Following a good showing on his first overseas trip, President Trump returned to the states and called for something that has some on the right scratching their heads. He’s wanting more dollars put towards health care.

One of the things that got the AHCA passed in the House was the decrease in spending on health care. The conservative Freedom Caucus pushed for several additions before voting for it, including the ability for states to opt-out of some of the more liberal points such as pre-existing conditions. However, the reason some gave for finally backing the bill is that it reduces overall spending on health care. What is the President asking for now?

Regardless of whether this was just a Tweet that can be disregarded as rhetoric in 140-characters-or-less or if its a sign that he really wants more money put into health care, the overarching theme is the same. Many in the GOP (and pretty much every Democrat), including the President, are missing the fundamental point that health care can only truly be fixed if the federal government systematically removes itself from the equation.

Obamacare isn’t failing because of subtle details or nuances. It’s failing because the concept behind government-mandated health care is fatally flawed. The differences between the ACA and the AHCA are so small that their cores are essentially the same. Both insert DC into an area where it simply doesn’t belong. By doing so, either will fail whether it has the letter (R) or (D) on its stamp of approval.

We don’t need more money plugged into health care. We need the massive amounts of money that are already pumped into health care focused by a consumer-driven free market. Businesses operate based upon the demands of three forces: government, consumers, and market conditions. Today, government has primacy in the equation by forcing the other two factors to be secondary. Consumers have very little impact in the equation because of mandates in both Obamacare and the current Trumpcare replacement being worked on in the Senate. As for market conditions, they are artificial because of government intervention. They will continue to be artificial if Obamacare is repealed and replaced with a variation of the AHCA.

Nearly everyone on Capitol Hill fears a full repeal for the same basic reason. They know that if it’s done right, it will work in the long term. The Democrats don’t want that because it exposes the long-con they’ve been working in DC for decades, the concept that more government is better. The Republicans don’t want that because they fear it won’t work quickly enough for them to retain power in the midterm elections. The AHCA isn’t designed to fix health care. It’s designed to pretend to fix it while mitigating fallout until election day.

As I stated in a different post:

If we systematically repeal Obamacare, we can have privatized health care once again. A replacement plan that tries to predict what will happen is foolish. Instead, we should repeal, then monitor and analyze the market. Over time, we’ll find the holes that need to be plugged. States, charities, and other organizations can fill most of these holes. Whatever is left, if anything, can fall to the federal government. This way, DC becomes the final safety net instead of being the first line of defense. That’s the way it should be in health care and a plethora of other areas.

The last thing this nation needs is more dollars redirected into health care. Those of us watching our premiums rise despite higher deductibles and worse coverage (which is a vast majority) know that there’s already “more dollars” in health care. It needs to be allocated properly through competition and the push for innovation. We can’t have the best health care in the world as the President hopes unless DC is willing to remove itself from the equation. Until then, the math will continue to fail miserably.

The fist bumps coming from the GOP after passing the American Health Care Act in the House were plentiful. Republicans around the country were giving each other high-fives for having finally made the first real steps towards repealing Obamacare. Here’s the problem. We haven’t seen the beginning of the repeal of Obamacare. We’ve seen the seeds of Trumpcare being planted. Perhaps the better name for it would be “Obamacarelite.”

This a repeal in name only. Congressman Justin Amash revealed the truth about the AHCA in a Facebook post yesterday (emphases are mine):

This is not the bill we promised the American people. For the past seven years, Republicans have run for Congress on a commitment to repeal Obamacare. But it is increasingly clear that a bill to repeal Obamacare will not come to the floor in this Congress or in the foreseeable future.

When Republican leaders first unveiled the American Health Care Act, a Democratic friend and colleague joked to me that the bill wasn’t a new health care proposal; it was plagiarism. He was right.

The AHCA repeals fewer than 10 percent of the provisions in the Affordable Care Act. It is an amendment to the ACA that deliberately maintains Obamacare’s framework. It reformulates but keeps tax credits to subsidize premiums. Instead of an individual mandate to purchase insurance, it mandates a premium surcharge of 30 percent for one year following a lapse of coverage. And the bill continues to preserve coverage for dependents up to age 26 and people with pre-existing conditions.

I want to emphasize that last point. The bill does not change the ACA’s federal requirements on guaranteed issue (prohibition on policy denial), essential health benefits (minimum coverage), or community rating (prohibition on pricing based on health status). In short, Obamacare’s pre-existing conditions provisions are retained.

The latest version of the AHCA does allow any state to seek a waiver from certain insurance mandates, but such waivers are limited in scope. Guaranteed issue cannot be waived. Nobody can be treated differently based on gender. And any person who has continuous coverage—no lapse for more than 62 days—cannot be charged more regardless of health status.

Consider what this means: Even in a state that waives as much as possible, a person with a pre-existing condition cannot be prevented from purchasing insurance at the same rate as a healthy person. The only requirement is that the person with the pre-existing condition get coverage—any insurer, any plan—within 62 days of losing any prior coverage.

If a person chooses not to get coverage within 62 days, then that person can be charged more (or less) based on health status for up to one year, but only (1) in lieu of the 30 percent penalty (see above), (2) if the person lives in a state that has established a program to assist individuals with pre-existing conditions, and (3) if that state has sought and obtained the relevant waiver. Here in Michigan, our Republican governor has already stated he won’t seek such a waiver, according to reports.

So why are both parties exaggerating the effects of this bill? For President Trump and congressional Republicans, the reason is obvious: They have long vowed to repeal (and replace) Obamacare, and their base expects them to get it done. For congressional Democrats, it’s an opportunity to scare and energize their base in anticipation of 2018. Neither side wants to present the AHCA for what it is—a more limited proposal to rework and reframe parts of the ACA, for better or for worse.

In March, when this bill was originally scheduled to come to the floor, it was certainly “for worse.” The previous version provided few clear advantages over the ACA, yet it haphazardly added provisions to modify essential health benefits without modifying community rating—placing the sickest and most vulnerable at greater risk.

Over the last month, several small but important changes were made to the bill. The current version abandons that fatally flawed approach to essential health benefits (though the new approach includes new flaws), incorporates an invisible risk sharing program, and permits limited state waivers. These changes may slightly bring down (or at least slow down the increase in) premiums for people who have seen rates go up. Even so, the AHCA becomes only marginally better than the ACA.

Many have questioned the process that led up to the vote on May 4. I have publicly expressed my disgust with it. The House again operated in top-down fashion rather than as a deliberative body that respects the diversity of its membership. But it’s important to acknowledge that the bulk of this bill (123 pages) was released on March 6. Only about 15 pages were added after late March. Members of Congress were given sufficient time to read and understand the entire bill.

While an earlier version of the AHCA included a CBO score, the types of changes made to the AHCA in more recent stages render an updated score highly speculative and practically meaningless. For that score to be useful, the Congressional Budget Office would have to effectively predict which states will seek waivers, which waivers they will seek, and when they will seek them. This complex analysis of the political processes and choices of every state is beyond anyone’s capability. I weighed the lack of an updated score accordingly.

When deciding whether to support a bill, I ask myself whether the bill improves upon existing law, not whether I would advocate for the policy or program if I were starting with a blank slate. In other words, the proper analysis is not whether it makes the law good but rather whether it makes the law better. In this case, I felt comfortable advancing the bill to the Senate as a marginal improvement to the ACA. The House has voted more than 30 times to amend (not just repeal) Obamacare since I’ve been in Congress, and I have supported much of that legislation, too, on the principle of incrementalism. If it advances liberty even a little (on net), then I’m a yes.

Nonetheless, the ACA will continue to drive up the cost of health insurance—while bolstering the largest insurance companies—and the modifications contained in the AHCA cannot save it. Many of the AHCA’s provisions are poorly conceived or improperly implemented. At best, it will make Obamacare less bad.

The Framers of the Constitution understood that federalism—the division of powers between the national and state governments—would maximize the happiness of Americans. As long as Washington dictates health insurance policy to the entire country, there will be massive tension and displeasure with the system. I’ve always said, and I will continue to say, we need to start over: Fully repeal Obamacare, let the people of each state choose their own approach, and work together in a nonpartisan manner.

The Congressman is correct when he says that it’s his duty to decide whether or not a bill is an improvement on existing law. However, one should also consider whether it’s possible for the law to be dramatically improved with more effort put towards bigger or smaller changes. In this case, I believe Amash would have voted against the bill if he believed there was a full repeal possible. He and the Freedom Caucus weighed the possibilities and decided that this was the best they were going to get. It was right move from a legislative perspective, but it also reinvigorates the necessity for the Federalist Party to rise.

It’s a shame that small-government-minded representatives are forced to pick between the lesser of two evils. Millions of voters can relate to this circumstance as we’re often faced with picking between Mr. Big Gov or his opponent, Mrs. Bigger Gov. As long as the two-party system holds primacy over all potential challengers, we will always be faced with this obtuse binary choice. The time for change is now.

The House just sent the American Health Care Act to the Senate. From there, it’ll face a tougher fight through Senate revisions before reaching the President’s desk. For the the first time in seven years, the prospects of repealing Obamacare are actually pretty high. Republicans around the nation are cheering. Democrats are spinning it as a call to retake Congress in 2018.

Most of my friends are Republicans, as are most of the readers on this site. I support their desire to rid the nation of the abomination of Obamacare. I also respect the need to put the GOP stamp of approval on a replacement plan. Heck, there are a couple of things in the AHCA that I don’t mind; it’s a slight improvement over the ACA.

One thing I wholeheartedly disagree with is the notion that the AHCA is a step towards smaller government. This does nothing to rein in DC. It keeps the national government firmly entrenched in an area where it absolutely, positively does not belong. By doing so, it prevents the free market from helping millions of Americans by driving down health insurance costs. It adjusts the mandate by shifting the penalty, but the mandate remains nonetheless. It gives states the option to opt out of pre-existing conditions, yet no state will actually use this option. Why? Because by giving the AHCA the GOP stamp of approval, any hope of educating people on the vast negatives associated with the pre-existing conditions clause have evaporated.

It isn’t just the AHCA. Look at the spending package that keeps the government funding President Obama’s sustained laundry list of programs. Look at pushes for huge infrastructure spending. Look at every big government program that is not facing extinction despite the GOP having full control in DC.

As a Federalist, I look at today’s GOP the same way many politically savvy conservatives view it: better than the Democrats. After the rise and fall of the Tea Party as well as a short-term spike in conservatives winning primaries over moderates, we’ve seen the status quo of the Establishment reaffirmed in 2017. The AHCA is just the latest example.

These are unpopular notions to be posting on sites that are supportive of the Republican Party, but I’m not alone in my dissent. Conservative pundits and Federalism-minded journalists around the nation are speaking out.

Ben Shapiro at Daily Wire notes:

On Thursday, House Republicans prepared to take final ownership over Obamacare, slapping a giant “T” atop the edifice of legislative manure and declaring victory. This follows Republicans embracing Barack Obama’s budget priorities in their newest budget bill, which did not fund Trump’s wall but did fund refugee resettlement, Planned Parenthood, and Obamacare. Republicans have apparently become the David Copperfield of garbage: they can take Obama’s garbage and turn it into Trump’s garbage right before your eyes!

Mark Levin has been very critical of the GOP on his show lately:

“Too many conservatives have simply accepted as effective power the minor concession of the progressives” as they “drive the political and cultural agenda,” Levin explains.

Andrea Ruth at RedState supports the bill, but only because not passing it would make the GOP look worse than it already does:

Voters first gave them the House immediately following the passage of Obamacare. Republicans subsequently show-voted on repealing Obamacare more than 50 times in the following six years when they knew such a bill would never be enacted while a Democrat was in the White House.

Noah Millman at The American Conservative isn’t supportive at all:

By their own repeated admission, the GOP leadership has no actual policy goal of any kind. They promised something. They have to deliver something — even if that something is wildly unpopular, satisfies nobody, and bears almost no relation to what they originally promised.

I believe in my heart that many Republican voters still believe in the type of small-government Federalism that Ronald Reagan espoused. It’s not their fault that a majority of Republican representatives view “smaller government” as a catchphrase in their campaign sales pitch instead of a goal. However, don’t try to convince me that they’ll come around eventually. Accept that they’re the big-government Democratlite Party so we can work together to really rein in DC.

I don’t make it a practice to comment on potential legislation before reading it. Speculation takes too much bias and rumors into account which tends to sway the reader (and author) in directions before the truth is even known. I’m making this exception because if reports that Vice President Mike Pence has negotiated a deal with the Freedom Caucus turn out to be true, it could be the best move made by the administration on health care since taking office.

Then again, it might be a big nothingburger.

The good news: limited waivers for the states. This means states have opportunities to bypass certain provisions of the AHCA that would allow them to help drive down premiums.

The bad news: essential health benefits carry over from Obamacare. This will limit the decrease (and even perpetuate increases) in premiums for the vast majority of Americans.

We’ll see how it pans out, but here’s the thing. I know many if not most Republicans are in favor of repealing and replacing Obamacare with the AHCA. It would boost morale and take away certain chunks of the oppressive economic burden that Obamacare has placed on us. However, the details are terrifying to anyone who believes in limiting government and defending the freedoms we hold dear. The original AHCA was a repackaged version of nationalized medicine that would push us further down the road towards financial oblivion and what we’ve seen of the proposed changes don’t change that. It would potentially slow down skyrocketing insurance costs, but it wouldn’t reverse them. In essence, it’s not a solution to Obamacare but a way to spread out the ill effects. We will still be paying way more than we were just a few years ago. We will still be ballooning the national debt and making little impact on our outrageously unbalanced budget.

Full repeal is the right way to go. That’s not to say that we need to return to the pre-Obamacare era. Changes need to be made, but those changes should come based upon reactions and analysis once it’s repealed rather than trying to plug all of the potential holes ahead of time. If we repeal Obamacare and allow the free market to guide the government on changes to be made, the end result will be much better. We can already plan for some of the changes such as opening up competition across state lines. We can work with charities, communities, and local governments to fill the gaps and prevent people from falling through the cracks. By repealing Obamacare fully in stages over the next 1-3 years and then watching how consumers, health insurance companies, and markets react, we can make intelligent decisions rather than speculative ones.

Of note is that the Freedom Caucus is supporting the amendments to the bill. We’ll see what that really looks like. Getting government out of health care is the only truly conservative/federalist way of fixing it. If they’re willing to negotiate, I would hope it’s because they believe in the plan and not because they’re feeling pressure from donors and the White House.

Only time will tell and speculation at this point is premature, but it will be interesting to see just how revamped Ryancare 2.0 really is. The bright spot I’ve seen in initial reports is that leftist publications like WaPo and HuffPo seem to hate the idea, so that’s good.

One of the strategies Speaker Paul Ryan used in attempting to sell the American Health Care Act was to include defunding Planned Parenthood as part of the deal. It was a good attempt to sugarcoat “Obamacarelite” with some conservative honey for positive press and leverage against right-wing opposition to the bill, but it obviously didn’t work. While the dust is settling from their repeal and replace debacle, now is the time to introduce a new standalone bill to get rid of Planned Parenthood’s federal funding once and for all.

It makes strategic sense for both Congress and the White House to make this happen quickly. Fingers are already pointing in every direction. They need a high-profile win and this is just the thing to do it. Defunding Planned Parenthood will reassure conservatives that the Trump and/or Ryan agenda was not derailed by their AHCA loss.

The next big battle they plan on tackling is likely tax reform. That’s going to take time. Defunding Planned Parenthood will not. Drafting it and pushing it through committees would take no time at all. They could have it on President Trump’s desk in April. They can initiate their next moves on tax reform once Planned Parenthood is defunded.

I’m not going to go into a long diatribe of why Planned Parenthood needs to be defunded from a pro-life perspective. Either you’re in favor of it or not and nothing I can say can sway you. However, if you’re in favor of defunding, then you should be in favor of doing it quickly. At over half a billion dollars a year, it’s not a drop in the proverbial bucket. The longer we wait, the more money gets used to kill unborn Americans. This should have been done already, but I can understand the perceived need to attach it to the AHCA for sales and promotional purposes even if I absolutely disagree with the action itself. Ryan’s strategy allowed more babies to be killed. This should have been a Day 1 issue.

As a Federalist, I’m not giving them this advice for political reasons. The AHCA debacles has helped interest in the new party to spike, so I’m not trying to help the GOP clean up their political mess. However, we’re talking about human lives. I’ll happily push politics aside if it means one more child being saved.

Instead of using defunding Planned Parenthood as a negotiating chip, Congress needs to bite the bullet and make it happen right now. It’s quick, easy, and would draw the attention of mainstream media. Considering the obliteration the GOP is currently receiving this news cycle, it behooves them to turn the narrative towards saving the unborn rather than internal bickering.