unpopular. Add in Trump's proposed budget cuts to Medicaid and they may lose seats beyond what's considered in play now.

The political calculus argues for McConnell, and Ryan even more so, to dump efforts at repeal/replace and focus upon tax cuts as mid-term election politics come into sharpened focus. With the WH under siege, which is only going to get worse, Trump badly needs a legislative victory and health care is not likely to be it. Tick-tock.

Enlightened self-interest from the GOP, as is most always the norm, will likely result in looking busy about health care whilst not doing much and keeping a close eye on constituencies back home, who are increasingly angry over internecine warfare within the GOP.

Having had eight years to plan a health care victory the "complexities" of it appear to elude not just Trump but the majority party in Congress too. Tick-tock, Mitch and Paul.
Dennis Maher (Lake Luzerne NY)
The Republicans didn't understand that "repeal and replace" always meant something better than Obamacare, which they demonized. They couldn't see the good in providing better insurance to more people. Now they can't possibly do any better than that, because at heart they don't believe that health care is a right. They think we are all on our own or should be. There is a solution - single payer, universal health care, most easily established by gradual expansion of Medicare. But Republicans are going to make Obamacare impossible, so we will have to give up on gradual.
thundercade (MSP)
I guess I'm not seeing the rough path claimed here. It looks like they need 1 or maybe 2 senators to change their mind. They have at least 18 months to do that, if not more, if 2018 elections go their way.

Something will pass, and it won't be good. we should start preparing for that.
VH (Corvallis, OR)
If those in Congress could just admit that the idea of repealing ACA was about being anti-Obama and not about fiscal responsibility, it would go a long way toward the possibility of a bipartisan effort to improve upon what is working for so many Americans who desperately need health care.
Instead, it is treated like a sporting event where a fight to the end becomes the point. All the while, the lives of real people hang in the balance.
Let's grow up folks.
Kurfco (California)
One rifle shot fix: Obamacare requires anyone eligible for Medicaid to take it, because if they are eligible and don't take it, they can't get Obamacare with a subsidy. In California, a four person family can get Obamacare with a subsidy for the adults, but, if they earn less than about $63,000, the kids must be on Medicaid. Most doctors, of course, don't accept Medicaid. Some benefit. Allow families to all be on one policy with a subsidy or credit. Eliminate this Medicaid requirement.
John Ramirez (San Diego)
As a CA agent, your in a mixed household when kids are on Medi-cal and adults on exchange. Too costly to offer children exchange with parents. Also, they want to make sure kids have free care.
Chico (New Hampshire)
You would think by now, even simpletons like Mitch McConnell and Paul Ryan, could grasp that whatever scam they are trying to pull under the guise of a new healthcare plan, is not fooling anyone, and the public is wise to their charade.

It's like these clowns are just living in their own echo chamber, hearing their own voices reverberating back at them, convincing themselves that they actually have a mandate and know what they are doing, it's gotten downright embarrassing.

The bottom line is that the GOP idea of a new healthcare is a huge tax break for the wealthiest American's, all balanced on the misery of the rest of America.
Randall Johnson (Seattle)
The Manchester bombing was a tragedy.

But the casualty count was fewer than 100 killed and wounded -- orders of magnitude fewer than the casualty count that will result from passage of a the Trump-GOP AHCA.

Trump has expressed compassion for victims the Manchester Bombing, but none for victims of Obamacare repeal and replace. None from Paul Ryan either.
JS (Minnetonka, MN)
Peering through the murky complications of federal subsidies, Medicaid coverage, waviers, minimum standards, and a dozen other pieces, it's starkly obvious that Republican zeal to protect the profits of the insurance industry will forever exceed all other priorities; chronic illness, too bad; prenatal care, sorry wrong gender; contraception, don't even ask; low income, addiction, unemployed, disabled, what's wrong with you?
As long as shareholder profit is allowed to incentivize medical insurance, health care will continue to be a priviledge, not a right. Single payer, where are you?
Bill (Kuala Lumpur)
The developed world uses tax dollars to pay for universal coverage - it's an unfair advantage they have (japan, europe, canada, nz...) - and its keeping Americans destitute, vulnerable, and slaves of the AMA, insurance companies, and big pharma. And yes, its by design - us as money sponges for them to squeeze dry.
Uncle Sam (DC)
As long as corporate citizens are in control of government there will be little democratic progress. Their only interest by nature of their existence is profit. They have no morals only greed. This is being reflected in our political system now. Find people that will eliminate their power over us and vote them into office.
LS (Brooklyn)
Are we sure that this isn't just the same wishful thinking among my fellow Dems that got us into this situation to begin with?
With judicious use of grand-fathering and staggered start dates for the various features of their bill, and the usual messaging manipulations, the Republicans will easily be able to blame it all on us.
Let's face it, the Democratic Party is dead and until we can clear the carcass from the road the Republicans will continue to get most of what they want.
Glenn Marston (Bushnell, Florida)
The 2018 budget of President Donald Trump endangers the health and safety of U.S. citizens. “Rather than greatness, rather than good health, rather than better lives, Trump’s priority is enriching the wealthy while leaving those in need to rot,” says this editorial: https://www.justeditorial.com/editorial/2017/5/27/budget-of-bloody-zeros
European American (Midwest)
Stop trying to throw the baby out with the bath water...If Congress would pass legislation getting them, the legislators along with their families and staffs, out from under the ACA's health insurance requirements for their own plans, allowing them all to go back with the FEHB Program they had before the ACA's passage; then betcha, with strokes of the many signing pens, a lot of the impetuous to repeal the ACA would vanish as well as a lot of the vitriol surrounding it disappearing...if the legislation was hidden as an amendment to some obscure bill, then probably most of the electorate would never find out.
dormand (Seattle)
Ignoring the humanitarian benefits from the vastly superior healthcare outcomes derived from preventive model single payer healthcare systems,
the US can no longer sustain the far more expensive fee-for-services healthcare model that it has in place.

Medical afflictions tend to cascade when they are not diagnosed and treated. Preventive systems either prevent common health challenges or catch them at early stages where they are minor and very low cost to cure.

The US costs are 250% of the median healthcare costs in the OECD countries according to a scientific study published by PBS:

http://www.pbs.org/newshour/rundown/health-costs-how-the-us-compares-wit...
Howie Lisnoff (Massachusetts)
This is not health care: it's the transfer of wealth! Taking about 23 million people off of health care is a human catastrophe! It's fairly amazing, but not unexpected, that Republicans are so callous about harming masses of people to fill their own pockets.
Quandry (LI,NY)
Ryan, Price and Mulvaney are empty suits attempting to push through their sponsored Koch Bros ideological health legislation, which would harm 24 million of us, and bet the death squads for millions of others.

When you charge vulnerable seniors 5 times the amount they used to pay, which many can't afford since their social security, their only income, is slightly more than that amount, to live. And when you set up death squads for those with pre-existing conditions, who may be able to obtain health insurance, but is totally unaffordable, there is something wrong with their legislation.

McConnell would do well to reasonably modify the existing ACA with reasonable bipartisan input.
Susan Anderson (Boston)
When the best we can hope for is failure, we are truly broken.

But this failure would be a gift of reason to the American people, who need for health care to get better, not worse.

More tax cuts for the rich is not the answer, never was, never will be.
Susan Anderson (Boston)
In the Wedontcare plan, it's all about letting them die. Make sure the richie riches can't seem them, they wouldn't like the stench of poverty to sully their wealth creation, or see any need to pay a living wage or offer benefits.
David Martin (Vero Beach, Fla.)
We live in a nation where some states are rather fully part of the developed world (Massachusetts) and in others, much of the population live in a not-quite developed part of the world, something like Argentina. A new book, "The Vanishing Middle Class: Prejudice and Power in a Dual Economy" by Peter Temin, gets into that.

Perhaps a political deal can be reached that allows the top-tier states to maintain reasonable minimum standards of living, including access to health care, while states like Florida can take advantage of cheap labor and low social welfare costs/low taxes. I suppose that upper-tier states might find ways to establish residency requirements for Medicaid and such.

Meanwhile, I'm waiting to see what kind of bill the Senate might propose. I suppose it will destroy Medicaid, which is looking too much like a single-payer plan that might grow to cover most Americans. I suppose it'll provide a huge tax cut. And I suppose it might possibly reflect Sen. Marco Rubio facing a very angry audience of mostly Cuban-American, Republican Obamacare enrollees in Miami who are terrified of losing their insurance. Miami seems to have the highest rate of Obamacare enrollment in the country.
Steve Bolger (New York City)
The US is a complete travesty of equal protection of law.
AET (CO)
I'm poor, and I'm old, and I work as a slave in a minimum wage job. And I am bipolar. No medicare, high risk pool. Guess I won't be swimming. So, when this "heath care??" plan comes about....I won't have coverage and can't afford my medicines.

For shame on all those in the senate who vote for this. For shame on the liar Trump!!!

I'm looking my forward....my future is so bright I have to wear shades.
Jeff (Evanston, IL)
Ah, the Republican Senators. In most cases I wish them the worst. They represent a small fraction of the American population, the ultra rich. They use every gimmick they can think of to make their little constituency even richer. Lies, euphemisms, winks and nods. Fancy discredited theories like trickle-down economics to fool the people. Obstruction designed to sabotage the efforts of one of the best Presidents we've ever had, namely Barack Obama. Racism, homophobia, hate of immigrants, fear of terrorists: anything to further their narrow-minded policies. They are a wicked bunch. And it is time for Democrats to unite and defeat them. Vote for every Democrat in sight in the 2018 and 2020 elections!
gt (westchester, ny)
Do we really want all those people to die when they lose coverage? That's what will happen.
salvador444 (tx)
gt
Those people will show up at Hospital emergency rooms looking for help. What will the hospitals do? Turn them away or treat them at a high cost? We will find out as the people drop out of the ACHA in the coming years. I think in 5 years people will be steadily dropping ACHA plan insurance.
All members of Congress that voted for the ACHA should be signed up for it and drop out of their current Government Insurance plan.
Karl Kettner (Connecticut)
The mythical GOP death pannels are certain under the ACHA. This is the Make America Sick Again Super Charged Plan! 24 million for $880 Billion trickle up Donald Deal of the century. Tied up in a bow by Paul Ryan and repleat with full on fabricated TV lie feast slick commercials that, seriously, we all thought were over after the election, funded by the guys at the top looking for their big Payout. And don't just sit there saying they'll never pass it! That's what they said about Trump having a NO CHANCE to defeat Hillary.! Unless you want to see your kids, parents and spouses, friends, neighbors all die, and when you get old, have to choose between cancer pain or food, get out there and fight like a junk yard dog to fend off this healthcare catastrophe. it will be the same,as carrying car insurance, having an accident, and getting zero coverage. We never took their guns, but they're absolutly coming to take your healthcare. And yet Congress and Senate get free lifetime coverage ? Obama care drove DOWN bankruptcies and foreclosure. The ACHA will ignite a ballistic surge in bankruptcies and foreclosures. This is your last stand. And 2018 will be GOP ownership mass firings.What goes around, comes around. Say No until your tongue bleeds!
John (Chicago)
I think health care policy might be too complex for the collective congressional IQ. They are all so busy posing on cable news that none of them have time to read.
Boo (East Lansing Michigan)
So much for all the hateful rhetoric about what Obama couldn't get done. Karma hurts, doesn't it, GOP?
sep (nc)
It is shameful that Senator Johnson, R-WI, was quoted "We're talking about this nonstop between ourselves." An issue as important as healthcare for millions should not be decided behind closed doors by a group of select men who don't look or act or think like any of their constituents.

Why are congressmen entitled to more recesses than school children?
Adam Stoler (Bronx)
They represent their constituents not themselves.
The electorate should remind them ejection time
Dave (va.)
The promise is better, cheaper and everyone will have insurance. So far is seems all the Republicans have is worse more expensive and can't guarantee everyone will get or be able to afford their replacement plan.
The ACA has been sabotaged from the start, even though it is a excellent start for achieving a cost cutting curve based on outcome which has slowed the increase of medical costs.
I believe they will deliberately bicker until the Congressional election because they are afraid their base may realize they are the losers in this, and send Republicans packing.
All this would prove the ACA is is not the disaster they claim it to be.
John Brews ✅__[•¥•]__✅ (Reno, NV)
The GOP healthcare reform has two difficulties, depending which group you are in:

For those who really want to fix healthcare, how can you provide better care with lower premiums while reducing the amount spent by about $600 million (to be spent elsewhere).

For those who just want to cut the $600 million to spend it elsewhere, and don't care about healthcare, how do you present the matter to voters so they will re-elect you? That's a question of advertising with many possible approaches: blame Obamacare for "failing", delay Trump care until after the election, put the States in charge and pass them the costs, or all of the above.

The first group has an insoluble problem. But they are in the minority. The Ryan-McConnell group will solve the second problem with the connivance of their corporate sponsors and their campaign ads.
carrobin (New York)
It's too bad the Republicans can't seem to come to terms with the most obvious solutions: fix Obamacare, or expand Medicare to everyone. I can't feel sorry for people who truly believe that it's better for people to get sick, go bankrupt, and die than to have single-payer medical insurance.
Jack (California)
Well, well, well, now who's chairing the Trumpcare "Death Panels" and what about those "Huge" premium increases or the multi-millions being thrown out of their plans because they get sick? Take each and every GOP talking point (or gross exaggeration) from eight years ago and multiply that by 100 and you have "TRUMPCARE".
og (atlanta)
I don't know how this senators can stand looking themselves in the mirror,,, basically how to bankrupt this country make the uber rich richer on the middle and poor class backs, knowing full well that once they are done the democrats will come back to clean up their orgy.
rebecca1048 (Iowa)
I think the recently elected congressman in Montana who assaulted a reporter should be forced, by the people - all people, to resign. Good people demand to know the thoughts or those representing us. He asked a question and he deserved an answer. Instead, the congressman assaulted him. And the people voted him in ----- our public is ignorant.
Paul Adams (Stony Brook)
They'll ram it through, no matter what the cost to their party, the economy or to the American people: they hate Obama that much.
JoeM (Sausalito)
While we're letting each state decide what elements of a healthcare bill they wish to implement, let's get rid of the FAA and also let them set their own rules for pilot and aircraft certification, and flight safety enforcement.

Anyone want to fly on a plane certified in Mitch's state and piloted by someone with a ATP certificate from Paul Ryan's state?. . or in any state in Trump's "great" confederacy?
Just Me (Lincoln Ne)
Allow foreign healthcare insurance, providers, and drug development into capitalist America. Work with Democrats. Put American Healthcare before Republican and Trump.
Dan (Culver City, CA)
"We're talking about this nonstop between ourselves." Guaranteed fail.
Pac (USA)
Any change to the House bill by the Senate that helps the poor will kill it when it goes back to the house. In other words it is DOA,
J (PNW)
A basic economic principle is that you more of what you subsidize and less of what you tax. So why not tax harmful parasites like billionaires and fundamentalist religion?
arbitrot (Paris)
Pay attention to what California is staging to do. They are talking about phasing in a single payer plan for California. Gavin Newsom wants to ride the initiative to the Governorship in 2018 and then vault to a presidential candidacy in 2020.

If he plays his cards right he might just make it.

This is not Vermont, folks.

What California should do is demand that Congress let it buy into Medicare, on a phase in and fully costed actuarial basis in 10 year or so cohorts. But instead of doing it for just the obvious 55-65 cohort, they should go to work at the other end and demand buy in for the 18-29 cohort, to spread out the risk pool.

Then phase in the remaining cohorts over a 5-7 year period.

As soon as the idea were presented, Republicans, PhRMA, and Big Insurance would go bananas because they would see that it is:

1. Workable.

2. Hence the handwriting would be on the wall for a rational path forward towards Single Payer, i.e., Medicare for all.

3. This would be orders of magnitude better than salvaging Obamacare, especially in the face of a deliberate attempt to sabotage it by Republicans.

4. Republicans could not as easily publicly try to sabotage Medicare, though that is their long term intent.

5. Republicans would, of course, fight tooth and nail to obstruct the "California Plan."

6. But can you say killer mid-term and 2020 campaign issue, especially with California, and its ambitious wannabe Governor leading the charge?

California here we come!
Check Reality vs Tooth Fairy (In the Snow)
What is happening to this country is a concert of conspiracy between a large number of Treasonous Republicans, certain Uber wealthy (example Koch/Thiel), Donald Trump and Vladimir Putin. While I believe that a lot of the Sanders and Trump followers were righteous in their disdain for our government's problems, they have been duped into following a tyrant supported by an oligarchy to put into place a fascist, dictatorial government.
JS (Trumpistan)
If the mean spirited, poor shaming Republicans actually cared about the average American they would have modified the ACA. Of course they won't.
They only care about the bank accounts of their corporate masters.
Bruce (Denver CO)
This is not a "health bill." It is a Genocide Bill, targeting those who lack sufficient wealth to pay pretty much any medical desire out-of-pocket to lives of pain, suffering, anxiety, sadness and misery for no reason other than to "help" those who are so wealthy get even wealthier. It would be an act of generosity to add to the bill funding for free euthanasia services so those lacking medical care can put themselves out of their misery. Absolutely disgusting and indefensible!
p gillham (Moscow, ID)
I don't believe a word Senator Hatch or any other GOPer says about not wanting markets to fail. Most have done everything possible to undermine the ACA. Why? For ideological reasons and to score political points. Party first.
Aunt Nancy Loves Reefer (Hillsborough, NJ)
23 Million Americans lose their healthcare insurance in order to fund a huge tax cut for millionaires and billionaires.

That's Republican class warfare, with a vengeance.
Ellen Brown (Saint Paul MN)
Someday maybe folks will start talking about why health insurance costs are so high: because the cost of delivering health care is out of control and compounded by the medical problems caused by the obesity epidemic.
ZDude (Anton Chico, NM)
McConnell's choice is clear, there will be no repeal of Obamacare. Given that Putin's alter ego Trump presidency is imploding on a daily basis why would Republicans want to be part of canceling the healthcare of 25 million Americans? Because more confrontational meetings with their constituents are a good thing?

Putin's Puppet may go all bigly on the Senate but he'll probably not even whimper knowing that McConnell may soon have to vote on impeachment. Perhaps Trump will let Jared Kushner negotiate Obamacare with McConnell since Kushner did so well with the Russian ambassador?
ZHR (NYC)
Let me allay the concern of any of those concerned for the fate of this country's plutocracy. Whatever the Republicans do, don't worry for the rich will not suffer.
Anand (Atlanta)
The first step to ensure universal health care is to ensure Congress gets the same medical plan as we do. Once they happens, you will see an immediate change
R. Littlejohn (Texas)
One more thing, everyone, men and women, has a responsibility to contribute to reproductive health care . As far as I know, every kid in the world has two parents, it takes two to tango. There are too many dead beat fathers, at least they should pay for medical expenses including reliable contraceptives.
No self-respecting male would just mooch off women and have women foot the bill and risk their health and even life to have a child.
It is well known that our infant mortality and maternal mortality are the highest of advanced nation.
Men are in it for at least 50%, no kid without a male involved.
Ann Smith (Denver)
Ryan's "Better Way" plan includes ending Medicare as we know it and putting America's senior citizens on one of the gold, silver or bronze plans in the marketplace, with some voucher assistance to cover the cost of premiums. Ryan can't put this plan into action if Obamacare is repealed and the market place collapses. That is why he is insisting on his "replacement" phase one legislation. Phase two is the "throw grandma and grandpa off the cliff" legislation. Can you imagine what the premium quotes would be for a 75 year old senior citizen? If the CBO estimates that a 64 year old will face premiums of more than $16,000 per year, just what do the Republicans think Blue Cross will demand to insure an 82 year old woman or man?
r mackinnon (concord ma)
Let's start by STOPPING calling heath care for the citizens of the richest nation in the world an "entitlement".
Our tax dollars pay for it, not McConnell, Ryan or Trump.
How about making the top pay their far share ? (speaking of which, where are those tax returns?)
Quit subsidizing the uber-rich ( is it ever enough ? )
And put that money towards providing basic care for all citizens.
Most other civilized nations don't seem to have a problem.
richard schumacher (The Benighted States of America)
Single payer should be positioned as leveling the playing field for US business. Foreign competitors do not have the expense of paying for their employee's health insurance.
purpledot (Boston, MA)
The sheer quality of the Republican conversation about the House Bill is descending sets of double-speak, and planned nihilism. As summarized by Representative Paul Ryan,"Everyone will have access to health care. Millions of seniors and the working poor may reside in a state that chooses to offer seniors and the working poor a waiver of eligibility for reduced health care costs, but that's up to the states. Remember, this bill offers all of us freedom from the tyranny of the regulations of the federal government. Without Medicaid's bureaucracy, all states will have choices of insurance rates. In our bill, everyone has access to lower premiums." On the other side of never-never land, twenty-three million Americans will have no choice, and no access. Despair will reign over American families and the medical profession, prolonged by fear, anxiety, and death. We voted for this?
Vicki (Nevada)
The answer to US health care is single payer. Insurance companies do nothing but make our health care more expensive.
Kingfish52 (Rocky Mountains)
If the Republicans were truly interested in improving healthcare, instead of WEALTHcare, they would implement a single payer system, a.k.a. Medicare For All. This would increase coverage, and reduce costs, and be the improvement they claim they want. But they aren't really interested, they just want political cover so that their friends in the insurance, pharmaceutical, and health care industries keep making money off of the sick and dying.

Who needs "death panels" when you have Republicans in charge?
hen3ry (New York)
Who knew it was so difficult to do the right thing and make sure there's coverage for all Americans, not just those who are lucky enough to be rich or have jobs. Who knew it was so hard to learn from what other countries have done and done far more successfully than America: ensure that all their citizens have access to health care wherever and whenever they need it regardless of their job or economic status. I'd rather pay more in taxes in order to know that I and every other person in America can receive medical care when and where we need it than continue to feed the health insurance industry. They are useless to us. So too is the GOP unless they come out of their shells and begin to act like they serve us instead of their corporate masters.
Claus Gehner (Seattle, Munich)
It is truly pathetic that during the years that Republicans only worried about repealing ACA/ObamaCare, none of these so-called leaders ever recognized that they needed to come up with a replacement.

In the House it was easy to vote 60+ times to repeal ObamaCare, but when it finally came time to actually govern and pass REAL legislation, they were all caught with the pants down, including the so-called "policy-wonk" Paul Ryan, now also Speaker of the House - with "leaders" like that, who needs "enemies" like Russia or ISIS...
cherrylog754 (Atlanta, GA)
“But replacing it would be really hard”.
-Senator McConnell

Well that’s enlightening. The Democrats worked their tails off to plan, formulate, introduce, debate, revise and vote on the ACA. And it took months and there were many arguments back and forth but in the end it passed. Where was McConnell all that time? Asleep? Maybe President Obama was right in what he said in jest about the senator, “he doesn’t have a pulse”.

The House passed an abomination called the AHCA and tossed it over to their Senate colleagues. They in turn said it was a non-starter in so many words and would do their “own thing”. The trouble is they have not prepared themselves to do their “own thing”. The American people viewed the shenanigans of the House and knew well it was disastrous. So why weren’t the Republicans in the Senate doing something right then? Likely because every one of them well knows it can’t be repealed and replaced and still meet their commitment to improve it while slashing costs to the tune of $800 billion.

So where is the AHCA headed? My guess is a “black hole” somewhere in the basement of the Capitol building. To be resurrected sometime in the next…………….

Besides they don’t like working on pesky health care stuff. The Republicans are just itching to get into the tax cut for the wealthy and pass it. So the beneficiaries of the largest tax cut in history can refill the Republican campaign coffers for the upcoming elections.
Joel G (Upstate NY)
This is a rather poorly written article. They say over, and over, and over again, that passing tax reform may be easier than passing repeal and replace of ACA. Finally they end with the C- student sentence: "However, Mr. Trump has considerably less leverage with Mr. McConnell than he did over House leaders, as Mr. McConnell and Republican senators are less susceptible to pressure from the White House." This argument takes the form of "A is true because A is true," or "fire engines are red because fire engines are red." Who is the editor that approved this copy?
Lee Harrison (Albany/Kew Gardens)
The Republicans and Trump may crater the American health care system.

If they do, they'll likely be thrown out of power eventually, but don't assume that the Democrats could fix it. The fundamental problem, huge costs and the complexity of healthcare, is not partisan.

Single-payer by itself is a not much of a solution ... it might save 5% or so, that's worth having, but the obvious question is how does the Federal government manage healthcare networks, do cost containment? Single-payer is not automatically "medicare for all," and legitimate questions exist as to what would happen to the healthcare system if everybody was at medicare rates.

If the Democrats regain ownership of this problem, and have only thin working majorities, don't think it will be easy or even better.

That old proverb applies: "Any idiot can throw a big rock down a well. The wisest men may not be able to get it back out."
John Thomas Ellis (Kentfield, Ca.)
This proposed bill is an act of political and economic suicide. It's a poison pill tossed into the single largest funding source our whole economy depends on. Doubt me at your own risk. Markets and poison pills don't mix. Congress is hellbent on crushing the very lifeblood that sustains most of the growth and development we can see in our hometowns, our cities, universities and hospitals, too. It's the funding mechanism for a third of our GDP and our molester-in-chief wants to diddle with it, and most of the Republicans in congress don't seem to care that their bill will wreck our economy and hurt America in ways we will not be able to repair for generations. What is Mitch McConnnell's motive for wanting to tank our economy? He's too bright to deny the risks inherent in the, "Trumping of our economy," by weaving this kind of bad faith into such an import policy.
Leslie sole (<a href="mailto:[email protected]">[email protected]</a>)
I put Mitch McConnell lower than the knees of an alligator. South of horrific. But...this time he is coincidently right.
This issue could bring Americans back together. 7 Republican moderates 7 Democratic moderates.
Sit down un armed and fix Obamacare. No ties, every issue must have 8 votes, every ballot secret.
Change the name THE HEALTHCARE SYSTEM. Make it veto proof with a Bipartisan Secretariat that rotates the chair from Party to party every 30 months.
Richard Garner (Arlington MA)
Reason why the ACA (Obamacare) is struggling in some states is due to Republican recalcitrance -- eliminating many of the provisions that were to make it a viable program. In any case, Republicans are simply not interested in a health care law that is of national scope. Why don't they just admit it and roll back to what we had-- really just nothing. Of course this was only good as long as you had a job. In that scenario, the federal government ended up paying more for healthcare, since many people could not pay and hospitals had to get paid somehow (federal government ultimately). Thus, many people do not realize that some form of universal healthcare is actually a wise business decision by the federal government.
Steve (Los Angeles)
Look, the Democrats (Nancy Pelosi, Chuck Schumer, etc.) lost the election. The Republicans will cobble something together, you can be sure of that. It won't be pretty, it won't be fair. Look, Trump said the Mexicans are going to pay for the wall and wouldn't you know it, there is money in the Trump's Budget for Americans to pay for the wall.
Jim Tankersly (. . .)
We deserve the politicians we elect.
carrobin (New York)
I might agree, but there's the Electoral College.
scott grant (sun city, az)
unless elections are rigged.
scott grant (sun city, az)
Only for POTUS.
cherrylog754 (Atlanta, GA)
“But replacing it would be really hard”.
-Senator McConnell

Well that’s enlightening. The Democrats worked their tails off to plan, formulate, introduce, debate, revise and vote on the ACA. And it took months and there were many arguments back and forth but in the end it passed. Where was McConnell all that time? Asleep? Maybe President Obama was right in what he said in jest about the senator, “he doesn’t have a pulse”.

The House passed an abomination called the AHCA and tossed it over to their Senate colleagues. They in turn said it was a non-starter in so many words and would do their “own thing”. The trouble is they have not prepared themselves to do their “own thing”. The American people viewed the shenanigans of the House and knew well it was disastrous. So why weren’t the Republicans in the Senate doing something right then to be prepared? Likely because every one of them well knows it can’t be repealed and replaced and still meet their commitment to improve it while slashing costs to the tune of $800 billion.

So where is the AHCA headed? My guess is a “black hole” somewhere in the basement of the Capitol building. To be resurrected sometime in the next…………….

Besides they don’t like working on pesky health care stuff. The Republicans are just itching to get into the tax cut for the wealthy and pass it. So the beneficiaries of the largest tax cut in history can refill the Republican campaign coffers for the upcoming elections.
Welcome Canada (Canada)
Do not worry about Republican senators. They will find a way to make them proud of themselves, they always do. Their #1 fans, rich Americans, will be there to push them on to destroy everything that is good in America. Have you noticed that Republicans never create anything because it is hard. Destroying is so much easier and simpler.
Tombo (New York State)
So the senate Republicans are divided over their extremist, class warfare tax cut for the 1%, I mean health care bill, blah blah blah...

Give me a break. After feigning moderation and basic human decency, which the media will slavishly parrot, the senate Republicans will pass something that is 95% of the monstrosity that their equally extremist House colleagues sent them and President Putin/Trump will sign it.

The GOP has objectively proven that it is now an extremist, plutocratic party that is waging vicious class warfare against the 98% and it's past time the the press stopped pretending otherwise.
EmmaLib (Portland, OR)
Such sweethearts the Republicans are in Congress. Let pregnant women and children go uninsured, remove their safety nets, strip the elderly of affordable care, let the sickest amongst us pay five times more, when they are sick and most likely UNEMPLOYED, and allow 23 million to go uninsured to save a buck.
Obviously for the Pro-LIFE group, dollar bills are worth more than the health and safety of it's citizens.

Let's not forget, this AHCA would put hundreds of thousands in the healthcare industry on the unemployment line.

Why does the media or anyone not talk about the job losses the ACHA would create? In Oregon, it would be at least 30,000.
roger (boston)
Republicans have lied so often that they've begun to believe their own bunk! Fact is they demonized Obamacare to reap political gains from ignorant voters, not because there was a real concern with the program. Now that Obama is gone so is the primary reason to fight Obamacare.

What Republicans need to do is quietly table this issue and move on to something fairly simple to implement. How about a small infrastructure package that helps to restore a few major roads and improve a few mass transit projects? -- and that won't blow too big a hole in the national debt?
EB (Chicago)
Can we please scream about the tax cuts for the wealthy in the GOP plan? Lose those and stop the huge increase on those of us over 5o but not yet 65.
Baba Ganoush (Colorado)
Well maybe if you could find some and make an argument then people would scream about that. What are they?
Fred (NYC)
The GOP has really boxed themselves in on this one. They have labeled it Obama Care they have said it's a disaster yet many Americans when asked about many of its specific features without being labeled Obama Care they approve of it. Sadly there are pieces of it, like an bold new plan, that need adjustment and tweaks to improve and fix faulty parts. If the GOP were smart they would do just this and simply give their action an new name.
lechrist (Southern California)
Every day I wake up and one of my first thoughts is to wonder which parts of our democracy have the Republicans chipped away today.

California has a bill for single payer in the legislature right now. It has support from everyone except the insurance companies and medical so-called non-profits. The biggest hurdle is how to pay the significant costs in getting it going and maintaining it. Hopefully the state will start talking to everyone about how this can be accomplished. If California can make the leap, then the rest of the country won't be far behind.

For now though, in the US Senate, Obamacare and Medicaid must be protected and that should be Democrats' priority.
Cathy (Hopewell Junction)
Of course the repeal is hard. People will actually notice when they lose their insurance, and cannot get care. Things like that irk voters.

Repealing the ACA jettisons people who benefitted from the ACA and does nothing to help people who were too poor to afford ACA plans and too rich to get subsidies.

The people who will be obviously hurt are those who will lose Medicaid and subsidies. But also losing out will be older workers and sick workers,(and older people vote!) who are already targeted for being laid off, and will not have a plans they can afford to purchase. They simultaneously lose salary and face healthcare payments that cost the same as college for their kids.

There is not a replacement because the ACA WAS the GOP alternative to single payer. Everyone knows this, but the GOP is hoping they can convince people otherwise.

Cut subsidies, reduce access, let insurers raise prices for older people and sick people and people will die faster. A lot of people think it will be "those people" who lose, but they might want to look in the mirror. The image is "those people."

We have me the enemy, and he is us.
James K. Lowden (New York City)
The Times continues to report on the issue as though Republicans were engaged in a policy debate. As though they were looking for something better, and there were disagreements on how to get there.

Whatever slogans they use, no part of any Republican plan on healthcare claims better coverage or more inclusive coverage. The don't claim to reduce costs. They frankly reduce spending and frankly admit many people will lose coverage or face far higher premiums. It's all about taxes, as always with them. The only debate within the party is how much harm they can do while still getting reelected.

McConnell is a smart man and he surely knows better than I do that what I'm saying is true. He'd like to kick the can down the road, and get his tax cut enacted while they're still in power. That way, he can claim to have been thwarted by mysterious forces -- those sneaky shadowy elites -- and keep Obamacare as a bogeyman to rail against. Meanwhile the plutocracy gets what it paid for.

Democrats meanwhile are as rudderless and feckless as ever. Bernie Sanders nearly toppled the whole edifice single-handed, calling for traditional Democratic policies. The country longs for someone to corral the rich and powerful, the corporations and banks. Intuitively people know, without knowing how or why, that they're being ripped off.

Trump got elected promising to look out for blue collar worker. When will Democrats realize the zeitgeist favors them now, and put single-payer on the ballot?
B. Wilson (Tulsa, Oklahoma, US)
The question that I would like to ask Senate Republicans: Why are they intent on repealing the ACA entirely? Its been proven that the ACA allows tens of millions of Americans to obtain medical insurance. The poor low-income citizens that benefit from the ACA may not have insurance on the same level as high and middle-income earners but at least they do have it. When the CBO projections say that 23-something million people will lose medical insurance for one reason or another, that should be enough to give the Senate great pause. What do they want to accomplish with a health care bill that will disadvantage millions and take away their ability to keep their insurance? Savings? They don't want the federal government to spend money making protecting its citizens? If that's the case, stop giving wealthy people lower tax rates. Its not as if they need them and cuts like that have the direct and undeniable effect of reducing government revenue. We're all supposed to pay our fair share in taxes in order to provide financing for the government. Cutting taxes for the rich coupled with repealing the ACA is an obvious move that seems to show that the GOP has long-term plans to eradicate poverty in America. Not by helping to lift people out of poverty but by making it impossible to survive being poor.

Taking away medical choices in a country like ours can cause desperation among the poor, and that could end up being dangerous.
carrobin (New York)
I too have wondered why the Republicans are so obsessed with destroying Obamacare. I can only assume that it's because it was an Obama concept.
T Rex (Austin, TX)
Part of the problem for Republicans is that they would have to admit (a) the so-called free market is not the best solution to every problem, and (b) they work for the American people, not a few wealthy donors.

They will never admit either of those things, so the only solution for the American people is get them out of government. They don't understand governing, they have no idea how to work together with anyone who differs from them, and they can't stand governing by consensus. What are they even doing in public office? Let's send them back to the private sector where they can do less harm to the country in general.
W.A. Spitzer (Faywood)
I keep running into people who think Oamacare is an expensive program which has added to the National Debt. Until people get the facts and understand what is really going on, there is no hope for an intelligent solution.
Don P. (NH)
It's not too hard...let's pass universal Medicare for all with Medicaid & Medicaid Expansion for those who qualify.
R. Littlejohn (Texas)
Single payer would be the logical thing to do but not for twisted Republican minds. that is not possible. They want to fit a square peg in a round hole. They should have thought about it before they made promises they can't keep. Even in a banana republic they know better.
stan continople (brooklyn)
I just wonder how long it will take our Republican friends to hit upon the idea of handling the opioid epidemic by becoming the dealer of choice? Raise revenues and keep millions of disenfranchised, resentful and possibly dangerous individuals under constant sedation. It's a win-win!
Joe Six-Pack (California)
"And we're going to have a tremendous, I think we're going to have a tremendous success. It's a complicated process, but actually it's very simple: It's called good health care.” said candidate Donald PG Trump.

"No one knew health care was so complicated!" said fake president Tweetie Pie.

And the voice of the turtle was heard throughout the land...
luluchill (Winston-Salem, NC)
It is hard to imagine how the House version of the AHCA gets even 40 votes in the Senate. Let's hope for a compassionate solution to this critically important issue. What a nightmare.
Charles (San Antonio, TX)
The GOP has been running on being the Anti-Democrats for so long that they have lost the ability to govern. Since obtaining the trifecta of capturing the House, Senate and Presidency they have accomplished just ONE thing - getting Gorsuch in past the filibuster of Democrats - and they had to literally break the rules to do that. They couldn't even attain their #2 mantra - to defund of Planned Parenthood which we all know they campaign on all year long.

Not only aren't they reforming the Affordable Care Act, they won't be building a wall with Mexico, nor cracking down on trade with China, nor investing in infrastructure, nor reforming the tax code, nor creating more jobs.

They will however investigate Russia and Trump, then decide Trump must go and claim that with a new "True Conservative" in office they should be given 4 more years to try again.

Mark the day. You have been told.
Carol D (<br/>)
Either fix the ACA or initiate a Universal Health Care plan Single Payer like the rest of the industrialized world. American taxpayers and voters are not going to settle for less. You Republicans on the hill need to take note.
red sox 9 (Manhattan, New York)
Please explain why people with reasonably healthy life styles should be forced to pay for diseases related to obesity, drug addiction, abortions and other expensive lifestyle costs. Also, why should the population at large be paying for birth control for women; shouldn't their partners or whatever be paying for their own birth control?

Similarly, young people, who already bear a terrible burden in paying for Medicare, shouldn't have to support old, unhealthy people as required by Oblama Care.

A little common sense, mixed in with your politically correct but absurd positioning, please.
W.A. Spitzer (Faywood)
When the people to whom you refer room go to the emergency room for treatment, because they can't afford healthcare insurance, when the hospital can't collect the cost of their treatment, the hospitals make up for the uncollectable bills by charging their paying customers more - bottom line is like it or not, you are going to pay for them anyway. Better that they have affordable insurance so they aren't so sick and don't cost you so much. But if you like the idea of paying more.....
J. (Ohio)
Healthy people with impeccable health habits get cancer, have heart attacks, have catastrophic accidents, and get sick too. The whole concept of insurance is spreading risk. You may be surprised to find you need it someday.
Joan Liz (Seattle)
For the same reason that I would pay through my health insurance premiums when you fall ill with a brain tumor or Parkinson's disease, which affect people with even reasonably healthy lifestyles.
Tanya (LA, ca)
the conseratives would have been fine to leave the ACA at "repeal" only but the big orange one had to add "Replace" to the end of that. Now the poor poor GOP has to try to do something that frankly they have absolutely no interest in and I do not think the skill set exists in the party to actually figure it out. Of course this is going to be hard it's a very layerd issue, at some point universal healthcare has got to come forward as a possible solution to this issue, health care is a human right!
SarahB (Cambridge, MA)
McConnell - just do this right. Get a team that includes some women, some Democrats, talk to some folks in the insurance industry. ask some doctors, some patients. hold some hearings and write a bill that most people approve and some people hate that helps a lot people and the insurance industry and that'll be your legacy.
Mark (New England)
Elections have consequences. But so do yuge campaign promises that don't materialize. I'm liking Dem's chances next year.
oscar jr (sandown nh)
so the democrats need to explain there plan to save the A C A! I do not stand there hesitation. All they need to do is put an add in the paper explaining there path to enhancing the programs that are working and fixing the problem parts. I am starting to believe they do not have a plan.
Eric Carey (Arlington, VA)
32 years in the US Senate with his state now 47th in per capita income, tied with Guam, and his priorities are to take away affordable health insurance from working Kentuckians and to gift billions to other Americans already blessed with riches. Just amazing.
Bayshore Progressive (No)
WE can only hope that the Republican Senators place country before party and choose to improve the quality and coverage of ACA for the good of the country. As the richest nation in the world, how can we deny that quality healthcare is the right of every citizen? It is time to expand Medicare to cover all Americans with comprehensive quality healthcare. The USA spends hundreds of billions on the Pentagon's War/Death machines, it's time we place a priority on life and health instead.
EdS (South)
This "richest nation" that you mention is 20 trillion in debt and if it was a business would be bankrupt. Everyone that thinks this country can have subsidized healthcare is dreaming. Where would all this money come from, just print more ?
Ray (Seattle)
Is it better subsidizing rich corporations than needy people who truly need health care, not insurance?
There is such a thing as corporate welfare, you know.
John Ramirez (San Diego)
Amend the existing bill by tightening the enrollment period to 45 days from 90. Keep the mandate. If GOP really wants to drop mandate, than those who need ER or Chemo and don't have money or insurance because "I don't need it," should be denied care for not being responsible. The problem is we never educate the population how insurance works. As an insurance agent, I have heard of all the excuses why they don't want or have insurance. Even for the people who can only pay $1 a month (yes it's possible with subsidy)
EdS (South)
You do all that and this country will turn into Venezuela. We are 20 trillion dollars in debt now and cannot afford this foolishness.
Annie Dooley (Georgia)
A pro-business party that wants to create jobs would relieve businesses of the onerous burden of providing most Americans with health insurance. Group premiums for individual employees were about $6400 and for families $18,000 last year and employers pay around 70% of those premiums. It is an enormous expense and a drag on business creation and expansion. If it was called a "business tax" instead of an "employee benefit," it would be the first thing Republicans would cut or eliminate. Why should businesses (and only some, but not all) continue to carry this burden?
Aunt Nancy Loves Reefer (Hillsborough, NJ)
Not only that but it puts American businesses at a disadvantage to their foreign competitors.
Universal Single Payer Health Insurance, an idea whose time has come.
Miz (Washington)
The Republicans have used Obamacare as a rallying point for their base for the last 7 years, never really expecting to have to present their own plan. If they had really been interested in making health care accessible and affordable for all Americans they would have either come up with a plan themselves or worked with the Democrats in crafting a plan that would work. They did neither. They don't care about Americans--at least none of us who have relied on the ACA for protection from insurance companies who refused to cover pre-existing conditions. They don't even care about all those working class white evangelicals who continue to vote for them because of their "family values" while they sell them out. McConnell should go down in history as one of the worst leaders we've ever had in congress.
Surfrank (Los Angeles)
First ask Trump voters who get Obamacare to voluntarily give it up. A quick on-line survey would indicate how many would do so, and offer a projection on the savings. Let's have Republican voters prove their mettle. After all, isn't that what they all voted for?
JWinJH (Jackson Heights, NY)
Based on experience with this crew, I'm confident that the GOP Senators will come together and unanimously support something horrible.
Me Too (Georgia, USA)
Commenting on Trump's budget, and Congress trying to make TrumpCare work is getting old, big time.. The changes to ACA is offensive to those needing healthcare, actually it is overall an embarrassment to the world scene. How America can cast its people aside to insure the rich get richer at the expense of providing its citizens adequate medical care is insane. But that is the GOP, and if you voted for them to be in the white house, then you might see today how ridiculous what they are proposing.
Check Reality vs Tooth Fairy (In the Snow)
Use to project future economics of US economy, the difference between Republican and Democrat governing.

PoliticsThatWork Change in Unemployment Rate by Party of President- Since 1945

Each party has held the presidency for the same number of years since 1945. During those years, the unemployment rate has risen 11.8% under Republican presidents and has fallen 7.2% under Democratic presidents. Unemployment has fallen during the overwhelming majority of Democratic years since 1949. Unemployment rose steadily under Republicans up until 1982, then fell during the remaining Reagan years, and then rose again under both Bush Presidents.

PoliticsThatWork Dow Jones Performance by the Party of the President

During the most recent 15 years during which Republicans have held the presidency, the value of the Dow has increased by 42%. During the Democratic presidencies, it has increased by 609%- 14.5 times faster. The average growth in the value of the Dow under Democrats during this period has been 14.75% and under Republicans it has been 5.11%.

PoliticsThatWork Change in Disposable Income Since 1930 by the Party of the President

In the 44 years that we have had Democratic presidents since 1930, the real per-capita disposable income has increased 271%. During the 40 years during which we have had Republican presidents, it has increased 44%. On average, it has increased 3.1% (after adjusting for inflation) under Democratic presidents and 1% under Republican presidents.
DWS (Dallas, TX)
The Republicans and right-wing media invented the pejorative name Obamacare. Had they left the name as The Affordable Care Act the Republican majority in Congress today could legislatively fix ACA without much risk to being "primaried" or prematurely ending the lives of millions of Americans left without healthcare.

Buckets of crocodile tears and I can't wait until 2018.
Dean Fox (California)
The facts are the facts. Whatever the criticisms of ACA, Obama's intent was to initiate a program that would provide health care insurance to many people who otherwise could not get insurance. If he could have gotten all the way to a single-payer system like that of most western countries, he would have.

The GOP doesn't believe that government should get involved. As former GOP congressman Joe Walsh asked, "why should I have to pay for someone else's healthcare?"

Two very different philosophies of the role of government. The voters will have to do their part and make their preference clear, once and for all.
silty (sunnyvale, ca)
The GOP has really painted itself, and the nation, into a bad corner. It is neither willing to modify Obamacare so it works in rural regions, nor is it able to formulate a serious alternative. Action must be taken, but the the GOP is paralyzed. The result will be seen in the months to come.
EdS (South)
They painted themselves into a corner by trying to pass an Obama lite health care bill instead of outright repeal that they had promised. Only 17 % backed the bill that they wanted to pass.
Observer (Backwoods California)
Any insurer who pulls out of an individual market should be prohibited from offering insurance in that market under the FEHB. That's is a big, big group, and the federal government has total control over it.

Easy fix!
alan brown (manhattan)
It may be that Republicans cannot come up with a bill that is superior to the ACA and that can pass the Senate. It seems clear that the ACA was flawed from the outset although it contains features that are popular and beneficial to large segments of those who need health insurance. Republicans should abandon efforts to repeal Obamacare just because they promised it and it carries the name Obama. Democrats should abandon their determination to avoid anything associated with trump like the plague. Both parties should pass a joint, bipartisan bill with features needed to address premiums, guarantees for pre-existing conditions etc and give it a new name. Call it Obama-Trump or Trump-Obama or anything else but get it done.
RM (Vermont)
Lower the Medicare age to 40.

Federal subsidies for high risk or preexisting conditions.

Post a bond for $250,000. buy insurance, or opt out of health treatment unless you have the cash. Go Fund Me and charity care will become more widespread.

See, I solved the problem. Mostly, within conservative principles.
Mimi (NYC)
We need single payer. We do not need insurance companies. But the insurance companies will not let it happen despite the fact that the overwhelming majority of the population wants it, knows that it is the best option and has seen it work elsewhere all over the world. What does THAT say about our so-called democracy???
RM (Vermont)
Its the best that money can buy. Thank you, Joe Liebermann, from the great private insurance state of Connecticut.
DSS (Ottawa)
This is very simple to figure out. The Republicans are not really interested in fixing health care, they want to destroy anything with Obama's name on it. If they were serious about improving the lives of Americans, they would have worked on fixing Obamacare, which would be a lot easier than starting from scratch with a new Bill that will go nowhere.
Aaron of London (London, UK)
Your Republicans really don't care about the general electorate. If you think otherwise, then explain the new Republican Tax plan and the House's repeal of Obamacare. As long as they serve the bidding of the 0.1% constituency they will be fine.

If they really did want to help the lower 99.9% of the population they should take themselves and Mr. Trump and go visit Mr. Turnbull there in Australia. He can tell them about the public-private healthcare system they have there. The patients are happy, the docs are happy as they make more money than most of my peer's when I was working in the US. Medical innovation is great there, as well. I've worked at several companies that have acquired medical IP developed there. We almost uniformly choose Australia as a site for clinical trials, as the health care quality is so good.

Sadly, most Republicans just watch Fox "News" and wouldn't believe their lying eyes if they went over to Australia to take a look. It would run against their Rush Limbaugh / Hannity narrative that government can actually improve people's lives.
Sea Star RN (San Francisco)
The Republicans have failed to admit to the American public that they are trying to get rid of a Republican model for health care reform, right out of the Heritage think-tank and written by an Insurance executive.

The Health industry is booming for investors with a Market Cap that has doubled since 2010. Drug prices are skyrocketing. and CEO salaries are in the stratosphere.

Why would the party of Business ever want to get rid of that??
Robert Eller (Portland, Oregon)
Time to retire the term "conservative" forever from American political discourse.

There are no "conservatives," at least not operating in the government, and certainly not in the Republican Party.

Instead, I propose a more politically accurate term: "Self-servatives."
Margaret (Minnesota)
If anything resembling Trump/Ryan care passes and is signed into law, I'm dead. I will live about 1-2 weeks after my last shot of insulin and my body produces none of its own insulin. My husband died very young, disability took me out of the job market 17 years ago and when its all said and done, in about 3 years I will get about $800/mo gross before Medicare A & B deductions.

Gutting Social Security and Medicare/Medicaid will assure that I and many other poor, elderly, children and disabled will die early or have their quality of life greatly reduced.

Single payer is the way to go as our world ratings for numerous health markers compared to other countries is about 32 to 36.......we have the ability to be #1, but not with our current system. We will continue to drop with the status quo in place and significantly with Trump/Ryan care.
Michael (Boston)
The Republicans should have invested much more effort to figure out the complexities of healthcare and how to improve it long ago. Of course, that didn't serve their political purpose and most were never interested in improving lives of average Americans anyway. Their purpose was served by lying about death panels, sky rocketing costs, third world health care, government failures, etc. In fact, there were no death panels, healthcare costs grew at a slower pace, and access improved acroos the board.

But there was a givernment failure. That was the failure of one party to think beyond their own interests and contribute to making the ACA better.

In healthcare reform, they are exactly like Lucy pulling the football away from Charlie Brown (more like deliberately tripping him) and then laughing at the outcome. They should be ashamed of themselves.
WestSider (NYC)
Paul Singer of hedge fund fame just issued an ultimatum to Trump. Either he does healthcare, tax reform and other gifts to the wealthy, or else the market will crash.

Apparently, he doesn't have enough billions.
Andre (Vancouver)
As I see it, this entire debate seeks to define the kind of society that the USA wants to be. However, the country is highly splintered and I cannot possibly see how it can ever reach a consensus on this.

Good Luck in your efforts.
Mark Bosco (Worthington, PA)
The lack of leadership in the Republican party is apparent. What is troubling. The base of the party would rather support, journalist being body slammed to the ground and the rhetoric that goes with it rather than any meaningful solution to the nationals ills. Our Republic is in danger from our elected officials, the finacial elites who benefit from the disfunction of the NO party and the minority of the population who supports them.
The only hope is that, the do nothing party rubs off on Trump and he becomes the do nothing president.
Aaron of London (London, UK)
Your Republicans really don't care about the general electorate. If you think otherwise, then explain the new Republican Tax plan and the House's repeal of Obamacare. As long as they serve the bidding of the 0.1% constituency they will be fine.

If they really did want to help the lower 99.9% of the population they should take themselves and Mr. Trump and go visit Mr. Turnbull there in Australia. He can tell them about the public-private healthcare system they have there. The patients are happy, the docs are happy as they make more money than most of my peer's when I was working in the US. Medical innovation is great there, as well. I've worked at several companies that have acquired medical IP developed there. We almost uniformly choose Australia as a site for clinical trials, as the health care quality is so good.

Sadly, most Republicans just watch Fox "News" and wouldn't believe their lying eyes if they went over to Australia to take a look. It would run against their Rush Limbaugh / Hannity narrative that government cannot improve people's lives.
DSS (Ottawa)
For Obamacare to work, the individual mandate has to be enforced. You need a very large pool to cover those with pre-existing conditions. The larger the pool, the less the premiums. Trumpcare does away with the individual mandate and puts people with pre-existing conditions in high risk pools, which means their insurance will be unaffordable. The more the Republicans play with trying to deceive the public about insurance basics, the more they are justifying a single payer system, which is what we should have had in the first place.
Diogenes (Belmont MA)
As others have suggested, it may be impossible for the Republicans to craft a large tax cut if they are unable to repeal Obamacare, which would enable them to re-allocate billions of health-care dollars to tax relief for the wealthy.

Otherwise, their relentless effort to repeal Obamacare would make no sense.
Jim Brokaw (California)
The ACA took about a year of negotiations and evolution before reaching a form that could be passed, without any help from Republicans. It has many areas that could be improved, but not without help from Republicans, who didn't and won't even consider trying to make it work better. Well, now Republicans think they can put together an alternative in a few weeks that promises much more. Nothing that is promised by Republicans is delivered by the House bill - it offers less people coverage, it offers weaker and worse coverage, it removes most all the things people like the ACA for. The House bill does do then one thing Republicans really do care about - it massively, hugely cuts taxes on the very wealthiest few of us. So while denying coverage to millions and degrading what is left for millions more people, it gives hundreds of Billions in tax cuts to the fewest, wealthiest among us. McConnell is right, doing health care -is- hard. Giving more money to the rich, disguised as 'health care reform' is easy - House Republicans have done that. Let's see if the Senate can put some health care back in the bill.
Teg Laer (USA)
Republican efforts to replace Obamacare are hampered by one nearly insurmountable obstacle - the fact that they don't want to replace it. They don't want government to have anything to do with insuring health care for all.

They want to just repeal the ACA, but they want to keep their seats and power in Congress more. And Americans, even Americans who vote Republican, don't want to lose the health care that they couldn't afford before Obamacare.

The Republicans have 4 choices:
1. Repeal Obamacare outright and take their chances with voters blaming them for the loss of their health care.
2. Do nothing and let Obamacare crash and burn, perhaps being blamed for its collapse by the voters, perhaps being able to persuade voters to blame Democrats or the ACA itself.
3. Against the odds, manage to pass a health care bill of their own, being forced to take the full and unambiguous responsibility for its success, or, more likely, failure.
4. Withdraw their objection to Obamacare, stop sabotaging it, and join Democrats in making the reforms that are needed to fix it, maybe even being able to take credit for that.

None of these options are very good from their point of view, it seems to me...
paul (bklyn ny)
Here is the bottom line imo.

The republicans are seeing it is harder than they thought to bring us back to the "middle age" with health care. Even Trump supporters are balking about it in red states. They finally woke up.

The congress could go anywhere from saving ACA or the opposite extreme bringing in a voodoo plan and insure that poorer people for 5k can get covered by Haitian witch doctors.

If the republicans allow the basic ACA support them, if not oppose them with great vigor.
shp (Baltimore)
What is the objection to Medicare for all.
There is not a single senior who would give up Medicare.
No one is denied care, there are no pre existing conditions, no cancellation and no cap.
It costs 1.1% of every tax payors gross income..
97% of the money goes to health care.
Simple, increase the Medicare tax to 4.5% of gross income, stop giving the money to for profit insurance companies
Roger (Wiscosnin)
I agree. Lyin Paul Ryan wanted to steal our medicare and give us a $6500 voucher for it. That is still his long range plan. Lyin Ryan wants to put Dementia patients on the street. Cutting medicaid which pays for the long term care of Dementia patients would result in states refusing to pay nursing home bills. Will Ryan pick up his family member and be able to pay $100,000 a year for the dementia care? He might but most of us are barely surviving on our salaries. The news said yesterday that 77% of Americans could not pay for a medical bill of $2000. The Resickligan plan to cut medicaid will cause major tragedies when Alzheimer patients are dumped at ER rooms.
Rick Spanier (Tucson)
I am hoping those calling any legislation coming out of this congress Trumpcare will reconsider. The president has already admitted healthcare is too complicated for him to understand.

No. Call it what is is: Republicare. Over seven years of carping and the GOP has nothing to offer except slash and burn tactics that benefit only their wealthiest club members. The middle American worker types who supported him will be those screaming the loudest as they are offered low premiums for virtually no coverage.

This is a Republican bill in-the making, Trump lacks the attention span to concentrate on what is being foisted on the public in his name. He also lacks the empathy to even imagine speaking out in support of his supporters.
Nedra Schneebly (Rocky Mountains)
"Repeal and replace" is a non-starter. It was always merely a slogan, not a plan. The Republicans in Congress need to work with the Democrats to improve the ACA. That's the sensible way to go about it--keep what's good, fix what needs to be changed.
DavieFLDon (Davie, FL)
I thought the GOP was against government run healthcare, yet they propose government run high risk health insurance for people with pre-existing conditions. How is this a free-market solution? Sounds like someone is trying to pull the wool over our eyes.
Dan Raemer (Brookline, MA)
It is mind boggling that the solution to this whole mess is quite straightforward yet unreachable. Some sort of national insurance system like medicare is the obvious solution. Simply expanding medicare to younger and/or poorer Americans would be the most efficient and helpful solution to the uninsured citizen problem. But, that would leave out the third party payers and they could not collect their pound of flesh. At this point, between the fragile compromise of ACA and the bizarre House plan, the insurance companies are probably not so excited about the whole thing anyway. It is really the ideology of our elected leaders stands in the way.
Ri Roe (NJ)
Let me understand, Insurance companies raise rates, people don't buy their policies. get sick and need uninsured services (mandated by a visit to the ER), taxpayers pay for the medical services. What do we need insurance companies for? The US has a couple of single payer health care programs already, The military coreman model, Medicare/Medicaid, and the VA. Each has problems that are easily addressed.

Single payer program puts government clerks in the position of making health care decisions. Is that, in any way, different than the current insurance company clerks following a script to deny service? HOW?

With a single payer, government, program, only one entity is charging for service, or graft.
Wolfie (MA. RESISTANCE IS NOT FUTILE)
First Medicaid & Medicare are not the same. One is a benefit. The other is a premium paid health plan you have been paying for every paycheck. Do you want to give away all those premiums to some poor family who probably has never paid into Medicare at all? Or help them & everyone except vets & the elderly with a one payer system. That if you ever get it mostly right, you can give back all the premiums paid to everyone for Medicare, & move the elderly into the one payer system. That is if we can stop congress's embezzling of the trust funds. Both SS & Medicare. $3 trillion so far & counting. All are guilty, because even if they didn't take any of the money, they had to have known about it & are therefore accessories. The VA should stay mostly separate as veterans often have conditions & injuries that in the rest of us are rare. They deserve our best.
Josh (Tokyo)
Reading this fine piece, I realized what I was not paying enough attention to. Mr. Hatch from Utah is a Republican! I remember from my formative years in '70's that Mr. Hatch is a sensible and reasonable politician, eager to do good to renewable resources and others. If he is still such a politician, I wish he switches the side or becomes an independent. He shouldn't help the group led by Mr. T and transactional type to appear as a political party with some reasonable senses.
Ray (Seattle)
What will Mitch McConnell say to his constituents in Kentucky who have gained health insurance as a result of the expansion of Medicaid under Obamacare - if he were to pass the Ryan repeal in the Senate?
These Republican senators know that there is a fix to Obamacare - provide the subsidies back to insurance companies for taking on high-risk pool patients that Marco Rubio opposed, instead of providing tax credits.
How can the GOP say they stand for the protection of life if they can not ensure even basic healthcare?
Kathy Lollock (Santa Rosa, CA)
The day of reckoning has approached for Senator McConnell. In 2008, he set the tone to destroy anything accomplished by President Obama, even though it may help the nation at large, Republicans and Democrats alike. His basic tenet, his way of legislating, has always been to say no, unless of course such laws would help CEOs, big business, and Wall Street. A Republican senator or House representative with an iota of a conscience would understand that they also represent struggling blue collar workers in the mid-west and coal miners in Kentucky, McConnell's home state. They are among those most at risk for losing health insurance, for being susceptible to chronic or debilitating illnesses. McConnell - and Ryan - are given an opportunity now to step up to the plate, to be moral and ethical. The question is: Will they show they actually have souls?
Teed Rockwell (Berkeley, CA)
The Republicans are faced with a challenge of how to redistribute health care revenues so as to eliminate premium increases for many Americans. They then decide to make the problem even tougher by reducing those revenues through tax cuts for the Rich. Why do they do this, when it will almost certainly cause them to fail? Apparently there is a reflex in the Republican nervous system that forces them to add upper income tax cuts to every new bill. If they ever declare nuclear war, there will probably be a rider to the declaration that lowers taxes for the Rich.
W.A. Spitzer (Faywood)
I don't see what the problem is. All McConnell has to do is propose that everyone be put on Medicare. In one simple bill he could provide everyone universal healthcare and save the country at least $400 billion dollars a year; and he would be sure to get enough Democrat votes to pass it easily. Come on folks, this isn't that hard.
Wolfie (MA. RESISTANCE IS NOT FUTILE)
You do realize you have been paying premiums out of your paycheck every check since you started working, so that when you get to be 65 healthcare will be waiting for you, don't you? If we do as you suggest, all that hard earned money, YOUR money, will be gone (where is a difficult question as congress has been embezzling from the Trust Fund since it's inception). But, anyway, your money will be gone. Pfft. That is your idea of a good thing?
Making Medicaid the start of a one payer system, after studying Medicare (to learn the good things, the bad things, & the we are stuck with them things). You can make Medicaid for all. Then when you fix the stuff that obviously need fixing (nothing is ever perfect), you can stop the premiums for Medicare & give the Elderly free of any charge (as Medicare does have fees & charges for things now) for the rest of their lives, this new entity. The Vets deserve better, have many needs that are rare in the general population, & should have their own system for these needs. Regular stuff, the regular system.
But, stop trying to steal from us & yourself what we have been paying for for decades.
Greg (Texas and Las Vegas)
I have complete confidence that Mitch McConnell is not going to let a bill go across his desk and be signed and sent to the President that is not fair to the American people, including those who benefited so much from Medicaid expansion. Yes, America needs to target costs, both in premiums for those who currently bear a burden too high in some income brackets, and everything else that keeps going up related to healthcare. I am an independent. I voted for Reagan and Bush. I liked Bob Dole for President, a good man. Two leaders from both political parties in past decades came from my hometown, Darden and Eggers. Neither would support current leadership in the House or the Freedom Caucus. As for myself, I find it increasingly difficult to find much in substance in recent years coming from the Republican Party platform in terms of addressing America's challenges. Trump triple downs on that feeling. Mitch McConnell, on the other hand, is a reasonable man who will do the best he can to provide some relief to some Americans while keeping the overall plan intact.
Miz (Washington)
You sir are not an Independent. I have news for you, you're a Republican. And if you think Mitch McConnell is a "reasonable man" then you are actually a right wing Republican. McConnell will go down in history as the most divisive senate leader we've ever had. He doesn't care about this country. He cares first about his own power, then his party's power and finally his own pocketbook.
Scott Rose (Manhattan)
Mitch McConnell is despicable. Over the past weeks, instead of offering any good, solid ideas for expanding healthcare coverage for Americans while lowering costs, he has been on a social media and regular media campaign to demonize Obamacare and to point fingers of blame at Democrats.
Whatever (Sunshine State)
Who is this Mitch McConnell you write about?

Reasonable?

You describe someone I don't know.

The one I have know stated that he would make sure nothing put forth by Obama would be passed.

The one I know made it clear his entire goal was to make sure Obama was a one term president.

The one who refuses to work with democrats.

The one I know put together a secret committee to work on the health bill.

Seems you and I don't know the same Mitch McConnell.
Pam (Alaska)
If a state opts out of preexisting coverage, it shouldn't get any federal dollars for its "high risk pool". The young and healthy in blue states subsidize the old and sick in their own state through higher premiums; they shouldn't have to also subsidize (through taxes) the old and sick of a red state that has decided not to require its young and healthy to take care of its own. Let those red opt-out states live with the consequences of their actions. Also, one of the big factors in the current insurance problem arises from the uncertainty in Washington, including the uncertainty about subsidies. The GOP doesn't seem inclined to address that anytime soon.
Jim Steinberg (Fresno, California)
Blame Obama and vicious Democrats. They foresaw that greedy, callous, indifferent, selfish Republicans would succumb to their base instincts. Tricky Democrats played Republicans for their deepest emotional shortcomings.
YoYowhy (Connecticut)
Yes, by all means blame the Democrats for passing a bill that worked at getting MILLIONS of our fellow AMERICANS insured and on the path to wellness.

Dammit Dems! I dare you to get it together and make US a single payer nation - that would REALLY MAKE ME MAD!
Philip S. Wenz (Corvallis, Oregon)
Let me make it easy for the Republicans: Pass a Single Payer health plan that cut out the greedy and useless insurance companies, negotiates drug prices allows the country to move on with increased prosperity and security for the 99 percent.
Champagne socialist (Scottsdale, Arizona.)
Philip - that would be a good step- but only part way. Costs for medical procedures MUST be re-negotiated as well - after cutting out the 'greedy and useless insurance companies' who currently ration health care for us all. US costs are currently 200%+ those in most developed nations. Imagine the increased revenues available to drive the rest of the economy if health-care costs were truly managed well. Our 'deal maker in-chief' obviously cannot do it - but there are others who should be given the opportunity.
vickijenssen (Nova scotia)
In Canada, private insurance is alive and well...some of us buy it outright (especially to travel to USA where a hospitalization could bankrupt a Canadian visitor) and many employers provide it in addition to the provincial health care.
luluchill (Winston-Salem, NC)
There you go trying to suggest a rational solution to the problem. I just wonder how this horror show is going to end. Not well I suspect. Sadly, we will be the collateral damage.
Matthew Carnicelli (Brooklyn, NY)
If Republicans are indeed the "business-oriented" party, then they will go to school on works around the world, and introduce a version of that.

We already know that universal health care is far cheaper than this abomination of a system that we have in America.

As Warren Buffet stated a few weeks back, our bloated, inefficient health care system is making every non-health care company in America that much less competitive in a global market.

Stop trying to reinvent the wheel and simply copy what actually works.
A Reader (Huntsville)
Trump was already said that the health system in Australia is better than our system. Why not just copy it.
Observer (Backwoods California)
Indeed, there is no reason at all that employers, i.e. businesses, should be involved in any way with their employees' health insurance. It is an artifact of the World War II, when wages were frozen and employers looked for other ways to woo employees.

Now, it just makes employees wage slaves and holds down innovation from creative people starting their own businesses.
buck c (seattle)
Your mistake here, Matt, is that you think the Republicans might actually care about what works, just that their check gets written.
Don (Chicago)
Reading Senator Johnson's syntax reported in the article, I find myself wondering when people elected to the Senate began to fail to learn English grammar. But maybe the inability to express one's thoughts precisely and accurately doesn't matter to an electorate widely sprinkled with such individuals.
aoxomoxoa (Berkeley)
This is not new. During the Bush II reign, it became evident that his garbled syntax and muddled speech directly correlated with the thought processes behind the words. This phenomenon is on public display daily with our current president. This country attracts some of the most intelligent and concerned people from around the world to attend our universities, we have high levels of intellectual accomplishments in a number of areas, and yet a rather large proportion of the citizenry can apparently not be bothered to understand the basics about the workings of government, the economy, natural systems, etc. The result is the Trump Administration and the sycophantic Republicans who will go along with one corrupt deal after another, at least as long as they can benefit.
Wolfie (MA. RESISTANCE IS NOT FUTILE)
Ask most people between the ages of 18 & 50 when they stopped having to diagram sentences & take spelling tests in school & the answer you get is 'what's diagramming sentences', & 'I never took a spelling test in school.' 'that's what spell check is for. It's infallible.' Or usually they don't use the word infallible, they don't know what it means, they just say spell check is perfect.
Schools have been dumbed down for at least 50 years. Why learn to spell? Why learn history? Why learn Science (it's all a lie)? The trash now live all over the country, though most in the south & middle. They firmly believe 'edukashun is evil' & should be avoided. Then complain when they can only get hired as menial workers without any responsibility. It's even worse for their kids, who have never 'lost' at anything, had social promotions every year, & then couldn't graduate because they didn't have enough credits. They just loved taking no credit courses, they don't have tests, exams, homework, & you never fail. But once Physical Ed was dropped (to save money) suddenly they didn't have enough credits to get a real diploma. The systems quickly came up with a fake one. "This student spent 12 years in our system. They failed to get enough credits to graduate". Some companies in these areas now take those as 'real' diplomas, because they can't find enough graduates to fill their jobs. Their companies are doing worse each year as more of their employees don't even have grammar school educations.
Patricia (Pasadena)
People are afraid that they or their family members could suffer horribly and die because of this legislation. I hope McConnell recognizes that fact. Trauma can be a powerful motivator at the polls.
A Reader (Huntsville)
Trump's proposal would cut back Medicaid and force death committees to be set up. I would not like to be one one of those committees.
JanTG (VA)
Come on now, boys and girls-it can't be that bad. Your fearless leader (Trump, not Mitch) said we were going to have healthcare that was going to be beautiful, affordable, cover everyone, better than Obamacare. So just do it!!

Not so hard now, is it?

Who would have thought it would have been so hard??
LK (Florida)
The Republican's single-minded drive to defeat Obamacare is finally forcing them to reconcile their heartless ideas. They must either hurt their own constituents in order to save face, or admit they were wrong. I feel no sympathy for their predicament, only sympathy for those who will be impacted because of their reckless, win-at-all cost behavior.
steve (ct)
The Party that backs Medicare for All will win over voters for generations to come. Over 60 percent of the Republicans and 80 percent of the Democrats back this. Both parties are corrupted by Wall Street money.

Both parties though are ignoring the voters to their peril
Lynn (New York)
Look at how they vote.
Every single Democrat in the Senate, with 100% Republican blockade, voted to lower the age of eligibility for Medicare. They lost by 1 vote.
Get 60 Democratic Senators (for more than a few months), control of the House, and a Democratic President, and there will be a Public option.
Attacking Democrats and depressing their turnout will leave us where we are.
Wolfie (MA. RESISTANCE IS NOT FUTILE)
Unless you make it clear that your 'Medicare for Everybody' will not be on the backs of the Elderly who have been paying premiums for 50 years, you haven't seen anything yet. The generations coming after us, don't want to pay us what is owed for birthing them, feeding, clothing, sending many to college (party schools which taught them nothing), & cosigning loans for cars, condos, boats, lot's of other toys. We will destroy you. Take everything, try, convict, sentence & hang congress en mass for embezzling the SS & Medicare Trust Funds since their beginnings. $3 trillion so far. Then when you get old, you better have saved 85% of your gross pay your whole working life so you don't have to live under bridges. We will be gone. Knowing you will be punished, by each other, as you should be. You believe the embezzlers. So be it on your heads. The rich will have every cent you ever made. You will live in dormitories, doing whatever job they demand. If you do good, you will eat, if not, sorry. You will live segregated by gender. Only allowed to procreate with whom THEY choose, to bring in the next generation of workers. If it is decided that automation is better, you will all be sterilized, thrown out of the dorms, they will stop feeding you, & you will be on your own. The rich will do business with other countries who treat their citizens well. You won't be considered citizens, just low class workers. Enjoy.
drejconsulting (Asheville, NC)
"Get 60 Democratic Senators (for more than a few months)"

Obama had 60 Senators for 18 months, and squandered the opportunity. He was too busy trying to get the Republicans to love him.

Fast forward to his last two years, he couldn't care less, he went from Casper Milquetoast to Emperor Obama
R.C.W. (Heartland)
Why are some insurers abandoning states? Why can't health insurance compete across state lines? That sounds like a monopoly to me. A whole lot of little within-state monopolies, which prevent individuals from taking their insurance coverage with them whenever they might need to change jobs.
How much more competition would we see between health insurance companies if they were all required to cover the entire country.
SMB (Savannah)
Because that is a race to the bottom. Studies show consistently that crossing state lines just doesn't work in part due to demographics, and insurers themselves aren't interested. The ACA doesn't really prohibit it anyway, just sets up some minimal standards. https://www.nytimes.com/2015/09/01/upshot/the-problem-with-gop-plans-to-...

Old idea, old failure, doesn't work.
DavieFLDon (Davie, FL)
All insurance is regulated at the state level, you may think we have national insurance like Allstate, Geico, etc, but in reality, they operate at the state level. Heath insurance companies would need a network in every state in order to compete, setting up such networks would cost millions and cause premiums to rise.
Judy Pecsok (Castle Rock, CO)
Health insurance companies are able to operate in a number of states...but they must comply with each state's regulations. Otherwise, it would be a rush to the bottom. Are you OK with that?
andy b (Hudson FL.)
Health care is a universal right.
Iver Thompson (Pasadena, Ca)
Probably so too is food, as far as I believe, yet I still have to pay for it every time I go to the store. No one is saying you can't have it as long as you can pay for it. This is just the nature of the beast we now live under and are helpless to. I'm still holding my breath when it comes to air. I'm sure it's thinking about that aspect too.
Vicki Ralls (fremont)
It is and raising awareness of that belief is Pres. Obama's real legacy. Republicans call it an "entitlement" because they don't believe that 99% have any rights.
red sox 9 (Manhattan, New York)
Profound! But...
Do the doctors work for free? Who pays for this "universal right"? Do drug addicts, smokers and 500 pound people recieve the very highest quality care provided by your "universal right"? Does healthcare include expensive treatments to create clones (or whatever the latest method of creating unnatural babies in test tubes might be for weird variations of "parents"?) Does it include marijuana? Heroin? Meth? Are there other "universal rights"? How about sex? Sex often makes people feel good... shouldn't this also be a universal right?
Linda (Phoenix)
The most shameful cruel so -called Health CARE bill that is really nothing but a murdering bill to give wealthy more money while killing poor babies. . If it passes, they should all go to jail
JB (CA)
Better yet, vote them all out of office!
Wolfie (MA. RESISTANCE IS NOT FUTILE)
No, they should all hang. Their families thrown out on the street with no jobs, money, food, or more than the clothes on their backs. Whatever they & their families own should be sold, then all the money put into the SS & Medicare (for the old, not everyone) Trust Funds they have been embezzling from for decades. Let their families live under bridges, eat out of dumpsters, wash in polluted rivers. It is what they want for everyone else. It is all they deserve. Let them go to the gallows knowing what will happen to their extended families. That would be a good part of their deserved punishment. Let their women, from age 12 up, hook for food. Let the boys be put into the army at 12 to serve us as our cannon fodder, with the good soldiers trained to fight, & shoot down any of these trash who try to run. The women sterilized at puberty. Most trash are genetically inferior. Should not be allowed to procreate, unless the need for more cannon fodder becomes acute. For those, keep some with the least bad genes in labs to be impregnated by those of differing races with good genes, for the worker class. No work? Cannon fodder.
Montreal Moe (WestPark, Quebec)
Yesterday's election in Montana reminded me that Alberta Canada's most right wing Province and Montana share a very long interesting border. Alberta had a right wing Christianist government or a right wing Conservative government for 80 years from the middle thirties until 2015.
In 1948 the right wing Christianist Social Credit government introduced government universal hospital coverage. The towns along the border introduce us to two very different scenarios of conservative governance.
The town in Alberta are straight out the dreams of American conservatives, everybody seems to be doing very well, the parks , playgrounds and schools are state of the art and everybody seems to be doing rather well. Montana's towns tell a different story. They tell the story of winners and losers.
I fear the GOP is a party of winners who like to beat up losers and I fear governance by those who think life is a game. I am a Canadian and I am my brother's keeper.
I am thankful to McConnell and today's GOP for informing my fellow citizens that Canadian conservative governance and American conservative governance are to very different philosophies. While our conservatives try to keep the playing field as level as possible McConnell and Company try as much as possible to make sure they are marching down a hill.
Psst (overhere)
So it turns out the GOP Senate had as little intent on replacing the ACA as did the GOP House. Shocked.
Marla Burke (Mill Valley, Ca.)
The Republicans don't realize that they have finally made the case for why we need Medicare for all. It's become clear to us all that the business first approach to healthcare does not work any better than any compromise the Senate might conjure up to the flawed ACA. We could relieve individuals and businesses from carrying the burden of funding our healthcare system. It would raise our standard of living with a single policy shift. The savings alone would be worth it, but it also helps raise the level of care we can get.
Peter Wolf (New York City)
Hey Republicans, sorry for your difficulties. I have a new slogan for you. Feel free to use it:

Who knew making people sicker was so complicated.
Chet Harrison (<br/>)
I wonder who can kill more Americans ISIS, North Korea, or the G.O.P.?
Peter Wolf (New York City)
The Republican attempts at health care (sic) bills are like the drug company ads. Platitudes about freedom- like smiling faces of people playing with their children in the ads. Unfortunately, those politicians are not required to list negative side effects, such as suffering for millions, increased bankruptcies, death for thousands per year (40,000 deaths due to lack of health insurance before Obamacare), and extra costs due to poor people showing up in emergency rooms really sick rather than at doctor's offices before getting so sick.

There is only one way (with variations) of getting better healthcare at lower cost. All the Europeans have it. It is called Universal coverage or Medicare for all, or National Healthcare, or whatever that covers everybody.

Of course that takes billions from the insurance companies, who send millions to "their" representatives in Congress. I guess the Republicans are saving their compassion for them.
Ajvan1 (Montpelier)
Republicans wanted to be in power so badly and ran on repealing the ACA? Well, now they're in power. It is 100% on the backs of the Republican majority and the President. Republicans now own the healthcare mess. Voters in the flyover states let hate and greed get in the way of common sense and now we all have to pay the price. I'm a veteran and served our nation honorably and never thought I'd be ashamed to be an American but the unthinkable has happened. I'm ashamed by my country.
Wolfie (MA. RESISTANCE IS NOT FUTILE)
Thank you for your service.
Come back. We the decent Americans need you. You know lots of things we need to know. If we do as the Founding Fathers told us, in the Declaration of Independence, using the 2nd Amendment they gave us, we need to know how to build an army (non governmental militia), how to get organized, get supplied, learn how to fight. As we will be the Citizens' Army, not a mob. WE need you again. We need all our veterans again. To teach us the things taught you. We need to fight these atrocities. I know it is not fair to ask. I lost many in my generation to Vietnam & the greed of the rich. Now 2 generations later more are being slaughtered on the altar of greed again in the ME. It must stop. They must be stopped. Too many are still mouthing the words of 'wait, till '18 or '20, for elections. I fear there will be no more elections, that this time the step to dictatorship & despotism will be taken. Once it is, it will be much harder to fight back. First the 1st Amendment will go, followed quickly with the disappearance of the 2nd. The Declaration of Independence will disappear. Those who follow the despots will be used to get rid of us, then they will be disarmed & made the slaves. They don't see it. But, most can't read beyond the 2nd grade. It's been in the works for decades. Send the best to war, have them die, then convince the others that as heroes they need do nothing else, except turn us in. Guess it will be your choice. I hope it's a good one.
Loomy (Australia)
You sent men to the Moon,
Now rule the silver Spoons,
Calling a much different Tune,
All will realise the truth Soon,
Security will pop like a Balloon.
As Society loses previous Boons.
By money loving Greedy Goons.

Now in pursuit of their further Wealth,
They target people who lose their Health,
In any way, by any means, also by Stealth.

They are the rich and the one's who don't Care,
Who increase their wealth, from anyone, Anywhere.
Take more, make poor, pass a law, make it not Fair,
So many victims, no chance, except to ask in a Prayer.

Land of the free, can pursue happiness & the American Dream,
If only have money, get all milk and Honey, others can Scream,
As they lose all hope, selfish offer no rope, don't see or play Team.
Born equal all Men but not even then, nothing is what it may Seem.

Yet once, all together, united as one, got the impossible Done.
In just 9 years and a month after June, landed man on the Moon.
Rob (NYC)
Beautiful
FilmMD (<br/>)
The problem for the Republican Senators is this: how do you take health care away from millions, give tax breaks to the rich, and make it look dignified and statesmanlike all at once.
pak (The other side of the Columbia)
How do you accomplish those tasks? Blame the end games on Obama, Clinton, the Democrats, or preferably all three and believe me, trump voters will buy the lies.
Tombo (New York State)
Easy. The media will dilute it's extremism with the their false equivalency narrative while Fox and Rush and Brietbart and the AM radio propagandists sell it for the GOP just as they have been selling the GOP's other class warfare policies for decades.

And it will sell...
L'historien (<br/>)
Can't be done.
ronnyc (New York, NY)
As we have seen, these divisions within the GOP run very deep and are based on ideology. One group wants to see all poor people dead; the other doesn't mind if some linger around, perhaps for housekeeping duties and other day labor.
Dan Shannon (Denver)
If the GOP cared for the well being of all Americans, they would sit down with the Democrats and work cooperatively to fix the problems with the ACA. Their refusal to do so will hurt their supporters along with their detractors, and they will pay for their partisanship in future elections. When I contacted my Senator's office regarding the threatened repeal of the ACA, Cory Gardner's staff gave me absolutely non-nonsensical answers to my questions. Can we expect anything less from the party of climate change denial?
Wolfie (MA. RESISTANCE IS NOT FUTILE)
The could have 8 years ago, before the ACA passed. They could have after it passed & President Obama, when he signed it, said it still needed work. But, no, that word work scared them. Won't do anything that requires thinking & work. Now? Non-sensical answers are all they are capable of. Don't forget to get the aids names, so you can not vote for them when they run for congress.
Glen (Texas)
Here we go again. The Republican Party cannot get it through its collective skull that there are some things where profit is not the primary purpose for being.

Oh, they've got their blind spots. The military is one. All those soldiers and sailors and airmen and their expensive, "beautiful" toys. America's security, why we can't hold that hostage to profit. But America's health? Now that's another matter entirely. Republicans have no problem with arms makers demanding guaranteed profit. They find ways to cough up the required dough to keep the military-industrial complex humming. They could do the same for the health insurance providers. Or, better still, they could just put the health insurance industry to sleep, in a manner of speaking.

How much money does the profit of health insurance companies amount to? How much more leverage would the US have with drug and medical device manufacturers to rein in prices if every single American's primary health insurance provider was Medicare (and the Republicans had written into its rules what amounts to guaranteed profit for them)?

Study after study shows that countries with socialized medicine have better medical outcomes at lower cost than does the United States. Longer lifespans, fewer infant/maternal deaths. Why is America not leading the parade instead of being in 10th or 20th or 30th place? The most obvious reason for that is, these countries aren't saddled with the Republican Party.
Wolfie (MA. RESISTANCE IS NOT FUTILE)
Speaking of the military. Did you know the enlisted in all services who have families qualify for welfare? Their spouses can't find work, the companies say it's not worth training them for anything, they will just be transferred. Many do without enough nutritious food for their wives & children, to pay the rent.
I remember 45 years ago, I married a man in the Navy. To pay the rent, he ate on the ship, then came home. If he wasn't coming home I went over to my folks & just dropped in at supper time. They always fed me. I will never know if they caught on, or not. Never asked. Was too ashamed. A man expects to be able to feed his wife. We lived in a 3rd floor walk up, converted private home. In the attic. Cold in winter, brutally hot in summer. Bad neighborhood.
Things really haven't changed, except there is less military housing for non coms now, none for enlisted. But, they spend more money every year. Then we say nasty things about the people in the service, who are little better than slaves. They are snookered into enlisting,then find many officers believe no enlisted should be allowed to marry. They belong solely to the officers. Now with *45's need to up spending for the military (hardware, i.e. NEW TOYS), it's starting again. The personnel don't rate a raise from either side. Lets hope no one attacks us. They would have a good excuse to go home & protect their own, leaving us to swing in the wind.
Phyliss Dalmatian (Wichita, Kansas)
Please proceed, GOP. Even your " uneducated " base will eventually realize what your nefarious plans, and deeds, will do to THEM. 2018 will be here, sooner than you hope. I really can't wait.
Wolfie (MA. RESISTANCE IS NOT FUTILE)
What will you do if a state of emergency is declared, so martial law is, then the Constitution is suspended, & all elections canceled? Could happen before the elections in '18, or '20. No elections, all you'd have left to do is whimper & complain. Dictators don't care. Be it a single person, or a committee.
Get it through your tiny pointed head this is NOT POLITICS AS USUAL. You can't sit back & complain until the next elections, then maybe if it's not raining vote. Then sit back no matter what happens till the next elections then if it isn't too hot out, you'll vote, maybe. Mostly figuring your vote isn't needed. I VOTE. I'm disabled. Standing in line, nope can't do it, sit in my chair in line, doable but painful, I DO IT. You worry about a little rain, the cost of gas, having to get up early, or go after work & stand in a longer line after. Oh, so sorry, am I boring you? I'm 66, no kids, I might not live as long as our car, so maybe I will just sit back & watch you scream as you are thrown out of your home, have everything you own confiscated, forced to work hard for some rich guy with a wandering.....whatever. Maybe your generation isn't worth defending. Your making it so hard to care about you. Your kids. Your grandkids. I'd fight to save them. You won't.
RLW (Chicago)
Obama learned that herding Republicans was impossible. Now, McConnell and the rest of the country will see how well Republican "values" play out against the Trump (and their own) agendas. And, most importantly, the American voters will now learn what Republican values really are.
Framk (<br/>)
Why don't the Republicans be honest - just once.
Give everyone over 65 and qualified for Medicare a prescription for a drug that will painlessly kill them.
They will be happy, Wall Street will be happy, and, best of all, the heath insurance industry will be very happy.
DWS (Dallas, TX)
Don't encourage them! If it was up to the Republican majorities they will legislate a co-pay and require non-generic prescriptions for the L pill.
Patrick Stevens (MN)
Republicans picked this fight when they decided that national healthcare reform was a political liability for the Democrats and the new President, Barack Obama. Bi-partisanship could have solved all of the issues that the A.C.A. has faced since its passage, but Republicans used it as a political bludgeon to beat the Democrats in hundreds of local, sate and national elections. They hung the albatross of "Obamacare" around the neck of every Democrat in the nation and derided the very idea of national health care standards.
Finally, now. Republicans are seeing that winning the battle was not winning the war. Americans need a meaningful, affordable, quality healthcare package that helps all of us. We needed it in 2008; we need it now. Mitch and his toadies had better get a good plan together. They started this fight. They're playing with the lives and quality of life of millions Americans. I hope they have come up with a better healthcare reform plan, but I think they haven't. I think they are running scared and whistling in the dark.
Paul (California)
I guess health care is complex after all.

They aren't going to be able to repeal it and replace it to get the tax cuts for their benefactors and owners. Worse yet its starting to look like they may not even be able to stand idly by and let insurance markets crash either They may actually have to intercede and do something that will benefit somebody or keep the status quo.
Lennerd (Ho Chi Minh City, Vietnam)
Apparently, the share of GDP going to the top 1% is not quite enough -- yet. When their minions in the House and Senate finally get their tax cuts ordered the way they need to be aligned, the 1% will get the biggest share of the economy they've ever had -- and they will finally be satisfied!

America will indeed be great again!

You think?

Who knew health care and tax reform could be so complicated?
JB (CA)
Their other tactic is to nibble away at the ACA until it fails. Then they may pass the garbage program they are pushing.
McConnell (Senator one term Obama) has no problem with harming the countless poor Kentucky residents and they will probably keep voting him in since he is such a convincing liar!
a goldstein (pdx)
Our health care system needs improvement. Who thinks most Republicans are actually willing or able to re-design out health care system so that it improves on what currently exists, medically or financially? If you do, why is it that most organizations that speak for doctors, nurses, hospitals and healthcare consortiums like Kaiser Permanente are not behind anything Republicans have proposed or are likely to propose?

Health care delivery has improved for millions in the U.S. but we are far behind among first world countries. That we have the world's best medical centers of excellence means little to the millions of citizens who have no chance of accessing that level of care. In fact, despite Obamacare, we still deliver healthcare like it is being run by oligarchs.
John Adams (CA)
The GOP sure had a blast attacking Obama on the ACA though, rallied the base hard, all those promises of repeal and replace.

Turns out they had no plan, but this push to repeal and replace has nothing to do with looking out for the health and lives of Americans.

It has everything to do with the tax cuts for the ultra-wealthy. And guys like Paul Ryan are willing to lie through their teeth every day for those tax cuts.

Certainly these tax cuts are a priority for McConnell. The eyes of an entire nation are on him and the GOP members of the Senate.

American lives are at stake.
eva lockhart (Minneapolis, MN)
But so many of these folks pretend to be good Christians--it really irks. You are so right--American lives are at stake--some in my own family. Thank you for stating it so clearly.
Tom (Pa)
"And guys like Paul Ryan are willing to lie through their teeth every day for those tax cuts."

Put Pat Toomey in the same boat with Ryan.
Alan Schleifer (Irvington NY)
You don't need healthcare
1. If you don't fall
2. If you don't get sick.
3. If you do fall or get sick, die quickly.
JAM4807 (Fishkill, NY)
Why is it that so many articles on health care continue to reference a Republican plan for replacement. What should be clear is that the Reps ad agency told them that 'Repeal and Replace' sounded better than 'Repeal' by itself.

From the start the Reps refused to provide ANY insight into the issue, and their big chance to go with their 'Plan' has proven that such never has existed, and that they all went along lying to the nation as part of their strategy to divide and conquer the country so that they could gain power by any means.

Now they have it, and it turns out that (as we all knew) that what their little echo chamber wants has nothing to do with what the people actually want.
Kirk (<br/>)
It looks as though the greedy authoritarian Republicans have lied themselves into a pickle. The promise affordable health care for all, tax relief for all, huge military expenditures to keep their warring mentality satisfied and infrastructure improvements.

This is all to be done by giving more money to the rich, taxing consumption that makes up 75% of our economy, allowing their wealthy paymasters to pass billions onto the lucky sperm that was formerly taxed to help the society that allowed them to acquire the wealth, all while dissing our allies in NATO.

Come to think of it, not only are they liars, they are delusional, just like their president trump.
Billseng (Atlanta, GA)
Significant cost savings could be realized by getting rid of the middlemen. Get rid of the insurance companies and move to a single payer system, like the rest of the world does.
Paul Crowder (Louisville, Colorado)
I respectfully disagree, because I believe that insurance costs are not a significant cause of the most (by far) expensive healthcare in the world (ours). And it's not unheard of, even in strong single payer systems, for private insurance companies to play a role in administering publicly funded healthcare coverage. Examples include Canada and the Netherlands and, in the USA, Medicare Advantage. Given what much of the rest of the First World seems to be able to get done for their citizenry, it's embarrassing that the USA doesn't have universal coverage. We can do so much better than our system of healthcare coverage, but we seem to be a long, long way from doing even a little better.
Nathaniel Brown (Edmonds, Wa)
The goal is not significant savings, but significant profits. All else, even party orthodoxy, is subservient to the trickle-up policies of McConnell and his cohorts.
Claus Gehner (Seattle, Munich)
Amen to that!

We (my wife and two daughters) spent many years living and working in Germany, where we were insured under their mandatory single payer system. I spent three weeks in the hospital after Melanoma surgery (because of some complications) - my total co-pay was DM 9 (before the Euro) per day, and my care was excellent. My monthly premium (half of the total, as the employer pays the other half) was comparable to what I pay for Medicare now in the US, but for 100% coverage, not the 80% coverage Medicare provides.

Two years ago my wife and I spent another year in Germany, again covered by the obligatory German health plan - this time, since I was retired, I had to pay 100% of the premium (no employer to cover half), but still my premium was significantly lower than the US Medicare premium plus the Supplemental Plan needed to bring it to 100% coverage. Again, as fate would have it, I had to have surgery during that year, and this time I was 100% covered for excellent care.

In Germany the health care premiums are recalculated every year based (I believe) on the system-wide cost history of the past three years, and the health care fund is not allowed to have a surplus. So that year we actually got a (small) refund at the end of the year, because overall system-wide costs were actually lower than anticipated. Now there is a concept!!

It is impossible to overstate the peace of mind of having assured health insurance, and thus health care, even when between jobs...
just Robert (Colorado)
No talk here od working with Democrats who would like to change the ACA into a more effective health care tool. Partisanship and one upmenship will be the death of our Republic and we will have no one to blame but ourselves. As others have said so often if other nations around the world can create effective health plan laws our 'enlightened' society should be capable of doing at least half as well. The other thing, Republicans need to ban insurance lobbyists from the discussions.
Cowboy Marine (Colorado Trails)
I don't mean to be flippant but I think the main problem is that the percentage of Americans who are not playing with a full deck increases every year.
H. A. Ajmal (Tallahassee)
The GOP is the perennial protest party.
Wolfie (MA. RESISTANCE IS NOT FUTILE)
But they never learned a thing from those who made protesting their life's work. The Hippies. Instead they ignore everyone but themselves & get confused when no one listens to them. They haven't made any sense since at least the mid 80's.
ManhattanWilliam (New York, NY)
"They are also divided over a critical portion of the House bill, which would allow states to obtain waivers from two of the most important federal mandates: a requirement to provide a minimum set of health benefits, and a prohibition against charging higher prices to people with pre-existing medical conditions." WHAT kind of grotesque and morally dead people could ever think that denying the rights outlined in that quote should not be granted not only to every American but to every living human being on the planet? What kind of people live in this country that is so amazingly swiftly sinking into the abyss of much and slime and corruption, with the some aim of making the richest 1% that much richer.
Wolfie (MA. RESISTANCE IS NOT FUTILE)
Time to stop buying anything made by a rich corporation or any company owned by the stinking rich. Buy from small companies here, or even large companies overseas with NO ties here. As their game tokens shrink (money, which they use as game tokens in their life long game that is more important than anyone else's life), they will eventually panic. Then we can get together & go just drown em all.
Stubborn Facts (Denver)
I keep asking, but my representatives seem unable to address the real problem of health care in the USA.

Healthcare costs this country over $3 TRILLION a year—about $10,000 per person—and we pay more than DOUBLE what most other developed countries pay per person for similar levels of care. This is a huge gorilla on the backs of individuals, businesses, the US economy overall, and hugely impacts our federal debt.

As an ordinary citizen, there is almost no way for me to control my healthcare costs. It's just about impossible for me to know how much a doctor's visit will cost. Even with medical procedure codes in hand, I rarely can get pricing information from my doctor, hospital, or insurance company when I call and ask. This is clearly a market system that is broken! To have a market, prices have to be widely available so suppliers can compete.

Republicans continue to blame the ACA for the high cost of healthcare in the US, but this trend was already well in place long before the ACA.
MIMA (heartsny)
The only plan the Republicans have had since March 23, 2014, when Barack Obama signed the Affordable Care Act, was to oppose it.

Clearly they have no concept regarding healthcare, healthcare insurance, disease, pre-existing conditions, medicine, Medicaid, and treatment of healthcare needs.

They have a doctor, Tom Price, Secretary of Health and Human Services.
But he opposes Medicare, Medicaid, and the ACA. These are services which provide healthcare to Americans. And the Secretary of Health and Human Services opposes them. Quite unimaginable.

You see, we have no leaders to make certain Americans have a path to being treated for healthcare needs, nor a means to preventative medicine.

I can't tell you the time, energy, and emotion this old nurse has spent in caring about this absolutely cruel upheaval of healthcare for Americans.

June marks my 50th year working in the healthcare field, starting out as a CNA in a hospital. I worked and kept going with my education and as an RN, case managed 117 ICU beds in a large hospital with a Social Worker in each unit. I still work as an activity assistant in a local rehab part time just to keep in the loop, and serve on two community boards overseeing healthcare entities.

I've seen a lot. But I never dreamed I'd see a celebration among elected leaders at the invitation of the President of the United States to proclaim joy that 23 million people would be sent to try to live without insurance.

Republicans will never figure it out...
Naomi H (Laurel, MD)
It appears the Republicans are not prepared to lead and have no agenda--consumed by power but not accomplishing anything. Why don't they start repairing the infrastructure if they can't agree how to change healthcare or update the tax laws immediately. Repairing bridges, highways, providing transportation by rail...can benefit everyone regardless of party affiliation.
barbara jackson (adrian mi)
That was supposed to be done under Obama, but the traitorous republicans blackballed it, remember? They also blackballed Obamacare WHILE it was being developed. That's why there's so many problems keeping providers signed up. The sabotage was running hot and heavy all during the lead-up to our new health care.
AM (New York, NY)
Even if Republicans were not in power, we would still be reading about the difficulty legislators have in reforming healthcare. ObamaCare was an extraordinary breakthrough toward universal health care for all Americans, however, it does need to evolve: premiums for viable coverage have become unaffordable, and the affordable options are far from adequate coverage.

A real solution would be to repeal the health insurance coverage that the federal government provides for it’s employees, in particular Senators and Congressmen. It’s time universal coverage means that all Americans get the same health insurance: and by that I mean electeds and electorate. When that day comes, Washington will have no problem coming up with an insurance program that will make American great again, (regardless of who sits in the White House).

One challenge for the The New York Times would be to develop an article that educates the public on exactly what health insurance coverage Senators, Congressmen, and yes, even the president and his cabinet are actually provided at taxpayer expense.
don (Texas)
Someone correct me if I'm wrong, but I think that US legislators are already required to use Obamacare under the law.
Wolfie (MA. RESISTANCE IS NOT FUTILE)
The same the run of the mill federal employees pay through the nose for. They pay for their's & for their pensions every pay period as we do. They are forbidden by law from ever collecting SS & Medicare. Same law is supposed to cover those we elect, but, is usually ignored, so they can double dip, where someone who works hard for us for 29 years, then is downsized, will never get the full pension (that takes 30 years), & can still never collect SS & Medicare, even if they work enough 'quarters' to qualify. Again, the elected get both with no quibbling most of the time. Unless they get the current leadership of the congress p*ssed, then the law is after them. Typical politics.
SuperNova (New England)
It wouldn't be hard to replace Obamacare if Republicans were actually interested in working with Democrats to improve it instead of sating their pathological loathing of the last president by undoing every bit of his "legacy." The reason Republicans find it so hard to enact legislation is because they are not doing it with the good of the average citizen in mind, which galvanizes public resistance.

I voted for Trump and am appalled by this Republican "healthcare" plan. I'm not alone. The AHCA only enjoys 20 percent support nationally, which means that more than half of his voters disapprove. He won 46 percent of the country, so 20/46 = only 43% of his voters approve of this. Yet a Quinnipiac poll just came out showing 84% of Republicans believe he is keeping his campaign promises. Makes no sense.

Now, I knew when I voted for Trump that in order to get some of the policies I wanted -- less immigration, conservative judges, an end to the obeisance to Islam etc. -- I had to stomach some of the Ryan 0.01% agenda.

But the AHCA ridiculous and a total betrayal: Trump ran against the traditional Republican party and and needs to take a stand against legislation that conflicts with his campaign. So far he is an utter disappointment.
barbara jackson (adrian mi)
. . . and you're "surprised?"
Clare (Maine)
Trump is just the salesman.
Andy Sandfoss (Cincinnati, OH)
It should be real simple for the Democrats. No tax reform without seeing trump's tax returns. Since he refuses to divest himself or his family we need to know how he would personally benefit. No health care bill that cause people to lose insurance. Politically defensible and morally superior to the GOP's awful ideas.
Lynn (New York)
"It should be real simple for the Democrats"
Unfortunately, no
even if all the Democrats oppose it, it will pass if enough Republicans vote for it, as long as the parliamentarian rules that it conforms to the constraints of reconciliation. That's why McConnell needs his 50 votes plus Pence.
The true solution will come in 2018, assuming Republican state governments and uninformed sloganeers who claim to see no difference between the parties, dont suppress the Democratic vote.
George N. Wells (Dover, NJ)
Of course it is hard to "repeal and replace" the ACA, considering that the basic principles and structure came out of The Heritage Foundation and were first made law in MA by a Republican Gov.

Eight years of vilifying the ACA with specious arguments that were more Anti-Obama than anti-ACA have left the task of replacement unthinkable.

Frankly the RNC missed their moment when the ACA was first introduced - they should have claimed it as rightfully an RNC law, not a DNC law claiming that the DNC had nothing new to add. They would have been surprised to find that Obama would have been fine with that .

No, the ACA isn't perfect, nor are most laws in our nation. Our nation and our laws strive to be "more perfect" but not absolutely perfect.

In the meantime millions of American will suffer for lack of care or go into bankruptcy if they do get treatment and We-the-People will pick up the bill for all the unpaid medical bills as well as have the reputation of a nation that puts profit ahead of everything - even a healthy life with good medical care.

The hatred of Obama was, and still is, so great that we are willing to destroy the nation in order to satisfy our hate of one man.
bruce (ny)
Rather than repeal and replace the ACA, the better bet would be to improve by expanding coverage to being costs down. They - Congress and the Admin can start by approving pending mergers provided they offer plans through the exchanges.
Carl Ian Schwartz (Paterson, New Jersey)
There's a way to do this: take out the unnecessary middleman--the private, for-profit insurance companies. Our private healthcare used to be the not-for-profit Blue Cross/Blue Shield system which covered most everybody, but not they have been picked up as assets for the for-profits and their days as not-for-profits are either numbered or they will have their books cooked.
Medicare for All--as in all REAL advanced democracies--instead of this unnecessary middleman in this government of thieves.
Wolfie (MA. RESISTANCE IS NOT FUTILE)
And if the companies who merge are ever caught charging higher prices for any pre existing conditions, or because of age, disability, gender, color, or ethnicity, they will be forced to cover everyone for 50 years for nothing. Even if it means management must all be fired, no management pensions ever paid, no parachutes of any color. The punishment must fit those who do the deeds. It is management who makes those decisions, not the run of the mill workers, who if found culpable would be fired & made totally unemployable for life. Believe what you want. Your choice. Do what you want take any punishment given without appeal.
Decebal (La La Land)
No need to fret, they will find a way for the poor to do with less and the rich to do with more. There, problem solved.
Padman (Boston)
After many meetings, republicans have come up with a superior health bill that will repeal and replace Obama Care as they wanted. The winners of this bill will be the young, healthy and wealthy and people who do not have any serious health problems.The new bill is unlikely to include mental health, addiction treatment,maternity care, rehabilitation services . Losers will be poorer and older Americans and poor Americans who use Medicaid, 14 million fewer people would be in the program after 10 years. According to some reports, “Over time, less healthy individuals (including those with pre-existing or newly acquired medical conditions) would be unable to purchase comprehensive coverage with premiums close to those under current law and might not be able to purchase coverage at all".
Great !
Wolfie (MA. RESISTANCE IS NOT FUTILE)
All elected officials should only be eligible for the lowest quality health insurance for the highest price of the best health insurance. For their extended family. For life. If a 2 year old scrapes falls & scrapes her knee, it must be photographed, & with a written report sent to their health insurance provider, who will send back a lifetime letter of pre existing condition for the child. Making him/her never able to get insurance or walk into a doctor's office or hospital for any reason. Only legislators former or current would be held to this standard. For life.
serban (Miller Place)
It may be easier for the GOP to pass tax legislation but in the end any tax legislation that leaves more money in the hands of the very wealthy can only increase inequality. That is the path to more strife in the future and just as bad as a thoughtless repeal of Obamacare.
Gary W. Priester (Placitas, NM USA)
How hard is it to admit that yes, a democrat, and yes, a black democratic president came up with a pretty good plan. (For McConnell & Company next to impossible). And instead of coming up with something that is so much worse fpr the people, why don't the republicans make the ACA BETTER? Then they can re-brand it if they absolutely need to and take all the credit. Instead of taking all the heat.
Melvin Baker (Maryland)
Reality has arrived at mcconnell's front door.

Remember this is a majority leader that has both houses of congress and the WH and still had to invoke the nuclear option to get his SCOTUS pick through

He is incapable of governing.

Can't wait for the midterms of 2018 when more GOP dreams come crashing down!
Ron (Chicago)
Republicans will have to hold their noses and work with democrats on fixing Obamacare, to me this is disappointing, as I'm not a big government republican. Shame on republicans for being spineless and weak and not having a bill ready to go in January. The truth is they never did have an alternative to a big government program, they just used this as a reason to get elected since this bad bill was passed by democrats. Now that millions are hooked to entitlement republicans can't just rid themselves of it, they will have to come up with a better alternative which is more unlikely as the weeks pass or fix a existing bad bill. Sad that dependency has won out and self reliance has lost, we are a weak country with weak citizens who now expect every part of their lives provided by the government.
BobK (USA)
Seven Years! 7 Years of bluster and thunder, and the GOP has no proposal worth considering, no bill worthy of passing, and still clings to its rights as elected officials to the House and Senate, the Congress of the United States of America, to universal and life eternal premium health care for themselves, only, while continuing to seek any way possible to deny it to their constituents . . .

For Shame? No, far beyond Shameful . . . Downright damnably despicable. Spit them out before the poison takes hold of us all!
PJM (La Grande)
If republicans are so focused on incentivizing correct behavior, how about this: State are free to waive ACA requirements, but if the number of uninsured increases, or if average premiums increase, the State and Congressional legislators lose their health coverage.
Polifucius (Australia)
GOP, your donors want one thing, the American people want another. And the rest of the civilised world worked this out decades ago. Do you think trying single payer would doom the US to what? ... a healthy population free to change jobs or start businesses as they saw fit. And free from crippling mental anguish and desolation through bankruptcy from unforeseen and unavoidable medical issues? History will look back at your legacy as a very very cruel one Mitch.
JB (CA)
The only thing they are concerned with is preserving their jobs and keeping the money rolling in.
If they were concerned with the people, the solution would be simple!
Larry (St. Paul, MN)
Polifucius,

But it would mean a significant pay cut for insurance company CEOs, pharmaceutical CEOs, medical device company CEOs, and probably a number of medical specialists, including those who own their own diagnostic equipment. I'm sure I've left out many others. The current system isn't a disaster for everyone. The minority that benefit from it have a lot of money and hold a great deal of political power. Follow the money.
Paul (Trantor)
Mitch McConnell is a traitor to this country.
Leaving millions of people without healthcare is tantamount to wholesale cruelty not seen in 75 years. Lest anyone forget, the Trump administration is purposely sabotaging various elements of the ACA specifically for political purposes.

The commentariat is dancing around the most important fact facing this country. Until The Republicans are made to feel a political price for their actions nothing will be done. Trump will skate, Flynn will skate, Jared Kushner as well the rest of the grifters in the administration. And that means in these midterm elections if the house and senate are not flipped, our democracy is doomed.
Loren Bartels (Tampa Florida)
No, no! McConnell did not create the conditions prior to ObamaCare. McConnell has not proposed any specifics on ObamaCare. What the Republicans seem unlikely to understand is that the linchpin of fixing ObamaCare is strengthening the mandate. The 2nd most important thing to do is to graduate premiums more effectively. The 3rd most important thing to do is to calculate premiums based on some formula of assets and income. The 4th most important thing is to tack an extra tax on the Medicare tax to cover the subsidies necessary.
Sarah (Walton)
This times 1000. Unless and until Republicans are ousted from office nothing, I repeat nothing will change. They are counting on the stupidity of their votes and the short attention span of the rest of the population and the media. Democrats are to blame too. If you're too lazy to get out and vote then you also deserve what you get.
Paul (Trantor)
please, let's all step back, take a deep breath, and understand what's happening here. The only change to the ACA that any American should accept is Medicare for all.

And the only way we will have Medicare for all is to oust every single Republican, Republican sympathizer, quisling, sycophant from any public office. Bernie had it right… A political revolution is needed. But it's not as hard as we all think. Just everyone with a conscience get out and vote and the rest will take care of itself
David dennis (Michigan)
"The challenges facing Senate Republicans are so great that overhauling the tax code as Mr. Trump has proposed — "

Of course! It's very challenging to create a health care bill when you have no compassion or intention to provide it. What the Republicans really want is money for the already obscenely wealthy and a wink of approval from those profiting from Citizens United.
Eben Spinoza (SF)
Their retort would be. The ACA takes my money, mine, and gives it to a bunch of losers, many of whom don't work or pay taxes or anything else. The ACHA doesn't take away anything that really belongs to those people and will give me MY money back. Mine. Mine. All Mine.
Sophocles (NYC)
You mean the Health Scare bill. You're right, when you start the recipe with two pounds of self interest and a pound of ill will it's hard for the rest of us to eat the cake.
Cliff (Philadelphia, Pa.)
Who needs "death panels"? Trumpcare will cull the herd.
David Binko (Chelsea)
Don't underestimate the willingness of the American people to harm themselves. The rich are in control of the message and they don't want to pay for obamacare. The American public votes on emotion impulses, not intellectual. The Senate is a rich as it has ever been.
JSDV (NW)
I wish the media, including this paper, would stop saying the Republicans won't do this or won't do that. A few short weeks ago, we repeatedly were told that divisions among the Republicans (between so-called moderates and the Freedom Caucus) could not be healed and a health care bill was impossible: Ryan's utterances notwithstanding (nice bit of misdirection, that…), those who could count realized that only a few arms needed twisting and that never could stand in the way of such an important issue.
Now, we're hearing the same overly dramatic, optimistic liberal/progressive yearnings made public.
Trump may be a train wreck, but McConnell still is a wily old fox. It'll get done in the Senate. Bank on that. And also count on a destructive, 1%-helping tax bill w/tax cuts not only for corporations, but to those very few who own those shares.
Only by facing reality can those who oppose these shameless, un-American oligarchs have any chance.
Trump is the magician's distraction trick; Ryan and McConnell are the magicians that, behind the showy fool, are working their damage.
Gustav (Durango)
Ronald Reagan campaigned hard against starting Medicare. We heard the same scare tactics back then Now, everyone appreciates their Medicare and no conservative even dares to mention removing it. Same history with ACA.

One word of caution, McConnell may be trying to find an excuse to blame Democrats for their failure to repeal Obamacare. If he succeeds, Republicans would like nothing more than to have Obamacare always hanging out there as a convenient pinata to smash every election cycle, then do nothing about it. Just like Roe v. Wade.
alan brown (manhattan)
Ronald Reagan was opposed to Medicare in 1961. Medicare was passed in 1965 under LBJ. Hillary Clinton was a Goldwater Girl. That is ancient history as was Reagan's opposition to Medicare in 1962 and his liberalism prior to that. He was elected President in 1980 and restrained budget increases and lowered taxes and got congress to pass major tax reform in 1986 including eliminating abusive tax shelters. He did not campaign against Medicare to win the Presidency in 1980. Jimmy Carter was President and had a raging inflation and American hostages in Iran as the cause of his defeat. Medicare played no role. Just keeping the record straight.
Suzanne Moniz (Providence)
Leaving health insurance in the hands of Congress is about the most serious gamble Americans can take with their health. Politicians can not do health insurance. Single payer is the only option.
Loren Bartels (Tampa Florida)
Indeed, single payer is what we effectively have, now, with some exceptions. The most dramatic exception is that Medicaid pays pediatricians and pediatric specialists horribly but private insurance pays those same folks 2.5-3 times what Medicare pays. Since an enormous part of Medicaid is pediatric, making a single payer system would actually balance the pediatric market.
Otherwise, for adults, the net difference between Medicare and private insurance rates is minimal to the doctor but the difference for hospitals is enormous. The reason? Private health care premiums subsidize Medicaid hospital expenses--Medicare does not. Again, a single payer would balance the market.
We need single payer for another reason: without it, we won't be able to implement a dynamic Clinical Practice Guidelines process that streamlines justifications for health care interventions. And, if we had a single payer, a critical goal should be standardization of the datafields in electronic health records, introducing a form of artificial intelligence (machine learning), and methods to improve health care provider efficacy.
Annie (Pittsburgh)
I don't think Medicare is paying too many pediatricians and pediatric specialists much of anything since it's for people 65 and over.

According to kff.org, in FY2011, the breakdown for Medicaid spending was:

children 21%
disabled 42%
adults 15%
aged 21%

Many people don't realize that Medicaid pays for a lot of care for senior citizens in both institutions such as nursing homes and at home through home health care services. While Medicare pays for actual medical costs--treatments, etc.--Medicaid provides all the other care for those without sufficient funds to pay themselves. One thing to remember is that $8,000 to $12,000 a month for nursing home care, even people who start out with a decent nest egg can run through their resources within a very few years.
Gilber20 (Vienna, VA)
The best outcome for the 23 million Americans who would lose their health insurance is the death of the AHCA bill in the Senate. It's a good thing that the Founding Fathers made it intentionally difficult to pass harmful legislation!
David (Phoenix)
Let's get beyond "repeal and replace" and get to "fix". That's what Americans outside of D.C. expect, want and need.
JB (CA)
And, that is what Hillary would have done!
Keith Ferlin (Canada)
Is any thinking person surprised that the party no and obstruction has hit a brick wall when it comes to governing? The GOP has been dutifully practicing obstruction when they are not in power since Nixon. Decades of partisan rhetoric instead of policy geared towards helping the 99% has taken them to the place they currently inhabit. A corrupt party that can't even formulate policy that will benefit there middle class and working class supporters, just the policies that the donor class that they are in fealty to maintain their cushy jobs in Washington. It is truly astounding that a party that has been bereft of any decency for decades has been able to survive until you look at the electorate that has gobbled up their propaganda of racism, bigotry, and misogyny. The coup de grace was electing a person who embodies and brags about all of those traits. Look in the mirror America, it is not a pretty sight.
M. (G.)
I have been saying much of the same thing since Obama was elected. The GOP is incapable of legislating and governing. Utterly incapable. Why is this so difficult to understand when the evidence is all around us? I'm glad I'm not the only one who has noticed how intellectually and morally corrupt they are.
Robert (Atlanta)
Easy to obstruct; not so easy to govern.
Gdnrbob (LI, NY)
Maybe we should remember that it was Richard Nixon who first brought up the idea of Universal Heath Care.
Unfortunately, the Healthcare Industry has an agenda to keep itself from being regulated by the government, and will make any form of agreement as difficult as possible.
I love that those working class citizens the Republicans have embraced are now voicing discontent on losing ground on the healthcare that the ACA gave them.-And, their Republican legislators are afraid they will lose their jobs should they support the party line.
Annie (Pittsburgh)
No, it goes back a long way before that, actually all the way at least to Teddy Roosevelt. The first serious effort to make it happen, however, happened under Truman, who proposed a plan that was genuinely popular with the public. Until the American Medical Association (aka, the Union of Physicians) stepped in to bankroll a major propaganda effort to turn Americans against the idea. See The Lie Factory in The New Yorker (http://www.newyorker.com/magazine/2012/09/24/the-lie-factory) for a thoroughly depressing look at what happened. (Note that the section about health care comes some ways into a rather long article.) It's true that Nixon also wanted universal health care but the well was truly poisoned by then. And, unfortunately, the Democrats did not support his plan because they believed they could get something better. They were wrong.
Loren Bartels (Tampa Florida)
The practical reality is that the Rs cannot afford not to keep ObamaCare at least as good as it was with Obama but I am sure that they will try to reduce its cost, unsuccessfully. Even if they continue to fumble, failing even to provide sufficient funding and that subsequently worsens the ObamaCare exchange markets, the Rs will lose Congress is 2018. The Rs seem irreversibly committed, foolishly and stupidly so, to getting rid of the mandate but that is the most significant way to reduce the cost of ObamaCare and the only practical way to stabilize the ObamaCare 3rd party payer markets for ObamaCare. Because of the latter, I do not see the Rs as capable of fixing ObamaCare. I think it will take a Democrat controlled Congress and a POTUS willing to deal. If Trump does stay in office past 2018 (yes, I mean not get impeached), a chance to fix ObamaCare in the 2018-2020 Congress exists.
Casual Observer (Los Angeles CA)
The Republicans opposed Social Security, Medicare, and Medicaid, and now, the Affordable Care Act. Each of these programs represents a redistribution of wealth from those with more to those with less, but in each case they have assured that fewer people experience severe and debilitating impoverishment, a lot fewer, and they enable a huge majority of people to enjoy a better life than they would without them. This means that eliminating these programs cannot be accepted by enough voters to achieve that objective. The ACA cannot be replaced and save money while providing coverage for all who need health care to live and not impoverish them except by moving to a single payer system with universal coverage, all other plans will drive up costs for insurance companies and for their insured. It's time for the Republicans to admit that government's role in providing health care has become a given and to deal with it.
thomas salazar (new mexico)
Republicans oppose everything that helps America. They opposed The Grand Coulee Dam that provided the energy to produce the airplanes that won WW11, they opposed Veterans Affairs, every environment program since Nixon authorized EPA, Education and science investment.
Bing Ding Ow (27514)
Hey, facts matter.

"The Republicans opposed Social Security, Medicare, and Medicaid ..

Wrong. Some Republicans supported them.

It was PPACA, with millions of new regulations that killed jobs, that was a farce.
Pat (Somewhere)
Not really that hard. Keep the ACA as it is and just change the name to Republicare or something. Tell your "keep-your-government-hands-off-my-Medicare" constituents that this great plan was brought to you by the Republicans and they'll swallow that hook, line, and sinker.
Bing Ding Ow (27514)
Sure. And nominating political war-horses with 40 years on the taxpayer dime is such a grand plan.

Not.
Kiera2 (Maryland)
I don't expect the GOP to accomplish any legislation this year. No matter the issue they can't agree amongst themselves much less with the white house or democrats for that matter. They have no clue how to govern. It's always party before country, make the rich richer and the poor poorer then blame everyone else for their shortcomings. They've never wanted to deal with health care and now that they're actually faced with the issues, they have no idea what to do about it. I don't want them to pass any legislature and certainly none promoted by the white house because it will hurt the middle class and the poor while giving the greedy wealthy and corporations more. The republicans have always stood for greed and wealth but I think the GOP we have now is much worse then any I can remember in recent past. We must elect them out of office starting at the local level. The longer they remain the majority the more chances they have to ruin our country.
Annie (Pittsburgh)
Nevertheless, Montana just demonstrated that there's a lot of support out there for what the Republicans are offering. OK, so it's Montana, the state of legendary rugged individualism, but their going for Gianforte after he assaulted a reporter shows what the values of too many of them are. It doesn't bode well for the future.
Bing Ding Ow (27514)
Nominating a Democrat who is a proven tax-avoider with a bad credit record, that's a good idea?

Why not nominate the biggest FOIA violator for president, and ..

Oh. The Democrats did?

Never mind.

Adults, to the front, please. Thank you.
Jaybird248 (Florida)
All the GOP needs to do to solve health care is restore the risk corridor payments to insurers that Marco Rubio killed last year, and to allow development of a public option that right off the top would cut the up to 20% of costs private insurers charge consumers and government for those endless TV ads, exorbitant executive pay and yes, profit. This would immediately be reflected in lower rates for that plan without loss of coverage. Private insurers could then decide whether to compete or drop out, without affecting affordable access.
DR (New England)
Republicans don't want to solve health care, they want to eliminate it.
Bing Ding Ow (27514)
" .. a public option .."

That is LOL wack-o. Directly and indirectly, government bureaucrats control more than 75% of the medical-care market.

To think otherwise is to be detached from reality.
Mark Thomason (Clawson, Mich)
The House effort was so absurd that the Senate must start over again on a very difficult problem.

Then they must sell it to House leaders in Conference Committee, and get the House majority to vote for it.

That's impossible. They can't possibly do it.
John Paul (New York)
What "House" effort? That was strictly Repubs. Democrat's efforts were nil. We need to pay attention to HR 676 (112 co-sponsors to date.), and get recalcitrant Dems on board. Single payer MUST be part of the debate on universal healthcare.
Bing Ding Ow (27514)
" .. what "House" effort? That was strictly Repubs .."

What ACA? That was strictly Dems.

Vermont and Colorado have already defeated the Democrats' financially-absurd "single-payer" theories.

http://www.politico.com/story/2014/12/single-payer-vermont-113711

Time for those passable math skills to take over. The unhinged fantasies of the inexperienced are not needed.
gg (Canada)
It's surreal watching this. The Republicans don't seem to care about what they're doing so much as simply looking for "wins"; people be damned.
Glenn (Florida)
It may be too hard to kick 23 million people off healthcare.
How about 22 million?
That sounds easier.

Now about that tax cut......
Socrates (Verona NJ)
It's always a difficult decision to decide exactly how many of your fellow citizens' lives to end prematurely through public policy, but I have great confidence that the combination of Republican intellectual depravity, religious hypocrisy and inhumane worship of psychopathic greed will inspire this GOP Death Panel to come up with just the right number of maimed American bodies and millionaire tax cuts to make the Grim Reaper very, very happy.

"Take two tax cuts and call me from the morgue !"

The GOP Death Doctor Is In.
MLM (Va)
Being someone who had a scary cancer, and about to retire, I can only hope that I won't be denied health care due to a pre-existing condition. I'm an example of a person who eats healthy, exercises, tries to live a compassionate life, and STILL got sick. Do republicans and their loved ones NEVER get sick?
AZ-byte (Phoenix, AZ)
No problem with people dying early. We will force women to bear children against their will and then underfund the children's health care and education and trap them into a life of poverty and early death. It is the new Republican way.
Justin (DC)
It should be too hard to replace Obamacare with a knife to the eye of anyone who isn't rich.

Working as intended.
NM (NY)
The fact that McConnell knew how hard it would be to replace Obamacare raises an obvious question about why he and other Congressional Republicans have been so determined to repeal the law. The two alternatives, which passed the House or died there, were estimated to leave up to 23 million and 24 million people, respectively, without coverage.
McConnell and his party would play with our lives just to kill part of President Obama's legacy.
JB (CA)
If he crosses Trump, his wife may lose her job! Remember, loyalty is all for DT!
don (Texas)
"why he and other Congressional Republicans have been so determined to repeal the law."

Campaigning on repeal won them a lot of elections.
Hamilton (AZ)
McConnell and his party have wasted 7 years attempting to obstruct President Obama. This when they could have easily repaired the weaknesses in the ACA so that by now, healthcare in America would be cheaper, premiums lower and almost nobody uncovered.
Their deception is beyond transparent, yet many want to cling to the false "less government" narrative and others are blind to the hypocrisy of claiming to be "pro-life" while promoting the denial of healthcare to tens of millions.
Eric (Vermont)
We're probably going to try every other dumb and unworkable scheme first, but the solution is as obvious as it is inevitable: Move everyone onto Medicare.

Let's start by lowering the age of eligibility down year-after-year which will at least get the snowball rolling in the right direction.
Bing Ding Ow (27514)
"Move everyone onto Medicare."

Gee, then why did Vermont and Colorado defeat the "single-payer" theory?

http://www.politico.com/story/2014/12/single-payer-vermont-113711

Because those behind "single-payer" cannot do math and think there is a bottomless pit of taxes. Absurd, on its face.

Time for adults to take over.
gumnaam (nowhere)
How to pass a Obamacare repeal and replace bill in a Republican-controlled Senate in 7 easy steps:

1. Invest in healthcare stocks that will be affected by bill.*
2. Take no advice from experts.
3. Include no women and work in secret.
4. Schedule a vote before the CBO scores it.
5. Cajole (a little) and threaten (a lot) to get the pliable "moderate" Republicans on board.
6. Constantly and comprehensively lie, lie, lie about what the bill does.
7. Get propaganda outlets (Fox, Sinclair, RT) to provide positive coverage.

* OK, this may have nothing to do with getting the bill passed, but got to get paid, right?
Ralph Liberto (White Mills, Pa)
isn't this what they're doing now?
carol psky (Malvern, PA)
But I'll be darned, it works! They have duped a number of americans for a number of years about many things by doing just that. Especially #6 and #7. I'm not sure the democrats can do #6 very well, but they really need to get on the ball with #7.
The GOP has said over and over again that the ACA is in a death spiral. They have ensured that it would be by refusing to pay the subsidize the insurance companies monies that were promised in the law to help stabilize the insurance pools knowing that only the older and sicker populations would be the first to sign on.
Republicans refused to give them a dime and threatened to shut down the government by blockading the budget.
They sold their arguments by going on Fox and calling insurers greedy, saying they just needed to tighten their belts. And the Faux audience bought it. (#7)
It is tragic that they would rather lie to the American people and let them lose their health insurance, rather than admit that the ACA might be a partial solution to our healthcare crisis.