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The parents of a 3-year-old are silent as they sit in their pediatrician’s office in Potosi. They have just learned their son has leukemia. The treatment will be long and hard, but at least it is a type of leukemia that usually has a good outcome. Yet they are also frightened because, between the two of them, they are working five part-time jobs just to keep their family’s heads above water. So they are relieved to hear that Medicaid will cover the bulk of the enormous cost of their child’s treatments. (Robert W. Wilmott and Gary A. Silverman, 6/27)

The AHCA has less-generous tax credits tied only to age. The BCRA, meanwhile, keeps the basic ACA structure, which makes it seem friendlier to patients and to health-care providers. But a closer look reveals warts. In 2020, the income range for tax credits shifts down to 0 to 350 percent of the poverty level. That may help low-income people in states that didn't take the ACA's Medicaid expansion. That's arguably a positive for hospitals and insurers. But other aspects of BCRA erase that benefit. Cost-sharing subsidies will end in 2019. And tax credits will be far less generous. (Max Nisen, 6/27)

In many ways, calling the U.S. House of Representatives’ passed American Health Care Act (AHCA) or the Senate-proposed Better Care Reconciliation Act (BCRA) a “repeal and replacement” of the Affordable Care Act (ACA) is a misnomer. Neither bill fully repeals the ACA nor do their changes focus solely on replacing the ACA’s key provisions. At the most fundamental level, both bills have different goals than the Affordable Care Act. (Marianne Udow-Phillips, 6/27)

Congressional Republican proposals to “repeal and replace” Obamacare would slash Medicaid, the nation’s health insurance program for the poor. In so doing, they would devastate Los Angeles in ways that may not yet be fully appreciated. One in 20 of the nation’s Medicaid recipients lives in L.A. County and relies on the program for their healthcare. About 4 million strong, they make up about 40% of the county’s population. Many would be at grave risk of losing their health coverage, and consequently all but emergency medical treatment, under the Republicans’ program. Current programs to provide housing and treatment to thousands of people living on the streets, or heading there after their discharge from hospitals or release from jails and prisons, would be seriously curtailed. (6/27)

The health-care overhaul that Senate leaders floated this past week does more than roll back an entitlement Republicans have loathed since the day it was enacted in 2010. It portends a deeper struggle over the safety net that pits the elderly against the poor. The federal government is often called an insurance company with an army. Thanks to aging and health-care inflation, the cost of that insurance is rising relentlessly. Social Security, Medicare and Medicaid now swallow 58% of tax revenue, and are on track to take 80% by 2047. (Greg Ip, 6/28)

You can see the train wreck coming. Iowans who do not receive health insurance through an employer may not be able to buy it next year on a state-based exchange created by Obamacare. Only one insurer has applied to offer individual coverage here in 2018. That company, Medica, is proposing steep rate increases and may still pull out of the market. Iowans cannot purchase insurance if no one will sell it to them. What are they going to do? (6/26)