House Speaker Paul Ryan: We are gutting Obamacare

The election of Donald J. Trump and a Republican Congress provides an opportunity to immediately halt the leftward drift of American social policy and renew an era of prosperity defined by market-based, state-driven solutions that empower people. The kind of thing conservatives have long dreamed of.
But only if we keep the promises we have made.
That’s what the American Health Care Act is all about. It is the most bold and conservative health care legislation to come before Congress in decades.
Bold because it dismantles the progressive health care experiment and replaces it with a dynamic, patient-centered system. Conservative because it applies our founding principles—freedom, free enterprise, and federalism—to the problems of the day.
Repeal must happen, and urgently. Not because of ideology but because American families are already paying the price of the law's collapse. Under Obamacare, the average premium increase this year was 25 percent, and one out of three counties now have just one insurance provider to choose from. This trend will only worsen: Humana has already announced it will not offer coverage in the marketplace for 2018. Others are threatening to do the same. As the CEO of Aetna recently said, the individual market is in a death spiral.
We propose a radically different approach. Instead of arrogant and paternalistic mandates, we will use choice and competition to create a vibrant market where every American has access to quality, affordable coverage. Achieving this goal will require a three-pronged approach:
  1. using the budget reconciliation process to repeal Obamacare and replace it with the foundation of a patient-centered system;
  2. administrative actions by the Department of Health and Human Services to further deregulate the market;
  3. and additional legislation that we cannot pass through reconciliation.
The American Health Care Act is the linchpin of this process. It is modeled on legislation introduced by HHS Secretary Tom Price during numerous Congresses. It reflects decades of policymaking by conservative scholars and organizations.
The bill effectively guts Obamacare, and all its taxes, mandates, and spending. It initiates a stable transition, where no one will have the rug pulled out from under them. And it puts in place good conservative health care policies.

First, we are defederalizing Medicaid and giving control back to the states.

This is—without question—the biggest entitlement reform in generations.

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