Paul Ryan Outlines Why It Takes Three Steps For ObamaCare Repeal and Replacement…

Good news, they’re listening to you.  No other approach to repealing ObamaCare is possible.  It’s not ideological, it is simply reality.  The backstory on our prior explanations are HERE and expanded HERE.

After listening to conservative groups at a White House meeting yesterday, it became obvious to POTUS  those group leaders/members did not understand WHY no other approach to repeal is possible.   POTUS asked Speaker Ryan to put this together and deliver it today:


Most of you already know this outline because you’ve understood the bigger picture.  Hopefully this message will reach the 99% who don’t understand that “reconciliation” doesn’t allow for substantive structural add-ons to ObamaCare, until step #3.  Again, HERE and HERE.

FACT: ObamaCare was passed, using the original legislative vehicle, at 1:38am on 12/24/09 with 60 votes in the Senate (see below). The House then approved that Senate Bill without changes; and in February 2010 created a secondary bill which created the opportunity for the Senate to modify ObamaCare using “reconciliation” for a lower vote threshold of 51 votes.

Literally under the cloak of darkness Democrats rammed their holy grail of a socialist construct down the throat of every American. We no longer needed to imagine having usurping representation that did not represent the will of the people – we saw it.

[Understand the full construct by reading HERE] If you do not understand how legislation is created; if you do not understand the difference between the Senate and House; if you do not understand the way ObamaCare was created, you really need to read this first.

A clean repeal bill, meaning a law to repeal the entire ObamaCare construct only, would require another 60 vote hurdle in the Senate.

Republicans, while in the majority, only control 52 seats. Without 8 Democrats voting to approve a “repeal bill”, any House (Or Senate) bill that repeals ObamaCare cannot pass the Senate.

This is why Mark Levin is a con-man; selling snake oil as outrage to keep a listening audience angry, yet clueless and hopeless. That’s what I don’t like.

A complete repeal of ObamaCare is currently impossible. The House Freedom Caucus can push all the repeal bills they want, but they cannot get a clean repeal bill through the Senate because they cannot get the 60 votes needed. Period.

Additionally, despite claims to the contrary, the GOP has never passed an Obamacare “repeal bill”. Ever. What they did previously pass was a “defund bill” using the lower vote reconciliation process. President Obama vetoed it. A defunding bill was possible because of the financial pathway which falls under reconciliation rules. The current Ryan bill is almost identical to the 2016 defunding bill everyone is mistakenly calling a prior “repeal bill”.

A complete independent repeal bill of ObamaCare is currently impossible.

The only bill that can pass the Senate is a bill that can utilize the process of reconciliation, which has a lower vote threshold of 51 votes. A reconciliation bill is a budgetary bill designed around the financial drivers of ObamaCare. This is what HHS Secretary Tom Price, Speaker Ryan and President Trump are attempting to do.

A reconciliation bill cannot add substantively to the existing law. It can only modify the financial structures and retain the same 10-year budgetary impact. If you want substantive adds or removals of the law, beyond the financial structure, it is no longer a reconciliation bill.

If it is no longer a reconciliation bill, it requires 60 votes. 52 Republicans + 8 democrats. Democrats have already stated they will not support any substantive changes that undermine the key ObamaCare provisions.

Accepting the Democrats will not vote to repeal their signature law… The only way to fully repeal ObamaCare as an independent bill, and overcome the 60 vote threshold, would be to eliminate the filibuster rule (3/5ths vote threshold or 60 votes) in the Senate and drop the vote threshold to 51 votes, a simple majority, for all legislation.

However, if the Senate was to drop to a simple majority vote for all legislation the entire premise of the upper chamber minority party protection is gone. Forever.

There would no longer be any difference in the House or Senate for vote thresholds, and as a consequence there would no longer be any legislative protections for the minority positions. What this means, in combination with the previous passage of the 17th amendment, is the constitutional republican framework is gone.

The constitutional republic being now replaced with a pure majority rule democracy. The founding fathers regarded majority rule democracy less desirable than a monarchy because a simple majority means mob rule. At least in a monarchy you might get a wise king once-in-a-while. In a mob rule democracy emotion drives everything. You go from being a nation of laws, to a nation of laws of the moment based on emotion.

Eliminating the 3/5th’s vote threshold in the Senate would also mean there’s no real reason to keep the Senate around when in the hands of the same party as the House. The House can pass 50% +1 bills all by themselves. The Senate, the place where grand deliberations required the protection and consideration of the minority position, would be unnecessary.

All structural protections for the minority views would be dispatched. Forever.

Without the filibuster rule, and with the Senate having only a simple majority rule for passage, there would no longer exist an internal legislative check for any minority party to protect themselves from the laws created by a greater mob.

The ruling party would be in power as if they held a Senate super majority at all times. As a consequence, with minority protection eliminated, legislation impacting Texas (or any state) is then ruled by the legislative federal dictates from those representing New York and California (or any other aggregate). There is no legislative pressure to listen to, or consider, the position of the minority party.

You would think that constitutional conservatives would be necessarily predisposed against the dropping of a constitutional republic in favor of a pure democracy (mob rule).

However, within this current argument over the Price/Ryan approach to replacing ObamaCare you find exactly that. Emotional conservatives, and crony-constitutional conservatives like Mark Levin, arguing against the current House bill leaving only the option to drop the Senate filibuster on legislation and pass laws with a simple majority.

So you tell me, is this really a constitutional-conservative approach?

Really and honestly?

Two more points on this issue:

Point One  –  OK, lets say your Senator would agree to change the Senate Rules and eliminate the filibuster, allowing legislation to pass with 51 votes (there are about 28 +/- of them who would).   To change the rules you need a majority of Senators to agree to do it.  THERE ARE NOT 51 Senators willing to change the Senate rules to pass legislation.

Point Two – There are not even 51 Senators who would agree to repeal ObamaCare.   Forget the 60 vote threshold, for a moment.  Even if you didn’t have the filibuster rule, there are not currently 51 Republican Senators willing to repeal ObamaCare without an existing replacement available.

Of course there are problems with the current Ryan bill. It can only approach ObamaCare from the reconciliation aspect. It cannot go into the substantive changes, adds or modifications because that would require the 60 vote Senate. Again, See Here.

Additionally, despite claims to the contrary, the GOP has never passed an Obamacare “repeal bill”. Ever. What they did previously pass was a “defund bill” using the lower vote reconciliation process. President Obama vetoed it. A defunding bill was possible because of the financial pathway which falls under reconciliation rules.

Yes, the GOP could defund it 100% again, but then what?… It still exists as a program, and Trump would have to fund the existing (non repealed law) from somewhere. So you’re back to the 60 votes for a replacement again or eliminate the filibuster and go with the 51-vote threshold for all future legislation.

Back to current ObamaCare’s replacement – there are three options if we are going to retain a constitutional republic, and pass laws with the 60 vote senate filibuster threshold:

Option #1 – We can do nothing – and allow ObamaCare to collapse on it’s own. In the interim many Americans will be negatively impacted and the more vulnerable and needy will be worst hurt. Premiums and co-pays continue to skyrocket while the insurance system tries to preserve itself.

Option #2 – We can Repeal and Replace using the three-phase approach being proposed by Tom Price, Paul Ryan and Donald Trump:

  • 1. Pass reconciliation legislation targeting the financial mechanisms.
  • 2. HHS rewrites rules.
  • 3. New laws are proposed by a full congress to adjust ObamaCare and add to it, and laws debated/passed.

Yes, this has it’s risks. No guarantee you’ll get the cookie you want in phase three because any structural amendment, any add-on, will take 60 Senate votes to pass.

Option #3 – Pass futile structural repeal bills in the House, and watch them pile up in the Senate without the ability to pass and earn 60 votes. Shout and holler some more, gnash some teeth, and wait for 2018 when Republicans will attempt to win the other 8 seats needed. Again, even less of a guarantee on the outcome.

Those are our options.

Choose wisely.

This entry was posted in Big Government, Big Stupid Government, Decepticons, media bias, Mitch McConnell, Obamacare, Paul Ryan, President Trump, Uncategorized. Bookmark the permalink.

611 Responses to Paul Ryan Outlines Why It Takes Three Steps For ObamaCare Repeal and Replacement…

  1. silverlakela says:

    OFF TOPIC…..
    Malik Obama shares photo of brother Barack’s Kenya ‘certificate of birth’


    • Alexsandra says:

      Ah, but if it were so. But I think that is FAKE news. There was a video in the comments on gatewaypundit that shows it by some anonymous guy looking at it on a clipboard and the whole video is highly suspect. I think it is likely a silly hoax.


    • Mike says:

      Wow just wow! From his brother no less. It has the verified blue checkmark, too.

      Liked by 1 person

      • Peter Barry says:

        Don’t forget OBOZO’s KENYAN grandmother is also on record as saying she was at the BEDSIDE in KENYA when he was born.


        • Mike says:

          I’m hoping BirthCertificateGate and CollegeTranscriptsGate bust wide open at some point in time.

          Liked by 1 person

        • Gail says:

          Michelle said it several times as well.


        • 4bleu says:

          If I paid her enough, she’d swear she was at my bedside on my birth too. And it’d take about 15 minutes off the plane to be directed to the street where the document ‘artisans’ fabricate whatever certificate you need to get ahead in life.
          Very good quality. Nzuri sana.


      • majorstar says:

        It’s very fake. There’s a critique of it from 2009 with about 6 or 7 bullet points of glaring bogus information. The obvious one is that the American date system is used rather than the British. Stand down. Obama’s still probably a Kenyan, but this one isn’t real (the same critique reported that the Kenyan gov’t went to the hospital and seized all BCs between 1960 and 1963 after Obama was elected).

        Liked by 1 person

  2. Timmy-the-Ute says:

    Does Ryancare include the mandates? Do you have to have health insurance? You should be able to op out. That is the only way to force competition.

    I know some will say that you have to have car insurance. First that is a state law. And second you don’t have to have car insurance because you don’t have to own a car. You can solve your travel needs with a bike, bus or even walk.

    Under Obamacare you have to treat your health needs with a health insurance approved by the Federal Government.

    Liked by 3 people

    • You don’t have to have health insurance, but in Ryan’s plan if you do have health insurance and then you cancel then you have to pay 30% of the value of your plan for some time. (cue to 4:12 where Styx discusses this)

      KEEP IN MIND TRUMP SAID “It’s malleable, it’s not in its final form.” Don’t worry, Trump is not going to give us some crappy deal. We’re far from over. As Sundance said, it is in steps.

      Liked by 3 people

      • Aparition42 says:

        Exactly. PDJT is the negotiator in chief. Negotiations are ongoing. In the meantime, he’s letting Ryan put his fingerprints all over this. The people claiming that Trump has endorsed it are misreading the message. So far Trump has said that his promises WILL be kept, albeit not in this bill. He has said that the FINAL PICTURE will be beautiful, that’s not this bill either. He’s also sat down with several conservative groups and addressed their concerns, and even had a parlay with Elijah Cummings on prescription drug prices and left the Senator so dazed he actually publicly stated that Black Communities are doing fine and Trump shouldn’t worry about them so much.

        I’ll save the wailing and gnashing of teeth for a later date after the fog of war has cleared and Our Chief Executive has finished making his move.

        Liked by 1 person

      • Jedi9 says:

        It is Ryan’s plan, plain and simple, and by keeping the individual mandate I still think it is a load of crap! I am not falling for this, and Rand Paul is right in calling this what it is! “Obamacare 2.0 !The only way to fix this mess is a complete repeal!


    • Timmy-the-Ute says:

      Hope they exempt veterans like Obamacare did.


  3. Ficklefinger says:

    ObamaCare is dying its own death. Why would the Republicans want to administer CPR on something owned by Democrats? ObamaCare cannot be sustained. What is the hurry for Republicans to put the noose around their own necks? When the system fails, the line will be “It would have been fine if the Republicans hadn’t touched it?”

    Liked by 3 people

    • All good points. President Trump and even when he was candidate Trump during the election has answered that many times. He has said what you said. What he has said for a long time agrees with what you said. But he said in the meantime while Obamacare is dying that doesn’t want the American people to be without coverage in the meantime. He mentioned “compassion” for those that if he were to just let it die would be in dire straights.

      Liked by 1 person

    • Aparition42 says:

      The Problem is, now that the Republicans own congress and lay claim to the White House via President Trump, they’ll on all the suffering from letting the ACA fail. Now is not the time for a grand “I told you so”. The swing voters on the ground don’t actually give a crap about whose fault it is, they just want to know who’s going to fix it, and if it isn’t readily apparent that the Republicans will, then the Democrats will have a very powerful tool to swing seats in 2018. If Republicans do nothing it will be, “They said they were going to make everything Great again and look how much worse it is now.”

      PDJT is not a “real Republican”. He’s not a “True Conservative” either. He is an American Patriot who actually cares about the voters. He’s not going to stand around doing nothing because of “principles”, and he’s not going to let the fact that he can’t immediately get everything he wants stop him from getting anything at all. He’s going to get as much as he can every time he can and keep coming back for more. There’s seven years and ten months of that left to go.

      Liked by 2 people

  4. Don’t worry. Remember Trump said “It’s malleable, it’s not in its final form.” For those who are worried, have a listen to this video, at least the first 5 minutes.

    “Trump Thankfully Declares Hideous GOP Healthcare “Fix” As Malleable” (Length 12:08 min)

    Styx, a libertarian millennial puts Ryan’s healthcare in perspective and praises President Trump who said “It’s malleable, it’s not in its final form, {{snicker snicker} undercutting Ryan. Ryan must have cried after that because he wanted his neocon bill, his so-called reform bill to go through.”

    Styx in the true business spirit of Trump says “If you go after lawsuits, drug patents, and interstate competition, you can so vastly lower the price of healthcare in the country that you don’t almost need to supply healthcare insurance to the middle class because it will be well within their ability to pay for things out of pocket without having to have health insurance.”

    Liked by 1 person

  5. dogsmaw says:

    Okay listen up you little peeps, the older people here have no choice…so what makes you think you are special. After working all their lives raising family, buying their home, saving for retirement, you reach social security age and required(need I repeat required) to enroll in medicare…so then if you choose not to pay out for Part B, a penalty is assessed if you desire more coverage at a later date.

    Now you are being asked to be more responsible for your health coverage and its not being forced down your throat…enuff said.

    Liked by 4 people


    Let Ryan knock himself out BUILDING THE CANVAS.

    Trump will paint the picture!

    “It’s malleable, it’s not in its final form.” –President Trump on the new healthcare system

    Liked by 5 people

  7. sickconservative says:

    Most of you already know this outline because you’ve understood the bigger picture. Hopefully this message will reach the 99% who don’t understand that “reconciliation” doesn’t allow for substantive structural add-ons to ObamaCare, until step #3. Again, HERE and HERE.
    But then again you have to realize that step 2 and 3 will never happen!
    When will we fight like D’s?
    With current leadership it won’t happen as they agree with the growth of the Federal Gov’t control.

    Liked by 2 people

  8. milo minderbinder says:


    Liked by 1 person

    • Aparition42 says:

      It’s not a real repeal. It was a showboating bill that they only voted on in the House when the knew it wouldn’t pass anyway. All it does is defund the law without repealing it. THEN if PDJT doesn’t continue to enforce the law and drive up the deficit to do so, the Dems would actually have cause to say that he’s not obeying the law.

      Liked by 1 person

  9. milo minderbinder says:


    Liked by 3 people

  10. gamecock123 says:

    Whoa. Wait a minute,.. dont be so quick to throw Rand and the Freedom caucus under the bus. The most of them are doing what their constituents sent them to do. They promised repeal and dont trust Ryan. Can you blame them? We got to make a better sale, Paul Ryan aint cutting it. Sorry but he isnt, just look on social media. Hopefully Pence or Tom Price can. I havent heard Price, maybe he should step up, all I know is Ryan isnt the messenger for this, he has burned too many bridges, including being the Head NeverTrumper.

    Liked by 3 people

  11. Ok finally a topic I understand and have an interest in!!! The explanation SD has given above is correct regarding passing legislation. The purpose of my post is to give my opinions on some specific parts of the proposed legislation. Before getting to that a bit about my background. I have 25+ years in the healthcare industry and another 5+ years in the Pharma industry. My perspectives come from my work experience and dealing with my own health issues and having recently lost both of my parents (father 9.17 and mother 1.24) to cancer. My experience in the healthcare industry started many moons ago (haha) building the systems that actually process the medical claims. For those of you that have healthcare coverage pull out an EOB. I helped design and implement the main system that processes the claims, generates the EOBs and pays the physicians and hospitals. I got my start working at the largest healthcare payer in the US. My experience led me to working within about 75% of the operations and IT departments and at one point I was responsible for all legal/regulatory implementations across multiple states in which we did business. I then moved on to working in the largest healthcare IT firm in the country. Over 80% of the healthplans use the systems I helped to build and implement in US payers you have all heard of (UHC, Cigna, Humana, numerous Blues plans etc…). I was also responsible for overseeing onshore and offshore code development done in India (H1-B’s anyone—oh the stories I have). Project budgets exceeded 500 million dollars so these were large scale high risk projects. I also have experience working within medical physician groups and hospitals. I was also responsible for monitoring and determining how to implement the ACA from our software perspective before I left that job and made a move into the Pharma industry working with major companies such as Eli Lilly, GSK etc……Thankfully I am no longer in the healthcare industry (and that is another story). So my opinions and ideas come from my background and experience.

    One thing I will say and I think President Trump is just now starting to realize this after meeting with some of the payer CEO’s (a couple of which I know) is that healthcare is VERY complex. And that my friends is a big part of the problem. The next part of the problem is our elected officials truly don’t understand all of the issues and how we can (or cannot in some cases) fix them. Each person has a different perspective and knowledge and personal interests and often competing interests (Mr. Price would be a good example–his interests are the physicians).

    With that said this will be my first posting on this whole healthcare debacle (sad, but that is what it is). Sadly due to my moms death 3K miles away I am short on time this evening so I will pick a single topic to write about. This topic is selling insurance across state lines.

    Before getting into this something each person trying to wade through all of this insurance mumbo jumbo should understand is healthcare companies divide their business into what is called LOB (lines of business). Not all healthplans sell all these types of lines. In short these are as follows:
    1. Individual (prior to ACA this required underwriting and medical information and many pre-existing conditions were excluded)
    2. Small Groups (employers with 3 to 49 employees)
    3. Mid-size Groups (employers with 50-499 employees)
    4. Large Groups (employers with 500+ employees)
    5. National Accounts (employers with 500+ employees across multiple states)
    6. Employer-Sponsored (administrative services only-these employers self insure–this is a very interesting topic and I may just write about this later). These employers cover an estimated 60% of Americans insurance. Typically, these plans are self-insured, with the employer shouldering the risk and the insurance company providing mostly administrative services. These types of plans/groups are subject to federal law and exempt from state regulation.
    7. Retiree plans
    8. OPM (this is our gov’t employees)
    9. Medicaid
    10. Medicare

    In today’s market companies already sell across state lines. Meaning the company CHOOSES to sell certain LOB’s in specific states because the actuaries have determined it is a profitable area. The key thing to understand here is the health plan CHOOSES to sell in certain states and markets and they do so for PROFIT! Even if all state healthcare related regulations were wiped off the face of the planet a company may still refuse to sell across state lines because it is not profitable (provider costs are high, population is not health etc…..)

    In order to sell health plans in a state the health insurance company has to do the following:

    1. First they must have established provider and hospital networks where they want to do business. Establishing networks is very costly and time consuming and is an annual ongoing process for a healthplan and it requires appropriate staffing. Also note the laws of each state in which a plan wants to do business are different. It would take considerable time, monies and staffing for a health insurance company to enter a new state. The workaround is to rent provider networks from other healthcare plans but there are no cost savings in this so this is a low probability (it has been done before, but for other reasons).

    2. They must have a product(s) to sell that is approved by the state. Just because a PPO plan with say a 5K deductible was approved in Kansas does not mean it is or will be legal and approved to sell in say California. So the health insurance company has to have regulatory and product staff that knows the laws of the state in which they want to do business and how to file the plans (again this is an annual ongoing process). Something to note that for California there are 2 different state entities that regulate plans so filings for this state as well as ongoing handling of consumer issues is cumbersome (no surprise).

    3. They have to change/modify their systems to handle processing of the medical information (in general terms this is operations). This cost $$$$ and the people that do this (as I used to do) all make over 6 figures. It can be very complex and mistakes can result in high dollar losses as well as members being denied benefits. This is an expertise that takes years to learn (I have former coworkers that now do this as independent consultants and their rates are 175.00 per hour if not more in some cases). So what I am saying here is there is an operational cost to doing business in a new state as well as costs when laws are changed.

    So in summary health plans today can (and do) sell business across state lines. What new legislation would need to do is to eliminate individual states’ abilities to regulate their own health insurance markets. This would directly contradict another goal appearing in Trump’s policy statement (paragraph one), which advocates returning “the historic role in regulating health insurance to the States.” See the challenge here?

    So let us pretend that tomorrow all state healthcare regulations were gone. Poof! There would remain other barriers/issues for health insurance companies such as the difficulty of building a network, attracting enough customers (providers look at a health plans customer base as part of the contract negotiations process) to create a large enough risk pool. Costs of additional staffing etc…. these factors may make it unappealing to insurers to pursue new business in other states. Managing the insured risk pool and maintaining plans and networks is how health insurance companies control their costs.

    And last but not least…………………blue cross and blue shield plans. Without getting into great detail……….they have territory and licensing agreements. Legislation to sell across state lines would also have to have a way to dissolve these agreements.

    I hope this helps clarify selling across state lines……it is already done (when an insurer chooses to do so). To completely open this up and make it easier for plans only solves part of the problem.

    Liked by 5 people

    • Finalage says:

      I think the point of allowing CONSUMERS to buy across state lines (including businesses) is to get around state regulations. If I am in CA, I am no longer restricted to the regulatory scheme of CA. I can buy across state lines and find a plan that works for me. Insurers therefore can create optimal plans based on the least regulated states for everyone, instead of spending money trying to comply with 50 different state regulations. States may decide to tax outside plans but those states that do so risk the ire of their voters.

      Liked by 1 person

    • maiingankwe says:

      Thank you for taking the time to explain some of this. I know I find it very confusing and seem to go in circles trying to figure parts out. It makes me feel really dumb at times.

      Do you have any advice for President Trump on making any of this work? If so, would you be willing to share it on their web page? I would add your background of course. It’s quite impressive to say the least. I think a person’s brain has to be wired a certain way in order to understand all of the complexities of health care and setting it up. I know I would be one of the last people called for it, and I’m more than fine with that. However, I would like to start understanding as this as it goes along. I hope you will continue explaining things for us.

      I am very sorry about your parents and the closeness in their passings. My prayers have been sent your way. My adopted parents passed four months apart last year, my Mom passed away in 2013 and my Father just passed away the Sunday/Monday before last. I lived 4,000 miles away from all of them, so it’s been a lot of traveling too. I understand a small bit of what you are going through since we are all affected differently and were raised differently as well. It’s not easy, as a matter of fact, it is really really hard. They all say it gets easier with time, but I haven’t gotten there yet with any of them. Who knows, it just may be right around the corner, I just hope you reach that part far quicker than I am doing.

      My prayers are with you. Be well,


    • M. Scott faris says:

      I like your explanation. My comment would be “It doesn’t have to be this way.” Medical insurance companies have grown into huge bureaucracies with their own complex language (medical coding). I worked in a large retail pharmacy for four years and had to deal with insurance companies every day. I saw how the medical coding was intertwined with government-sponsored health care (Medicare/Medicaid). For instance, it the coding on a RX wasn’t correct, Medicare Part B wouldn’t pay the claim. Dealing with insurance company bureaucracy also increased staffing at hospitals and doctor’s offices.

      I understand the complexity of the modern American healthcare system, but, as stated above, it doesn’t have to be this way. We may need to tear the whole thing down and start over again. The insurance companies would scream bloody murder, but it would be good for the people, I believe. Obamacare made things much worse, not better at all, but what the House is working on now doesn’t really address the main problems.

      When I was growing up, only government employees and maybe union members had guaranteed health insurance. My parents paid out of pocket for everything. It wasn’t until I was in high school (early 1970s) that my parents had health insurance. Now it has become an entitlement and mandated like auto insurance.


    • Maquis says:

      Keep posting, Treeper!

      This is one of the many readons I love this site so…such intelligent and well experienced participants.

      This is all Down-the-Rabbit-Hole kind of stuff.
      So glad my Chief Executive is so good at wrapping his arms around hugely complex subjects, as well as the people involved.

      He will do just fine, no, Great!


  12. CleanhouseinDC says:

    The big challenge here with the approach they are taking is that many of us simply don’t trust either Ryan or the GOPe. There are so many examples of them saying one thing, doing nothing or something else, or doing part of the job but never reaching the goal line. It does seem that the Repubs are trying to unwind this to a “Republican” version.- personally, I’d rather see the government get out of our healthcare shorts … grease the skids to patient-centric medicine, and get out of the way. It doesn’t at first glance look like that is what they are doing after three phases, none the less this first one.

    And having aus Ryan trying to seek us? Wrong guy to sell it for sure.

    Liked by 2 people

  13. Funny side effect of Obamacare. I have a general practitioner who is average at best. Informed me that he’s leaving to start a “concierge care” practice. Supposedly he is capping membership at 400 patients. Dues: $2500 per year! So this guy who graduated from the island of Grenada medical school (yes the one the marines liberated) is planning to take down a cool million a year without doing anything (or maybe it includes an annual check up, I don’t know.) But the funny thing is, I’m worried what happens if most of the “decent” (i.e. born here) doctors go this route? Would I feel compelled to sign up to avoid being with a “medicaid tier” doctor? I don’t know. But it’s clear that it’s not just the insurance companies who are capitalizing on all this “reform”.


  14. Finalage says:

    It was an excellent presentation by Ryan.

    I think Phase 3 will actually be quite achievable because it involves tweaks that are non-controversial to be voted on individually such as buying insurance across state lines, drug price renegotiation and association health care plans. The tort reform will be killed by Dems. But Trump can get Phase 3 through with the big carrot of drug price renegotiation.

    I like the contours of the Ryan-Price health care plan and some aspects of the Rand Paul plan. I believe a joint product can be achieved so that we can have incentive based, free market, consumer driven health care reform passed by June. The two sides are not that far apart.



    • soozword says:

      NumbersUSA came out with an alert today that said the Ryan plan will include care to illegals, just like Obamacare. They did not mention the Paul plan. However they mix-match, blend the plans, I certainly hope that care to illegals gets excluded.

      Liked by 1 person

    • Wookiebush says:

      The RATS will not vote for ANYTHING to disparage Ovomit’s legacy Tm.
      Parts 2 and 3 will never happen and the people will get stuck holding the bag.



      • grlangworth says:

        The passing of Part one will set in motion Dr. Price’s 1442 rules changes not requiring legislation (thank you, Harry). Part 3 will obtain 60 votes because we will already have unstoppable momentum and the ‘Rats will climb on the train or be ground under the next election. The strategy is inescapable. Also, specific terms and conditions of this Part one bill could certainly benefit from tweaking.


  15. snaggletooths says:

    I think they underestimated how much Trump supporters can’t stand Paul Ryan if anyone else would have rolled out this plan it would have been met with less resistance. People for good reason do not trust Ryan its as simple as that.
    You can tell no matter where you read people are not reading the articles they are just hating on the whole bill because of Paul Ryan.

    Liked by 1 person

    • bigsy says:

      This is getting blasted across social media because the real problem is that people aren’t buying the, “but, you don’t understand the intricacies of this”, argument.

      The real problem is that such intricacies are deemed necessary by the political elite. Patience with pragmatism (end justifies the means) and circuitous argument is over.

      Put a simple plan on the table and take a vote. See what the cat drags in.

      It’s like 3rd and 2, you have a great O line (Trump staff), quarterback (Trump) and backfield (Pence, Sessions), but you decide to run a statue of liberty end around with a puny wide out (Ryan)


    • grlangworth says:

      Whether you like Paul Ryan or not, as long as he does his job (very competent PPTX by the way) as defined by PDJT that’s what matters.


    • Help4newmoms says:

      Yes and this is still the government determining behavior. “Pay your bills, kiddos, or you will pay a fine to the insurance company, Rarrr!.” That is NOT conservative. The govt needs to stay the heck out of it and let individuals be repsponsible and take care of those who can not be responsible…that is it…stay out of it.


      • Help4newmoms says:

        Here are my questions, Sundance.

        Will the Ryan bill give individuals choice to pick any insurance plan they want?
        Will the Ryan bill allow insurance companies to offer any insurance plan they want?

        If either of these answers are “no” this is government insurance, not free market insurance and I think should be opposed by conservatives!


    • snaggletooths says:

      I don’t recall saying the bill was perfect it needs work I am saying if they chose a different messenger the splash back may have been less.


  16. JT says:

    “Option #2 – We can Repeal and Replace using the three-phase approach being proposed by Tom Price, Paul Ryan and Donald Trump”

    Generally, if the speaker, president and cabinet secretary are on board, you get on board and shut the hell up. These freedom caucus folks and othrrs are offering no solutions, only obstruction. The time for obstruction is over, that’s why Trump is in there in the first place. Granted they should make some tweaks, but push it through and get it over with. These guys have had 7 years to fight over this.


    • grlangworth says:

      The Sundance explanation should be spread like sunlight far and wide, so that people cannot be hoodwinked by the sophistry of the Levins in our midst.


    • Help4newmoms says:

      The freedom causes HAVE presented solutions…free market solutions…they get no air time because Ryan and Co have prevented it. Ryan said in 2012, while he was campaigning that “85% of Obamacare can be repealed using reconciliation.” What has changed? Was Ryan wrong in 2012? Listen, any plan that continues subsidies (i.e. Tax credits), fees or taxes (Cadillac tax), and/or mandates on what insurance companies can offer is NOT a solution, as well as exchanges will simply will not fix a thing. Thus, leaving as is without republican fingerprints is a better way.


  17. SandraOpines says:

    If I had my rathers, I would go back to how it was Pre-O’Care…. since I don’t……

    I will take whatever the children in Congress can agree to. Their arguments are embarrassing.

    Get in a room and make a decision that works for all and write an amendment. For crying out loud! Ahem


  18. Mike says:

    Seems to me a complete repeal and replace CAN be done now via Reconciliation, you’d just have to put a sunset on the entire repeal 10 years hence (after which Obamacare would spring back to life unless a permanent 60-vote repeal was passed before the sunset).

    Am i mistaken in that? Isn’t that how GWB got his 2001 tax cuts passed with without 60 votes? And why the Dems rigged the CBO score with more years of revenue than expenses in order to be eligible for Reconciliation in 2009 to get it launched in the first place?

    So eliminate the mandates, allow insurance across state lines, catastrophic plans again, etc, all right now, and let them get to work for a 10-year term. Plus we still get to keep the heat on every election until we finally have 60-votes to make the repeal permanent… the looming prospect of returning to the Obamacare dungeon after 10 years will have the voters’ full attention. And GOP can finally say they kept their promises.

    There are probably not currently 50 GOP votes for this (despite all their empty promises to their voters). But if Trump set out on a focused campaign for it I believe he would get there.

    IMO the Ryan/Phase1/ObamaLite will put us in a no-man’s land quagmire, and Trump/GOP will be saddled with ownership of the massive downside of the entire Obamacare debacle, letting the Dems off the hook. Expecting Phase 3 to materialize in the swamp is betting on the come with the whole stack. I trust Trump but i don’t trust Uniparty Congress, and they have a lot of sand available to throw in the gears. I’d rather Trump apply the will of the people directly against them like a Band-aid… one pull, right off!

    Liked by 2 people

  19. MVW says:

    Open the hood and look. The majority of health care is for chronic disease, $Trillions. 50% of Americans have one or more, and 25% have two or more chronic diseases. Treatment? Virtually all is palliative, symptom bandaids palliatives, all IMMUNE SUPPRESSIVE. The problem is that the cause is not being addressed. Cure is not the goal. Until recently the body was considered to be virtually sterile. Until recently that is. Health Care today is expensive because it is treatment not cure based. That is why it is called ‘Chronic Disease’. Backwards, 20th, not 21st century.


  20. Timmy-the-Ute says:

    Sorry SD, This is not the bill that Trump wants even if he knows there are stages. Trump will let this bill float for a few more days. Just long enough to totally undermine Paul Ryan as Speaker, and then he will come in cut him off at the knees and say he and the administration are taking over.

    Liked by 1 person

  21. Wookiebush says:

    step 3 will take 60 votes not 51, unless the filibuster rules are changed.



  22. grlangworth says:

    By the way, Ya’ll, the few hat-tips I’m seeing about ‘medical malpractice insurance’ needs more of a spotlight. This issue is really about tort reform. See this:


  23. mamahorn says:

    So let me get this straight. We call this repeal and replace as a marketing tool because we can’t repeal it because the Senate would block it with a filibuster. So like Sleeping Beauty’s curse, we can only soften the effects to have a way out later, by playing the reconciliation trick. Guys, I don’t like it, or if it will help healthcare’s out of control inflation. But if we can get rid of the individual mandate and the mandatory abortion coverage, I can live with it. … Ugh, and I hate Paul Ryan but what can you do?


  24. deh3k says:

    Pre-existing conditions might be treated better with Rand Paul’s ideas – pooling people into large association groups where sick people get absorbed, as opposed to Ryan Plan where they are thrown into a high- risk pool. Does anyone know if the previous state high risk pools worked well?


  25. USMCLt says:

    So, are we to trust a bureaucracy, HHS, to bravely execute the actions required in Step 2? It is safe to assume that HHS, in spite of the presence of Tom Price as Secretary, is filled to the brim with leftist, career bureaucrats who can be expected to oppose and sabotage these actions at every turn. 80,000 people work for HHS, and any seasoned manager will tell you that 10% of any organization can be assumed to be “problem employees”. So, until I hear that Dr Price is letting go at least 8,000 HHS employees, then I have little faith that the actions in Step 2 can be accomplished.


  26. Alan Wilmot says:

    I don’t know why this article is so far down the page. This is the key argument. Either Paul Ryan’s bill is part of an overall strategy that will unfold in 3 stages, of which this is merely the first (this article’s argument), or Paul Ryan is a RAT (much of the rest of the Conservative blogosphere). This article makes a strong case to me, and it should be given broad consideration…

    Liked by 1 person

  27. scotl70 says:

    Way too many excuses. It’s really very simple. Democrats saddled us with this monstrosity with a simple majority vote. There is no reason our side can’t do the same. This whole “60 vote” foolishness was never an impediment to democrats.

    Liked by 1 person

  28. Deplorable Voice of Reason says:

    I have what may be a dumb question but here goes…….

    Why hasn’t Phase Two already begun? No votes have to occur……we just need DHS to slash the regs right?

    I’d have a lot more confidence and thereby trust for all this working out lie we hope if it didn’t seem that they were shoving the turd down our throats with the promise of cake and ice cream to follow.

    Give me some cake and I’ll settle down and let you shove some turds.

    Thanks in advance for your insight.


  29. mikeyboo says:

    I don’t trust Ryan for spit but I trust Pres. Trump. If he thinks this is the best way to go, I think he deserves support. The President has Dr. Tom Price as an advisor (as well as Dr. Carson). He is not operating in the dark. If Pres. Trump thinks this is the best way to go I think we should back him on this very complicated issue.

    Liked by 1 person

  30. Maquis says:

    Parlimentary systems are chaotic, unstable, and, yes, undemocratic. Small cabals assembled run roughshod over the will of the people. Elections called at the drop of a hat. Nor are they republican.

    And peeps, Repeal, and Replace, were there all campaign long. We will never achieve the “Purity” so many of y’all want, and, apparently, believe possible.

    One Two Three. Anyone think they will be able to outwork President Trump when it’s Phase Three time? You are not dealing with an average politician, not even an average Human. We are blessed with an anomally, a delightful freak of nature with gifts from On High. I am astounded and amazed by our President. If anyone refuses to get behind him in his Righteous Quest, choosing instead to stand in his path, don’t expect him to steer his un-stoppable steamroller around you.

    My God, you see the incredible things he has done in a matter of weeks, yet still play armchair ankle-biting?

    O ye of little faith.


  31. Sonny's Mom says:

    Everyone – please listen to Betsy McCaughey’s interview on Dennis Prager’s talk show – Mon, Mar 13, 2017, Hour #1
    Podcast available on:
    (or on the Stitcher app)


  32. dawndoe says:

    Some are saying that Trumps handlers aren’t letting those who seem to say that we don’t need three-phases to do this in to meet with him, so maybe Trump isn’t aware that there may be an easier quicker way?


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