You've go the Freedom Caucus insisting on 1) elimination of the 26 year old addendum, 2) elimination of guaranteed issue, and 3) phase-out of the federally subsidized Medicaid expansion. You've got the RINO's insisting on 1) keeping the 26 year old addendum, 2) keeping guaranteed issue, and 3) maintaining the federal Medicaid expansion subsidy.
How do you rewrite the bill to satisfy those two irreconcilable views?
1) The 26 y/o addendum is ridiculous. 21 y/o unless you are in college. After that you must be a verified dependent for tax purposes. If you refuse to get insurance, you get kicked to Medicaid and pay a high tax out of your paycheck till you get insurance, whatever makes the program whole. And in reality that should be for emergency room treatment only in life threatening accidents and such.
2) Guaranteed issue is also ridiculous. You can give incentives to get insurance co's to take pre-existings, or do carve outs, but there is some point where they got to get kicked to Medicaid, which goes back to 1). Those that are now would have to grandfathered. Guaranteed issue of insurance is practically a contradiction in terms.
3) Medicare and Medicaid both need to be reformed to the point where those that can't or won't get insurance will have to be catch all of last resort and be viable. It will be expensive but it can be reduced to the worst cases only to lower cost.
The moderates need to give up on 1) and 2) and the conservatives on 3). That's the only way it's going to work right, among other things.
