Democrats often are seen on television chortling over the fact that the GOP hasn't coalesced around a single repeal-and-replace plan for Obamacare, the former president's signature law of thousands of pages that was adopted only by Democrats after much political arm-twisting.
But changes to the law already are being made, even if it's not the "trash-it-all" move that some have advocated.
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The Department of Health and Human Services on Wednesday released a series of rule changes to "stabilize" the markets for individual and small groups.
The agency said already in the crosshairs are "enrollment period, guaranteed availability, network adequacy rules, essential community providers, and actuarial value requirements."
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"Americans participating in the individual health insurance markets deserve as many health insurance options as possible," said Dr. Patrick Conway of the Centers for Medicare & Medicaid Services. "This proposal will take steps to stabilize the marketplace, provide more flexibility to states and insurers, and give patients access to more coverage options. They will help protect Americans enrolled in the individual and small group health insurance markets while future reforms are being debated."
That "debate" also took a step forward on Wednesday, with the announcement of a replace plan from Sen. Rand Paul, R-Ky., and Rep. Mark Sanford, R-S.C.
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It was immediately endorsed by the House Freedom Caucus, the influential group of members who advocate smaller-government and freedom of the individual.
The proposal would, according to CNN, "lift restrictions on insurers and give Americans more tax breaks for buying and using health care. Politically, the bill is intended to send a clear signal that there is no excuse for delaying a vote to roll back the health care law, as top Republicans have yet to unveil a blueprint for an alternative."
Rep. Mark Meadows, R-N.C., the chairman of the caucus, said the "speculation on what a replacement will look like has created an unnecessary climate of anxiety in this discussion."
"As members of Congress, we have a responsibility to reassure Americans – particularly those with pre-existing conditions – that they will be protected under a new system."
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Several other strategies for replacement have been rolled out, although none has yet acquired overwhelming support in the House. That has prompted critics to suggest that there is no plan and that nothing will change.
But Sanford said a half-way effort isn't going to be enough.
"Our simple message is we don't want to have 'Obamacare light.' That would be a mistake," he said, according to CNN. "We've all seen the crowds in different town hall meetings. We've all gotten the emails and phone calls, and there will be a real temptation to do that based on political forces and based on political fear."
He said, for example, he and others have been calling for a repeal plan that was first lined up two years ago. It calls for dropping the Obamacare taxes immediately and allowing Congress two years to develop a replacement.
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While critics see mounting "pressure" on House leaders, the leaders insists they're making progress step-by-step.
"We want to get it right, and we've been taking our time to do that," said Rep. Greg Walden, R-Ore., the chairman of the House Energy and Commerce Committee. "You're going to see us come forward with a replacement bill after we repeal that makes sure that people have access to affordable care health for the first time."
The rules changes put into the process include allowing insurers more time to figure out 2018 plans, increasing the inspections of special enrollment periods and allowing insurers to require that premiums are current before allowing new coverage.
Establishment media outlets describe the GOP as in "combat" mode, subjected to "divisions" and being "jammed" over the issue.
But considering the thousands of pages in the law, and the tens of thousands of pages of rules that were imposed under the law, the project never was going to be a simple change, such as altering a speed limit.
Freedom Caucus members pointed out that Sen. Paul's bill already exists. It expands health savings accounts, eliminates most regulations on plans and prevents the funding of abortions through health savings accounts.
It also would eliminate Obama's "essential health benefit" demand, which largely has been used to include unneeded coverages for a large number of people. And to the horror of conservatives, Christians and others, it demanded coverage for abortion.
The conservatives, in making the announcement about their support for Paul's ideas, appeared to want to take the lead in what inevitably will be a complicated fight over how best to rid the nation of the morass that Obamacare has become.
"If we don't repeal Obamacare, then what was our fight about for the last six years?" Rep. Raul Labrador, R-Idaho, asked in the Washington Post. "If our party was only opposing it because it was proposed by Obama and Democrats, the base is going to leave the party."
The Freedom Caucus took to Twitter to explain the GOP has "an obligation" to American taxpayers.
WND reported another significant recent change was the de facto end of the mandate to buy health insurance.
The IRS said it would stop turning away filers who fail to provide the once-required proof of health-insurance coverage on their tax forms.
One of Trump's first executive orders told federal agencies to come up with plans for relief of Obamacare mandates for the American people.
Under the law passed during Obama's White House time, all tax filers had to affirm on their forms they have health care. Those who didn't check the box, and who didn't have some sort of exemption explanation, would see their returns shifted into a pile the IRS dubbed "silent returns."
House Speaker Paul Ryan and others on Capitol Hill have been rallying in recent days to repeal, replace or otherwise reform Obamacare.
"This law is in a collapse," Ryan said in a recent press conference.