House Republicans revise ObamaCare replacement: Tax cuts sooner, work requirements for Medicaid, expanded tax credit eligibility

I assume you already know enough not to take anything Justin Amash says seriously, so the fact that my ex-congressman isn't satisfied means nothing. For people who don't live in the utopian fantasyland of their adolescent dreams, here's how House Republicans have improved the American Health Care Act in the past 24 hours:

Under the modified version of the GOP replacement bill, states would be allowed to require able-bodied Medicaid recipients without dependents to work beginning in October — and would get a funding boost as a reward for doing so. States could also receive federal funding for the program as a lump sum — instead of a per capita allotment — for children and non-disabled, non-elderly adults.

Taxes imposed by the ACA on the wealthy, sectors of the health care industry and others to pay for expanded coverage would be repealed in 2017 instead of 2018. Those changes were made to draw support from conservative members disappointed the original bill didn’t go far enough to undo the ACA, popularly known as Obamacare. “There are several groups where it addresses their concerns, that’s why we’re doing this,” said Rep. Pete Sessions, the Texas Republican who heads the House Rules Committee, which will take up the legislation Wednesday, Republicans also said the changes will allow the Senate to expand subsidies for older people who buy coverage on the individual market. That would help offset the premium increases they’ll see once insurers are allowed to charge them five times as much as younger people for the same plan.

Paul Ryan describes it like this:

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The American Health Care Act is a result of a long, member-driven process, and these improvements are an extension of that inclusive approach. I want to think the White House and members from all parts of our conference who have helped make this the strongest legislation it can be. With this amendment, we accelerate tax relief, give states additional options to spend health care dollars how they choose, strengthen what are already substantial pro-life protections, and ensure there are necessary resources to help older Americans and the disabled. With the president’s leadership and support for this historic legislation, we are now one step closer to keeping our promise to the American people and ending the Obamacare nightmare.

The greater flexibility in Medicaid spending is doubtless designed to win over Republican governors like Ohio's John Kasich and Michigan's Rick Snyder, who went ahead with the ObamaCare Medicaid expansion and are now seeing their budgets pressed because the federal funding was only temporary and designed to decline quickly. They were looking for more freedom in what they could do with Medicaid dollars from Washington, and Ryan is hoping the amendment satisfies them - or at the very least, makes it easier for House and Senate members from the affected states to get on board. I'll say again what I've been saying all along: ObamaCare put Trump and the Republican Congress in a terrible position, and there was never any chance of all the problems it caused being fixed in one fell swoop. You may not like the three-phase approach, and you might believe Ted Cruz when he says it's never going to happen. What I'm telling you is that there is no alternative to at least trying to do it that way, because the repeal bill that has to be passed via reconciliation can only deal with so many issues. And as I explained earlier this morning, ObamaCare simply must be repealed, even if the replacement is less than what we'd like to have done given stronger majorities - particularly in the Senate. And as the boss explained on Sunday, there is no possiblility of simply repealing it and not replacing it, however much some of you purists wish there was. This is why I get so pissed off with libertarian poseurs like Rand Paul and Justin Amash. These frauds claim they are for limited government. Yet they're perfectly willing to leave ObamaCare in place as the inevitable result of scuttling any and all replacement bills as insufficiently conservative. And the result of that would be the biggest expansion of government since the New Deal. No matter how good or bad the replacement bill may be, getting ObamaCare off the books as soon as possible is an absolute most. Anyone who is willing to sabotage its repeal in order to brag about his own ideological purity should be understood not as an opponent of big government, but as its best friend in the world. I still have problems with the new bill just as many of you do. Solution? Pass it, then keep working to try to do more to make health care more market-oriented. No one says this has to be the last thing you can ever do to improve health care. But you can't do any of it until you get rid of ObamaCare. So get the hell rid of it and stop listening to these jerks.