United States Congress of Fail (Part 2)

[GreyhoundFan]

"This union ironworker wants Paul Ryan’s job. He’s got a great ad but a losing record."

Spoiler

A Wisconsin congressional campaign ad has politicos buzzing. It opens with footage from President Trump’s victory lap news conference in early May, when he and House Speaker Paul D. Ryan jubilantly celebrated the House vote to repeal and replace Obamacare.

Then it cuts to sprawling sunrise shots of open fields and grain silos in southeastern Wisconsin, finally landing in a living room where a woman who has multiple sclerosis describes the 20 drugs she must take to control her excruciating pain.

She is speaking to her son, Randy Bryce.

Bryce is a Democrat who on Sunday announced he would challenge Ryan in the 2018 midterm election. He portrays himself as the antithesis of Ryan. He is a blue collar Democrat, union leader, ironworker, Army veteran and single dad.

After listening  to his mom, Bryce makes clear how he plans to win: by selling himself as a working class hero who wants to save health care.

He’s a man’s man. He wears T-shirts and dad jeans, hard hats and welding masks. He’s nobody’s wonk. Where Bryce works, sparks fly.

“Let’s trade places,” Bryce says at the end of the ad, addressing Ryan. “You can come work the iron, and I’ll go to D.C.”

Just 48 hours after its release, Bryce’s two minute and 30 second spot is being hailed for its evocative messaging — and being cast as exactly what Democrats need to win over Trump country in 2018.

...

Some sharing his ad online have compared him to the fictional mustache-wearing Parks and Recreation character Ron Swanson. Someone wrote that Bryce is “genetically engineered from Bruce Springsteen songs.”

Bryce’s Twitter handle — @IronStache — shows his social media swag.

“I don’t just want @IronStache to be my Congressman,” one man tweeted. “I want him to be my father.”

Even Bryce professed to be surprised by the attention the ad is getting.

...

But it’ll take more than a great ad and working class cred to elect Bryce.

The district covers southeastern Wisconsin from the city of Janesville in the west to Racine and Kenosha to the east on Lake Michigan, south of Milwaukee. It’s Republican. It hasn’t elected a Democrat since 1993. And Ryan has won it with ease since he was first elected nearly 20 years ago.

It went for Trump by 11 percentage points last fall. Ryan won by 35 points.

On top of that, Bryce’s three prior attempts at winning elected office have failed.

He lost a Democratic primary for state assembly in 2012. Two years later, in 2014, Bryce was defeated in the general election for state senate. And in 2013 he lost a 10-way primary for Racine County Board of Education, according to the Milwaukee Journal Sentinel.

“The voters of Wisconsin have already rejected Randy Bryce multiple times,” Republican Party spokesman Alec Zimmerman told the AP. “Instead of fighting for hard-working Wisconsin families, Randy Bryce will say and do anything to get to Washington and defend his liberal special interest friends.”

But Bryce is counting his previous defeats as formative, valuable experiences. He told the Journal Sentinel that he plans to raise $2 million. The newspaper reported that Bill Hyers, campaign manager for New York Democratic politicians Sen. Kirsten Gillibrand and Mayor Bill de Blasio, is guiding Bryce’s campaign.

The Wall Street Journal’s Reid Epstein reported on Twitter that Bryce’s campaign confirmed raising more than $100,000 within the ad’s first 24 hours.

“I’ve learned a lot,” Bryce told the Journal Sentinel. “The people of Wisconsin know who I am. I have community roots.”

His life story is one with deep blue collar ties, the kind of narrative that used to entice Midwesterners to the Democratic Party but in 2016 had them flocking to Trump’s pledge to “Make America Great Again.”

The ironworker and union activist is a lifelong resident of southeastern Wisconsin. His mother worked in a doctor’s office and his sister is a public school teacher. Bryce’s father, who lives in an assisted living facility, was a police officer, according to a campaign news release. His brother followed that same path into law enforcement.

Bryce, an Army veteran, took some college classes but never graduated, reported the Daily Cardinal. He survived testicular cancer in his 20s, the campaign said, and had a “miracle child” in his 40s. Bryce is divorced, according to his Facebook page, but his young son Ben makes an appearance in the viral campaign ad.

“I work everyday so that me and my son have insurance,” Bryce says in the spot, a tool belt slung over his  shoulder. “I’ve been an iron worker for 20 years. I work hard and I earn every penny that I make. And I know everybody that I work with is the same way.”

He represented the union Ironworkers Local 8 for nine years as a volunteer political coordinator, reported the Journal Sentinel. Bryce is president of the Wisconsin Veterans Chamber of Commerce board of directors, chair of the Democratic Party of Wisconsin Veterans Caucus and until recently served on the Milwaukee Area Labor Council board of directors.

The ad, which is in the article, is excellent. And Paul Ryan wouldn't make it 10 minutes trying to be an ironworker.

[VixenToast]

1 hour ago, GreyhoundFan said:

"This union ironworker wants Paul Ryan’s job. He’s got a great ad but a losing record."

The ad, which is in the article, is excellent. And Paul Ryan wouldn't make it 10 minutes trying to be an ironworker.

I really liked that article. Ty Greyhound! I wish this guy the best.

[GreyhoundFan]

"Policies that will make the next recession both more likely and worse"

Spoiler

In case you were thinking I’ve been too upbeat lately, let’s talk about recessions. Economists can’t tell you when the next downturn is coming, but we can tell you if we’re ready for it.

We’re not.

Moreover, at least by one standard measure, even as the current expansion enters its ninth year, which is pretty old for a recovery, we still haven’t fully made up the damage from the last recession. And if President Trump and congressional conservatives have their way, the government’s “countercyclical function” — the temporary, automatic ramp-up in spending to offset recessions — will do much less to help those whacked by the next downturn. Meanwhile, conservatives’ financial deregulation agenda makes another economic shampoo cycle — bubble/bust/repeat — more likely.

In other words, Congress is undermining recession-readiness at the same time they’re proposing actions that make the next downturn more likely to occur.

Start with the figure below. The two lines are real and potential GDP per person, the latter being what GDP would be, according to the Congressional Budget Office, if the economy were operating at full strength. Thus, the difference between the two lines gives you an estimate of the per-person cost of recession.

...

Just eyeballing the figure, it’s clear that the current gap is larger than previous ones. Accumulating the losses over the full recovery amounts to a loss of $12,000 per person, a far greater loss than any other shown in the figure. That’s three times the loss in the second biggest gap in the figure, the one after the early 1980s recession. (Note to high-school calculus students: We’re integrating under the curve! See, you do use this stuff later in life.)

There’s another, more subtle observation allowed by the figure. The slope of the red line (potential GDP) has flattened of late. For several reasons, including scarring effects from the last recession and slower productivity growth, per-capita GDP growth even at full employment is slower than it used to be. And yet actual GDP still hasn’t caught up. It’s like a runner having trouble crossing a goal line that’s moving toward her!

With the costs of recessions/weak recoveries so high, it’s imperative that we arm ourselves with the tools to fight them. My big worry, again, isn’t that a big recession is around the corner but that we’re not ready for it when it inevitably arrives.

There are two bins of countercyclical, recession-fighting policy: monetary as per the Fed, and fiscal as per the Congress. Depending on when the downturn hits, monetary policy may not have had time to reload, meaning that the Fed’s main recession-fighting tool — the benchmark interest rate they lower in downturns — may still be too low to have much traction (not that I would want them to raise rates any faster!). A related problem is our low inflation rates. Slightly higher inflation going into a recession helps by making real interest rates lower and by making it cheaper for people to service their debts. Still, depending on who’s in charge over there, I’m confident that the Fed will do what they can to help.

It’s Congress I’m worried about. First, one reason for the big gap at the end of the figure above is that the federal government pivoted to deficit reduction too soon (to be fair, the Obama administration, which I was in at the time, contributed to this mistake). Any ramping up of countercyclical spending — for infrastructure, boosting safety net programs, even tax cuts — may well be blocked by the same ideological opposition to anything Keynesian that we saw in Congress last time, not to mention caps on discretionary spending that came out of that period.

But at least we’ve got the automatic stuff that kicks in when people start falling through the cracks, right? Not if anything like the proposed cuts to the safety net go through. Medicaid, SNAP (food stamps), employment programs, infrastructure spending — they’re all on the chopping block in both Republican budgets and health-care bills. One of the worst things they’re trying to do in this space is turn safety net programs, like SNAP and Medicaid, into block grants, which would end those programs’ critical countercyclical function (“per-capita caps” start out slightly better in this regard but, eventually, amount to the same thing).

Another Republican initiative in this space that would compound the damage to vulnerable people in recessions is the intention to add work requirements to safety net programs. Even in strong recoveries, that’s a terrible idea — do you really think less than $5 a day in food stamps is what’s keeping someone from working? But in recessions, when unemployment is rising quickly, work requirements make even less sense.

Pause for a second and note the cruel irony: Republicans are telling the poor, “damn it, get a job!” and then doing everything they can to make it harder for the poor to do so.

One bit of semi-positive news is that state “rainy-day” and unemployment insurance funds are mostly back to (or in some cases even above) pre-recession highs (see Figures 9-10 here). Why just “semi-positive?” Because, as budget expert Elizabeth McNichol pointed out to me: “State revenue have been growing very slowly for a few years, and the trend is expected to continue. For example, for the fiscal year just about to end, state revenue came in below original estimates in 33 states.” Depth of recession matters here, as well. Liz made the important point that states didn’t have the reserves they needed going into the last downturn, and “getting back to rainy-day fund levels that weren’t adequate in the past is not a sign of great fiscal health.”

Finally, consider that the last few downturns were caused by the bursting of speculative credit bubbles (dot.com and housing). Congress passed Dodd-Frank financial reform to deal with this problem, but as alluded to above, the passage of the Choice Act in the House signals an attempt by conservatives in the thrall of the deep-pocketed financial lobby to unwind these reforms and put the economy at risk again.

There’s a cost to dysfunctional, unrepresentative government. It may take a while to show up, but trust me, it will.

There are so many things to worry about with this congress and administration, but this is definitely a lasting issue.

[GreyhoundFan]

This worries me so much. I tried calling McTurtle's office, but got a "voicemail full" message. I've talked to several staffers at both my senators' office so many times that we're almost on a first name basis. "Senate GOP leaders will present health bill this week, even as divisions flare"

Spoiler

After weeks of secret deliberations, Senate Republicans are in the final stages of a sweeping rewrite of the nation’s health-care laws amid growing frustration among the rank and file over how to fulfill the party’s top campaign promise over the past seven years.

Senate Majority Leader Mitch McConnell (R-Ky.) said Tuesday that GOP leaders will produce a “discussion draft” on Thursday and hinted that a final vote could come next week — even as key senators expressed concern about the emerging legislation, the lack of transparency surrounding it and the disagreement that remains.

McConnell’s desire to wrap up before the Fourth of July recess reflects the sense of urgency among Republicans, including President Trump, to show progress on health care after years of vowing to “repeal and replace” the Affordable Care Act.

But McConnell’s strategy for achieving that goal — writing a bill with a handful of aides behind closed doors — has come at a cost that reached new heights on Tuesday: anger among Republicans who feel shut out of the process.

“Do you know what the health-care bill looks like?” Sen. Lisa Murkowski (R-Alaska) asked reporters Tuesday, her frustration evident. “Because I don’t.”

McConnell told reporters that he would “lay out a discussion draft Thursday morning; you’ll be able to take a look at it” — but he declined to discuss the specifics. He said the Senate would take up the bill on the floor once it receives a score from the nonpartisan Congressional Budget Office — possibly Monday.

Trump has sent mixed signals to Capitol Hill and has played a more hands-off role in Senate deliberations than he did in the House. While the president has pushed for swift action on health care and celebrated the passage of the House bill in May, he also “wants a bill that has heart in it,” press secretary Sean Spicer said at the White House on Tuesday. And at a private meeting with senators recently, Trump called the version that passed the House “mean.”

Senate Republicans have vowed to repeal and replace key parts of the ACA, commonly known as Obamacare, the 2010 law that has provided insurance to about 20 million additional Americans through a combination of expanded Medicaid coverage and private insurance, much of which is federally subsidized.

But even among Republicans — no Democrats are expected to support the bill — competing ideological goals have complicated Senate negotiations. Among the challenges in a messy drafting process: how to lower insurance premium costs and eliminate what some view as burdensome coverage mandates without increasing the number of uninsured Americans. It has become both a political and a substantive question for some GOP senators — many of whom campaigned on a promise to “repeal and replace” but now face strong evidence that their constituents like their coverage and insurance protections under the ACA.

The more contentious issues have included how to slow spending growth in Medicaid and reducing requirements for health plans, such as mandated coverage for certain diseases or preexisting conditions.

Senate leaders hope to start debate by Tuesday or Wednesday of next week, said two senior GOP aides who spoke on the condition of anonymity to describe strategy — yet it remains unclear whether McConnell has the 50 votes he needs (plus the tiebreaking vote of Vice President Pence) to pass the bill. Democrats and Republicans will each have 10 hours to debate the bill before being allowed to offer an unlimited number of relevant amendments in what is commonly known as a “vote-a-rama.” If all goes as planned, a final vote could occur by the end of next week, the aides said.

Even lawmakers who have supported the idea of moving swiftly said they don’t know what will be in the bill.

Sen. Bob Corker (R-Tenn.) told reporters that while he and his colleagues “all understand what the tensions are” in reaching a compromise, it was impossible to say whether they had resolved them yet.

“Every single person is in the same place. They want to see the text,” he said. “There’s no way for anyone to know what we have until we have language.”

Sen. Ted Cruz (R-Tex.), a key architect of a health-care working group that has been huddling regularly for weeks, said that while the senators “continue to make good progress” on crafting a compromise, “a great deal of work remains to be done.”

The critical test, Cruz said, is whether the bill would drive down premium costs. “Right now, the current draft doesn’t do nearly enough in that regard,” he said.

As he left a working-group meeting Tuesday, Sen. Orrin G. Hatch (R-Utah) was asked whether Republicans had moved any closer to completing their work.

“Didn’t seem like it to me,” Hatch responded, with a chuckle. “There’s still a lot of different points of view. And there are no simple answers to these problems.”

One of the biggest and most divisive matters under discussion is how to structure Medicaid. Some GOP senators from states that expanded Medicaid under the ACA are trying to phase out higher federal payments at a slower rate than a bill that passed the GOP-controlled House in May. Some conservatives, meanwhile, are seeking to slow the growth of Medicaid’s costs.

Sen. Patrick J. Toomey (R-Pa.) called talks on the bill “a work in progress” on Tuesday. Toomey is leading the conservative Republicans who want to slow Medicaid’s costs.

On the opposite end of the spectrum is Sen. Rob Portman (R-Ohio), who has been pushing for a seven-year phaseout of Medicaid expansion that he called a “glide path.” McConnell has been pushing for a three-year phaseout. Both would be more gradual than the House bill.

Republicans hold a 52-48 advantage over Democrats and thus can afford to lose only two votes, even under the maneuver known as reconciliation they are using to enable them to pass it with a simple majority rather than the 60-vote majority required of most legislation.

Asked whether negotiations were far enough along to allow for a vote next week, Cruz, who is more concerned with paring back regulations in Obamacare than he is in the Medicaid debate, said, “I think our decision not to set artificial deadlines was the right decision.”

Democrats have registered their displeasure this week with both the process and policy Republicans are spearheading. On Tuesday, they continued their protests, using a parliamentary tactic to slow other Senate business.

“If the Republicans continue down this path, ignoring the principles of transparency and the open debate that define this legislative body, we Democrats will continue to do everything we can to shine a light on what our Republican friends are doing,” Senate Minority Leader Charles E. Schumer (D-N.Y.) said on the Senate floor.

In 2009, two key Senate committees held extensive hearings and votes on bills that eventually formed the basis of the ACA. Two separate committees adopted dozens of GOP as well as Democratic amendments in meetings that lasted 13 days and eight days, respectively. The final Senate bill passed in December 2009, after 25 days of consideration on the floor. All told, the Senate considered the health-care bill for a total of 160 hours.

Cruz dismissed the Democrats’ criticism as unfounded.

“There has been no political issue in modern times more debated than Obamacare,” he said, noting that controversy over the bill helped propel Republicans’ electoral gains in 2010, 2014 and 2016. “The Democrats’ complaint that we haven’t talked enough is rich with irony.”

The closed-door process has left many health-care advocates at a loss. Dick Woodruff, senior vice president of federal advocacy for the American Cancer Society, said in an interview Tuesday, “We’re doing what we can to communicate to the Hill what impact on coverage” the health-care overhaul could have on its members.

Woodruff, who said his group was particularly concerned about potential cuts to Medicaid and the bill’s impact on people with preexisting conditions, added: “The difficulty is that there isn’t much coming back. It’s like we’re talking to a black box.”

The Senate is scheduled to go into recess at the end of next week. If Republicans do not finish their work on health care before then, they may risk losing steam, as senators return to their home states and potentially face fresh resistance to their efforts.

Still, some Republicans said they were confused about the bill taking shape and warned against rushing.

“I’m hearing lots of conflicting information,” said Sen. Susan Collins (R-Maine), a key centrist.

In a video he posted Tuesday afternoon on Facebook, Sen. Mike Lee (R-Utah) said he had not seen the bill, despite being a part of the Senate GOP health-care working group.

“I’d be fine, don’t get me wrong, to be voting on something soon,” Lee said. “But we should be able to see it first.”

 

[GrumpyGran]

37 minutes ago, GreyhoundFan said:

This worries me so much. I tried calling McTurtle's office, but got a "voicemail full" message. I've talked to several staffers at both my senators' office so many times that we're almost on a first name basis. "Senate GOP leaders will present health bill this week, even as divisions flare"

  Hide contents

After weeks of secret deliberations, Senate Republicans are in the final stages of a sweeping rewrite of the nation’s health-care laws amid growing frustration among the rank and file over how to fulfill the party’s top campaign promise over the past seven years.

Senate Majority Leader Mitch McConnell (R-Ky.) said Tuesday that GOP leaders will produce a “discussion draft” on Thursday and hinted that a final vote could come next week — even as key senators expressed concern about the emerging legislation, the lack of transparency surrounding it and the disagreement that remains.

McConnell’s desire to wrap up before the Fourth of July recess reflects the sense of urgency among Republicans, including President Trump, to show progress on health care after years of vowing to “repeal and replace” the Affordable Care Act.

But McConnell’s strategy for achieving that goal — writing a bill with a handful of aides behind closed doors — has come at a cost that reached new heights on Tuesday: anger among Republicans who feel shut out of the process.

“Do you know what the health-care bill looks like?” Sen. Lisa Murkowski (R-Alaska) asked reporters Tuesday, her frustration evident. “Because I don’t.”

McConnell told reporters that he would “lay out a discussion draft Thursday morning; you’ll be able to take a look at it” — but he declined to discuss the specifics. He said the Senate would take up the bill on the floor once it receives a score from the nonpartisan Congressional Budget Office — possibly Monday.

Trump has sent mixed signals to Capitol Hill and has played a more hands-off role in Senate deliberations than he did in the House. While the president has pushed for swift action on health care and celebrated the passage of the House bill in May, he also “wants a bill that has heart in it,” press secretary Sean Spicer said at the White House on Tuesday. And at a private meeting with senators recently, Trump called the version that passed the House “mean.”

Senate Republicans have vowed to repeal and replace key parts of the ACA, commonly known as Obamacare, the 2010 law that has provided insurance to about 20 million additional Americans through a combination of expanded Medicaid coverage and private insurance, much of which is federally subsidized.

But even among Republicans — no Democrats are expected to support the bill — competing ideological goals have complicated Senate negotiations. Among the challenges in a messy drafting process: how to lower insurance premium costs and eliminate what some view as burdensome coverage mandates without increasing the number of uninsured Americans. It has become both a political and a substantive question for some GOP senators — many of whom campaigned on a promise to “repeal and replace” but now face strong evidence that their constituents like their coverage and insurance protections under the ACA.

The more contentious issues have included how to slow spending growth in Medicaid and reducing requirements for health plans, such as mandated coverage for certain diseases or preexisting conditions.

Senate leaders hope to start debate by Tuesday or Wednesday of next week, said two senior GOP aides who spoke on the condition of anonymity to describe strategy — yet it remains unclear whether McConnell has the 50 votes he needs (plus the tiebreaking vote of Vice President Pence) to pass the bill. Democrats and Republicans will each have 10 hours to debate the bill before being allowed to offer an unlimited number of relevant amendments in what is commonly known as a “vote-a-rama.” If all goes as planned, a final vote could occur by the end of next week, the aides said.

Even lawmakers who have supported the idea of moving swiftly said they don’t know what will be in the bill.

Sen. Bob Corker (R-Tenn.) told reporters that while he and his colleagues “all understand what the tensions are” in reaching a compromise, it was impossible to say whether they had resolved them yet.

“Every single person is in the same place. They want to see the text,” he said. “There’s no way for anyone to know what we have until we have language.”

Sen. Ted Cruz (R-Tex.), a key architect of a health-care working group that has been huddling regularly for weeks, said that while the senators “continue to make good progress” on crafting a compromise, “a great deal of work remains to be done.”

The critical test, Cruz said, is whether the bill would drive down premium costs. “Right now, the current draft doesn’t do nearly enough in that regard,” he said.

As he left a working-group meeting Tuesday, Sen. Orrin G. Hatch (R-Utah) was asked whether Republicans had moved any closer to completing their work.

“Didn’t seem like it to me,” Hatch responded, with a chuckle. “There’s still a lot of different points of view. And there are no simple answers to these problems.”

One of the biggest and most divisive matters under discussion is how to structure Medicaid. Some GOP senators from states that expanded Medicaid under the ACA are trying to phase out higher federal payments at a slower rate than a bill that passed the GOP-controlled House in May. Some conservatives, meanwhile, are seeking to slow the growth of Medicaid’s costs.

Sen. Patrick J. Toomey (R-Pa.) called talks on the bill “a work in progress” on Tuesday. Toomey is leading the conservative Republicans who want to slow Medicaid’s costs.

On the opposite end of the spectrum is Sen. Rob Portman (R-Ohio), who has been pushing for a seven-year phaseout of Medicaid expansion that he called a “glide path.” McConnell has been pushing for a three-year phaseout. Both would be more gradual than the House bill.

Republicans hold a 52-48 advantage over Democrats and thus can afford to lose only two votes, even under the maneuver known as reconciliation they are using to enable them to pass it with a simple majority rather than the 60-vote majority required of most legislation.

Asked whether negotiations were far enough along to allow for a vote next week, Cruz, who is more concerned with paring back regulations in Obamacare than he is in the Medicaid debate, said, “I think our decision not to set artificial deadlines was the right decision.”

Democrats have registered their displeasure this week with both the process and policy Republicans are spearheading. On Tuesday, they continued their protests, using a parliamentary tactic to slow other Senate business.

“If the Republicans continue down this path, ignoring the principles of transparency and the open debate that define this legislative body, we Democrats will continue to do everything we can to shine a light on what our Republican friends are doing,” Senate Minority Leader Charles E. Schumer (D-N.Y.) said on the Senate floor.

In 2009, two key Senate committees held extensive hearings and votes on bills that eventually formed the basis of the ACA. Two separate committees adopted dozens of GOP as well as Democratic amendments in meetings that lasted 13 days and eight days, respectively. The final Senate bill passed in December 2009, after 25 days of consideration on the floor. All told, the Senate considered the health-care bill for a total of 160 hours.

Cruz dismissed the Democrats’ criticism as unfounded.

“There has been no political issue in modern times more debated than Obamacare,” he said, noting that controversy over the bill helped propel Republicans’ electoral gains in 2010, 2014 and 2016. “The Democrats’ complaint that we haven’t talked enough is rich with irony.”

The closed-door process has left many health-care advocates at a loss. Dick Woodruff, senior vice president of federal advocacy for the American Cancer Society, said in an interview Tuesday, “We’re doing what we can to communicate to the Hill what impact on coverage” the health-care overhaul could have on its members.

Woodruff, who said his group was particularly concerned about potential cuts to Medicaid and the bill’s impact on people with preexisting conditions, added: “The difficulty is that there isn’t much coming back. It’s like we’re talking to a black box.”

The Senate is scheduled to go into recess at the end of next week. If Republicans do not finish their work on health care before then, they may risk losing steam, as senators return to their home states and potentially face fresh resistance to their efforts.

Still, some Republicans said they were confused about the bill taking shape and warned against rushing.

“I’m hearing lots of conflicting information,” said Sen. Susan Collins (R-Maine), a key centrist.

In a video he posted Tuesday afternoon on Facebook, Sen. Mike Lee (R-Utah) said he had not seen the bill, despite being a part of the Senate GOP health-care working group.

“I’d be fine, don’t get me wrong, to be voting on something soon,” Lee said. “But we should be able to see it first.”

 

Yeah, I agree, @GreyhoundFan, this is very disturbing. I don't trust McConnell any further than I could kick him. He's up to something. It makes no sense that he would essentially give the finger to other Senators in his own party. And he has to be well aware that they are saying what they're saying. How is he going to get the votes he needs?

And Cruz should just quit talking. His "logic" didn't make sense.

[Penny]

My daughter texted me that Ted Cruz will be in our area in a few weeks but tickets are all sold out. Maybe it is a better idea that I can't go I would get more upset than I already am.

[GreyhoundFan]

"The culture war is alive and well. And Republicans will keep fighting it."

Spoiler

The culture war is alive and well — even where you might not expect it. That’s one of the most overlooked lessons of yesterday’s special election in Georgia. While a lot of was made of the absurd amounts of money spent on the race, the question of Donald Trump’s effect down-ballot or which voters would turn out, Republicans won by going back to a playbook they’ve used a thousand times before, one based on fear and contempt of culturally alien liberals.

In many ways, this race was unique — it’s not as though in 2018 there will be a national spotlight and $50 million poured into all 435 House districts. But if you weren’t watching closely, you may have missed the scorched-earth culture war campaign that Republicans ran against Democrat Jon Ossoff. They barely attempted to make a case for Karen Handel; instead, their argument was that Ossoff is basically a Hollywood San Francisco radical hippie anarchist lunatic controlled by — cover the children’s ears — Nancy Pelosi.

That was the running theme of the television ads and direct mailers that flooded the district, convincing Republican voters that whatever misgivings they had about the Trump administration and however much Ossoff portrayed himself as a mainstream technocrat whose biggest priority was bringing high-tech jobs to metro Atlanta, nothing mattered more than their tribal hatred of liberals. You might think Karen Handel’s brand of extreme social conservatism (among other things she would outlaw not only same-sex marriage but also gay couples adopting children) would be a liability in a highly educated district like the Georgia 6th, but it wasn’t.

As Nate Cohn pointed out a few days ago, 13 of the 15 congressional districts with the highest levels of education in the country are safe Democratic districts; only Georgia’s 6th and a suburban Virginia district are in Republican hands. That’s why Democrats saw an opening in this election. They hoped that with this electorate, which was far more comfortable with Mitt Romney than with Donald Trump (Trump won the district by 2 points, while Romney won it by 23), a mainstream, non-threatening Democrat could win.

But he couldn’t. Which isn’t to say Ossoff wasn’t a candidate without plenty of weaknesses, but if Republicans can win on the culture war in Georgia’s 6th, they can do it almost anywhere.

That’s partly because they have so much practice. For half a century, they’ve been telling voters that Democrats are alien radicals who indulge criminal minorities and bring chaos and violence wherever they go. Richard Nixon rode that message to the White House in 1968 (just check out this ad), and Republicans have been doing it ever since. So Ossoff, Republicans said, was “not one of us,” the ultimate distillation of the culture war attack. As one ad from the National Republican Congressional Committee said over pictures of anarchists smashing windows and Kathy Griffin holding up Trump’s severed head, “D.C. liberals, Hollywood elites, this is who supports Jon Ossoff. Because Jon Ossoff is one of them. Childish. Radical. They’ve targeted Georgia, but we can stop them.”

In the wake of yesterday’s result, a lot of people have advised the Democrats that the solution to this problem is for Nancy Pelosi to resign, which would supposedly prevent Republicans from demonizing her. Some of that advice is coming from people who obviously don’t have the Democrats’ best interests at heart, but a lot of it is sincere. Unfortunately, it misreads not just that attack but also the way the GOP does business. While there may be legitimate reasons to ask whether Pelosi should remain the leader of House Democrats — we probably should debate whether the current Democratic leadership is making good strategic and investment decisions — that’s a separate topic from whether she has become a liability as a cultural symbol.

It’s certainly true that Pelosi is a villain for rank-and-file voters. Is that because of her politics? Of course not — her positions on issues are basically those of the entire Democratic Party. Is it because she’s from San Francisco? Of course — Republicans have been using “San Francisco” as a symbol for conservative baby boomers’ resentments for decades, a representation of all the drug-taking and free love and fun that the hippies had while the buzzcut squares seethed with jealousy and contempt. Is it because Pelosi is an older woman? Oh, you bet it is. Just like Hillary Clinton, she has been the target of a nakedly misogynistic campaign of vilification for years, one that is now baked deep into Republican politics.

And if you’re not a regular consumer of conservative media, you might not realize just how relentless that campaign has been, how often Pelosi is held up by Rush Limbaugh and Sean Hannity and the rest of the talk radio/Fox News nexus as everything that good honest Americans should hate. Which is why nothing Pelosi does actually matters. She barely appears on TV, but she’s as potent a symbol for Republicans as ever. She could retire tomorrow, and I promise you, Republicans would still run a thousand ads with her face in them in 2018.

That wouldn’t last forever, but by the time it faded, the conservative propaganda machine would have replaced her with a different villain. We’ve seen again and again how effective that machine can be: One Democratic politician after another has begun with a profile as an inoffensive, hardworking, substantive public servant (think Dukakis, Gore, Kerry), then quickly turned into a monster who threatened everything Republican voters hold dear.

What that means is that the one mistake Democrats can’t make again — the one they’ve made so many times before — is to say, “If we find the right person, Republicans won’t be able to attack him.” They will, no matter who that person is. Democrats need to take that culture war attack as a given and find more potent attacks in response — the way they did with Mitt Romney, but didn’t with Donald Trump. Or with Karen Handel.

This article is sadly very true.

[JMarie]

1 hour ago, GreyhoundFan said:

"The culture war is alive and well. And Republicans will keep fighting it."

  Hide contents

The culture war is alive and well — even where you might not expect it. That’s one of the most overlooked lessons of yesterday’s special election in Georgia. While a lot of was made of the absurd amounts of money spent on the race, the question of Donald Trump’s effect down-ballot or which voters would turn out, Republicans won by going back to a playbook they’ve used a thousand times before, one based on fear and contempt of culturally alien liberals.

In many ways, this race was unique — it’s not as though in 2018 there will be a national spotlight and $50 million poured into all 435 House districts. But if you weren’t watching closely, you may have missed the scorched-earth culture war campaign that Republicans ran against Democrat Jon Ossoff. They barely attempted to make a case for Karen Handel; instead, their argument was that Ossoff is basically a Hollywood San Francisco radical hippie anarchist lunatic controlled by — cover the children’s ears — Nancy Pelosi.

That was the running theme of the television ads and direct mailers that flooded the district, convincing Republican voters that whatever misgivings they had about the Trump administration and however much Ossoff portrayed himself as a mainstream technocrat whose biggest priority was bringing high-tech jobs to metro Atlanta, nothing mattered more than their tribal hatred of liberals. You might think Karen Handel’s brand of extreme social conservatism (among other things she would outlaw not only same-sex marriage but also gay couples adopting children) would be a liability in a highly educated district like the Georgia 6th, but it wasn’t.

As Nate Cohn pointed out a few days ago, 13 of the 15 congressional districts with the highest levels of education in the country are safe Democratic districts; only Georgia’s 6th and a suburban Virginia district are in Republican hands. That’s why Democrats saw an opening in this election. They hoped that with this electorate, which was far more comfortable with Mitt Romney than with Donald Trump (Trump won the district by 2 points, while Romney won it by 23), a mainstream, non-threatening Democrat could win.

But he couldn’t. Which isn’t to say Ossoff wasn’t a candidate without plenty of weaknesses, but if Republicans can win on the culture war in Georgia’s 6th, they can do it almost anywhere.

That’s partly because they have so much practice. For half a century, they’ve been telling voters that Democrats are alien radicals who indulge criminal minorities and bring chaos and violence wherever they go. Richard Nixon rode that message to the White House in 1968 (just check out this ad), and Republicans have been doing it ever since. So Ossoff, Republicans said, was “not one of us,” the ultimate distillation of the culture war attack. As one ad from the National Republican Congressional Committee said over pictures of anarchists smashing windows and Kathy Griffin holding up Trump’s severed head, “D.C. liberals, Hollywood elites, this is who supports Jon Ossoff. Because Jon Ossoff is one of them. Childish. Radical. They’ve targeted Georgia, but we can stop them.”

In the wake of yesterday’s result, a lot of people have advised the Democrats that the solution to this problem is for Nancy Pelosi to resign, which would supposedly prevent Republicans from demonizing her. Some of that advice is coming from people who obviously don’t have the Democrats’ best interests at heart, but a lot of it is sincere. Unfortunately, it misreads not just that attack but also the way the GOP does business. While there may be legitimate reasons to ask whether Pelosi should remain the leader of House Democrats — we probably should debate whether the current Democratic leadership is making good strategic and investment decisions — that’s a separate topic from whether she has become a liability as a cultural symbol.

It’s certainly true that Pelosi is a villain for rank-and-file voters. Is that because of her politics? Of course not — her positions on issues are basically those of the entire Democratic Party. Is it because she’s from San Francisco? Of course — Republicans have been using “San Francisco” as a symbol for conservative baby boomers’ resentments for decades, a representation of all the drug-taking and free love and fun that the hippies had while the buzzcut squares seethed with jealousy and contempt. Is it because Pelosi is an older woman? Oh, you bet it is. Just like Hillary Clinton, she has been the target of a nakedly misogynistic campaign of vilification for years, one that is now baked deep into Republican politics.

And if you’re not a regular consumer of conservative media, you might not realize just how relentless that campaign has been, how often Pelosi is held up by Rush Limbaugh and Sean Hannity and the rest of the talk radio/Fox News nexus as everything that good honest Americans should hate. Which is why nothing Pelosi does actually matters. She barely appears on TV, but she’s as potent a symbol for Republicans as ever. She could retire tomorrow, and I promise you, Republicans would still run a thousand ads with her face in them in 2018.

That wouldn’t last forever, but by the time it faded, the conservative propaganda machine would have replaced her with a different villain. We’ve seen again and again how effective that machine can be: One Democratic politician after another has begun with a profile as an inoffensive, hardworking, substantive public servant (think Dukakis, Gore, Kerry), then quickly turned into a monster who threatened everything Republican voters hold dear.

What that means is that the one mistake Democrats can’t make again — the one they’ve made so many times before — is to say, “If we find the right person, Republicans won’t be able to attack him.” They will, no matter who that person is. Democrats need to take that culture war attack as a given and find more potent attacks in response — the way they did with Mitt Romney, but didn’t with Donald Trump. Or with Karen Handel.

This article is sadly very true.

Plus, Republicans had to be scared of Ossoff because he's only thirty.  Think about it - he could be in office for a good thirty or forty years, if he chose to stay in Congress.  All those Democrat votes for all those years.

[GreyhoundFan]

The American public is so screwed: "The Health 202: Here's what's in the Senate health-care bill"

Spoiler

Senate GOP leaders are poised to release an Obamacare overhaul that clearly tries to woo the moderate members of their party while also keeping spending in check and giving conservatives a few goodies, too.

Yesterday afternoon, The Health 202 scooped the major details of the draft health-care legislation that Senate Majority Leader Mitch McConnell (R-Ky.) wants to bring up for a vote next week. Like the the House bill passed in May, the Senate version would put big dents in the Affordable Care Act, repealing just about all of its taxes, pulling back on Medicaid expansion and ditching the individual mandate to buy coverage and the employer mandate to offer it.

But the Senate bill contains three elements McConnell is betting will win over a half dozen or so moderates who remain skeptical but whose votes are crucial to overall passage (remember: the majority leaders needs only 50 votes since arcane budget rules are being applied to the measure, meaning he can lose just two Republicans). McConnell's draft, hashed out behind closed doors, basically retains Obamacare's insurance subsidy structure -- with just a few tweaks -- takes a gentler approach than the House bill in the short-term to Medicaid expansion, and wouldn't allow states to opt out of key protections for patients with preexisting conditions.

The idea, aides and lobbyists say, is to provide a softer landing for people at lower ends of the income spectrum than under the House bill. That measure based the subsidies only on age and didn't peg them to actual premiums, resulting in estimates of dramatic cost spikes for some Americans and prompting a heavy onslaught of public criticism that spooked many House moderates.

The Senate bill tries to fix that problem -- sort of. Its subsidies closely mirror Obamacare subsidies, which are currently available to Americans earning between 100 percent and 400 percent of the federal poverty level. Starting in 2020, under the Senate bill, this assistance would be capped for those earning up to 350 percent — but anyone below that line could get the subsidies if they’re not eligible for Medicaid. As under the ACA, the subsidies would be pegged to a benchmark insurance plan each year, ensuring that the assistance grows enough over time to keep coverage affordable for customers.

McConnell is also offering moderates an approach to Medicaid he hopes will be more politically palatable to them. It's true the draft proposes even deeper cuts to Medicaid than the House version by tying federal spending to a slower growth index. But that wouldn't kick in for another seven years, well past moderate senators' next reelection battles. And it doesn't fully end the ACA's Medicaid expansion until five years from now, gradually easing down the extra federal payments over three years starting in 2021.

The Senate bill also retains the ACA's protections for patients with preexisting conditions. It eliminates the House bill's pathway for states to lift a ban on insurers from charging people with serious medical conditions higher premiums, which would have been another political hotbed for moderates. It does expand the use of certain "1332 waivers" to give states more flexibility -- a provision that conservatives like Sen. Ted Cruz (R-Tex.) wanted -- but those waivers don't open the door to ducking the preexisting protections.

The Senate bill would also provide funding in 2018 and 2019 for extra Obamacare subsidies to insurers to cover the cost-sharing discounts they’re required to give the lowest-income patients. Insurers have been deeply concerned over whether the subsidies will continue, as the Trump administration has refused to say whether it will keep funding them in the long run.

With this approach that sticks a little closer to existing law, McConnell is hoping to win over Republicans in states that embraced parts of the ACA, like Lisa Murkowski of Alaska, Rob Portman of Ohio, Shelley Moore Capito of West Virginia and Dean Heller of Nevada. Their votes are absolutely crucial to the whole effort to repeal and replace parts of Obamacare, the promise Republicans made time and time again over the past seven years and which McConnell is determined to fulfill. He will present the draft to his wary members at a 9:30 meeting this morning in a pivotal gathering.

Even yesterday, many members expressed deep skepticism toward elements in the draft as it took shape. “Up to this point, I don’t have any new news — tomorrow we will see it definitively — that would cause me to change that sentiment,” Capito told my colleagues Sean Sullivan, Kelsey Snell and Juliet Eilperin yesterday.

Many moderates are still likely to be displeased that the Senate draft will almost certainly result in significantly more uninsured people than under the ACA, although it could look a little better than the House version on that measure, which is estimated to cost 23 million people their coverage in a decade. All of this won't be known for sure until the Congressional Budget Office score is released, likely on Monday. Furthermore, the measure retains a provision to strip Medicaid funds from Planned Parenthood clinics for one year, potentially alienating Murkowski, who supports abortion rights.

So what do conservatives get out of this bill? Big cuts to Medicaid further down the road and a repeal of nearly all of Obamacare's taxes. Under the Senate draft, federal Medicaid spending would remain constant for three years. In 2021, it would be transformed from an open-ended entitlement to a system based on per-capita enrollment. Starting in 2025, the measure would tie federal spending on the program to an even slower growth index, which in turn could prompt states to reduce the size of their Medicaid programs.

Conservatives, and the health-care industry at large, will also be pleased that the draft proposes repealing all of Obamacare's taxes except for its so-called “Cadillac tax” on high-cost health plans in language similar to the House version. Senators previously toyed with the idea of keeping some of the ACA’s taxes.

But there's a strong chance the Senate bill could spark a revolt on the right. Conservative groups like the Heritage Foundation and Americans for Prosperity wanted to erase Obamacare's Medicaid expansion right away, and they're also likely to view the Senate GOP's approach to subsidies as another big, bad government entitlement. Antiabortion groups may oppose the measure too since it removes the House bill language restricting federally subsidized health plans from covering abortions, which may have run afoul of complex budget rules.

Aides stress the GOP plan is likely to undergo more changes to garner the votes Republicans need. It's in discussion draft form, meaning elements could be added or stripped out over the next week as Republican leaders try to propel it toward a vote before the end of next week. And there are ongoing conversations with the Senate parliamentarian over which provisions can even be included under rules governing what can go in a budget reconciliation bill.

And don't forget that even if this bill passes the Senate, there's another steep hurdle. It would have to pass muster with the more conservative House before heading to President Trump's desk for a signature. And the House already had a difficult time passing its own version, meaning none of this is assured to become law.

Stay tuned...

To help you follow along, The Fix's Amber Phillips and the Post's graphic team will keep tabs on who supports and who opposes the Senate bill in the runup to the expected vote next week with a Whip Count. And the Post will write about developments as the draft gets released this morning here and here with our health-care liveblog.

...

Some observers noted the similarities between the Senate bill and the ACA. From the senior VP of the Kaiser Family Foundation:

...

The associate director of the Kaiser foundation noted the effect the measure would have on people who don't qualify for subsidies:

...  <LOTS of good tweets>

OOF: Insurance giant Anthem has announced it will leave the Obamacare marketplaces in Indiana and Wisconsin in 2018, my colleague Carolyn Johnson reports. The company said in a statement that the business of selling health coverage on the Affordable Care Act marketplaces has become "difficult due to a shrinking and deteriorating individual market, as well as continual changes and uncertainty in federal operations, rules and guidance, including cost sharing reduction subsidies and the restoration of taxes on fully insured coverage."

Anthem's announcement came yesterday, the deadline for insurers to tell federal regulators whether they plan to keep selling marketplace plans next and if so, how much they would like to charge. The deadline applied to all 39 states whose marketplaces are run by the federal government. An evolving map by the Kaiser Family Foundation shows that 44 counties in four states, where about 30,000 people buy insurance through the marketplaces, are at risk for having no insurance options next year.

The day was something of a moment of truth for the marketplaces, whose health depends on how many insurers participate, Carolyn writes.

"So far, states are seeing mixed results: One major insurer has made a big pullout, while a different one announced it would expand into new states," Carolyn reports. "Oscar Health, a start-up company that was co-founded by Ivanka Trump's brother-in-law, announced it would expand in Ohio, New Jersey, Texas, Tennessee, California and New York."

In Indiana, MDwise Marketplace announced it would leave that state's marketplace, putting four counties at possible risk of having no insurer next year, although a different Centene has announced it is expanding in the state. A spokeswoman for Centene said the company was still working through the filing process and would not share information until it was complete, Carolyn reports.

As the marketplace situation becomes more clear over the next few days, it will influence the urgency with which Republicans pass a bill replacing big parts of the ACA and puts more pressure on the Trump administration to respond to insurers asking for more certainty.

"To date, there has not been a county with zero insurers selling policies on its marketplaces, and it's not totally clear what will happen if a county is left without any plans. It's possible, however, that without a functional exchange, would-be participants would have to shoulder the full costs of their health insurance -- or go without," Carolyn writes.

AHH:  President Trump is still calling for a final health-care plan “with heart.” As Senate Republicans prepared to released their discussion draft this morning, and details of the draft were starting to emerge, the president expressed his desires for the bill to an audience at a rally in Iowa last night.

“I can’t guarantee anything, but I hope we’re going to surprise you with a really good plan,” Trump said in Cedar Rapids, Iowa.

"We basically can’t lose anybody," he added.

His comments follow reports that he had privately called the House version of the bill “mean.” This was after Trump had celebrated the passage of the bill with members of the House in the Rose Garden.

Democrats, including Rep. Al Franken (D-Minn), jumped on the opportunity to use the presidents words against him. 

...

OUCH: According to a Politico/Morning Consult poll, the Republican health-care bill has become less popular than when the House advanced its version last month. Just 35 percent of voters support the House version of the bill, and 49 percent disapprove of it. That’s down from 38 percent approval and 44 percent disapproval immediately after the bill passed in May.

I have little doubt there are lots of little gotchas in the draft.

[GreyhoundFan]

The WaPo is doing live updates on the deathcare bill being brought up in the senate today. Some interesting stuff thus far.

 

[GreyhoundFan]

In the running updates article on the WaPo, they indicate a group of protesters have been forcibly removed from the hallway outside Bitch's office.  There are a couple of pictures. It's sickening.

 

[Childless]

Heard an interview with a Dem and he said the Senate bill wasn't much better than the House bill.

[GreyhoundFan]

20 minutes ago, Childless said:

Heard an interview with a Dem and he said the Senate bill wasn't much better than the House bill.

It's crappy. The NYT has a good and clear outline. Selfishly, I'm most worried about the employer mandate, the changing of essential benefits requirements, and the ability of states to opt out of yearly and lifetime maximums.

[GreyhoundFan]

Not that the Repugs will listen (or care): "Parents of sick kids try to remind Congress what the health-care debate should be about"

Spoiler

“Is she okay?” the startled legislative staffer asked, eyes shifting to the adults around him as the trach tube protruding from the neck of a 2-year-old gurgled.

In the air-conditioned, marble halls of Congress, you often hear the click of heels as staffers rush from room to room or the booming voices of our nation’s representatives making a pitch for some legislation.

You do not hear the gurgle of a trach tube.

Until this week.

“Let me just suction,” one mom said as a blue-suited staffer’s eyes widened at the strange sounds coming from the toddler in pigtails.

“We could see it in their eyes, most of them have never seen a child with a trach tube,” said Elena Hung, one of the moms who on Tuesday walked the halls pushing her child’s giant medical rig, showing Capitol Hill folks the actual kids their wheeling, dealing, backroom bargaining and political gamesmanship will affect in the repeal and replacement of the Affordable Care Act.

No public hearing? No answers to emails? No one picking up the phone calls?

No problem.

These kids smiled, giggled and then their tubes gurgled to show what’s at stake here.

It was real-life lobbying done by a brigade of 12 intrepid families who pushed their way through Capitol Hill’s offices and shared their stories and the stories of nearly 150 other families from across the country who feel ignored.

“We heard from a lot of families that it’s really, really difficult to get in touch with any of their representatives,” Hung said. “They say, ‘Call your representatives,’ but most of these offices aren’t even taking calls.”

So they showed up in person.

Hear the whoosh of a ventilator? Mind holding the formula, sir, while I pump liquid food into my 6-year-old’s gastrointestinal tube?

This costly, frightening, complicated world of medicine is reality for millions across America — kids who need 24-hour care, whose medical bills can hit $3 million in five months, the kids whose families would have gone bankrupt long ago if it weren’t for Medicaid.

The Affordable Care Act included a small but significant provision that removed the lifetime spending cap of most insurance plans — which usually cut a patient off at $1 million. These kids easily hit that in a few months.

The American Health Care Act that the House passed would allow many employers to bring that cap back.

So some Washington-area families — who saw parents across the country take to Facebook to talk about the possibility that their children’s lives would be left out of this health-care debate — decided to help.

It took them forever to get through security. Imagine that oxygen tank and the metal detector. But they made it in. And as they shared elevators with lobbyists from the liquid metal industry who smiled tightly at the elevator full of wheelchairs, they brought real life to this tidy enclave of lawmakers.

They had binders — tabbed by state — full of nearly 150 stories of medically fragile children — their photos, their parents’ voices, what their care costs and what their lives are like.

If they could get someone in each office to sit down with them, they would open the binder to the state and ask them to look.

If.

Look at smiling 12-year-old Parker from Utah, who needs a feeding tube, an aspirator, a trach and loads of medication to survive. One drug costs $100,000 a year. For a while, his family relied on food that neighbors left on their doorstep because Parker’s medical bills were so high after their health insurance capped out.

Look at 11-year-old Austin from Pennsylvania running on the beach, something he can do just one hour a day, when he doesn’t have to wear the mobile IV that pumps fluid directly into his heart the other 23 hours. He goes to the hospital often. And he was so haunted by the homeless folks he saw outside the hospital that he put together a backpack of Hershey’s Kisses, snacks and a blanket he got at camp to give to one of them, said his mom, Jen Rath. If the House health-care plan becomes law, “my son would likely die,” she said. It would be “catastrophic.”

Hey, Louisiana, look at Riley. He’s a super-smiley 7-month-old with a medical history that is already 4,000 pages long.

These parents had their target states — the ones with Republican senators who may be on the fence about the upcoming health-care vote — and they lobbied them hard. Some representatives sent staffers out to sit and talk with the families.

“The nursing care that Medicaid covers is absolutely critical,” explained one mother. She had come to Capitol Hill with her son, Pierce, who is 3 and was born with Moebius syndrome, a brain injury that causes facial paralysis. He needs a feeding tube to eat, a trach tube to breathe and the nurse who helps her to care for him.

She told of her fear, the fear that so many parents like her have, of dozing off, not hearing the oxygen monitor, having her child die. She tried to make the case that all the assistance they get — from the costly medication to the 24-hour care — is vital. And the new plan simply won’t cover it. And their children won’t survive it.

So no, congressional staffers surprised by the trach tubes, the oxygen tanks, the wide smiles from kids who can’t eat or breathe without help, the kids won’t be okay. Not if you’re not listening.

 

[Childless]

6 hours ago, GreyhoundFan said:

Not that the Repugs will listen (or care): "Parents of sick kids try to remind Congress what the health-care debate should be about"

  Reveal hidden contents

“Is she okay?” the startled legislative staffer asked, eyes shifting to the adults around him as the trach tube protruding from the neck of a 2-year-old gurgled.

In the air-conditioned, marble halls of Congress, you often hear the click of heels as staffers rush from room to room or the booming voices of our nation’s representatives making a pitch for some legislation.

You do not hear the gurgle of a trach tube.

Until this week.

“Let me just suction,” one mom said as a blue-suited staffer’s eyes widened at the strange sounds coming from the toddler in pigtails.

“We could see it in their eyes, most of them have never seen a child with a trach tube,” said Elena Hung, one of the moms who on Tuesday walked the halls pushing her child’s giant medical rig, showing Capitol Hill folks the actual kids their wheeling, dealing, backroom bargaining and political gamesmanship will affect in the repeal and replacement of the Affordable Care Act.

No public hearing? No answers to emails? No one picking up the phone calls?

No problem.

These kids smiled, giggled and then their tubes gurgled to show what’s at stake here.

It was real-life lobbying done by a brigade of 12 intrepid families who pushed their way through Capitol Hill’s offices and shared their stories and the stories of nearly 150 other families from across the country who feel ignored.

“We heard from a lot of families that it’s really, really difficult to get in touch with any of their representatives,” Hung said. “They say, ‘Call your representatives,’ but most of these offices aren’t even taking calls.”

So they showed up in person.

Hear the whoosh of a ventilator? Mind holding the formula, sir, while I pump liquid food into my 6-year-old’s gastrointestinal tube?

This costly, frightening, complicated world of medicine is reality for millions across America — kids who need 24-hour care, whose medical bills can hit $3 million in five months, the kids whose families would have gone bankrupt long ago if it weren’t for Medicaid.

The Affordable Care Act included a small but significant provision that removed the lifetime spending cap of most insurance plans — which usually cut a patient off at $1 million. These kids easily hit that in a few months.

The American Health Care Act that the House passed would allow many employers to bring that cap back.

So some Washington-area families — who saw parents across the country take to Facebook to talk about the possibility that their children’s lives would be left out of this health-care debate — decided to help.

It took them forever to get through security. Imagine that oxygen tank and the metal detector. But they made it in. And as they shared elevators with lobbyists from the liquid metal industry who smiled tightly at the elevator full of wheelchairs, they brought real life to this tidy enclave of lawmakers.

They had binders — tabbed by state — full of nearly 150 stories of medically fragile children — their photos, their parents’ voices, what their care costs and what their lives are like.

If they could get someone in each office to sit down with them, they would open the binder to the state and ask them to look.

If.

Look at smiling 12-year-old Parker from Utah, who needs a feeding tube, an aspirator, a trach and loads of medication to survive. One drug costs $100,000 a year. For a while, his family relied on food that neighbors left on their doorstep because Parker’s medical bills were so high after their health insurance capped out.

Look at 11-year-old Austin from Pennsylvania running on the beach, something he can do just one hour a day, when he doesn’t have to wear the mobile IV that pumps fluid directly into his heart the other 23 hours. He goes to the hospital often. And he was so haunted by the homeless folks he saw outside the hospital that he put together a backpack of Hershey’s Kisses, snacks and a blanket he got at camp to give to one of them, said his mom, Jen Rath. If the House health-care plan becomes law, “my son would likely die,” she said. It would be “catastrophic.”

Hey, Louisiana, look at Riley. He’s a super-smiley 7-month-old with a medical history that is already 4,000 pages long.

These parents had their target states — the ones with Republican senators who may be on the fence about the upcoming health-care vote — and they lobbied them hard. Some representatives sent staffers out to sit and talk with the families.

“The nursing care that Medicaid covers is absolutely critical,” explained one mother. She had come to Capitol Hill with her son, Pierce, who is 3 and was born with Moebius syndrome, a brain injury that causes facial paralysis. He needs a feeding tube to eat, a trach tube to breathe and the nurse who helps her to care for him.

She told of her fear, the fear that so many parents like her have, of dozing off, not hearing the oxygen monitor, having her child die. She tried to make the case that all the assistance they get — from the costly medication to the 24-hour care — is vital. And the new plan simply won’t cover it. And their children won’t survive it.

So no, congressional staffers surprised by the trach tubes, the oxygen tanks, the wide smiles from kids who can’t eat or breathe without help, the kids won’t be okay. Not if you’re not listening.

 

I hate to tell these parents but the GOP politicians don't care.  They care more about the extra money their rich friends will get via tax breaks than the lives of medically fragile children.  Don't they know?  Kids only matter when they're fetuses and aren't a burden on old, rich white men.  After they are born, they can just go die if their parents can't afford to feed them or get them the medical care they need.

[bashfulpixie]

37 minutes ago, Childless said:

I hate to tell these parents but the GOP politicians don't care.  They care more about the extra money their rich friends will get via tax breaks than the lives of medically fragile children.  Don't they know?  Kids only matter when they're fetuses and aren't a burden on old, rich white men.  After they are born, they can just go die if their parents can't afford to feed them or get them the medical care they need.

They don't even care when they're fetuses. They're just used to manipulated the ignorant fundamentalists into voting for them

My main point though: maybe that's what they mean when they say trickle down economics works. They uber rich donors get tax breaks and who in turn give more to the politicians in bribes. Oh I'm sorry.  "Donations." It trickles down into their own pockets

[GreyhoundFan]

This shows how the Repugs will move heaven and earth to screw over the American people: "The Daily 202: Senate Republicans want to get to yes on the health care bill"

Spoiler

THE BIG IDEA: Much of the concern that Republican senators expressed yesterday about the draft health-care bill felt more like political posturing than genuine threats to torpedo the effort.

There are not currently the 50 votes necessary to advance the legislation that Mitch McConnell unveiled Thursday. There will need to be concessions and compromises, and there are several ways the push could still fall apart in the coming days.

But pretty much every Republican, including the current holdouts, wants to pass something. And no GOP senator wants to bear the brunt of the blame from the base for inaction. That factor must not be discounted.

-- President Trump, who endorsed the Senate bill last night, also badly wants to get something done, and he’s made clear that he’ll sign whatever makes it through Congress.

...

-- Ted Cruz carried around a “path to yes” memo in his suit coat pocket yesterday that contained a list of his asks. “This current draft doesn’t get the job done, but I believe we can get to yes,” said the Texan, who is up for reelection next year and has been trying to rebrand himself as an effective legislator. “We continue to have positive, productive conversations.”

Cruz issued a joint statement with three other conservatives — Sens. Rand Paul of Kentucky, Ron Johnson of Wisconsin and Mike Lee of Utah — saying that they cannot support the legislation as it stands. Parse their words carefully, and it’s notable how many outs they gave themselves.

Here is the statement in full (I’ve added italics on the wiggle words): “Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor. There are provisions in this draft that represent an improvement to our current health care system, but it does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs.”

Many believe Cruz is bluffing and will come around, even with small concessions that let him save face. As Republican strategist John Weaver, who played top roles on the presidential campaigns of John McCain and John Kasich, put it:

... <this tweet is SO FREAKING TRUE>

-- An NBC News/Wall Street Journal poll, which was in the field earlier this week and published yesterday, helps explain the balancing act we’re seeing from so many Republicans: Only 16 percent of Americans believe that the House health care bill is good, down from 23 percent last month. Even among Republicans, just one in three view the measure positively. But the public is basically split down the middle over Obamacare, with 41 percent saying the 2010 law is a good idea and 38 percent saying it’s a bad idea. Asked if Congress and the president should continue their efforts to repeal and replace the Affordable Care Act, the split is similar: 38 percent say yes, 39 percent say no, and 20 percent have no opinion. But here’s the rub: 71 percent of Republicans want Congress to continue its effort to repeal the ACA, and only 12 percent of GOP voters want to move on. Independents also slightly favor forging ahead with repeal, 38 percent to 32 percent.

Those numbers demonstrate why lawmakers are eager to be perceived as extracting concessions (so they can say they made improvements), but the partisan breakdown also shows why most GOP senators are willing to get behind what remains an unpopular piece of legislation. Even as they do so, however, they are carefully positioning themselves. A bunch of Republicans who will vote yes next week released noncommittal statements yesterday suggesting that they are keeping an open mind. Marco Rubio, for example, said that he’s studying the bill and will “decide how to vote … on the basis of how it impacts Florida.”

-- McConnell can only afford two defections, and he’s facing objections from the right and the middle. But if anyone can thread this needle, it’s the Senate majority leader. “McConnell unveiled his proposal knowing full well that — as currently written — it lacks the votes to win approval,” congressional correspondent Paul Kane writes. “But using a time-honored tactic of congressional leadership, the Kentucky Republican decided it was time to call the bluff of his GOP colleagues. … Republicans now head into five or six days of intense negotiations … Many GOP senators complained bitterly about the secretive process, while privately breathing a sigh of relief that they didn’t yet have to take a position on the emerging legislation.”

There are some obvious “gives” that could get a few of the wavering moderates on board: “Sen. Susan Collins (R-Maine) told reporters Thursday that she and Sen. Lisa Murkowski (R-Alaska) would try to amend the Planned Parenthood restrictions during next week’s ‘vote-a-rama,’ a period when senators can offer unlimited amendments to the health-care measure,” Kane reports. “GOP insiders expect Sens. Rob Portman (R-Ohio) and Shelley Moore Capito (R-W.Va.), who oppose the bill’s deep cuts to Medicaid, to be mollified by more cash to combat the opioid epidemic.” That might leave Rand Paul as the biggest hurdle, but McConnell could afford to lose the junior senator from his state. (We’re keeping a running whip count here.)

-- McConnell explicitly urged GOP senators to withhold statements announcing outright opposition to his proposal yesterday so that everyone can retain flexibility, Politico’s Burgess Everett reports. “McConnell’s strategy has been a slow burn, allowing his members to vent in private party discussions while gradually writing a bill that takes in their considerations over the past six weeks. He’s had more than 30 meetings with his members (about the proposal).”

John Thune, No. 3 in GOP leadership, is warning the conservative holdouts that Republicans will be stuck with a single-payer system if they don’t pass this bill. “If you get 80 percent of what you want in a circumstance like this, it’s going to have to be a victory because we’re not going to get 100 percent,” he told Burgess. “If we don’t get this done and we end up with Democratic majorities in ‘18, we’ll have single payer. … (McConnell) believes that, given the amount of input we’ve had from everybody, we’ll get to 50.”

Pat Toomey (R-Pa.) freely acknowledged problems with the Senate bill, but he also said that he’s “likely” to vote for it because it will be better than the status quo. “I don’t have a list of things at this point I must change,” Toomey said on a conference call with reporters, making a statement that reflects the mindset of most Senate Republicans. “Everything I want is not going to happen in one bill.”

WHAT YOU NEED TO KNOW ABOUT THE SENATE BILL—

ON TIMING:

-- The Congressional Budget Office said it expects to release a score for the Senate bill “early next week.”

-- Despite grumbling from some members of his conference, McConnell still plans on holding a final vote next week. (Sean Sullivan, Kelsey Snell and Juliet Eilperin)

-- Democrats have little power to stop the vote from occurring, though 20 senators filed procedural motions designed to throw sand in the gears. Republicans will have to address each individually. This will slightly delay holding a vote and could mean some late nights next week, but it won’t stop passage if Republicans have 50 votes. (Kelsey Snell and Elise Viebeck)

-- House Democrats, including Steny Hoyer, say they are on guard for a quick vote if the bill passes the Senate next week. But, again, there’s very little they can do to stop it if Republicans have the votes. (Mike DeBonis)

-- Vice President Pence expressed hope last night that the bill will be signed into law before the end of the summer. (John Wagner)

THE HOUSE VS. THE SENATE:

-- Overall, the Senate bill does not go as far as the House bill in rolling back the Affordable Care Act. (Our graphics team visualized the similarities and differences between the plans. Read the full text of the Senate’s 142-page bill here.)

-- The Senate version says insurers could not deny coverage based on preexisting conditions.

-- Like the bill that passed the House last month, the Senate measure phases out expanded Medicaid funding for states, but it does so more gradually between 2020 and 2024.

-- But because of an accounting gimmick, the Senate bill guts Medicaid much more drastically over the long-term than the House bill. Max Ehrenfreund reports: “Through 2025, both bills would adjust the cap based on a measure of how rapidly medical costs are expanding — a measure known as the CPI-M. Starting in 2025, however, the Senate bill would change the formula, instead funding Medicaid based on a measure of how rapidly all costs are rising, … General costs, however, typically rise more slowly than medical costs … After a decade or two, that discrepancy would add up to of hundreds of billions of dollars.”

-- The Medicaid cuts in the Senate proposal could disproportionately hurt rural hospitals, 700 of which across the country already teeter on the brink of closure. (NPR’s Bram Sable-Smith)

-- The Senate bill would cut almost $1 billion in funding for the Prevention and Public Health Fund, which provides 12 percent of the CDC’s budget, starting this October. Lena H. Sun reports: “The money supports programs to prevent bioterrorism and disease outbreaks, as well as to provide immunizations and screenings for cancer and heart disease … About $625 million goes directly to states and communities to address their most pressing health needs, including drug misuse, infectious diseases, lead poisoning, obesity, diabetes, hypertension, cancer and tobacco use.”

-- The bill appropriates only $2 billion in fiscal year 2018 to address the opioid drug epidemic, Vox’s Ella Nilsen reports. This is less than the $45 billion over 10 years that Republican Sens. Rob Portman and Shelley Moore Capito requested and far less than $190 billion over 10 years, which is what a Harvard health economics professor estimated this week was needed to truly address the problem.

-- Both House leaders, Paul Ryan and Nancy Pelosi, argued that the Senate bill is not radically different from what their chamber passed last month. The Speaker is saying this so that it’s easier to get his members on board. The Minority Leader is saying it to make the point that the Senate version is not a meaningful improvement on the toxically unpopular House bill. (Mike DeBonis)

WHAT THE BILL DOES TO PREMIUMS:

-- Republican promises to stabilize individual health insurance markets could prove hollow. Amy Goldstein explains why: “Republicans have vowed for months to … stave off the collapse of the nation’s most fragile health insurance markets, which serve people who buy coverage on their own. In the Senate, that turns out to be a short-term goal. (The Senate bill) would keep billions of dollars flowing — but only for two years — to health plans that have been begging for continued help with the expense of millions of lower-income customers in ACA insurance marketplaces. After 2019, the payments would stop…

“The cutoff of those payments would coincide with the end of subsidies that help the vast majority of people with ACA health plans afford their premiums. The subsidies would be replaced with smaller tax credits … The new credits would not reach as many middle-income Americans, and although they would be available for the first time to people below the poverty line, the amounts could be too small to be useful…

“Taken together, these and other features of the Better Care Reconciliation Act could drive prices up after a few years for people who buy individual insurance — a core group the ACA is designed to help. After the next three years, it also would begin a sharp downward path in federal support for Medicaid, the cornerstone of the nation’s health-care safety net for the past half-century.”

-- Laurie McGinley, Lenny Bernstein and Lena H. Sun provide a few illustrative examples of Americans who could be significantly impacted if the Senate bill becomes law, including a 44-year-old breast cancer survivor, a 27-year-old man receiving drug treatment through Medicaid and a 59-year-old man who works as an independent contractor.

-- One way to think about all of this: Obamacare cut the uninsured rate almost in half by redistributing resources from the wealthy to the poor. This bill seeks to undo that redistribution, The New York Times’ Margot Sanger-Katz explains.

Sarah Kliff summarizes it this way on Vox: “The bill asks low- and middle-income Americans to spend significantly more for less coverage.”

STAKEHOLDERS PANNED THE BILL:

-- Hospitals decried the cuts to Medicaid, with the chief executive of the American Hospital Association calling them “unsustainable.” (Juliet Eilperin)

-- The AARP said the Senate bill allows insurance companies to charge the elderly up to five times more than young people. The senior’s lobby is mobilizing its membership against what it calls an “age tax.” (The Hill)

-- A chorus of providers warned that the Senate bill would “turn back the clock on women’s health.” “This legislation deliberately strips the landmark women’s health gains made by the Affordable Care Act and would severely limit access to care,” the president of the American Congress of Obstetricians and Gynecologists wrote in a statement.

-- One exception: Insurance executives are happy because the Senate bill reverses a provision in Obamacare that penalized their companies for excessively paying top staff. (Ehrenfreund)

BARACK OBAMA EMERGES FROM COCOON TO DEFEND SIGNATURE ACHIEVEMENT:

-- The former president made a rare public statement to denounce the Senate proposal. “Simply put, if there’s a chance you might get sick, get old, or start a family — this bill will do you harm,” he wrote. “And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation.”

-- “The 44th president did not mention his successor … but his scathing criticism and urgent tone … set up a direct public fight with the current White House occupant over the future of the nation’s health care system,” David Nakamura writes.

-- On a related note, Obama will soon hit the campaign trail again. He plans to stump with Ralph Northam, the Democratic candidate in the Virginia governor’s race. (Fenit Nirappil)

-- Obama didn’t go as far as many Democrats on the Hill: Chuck Schumer called the draft “a step to eradicating Medicaid.” “People will die,” Elizabeth Warren said in a floor speech. “These cuts are blood money."

BIG PROTESTS CREATED BAD VISUALS ON THE NIGHTLY NEWS:

-- Forty-three disability advocates protesting the Senate draft were arrested outside of McConnell’s office. “The protesters staged a ‘die-in’ in front of the office, with many of the protesters in wheelchairs removing themselves from the chairs then lying on the floor,” Perry Stein reports.

-- “Parents of sick kids try to remind Congress what the health-care debate should be about,” by Petula Dvorak: “These kids smiled, giggled and then their tubes gurgled to show what’s at stake here. It was real-life lobbying done by a brigade of 12 intrepid families who pushed their way through Capitol Hill’s offices. … ‘We heard from a lot of families that it’s really, really difficult to get in touch with any of their representatives,’ [one of the parents, Elena Hung] said. ‘They say, ‘Call your representatives,’ but most of these offices aren’t even taking calls.’ So they showed up in person.”

I think the most telling line in the article is the one about how the Repug deathcare bill allows insurance companies to pay their CEOs basically an unlimited salary. Could they be more transparent in their love for big business and hate for the poor and middle class? I don't think so.

[CTRLZero]

18 hours ago, GreyhoundFan said:

Selfishly, I'm most worried about the employer mandate, the changing of essential benefits requirements, and the ability of states to opt out of yearly and lifetime maximums.

Not selfish at all.  I've been watching for signs that my own health care plan might erode, and so far it looks good, but there may be an increase in premiums.  Health care is so complex, it's hard to figure it out on a good day, much less when suffering from an illness.

Some people I've talked to aren't worried because they receive health care through their employers.  All I can say is, "Uh..."  I guess there is always Scamaritan.

PS:  Thanks for all the links and posts.  I've been throwing up my hands in despair so often that it's affecting my keyboarding.

 

[GreyhoundFan]

"Senate Republicans ready themselves for a massive theft from the poor"

Spoiler

The “health-care bill” that Republicans are trying to pass in the Senate, like the one approved by the GOP majority in the House, isn’t really about health care at all. It’s the first step in a massive redistribution of wealth from struggling wage-earners to the rich — a theft of historic proportions.

Is the Senate version less “mean” than the House bill, to use President Trump’s description of that earlier effort? Not really. Does the new bill have the “heart” that Trump demanded? No, it doesn’t. The devil is not in the details, it’s in the big picture.

Fundamentally, what Republicans in both chambers want to do is cut nearly $1 trillion over the next decade from the Medicaid program, which serves almost 70 million people. Medicaid provides health care not just for the indigent and disabled but also for the working poor — low-wage employees who cannot afford health insurance, even the plans offered through their jobs.

Additionally, about 20 percent of Medicaid spending goes to provide nursing home care, including for middle-class seniors whose savings have been exhausted — a situation almost any of us might confront. Roughly two-thirds of those in nursing homes have their care paid by Medicaid.

Why would Republicans want to slash this vital program so severely? You will hear a lot of self-righteous huffing and puffing about the need for entitlement reform, but the GOP’s intention is not to use the savings to pay down the national debt. Instead, slashing Medicaid spending creates fiscal headroom for what is euphemistically being called “tax reform” — a soon-to-come package of huge tax cuts favoring the wealthy.

That’s the basic equation in both the House and Senate bills: Medicaid for tax cuts. Both bills start with various of the taxes imposed by the Affordable Care Act, but those are mere appetizers. The main course is intended to be big cuts in individual and corporate tax rates that would benefit the rich.

There is no other point to this whole exercise. All the “Obamacare is in a death spiral” talk is Republican wishful thinking, aided and abetted by active sabotage.

The ACA is far from perfect, but recall that it was designed with input from the insurance industry. The main reason so many insurers are pulling out of the program is that Congress and GOP-dominated state governments refuse to live up to their end of the bargain. Congress will not commit to funding promised subsidies to cover treatment for the poor and those with expensive ailments, or to keeping in place the mandate forcing individuals to buy insurance or pay a penalty. Republican governors and state legislatures refused to set up exchanges that would make insurance more affordable and declined the opportunity to expand Medicaid coverage.

It’s actually a wonder that the ACA works as well as it does, given the GOP’s determination to make it fail.

Neither the House nor the Senate bill fully dismantles the scaffolding of Obamacare; rather, they allow the states to do most of the dirty work. Philosophically, Republican majorities in both chambers want to erase the central concept that the ACA established: that health care is a fundamental right, not a privilege depending on one’s income.

Like the House, the Senate wants to offer tax credits rather than subsidies to help the needy afford insurance. Like the House, the Senate wants to leave up to the states whether policies must cover such services as emergency, maternity and mental-health care. Like the House, the Senate wants to eliminate the requirement that large employers offer insurance plans to their workers.

There are a few distinctions, though I wouldn’t call them real differences. The Senate would determine who gets tax credits to help buy insurance by income, rather than age. And the Senate bill would take more time to phase out the ACA’s expansion of Medicaid coverage; despite claims that this represents “heart,” it may have less to do with compassion than skewing how the bill is scored by the Congressional Budget Office. This pig’s lipstick is being applied with a trowel.

Ultimately, however, the impact is the same: sacrificing Medicaid for tax cuts. Senate Majority Leader Mitch McConnell (R-Ky.) had the bill drafted in strict secrecy and hopes to ram it through as early as next week. The ACA, by contrast, was drafted over the course of a year, with more than 100 public hearings.

Does McConnell have the votes? Wavering senators should know that we’re not fooled. We see exactly what you’re doing — and you should expect to be held fully accountable.

This article says it very plainly -- the Repugs want to rob the poor and working class to give to the rich. My senators' staff members told me they've been flooded with calls, even though they are both Dems who are against this travesty.

[GreyhoundFan]

Another good one from Jennifer Rubin: "Six takeaways from the Senate health-care debacle"

Spoiler

Not since the rollout of the flawed HealthCare.gov site has a health-care measure drawn such utter scorn. The Senate’s health-care effort was so widely panned that one wonders what the 13 members of the working group had been doing behind closed doors all this time. The bill contains multiple, serious deficiencies — but also a few opportunities.

First, the bill in no way, shape or form repeals Obamacare. For a couple of years, Republicans’ bill would prop up the system as is with subsidies to insurers, precisely what Sen. Marco Rubio (R-Fla.) and others have fought to prevent for a few years now. This belies the notion that Obamacare is unfixable. We’ll get back to this below.

Second, the bill then makes the newly stabilized exchanges unstable once again by repealing the individual mandate. Only the sickest will sign up; the premium costs will skyrocket, and we’ll be back to bailing out insurance companies or closing the exchanges. Peter Suderman explains:

Like the House plan, the Senate plan retains Obamacare’s major insurance regulations, including the requirement to cover pre-existing conditions, at the federal level. Unlike the House plan, it does not allow states to apply for a waiver to opt out of those rules. It also eliminates Obamacare’s health insurance mandate.

Every state that has attempted this combination of coverage regulations without a mandate has seen a swift meltdown in the individual market. There is every reason to expect that the same would happen under the Senate plan, especially since Obamacare’s exchanges were struggling with a too-small, too-sick enrollee pool even with the mandate in place.

Third, although the Senate bill keeps the exchanges and the Affordable Care Act’s protection for preexisting conditions, it gives out stingier support to lower- and middle-income Americans and lowers the threshold from 400 percent to 350 percent of the poverty line for phasing out subsidies. More cost is shifted back to the sickest patients. Insurers could offer alternative plans without the minimum list of benefits, but that would entail higher out-of-pocket costs and/or less coverage. It is as if someone asked the Senate to come up with a less generous version of Obamacare.

Fourth, the Medicaid cutback sets up a situation like the “doc fix,” an annual ritual by which Congress had to increase payments to providers to keep them in the business of offering care to Medicare patients. In both cases, Congress announces big cost reductions — but then delays them so that future presidents and lawmakers have the task of either pulling the trigger or coming up with more money. The changes in the Senate bill to Medicaid are so substantial (both in rolling back the pool of eligible people and in implementing a slower formula for keeping up with inflation) that there is a good chance that House Speaker Paul Ryan’s dream of ending the Medicaid entitlement and shipping it back to the states won’t ever come to pass.

Fifth, the premise of this repeal effort was that the exchanges were failing. If so, there’s little to no justification for cutting back Medicaid — except to give very big tax cuts to the rich. Why not keep the taxes in place and use the funds to, say, give Medicaid patients private coverage? Instead of tax cuts for the richest, Congress could improve health-care access in rural areas or through the Department of Veterans Affairs, or it could increase rather than cut back on drug addiction treatment. (Aren’t the rich already getting a tax cut from the GOP’s tax reform plan?)

Sixth, there is a tremendous opening here for Senate moderates to end this fiasco and try to work with Democrats on a shortlist of reforms. Republicans are willing, it seems, to support the exchanges as is for a couple of years. Democrats should put forth their own suggestions for bolstering the exchanges. Rather than do away with the individual mandate, the lawmakers could seek to prevent young, healthy people from gaming the system (i.e. going into the system only when they get sick or injured). They could even agree to keep or — gasp! — increase the pool of people covered by Medicaid in exchange for some reforms. (Why not a work or school requirement for able-bodied adults with no children?) They should bring the governors into the discussion and get buy-in from both Republicans and Democrats who have actually run their state’s Medicaid systems.

Instead of getting run over by the right wing of their party, as their House counterparts did, Senate moderates have the chance to strike out on their own and come up with reforms that bolster the exchanges and that improve Medicaid. They can test Democrats’ promise to work constructively across the aisle. Conservatives, meanwhile, should understand that the bill is nothing more than a repudiation of their seven-year fight to repeal the ACA. They will leave a legacy that amounts to: Obamacare, but worse!

I don't believe that Repug "moderates" will stand up to McTurtle.

[GreyhoundFan]

"How Trump and Republicans may get away with hurting millions of people"

Spoiler

The single most glaring feature of the Republican health-care plan is how massively regressive it is. Whether in the Senate or House version, it cuts health-care spending on poor people by hundreds of billions of dollars, to finance (relative to current law) an enormous tax cut for the rich. The regressiveness of the plan is a feature, not a bug. Even if you allow that Republicans believe in a principled way that this will benefit America, it is the plan’s overriding ideological goal. Cutting spending on the poor to facilitate a huge tax cut for the rich, in many ways, is the plan.

But what if a large majority of Americans don’t have a clear sense that the plan even does this? A new Kaiser Family Foundation poll out today suggests this may be the case, which hints at a number of troubling things about where this debate is headed next.'

The Kaiser poll finds that only 38 percent of Americans know that the GOP plan makes “major reductions” in Medicaid spending. Another 27 percent say it makes “minor” reductions; 13 percent say it makes no reductions; and 20 percent say they don’t know. If this polling is right, that means at least 6 in 10 Americans are unaware of the central feature of the GOP plan to reconfigure one-sixth of the U.S. economy, one that will impact many millions of people over time.

At the same time, though, the poll finds that the public broadly approves of Medicaid as it is and supports continued spending on it — and that very few Americans support the GOP cuts when asked. Sixty-one percent of Americans say that Medicaid is “working well” for most low-income people it covers. But only 36 percent support cutting funding for Obamacare’s Medicaid expansion; and only 35 percent support changing Medicaid’s funding to limit how much states get each year. The GOP plan phases out the Medicaid expansion and uses per-capita caps to limit payments to states, in what could shape up as a dramatic overhaul of Medicaid well beyond ending the expansion, resulting in deep cuts to the program’s assistance to poor children, people with disabilities and the sick.

As it is, the Kaiser poll finds that only 35 percent approve of the GOP plan, which is actually better than other polls. It’s hard to explain the disapproval of the plan in light of public unawareness of its key features. Maybe it’s “status quo bias,” reflexive opposition to change. Maybe it’s all the headlines saying 23 million will lose coverage — perhaps the public has a vague sense that this would be the outcome, without knowing specifically how. Regardless, if more Americans fully grasped the plan’s enormous Medicaid cuts, disapproval might be even deeper.

All of this suggests that in some key ways, the GOP strategy is working. Republicans have gone to enormous lengths to obscure the plan’s profoundly regressive features. They have endlessly told the lie that no one will be worse off (because everyone will have “access” to affordable coverage), and they’ve developed numerous cleverly designed talking points designed to create the impression that, by slowly phasing in the loss of coverage for millions over time, this will create a painless transition to … well, to a blissful state in which everyone, again, has “access” to affordable coverage. Among these: “Smooth glide path.” “Rescue mission.” “Bridge to better health care.” “Soft landing.”

But it’s important to understand that this scam has multiple layers. The slow phase in isn’t merely about creating the impression of a painless transition. It’s also about deferring accountability. This is particularly the case with the Senate version of the bill, which must appear softer than the House bill in order to get the support of key Republican moderates who represent states with large Medicaid expansion populations. Nicholas Bagley, a health policy expert at the University of Michigan, emails me:

The Senate bill front-loads the sweet stuff and delays all the painful stuff. The tax cuts kick in immediately; so too does relief from the individual mandate. But the bill holds off on slashing Obamacare subsidies until 2020, well after the next round of congressional elections. And it delays the Medicaid cuts until 2021, right after the next presidential election. So, by design, the law aims to allow Republicans to duck political accountability for taking insurance away from people.

The strategy is even more devious than this, however. The Senate bill phases in the Medicaid cuts more slowly than the House bill over time, to allow moderates to argue it is softer. But it uses a harsher funding formula in order to cut the program at least as deeply later. As the Kaiser Family Foundation’s Larry Levitt has explained, the basic overriding truth here is that, because the Senate bill keeps the House bill’s enormous tax cuts for the rich, it must cut spending on health care for the poor by similarly large amounts; all it can do is move those cuts around. And that’s exactly what the Senate bill does. It’s a cruel and cynical shell game.

There is no telling what will happen to the millions and millions of poor people who can’t get coverage in the next decade. Right know, though, large majorities may not even know that the plan Republicans are trying to pass even would bring this about. And when the cuts do phase in, many won’t even remember this vote, perhaps leaving any hope of accountability far back in the past.

...

Interesting perspective on the Repug scheme.

[GrumpyGran]

So we go back to the days of people using the ER for healthcare. I'm sure hospital are thrilled about this notion. And I can see why governors of the states aren't happy, the GOP is throwing them under the bus.

And as an example of what would be at stake for someone here in the good old USofA, for my friends on FJ who live in other lands:

Just got my bill for surgery I had at the local hospital four weeks ago. It required an overnight stay. The use of the operating room cost $25,500. My room, which was private cost $1100. I had implants-bone. They cost $20,300. Pain meds for 24 hours cost $3900. The other supplies used in the surgery cost about $8600. The anesthesia cost $4300. The time I was in recovery room cost $4350. Total bill: $69141.00

I'll get my bill from the surgeon later as well as the anesthesiologist. Can you imagine if you didn't have insurance and had to face this?

[CTRLZero]

22 hours ago, GrumpyGran said:

So we go back to the days of people using the ER for healthcare.

I remember those days, and here is a link to a CNN Money article about the closure of rural hospitals:

When Medicaid goes away, so do rural hospitals

22 hours ago, GrumpyGran said:

Can you imagine if you didn't have insurance and had to face this?

I had a recent experience (yesterday!) which gave me great empathy with countless current and soon-to-be insurance-less Americans.  (Putting it under spoiler, because it's long and boring.)

Spoiler

 

I have  what seemed to me to be a simple, easily-dealt-with medical issue.  I acquired a minuscule rock chip to the cheek; it's too deep for me to tweezer out on my own (even if I had good eyesight to do so), it's unsightly and lumpy (hurts when I lay on it at night), and I'm not very vain, but I want it gone.

So...I went to my primary physician, figuring she'd refer me to someone who could extract my little geological souvenir.  She called around and no one would accept my insurance (like they did up until some undisclosed point recently).  I asked for a quote to see if I could get it done for cash?  No, because I carry insurance, they can't accept cash payments even though they won't accept my insurance.  If someone has any  insurance policy, they can't accept cash because of some regulation.  Flummoxed!

As a work around, my doctor suggested I go to an urgent care facility that's part of the system and ask if anyone is good with a scalpel.  I hate the thought of competing with people waiting to be seen for true emergencies.  I asked if I attempted to remove it myself and botched it, could I return to my primary physician and have them fix it.  With a *wink, wink*, they indicated if I cut it open and, say, it got infected, they'd patch me right up.

My choices are to go to an emergency room or engage in self-mutilation.  Welcome to the new world of health care, I guess.  Anyway, I never imagined my insurance would become inadequate so rapidly.  Fortunately for me, we have a family friend who is a doctor and she volunteered to lance it, maybe at our next barbecue.  Life in America...

 

 

[fraurosena]

This is why politics in America can never be a democracy within the current system. Anyone with enough money can buy their policy preferences. 

 

I'm not sure what to call it. A financecracy?

 

Kamala Harris wrote an op-ed on the new Kill-Bill:  I can help you understand Trumpcare, but I can't defeat it alone

[GrumpyGran]

1 hour ago, CTRLZero said:

I remember those days, and here is a link to a CNN Money article about the closure of rural hospitals:

When Medicaid goes away, so do rural hospitals

I had a recent experience (yesterday!) which gave me great empathy with countless current and soon-to-be insurance-less Americans.  (Putting it under spoiler, because it's long and boring.)

  Reveal hidden contents

 

I have  what seemed to me to be a simple, easily-dealt-with medical issue.  I acquired a minuscule rock chip to the cheek; it's too deep for me to tweezer out on my own (even if I had good eyesight to do so), it's unsightly and lumpy (hurts when I lay on it at night), and I'm not very vain, but I want it gone.

So...I went to my primary physician, figuring she'd refer me to someone who could extract my little geological souvenir.  She called around and no one would accept my insurance (like they did up until some undisclosed point recently).  I asked for a quote to see if I could get it done for cash?  No, because I carry insurance, they can't accept cash payments even though they won't accept my insurance.  If someone has any  insurance policy, they can't accept cash because of some regulation.  Flummoxed!

As a work around, my doctor suggested I go to an urgent care facility that's part of the system and ask if anyone is good with a scalpel.  I hate the thought of competing with people waiting to be seen for true emergencies.  I asked if I attempted to remove it myself and botched it, could I return to my primary physician and have them fix it.  With a *wink, wink*, they indicated if I cut it open and, say, it got infected, they'd patch me right up.

My choices are to go to an emergency room or engage in self-mutilation.  Welcome to the new world of health care, I guess.  Anyway, I never imagined my insurance would become inadequate so rapidly.  Fortunately for me, we have a family friend who is a doctor and she volunteered to lance it, maybe at our next barbecue.  Life in America...