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With the withdrawal of the ACHA bill due to shortage of votes

Speaker Paul Ryan says the collapse of the House Republican health care bill means former President Barack Obama's health care law will be around for the foreseeable future.

The Wisconsin Republican addressed reporters minutes after GOP leaders abruptly shelved the legislation, averted likely defeat for the bill. But it still dealt a damaging setback to President Donald Trump, Ryan and an entire party that has long said it wants to annul Obama's statute.

Ryan says pulling the bill was "a setback, no two ways about it."

The speaker is chiding Republicans who refused to back the legislation for being too inflexible. He says lawmakers must be "willing to give a little to get something done."

Many conservative and moderate Republicans opposed the legislation.

and thus a failure to repeal Obamacare. In light of this news, Donald Trump puts the blame on Democrats for the failure although, others believe The House Freedom Caucus swayed the vote.

Politico writes in How a secret Freedom Caucus pact brought down Obamacare repeal:

Freedom Caucus members told the White House they distrusted Ryan because he doesn’t listen to their concerns. They refused to work with him, going around his back to negotiate with the White House. Little Trump did to woo them worked because the group always wanted more, White House officials and GOP leadership insiders said. They were buoyed by outside groups rooting them on, and didn't fear the White House's fury because the law was unpopular — and, increasingly, so was the president.

Rhetoric:

Did the Freedom Caucus expand on how much more was needed to get their vote? or was it simply them saying 'Okay, there's not enough. We're saying no'?

Question:

What more would the ACHA bill have needed to garner support from the House Freedom Caucus?

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    "Anything you want to change in the bill so it doesn't poll at -20 would be a good start" :) – user4012 Mar 27 '17 at 15:49
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    More seriously, blaming anyone for the bill failing other than the bill's author is kind of ... incorrect. But having said that, there are several times more Democrats than Freedom Caucus members (190+ vs ~30); so if any blaming can occur, it's not entirely unreasonable to blame people who had 6+ times the "no" votes (to put it another way, if only 16% of Democrats voted "yes", it wouldn't matter if 0 or 100% of Freedom Caucus voted "no"). If 16% of F.C. voted "yes", it wouldn't have helped the bill. – user4012 Mar 27 '17 at 15:53
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    Many conservative and moderate Republicans opposed the legislation. That quote makes me laugh. Is a conservative an extreme hardline Republican? Is a liberal an extreme hardline democrat? I was under this silly understanding that conservatism and liberalism where the ideologies backing the Rs and Ds respectively... not some scalar value of extremism. – David Grinberg Mar 27 '17 at 16:16
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    @SoylentGray how is it hypothetical? So, the House Freedom Caucus didn't have any specific ideas about THIS bill, not any generalization of how the Freedom Caucus have acted in the past? I'm sure they had specific ideas for the version of the bill they wanted and i'm also sure they announced them. That is why I'm asking. I'm using the scenario of the bill passing to specify what they wanted to get it passed not to emphasize the hypothetical of it passing. I feel you've misinterpreted the question. – Bradley Wilson Mar 27 '17 at 16:23
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    @SoylentGray it's not hypothetical. They asked for things and didn't get them. The question is what things they asked to be included or changed. – lazarusL Mar 27 '17 at 16:38
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The Freedom Caucus is looking for a complete repeal of Obamacare and a return to a free market healthcare system. Ryan's plan, which they dubbed Obamacare-lite, was not a full repeal of Obamacare. Ryan had stated that this was the first phase of a 3 phase plan that would ultimately complete the repeal and replace promise. However, the Freedom Caucus do not trust the leadership (including Ryan) to complete this plan and they do not believe it goes far enough.

So what would it take to win over the Freedom Caucus? Well the details would be up to political horse trading, but big items would be an immediate repeal of Obamacare and the individual mandate. Other things that would help a lot would be significant reductions to healthcare regulations, such as requirements to cover pre-existing conditions and restrictions of selling healthcare across state lines.

Representative Jeff Duncan (R-SC) has written an informative letter explaining his position on the bill. Here is a short selection from his letter:

What the House Bill Does (And Doesn’t Do)

First and foremost, the American Health Care Act does not repeal Obamacare.

The bill does repeal some facets of Obamacare, and there are some things to like about the bill. These include:

  • Defunding of Planned Parenthood, something Republicans should have already been able to do.
  • Repeal of the individual mandate, which requires everyone to purchase health insurance or pay a gradually increasing fine.
  • Repeal of the employer mandate, which subsequently changes the definition of full-time employment.
  • Repeal of the medical device tax and other taxes on health insurance premiums and pharmaceuticals, while increasing the expense threshold for medical expense deductions.
  • Ending the Medicaid expansion after three years.
  • Repeal of the government subsidy for health insurance premiums.

These are good things that were all included in the 2015 budget reconciliation bill, which passed both houses of Congress.

The American Health Care Act also repeals the individual mandate that requires everyone to have health insurance or pay a gradually increasing tax. But the House GOP plan replaces the individual mandate with its own penalty—a 30 percent penalty to the insurer if there is a lapse in coverage.

In essence, this is requiring people to have health insurance or risk paying more when they do obtain it. The penalty will just be retained by the insurance companies instead of being collected by the government in the Obamacare tax.

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