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The bill recently approved by the U.S. House of Representatives and now headed to the Senate for consideration would replace the Affordable Care Act's income-based government subsidies with credits ranging from $2,000 to $4,000, depending on age.

The AHCA would give tax breaks to millionaires and billionaires while cutting $1 trillion in health care assistance to disadvantaged Americans.

Mr. Tipton fails to mention the significant American Health Care Act loophole regarding those with pre-existing conditions. These plans will mainly continue as before. And they could penalize and phase-out more non-compliant plans. He was talking about Obamacare, which Republicans are trying to replace with legislation now in the hands of the Senate.

The states have filed a motion to intervene in a court case that could decide whether critical payments, called cost-sharing-reduction payments, are made to insurers in the ACA's individual insurance exchanges. This flexibility will probably be favored mostly by small businesses and those with smaller profit margins. While the Donald Trump/Russia debacle has been rapidly unfolding let's not forget about legislation that could, um, kill people.

Many senior administration officials, including Health and Human Services Secretary Tom Price, are leery of ending the payments, however, because doing so could immediately unravel the Obamacare insurance markets and strongly discourage insurers from participating next year.

My take is that the new bill does not represent any great shift or dramatically alter where the health system is on that spectrum.

Now Trumpcare wants to gut Medicare, Medicaid and Planned Parenthood, which provides care to tens of millions of Americans. However, a Kaiser Foundation poll shows 61 percent of voters, including 65 percent of independents, will blame Trump and Republicans in Congress if the exchanges created through Obamacare fail.

They're concerned changes to the law would result in a loss of some benefits or access to care.

High-risk pools are a key ingredient of the Obamacare replacement bill that passed the House and is being debated in the Senate, though detractors say they're often underfunded, leading to wait lists or high costs for people with preexisting medical conditions. Screwing over 7 million low-income policy-holders, and destabilizing the insurance markets for many millions more, would be an underhanded blow that should shame its perpetrators, particularly the one who is jetting off to the Middle East and Europe to proclaim America's return to greatness. Medicaid is a vital safety net and intergenerational lifeline for millions of individuals, including almost 7 million people 65+. This will hurt hospitals, especially those in rural areas with smaller profit margins.

"I do think it's hard sometimes for people who have always had the luxury of having coverage to understand what it's like to not, and it's not necessarily a situation that you can personally control", said Jennifer Lightbody, executive director of Peoples Community Health Clinic in Waterloo.


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