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Speaker of the House Paul D. Ryan (R-Wis.) seems to reiterate weekly that the GOP has a health-care plan to replace the Affordable Care Act. To be honest (why isn’t he?), his “A Better Way” plan provided a rough outline of health-care reform, but there are a zillion details to be determined. In addition, thanks to President Trump, the bar for a replacement has risen considerably since Ryan presented his plan. It must “have insurance for everybody,” be cheaper, be more flexible and offer better care. Oh, and Republicans promise no tax increases to pay for it. Most important, so far the Republicans have yet to converge on any single plan. And that is all before we get to the task of corralling eight Democratic senators to break a filibuster.  (Jennifer Rubin, 2/13)

The ACA is the latest in a series of laws designed to improve an employment-based health care system that has never delivered universal coverage. The characteristics of the employment-based system coupled with the intrinsic qualities of insurance make it difficult to cover everyone. Combine that with the fact that our political process relies heavily on lobbying by insurance companies, pharmaceutical firms, the American Medical Association, and others, and curing the common cold seems more likely than “fixing” health care. (Melissa Thomasson, 2/13)

Remember the good ol’ days of U.S. health care? You know, when you could be denied insurance or charged a higher premium for a pre-existing condition, or kicked off of your health insurance plan if you got very sick. Back when there was no cap on your out-of-pocket loss .... With the repeal of Obamacare/the Affordable Care Act (ACA) a foregone conclusion, that past could become our future. And without an equivalent replacement, here’s what else you could lose. (Kimberly Kennedy, 2/13)

When President Obama was in office, Republicans made a mantra of their call to “repeal and replace” his signature health care program. But now that they are actually in position to do something, they’re flummoxed. They have no plan for a replacement anywhere near as robust as Obamacare. They can't even agree on what a significant rollback would look like. So might we suggest an alternative approach? It starts by treating Obamacare the same way that a doctor would treat a patient: First, do no harm. (2/13)

Many argue we should keep the Affordable Care Act intact because it has provided health insurance for more people. But to what end? Insurance under the ACA is too expensive for most to afford. Average premiums on the law’s marketplace have soared by double digits since its implementation — including an average 25% hike in 2017. Research from health care economist Stephen Parente shows there is no end in sight for substantial increases going forward. And while the law does provide subsidies, they won’t be able to keep up with these premiums. (Tim Phillips, 2/13)

Promises made by Donald Trump and Republicans in Congress to repeal and replace the Affordable Care Act are proving to be more complicated than they sounded on the campaign trail. With reality now setting in, what's most likely to happen? I expect to see Republicans stage a dramatic early vote to repeal, with legislation that includes only very modest steps toward replacement -- and leave most of the work for later. Next, the new administration will aggressively issue waivers allowing states to experiment with different approaches, including changes to Medicaid and private insurance rules. ... In other words, the repeal vote will be just for show; the waivers will do most of the heavy lifting. (Peter R. Orszag, 2/14)

The Affordable Care Act's (also known as Obamacare) days are numbered. Last week, both the Senate and House approved a budget resolution over the objections of the chamber's Democrats ordering several congressional committees to draw up legislation repealing much of the law. ... The GOP's replacement contains a lot that Democrats should be able to support. (Sally C. PIpes, 2/14)

When state lawmakers in 2013 decided to expand Medicaid as President Obama encouraged with the Affordable Care Act, they knew their plans would require a significant tax increase. ... Since then, the enrollment and costs for the program have skyrocketed above the original estimates. By the middle of 2017, state officials estimate that 650,000 Arizonans will be enrolled in the Medicaid expansion, which is roughly double the original estimates. (Naomi Lopez Bauman and Christina Sandefur, 2/13)