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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsThe Senate GOP hid the meanest things very deeply in its Obamacare repeal bill. We found them
The Senate GOP hid the meanest things very deeply in its Obamacare repeal bill. We found them
BUSINESS Michael Hiltzik 6-24-17
The Affordable Care Act repeal bill unveiled Thursday by Senate Republicans has aptly drawn universal scorn from healthcare experts, hospital and physician groups and advocates for patients and the needy. That’s because the bill is a poorly-disguised massive tax cut for the wealthy, paid for by cutting Medicaid — which serves the middle class and the poor — to the bone.
Yet some of the measure’s most egregious, harshest provisions are well-disguised. They’re hidden deep in its underbrush or in the maze of legislative verbiage. We’ve ferreted out some of them and present them here in all their malevolent glory.
—States will have more authority to reimpose lifetime and annual benefit caps and eliminate essential health benefits.
This may be the most insidious provision of the repeal bill, and certainly is the most deeply hidden.
—Protection for people with preexisting conditions is destroyed.
Senate Republicans claim in their talking points that the measure protects people with preexisting conditions from being denied coverage or priced out of the market. Don’t believe them. As Gene Sperling, a former economist for the Clinton and Obama administrations, and Michael Shapiro observe, “the Republican plan may not allow insurers to discriminate … through the front door, but they’ve created a backdoor way in.”
—Older Americans would get socked with much higher premiums and costs.
The Senate bill changes the ACA’s premium subsidies in ways that severely hurt older customers.
—The biggest tax cut for the rich is retroactive.
As we’ve reported before, the repeal measure delivers an estimated $346 billion in tax cuts over 10 years, all of it going to households with income over $250,000. But the biggest component of the cut — repeal of a 3.8% surcharge on capital gains and dividends for those taxpayers — would be retroactive to the beginning of this year. That turns it into more of a free handout for wealthy people who already had sold securities or collected dividends since Jan. 1.
—The fight against opioid addiction is crippled.
—Salaries for health insurance chief executives can go through the roof.
This provision matches one that was buried in the House bill, and is similarly obscured in the Senate version. It removes a limit on the deductibility of CEO pay in the health insurance industry written into the ACA.
http://www.latimes.com/business/hiltzik/la-fi-hiltzik-senate-hidden-20170623-story.html
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dalton99a
(81,476 posts)
Freddie
(9,265 posts)They can't specifically charge you more for it. BUT they can charge everyone the same price for a bare-bones, covers-nothing plan (will now be allowed again) and charge exhorbitant rates for plans that actually cover things, which anyone with an actual health condition will need.
annabanana
(52,791 posts)protecting pre-existing condition coverage, and States that are NOT protecting that coverage.. It can decide to buy their employees coverage from the State that allows denial of coverage.
So no one is "safe" pretty much anywhere.
still_one
(92,187 posts)workinclasszero
(28,270 posts)Will be the worst thing that has happened to this country since Pearl Harbor.
They are going to destroy everything in this country that helps the common citizen and give the proceeds to the rich and big corporations.
We are well and truly fucked.
The Republican Death care bill is just the beginning.
Volaris
(10,270 posts)Wait till the ACTUAL tax cut bill gets written...
Hateful fuckers
Honeycombe8
(37,648 posts)But I think removing the requirements that all ins. must contain an infinite lifetime cap and all essential benefits is a good thing. This is because the cost of ins. is so high that being able NOT to have buy coverage you don't need is one way to get the cost down.
So a person over 55 faced with a $1,000/mo. policy, which would be impossible to afford, could cut maternity benefits, mental care, drug rehab care, and get a $2Million lifetime cap, and get the premium down so that he/she could at least get coverage.
The ACA benefits were structured like a group policy, but shouldn't have been in the individual market, since the individuals are not a group, have no leverage in negotiating price or getting bids, and as individuals are powerless against big ins. cos. The individuals cannot even cancel their own policies or change them; only the govt can do that. So the individuals should be able to at least be treated like individuals and make their own choices.
genxlib
(5,526 posts)A major point of the ACA was that the individual market needed the characteristics of a group policy to be more stable with a broader risk base.
What you are describing are boutique policies that carve out unique risks to individuals. While that may be beneficial to an individual on a micro scale it damages the macroeconomics of the market.
Within any given group of people, there is a set amount of risk. When you start carving that risk out of some policies, you are just shifting the cost to the group that is most susceptible to that risk. Maternity coverage is the most obvious example. If your sample 55 yr old eschews maternity coverage, it just means her daughter will pay more for it.
Even this may seem like a fair approach until the younger crowd says they don't need coverage for high blood pressure or osteoporosis or arthritis. Or indeed any coverage at all. Then your 55 yr old ends up paying more because the costs to her type of ailments end up concentrated into a narrower group of policies.
Fragmenting the coverage is not the answer. The more people covered across the broadest range of risks is the most efficient way for insurance to operate. It is one of the major reasons that single payer works in other countries.
Honeycombe8
(37,648 posts)for someone who would repeal Obamacare, even though he was unfit for office.. Because it was unaffordable for the middle class, particularly older ones, who were stuck with being forced to pay an unacceptably high rate of premium for coverage that didn't apply to them.
What you are describing is appropriate for a single payer system. That is not what Obamacare was.
Obamacare is a system that HAS DIFFERENT GROUPS, and by law charges groups MORE or LESS. So there are isolated groups built in. This means that different coverages for those groups should also be built in.
If you're going to have group policy coverages for all, then you must have group policy rates for all. But that's not what was occurring. Certain groups were forced to have group policy coverages, but then they were isolated out and charged MORE...so they were no longer part of the big "group." They were a micro-group.
Consider this: People over 50 or 55 were paying TRIPLE rates over the ones who DID use the maternity benefits and mental health coverage and inpatient drug rehab. I was actually charged a lot more for insurance, despite being super healthy, because I was paying for all those coverages that I would never use, like maternity benefits, mental care, inpatient drug rehab.
Meanwhile, although I was paying for hormones for free birth control pills for others, MY hormones were not covered under my bronze level plans, so I had to drop them altogether because of the cost. If they had been included in the drug list, though, my deductible was $6,000. That is grossly unfair: To pay for free hormones for others, yet not getting coverage for MY hormones, despite being charged over $700/month for "insurance." The insurance was useless for my purposes, but I had to buy it, so that others could get great insurance at a much lower cost.
There is no separate coverage for hbp or arthritis. Maternity coverage is a standard separate coverage that has traditionally been an add-on, as is mental health care. Not so with specific illnesses or conditions, such as coverage for hbp or arthritis.
Being able to tailor coverage for one's needs is the answer, IMO, for a system that has a tiered premium approach, since it already separates out groups into sub-groups. Separating out sub-groups for premiums while claiming it's all one big group for coverages is unfair to those being charge triple premiums for coverages for the other sub-groups.
If you separate out groups of people, then you must separate out coverages.
Finally, the "group" is much smaller than a single payer system is. So the # of people to spread out the cost of, say, free birth control pills, is less. This hits harder the group that is allowed to be charged more .
The over 50 group was used as a catch-all, to try to recoup losses causes by all the claims in the entire group. Not because that group cost more, but because it was the ONLY group they were allowed to charge MORE.
So if you're going to do a group policy thing as to coverages, then ALL the group needs to have the cost spread out, and not one sub-group singled out for higher premiums. If you want to charge a 55 year old man for maternity coverage costs, then you have to charge a 30 year old for a specialty coverage that is used exclusively by seniors (there is none, that I'm aware of). That's the way group policies work. The ins. co. takes the estimated cost of claims for the whole group, then charges the employer one big premium, and the employer divides that up according to number of employees, to get the total amount of premium cost per employee. The employer doesn't separate out the employees into a sub-group of those over 50. All members of the group get the same coverage, and have the same premium cost.
I see little difference in the current system of charging certain sub-groups MORE based on age, and the proposition of charging a sub-group of pre-existing condition insureds MORE based on claims history. Yet Obamacare did the former and people consider the latter grossly unfair. I think they should all be charged the same, if you are going to make them all have the same coverages.
snot
(10,524 posts)by making it more extreme?
Who gets to decide who goes into which groups? Should there be a separate group for older people of my gender who are not taking hormones, are not overweight, who exercise, eat healthily, have low blood pressure, do not have diabetes, do not drink or smoke, do not have arthritis, but DO have a couple of rare, scary disorders lurking in their family history?
Honeycombe8
(37,648 posts)It's that simple. It's not brain surgery.
Currently, they charge more or less based on age of a SUB-GROUP. Therefore, there should be a plan of coverages for each sub-group. Not individuals. THE EXISTING SUB-GROUPS.
For the under-30 sub-group, there would be plans that incorporate almost everything, since almost every medical condition applies to them.
For the over-55 sub-grou, the plans should exempt maternity coverage and birth control pills, since those are not applicable at all to that age group.
OR, alternatively, charge EVERYONE the same premium, if you are going to have ONLY ONE SET OF COVERAGES that apply to all.
It's pretty simple, really. But pretending it's a group policy thing flies in the face of reality. Obamacare is not a "group policy" setup, except insofar as the coverages that are mandated. As to premiums, it's a SUB-GROUP system. And that's unfair, and is what made Obamacare unpopular to many.
The Democratic politicians talk NOW about tweaking or fixing Obamacare, but they refused to even acknowledge the problems before, much less propose a way to fix them. Until HRC came along, who mentioned tweaking it. All programs have problems, esp in the beginning years.
It struck me for the first time during the last few years how people really don't appreciate another's situation, unless they are faced with it themselves. If I were to send someone else a bill for $300 a month, every month, for the foreseeable future (only increasing a lot every year), to pay for MY insurance, that person would then see the unfairness of it. Mind you, I would not be getting a bill for that other person's insurance. It's a one-way street.
The GOP bill is worse, allowing to charge seniors five times more, not just three times more. So I'm not saying the GOP fixes anything. But being able to not pay for stand-alone coverages that really don't apply to a certain group would have helped somewhat. But the ins. cos. needed the extra profit to offset losses.
genxlib
(5,526 posts)People (including leadership) have been saying since the very beginning that the ACA needed tweaking.
However, the political landscape has not allowed it.
During passage there were limitations, both procedure and political, that limited what could be done. Even at that time, there was an intention that it needed to be improved over time.
However, the balance of power shifted in the Senate and we last the ability to get things done.
Since then, it has gotten even worse because the GOP has undermined it through litigation and policy tweaks of their own. Part of the reason that rates went up is that the Government reneged on payments that were supposed to reimburse the insurance companies for taking on the risk of new clients. (thanks Rubio)
Honeycombe8
(37,648 posts)not allowing those people not to buy coverages that don't apply to that group. Quite the opposite. The Party doubled down on requiring ins. cos. to sell all coverages to everyone. So if there's no acknowledgement, there can be no "fixing."
They were mainly concerned about the ins. cos. dropping out, which is understandable, and the loss of healthy people in the program, which was leading to the big losses of the ins. cos. But they were regarding the healthy people as those under 30. There was never any concern about those over 50, that I heard.
But no matter, now, I guess. The GOP won't give up on repealing it, and the ins. cos. and providers are already hesitant to continue with the ACA because everything's up in the air.
I hope all this means we end up with single payer eventually, even though it's too late for me. All this time, effort, and money wasted trying to get health care to people, and coming up short.
But I am not sure anyone was getting that detailed in their comments about what about the ACA needed tweaking. They may have been talking about that clause but just not being specific.
In general, the 3:1 ratio is better than it was pre-ACA and certainly better than it will be post-ACA.
The reality of healthcare is that someone is always going to be paying more than they need so that others pay less. It is the nature of insurance of any kind; public or private. That imbalance can be distributed across a number of spectrums: healthy-vs-sick, rich-vs-poor, old-vs-young, etc.
Healthcare policy essentially boils down to determining how the costs are spread across those spectrums.
I think we agree that we would rather have single payer so the cost distributions spread across the wealth spectrum instead of the age or health spectrum.
snot
(10,524 posts)1. Charge everyone the same premium. This is what insurance is supposed to be.
2. Calculate premiums based on a progressive scale, based on ability to pay.
The only exceptions I'd make would be sub-groups for things clearly within individual control, e.g., smoking.
PS: I understand and agree with your general point about what made the ACA unpopular. To me, though, the fundamental problems are what need fixing: (1) that our healthcare system is inefficient and overly expensive due to a lack of bargaining power or other effective cost controls, as well as the plethora of providers, insurers, and programs; and (2) that health insurance, like so many other services, is not adequately funded because our government has been turned into an accessory to the 1%'s ongoing looting of the middle and lower classes.
Motownman78
(491 posts)Are coverages needed by only older people.
annabanana
(52,791 posts)genxlib
(5,526 posts)Both of those links are really about middle aged people being on the look-out for things that are generally considered to only affect the elderly. For instance, the prostrate cancer article has several examples of people but they are all +50.
For the sake of the discussion above, the comparison point was child bearing years versus non-child bearing years so it doesn't necessarily prove the point.
Even so, the general point is that even though something is rare it can happen. All the more reason to just cover everything so that you don't have to pick and choose what might happen to you.
Honeycombe8
(37,648 posts)I will never have prostate cancer. 
It's not that common, but young people can get osteoporosis, too. There are certain medical conditions that cause it.
genxlib
(5,526 posts)that it isn't popular with everyone. And this particular characteristic of the ACA has been weaponized as one of the talking points to drive public opinion about it.
I get it.
I just don't believe it is a correct analysis of the economics.
Your insinuation is that you are subsidizing other people for coverage you don't need.
While that is true within this narrow category, it doesn't necessarily hold true for the overall cost of coverage. In fact, the net effect of the ACA is to have younger people subsidize older people. That is why the 3x multiplier is even needed. Otherwise, left to the pure economics of the situation, rates for older people would be more than 3x.
You seem to under the impression that older people were charged more solely because they could absorb the cost. The reality is that older people use more medical services than younger people, even when you account for maternity and the other services you want to exclude.
In reality, you will be exposed to a 5x multiplier in this new plan even if you are able to avoid the maternity. So you will have effectively unburdened yourself of supporting maternity while absorbing an even larger responsibility for the medical uses of your age bracket. This will be the ultimate effect of pegging coverage more closely to usage.
Furthermore, it is a two edged sword. Customizing coverage to things you don't need goes hand in hand with customizing coverage of things the insurance company doesn't want to pay for. Yes, you can get more affordable coverage if it doesn't actually include things that would cost the insurer.
Believe me, there is a lot about the ACA that isn't entirely fair and you have hit on one element of it. However, the current proposal will move in the direction of being even less fair. Picking out a few tidbits that seem better for you isn't going to change that.
Honeycombe8
(37,648 posts)And that, folks, is why older people ran to the voting booths to vote to repeal Obamacare.
We matter, too. Not just poor people or pregnant people or women who want to take birth control pills or young working males.
People are deaf when it comes to this. Because it's not THEM. Or a "more important" group of people. We are a "narrow category," now. NO, WE ARE A LARGE CATEGORY. There are far more older people in the ACA individual exchanges than any other group. WE ARE FUNDING THE ACA with enormous premiums. Not the rich people or the poor people or the women on birth control pills.
Think of it this way: The records clerk at a company getting his ins. through the exchange is 55 years old and paying a part of $900/month for his insurance. He earns $35,000 a year. His premium is so high in part so that the secretary down the hall who is earning $70,000 a year can get her birth control pills for free. She pays about $450/mo. for her individual insurance, because she is younger. But the records clerk has to pay a higher premium to fund HER birth control pills, even though she earns twice as much as he does, and her ins. costs half as much.
This "narrow category" is the ONLY group of insureds that is hit with high premiums. They pay triple premiums, for no reason of their own doing.
Yet there is an outcry when it's mentioned that maybe pre-existing condition insureds with high claims should pay triple premiums? Where's the logic in that?
genxlib
(5,526 posts)But that is not what meant at all.
The "narrow category" I was referring to was maternity care. It is convenient to target maternity care as a narrow category when there are plenty of other categories of healthcare expenditures where younger people spend a whole lot less than those of is in our 50's. (And yes, I am one of the older people you refer to)
As to your example, you have not accounted for tax credits.
I ran the numbers through Kaiser's Marketplace calculator and got this
35 yo at 70k = $345
55 yo at 35k = $629 (with a tax credit lowering the cost to $278)
Perhaps a better measure would be both ages making 70k where tax credits do not come into play. In that case, the difference is a 1.82 multiplier. This is less than 3x because the full range of multiplier is for the cheapest 21 year old versus the most expensive 64 year old. (I ran those ages and got exactly 3x)
I only offer the above info to clarify that it is means tested by tax credits and the indicated multipliers are a worse case scenario.
But your point is understood, older people are paying more than younger people. I am not sure I agree that it is "for no reason". We older people use more health services and result in higher costs to our insurance plans. If we didn't the free market would take care of itself and limit cost differentials based on the market conditions.
The proof of this is in the need to cap the multiplier in the first place. If it wasn't capped, the free market multiplier would be even higher. You don't think it is fair but it is a real representation of costs within the system. If anything, it is shifting the cost burden towards the younger people since their premiums would have been less in the pre-ACA.
If the premiums were level across age groups as you suggest, then younger people would have the same reaction that you are saying that older people have now. They would be mad that they are subsidizing older people and they would vote accordingly.
In any scenario, somebody is going to feel that they are being wronged. I am sorry that you feel wronged by the ACA. I sympathize but do believe it is the best we could hope for at the time and certainly better than what the GOP has in store for us.
For what it is worth, I support single payer where this particular question would go away. It would be replaced by a different question of why high earners should pay more than low earners for the same benefits. I make enough money that the associated taxes for single payer would almost certainly cost me more than what we have. I am still for it because it is the right way to do things.
Thunderbeast
(3,407 posts)I am astonished that folks talk about mental health and addiction as if they or their families are imune. Mental illness can not be an excluded risk any more than cancer or heart disease. One person in five will suffer from mental illness or addiction in their lifetimes. If you assume that you, your spouse, or your covered children are imune from the risk, you are already suffering from magical thinking.
Honeycombe8
(37,648 posts)It's really not for me to say whether someone should get mental health care coverage or needs inpatient drug rehab coverage. People know what they need, but in any case, that's their choice.
My posts are about individual Obamacare policies for older Americans. Not family plans. There are no kiddos.
As for me, I know I will never need inpatient drug rehab. I also know I will never "need" mental health care.
One advantage to getting older is you get to know yourself pretty well. Can something bizarre happen? Realistically, no. But possibly, in the sphere where anything can happen, sure. I could also win the lottery or get hit by a bus.
If I suddenly get really depressed and want to see a psychologist a few times for counseling, I could pay that out of pocket far cheaper than buying insurance for that.
calimary
(81,238 posts)I keep thinking about Matthew 25: 35-45. That's the one about "whatever you do to the least of these, you do to Me." I wonder about many of those nice "Christian" republi-CONS who usually can be found busily patting themselves on the back in the middle of the town square in front of every mic and camera about how noble and virtuous and godly they are.
What a disgrace. What have we become?
Moostache
(9,895 posts)Because when the bodies start piling up and the impact of this hateful bill begin to hit, I plan to organize "die ins" in their neighborhoods.
People strung out on opioids? Tent city right outside their gated communities....have fun driving by the misery every single day in your tax-cut provided Bentley...
Elderly incapable of surviving on their own and no nursing homes care available? Right this way to the open air death centers...next door to the opioid tents. Sorry about the lack of corpse removal, but the funding for that is still in committee...
Children born into poverty or simply unlucky in the genetic lottery to be born with a life-long condition requiring care? Well, the good news is we still have lots of churches to park you all in front of or in their parking lots or lining the streets to get to their shiny mega-churches...don't forget to bring a cup for donations and look really, really sad as the luxury vehicles with the smoked windows speed past...
Its time to put the consequences of these actions into the front and back yards of the McMansion living, out-of-touch, sheltered oligarchs...you guys don't want to pay taxes that support a peaceful society? Fine. But I refuse to let you hide from what you are buying. I refuse to allow the MILLIONS of seniors and MILLIONS of youth who you are gleefully hurting fade into obscurity or even a safe viewing distance.
When the dying starts, it is going to be on your fucking front lawns you bastards....even if I have to start a ghoulish business collecting the corpses myself and throwing them into your fucking pools...
El Mimbreno
(777 posts)So am I.
GrapesOfWrath
(524 posts)+1000
I'm right there with you man 
Achilleaze
(15,543 posts)the republican plan is to rip off the middle class, poor, elderly and sick, and to keep them preoccupied with drugs, crime, and illness from crappy chemicalized processed food and an exploited & befouled environment while fat cat republicans luxuriate in golden, casino-glitter luxury.
Bengus81
(6,931 posts)Retroactivell Street Journal is aghast. “Retroactive tax cuts like this don’t create an incentive and can yield windfall gains for people who already made decisions,” the paper observed. A millionaire who already had booked a $1-million gain on a stock sale, for example, would collect a $38,000 benefit.
These Republican asshats writing laws like this are CRIMINALS. People DIE from having their health care GUTTED and amillionairee gets himself another FAT $38,000 tax refund. Hell most will get 5-10-20 TIMES that amount,all in the name of taking away health care.
onethatcares
(16,168 posts)begin to die in numbers on the streets and the stench permeates blocks.
pangaia
(24,324 posts)GrapesOfWrath
(524 posts)With diamond encrusted blinders
bronxiteforever
(9,287 posts)
Skidmore
(37,364 posts)
dchill
(38,484 posts)snot
(10,524 posts)Among other things.
sheshe2
(83,751 posts)This is a must read for everyone.
duncang
(1,907 posts)Think about it. A repub area doesn't have to pay in to medicaid, but residents, hospitals, and doctors will still be receiving medicaid payments. This is normal repub way of screwing others.
Stuart G
(38,421 posts)KewlKat
(5,624 posts)DallasNE
(7,403 posts)When is the last time a new town has been added to the list of Tucson, Arora, Virginia Tech, Omaha or Newtown? Have we just been lucky or has being able to keep children on their parents policy until age 26 made a big contribution to this good news. While the replacement bill partially keeps this in place the pre-existing condition removal (back door) means the parent cannot change insurance and keep coverage, meaning they can't change jobs or dump an old high rate policy for a new more affordable policy on the marketplace - not to mention if you are one to the 23 million that will lose coverage. Granted, these horrific slaughters have been replaced with San Bernardino and Orlando but that is a completely different story. There should also be statistics on how many lives have been saved because people now have insurance as well as better outcomes as a result of having insurance.
I say this so a start can be made on identifying legislative proposals to repair the gaps in ACA coverage. That may not be that easy because the Supreme Court has already struck down making Medicaid expansion mandatory for all States.
lambchopp59
(2,809 posts)Yet without even researching it I'd be willing to bet Faux is hawking how wonderful and fabulous and patriotic and just the bestest, bestest, bestest thing yet to come from the Frump administration, now aren't you "patriots" proud.
There is so much horrible karma to come for the RW faithful it turns my stomach.
Death and destruction, sheer fascist evil has taken control of our country, wrapped in the flag and carrying the cross.
It makes me cry to think of how we could have all been
Nitram
(22,794 posts)trueblue2007
(17,217 posts)stuffmatters
(2,574 posts)It's not just that it now allows all employers to sewer shop policies across any state lines, it also relives all employers from providing
insurance. Also by lifting lifetime caps and making older rates unaffordable, it brings those with more medical needs into medicare, if they've managed to survive Kochcare until they reach 65.
The Democrats and the completely clueless MSM have not informed all America that GOPshitcare will destroy everybody's heath insurance access and security in order to give the richest this obscene huge tax cut/refund. It's not just the poor and the elderly, it's everybody ...why can't the Dems scream this nonstop.
stuffmatters
(2,574 posts)The GOP House voted to exempt themselves from AHA and keep themselves in cadillac Obamacare policies. I'm confident that the GOP Senate bill provides them the same utterly disgusting exemption from AHA.
Stonepounder
(4,033 posts)Long story short, ambulance to ER, bunch of tests, open heart surgery. Bill: $130,000.
Three months of 3x/Wk PT. Bill: $4500.
Now, if I made $100,000/yr, and had about 10K in the bank. Then obviously without insurance it would take me over a year to pay off my debt it I lived under a bridge, walked to work, and never ate.
If I was a millionaire with $10,000,000 in the bank, then the total bill would be 01.35% of my savings. Translating that into my $10,000 in the bank 1.35% of my savings would be $135.00.
Most of us could manage $135.00 for a major life crisis. The rich don't worry about insurance or getting sick, any more than they worry about paying the electric bill and don't have a clue how it works for the vast majority of us. And they really don't give a damn. That is the problem with politicians catering to the fat cats instead of the folk who elect them.
betsuni
(25,488 posts)
alfredo
(60,071 posts)C Moon
(12,213 posts)
customerserviceguy
(25,183 posts)But I don't see it passing, and if I'm wrong, I don't see it being passed by the House, or successfully getting through in passable form from a conference committee. The GOP'ers are all over the map on what they want from "repeal and replace", and there is no possible bill that will please essentially all of them.
At this point, it's all a matter of assigning the blame for failure of their signature promise to one side of Congress or another. My money is on the Senate getting it hung on them that they "failed", allowing House members who voted for the "mean" bill to claim innocence to their constituencies.
