Big Louie whispers to you, “Say, Mac. The fix is in. The Redskins are throwing it to the Browns. It’s all set. Guaranteed.”

“No, kiddin’, Louie?”

“I’m tellin’ ya. Now listen. I want you to bet me the Skins win.”

“Wha…? But you just told me ….”

“You aren’t paying attention. What’s wrong with you, Mac? You want trouble? I said the Skins will lose and you will bet they’re going to win. Now gimme sixty bucks that says the Skins will win.”

“Hey! You don’t have to be so rough …”

“Say, these twenties are new! Considerate of you. Listen. Don’t be so glum. You’re contributing to a good cause: me.”

What Insurance Is
Any of this remind you, Dear Reader, of the insurance business? It shouldn’t. Yet the word insurance has undergone a strange metamorphosis, which is caused, as you won’t be surprised to learn, by government.

Insurance used to be a bet you would make that you hoped you wouldn’t win. You went to an insurer and made a bet that something bad would happen, say, you got cancer or your house would burn down. The insurer figured out how much it would cost to pay you to fix the bad thing. He then said, “Okay, gimme Y dollars, and if the bad thing happens, I pay you X.” If you didn’t like Y or X, you negotiated with the insurer until a pair of numbers were mutually agreeable — or you agreed to part ways.

But suppose you told the insurer, “I have cancer. It will cost X to treat. I want to bet with you that I get cancer. What’s the minimum Y I should pay you?”

The insurer would either laugh you out of his office, as he commiserated with you about the sad state of your health, or he would pick a Y greater than X. Why? Because it was guaranteed that the insurer would pay out X. Why would he ever take an amount less than X?

The Government “Fix”

Because government, that’s why. Because your cancer is a “pre-existing condition” and it was seen as cruel and heartless for the insurer not to lose money on your behalf. But government forced the insurer to lose money. Government enjoyed playing Robin Hood. Hood as in criminal, crook, confidence trickster (did you not know that? Big Louie knew).

However, because the entities that comprise government move in and out of insurers (and their banks), the government also took pity. Government knew insurers had to make up their forced deficits. So it mandated that citizens who did not want to make a bet with any insurer had to give the insurer money for bad things that would almost never happen. ObamaCare became Big Louie muscling twenty-somethings to insure themselves against Alzheimer’s.

Thanks to Supreme Court Justice Roberts, you being forced to fork over funds to a private entity was called a tax. (Same thing Big Louie calls it!) Thus, not only was the word insurance gutted of most of its actual meaning, so was tax. Orwell lives.

Of course, insurers assisted in their own demise. They, like everybody else, were happy to let folks conflate the incompatible terms health insurance and health care. Once people could no longer keep these separate in their minds, the end of insurance was guaranteed.

What Insurance Isn’t

Insurers blurred these distinctions by separating themselves from the purely betting side of business, by dealing with people’s employers and not people (a condition ensconced by further Government mandates), by paying doctors and hospitals and not people, and by writing blanket instead of specific contracts. It came to be seen as normal for a person to expect “insurance” to pay for their kid’s visit to the doctor for sniffles.

Having the sniffles is almost guaranteed; it is thus numerically no different than a pre-existing condition. Having an insurer pay out on these “sure bets” meant that an additional layer of bureaucracy had to be built to handle the paperwork and shuffle funds around. Insurers unwisely moved to make a profit on these sure bets, which caused them to be penurious when paying out on large claims. Doctors had to increase their staff to handle the busywork. Monies that would have gone to pay for “bettable” diseases had to be diverted to pay for aspirins and bandages. Every step along the way caused premiums to be driven higher.

Now no one understand’s the true cost of care. Worse, we’re at the point where the true meaning of insurance is under active attack. A recent article in Bloomberg complains that it would be better if insurers used data to calculate a person’s chance of this or that disease — which is exactly what insurers should do. The author of that article also frets that insurers might “once again [be] allowed to charge extra for pre-existing conditions, an idea currently being debated in Congress.” In other words, the author is worried that insurers might once again be allowed to do what insurers are supposed to do, and what they must do if insurance is to work.

When Congress scraps ObamaCare, they must not replace it with any scheme that confuses insurance and care. This confusion guarantees that costs will go up and the bureaucracy will grow. (For more from the author of “When Replacing ObamaCare, Remember Health Insurance Isn’t Health Care” please click HERE)

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For at least one conservative lawmaker, the current process for repealing and replacing Obamacare is beginning to look very similar to that of 2009, when Republicans accused Democrats of writing the Affordable Care Act behind closed doors.

Armed with a portable copy machine, Sen. Rand Paul, R-Ky., went on a crusade through the U.S. Capitol on Thursday to find the legislation that will ultimately repeal and replace the Affordable Care Act.

His goal was to see the elusive Obamacare bill himself, which was available in a reading room only to members of the House Energy and Commerce committees and their staff, and “demand a copy for the American people.”

“We’ve been talking about it for six years, so we thought we ought to see it,” Paul said of the replacement plan. “We heard it was in a secret room, and that it was under lock and key with guards. And sure enough, when we got there, there were policemen posted at the door, and we were not allowed to see the Obamacare repeal bill.”

Ultimately, the Kentucky senator was unsuccessful. But in his quest, he was joined by some unlikely allies: congressional Democrats like Minority Leader Nancy Pelosi and Rep. Frank Pallone, D-N.J., who wanted to see a copy of the plan, too.

“This is not regular order, and it’s not good order for the American people,” Democratic Whip Steny Hoyer of Maryland told reporters after broadcasting live on Facebook his search for the bill.

The House Ways and Means and Energy and Commerce committees are expected to take up the Obamacare replacement plan next week, and members of the Ways and Means Committee are planning to work through the weekend to continue hashing out the details.

But while GOP leaders say they haven’t yet finalized the bill, conservatives believe the legislation is being drafted in secret, out of view from them and the American people.

For the lawmakers, the process for crafting the bill repealing and replacing Obamacare harkens back to 2009, when Democrats wrote the health care law.

“If you’d recall, when Obamacare was passed in 2009 and 2010, Nancy Pelosi said you’ll know what’s in it after you pass it,” Paul told reporters Thursday, paraphrasing what Pelosi said at the time. “The Republican Party shouldn’t act in the same way.”

Paul and the House Freedom Caucus, a group of approximately 40 conservative lawmakers, are urging Republican leaders to repeal as much of Obamacare as possible and use legislation from 2015 that repealed the major provisions of the health care law as a starting point.

That bill passed the House and Senate, but President Barack Obama vetoed it.

But as Republicans on the Ways and Means and Energy and Commerce committees continue to work on the bill, it’s unclear whether conservatives will get their way.

Even as Republicans head into the weekend, Paul continued to play hide-and-seek with the replacement bill and solicited his followers on Twitter for tips on where the plan may be hidden.

Conservatives and Democratic lawmakers were given an accidental early glimpse at what Obamacare’s replacement may look like after a draft bill was leaked to the press late last month.

The document, which was reportedly from early February, repealed much of Obamacare and phased out the Medicaid expansion, which would eventually be replaced with a per capita allotment. Under a per capita allotment, states get capped payments based on the number of people enrolled in Medicaid.

It also capped the tax exemption for employer-sponsored coverage, required Americans to maintain continuous coverage or face a 30 percent increase in premiums for a year, and put a new system of refundable, age-based tax credits for purchasing health insurance in place.

But six conservative lawmakers—three in the House and three in the Senate, Paul included—revolted against the draft replacement plan, calling it “Obamacare lite.”

Paul said the draft bill kept elements of the Affordable Care Act like an individual mandate and Cadillac tax on expensive employer-sponsored plans, and the members vowed to oppose any legislation that didn’t repeal the health care law in full.

“These are Democrat ideas dressed up in Republican clothing,” Paul said of the draft document.

After the conservatives vocalized their opposition, House Republican leaders stressed that the proposal released was one from the early stages of discussion.

“That draft is no longer valid,” House Majority Whip Steve Scalise, R-La., told reporters Tuesday.

The opposition from the House and Senate conservatives is the latest setback for GOP leaders, who planned to put the repeal-and-replace measure before lawmakers for a vote in the coming weeks.

Conservatives specifically disagree with the inclusion of the refundable tax credits available to consumers purchasing coverage in the individual market, which they believe creates a new entitlement program.

But the lawmakers aren’t opposed to the notion of a tax credit as a whole.

A replacement plan crafted by Paul calls for a $5,000 tax credit available to individuals who contribute money to a health savings account, or medical savings account.

Despite the opposition from House and Senate conservatives, GOP leaders don’t appear to be backing down from the draft document.

A newer version of the Obamacare repeal bill obtained by Politico contains many of the same provisions as the earlier document, including the refundable, age-based tax credits.

According to Politico, though, there is one change: Wealthier Americans would not be able to qualify for the financial assistance.

Republican leaders said this week’s negotiations are still ongoing and that the replacement plan hadn’t yet been finalized. They said that’s the reason a draft wasn’t yet available to Democrats and Paul.

“[Republican] members and staff are continuing to discuss and refine draft legislative language on issues under our committee’s jurisdiction,” House Energy and Commerce Chairman Greg Walden, R-Ore., said in a statement Thursday. (For more from the author of “For One Conservative, 2017 Looks Similar to 2009 Obamacare Debate” please click HERE)

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Conservatives in the House and Senate are leveraging their numbers in an attempt to influence the direction of legislation repealing Obamacare and ramp up the pressure on Republican leadership to bring a 2015 repeal bill back before members for another vote.

Their efforts began Monday night when Sens. Ted Cruz of Texas, Mike Lee of Utah, and Rand Paul of Kentucky said in a series of coordinated tweets, and later a joint statement, that they would support only a “full repeal” of Obamacare.

2 yrs ago, the GOP Congress voted to repeal Obamacare. That 2015 repeal language should be the floor, the bare minimum. #FullRepeal

— Senator Rand Paul (@RandPaul) February 28, 2017

2 yrs ago, GOP Congress voted to repeal #Obamacare. That 2015 repeal language should be the minimum. #FullRepeal @SenTedCruz @SenRandPauI

— Mike Lee (@SenMikeLee) February 28, 2017

2 yrs ago, GOP Congress voted to repeal #Obamacare. That 2015 repeal language should be the minimum. #FullRepeal @SenMikeLee @SenRandPauI

— Senator Ted Cruz (@SenTedCruz) February 28, 2017

They were joined by three key House conservatives—Republican Study Committee Chairman Mark Walker of North Carolina, Freedom Caucus Chairman Mark Meadows of North Carolina, and former Freedom Caucus Chairman Jim Jordan of Ohio—in opposing a draft of the repeal they called “Obamacare-lite.”

“We have the votes to now tell the leadership this is what we want to do,” Paul said during a conference call with reporters Thursday. “We do have the votes. We’re a force to be reckoned with, and we want to be part of the negotiation over trying to make sure that we have complete repeal.”

The conservatives are rebelling against the draft bill leaked last week and instead want GOP leaders to revive the successful repeal bill from 2015 and bring it before members for a new vote.

That legislation passed both chambers of Congress, but President Barack Obama vetoed it in January 2016.

The 2015 bill repealed key provisions of the Affordable Care Act, including the individual and employer mandates, Medicaid expansion, tax credits, and taxes. It also stripped Planned Parenthood of federal funding.

But GOP leaders haven’t committed to that wording and instead say they want to include parts of a replacement plan in the bill dismantling the health care law.

Republicans will use a budget tool called reconciliation to repeal Obamacare; reconciliation fast-tracks legislation through the Senate and allows it to pass with 51 votes.

With control of 52 seats in the Senate, Republican leaders view reconciliation as the best way to repeal the health care law, especially since the legislation would earn President Donald Trump’s signature once it lands on his desk.

The GOP has a slim margin in the 100-member Senate, so Paul and his fellow conservatives are hoping to use their numbers to extract concessions from Republican leaders.

Since Vice President Mike Pence can break a tie, Republicans can lose no more than two votes.

“There have been rumors and rumblings of those in leadership putting forward something that is not a complete repeal, that some of us would refer to as Obamacare-lite,” Paul said. “We are for complete repeal.”

The same situation is unfolding in the House, where the bill fails if Republicans lose more than 20 votes.

The House Freedom Caucus stands roughly 40 members strong. If the entire group of conservative members opposed legislation repealing less of Obamacare than the 2015 reconciliation bill did, it wouldn’t pass the lower chamber, where Republicans have 238 seats.

When asked by The Daily Signal whether conservatives were worried their demand for the 2015 bill possibly would derail repeal efforts entirely, Jordan said the lawmakers weren’t concerned.

“We actually think you should do what you said you would do [in the 2016 campaign],” Jordan said.

“They didn’t tell us to repeal it, but keep the Medicaid expansion,” he said, referring to voters. “They didn’t tell us to repeal it, but keep this new tax increase. They didn’t tell us to repeal it and start a whole new entitlement program. They told us to repeal it and replace it.”

House Speaker Paul Ryan said last month that Republicans would vote on a repeal bill this month, but details of a proposal haven’t yet been released.

A draft bill to replace Obamacare was, however, leaked to the press last week.

It was that legislation that sparked the critical response from the six conservative lawmakers, who said the proposal amounted to “Obamacare-lite.”

The draft document would repeal Obamacare’s major provisions, with some aspects effective in 2020 and others sooner, and implement parts of a replacement centered around age-based tax credits.

The conservatives, though, said the draft document stopped short of full repeal and, through the refundable tax credits, would create a new entitlement program.

“The draft legislation, which was leaked last week, risks continuing major Obamacare entitlement expansions and delays any reforms,” Walker said in a statement.

“Worse still, the bill contains what increasingly appears to be a new health insurance entitlement with a Republican stamp on it,” the Republican Study Committee chairman said.

Now, House Republican leaders are distancing themselves from the draft replacement plan.

Majority Whip Steve Scalise, R-La., told reporters at a press conference Tuesday that he had spoken to Walker, who said he couldn’t recommend the 170 members of the Republican Study Committee support the document.

“That draft is not even representative of where we are,” Scalise said. “[Walker is] working with us, and we’re in direct conversations with the chairman of the RSC as well as others about the best way to build a consensus to pass a bill to gut Obamacare.”

“That draft is no longer valid,” he said.

A spokesman for Scalise, the No. 3 House Republican, later told The Hill that the leaked document was an “older draft.”

For the last month, conservatives irked by the slow speed of repeal efforts have been pushing Republican leadership to pass a new bill with the 2015 language.

But although that language cleared both the House and Senate, some senators are skeptical about repealing Obamacare’s taxes and expansion of Medicaid eligibility.

Further compounding the divide between conservatives and their fellow Republicans is Trump, who has said the White House and new Health and Human Services Secretary Tom Price would send their own Obamacare replacement plan to Capitol Hill.

Trump has yet to do that, and it isn’t clear when he will. But the president has advocated a simultaneous repeal and replacement of Obamacare, a strategy that some conservatives, Lee among them, said would be dangerous.

Jordan and Paul, though, said Congress should pass a repeal of Obamacare and Paul’s Obamacare Replacement Act the same day.

Though Trump, the House, and the Senate aren’t yet on the same page regarding the future of the health care law, Jordan appeared poised to deliver a message to the president during an interview Tuesday morning on Fox News’ “Fox and Friends,” a morning show Trump is known to watch.

“We make this job too hard,” Jordan said. “Let’s do what we told the voters.” (For more from the author of “Conservatives Use Clout to Press for Full Repeal of Obamacare” please click HERE)

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Conservatives and business leaders in the health care market have a message to Congress on Obamacare: Deliver on your promise to repeal the health care law and begin the process of returning to a health sector that can be “America’s greatest.”

During a panel at the Conservative Political Action Conference, or CPAC, on Thursday, Grace-Marie Turner, president of the Galen Institute, told attendees to think of Obamacare’s repeal as a “down payment” that will allow Republicans to implement their own health care reforms in the future.

But first, Turner said Republicans need to take action to repeal the law using a fast-track budget tool called reconciliation.

“We have to do this,” she said. “We have to be get this out of here to be able to deliver on the repeal-and-replace pledge to the American people, and then to begin the process of truly returning to a health sector that can be America’s greatest health sector again.”

Rep. Michael Burgess, R-Texas, Scott Flanders of eHealth, and Dale Bellis of Liberty HealthShare joined Turner on the health care panel at the annual event.

While Republicans campaigned since 2010 on repealing Obamacare, efforts to advance the legislation dismantling the law have slowed over the last few weeks.

The GOP-led Congress passed a bill using reconciliation to undo major provisions of the health care law in 2015. But President Barack Obama ultimately vetoed that legislation.

Now, conservatives in Congress are calling on their leaders to bring that same bill before members for another vote.

“It’s going to happen,” Burgess said of Obamacare’s repeal. “What [the 2015 bill] demonstrated to me was that if you got the right president in the White House, you could send that bill back down to the other end of Pennsylvania Avenue, and you could repeal large pieces of the Affordable Care Act.”

The 2015 reconciliation bill repealed Obamacare’s individual and employer mandates, Medicaid expansion, and subsidies. It also stripped the federal government of the authority to run the exchanges, and eliminated federal funding for Planned Parenthood.

Though that legislation passed both chambers of Congress, tensions have emerged among GOP lawmakers over which parts of the health care law to unwind.

Republicans are split over whether to leave the Medicaid expansion in place, while GOP leaders want to include parts of a replacement plan in the same legislation that will repeal the law—a strategy that some conservatives have derided.

But Burgess, who serves on the House Energy and Commerce Committee, said the 2015 reconciliation bill will serve as a “starting point” for Congress this year, with Republicans understanding that the repeal bill will be at least the same as that passed in 2015.

In addition to disagreement over whether to include parts of Obamacare’s replacement in the repeal bill, Republicans also split on whether to provide tax credits or tax deductions to consumers.

But Turner stressed that the process for replacing the law—what she said will become a “once-in-a-generation reform”—will be a lengthy one that requires thought, particularly since Republicans are starting not from a blank slate, but with an already changed health insurance market.

“It’s really what would we want if we were starting from the right kind of policy for the health sector? We are not starting there. We’re starting with Obamacare,” she said. “We’re starting with some number of millions of people … relying on Obamacare. You have to create a lifeboat for them, and structures that provide the kind of resources people need who don’t have means to purchase health insurance on their own so they can continue coverage.”

Like Republicans in Congress, President Donald Trump campaigned on repealing Obamacare.

During his first day in office, Trump signed an executive order addressing Obamacare and giving his federal agencies the discretion to no longer enforce the individual mandate.

And he’s repeatedly said that his new Health and Human Services secretary, Tom Price, will present a replacement plan before Congress.

But so far, no proposal has been presented.

Trump will address a joint session of Congress next week, and Burgess had his own wishes for what he hopes the president will tell Republicans and Democrats in Congress.

“I would like for him to say very directly to us, to my leadership in the House, Republicans and Democrats, that ‘this is your job,’” Burgess said. “‘I want you to get it done.’ Simple as that.”

CPAC, the largest annual national gathering of conservative activists, runs from Wednesday to Saturday at the Gaylord National Resort and Convention Center in National Harbor, Maryland, just outside Washington. (For more from the author of “Conservatives to Congress: Deliver on Obamacare Repeal and Replace Promise” please click HERE)

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