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And a persistent GOP talking point is that folks need to have skin in the game, that if you pay more out of pocket, you’ll claim fewer benefits but that’s a starting point unlikely to ensure public health.It’s an hodgepodge of talking points and ideological fragments circumscribed by political reality that cannot make good on its promise.The legislation keeps some popular Obamacare provisions: Insurers still won’t be able to decline to provide coverage because of pre existing conditions, young people will be able to stay on their parents’ insurance until age 26, and lifetime caps on coverage will stay gone. The AHCA also, surprisingly, keeps an Affordable Care Act requirement that insurance plans offer birth control at no additional charge.But that’s the good news.Start with the analysis by Standard and Poor’s that says 6 million to 10 million Americans will lose health care if the AHCA passes, and that a wide range of stakeholders, from senior citizens to medical associations to right wing groups, don’t support it. House Republicans are advancing the bill without a score from the Congressional Budget Office, which projects the cost and impact of legislation.Take the Health Savings Accounts that are a favorite ofHouse Speaker Paul Ryan, Republican of Wisconsin,which allow people to save more of their own pre tax dollars to pay for health care.

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