In what will be a busy week in Washington, the Republican House hopes to take another whack at ObamaCare reform, a large chunk of which is Medicaid. As if this were not enough to handle, Donald Trump promises a “big announcement” Wednesday about his tax plan, which will likely include cuts in the corporate tax rate.

Let us stipulate that Medicaid reform and corporate tax cuts are both excellent initiatives. Done properly, each would offer Americans, including those at the lower end of the income scale, a better deal than they have now. Unfortunately, pitching health-care reform as the way to help “pay for” corporate tax cuts undermines the best arguments for both.

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House GOP leaders during a members-only conference call Saturday vowed to avoid a government shutdown and said they’re closer to a deal to repeal and replace Obamacare, according to members who participated on the call.

But Speaker Paul Ryan also downplayed the possibility of a vote next week, the same sources said. The Wisconsin Republican said the chamber will vote on a conference-wide deal when GOP whips are confident they have the votes for passage — but not until then.

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Republicans have put themselves in a deep hole on ObamaCare, both politically and on the health-market merits, but maybe they’ll grab the rescue line now dangling in front of them. A potential compromise among the House’s contentious GOP factions could begin the climb out.

The chance to revive the failed repeal-and-replace bill developed this week when the House Freedom Caucus’s Mark Meadows and the centrist Tuesday Group’s Tom MacArthur struck a tentative deal. Their compromise would allow states to seek waivers to opt out of most of ObamaCare’s insurance mandates.

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As House Republicans regain momentum in their quest to replace Obamacare, GOP moderates have done something unexpected: they’ve focused not broadly on covering the uninsured, but specifically on protecting those with pre-existing conditions. There’s a reason for that, and it has to do with wildly exaggerated claims that Democrats made when they were passing the law in 2009 and 2010.

The vast majority of Americans who are uninsured aren’t without coverage because of a health problem. They’re uninsured because of an economic problem: the problem that American health care costs too much, especially for lower-middle-income Americans who earn too much to qualify for government assistance.

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Fresh hopes for resuscitating the American Health Care Act are pegged to an amendment being offered by Rep. Tom MacArthur (R-N.J.) that aims to attract enough conservatives and moderates so the measure can pass in the House. The tentative deal would allow states to apply for limited waivers from some of ObamaCare’s regulatory requirements if they establish a high risk pool to protect sicker enrollees. While some senior White House administration officials suggested that a vote will occur next week, Speaker Ryan won’t bring it up unless he knows there are enough votes for passage.

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As Members of Congress debate repealing and replacing Obamacare, they should learn from the failures of that law in crafting a better set of health care policies. One important step in that crafting is the establishment of a fairer and more reasonable set of rules for limiting health plans’ application of pre-existing condition exclusions. Policymakers should link the ban on exclusions for pre-existing conditions to a requirement of continuous coverage. Setting the right rules around the prohibition on plans applying pre-existing condition exclusions will not only stabilize insurance markets, but also provide a firmer foundation for future reforms of other aspects of health care policy.
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Many people are going without insurance under ObamaCare because they cannot afford the law’s expensive plans or aren’t aware of their options. Congress can help these Americans and many others get insurance by enrolling them in no-premium, no-obligation plans from which they could withdraw if they wanted to. Opponents will argue that automatic enrollment infringes on personal liberty. But people placed into such coverage would be free to opt out or to select an option that better suits their needs. Few people opt out of employer pensions when they are placed into them automatically, and no-premium insurance would impose no cost on the enrollees.

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It has become a tired, familiar act. Members of the House Freedom Caucus say they are the only true conservatives, while other congressional Republicans are RINOs, “Republicans in Name Only.” In the latest episode, the Freedom Caucus and its outside allies—including Heritage Action and FreedomWorks—denounced the GOP health-care bill as “ObamaCare Lite.”

These claims confused the grass roots but were simply untrue. Look at the legislation’s text, which canceled ObamaCare’s insurance exchanges, halted and reversed its Medicaid expansion, killed its taxes, and whacked its individual and employer mandates.

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You cannot do health care reform if it frightens patients who believe they will lose access to the care they are already receiving. This is why the Congressional Budget Office estimates showing tens of millions of people losing insurance as a result of what Speaker Paul Ryan and company were trying to do was so devastating. It’s that kind of reality that killed Obamacare after it became law. Whatever Congress does must ensure stability and continuity of care, especially among the most vulnerable populations during the transition period between what we have now and what comes next. Congress’ first concern when it comes to health care reform should be about producing better health outcomes.

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The Wall Street Journal makes an important point today about a subset of the Obamacare repeal fight: the lobbying to repeal the law’s taxes, like the ones on medical devices and investment income for the wealthy. It gets more complicated to get rid of them, the Journal points out, if President Trump and Congress don’t reach some kind of resolution on Trumpcare. That would shift all of the lobbying for repeal of those taxes to the tax reform fight, which is already likely to be complicated enough.

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