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The only silver lining in the massive storm cloud hovering over the Affordable Care Act is the persistence of bipartisan support for payment reforms aimed at improving healthcare quality and lowering its cost. ... But that doesn't mean the CMS is proceeding smoothly toward value-based reimbursement. (Merrill Goozner, 7/7)

I always considered the Affordable Care Act to be more about health insurance reform than healthcare delivery reform. While far from perfect, it has expanded coverage to millions of Americans who were previously unable to afford health insurance. ... Seven years later, I thought the national debate would finally shift from how we pay for healthcare to how we deliver it. By now, I thought the conversation would be about making Americans the healthiest people in the world and developing a healthcare system that's affordable, high quality and convenient for everyone. Instead, we're back to square one.​ (Dr. Rod Hochman, 7/10)

The opposition of the American Medical Association, American Hospital Association, AARP and other prominent groups did not stop the House from passing its version of a replacement for the 2010 health care law. Now, those lobbies are searching for the precious few pressure points to help derail the Senate bill. It’s already clear that the political forces driving the bill, or the ones that might ultimately take it down, are bigger than they are. After all, this is about a promise Republicans repeated for four elections: to undo Obamacare. (Kate Ackley, 7/10)

When it comes to health care coverage, House Speaker Paul Ryan says, “We’re going to have a free market, and you buy what you want to buy,” and if people don’t want it, “then they won’t buy it.” In this model of health care, the patient is consumer, and he must decide whether the goods and services he wants to protect his life are worth the cost. But this is often impossible. And what Republicans, and many Democrats, forget to stress, is that in a totally free market health care system, you must be willing to let some patients die. (Dr. Farzon A. Nahvi, 7/10)

This year, Congress has worked hard to craft solutions to the real challenges being experienced in the health care marketplace. In many states, including Wisconsin, the individual insurance market needs to offer more health plan options at a lower cost. (Bernie Sherry, 7/7)

The biggest problem with Obamacare is that it expanded health coverage through Medicaid, a program with notoriously poor access to doctors, because Medicaid pays doctors far less than private insurance. The Senate Republican health care bill aims to change that, by giving states the ability to offer an innovative new model to their poorest residents: direct primary care. ... The way to think about DPC is that it’s like concierge medicine, but for everyone, including the poor. The idea, at its core, is simple: for a nominal fee amounting to the cost of a gym membership, a patient gets broad access to a physician’s time. (Avik Roy, 7/9)