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The election of Donald Trump and a Republican Congress provides an opportunity: We can immediately halt the leftward drift of American social policy, while renewing prosperity through market-based, state-driven solutions that empower people instead of bureaucrats. This is the stuff of conservative dreams. But it will become reality only if Republicans keep the promises we have made. (House Speaker Paul Ryan, 3/22)

On Thursday, House Republicans and President Trump face their first big test since the election that put the GOP in complete control of the federal government. The House will be voting on a bill to repeal much of the healthcare reform law Democrats pushed through Congress in 2010, replacing it with a skinflint alternative that’s projected to leave 24 million more people uninsured in a decade. It’s a horrible proposal, and the main hope for the country is that dissident Republicans will kill it because it’s not awful enough for them. (3/22)

Someone with bipolar disease might have no way to pay for a psychiatrist to monitor his condition. A couple might have to fork over $15,000 to have a baby. These are just two of the possible consequences of a deal now under discussion in the U.S. House as Republican leaders working with the Trump administration try furiously to round up the votes they need to win approval for their bill to repeal the Affordable Care Act. (Jonathan Cohn, 3/23)

David Anderson of Duke points us to a recent paper by Milliman, the preeminent cost-analysis firm in healthcare, about how much these essential benefits actually add to the cost of health insurance and the consequences of removing the mandates. The paper finds that eliminating the most vulnerable mandates, such as maternity care, will reduce average premiums somewhat but drive costs for people who need those services sky-high and transfer much of the cost to other public programs. The net gain for society is almost invisible. To put it another way, the savings are an illusion. In fact, eliminating the mandates might even cost the federal government more money. (Michael Hiltzik, 3/22)

During the presidential campaign, Donald Trump repeatedly promised to repeal Obamacare and replace it with "something terrific." There are many words for the House Republicans' latest health care plan, embraced by Trump and scheduled for a vote on Thursday. "Terrific" is not among them. (3/22)

For decades, the National Federation of Independent Business (NFIB) has asked small business owners to rank the top challenges. For more than 30 years, their No. 1 problem has been the high cost of health care. Obamacare turned this concern into a crisis for small businesses. It fails to deliver on its main promise to make health care more affordable. For small business owners, the law has made insurance more complicated, more restrictive and more expensive. (Juanita Duggan, 3/22)

The Affordable Care Act, or Obamacare, was perfectly misnamed. It failed entirely to make insurance affordable for small business owners and millions of other Americans. On the contrary, Obamacare has driven up costs for small business owners, who are hit with higher payroll taxes, taxes on health insurance products, the employer and individual mandate penalties, and the so-called Cadillac tax on expensive health insurance plans. (Tom Scott, 3/23)

Eight years ago, small-business owners were given many promises about the Affordable Care Act: that it would drive down costs; that small-business owners could take advantage of new tax credits; and that new exchanges would give owners and employees new options to purchase coverage. By the time President Obama signed the bill, it was abundantly clear that the law would do more to harm small businesses than help them. (Nicole Riley, 3/22)

There’s a lot not to like about America’s fragmented, inefficient health-insurance system. If you had to identify its fundamental flaw, however, it would probably be this: People need medical care whether they have a job or not, yet the U.S. system is built on a linkage between health insurance and employment. (Charles Lane, 3/22)

As the House of Representatives prepares to vote Thursday to repeal the Affordable Care Act, there’s a new estimate of the cost of one of its hidden provisions, a rollback of rules designed to restrain executive pay at health insurance companies. Here’s the bottom line: Rolling back the provision will result in an even bigger ripoff of the American taxpayer than previously calculated. (Michael Hiltzik, 3/22)

“Mend it, don’t end it” was President Bill Clinton’s rhetorical straddle regarding affirmative action. Republican efforts to “repeal and replace” the Affordable Care Act (Obamacare) look increasingly like “mend it, don’t end it.” (George F. Will, 3/22)

Under Barack Obama, the Affordable Care Act adapted the Massachusetts model, and it now covers 22 million formerly uninsured Americans. But congressional Republicans are attacking national health reform and are seeking to destroy the ACA, not reform it. If they succeed, a moderate Republican governor and a liberal state legislature will soon face the choice of undoing coverage or once again leading the country on health reform. (Jon Kingsdale, 3/22)

Romneycare, as it came to be known, provided the conceptual foundation for Obamacare. And President Trump’s commitment to repealing President Obama’s signature accomplishment — the Affordable Care Act — also puts Romney’s signature accomplishment at great risk. Governor Charlie Baker is warning that the Republican plan to repeal the ACA would reduce federal funding to Massachusetts by as much as $1.1 billion to $1.9 billion. (Joan Vennochi, 3/22)

Yesterday, the GOP released amendments to its health care bill, and in response to the shortcomings highlighted by the CBO report, the changes to the bill would add more tax breaks for the rich and further slash Medicaid funding. Yup, you read that right. But as counterintuitive as it may seem, there is a method to the GOP's madness, as yesterday's changes 1) make it more likely the bill will pass the House and potentially, the Senate, and 2) it brings within reach the bigger prize being sought by Republican leaders: tax reform. (Tony Nitti, 3/22)

Today, the House Republicans are voting on what I consider their awful health-care replacement plan for the Affordable Care Act. I’ve already explained my negativity about the highly regressive American Health Care Act. If you think the problem is that the wealthy don’t have enough after-tax income and the poor have too much health care, this is the plan for you. ... Why are Republicans making their lives harder by starting with a complicated health-care replacement plan, one that itself conflates health policy with tax cuts? The answer, as tax analyst Chye Ching Huang points out in a new piece, is that “passing the health package first facilitates deeper tax cuts for the wealthy and corporations in subsequent tax legislation.” (Jared Bernstein, 3/22)

Under the AHCA, each state would instead be given a capped allowance, and that amount would rise each year with medical inflation. It would not account for any unforeseen expenses. Over time, as the rise in per-patient costs outstripped the rise in general medical inflation -- as the Congressional Budget Office assumes they will -- the federal share of funding would decline. Hundreds of billions in costs would be shifted from the federal government to the states. In response, states would need to either raise their own spending on Medicaid -- or more likely, offer fewer services to fewer people. (3/22)

As discussions continue to swirl around the future of our nation’s health-care system and the American Health Care Act (AHCA), it’s vital we do not forget about the well-being of those who represent the future of our nation — our children. Medicaid is the most critical health care program for our country’s youth, and we at Seattle Children’s are deeply alarmed about the proposed changes to Medicaid that would disproportionately impact our children. (Jeff Sperring, 3/22)

Paul Ryan’s plan to replace Obamacare is headed to the House floor on Thursday for a vote that, even now, could go either way. That may sound surprising since Republicans have a sizable majority in the House. But if you’ve been following the debate over their replacement plan, the American Health Care Act, you know that, as harsh as it is, it’s not draconian enough for some members of Speaker Ryan’s party. In an attempt to win over those lawmakers, the Republican leadership has offered ideas to restrict coverage even further. One of the worst is a Medicaid work requirement. (Jared Bernstein and Ben Spielberg, 3/22)

There is no question that former President Barack Obama’s signature legislation – Obamacare – has been a massive failure with deadly consequences. The law, which requires Americans to buy insurance from private companies, also manages to increase premiums drastically. ... Democrats have been stunningly comfortable playing politics with the life and death consequences of health insurance coverage. ... Now is the chance to repeal Obamacare, and it is not a minute too soon. (Ken Blackwell, 3/22)

No fiscal conservatives make health care policy or legislation. Nothing about today’s health care system is fiscally conservative. Insurance is a “needless markup” in the healthcare industry. The management and control of the medical/industrial/Congressional complex must be returned to physicians. Doctors receive only 10 percent of the monies that flow through this system, so they are not the cost problem. (James Baker, 3/22)

House Republicans plan to vote Thursday on an Obamacare replacement plan, called the American Health Care Act. On Tuesday, Post Opinions writer Jennifer Rubin and Alice Stewart, former spokeswoman for Sen. Ted Cruz’s 2016 presidential campaign, discussed how passage of the bill would affect the GOP’s political fortunes. The email discussion was moderated by Post Opinions digital editor James Downie and has been edited for style and clarity. (3/22)

A timely question from Cherlyn in light of Thursday’s expected House vote on the Republican plan to repeal and replace the Affordable Care Act. She asks: “Does the president get special healthcare?” The answer: Bigly. (David Lazarus, 3/22)