The healthcare story today looks like a list of appealing promises have somehow lost their luster in the Cold Light of legislative consideration. Politico has itemized them on this snowy morning. Perhaps the most ignored unkept promise -- a quick fix -- is the most obvious. The GOP has already conceded that repealing and replacing Obamacare will take multiple legislative steps. Nothing about the current effort, even if it gets off the ground, is quick.

Where did "everybody" go

Then there is the promise that everybody would have insurance, given by the president to the Washington Post.

In today's cold light we have the Congressional Budget Office (CB0) estimate that 14 million will lose coverage off the bat and that this number would rise eventually to 24 million. The White House disputes these figures even though its own Office of Management and Budget has concluded that CBO underestimated the actual number that would lose insurance. Regardless of the exact figures, everybody will not have insurance under any existing or proposed US health plan.

Medicaid problems

Another promise that Donald Trump made in more than one venue was that there would be no cuts in Medicaid.

It has been clear from the start that the current bill which comes from Paul Ryan but now is called Trumpcare cuts of Medicaid expansion in 2020. In fact, Trump himself may have tried to get the cutoff moved to 2017 to please some Tea Party members of Congress.

The Kellyanne pledge

The promise that no one will lose coverage was delivered by Trump counselor Kellyanne Conway.

On the face of it, this promise cannot be kept The Trump legislation explicitly removes coverage from millions.

Better or worse off

The biggest question for some may well be whether the Trump legislation will lead to more or less financial pain. The answer is not straightforward. CBO predicts premiums will rise in the first two years if Trumpcare is law. Then they might go down due in part to forthcoming regulatory laxity and younger people entering the system. It is the elderly who would suffer most from rising premiums and growing expense.