It's been a running joke for many years now that Republicans in Congress are always saying they're just about done putting the finishing touches on an Obamacare replacement plan that everyone is going to love. We'll be talking with a former top congressional Republican about this in a few minutes, former Majority Leader Tom DeLay, and a top Democrat, the chairman of the Democratic National Committee, Tom Perez.
Yet repealing and replacing the ACA was always easier said than done.
About 11 million are covered through an expansion of Medicaid, the health program created to help poor Americans. Withdrawing this support would cause insurers to flee Obamacare markets, leading to massive coverage losses. When those benefits were threatened, Obamacares beneficiaries realized that they had a real stake in the program.
President Donald Trump and Vice President Mike Pence spoke with several House members over the weekend to discuss a path forward, a senior administration official and Republican official with knowledge of the discussions told CNN. The failure of the AHCA may well have been the most important event of the 21st century. And for those who were shielded from rising premiums by subsidies, the government picked up that much more of the bill. The survey asked them to assess Congresss performance, and respondents generally gave Congress poor marks. Moreover, he's got some unique problems of his own making: People are learning his "art-of-the-deal" shtick, so they know that what he says Monday may well be totally different from where he is Tuesday.
What the experts said Congress does care about is public opinion, interest group views and the assessments of the Congressional Budget Office. Part of this was a variation of the "no bench" point above: "In the 25 years I served in the United States Congress, Republicans never, ever, one time, agreed on what a health-care proposal should look like".
That's a central question for Americans when it comes to health care: is it the government's role to ensure it's provided for everyone? Reading that, one was left wondering whether she has read her agency's mission statement to "support economic prosperity and quality of life".
The fact remains, however, that House Republicans aren't in a different position than they were on Friday.
Or as conservative scholar Michael Strain put it in a 2015 Washington Post editorial: "In a world of scarce resources, a slightly higher mortality rate is an acceptable price to pay for certain goals - including...less government coercion and more individual liberty".
Few regard Obamacare as ideal, but many emphasize that when Republicans next consider a health-care makeover, it's critical they listen to those throughout the state and country - including countless fellow Republicans - who would not be able to afford coverage without it. But there are still 10 million people that - on the individual market that buy health insurance and have - they don't qualify for the financial assistance. The Obama administration appealed the ruling, but the new Trump administration has been silent until now whether it will continue to challenge the court ruling. How far are Republicans willing to go to undermine the ACA through administrative and legal actions? This, among other things, contributes to the rise of health care costs. Will the GOP again try to cut Medicaid to help offset tax cuts and infrastructure spending?
His latest book, "Nation on the Take: How Big Money Corrupts Our Democracy and What we can do About it", emphasizes how Americans can take a stand.
But at the end of the day, the reason reform is a priority is that Medicaid is a awful way to deliver health care to low-income Americans.
One more sign of problems with U.S. health care today: The U.S.