There are some things to like about the AHCA, but ultimately it needs serious improvement (and that is unlikely to happen).
President Trump said during his address to Congress that they key to making health insurance more accessible is to make it more affordable. That was absolutely right. But I'm not reading anything about this law that fixes the two biggest drivers of premiums: minimum coverage mandates and guaranteed issue.
You abolish the minimum coverage mandates by allowing the purchase of insurance across state lines. But that's not in this bill, as far as I can tell (despite the express promise of damn near every Republican). As for guaranteed issue - requiring insurers to insure people with preexisting conditions - the AHCA preserves it. As a disincentive, it allows a 30% premium increase - for one year - for people who let their coverage lapse. That's not a strong enough incentive to encourage people to maintain continuous coverage, and it's not going to raise nearly enough money to prevent the continuing rise in premiums from insuring sick people.
So while this is a marginal improvement over Obamacare, it falls far short of the reform we need. And it's unlikely to be improved much at all. The GOP strategy appears to be to craft a compromise bill that they can push through by a bare majority. As a result, it contains things that both conservatives and moderates hate. So this thing either blows up and we're stuck with Obamacare, or we get something only marginally better than Obamacare which the GOP now owns. That's an easy choice but not a very exciting one.
