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“Guaranteed issue” is one of my main sticking points, too.

I say fully repeal Obamacare, put the proposed Ryancare budget into Medicare/Medicare to cover those without insurance, and the rest to the private market.

the law requires us to have auto insurance, true, but doesn’t mandate from where. It’s open to the market, and folks can always find auto insurance that’s affordable.

Make it multi-state access, pass tort reform, lower medical costs, and it might be more palatable on the open market.

I’ve always been able to provide health insurance to my family, at least until Obamacare was passed. Premiums for my wife, only, (I’m on Medicare advantage) went from $200 a month, and is now $800 a month, predicted to go to $1000 a month. That’s more than our mortgage...and we can’t afford it.

Buying insurance is transferring risk. Insurance companies accept your risk in exchange for a payment based on their calculation of their exposure to that risk. Three things drive up the risk to the insurance companies, and send the premiums sky-high, and those are insuring pre-existing conditions, no cap on benefits paid, and a customer base made up primarily of people guaranteed to make multiple claims. The GOP plan does nothing - nothing at all - to address those problems. Their plan will not reduce insurance premiums, it will reduce people who can afford insurance, and it will cost almost as much as Obamacare since it offers credits to people who didn’t qualify for aid before. It is a train wreck of enormous proportions.

This is a very good article. I would only suggest that there are THREE things that guarantee the failure of ObamaCare and Ryan's bill:

1. Guaranteed issue.

2. No lifetime coverage limits.

3. Community rating.

Either one of these would cripple an insurance pool. The combination of both of them is a disaster. The Federal government is telling insurers that they have to: (1) sell health coverage to everyone without regard to their health status, (2) there's no limit to the amount of money the insurer will have to pay out over the life of the coverage, and (3) they have to charge their highest-risk customers the same as those with minimal risks.

This isn't "insurance" by any stretch.

I was watching a Facebook feed of Trump's listening session yesterday. The comments were scrolling past very quickly, but one person posted a great comment in which he/she asked why insurers aren't even given the option of offering plans that include lifetime caps, exclusions for pre-existing conditions, etc. As this person said (I'm paraphrasing here): "Mr. Trump, if you were constructing a building you'd never use a concrete supplier who won't tell you how much his materials will cost until after he delivers the concrete to your site."

As I understand it, this bill will cordon off with expensive health issues / preexisting conditions and help fund their care, Ideal or Libertarian? No, humanitarian yes. I researched the focus on Credits vs Deductions. While small business can take their health care cost as a deduction, I am not sure it is parity and now an equal playing field of which we have been asking for for years, but closer. I will send out an email to my CPA gnome for further clarification.

But Lou Dobbs last night was key to getting me in the camp for being for this bill for now.

As Lou noted, this is a Jobs Bill In the multi-dimensional insanity that is all things Obamacare, I actually let that concept slip into the back folders in my brains file cabinet. But it is very important, and frankly, a brilliant strategy for President Trump to put it first as he is all about jobs and Obamacare and things like greater than 50 equals mandatory coverage are a job killer and he wants to kick in the supercharger and nitrous oxide on creating jobs, getting this going via this imperfect bill is a must.

Besty McCaughley was on his show and noted: "“The seeds of success are in this bill in the section of this bill that pays directly for the cost of the sickest, allowing premiums to come down for the healthy, He can offer conservatives a beefed up stabilization fund and no subsidies and they will sign on and ram this thing thru”

Frankly I like Lou, but he was a bit of a bloviator last night as he really needed to let Betsy talk, not hear himself speak, but it is worth a watch, go to the link below:

https://www.youtube.com/watch?v=EjZp6kZFtWM

Finally... The article over on the American Thinker about how the Adminstrator "Shall" ( Now Tom Price vs Sebillius ) in changing the administrative landscape and possibly getting rid of "the qualified plan" one size fits all policies ( it came from "her" if my memory is correct ) is extremely powerful. Obama, Ezekel Emauel, Johathan Gruber and all the miscreants that stuck us with this beast, will be hoisted by their own petard, as we use the framework of Obamacare to make it a free-market winner instead of a road to Single Payer.

And when Dr Price rewrites these 100+ pieces, it will be a series Schadenfreude-al moments that will be so deliciously sweet, as he exercises these "shall" and "mays", I may have to go on a diet.

http://www.americanthinker.com/articles/2017/03/how_trump_can_gut_obamacare_without_congress.html

Some people don't take care of themselves. Many health conditions are self-inflicted. Many are not of course, but the way government operates now is that the innocent are punished along with the guilty.

The Federal and state governments want to allow folks like this to buy into health insurance, subsidized by the responsible, after they encounter health problems.

It is akin to purchasing fire insurance after you home burns down.

But "guaranteed issue" does not work

Two issues that the people have given their hearts to are guaranteed issue and emergency care without ability to pay.

No matter how much you twist and turn, no matter how many Rube Goldberg contraptions you put in place, no matter how much money you give to insurance companies - these two issues will destroy any true free market solution, leaving only two options: Crony capitalism for insurance companies, or nationalization.

If Congress cannot repeal EMTALA and forbid guaranteed issue, then they might as well go ahead to single payer, because that's where they will wind up.

The people will not tolerate Goldman Sachs and Bank of America owning all the hospitals and medical practices in America.