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Ronald Reagan wanted to shrink the government and Bill Clinton said the era of big government was over. But their talk was premature. There was still one great task for the world’s wealthiest, most powerful nation to accomplish, and that was to make sure all Americans could get health care. The Affordable Care Act has put us closer to that goal than we’ve ever been, yet President Trump and many in the Republican Party appear determined to reverse these gains. Why? It sure seems like it's because they’re wedded to ideological purity, the fantasy of a skeletal government, and a cruel political tactic (rip out “Obamacare” root and branch) that has outlived its purpose. (Jill Lawrence, 3/21)

The House health-care bill is gaining momentum, and on Monday night the GOP posted amendments meant to add fence-sitters to the coalition. Don’t discount the stakes: The vote scheduled for Thursday is a linchpin moment for this Congress, and a test of whether the GOP can deliver on its commitment to voters. (3/21)

Although this week got off to a crackling start with high-profile hearings on Judge Neil Gorsuch’s Supreme Court nomination and potential Russian interference in the 2016 presidential election, the event with the largest consequences for the Trump administration and the Republican congressional majority occurs on Thursday. That’s when the full House takes up legislation to repeal and replace the Affordable Care Act. (William A. Galston, 3/21)

Next comes the House Republican plan, which Trump enthusiastically supports, to repeal the Affordable Care Act and replace it with a system that will cause 14 million Americans to lose their health insurance next year, and 24 million by 2026, according to the Congressional Budget Office. How does Trump justify this human hardship? The plan barely makes a dent in the national debt. It cuts the federal budget deficit by only $337 billion over the next 10 years — a small fraction of the national debt. (Robert Reich, 3/21)

The poor can be safely ignored largely because they allow themselves to be split along tribal lines of creed and color and kept at one another’s throats. Then they are nickled and dimed and robbed damn near blind by monied interests and their political henchmen. The new health care bill is a prime example. (Leonard Pitts, 3/22)

Exactly seven years ago Thursday, after decades of effort to make health care available to all Americans, the Affordable Care Act was signed into law. Now, in what House Speaker Paul Ryan calls “an act of mercy,” the House is planning an anniversary vote to repeal it and, in addition, to radically alter the Medicaid program that has been a staple of the national safety net since the 1960s. For members of Congress, this is one of the most consequential votes they might ever face. (Andy Slavitt, 3/22)

The House GOP leadership has aligned itself so closely with President Trump on healthcare, it’s borrowing his signature sales tactic as it tries to ram through a bill this week to “repeal and replace” Obamacare: the bold but empty promise. Specifically, it’s promising House Republicans a solution to their concerns about drastically increasing insurance premiums for millions of older Americans, but leaving the Senate to figure out how to deliver it. (Jon Healey, 3/21)

No great political acumen or psychology degree is necessary to conclude that President Trump is highly susceptible to flattery. It’s little wonder then that House Speaker Paul D. Ryan (R-Wis.), desperate to pass GOP health-care reform or at least not be blamed if it fails, keeps talking about what a terrific “closer” Trump is. (Jennifer Rubin, 3/21)

What do we lose when social insurance unravels? It is startling to realize just how much the social safety net expanded during Barack Obama’s presidency. In 2016, means-tested entitlements like Medicaid and food stamps absorbed 3.8 percent of the nation’s gross domestic product, almost a full percentage point more than in 2008. (Eduardo Porter, 3/21)

The Congressional Budget Office recently said that around 24 million fewer Americans would have health insurance in 2026 under the Republican repeal plan than if the current law stayed in place. That loss was bigger than most experts anticipated, and led to a round of predictable laments from congressional Democrats — and less predictable ones from Republican senators, including Bill Cassidy of Louisiana and John Thune of South Dakota, who told reporters that the bill needed to be “more helpful” to low-income people who wanted insurance. (Margot Sanger-Katz, 3/21)

Health care is complicated, as the president has discovered. But here is one thing that is not so complicated: if people have modest means and limited tax credits, and coverage is expensive, they will mostly buy health plans with lower premiums — and high deductibles. This is what is likely to happen under the GOP health care bill, the American Health Care Act. Only people who need more health care will stretch for more generous coverage. If that happens, those health plans will draw too many sick people, causing insurance companies to stop offering them for fear of losing money. That would leave mostly the low-premium, high-deductible plans. (Drew Altman, 3/22)

Republican leaders in the House have been huddling over the last few days in a frantic search for enough votes to win passage of their proposed revision of Obamacare, in the process making an already flawed bill even worse. One measure of their desperation was a cynical last-minute provision that would shift Medicaid costs from New York’s rural and suburban counties to the state government, pleasing upstate Republicans who represent those counties but reducing coverage provided by the state. (3/21)

Per capita caps on Medicaid beneficiaries? Block-granting Medicaid? Do these wonky and innocuous-sounding proposals really make any difference? They do. The American Health Care Act – the Republicans replacement for Obamacare – is scheduled for a vote this week in the U.S. House. You will hear much discussion about the individual insurance marketplace, tax credits, and promotion of health savings accounts. However, the changes in Medicaid are the most profound in the AHCA. (Jessica Schorr Saxe, 3/21)

"America spends more on health care than other rich nations, but has lower life expectancy." If I had a nickel for every time I have been informed this by an email, seen it in a headline, heard it in conversation, or watched it scroll across my social media feed, I would be able to personally fund a single-payer health-care system. (Megan McArdle, 3/21)