Republicans Still Can't Figure Out Healthcare Reform

There's just no way Republicans can pass the AHCA in any revision dreamt up by Republicans. The dynamics have never changed; you still have the Establishment vs the Freedom Caucus vs the Moderates.

Look at KFF's poll. Notice how 39% of Republicans thought that it was a good thing the AHCA didn't pass?

Their current plan, in an appeal to the Freedom Caucus, is to allow states to waive ACA requirements they do not want, whether it is coverage for essential health benefits or the ban on pre-existing conditions, etc. That's not going to go over well with the moderate House Republicans whose seats are the most vulnerable.

Senator Rand Paul's plan is to keep the ACA in place but to reduce the subsidies, which is probably the worst idea of them all as the beneficiaries of the ACA -- the poorest -- will thus see their out of pocket costs rise and does nothing to expand competition.

The one thing they could put into the AHCA, and therefore allow them to glom on every Freedom Caucus idea in order to pass the bill, is the one idea that Democrats want above all else: Public Option. You can go all the way back to the start of the healthcare reform discussions in 2009 and find the Public Option as the preferred goal of Democrats. The Public Option doesn't need to require an entirely new system to be built; in areas where there were no market plans available, people would be allowed to buy / subsidize their way into Medicare. In markets where competition is limited, you could allow for a buy-in to Medicare Advantage (where private insurers manage the plan).

Short of the Public Option, Republicans are left to fighting amongst themselves, leaving no chances of the AHCA passing in any modified form they come up with.

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ADD:

The bottom line for Republicans: Modify the ACA to make it work, not to replace it, or else you'll be replaced.

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ADD2: Cough, cough [told you so] cough, cough: "Centrists push back on new ObamaCare repeal plan"

This choice quote from Paul Ryan: "We’re at the concept stage right now."

This, coming from the guy who offered up the AHCA and tried to rush it through to a vote without CBO scoring. It seems obvious, Ryan has always been stuck in the "concept stage".