An Open Note To The House GOP

I know you have your hands full as we approach tomorrows scheduled vote on the AHCA, which I believe is HR 1628.

I wanted to write to add another voice of support for your coming NO vote on the AHCA.

I hope you will, and I would urge you strongly to oppose this first effort at doing what you and I have talked about for more than 6 years; repealing and replacing Obamacare.

Anyway, the practical execution of this bill will not meet the expectations of conservatives, tea party members, or the party faithful as set by the public rhetoric of GOP candidates and incumbents over the past 7 plus years.

I'm certain you've have seen the varied calculus on the negative economic impacts of Obamacare and fiscal projections for the AHCA (did you notice the AHCA penalty for non-coverage is more expensive than the Obamacare penalty), so I won't take time repeating all that except to say it isn't good.

However, I would add:

This Obamacare replacement being pushed by Paul Ryan is not what was promised to voters on the right over the past six years.

The AHCA is half measures. It is not repeal and replace.

This bill doesn't solve the problems of Obamacare, and will not reduce the upward pressure on both insurance costs and medical costs. Passage of this bill will only result in primary challenges across the country in 2018, and the need for new health insurance legislation in the next cycle.

I urge you to keep these things in mind as you deliberate with your colleauges:

  • The Obamacare individual mandate must go; it certainly shouldn't be replaced with a higher tax paid to insurers.

  • Mandated benefits imposed on insurers must be reduced.

  • 10 year projections on costs and revenues must be ignored, they will be wrong; work with 5 year projections or less.

  • Accept that no matter what you do to get rid of Obamacare some Americans who get free health insurance under that plan will lose it under a new plan. There is not way around this. There are no painless solutions to the catastrophe that is the ACA. Health insurance coverage is not a right.

  • Don't further complicate the tax code with more credits, use subsidies for health insurance and medical costs for the truly needy.

  • Recognize revenue gainers (taxes) in Obamacare have to be terminated; use the upcoming tax reform process and budget measures to compensate.

  • Always keep separate the issue of health insurance costs from medical care costs.

  • Change the generous tax treatments of employer health plans to reduce over use and abuse of medical care.

  • Allow for cross border insurance sales.

Please, don't settle for this bill. The GOP led House has already passed superior replacement bills, and an even better one can be had with courage and conviction. Free markets can help. There is a path to more and cheaper health insurance plan options.

It is worth noting this is not the replacement bill President Trump spoke about as candidate Trump. He too will be hurt by passage of this Ryan replacement.

These are the tough votes. You have my support. I urge you to do the best thing for America and await a better plan to repeal and replace the ACA. The AHCA is not the right answer.

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