House Republicans may face the possibility of having to vote again on the American Health Care Act (AHCA), which passed the House earlier this month. House Speaker Paul Ryan hasn’t yet sent the bill to the Senate because there’s a chance that parts of it may need to be redone, depending on how the Congressional Budget Office (CBO) estimates its effects. House leaders want to make sure the bill conforms with Senate rules for reconciliation, a mechanism that allows Senate Republicans to pass the bill with a simple majority. The CBO is expected to release an updated estimate next week.

The American Health Care Act (AHCA), which passed the House earlier this month, is a health care revolution. It isn’t about returning to the way things were. It’s about asking the country to imagine a system that has never existed before. Instead of offering a plan centered on Washington, D.C., the AHCA is centered on you. It empowers you and respects your relationship with your family and your doctor. It delivers to you increased access, benefits, choices and health savings. The opposition has been so intense precisely because the plan is so ambitious. One bogus argument government elites are using is the claim that thousands of Americans with pre-existing conditions will die if the AHCA becomes law. Actually, the bill includes “continuous coverage” protections for people with pre-existing conditions. For anyone with continuous coverage, pre-existing conditions do not apply.

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More than a dozen states and the District of Columbia filed a motion on Thursday to intervene in the appeal of a lawsuit targeting the ACA’s cost-sharing reduction (CSR) subsidies. The lawsuit was originally brought by the U.S. House of Representatives against the Obama administration, which the Trump administration must now deal with. The Kaiser Family Foundation has estimated that the average premiums for silver plans sold on the ACA exchanges would increase by about 19% to compensate for insurers’ lack of funding without the CSR payments. The Trump administration and the House are set to update the court on Monday on how they plan to proceed with the case.

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Those advocating for universal health coverage know very well that resources are limited, and that costs must be contained. They also understand that the burgeoning bureaucracy must be well paid. So the answer is to cut services. Some plans “incentivize” doctors to make more money by skimping on care. Others call for a “global budget”—the deliberate creation of scarcity. When the money is gone, treatment is canceled. There will be fewer beds, fewer CT scanners, fewer drugs, and fewer doctors. But all will be fair. No rationing by price, just by waiting lines, political pull—and death. There will be no medical bills to pay after a service, if you get any service. Only taxes in advance, service or no service.

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