The House Moves to Repeal and Replace Obamacare

Republicans in the House of Representatives finally cobbled together enough "yes" votes to do what they’ve been promising to do for some seven years … repeal and replace the "Affordable Care Act" (ACA), aka Obamacare.

In his floor speech just prior to the vote, House Speaker Paul Ryan said:

"A lot of us have been waiting seven years to cast this vote … This bill delivers on the promises that we have made to the American people."

If I were Paul Ryan, I guess I would be happy that the vote turned out the way it did.

In a party-line victory of 217 to 213, the House passed the "American Health Care Act" (AHCA).

Yes, it must be said that this is a legislative victory for House Republicans, and for President Trump. And, a victory was much-needed after the first round of negotiations in the House failed to even reach a vote.

Yet it’s a victory that will most likely only be fleeting.

I say fleeting, because now the bill must go to the Senate. There, it will undoubtedly undergo a major rewrite that will leave it nearly unrecognizable from its current form.

And even if the Senate manages to agree on changes to the ACHA and passes it, the House and the Senate would then have to renegotiate some kind of compromise legislation.

Well, that’s really unlikely given the deep divisions in the healthcare camp among Republicans.

So, what are the basic tenets of the new ACHA, and what are the major changes from existing law?

Here are the highlights of the bill, as written in an article today at CNBC:

• Increase the amount of premium subsidies for younger adults, and reduce the amount for older adults, while allowing subsidies to be used to buy individual plans outside Obamacare exchanges.

• Allow older adults to be charged premiums that are five times higher than the premiums charged younger adults, instead of the 3:1 ratio established by Obamacare.

• Impose a premium penalty for people who do not maintain continuous health coverage.

• Convert Medicaid funding for states to a block-grant system.

• Give states power to request waivers for insurers that allow them to charge people with pre-existing health conditions higher premiums if they let coverage lapse.

• Establishes funding for states that can be used for "high-risk" individuals, or other purposes.

The ACHA also will end tax increases on higher income earners, and it will end the penalties for those who choose not to buy coverage. (Although there will be a penalty for those who let insurance lapse, and then re-enter the system.)

Interestingly, and perhaps not surprisingly, the House voted on the bill without it being scored by the Congressional Budget Office (CBO).

The previous version of the bill’s score wasn’t all that favorable, as that CBO analysis said the original bill would leave 24 million fewer people uninsured over the next decade while saving about $337 billion.

Related story: Obamacare Repeal/Replace: Good Changes, or Just ACA ‘Light’?

Unfortunately, if you are of the mindset that the big government is far too involved in the healthcare business, what House Republicans have done today doesn’t really offer much comfort.

Basically, the House voted to keep Obamacare’s essential subsidy and regulatory constructs in place. Sure, Republicans tweaked things a bit, and rearranged the deck chairs … but where’s the free-market push in this bill?

Maybe my eyes aren’t that good, but I’m having a really hard time finding the freedom buried among all this regulation.


What say you? Leave a comment on our website or send us an e-mail.


Stocks traded flat after the Fed held interest rates steady yesterday and in anticipation of today’s late-day AHCA vote in the House. Healthcare stocks were among the better performers, with the Health Care SPDR (XLV) gaining 0.7%. As for the broader markets, the Dow slid 6 points while the S&P 500 gained 1.4 points.

• Energy was the day’s worst performer. WTI crude slid 4.8% to $45.52 a barrel thanks to rising U.S. output and word that Libya’s production may ramp-up to compensate for recent shutdowns/outages.

• Gold fell $20 (-1.6%) to $1,228.60 as traders digested the Fed’s decision not to hike rates. As Sean Brodrick pointed out this morning, gold is trading near its 200-day moving average.

• ‘Woodstock for Capitalism’ this weekend: Warren Buffett and his Berkshire Hathaway (BRK.A) Vice Chairman Charlie Munger will spend five hours answering questions at the company’s annual meeting on Saturday.

Good luck and happy investing,

Brad Hoppmann
Uncommon Wisdom Daily

Your thoughts on “The House Moves to Repeal and Replace Obamacare”

  1. This “Bill” makes a flawed situation far worse. What kind of “freedom” are
    you talking about when the choice is to either buy lousy insurance that covers very little or not buying at all because you’ve been priced out. Older patients who have to buy on the open market will face these ugly “choices” and will get shafted.
    The MacArthur amendment will leave even people who get insurance thru their job subject to medical bankruptcy if they get the wrong illness. No surprise that congress would not subject themselves to this plan.

    It makes no sense economically or from a public health standpoint, to allow the private, for profit insurance industry to be the gatekeeper for our healthcare. It’s fatally flawed, and does not serve us well as patients. History should teach us that this system is by far the most expensive and gets relatively mediocre results health wise. In this case, apparently Congress thinks that insurance company profits are more important than our own health. It’s long past do to go to a single payer system that covers everyone. The gatekeeper for our system should be answerable to patients, not shareholders. If we choose to put profits above our own health, we’ve really lost our way.

  2. We need a single payer system (medicare for all) period. We should not pay anymore than other countries pay for health care, so we should emulate Canada, England etc. If people want better insurance than allow individuals to pay for private care.

  3. I am very, very concerned as part of this bill may allow health insurers to exclude mental health care for people with/without disabilities and who are not old enough to be on Medicare. Some thing needs to be done so that this does not happen! People in the mental health care profession and people with mental health issues fought long and hard to get what they need to get through every day.

  4. I have been a registered Republican for over 40 years. I am a pastor and a retired USAF Lt Col. I spent 2 years in US Army Special Forces as a sniper. All of that makes me a pretty conservative guy. However, I cannot believe that this is the best the Republicans can do with control of all three governmental branches. It’s so pathetic when the Tea Party, the Tuesday Party, the Thursday Party, the Beer Party, the Let’s Figure Out How We Can Put More in Our Pockets Party, can’t come together to put meaningful legislation on the table that actually helps the average American. Peggy was very right when she said, ” nothing will change until Congress is forced to live under the same rules as the American people.” Bob Schubring said, “It’s disturbing that so many ignorant people are allowed to intrude in the decisions we each make, that affect our health.” You need to expand that Bob to our children as well. A particularly dysfunctional Democratic Pro-abortion Senator just said that in his opinion until a child is born it is only a mass of cells with none of the characteristics that make us human. A mother in the audience raised her hand and asked, “What if the ‘mass of cells’ as you call it is aborted 1 day before it would have been born naturally. Does it still not have human characteristics? ” The answer was not forthcoming from the Senator and he simply said, “Next question.” The old saying, stupid is as stupid does should be modified with the addition, greedy is as greedy does. Now we have something that really can be applied to virtually all of Congress, the FDA, the Federal Reserve, and other Washington entities whose job it is to protect and to serve the American people–the people whose ancestors envisioned and created by the sweat of their brows and the blood in their veins, this Republic (we are not a Democracy and never have been) many have died to protect. And this Republic also protects those who choose to wallow in stupidity. Jesse Watters of Fox News has proven time and again with his Man-on-the-Street interviews, just how stupid the vast majority of Americans are; especially those under 25. My favorite was the Harvard co-ed who,when showed a picture of Reagan, identified him as “Some old white guy.” Or when he asked a Yale Medical School student, “Who is buried in Grant’s tomb,” was rewarded with the reply, “Is this a trick question?” I hope this guy never makes it to his internship.

  5. The house few moderate repiblicans caved to The Freedom to Die caucus and Trump and his compatriots who will receive a Much? needed tax cut.It will be enlightening to see the CBO scoring.

  6. The “waiver” option gives states the opportunity to move to more of a free market system (if that is what they really want). Waivers essentially cancel two of the most significant components of ACA.

    Oh, by the way, you forgot to mention that the “grand old party” gave themselves a “get out of jail free” pass on the shiny new AHCA, evidently preferring the old ACA for themselves. A sure sign they are screwing the rest of us!

  7. We do not need regulating in the area of health care. Each person that wants to work for it should be able chose whether or not to pay for health care. It should never be given to anyone just because they are a live. Health care is not a right but as other things a privilege, i.e. driving, etc. One person should not be required to give anyone else health care payments just because they want to work for theirs.

  8. Big mistake for the Republicans, in my opinion. As long as Obamacare was the law of the land, they could blame the Democrats for all its faults and failings. If this passes the Senate and is signed into law, the Republicans will now own it, and be held accountable for all its flaws and shortcomings, and since it’s basically just a slightly modified version of Obamacare, you better believe that those faults and shortcomings are still there, and likely even worse, at least in some cases.
    In any case, I really doubt that this bill will be something that the Republicans will be bragging about when it comes time to run for re-election next year.

  9. To be anything but horrified at the taking away of healthcare from millions, probably more than the 24 million stated by the CBO ( that is why the Republicans rushed the bill through w/o CBO review) is unforgivable.
    Uncommonwisdom…give me a break.
    I unsubscribe as of today

  10. You’re kidding, right? Legislative victory? I may have lost count, but the Republicans in the House voted some 60 (SIXTY) times to repeal Obamacare. So the only thing that’s new is that for the second time, (and never during the Obama administration) the Republicans are committing their ideas to paper- that is historic when it comes to health care.

    It is conceivable that some modified form of this initiative might pass the Senate on a party line vote. I’m skeptical because of the disparate factions.

    Personally, replacing the flawed Obamacare with an even more Trumpcare does not set with me as a step forward. France and other countries have vastly better care at vastly lower prices. Time for us to craft a plan on what works in the real world rather than a Solomon’s baby stepchild of the “sickness care industry.” GSA pricing for all medication would be a good place to start, requiring drug companies to sell to any agency within the US government at prices no higher than the same drugs are sold anywhere else in the world.

  11. One thing I really want to comment on is the penalty if someone does not have insurance and then goes to purchase insurance after a break in time.
    This is not helpful and worse, is harmful because if a person or young family cannot afford a policy, how does it help them to pay an even higher cost than “normal” when they do get the income to shop for a policy?
    This is a gift to the insurance companies.
    If a person cannot afford a policy, yet they might be able to go to a walk in clinic or arrange payment with a doctor’s office. This penalty payment takes potential healthcare or living expence cashflow away from people who need it and lines the pockets of those who don’t—the insurance providers. This penalty is not about good healthcare decision making but about greed. Penalties (by any name) should be taken out of the bill.
    Obamacare tax penalty wasn’t any better.

    Might I gripe about another thing? Insurance companies allowed to charge seniors up to 5 times the amount of younger people. Sure, the cost of care for someone young can be quite a bit less, but not necessarily due to any number of health problems that can affect someone young. Seniors on fixed income have a tough time paying for housing or assisted living if they need help with even just meals; this is another gift to insurance companies.

    Wolves are guarding the henhouse.

  12. It’s disturbing that so many ignorant people are allowed to intrude in the decisions we each make, that affect our health.

    Beginning in 1913, it became a crime to use medicines for pain, unless one persuaded a licensed doctor to prescribe them. Democrats told our great-grandparents that this law only affected people of color, who had a problem called “addiction”, that required government intrusion into their lives.

    The 1913 law made ignorant politicians into arbiters of medical practice, national morals, and the alleged differences between Americans of different races.

    Before 1913, a Black man could walk into a Post Office to mail a letter, and a white man had to stand in line behind him. A white guy who grumbled about this line, was presumed to be one of those ignorant fools whom Mark Twain made a lot of money criticizing in his books…the sort of fool who dreamed of how life might be, if only Grant had gotten killed at Vicksburg and the Confederacy had won the war…who never quite grasped that there cannot be such a thing as a free country, in which some of the people aren’t free.

    After 1913, Post Offices in Southern states like Florida, had separate lines for Blacks and for everybody else. This made Democrats and fools feel superior to Black folks and Abolitionists’ children, whose parents had opposed Slavery and had taken a lot of crap for their beliefs.

    We now have a regulated medical oligopoly, that’s pretty indistinguishable from a Plantation.

    Our owners have the absolute power to command us to accept therapy, if they can get a judge to agree that the therapy would be good for us. For this benefit, they also have the absolute power to seize all of our funds, land, and possessions, to pay the cost of the therapy.

    Because nobody bothered repealing Democracy, there’s this inconvenience called Elections, which politicians lose if they give too much power to our medical owners.

    So, for example, when one of the medical ruling class arbitrarily raised the price of the Epi-pen, a lifesaving technology that’s about 100 years old, Congress made a show of chastising the fools. What Congress did not do, is replace the FDA monopoly system with a system of specifications that enables anyone to bid competitively, to make medicines and sell them to buyers.

    There had been such a competitive system before 1913. After 1913, one needed a license to prescribe and another license to fill prescriptions. A federal law that made every manufacturer’s medicines uniquely licensed, also makes real competition impossible.

    If the Army buys a boatload of rifle bullets, it buys them by specification. The bullet is a certain diameter, a certain shape, and has a certain amount of gunpowder in the cartridge. Anyone who can read, is capable of deciding whether to supply the Army with more bullets. As a result, competition ensures that the Army never has a bullet shortage.

    But the doctor does not order medicine by specification. He prescribes a drug by it’s trade name. The pharmacist may substitute a cheaper equivalent drug, if one exists. But what nobody is free to do, is enter the market, make yet an even cheaper equivalent drug, and sell it to anyone who asks. That is strictly prohibited! To make a cheaper generic drug, one must first get permission from the FDA, to make the drug and to sell it. It can take years to qualify. Meanwhile, the costly brand-name drugs are the only drugs available.

    Personally, I’d like to repeal every law that got passed in 1913 and make anyone who wanted to save a particular law, show why that law deserves to exist. This would also get rid of the Federal Reserve System, which put a banking cartel in charge of inflating the money supply and lending the proceeds to politicians. Republicans learned how to depend on the inflation handouts, and we’ve not had meaningful political discourse on any subject, ever since.

    The Army no longer has any surplus mules, and it’s too late to seize 40 acres of land for war vets, from traitors. But the coming crisis over debts run up by politicians, is going global, and when it ends, it’s worthwhile knowing what we once had here and lost, because freedom actually can work, when we allow everybody to have it.

  13. I want the federal government OUT of the “health-care” business, which should be called “sickness care”. I want the Congressmen and women to be forbidden to take money from the pharmaceutical companies. I want Big Pharma to be forbidden to contribute to our elected and non-elected (think FDA members) officials. I want our government leaders to show some gumption and stop rearranging the deck chairs on the health-care Titanic!

  14. F*ck the government healthcare, looks like I won’t be participating in this BS law either. Anyone who believes the FedGov has the authority to regulate health care point out the backing Article and Section in the Constitution where this authority was granted.

  15. We voted for Trump on the premise that he would drain the swamp. repeal Obamacare care, control the influx of illegals, and make America great again. The jury is still out; however, the new Obamacare being voted on does not hold much promise for senior citizens who will undoubtedly carry much of the financial burden if it passes. Higher premiums are not something retirees on fixed incomes can tolerate. In my humble opinion, nothing will change until Congress is forced to live under the same rules as the American people; and I think we all know that is not going to happen?

  16. I have been in Hospital Administration for over 40 years as first a CPA auditor of healthcare organizations then CFO and CEO of healthcare organizations . I am amazed at people who think that the healthcare financial problems are going to be solved to the positive by giving more freedom to the Health insurance private sector. The market place concept does not and will not reduce premiums, healthcare costs and definitely not provide better healthcare services for most people. What it will do is basically eliminate local healthcare services for the majority of rural citizens in the United States. I don’t believe that Obamacare or the current proposed House repeal will reduce over all Healthcare costs or improve healthcare overall outcomes for many reasons.

  17. It would be so much easier to simply set up Medicare for all. By allowing states to have waivers, effectively many people will get dumped. Also, the states’ revenues haven’t recovered from the Great Recession, and in many areas the tax base is poor, these states would apply for waivers and people would go without health care.

  18. This amendment to Obamacare is not close to a repeal. Misleading headline notwithstanding. Just claiming it so doe not make it so.



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