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  • Donald Trump wants to replace ObamaCare, but GOP plans would see 22 million people lose their coverage, according to government estimates. (Photo: Getty)

    President Trump, as usual, has been all over the map about congressional health care legislation. The sad fact is he’ll say anything to advance the GOP agenda and to satisfy his political vendetta against former President Barack Obama.

    On Capitol Hill, the hypocrisy is just as palpable.

    GOP lawmakers have no qualms about spending taxpayers’ money on their own gold-plated health insurance, but snap the purse strings when it comes to health insurance for average Americans.

    They simply don’t want to spend the money, which is at the root of the nation’s health care dilemma.

    Insurance companies can’t afford to insure people who are sick, or who have per-existing conditions, without also enrolling young people in their plans.

    The young are basically healthy and require far fewer health services. Of course, as they grow older, they’ll require more medical attention. By then, however, a new generation of young people will help support them.

    That’s the way insurance is supposed to work.

    But many young people don’t see it that way. They avoid buying health insurance until they are sick, in effect, jumping into the pool, without doing their part to support the system.

    To bring more young people into insurance pools, ObamaCare required them to buy insurance or pay a fine. The measure also imposed a surtax on the wealthiest Americans. The money is used to cover the cost of health insurance subsidies that make insurance more affordable for poor and lower-income middle-class families.

    Without those funding sources, insurance companies can’t make money (that’s really what they are in business for) without even steeper increases in premiums and deductibles.

    If TrumpCare is going to take care of people with pre-existing conditions, the money has to come from somewhere.

    But the GOP measure ends the mandate on young people and the tax on the wealthy. In effect, the bill amounts to a massive tax break for the richest 1 percent of Americans.

    The only way for insurance companies to make money is to lowers expenditures. That means denying coverage to millions off mostly sick people, mainly by pricing them out of the market.

    When uninsured people get sick, however, they tend to show up at Emergency Rooms. They cannot, by law, be denied treatment.

    So the government (read taxpayers) picks up the cost for services, anyway. The problem is emergency room treatment is 10 times more expensive than regular treatment. So who wins?

    TrumpCare advocates insist insurance premiums will go down for many. But that’s because insurance companies will be allowed to offer stripped down policies with few benefits. That’s great if you’re young and healthy. But look out if you’re sick, injured or elderly.

    ObamaCare is certainly flawed, but not for reasons that Trump and the GOP claim.

    Here’s the shell game the GOP has been playing.

    Congress passed ObamaCare with a starvation budget. A public option that would have kept insurance companies honest and spurred competition was cut from the bill at the request of health insurance lobbyists.

    Many governors, in mostly GOP red states, also refused–for largely political reasons–to accept additional Medicaid funds to help expand coverage.

    Medicaid would be slashed dramatically under the House and Senate bills over the next 10 years.

    In other words, it was sabotaged from the get-go.

    Yet, the law has still expanded coverage, in many cases at lower cost, thanks to subsidies that make insurance affordable for millions of people.

    The problem is the subsidies don’t go far enough. Many middle-class families who need help aren’t eligible for financial aid. But you can thank the Congress for that as well.

    ObamaCare is a solid strategy because private companies remain first-line providers of health insurance. It stops short of a total government-subsidized system like Canada, Great Britain and every other developed nation.

    Republicans and Trump need to start being honest about health care, and stop trying to pull the wool over people’s eyes just to give the rich a tax break.

    ObamaCare can work, let’s fix it.