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Trumplandian Feudalism: Employ the Unemployed While Still Starving Them

Something odd is going on in the White House. Donald Trump just did a massive flip-flip. Ok, it’s not that odd. But it’s still somewhat odd because it’s unclear if he actually did the flip-flop or is attempting to hold two mutually exclusive views simultaneously. You see, Donald Trump used to say the US unemployment rate was a complete fraud and actually much, much worse than the headline sub-5 percent unemployment rate makes it out to be. Like closer to 42 percent. That’s what Trump said over and over on the campaign trail and since getting elected while lamenting that 94 million American adults are “out of the labor force” (which includes all retirees and students). But all of sudden that changed and now Donald Trump is super excited about the official unemployment rate. Why? Because the jobs report for the first full month of his presidency just came in and it wasn’t too shabby.

So did Trump suddenly drop his oft-repeated criticism of tradition unemployment reporting? Well, as we’re going to see, probably not because his administration is still planning on redefining the “official” unemployment rate to be much “looser” and his claims that 42 percent if American adults are out of work are necessary to achieve a long-held GOP goal championed by House Speaker Paul Ryan: converting the US safety-net – including Medicare, Medicaid, and Social Security – into a “work for a pittance to get a pittance of government support”-net that traps the poor in system where if you have to find full time work to get any help at all. Maybe even for the elderly. And the help you get in return for that work-requirement will keep shrinking year after year. It’s a plan that can’t happen unless almost all non-working adults are defined as “unemployed”. So, no, Trump didn’t change his mind. He just still thinks we’re all stupid (maybe).

***

The jobs report for the first full month of the Trump presidency came in at a robust 235,000 new jobs and the unemployment rate dropped to 4.7 percent. Not too shabby for the first month and as one might imagine Donald Trump was quite pleased. And tweet-happy. But as one might also imagine, the fact that Donald Trump was so pleased has less to do with anything Trump actually did (235,000 new jobs a month is roughly inline with the last four years), and more to do with his fanciful imagination. In this case, it’s Trump’s imaginative hallucination that we wouldn’t all notice that he called the unemployment rate completely fake – and possibly 42 percent – right up to the moment that this jobs report came out:

Fortune

The White House Is Celebrating Jobs Numbers President Trump Used to Call ‘Phony

Tessa Berenson
3/10/2017 4:32 PM Central

The Trump Administration is celebrating the Department of Labor’s latest jobs report. But in the past President Trump has called the same monthly report “phony” and a “hoax.”

Friday morning the president retweeted a Drudge Report link to the numbers that said “GREAT AGAIN: +235,000.” (Employers added 235,000 new jobs in February, bringing the unemployment rate down to 4.7%, the report found.)

White House spokesman Sean Spicer tweeted that the report is “Great news for American workers” and “Not a bad way to start day 50 of this Administration.”

Other Administration officials touted the numbers as well, including Chief of Staff Reince Priebus and Vice President Mike Pence.

‘Phony’ and a ‘joke’

During a press conference in 2015, Trump said the unemployment rate, then at 5.1%, was too low to accurately capture the real economic situation in the country. He called it “such a phony number” and said, “the number isn’t reflective … 5.3 percent unemployment, that is the biggest joke there is in this country … The unemployment rate is probably 20 percent, but I will tell you, you have some great economists that will tell you it’s a 30, 32. And the highest I’ve heard so far is 42 percent.”

PolitiFact rated Trump’s 42 percent claim “pants on fire” and wrote at the time, “Getting a percentage that high requires believing that being a high school, college or graduate student, a senior citizen, a stay-at-home parent, a job-training participant, or having a disability is no excuse for not holding down a job, or for working less than 40 hours in a week. The highest alternative unemployment-rate measure we could come up with that had any credibility was 16.4 percent, and even that exaggerated figure is only about one-third of the way to Trump’s 42 percent.”

‘One of the biggest hoaxes’

In August 2016, Trump once again claimed that the actual unemployment rate was higher than the jobs report reflected. ” We have the lowest labor force participation rates in four decades,” Trump said in a speech to Detroit Economic Club during the general election campaign. “Fifty-eight percent of African-American youth are either outside the labor force or not employed. One in five American households do not have a single member in the labor force. These are the real unemployment numbers – the five percent figure is one of the biggest hoaxes in modern politics.”

‘Ninety-four million Americans’

During his first address to Congress to Congress, Trump threw out a startling statistic: “94 million Americans are out of the labor force.” But that figure is misleading. Like the other unemployment statistics Trump mentioned as a candidate, it includes retirees, students, stay-at-home parents and people who are disabled—people who are not actively looking for a job. If Trump were being consistent about using that definition, the Administration could not also tout the 4.7 percent unemployment rate from this month’s jobs report.

‘Not a good sign’

In December 2012, the jobs report said employers added 244,000 jobs, about 10,000 more than this week’s report that Trump seems excited about. But at the time, Trump, then a private citizen, was not pleased. “Today’s job report is not a good sign & we could be facing another recession,” he tweeted. “No real job growth. We need over 300K new jobs a month.”

‘Not real’

And here’s a bonus mention for Trump’s new Treasury Secretary Steven Mnuchin. “The unemployment rate is not real,” Mnuchin told the Senate Finance Committee during his confirmation hearing in January. “I’ve traveled for the last year. I’ve seen this.”

PolitiFact rated Trump’s 42 percent claim “pants on fire” and wrote at the time, “Getting a percentage that high requires believing that being a high school, college or graduate student, a senior citizen, a stay-at-home parent, a job-training participant, or having a disability is no excuse for not holding down a job, or for working less than 40 hours in a week. The highest alternative unemployment-rate measure we could come up with that had any credibility was 16.4 percent, and even that exaggerated figure is only about one-third of the way to Trump’s 42 percent.””

Just FYI to all the high school, college or graduate students, senior citizens, stay-at-home parents, job-training participant, and people with a disability. Trump want you to know that there’s no excuse for not holding down a job, or for working less than 40 hours in a week. All 94 million of you.

And in case you’re tempted to assume that Trump’s 42 percent guestimate that he kept mentioning on the campaign trail was merely the high-end of the guestimate range that Trump and threw out there for shock value on the campaign tail but was going to drop once he became president, he wanted you to think otherwise during his first big televised address to Congress:


During his first address to Congress to Congress, Trump threw out a startling statistic: “94 million Americans are out of the labor force.” But that figure is misleading. Like the other unemployment statistics Trump mentioned as a candidate, it includes retirees, students, stay-at-home parents and people who are disabled—people who are not actively looking for a job. If Trump were being consistent about using that definition, the Administration could not also tout the 4.7 percent unemployment rate from this month’s jobs report.

His first address to Congress and he straight up using the 94 million number. This is going to be brutal. And that was during his first address to congress a week and a half ago. Unless he really did drop the 42 percent unemployment meme over the last week and a half and is now relenting on his apparent determination to redefine the unemployment rate as including almost living adult who is not working. Including retirees. And students.

Trump’s Treasury Secretary Agrees. Suddenly. Sort of

And yes, Treasury Secretary Steve Mnuchin echoed Trump during his confirmation hearings by saying he’s changed “unemployment rate isn’t real”:


And here’s a bonus mention for Trump’s new Treasury Secretary Steven Mnuchin. “The unemployment rate is not real,” Mnuchin told the Senate Finance Committee during his confirmation hearing in January. “I’ve traveled for the last year. I’ve seen this.”

Now, it’s important to realize that what Mnuchin said wasn’t an outrageous statement on it’s own, in part because there are many different ways to define an official unemployment rate. It’s a subjective call so there isn’t a “correct” “official” unemployment metric. It just depends on what you want to measure as “unemployed” for the official metric. You can limit it to people actively looking for work (the current “official” rate) or everyone who isn’t working but could work whether they’re actively looking for a job or not. There’s not a “correct” way to do that. There really is a much larger pool of long-term unemployed/under-employed people who would like to work but gave up looking and it’s not unreasonable on it’s own to say “hey we should count those people who gave up looking too”. Although it is unreasonable to suggest that the government isn’t actually looking at that expanded definition of the unemployment rate since those metrics collected and reported.

Also note that when Mnuchin gave his confirmation testimony and echoed Trump’s unemployment rate views it’s pretty unclear what exactly he went when he because, while he didn’t lament that 94 million adults were out of the labor force like Trump did during his congressional address and so many times before, Mnuchin did call for “all potential workers” to be considered in a new unemployment rate. And how you define “all potential workers” is also a subjective call. Is it all the long term unemployed who want and job and those who don’t. Or maybe retirees and students counted in the unemployment rate too. There really are 94 million “potential workers” too, at least potentially if that’s how you want to define all unemployed adults as a “potential worker”. So determining how Mnuchin defines the pool of “potential workers” is pretty urgent as he vaguely describes this plank of the Trump agenda:

The Hill

Mnuchin: Unemployment rate is ‘not real’

By Peter Schroeder – 01/19/17 01:49 PM EST

Steven Mnuchin dismissed the sharp decline in the unemployment rate as “not real,” arguing that the average American still hasn’t felt anything from the economic recovery.

Testifying before the Senate Finance Committee Thursday, Mnuchin said that his travels with President-elect Donald Trump have changed his perspective and argued the nation’s needs a new approach.

In so doing, Trump’s pick to head the Treasury Department dismissed the validity of one of the nation’s central economic guideposts, which currently sits at 4.7 percent.

“I absolutely understand why he got elected,” said Mnuchin. “The average American worker has gone absolutely nowhere. The unemployment rate is not real.”

Republicans have argued in the past there should be more focus on alternate ways to measure the nation’s labor market, noting that potential workers that give up searching for a job after six months are no longer counted as unemployed.

“Republicans have argued in the past there should be more focus on alternate ways to measure the nation’s labor market, noting that potential workers that give up searching for a job after six months are no longer counted as unemployed.”

Who’s not going to be a “potential worker”? That’s a pretty big question. Students who have never worked? Retirees? The disabled? Keep in mind that, there is a kind of value judgement at work for different labels. For instance, if retirees were counted in the “official” unemployment rate that sort of implicitly suggests they should actually be working. Full time. Same with students. And don’t forget that when Donald Trump repeatedly lamented how 94 million Americans were out of the labor force, he was implicitly suggesting retirees, students, and basically all adults capable of working should be working full time. In other words, you retire when you’re either too sick or disabled to work or you die. That’s what’s implied if Trump’s “94 million Americans are out of the labor force” comment is to be taken seriously.

So what percentage of that 94 million pool of adult Americans without full-time work does Treasury Secretary Steve Mnuchin consider “potential workers”? Well, the article below points to a hint Mnuchin gave us back in the beginning of February in his written responses to questions from Senators during his confirmation hearing (the hearing where he referred to “potential workers”. In his written response Mnuchin suggested still using existing Bureau of Labor Statistics (BLS) unemployment statistics as the “official” unemployment rate system, but just using one of the “looser” unemployment rates as the “official” one instead. The BLS system ranges from the “U-1” unemployment rate (narrowest definition of unemployed that isn’t typically seen as very useful) to the “U-6” (all unemployed, underemployed, and people capable of working, but not students and retirees). Currently, the “U-3” rate (unemployed people who have looked for work in the last 12 months) is the “official” unemployment rate.

It’s the U-3 that just came in at 4.7 percent that Trump claims is now suddenly real after claiming for years it was garbage and hiding the real extent of US unemployment because it didn’t count people who want to work but just gave up trying to look. And, again, that’s not an invalid point Trump is making about the inadequacy of the “U-3” rate as an unemployment metric. it’s Trump’s 42 percent/94 million claims that are invalid points because they assume every physically capable adult is working full time. But the points that Trump was also making about the U-3 “official” unemployment rate not capturing what’s really going in the economy isn’t invalid.

There’s no reason we couldn’t follow Trump’s suggestion of using a “looser” definition of being unemployed and, say, call the “U-5” rate (the “U3” plus workers looking for work more than 12 months and workers who are capable and interested in working but haven’t looked for a job for whatever reason in the last four months) the “official rate”. There’s nothing wrong with that as long as we understand how to interpret it. As Paul Krugman pointed out in 2014, there’s a lot of value in looking at “U-3” vs “U-6” rates together just to get a better idea of how much slack there is in the economy (and as Krugman also noted we should apply government stimulus if there’s too much slack).

And as the article below points out, Treasury Secretary Mnuchin suggested in his written response to the Senate that maybe the “U-5” should be the official rate. As the article also notes, the “U-5” was at 5.7 percent in early February (and is presumably lower now). So if shifting to the U-5 rate really is the change to the unemployment rate that the Trump administration is planning on implement, the unemployment rate is going to be permanently higher. And at times perhaps much much higher depending on the slack in the economy. And there’s nothing necessarily wrong with using the U-5. But if the U-5 is what the Trump administration makes the “official” unemployment rate going forward, there’s definitely not going to be an 42 percent unemployment rate any time soon…unless he changes the “U-5” definition to include all 94 million students, the disabled, and retirees out of the labor force, of course:

Bloomberg

Full Employment May Be Redefined as Trump Attacks Benchmark
by Patricia Laya
February 1, 2017, 11:01 PM CST February 2, 2017, 12:15 PM CST

* Treasury nominee says unemployment rate has too much clout
* Main rate is still best indicator, former stats chief says

Just as the U.S. nears full employment based on the principal measure used for almost eight decades, President Donald Trump and his team are looking at new yardsticks.

The jobless rate probably held in January at 4.7 percent, according to the median estimate from economists ahead of Friday’s Labor Department report. Federal Reserve policy makers see such a level — which is down from a post-recession high of 10 percent in 2009 — as being at or near full employment, meaning anything lower would push inflation higher.

While the rate’s use as a chief indicator dates to the Depression era, Trump spent last year’s election campaign calling the measure “phony” and arguing it overstates the strength of the labor market. More recently, his Treasury secretary nominee, Steven Mnuchin, said the number has “excessive influence” over policy and that it fails to account for people who have dropped out of the labor force or aren’t actively looking for work. White House spokesman Sean Spicer said Trump’s economic team will look at a “multitude of statistics” in assessing labor-market strength.

Trump’s officials actually share common ground with Fed Chair Janet Yellen on their support for reviewing a range of labor-market indicators. Yellen has argued in the past that the jobless rate didn’t capture slack evident elsewhere, as the Fed kept interest rates near zero until late 2015. She’s pointed to low levels of labor-force participation and the large number of part-time workers who would prefer full-time employment.

Fed policy makers indicated in their post-meeting statement Wednesday that there’s still room for improvement in the job market. While the unemployment rate “stayed near its recent low” in December, “some further strengthening” is expected in labor conditions.

Comparable Rates

That doesn’t mean central bankers or Labor Department economists are about to abandon the unemployment rate as their main gauge. That figure is the “number that’s most comparable over time and one that’s most comparable internationally,” said former Bureau of Labor Statistics Commissioner Erica Groshen, who left the government last month at the end of her four-year term as President Barack Obama’s appointee to the post.

Mnuchin, in written responses to senators’ questions following his confirmation hearing last month, cited the so-called U-5 rate as an alternative indicator. That rate, which stood at 5.7 percent in December, includes discouraged workers as well as a group called marginally attached workers, who aren’t working or actively looking for work but want a job. Another measure, the U-6 or underemployment rate, was 9.2 percent in December. It also includes part-time employees who want full-time work.

“People change their minds about whether they’re discouraged,” said Groshen, who was previously a Fed economist. “We’ve been measuring the unemployment rate the same way since the 1940s. Most other countries that have an unemployment rate use a definition that’s similar to ours — partly because we created it and because it works.”

While other measures can help give a more nuanced view of the labor market, they don’t go back as far, Groshen said.

Changing the target unemployment rate “would just say to me that you’re confused, that you don’t know what you’re aiming for,” said John Silvia, chief economist at Wells Fargo Securities LLC in Charlotte, North Carolina.

Payrolls, Wages

Friday’s report is projected to show a steadily improving labor market, according to economists’ estimates. Employers probably added 175,000 workers to payrolls in January, an improvement from December, while average hourly wages probably rose 2.8 percent from a year earlier, compared with the 2.5 percent rise in January 2016.

Trump’s skepticism was part of his message that helped him win the 2016 election. The president is “absolutely right in saying that the labor market has much more slack in it than the Fed and other commentators are thinking about,” David Blanchflower, a Dartmouth College economics professor and former Bank of England policy maker, said on Bloomberg Television. “Millions of people voted for Trump saying there are no decent jobs out there and nothing much is changing.”

U.S. efforts to define and measure unemployment stemmed from the Great Depression, when about 13 million people were out of work, amounting to a 25 percent jobless rate. But no one knew these figures at the time or whether they were improving or deteriorating, according to a 2009 paper by BLS economist Steven Haugen.

Researchers devised the methodology, and the monthly employment report began in 1940, based on a regular sample survey of the population. That practice continues today, with about 60,000 U.S. households surveyed each month by the Census Bureau. Payroll figures come from a separate survey of businesses and government agencies.

Since 1940, there have been various reviews of the concept and definition of unemployment, which have resulted only in minor revisions to the official measure, Haugen wrote. A range of alternative metrics, including the U-5 and U-6 rates, were developed in the 1970s.

Such measures now show that the “labor market is tightening,” said Neil Dutta, head of U.S. economics at Renaissance Macro Research LLC in New York.

Political Influence

While the BLS commissioner participates in the drafting of the monthly employment release and approves it, other political appointees aren’t involved, and long-standing guidelines are aimed at avoiding the politicization of the reports, Groshen said. Trump hasn’t named a new BLS chief yet. The position is subject to Senate confirmation.

If the focus is placed on a rate that measures unemployment differently, what would matter is that “you use it consistently over time, both backwards and forward,” said Stuart Hoffman, chief economist at PNC Financial Services Group Inc. in Pittsburgh.

Among people out of the workforce, “it’s hard to know how many are legitimately would-be employees,” Hoffman said. Still, “there are people on the sidelines that could come back in, who keep the labor market from being all that tight.”
d
“The spigot keeps twisting a little tighter, but it’s not bone-dry,” he said.

“Mnuchin, in written responses to senators’ questions following his confirmation hearing last month, cited the so-called U-5 rate as an alternative indicator. That rate, which stood at 5.7 percent in December, includes discouraged workers as well as a group called marginally attached workers, who aren’t working or actively looking for work but want a job. Another measure, the U-6 or underemployment rate, was 9.2 percent in December. It also includes part-time employees who want full-time work.”

That’s the line the Treasury is going to walk now that Donald Trump is calling into question the US’s long-standing unemployment rate metric: Use U-5 instead of U-3 as the “official” rate. Which would push it up to a whole 5.7 percent today. And not remotely 42 percent.

So What’s the Official Plan for the “Official” Unemployment Rate? Andy Puzder Gives Us a Clues. An Ominous Clue

So is Mnuchin’s “U-5” proposal reflective of what Trump thinks the “official” unemployment rate should be reset to? Well, don’t forget that Mnuchin delivered his response to the Senate with the “U-5” proposal at the beginning of February and Trump lamented how “94 million Americans are out of the labor force,” at his first speech to Congress at the end of the month.

And at this point who knows which, if any, of Trump’s pre-3/10/2017 (when the February jobs report came out) views on the unemployment rate are still in effect after his bizarre embrace of the jobs report that was in direct contradiction of his bizarre repeated lamentations of the idea that 94 million Americans are out of the labor force. Are there any other clues he’s left for us?

Well, there was one big clue, and it’s an ominous one. The clue came in the form of Trump’s decision to nominate fast-food CEO Andy Puzder as labor secretary. Specially, the clue comes from the choice of Puzder for that labor secretary role and how Puzder’s well known views on replacing all social safety-net and welfare programs with a national work requirement and wage subsidies in the form of the Earned Income Tax Credit (EITC) for low-income worker and how closely those views align with another key figure in this mess: House Speaker Paul Ryan’s desire to do the same. If Trump defines all adults physically and mentally capable of working as “out of the labor force”, that means all recipients of welfare and safety-net programs can be considered eligible for a work-requirement to get their government assistance (with an EITC). And that’s all required if Paul Ryan’s long-held goal of eliminating welfare programs (including Medicaid) can come to fruition.

So first, let’s take a look at the Andy Puzder’s views on replacing all welfare with a check from the government. A check you only get if you’re working in the form of the EITC. If you want food and shelter you’ll need find a job. At minimum wage if that’s all that’s available (perhaps at a fast food restaurant?). And while Puzder isn’t going to be labor secretary because he withdrew his nomination over a variety of personal scandals, this was still the well known views of Puzder when Trump selected him. And, again, Puzder’s dream of creating a giant work force of government subsidized minimum wage workers (for the benefit of all employers who might want to employ minimum wage workers) is the same as House Speaker Paul Ryan’s dream. So Puzder’s views on these matters, which he made clear in the following opinion piece he write in 2015, is a big clue as to why Donald Trump keeps talking about 94 million Americans being out of work:

The Hill

More work, less welfare

By Andy Puzder – 06/22/15 06:31 PM EDT

After six years of a recovery that has failed to meaningfully help working-class Americans, our nation is facing a crisis of entrenched poverty and declining opportunity.

Not surprisingly, the number of people dependent on the Supplemental Nutrition Assistance Program (SNAP), federal housing assistance and Medicaid continues to grow. The number of people receiving SNAP benefits (food stamps) alone has doubled since 2008, to 74.7 million; in troubled cities like Baltimore, more than 1 in 3 residents receives them.

These important programs genuinely help people in need, and we are a nation rich enough to assist the economically disadvantaged. But these programs have the unintended consequence of discouraging work rather than encouraging independence, self-reliance and pride.

At quick-service restaurant brands Carl’s Jr. and Hardee’s, we’ve seen these policies’ unintended consequences firsthand.

Consider that some of our crew members are declining promotions to shift leader positions because the increase in income would disqualify them for food, housing, medical or other government benefits.

These promotions are the first step on the ladder to becoming a general manager, potentially making up to $80,000 a year. It’s a shame they’re unable to take a promotion for fear of losing public assistance. Following local minimum wage increases, other employees have refused additional hours or requested fewer hours to keep their incomes below the cutoff for receiving benefits.

Called the “welfare cliff” by policy wonks, this growing trend is little more than people responding to incentives. Simply, people get trapped into working less and keeping valuable benefits over working more and losing them.

For example, eligibility for food stamps ends when annual income exceeds 130 percent of the poverty line, or a little more than $15,000 a year, for an individual. At $8.25 an hour or less, employees can work a full-time schedule of 35 hours a week and still qualify for these benefits. But when the minimum wage increases above this level, as it has recently in many cities and states, employees must reduce their hours to keep their benefits.

Similarly, in most states, Medicaid eligibility ends when annual income exceeds 138 percent of the poverty line. Understandably, some employees choose to work less and keep the thousands of dollars’ worth of benefits instead of working a little more and losing them.

The impact a loss of government benefits has on financial security for people living in poverty can be draconian. It can lock them into poverty by making the chasm between government dependence and independence too broad to cross.

As a result, people forgo opportunity for safety, which prevents them from realizing the independence and self-reliance that come with personal success and a job.

There is a solution that fulfills society’s obligation to help the poor without reducing opportunity: the earned income tax credit (EITC).

The EITC supplements incomes of the working poor through the tax code. Rather than access to myriad and complex government programs, people receive a government check supplementing their paycheck.

As their income from work increases, their government supplement declines. The decline, though, is never so steep that it results in a decline in total income. You make more when you work more, thus rewarding work, without the perverse incentives and massive government bureaucracy that characterize existing social programs.

The IRS recently estimated that nearly 28 million Americans received more than $66 billion in EITC payments in 2013, lifting an estimated 6.5 million people out of poverty, including 3.3 million children. While programs that provide food, housing and medical benefits are certainly important, the EITC is more effective in helping people rise out of poverty. These existing programs should be rolled into an expanded EITC.

The IRS recently estimated that nearly 28 million Americans received more than $66 billion in EITC payments in 2013, lifting an estimated 6.5 million people out of poverty, including 3.3 million children. While programs that provide food, housing and medical benefits are certainly important, the EITC is more effective in helping people rise out of poverty. These existing programs should be rolled into an expanded EITC.

Replace all federal programs that provide food, housing and medical benefits with an expanded EITC (that you only get with a job). That was published view of Trump’s first labor secretary. A view that makes defining a very “loose” definition of the “unemployed” a requirement because you can’t force people getting welfare services (like Medicaid) to work for those benefits if they aren’t considered “unemployed”.

Paul Ryan Gives Us Another Clue: His Long-Held GOP Agenda

So how closely do Puzder’s views on these matters match that of Paul Ryan’s? Well, the last time Ryan issued an poverty-program “reform” agenda it was last year and the agenda was just a vague set of goals that gave little idea of what he actually intended to do (it was a presidential election year). But we don’t need to guess what Ryan intends, since he’s been very clear when it’s not a presidential election year. Like he made clear in 2014 when he laid out a plan to fold all saftey-net programs in one big program that would be block-granted to states and scheduled to slowly whither away and die as people were pushed onto and expanded EITC (with an implicit work requirement):

The Nation

Paul Ryan’s Welfare Reform Ideas Are Even Worse Than You Think

Ryan is asking the poor to be more flexible in being oppressed.

By Michelle Chen
August 15, 2014

If you ask congressional conservatives about their plan to revive the economy, you’re not likely to get a very detailed answer, since they tend to doubt that the government is the solution—to a bad economy or anything else. But the neoliberal philosopher king of Capitol Hill, Representative Paul Ryan, has rolled out a plan to reduce government and reduce poverty simultaneously. He calls it “Expanding Opportunity in America”—and he plans to do it by shrinking what’s left of the welfare state.

Under the banner of “flexibility for accountability,” Ryan presents an agenda that reflects “deregulation for deprivation,” systematically reducing public assistance in hopes of “incentivizing” people to be somehow less poor. New research shows us that the plan would deepen the damage already inflicted by eighteen years of reforming welfare out of existence.

The centerpiece of Ryan’s latest budget plan is the so-called “opportunity grant,” which consolidates eleven federal programs into a single chunk of funding, including food stamps, subsidized childcare, and housing funds. This ultimately forces welfare admnistrations to parcel out money for, say, rehabilitation programs for people with disabilities, senior centers and subsidized daycare for toddlers, all from the same capped fiscal pot, which in turn dilutes overall funding streams and undercuts resources for directly assisting the poor.

Progressive critics say that this formula has been tried before, with the 1996 welfare reform law that gutted key public assistance programs. Those measures capped benefits and lumped programs into a single pot of funding, with disastrous effects on the poor.

Ryan’s “opportunity grant,” as Bob and Barbara Dreyfuss reported earlier, would impose the same austerity two-step of capping and consolidating. Following the “accountability” framework of the current welfare laws, Ryan’s “opportunity” program would impose strict requirements on welfare recipients, which would humiliatingly micromanage their household spending work-related activites.

The program also promotes the Earned Income Tax Credit, which subsidizes incomes through income tax refunds, as an alternative to direct cash benefits, suggesting that tax breaks are a form of assistance superior to cash payments.

At the heart of Ryan’s plan is an all-out assault on food stamps. Food stamps are a favorite target for small-government conservatives because (1) they run the way a welfare program should—benefits expand based on people’s need, not the political whims of Capitol Hill; and (2) even though benefits are extremely lean, only a few dollars per day, food subsidies are extremely effective at reducing poverty—so it’s the kind of welfare libertarians hate.

The restructuring proposed in the Ryan Plan, according to an analysis by the CBPP, would directly target crucial (and fragile) pillars of the welfare state: because about 80 percent of the Opportunity Grant goes toward food stamps and housing assistance, “the cuts would almost certainly reduce families’ access to these programs, which are effective at reducing poverty—particularly deep poverty.

Although the 1996 welfare reforms were supposed to promote self-sufficiency—and overall poverty has fallen by some measures—CBPP’s longitudinal analyses shows that “deep poverty”—or living on less than roughly $8.50 per day—has actually surged, particularly among children. And according to new research by H. Luke Shaefer and Kathryn Edin, published in Pathways, the number of households surviving in extreme poverty, or on less than about $2 per day, has more than doubled since the Clinton-era reforms were enacted.

Although all demographics experienced greater poverty and instability over a fifteen-year period, racial and gender disparities aggravate the effects. Extreme poverty shot up 186 percent among blacks, and 134 percent among whites. While households headed by married couples saw extreme poverty nearly double, single-woman households saw a staggering 230 percent rise.

Today funding for the Temporary Assistance for Needy Families Block Grant, the main source for cash assistance, managed jointly by states and Washington, is not only frozen but melting away. TANF has seen much of its value erode through inflation since 1996. According to the CBPP, spending on basic assistance declined in real dollars by 50 percent between 1997 and 2011.

Ryan’s plan, which embraces an elitist concept of flexibility by giving more freedom to employers to pay workers as little as possible and more freedom to officials to cut public spending, encapsulates the free-market logic of empowering capital through the unfreedom of labor. The working poor get to eat all the cake they can get. The hierarchy of employers over workers that the Ryan plan promotes reflects a profound mistrust of, along with social disinvestment from, those who already have the least power over their economic lives.

In contrast to Ryan’s rhetoric, numerous studies show that when entrusted with the flexibility to spend cash assistance however they want, people generally use it to fit their rational needs. These actual studies, of course, defy the stereotypes that the poor would rather splurge on frivolous expenses like cigarettes and beer.

Plus, the dignity of having control over your life—something that chronic poverty tends to rob people of—is priceless. When the economy declines, Schaefer explains, “cash support offers a flexibility to recipients that is absolutely essential if they want to succeed in the labor force. Let’s say someone loses their job and cannot get unemployment insurance (which is pretty common among the working poor). They need some amount of cash to use for the things that will help them find that next job (as long as the government continues to be unwilling to fund jobs of last resort)…. some amount of cash, immediately available when a crisis strikes, is crucial for people to pursue their self interest at the very bottom—and the lack of this is a gap in the current system.”

Ryan is asking the poor to be more flexible in being oppressed—to seize the opportunity to sleep under the bridge of their choice. This rationale presents the poor themselves, not the social system of poverty, as the scourge the government must get rid of. And as long as they’re wiped off the welfare rolls, they really do disappear, in a way. To many in Washington, they were never visible.

“If you ask congressional conservatives about their plan to revive the economy, you’re not likely to get a very detailed answer, since they tend to doubt that the government is the solution—to a bad economy or anything else. But the neoliberal philosopher king of Capitol Hill, Representative Paul Ryan, has rolled out a plan to reduce government and reduce poverty simultaneously. He calls it “Expanding Opportunity in America”—and he plans to do it by shrinking what’s left of the welfare state.

Reducing government programs and reducing poverty simultaneously. That’s the plan. Officially. Unofficially the plan isn’t actually about reducing poverty, but that’s the sales pitch: if we just set bundle all wefare and safety-net programs into one big federal block-grant to states, and then set that block-grant on a schedule for slow (or fast) death, people will be incentivized to find work because their government support will be constantly shrinking and the EITC tax credit for low-wage workers increases:


The centerpiece of Ryan’s latest budget plan is the so-called “opportunity grant,” which consolidates eleven federal programs into a single chunk of funding, including food stamps, subsidized childcare, and housing funds. This ultimately forces welfare admnistrations to parcel out money for, say, rehabilitation programs for people with disabilities, senior centers and subsidized daycare for toddlers, all from the same capped fiscal pot, which in turn dilutes overall funding streams and undercuts resources for directly assisting the poor.

Progressive critics say that this formula has been tried before, with the 1996 welfare reform law that gutted key public assistance programs. Those measures capped benefits and lumped programs into a single pot of funding, with disastrous effects on the poor.

Ryan’s “opportunity grant,” as Bob and Barbara Dreyfuss reported earlier, would impose the same austerity two-step of capping and consolidating. Following the “accountability” framework of the current welfare laws, Ryan’s “opportunity” program would impose strict requirements on welfare recipients, which would humiliatingly micromanage their household spending work-related activites.

The program also promotes the Earned Income Tax Credit, which subsidizes incomes through income tax refunds, as an alternative to direct cash benefits, suggesting that tax breaks are a form of assistance superior to cash payments.

Are you too poor to afford food, shelter, and medicine? Well, you better find a job at any wage at all and hope the expanded EITC covers the cost of living. Literally living. Have fun bargaining with the boss:


Ryan’s plan, which embraces an elitist concept of flexibility by giving more freedom to employers to pay workers as little as possible and more freedom to officials to cut public spending, encapsulates the free-market logic of empowering capital through the unfreedom of labor. The working poor get to eat all the cake they can get. The hierarchy of employers over workers that the Ryan plan promotes reflects a profound mistrust of, along with social disinvestment from, those who already have the least power over their economic lives.

That’s the plan. And it’s a plan that requires a “loose” a definition of the unemployed as possible. And even if you do have a job and are hoping that EITC government wage subsidy will cover your costs of living, that EITC is going to have to be expanded dramatically if the worker poor of tomorrow aren’t going to be the working deeply-poor:

Center on Budget and Policy Priorities

Commentary: The EITC Works Very Well – But It’s Not a Safety Net by Itself

March 26, 2014
by Sharon Parrott

House Budget Committee Chairman Paul Ryan’s recent report on safety net programs rightly praised the Earned Income Tax Credit (EITC) for reducing poverty and promoting work. But, Ryan’s report criticizes much of the rest of the safety net. And, over the past several years, Chairman Ryan’s budget plans have targeted low-income programs such as SNAP (formerly food stamps) and Medicaid for extremely deep cuts. While it’s heartening to hear Chairman Ryan trumpet the EITC’s success, policymakers need to understand that the EITC alone can’t do what’s needed to ameliorate poverty and hardship.

The EITC serves a specific role in our safety net: easing the taxes and supplementing the wages of low-income working families. It promotes work by providing the most help to families with significant earnings. A single parent with two children, for example, must earn between $13,650 and $17,850 in 2014 to qualify for the maximum credit. Those earnings are modest, to be sure, but most people in this earnings range work most of the year and work at least 30 hours per week when they have a job. In short, they have significant attachment to the labor force.

Here’s what the EITC (and its sibling the Child Tax Credit or CTC, which helps offset the cost of raising children) are not designed to do — and cannot do without other safety net programs:

* Help people who are out of work or can’t work. The EITC and CTC are designed to help families with at least modest earnings. But, some people don’t have jobs, particularly in a weak economy, or have long periods of unemployment during a year. Others can’t work due to illness or disability or the need to care for an ill or disabled child. Still others can’t work because they have young children and can’t earn enough to afford child care.

Without programs such as SNAP, Supplemental Security Income (SSI), and Medicaid, people in these families, including millions of children, couldn’t put food on the table, keep a roof over their head, and get needed health care. Helping them isn’t only the right thing to do — it’s also an investment in children. Research shows that basic assistance to children not only reduces short-term hardship but also improves their academic performance and long-term prospects. And, Medicaid coverage enables children to receive preventive care as well as treatment for everything from ear infections to cancer.

* Keep people out of “deep poverty.” Because the EITC and CTC aren’t targeted to the very poorest families, they don’t do much to keep people out of deep poverty, or above half the poverty line. Overall, the EITC and CTC plus other programs targeted on low-income individuals — such as SNAP, SSI, and Temporary Assistance for Needy Families — kept an estimated 15 to 20 million people above halfthe poverty line (about $11,000 for a family of three) in 2010. (That estimate is based on the federal Supplemental Poverty Measure, which most analysts favor. The upper end of the range reflects estimates based on Urban Institute data that correct for the underreporting of government benefits.) Roughly 70 to 80 percent of these people would have remained in deep poverty if the EITC and CTC were the only forms of income-tested assistance for very poor families (see Figure 1).

* Help families get health care. The average EITC benefit for families with children was $2,254 in 2011 — not enough to buy health insurance for a family or pay health care bills when someone gets sick or needs expensive medications. The programs designed to help low-income people get decent health care are Medicaid, the Children’s Health Insurance Program, and subsidies to buy private coverage through health reform’s new marketplaces, not the EITC.

* Help families on a monthly basis. Recipients get their EITC and CTC for the year in one lump sum when they file their income tax return. That works fine for many working families, helping them save for larger expenses and budget for the coming year, but poorer families and families whose incomes drop sharply due to a mid-year job loss need help during the year. And, for families that need significant help with large monthly expenses — such as putting groceries on the table and paying high rent or child care costs — monthly assistance programs are often a better fit. If a new mother needs help paying for child care to go back to work, for example, a tax credit that she needs earnings to qualify for and doesn’t arrive until she files her tax return the following winter or spring isn’t going to help her get back to work.

* Serve as an automatic stabilizer for the economy in recessions. Programs like unemployment insurance, SNAP, and Medicaid automatically expand during recessions when more people lose their jobs and need help. Since the EITC only goes to people who work, in contrast, it doesn’t help those who are out of work throughout the year. And, for people who still have earnings but whose earnings shrink during a downturn, the EITC rises for some, but falls for others. A recent study found that the EITC is only weakly counter-cyclical — that is, it expands only a small amount overall when unemployment rises.[1] For single-parent families, the largest group of EITC recipients, the study found “no evidence that the EITC stabilizes income” overall as unemployment rises. By contrast, other programs such as unemployment insurance and SNAP are far more responsive to increases in unemployment, according to the study.

The bottom line? The EITC is a critically important and highly effective part of the safety net, but it can’t — and wasn’t meant to — stand alone as our answer to poverty.

“The EITC and CTC are designed to help families with at least modest earnings. But, some people don’t have jobs, particularly in a weak economy, or have long periods of unemployment during a year. Others can’t work due to illness or disability or the need to care for an ill or disabled child. Still others can’t work because they have young children and can’t earn enough to afford child care.”

Can’t afford to eat? Well, you better find a job, any job, if you want to eat in the America Paul Ryan and Donald Trump want to make. And if the economy sucks that’s tough so you better not complain about your working conditions.

And if you think that this agenda is just going to impact low-income workers (and you’re sick enough not to care about their plight), keep in mind that the creating a sea of millions desperate workers who will work at just about any wage under any conditions just to get enough government assistance for basic food and shelter is a recipe for dragging down wages everywhere but the top. Imagine all the people who aren’t currently working and aren’t looking for work for whatever reason – maybe they can’t find any jobs that aren’t paying poverty wages or maybe they have physical or mental health issues that make employment difficult but don’t entirely prevent them from working – and now imagine them being forced to take any job at all at any wage just to get the most basic government assistance. How is that going to do anything other than drive down wages?

And What About the Poor Retirees. They’ll Might Need to Work For Thier Government Pittance Too

Now, so far, all the proposed changes to the “official” unemployment rate and how that ties into the broader agenda to replace the safety-net with a work-requirement and an inadequate government check haven’t involved programs for retirees. But don’t forget that in addition to the block granting of Medicaid – with the idea of steadily shrinking it to death which is already part of Paul Ryan’s Obamacare replacement proposalPaul Ryan and the GOP has also championed a similar idea for retirees: voucherizing Medicare. And ensuring those vouchers shrinking every year while the eligibility age is steadily ratcheted up. And if you’re a poor retiree who can’t afford health insurance with your future Medicare voucher, there’s also the option of bankrupting yourself and going on Medicaid…which just might include a work-requirement to receive after it gets block-granted if you particular state decides to implement a Medicaid work requirement that includes seniors. This is all on the agenda even if Paul Ryan, Trump, and the rest of the GOP don’t want you to know it:

The Huffington Post

Not Just Obamacare: Medicaid, Medicare Also On GOP’s Chopping Block
The health care safety net as we know it could be bound for extinction.

By Jonathan Cohn , Jeffrey Young
11/15/2016 11:50 am ET | Updated Nov 15, 2016

Donald Trump and Republican leaders in Congress have made clear they are serious about repealing Obamacare, and doing so quickly. But don’t assume their dismantling of government health insurance programs will stop there.

For about two decades now, Republicans have been talking about radically changing the government’s two largest health insurance programs, Medicaid and Medicare.

The goal with Medicaid is to turn the program almost entirely over to the states, but with less money to run it. The goal with Medicare is to convert it from a government-run insurance program into a voucher system – while, once again, reducing the money that goes into the program.

House Speaker Paul Ryan (R-Wis.) has championed these ideas for years. Trump has not. In fact, in a 2015 interview his campaign website highlighted, he vowed that “I’m not going to cut Medicare or Medicaid.” But the health care agenda on Trump’s transition website, which went live Thursday, vows to “modernize Medicare” and allow more “flexibility” for Medicaid.

In Washington, those are euphemisms for precisely the kind of Medicare and Medicaid plans Ryan has long envisioned. And while it’s never clear what Trump really thinks or how he’ll act, it sure looks like both he and congressional Republicans are out to undo Lyndon Johnson’s health care legacy, not just Barack Obama’s.

Of course, whenever Trump or Republicans talk about dismantling existing government programs, they insist they will replace them with something better – implying that the people who depend on those programs now won’t be worse off.

But Republicans are not trying to replicate what Medicaid, Medicare and the Affordable Care Act do now. Nor are they trying to maintain the current, historically high level of health coverage nationwide that these programs have produced. Their goal is to slash government spending on health care and to peel back regulations on parts of the health care industry, particularly insurers.

This would mean lower taxes, and an insurance market that operates with less government interference. It would also reduce how many people get help paying for health coverage, and make it so that those who continue to receive government-sponsored health benefits will get less help than they do now.

It’s difficult to be precise about the real-world effects, because the Republican plans for replacing existing government insurance programs remain so undefined. Ryan’s “A Better Way” proposal is a broad, 37-page outline without dollar figures, and Senate Republican leaders have never produced an actual Obamacare “replacement” plan.

But the Republican plans in circulation, along with the vague – and shifting – health care principles Trump endorsed during the campaign, have common themes. And from those it’s possible to glean a big-picture idea of what a fully realized version of the Republican health care agenda would mean.

Medicaid

As of August, 73 million Americans had benefits from Medicaid or the Children’s Health Insurance Program, according to the Centers for Medicare and Medicaid Services, which doesn’t break up the numbers for the two programs. All but around 16 million of them are covered by pre-Obamacare rules, but all Medicaid beneficiaries stand to be affected by the GOP’s plans.

Until the Affordable Care Act, working-age adults without disabilities were ineligible for this benefit in most cases, with some exceptions, including low-income pregnant women and very poor parents of children who qualified for Medicaid or CHIP.

As an entitlement like Medicare and Social Security, Medicaid gets however much money it takes to cover the medical expenses for everyone enrolled.

Over a 10-year time period, the Medicaid plan the House Budget Committee approved this year would reduce federal spending on the program by about one-third, or roughly $1 trillion, not even counting the effects of repealing Obamacare’s expansion of the program, according to the Center on Budget and Policy Priorities.

Repealing the Affordable Care Act and its Medicaid expansion fully would eliminate the coverage for the roughly 16 million people the Centers for Medicare and Medicaid Services reports have enrolled under this policy.

The federal government paid for 62 percent of the $532 billion in Medicaid expenditures in fiscal year 2015, the most recent year for which such a breakdown is available. In 25 states, the federal share of spending is higher still, so even states that may want to maintain today’s Medicaid benefits would find it extremely difficult, if not impossible, to replace the federal dollars that would disappear under GOP proposals.

One result could be 25 million fewer Medicaid beneficiaries, according to the RAND Corp.’s analysis of Trump’s plans.

Trump and other Republicans have long promoted “flexibility” that would enable states, which jointly finance and manage Medicaid with the federal government, to alter the program.

While this may seem on its face like simple federalism, the purpose is not to allow states to cover as many people as they do now in different ways, but to significantly reduce federal spending on Medicaid and to permit states to cut back on who can receive Medicaid coverage and what kind of benefits they have.

Ryan’s latest version of this 35-year-old idea would establish either “block grants” to states – that is, a flat amount of money each state would get from the federal government each year to spend on Medicaid as they like – or “per capita allotment” – meaning a flat amount of money for each person enrolled. These approaches would differ in terms of how much money states would receive yearly and how much the funding would increase from year to year.

In any case, the funding wouldn’t be high enough to maintain current coverage, inevitably leading to millions of currently covered individuals losing their benefits. And the financing would grow at a slower rate than health care costs, portending more lost coverage over time. For those who remain on Medicaid, Ryan would permit states to charge them monthly premiums and add other strings, such as a work requirement.

Medicare

The Medicare revamp in “A Better Way” would result in wholesale changes to the entitlement – ones that would realize Ryan’s long-term goal of privatizing the program.

Today, most of the 55 million Medicare beneficiaries enroll in the traditional, government-run program and then buy private supplemental insurance to cover remaining out-of-pocket costs. A sizable minority opts to buy private insurance plans, through the Medicare Advantage program. The government regulates these plans tightly, to make sure they provide coverage at least as generous as the traditional Medicare program does.

Ryan would replace this arrangement with a “premium support” system, under which each senior would get an allotment of money – a voucher, in other words – he can use to get insurance. When Ryan introduced the first formal version of his proposal, in 2010, he envisioned ending the traditional government program altogether. Now he says it should continue to exist alongside the private plans, competing with them for business..

What would this mean for beneficiaries? A great deal would depend on details Ryan has yet to provide, particularly when it comes to the value of that voucher – and how quickly it would increase every year – compared to the cost of the insurance. But the whole point of the system is to ratchet down the value of the vouchers over time.

That would reduce spending on Medicare, which Ryan always says is a goal, and some seniors would likely end up saving money, because they could easily switch to cheaper plans. The question would be what happens to everybody else. Without adequate regulation of benefits and other safeguards tailored to the special needs of an older, frequently impaired population of seniors, the consequence of moving to premium support could be higher costs for individual seniors who have serious health problems – with low-income seniors feeling it most intensely.

If at the same time Republicans shrink Medicaid, those seniors will suffer even more, since today the poorest seniors can use the program to pay for whatever medical bills Medicare does not.

Ryan promises that the proposal would not affect seniors who are 55 or older, since the new system wouldn’t begin operating for 10 years. But realistically the entire Medicare program would change once premium support took effect – private plans would almost certainly find ways to pick off the healthiest seniors, for instance – and, at best, the damage would simply take longer to play out.

Ryan’s Medicare scheme includes one other element – a provision to raise the eligibility age gradually, so that seniors would eventually enroll at 67, rather than 65. Particularly in a world in which the Affordable Care Act no longer exists, 65- and 66-year-olds searching for private coverage would find it harder to obtain, more expensive and less generous than what they’d get from Medicare today.

The end result would almost surely be higher out-of-pocket costs for those younger seniors – and a significant number of them, maybe into the millions, with no insurance at all.

“But Republicans are not trying to replicate what Medicaid, Medicare and the Affordable Care Act do now. Nor are they trying to maintain the current, historically high level of health coverage nationwide that these programs have produced. Their goal is to slash government spending on health care and to peel back regulations on parts of the health care industry, particularly insurers.”

Yep, the goal isn’t “repeal and replace” Obamacare as Republicans made their rallying cry. The goal is “repeal all entitlements and replace them with something steadily cheaper”. That’s it. That’s the goal. And that means things like turning Medicare into a steadily shrinking voucher and converting Medicaid into steadily-shrinking block grants that can include things like work-requirements:


Ryan’s latest version of this 35-year-old idea would establish either “block grants” to states – that is, a flat amount of money each state would get from the federal government each year to spend on Medicaid as they like – or “per capita allotment” – meaning a flat amount of money for each person enrolled. These approaches would differ in terms of how much money states would receive yearly and how much the funding would increase from year to year.

In any case, the funding wouldn’t be high enough to maintain current coverage, inevitably leading to millions of currently covered individuals losing their benefits. And the financing would grow at a slower rate than health care costs, portending more lost coverage over time. For those who remain on Medicaid, Ryan would permit states to charge them monthly premiums and add other strings, such as a work requirement.

Today, most of the 55 million Medicare beneficiaries enroll in the traditional, government-run program and then buy private supplemental insurance to cover remaining out-of-pocket costs. A sizable minority opts to buy private insurance plans, through the Medicare Advantage program. The government regulates these plans tightly, to make sure they provide coverage at least as generous as the traditional Medicare program does.

>Ryan would replace this arrangement with a “premium support” system, under which each senior would get an allotment of money – a voucher, in other words – he can use to get insurance. When Ryan introduced the first formal version of his proposal, in 2010, he envisioned ending the traditional government program altogether. Now he says it should continue to exist alongside the private plans, competing with them for business..

What would this mean for beneficiaries? A great deal would depend on details Ryan has yet to provide, particularly when it comes to the value of that voucher – and how quickly it would increase every year – compared to the cost of the insurance. But the whole point of the system is to ratchet down the value of the vouchers over time.

If at the same time Republicans shrink Medicaid, those seniors will suffer even more, since today the poorest seniors can use the program to pay for whatever medical bills Medicare does not.

Shrinking Medicare by pushing health care costs onto seniors, which will push more seniors onto Medicaid, whil simultaneously shrinking Medicaid and giving states the option creating things like work-requirements to get it. That’s the plan. And while President Trump hasn’t formally agreed to that plan, don’t forget that his “94 million out of the labor force” comments that he repeatedly made implicitly assumes that all retirees are potential employees.

And then there’s the fact that privatizing (and cutting) Social Security is very much part of the GOP/Ryan agenda too.
:

Forbes

Why Social Security Cuts Are Still In GOP Agenda

John Wasik
Mar 10, 2017 @ 09:19 AM

Despite what President-elect Trump says, Social Security cuts are still very much on the table. His Secretary for the Department of Health and Human Services — Rep. Tom Price (R-Georgia) — filed legislation last year to trim the program’s benefits. And I suspect it’s still on his radar screen.

Price’s strategy was to bury Social Security “reform” inside of a a massive budget bill, so the issue wouldn’t necessary receive a separate hearing in Congress. Price was chairman of the powerful House Budget Committee in the last Congress.

The conservative Georgia doctor has long been a proponent of major cutbacks to Social Security, Medicare, Medicaid and Obamacare. In a speech before the conservative group Heritage Action for America on January 12, 2015, Price told the group about his plans for Social Security:

“This is a program that right now on its current course will not be able to provide 75 or 80 percent of the benefits that individuals have paid into in a relatively short period of time. That’s not a responsible position to say, ‘You don’t need to do anything to do it.’

So all the kinds of things you know about – whether it’s means testing, whether it’s increasing the age of eligibility. The kind of choices — whether it’s providing much greater choices for individuals to voluntarily select the kind of manner in which they believe they ought to be able to invest their working dollars as they go through their lifetime. All those things ought to be on the table and discussed.”

None of these ideas are new and have been floated by Republicans such as Paul Ryan, speaker of the house, and conservative think tanks for years. But the word Price doesn’t use — privatization — is still very much on the GOP agenda for Social Security and Medicare.

Even worse, Price used false information as a scare tactic to provide political cover to carve up the program. Social Security is not in any danger of not being able to provide “75 or 80 percent of benefits in a short period of time.”

According to the non-partisan Congressional Budget Office (CBO), the Social Security trust fund that serves as a kitty for retirees, will be forced to reduce benefits in 2030. And that’s only if Congress does nothing to boost funding of the system.

That means that only complete inaction by Congress will drive the trust fund balances to zero. Even then, Social Security will still pay benefits.

By 2030, “the Social Security Administration would no longer be permitted to pay full benefits when they were due,” with future benefits by annual income, the CBO report said. At most, benefits would likely be cut by 29%.

President-elect Trump has said on the campaign trail that he wouldn’t touch Social Security or Medicare, but he’s clearly at odds with his party, which has wanted to trim or privatize Social Security and Medicare for more than a decade.

“None of these ideas are new and have been floated by Republicans such as Paul Ryan, speaker of the house, and conservative think tanks for years. But the word Price doesn’t use — privatization — is still very much on the GOP agenda for Social Security and Medicare.”

Privatization, the word that GOPers always think about but dare not speak. But they sure love proposing it:


So all the kinds of things you know about – whether it’s means testing, whether it’s increasing the age of eligibility. The kind of choices — whether it’s providing much greater choices for individuals to voluntarily select the kind of manner in which they believe they ought to be able to invest their working dollars as they go through their lifetime. All those things ought to be on the table and discussed.”

Those were the words of Tom Price, Trump’s choice for Secretary of Health and Human Services and the House GOP’s long-time point man on gutting entitlements. And what those word describe is a Social Security privatization option even if he doesn’t use the word “privatization”. But that’s what it is, even if it’s not the full privatization of Social Security and merely a private option. That’s how privatization is supposed to work under the Paul Ryan agenda: start with the option to have your social security taxes go into a Wall Street-run private fund, and then steadily shrink the defined benefits of the traditional program.

And don’t forget that when you move people away from a defined benefit system – the way social security operates today – and towards a defined contribution option – which is how the private option would work – that is a plan allow people to make really bad investments when they’re young and have almost nothing left in that Social Security private personal account when they hit retirement age. And if ther’s a massive financial crisis, a whole generation of retirees or near-retirees could see their Social Security accounts wiped out. Which means the privation of Social Security is a recipe for pushing seniors onto Medicaid because they will be poor enough to qualify. And, again, Medicaid in the future just might require work requirements. Maybe for people over 65 if that’s allowed. Or 67. Or whatever the retirement age ends up being in the future.

So, once again, when Donald Trumnp repeatedly refers to a 42 percent unemployment rate and 94 million people being out of the labor force it’s not inconceivable that he’s intentionally framing the unemployment definition required for a “Ryan” vision of the future where everyone needs to work for government assistance. Including the elderly.

Yes, Trump Thinks We’re Stupid. Or Has Dementia

Of course, now that Donald Trump embrace the 4.7 percent unemployment rate it unclear what to think about what Trump actually thinks when it comes to the veracity of past and present unemployment rates. Especially after Donald Trump had Sean Spicer deliver to the press a mysterious tragicomic message: “I talked to the president prior to this, and he said to quote him very clearly: ‘They may have been phony in the past, but it’s very real now.’ ”:

The Washington Post

19 times Trump called jobs numbers ‘fake’ before they made him look good

By Christopher Ingraham
March 10, 2017 at 4:49 PM

We may assume President Trump is quite pleased with the strong jobs report from his first full month in office: He retweeted the Drudge Report’s triumphant “GREAT AGAIN” framing of the numbers Friday morning, after touting employment figures released by payroll firm ADP earlier in the week.

Not so long ago, however, Trump’s view of the monthly jobs report, which comes courtesy of the nonpartisan federal Bureau of Labor Statistics, was markedly different. As recently as December, he described the report as “totally fiction.”

If there was any argument over whether Trump was flip-flopping on the jobs report at the precise moment it reflected positively on him, White House press secretary Sean Spicer laid it to rest Friday afternoon, telling reporters: “I talked to the president prior to this, and he said to quote him very clearly: ‘They may have been phony in the past, but it’s very real now.’ ”

“If there was any argument over whether Trump was flip-flopping on the jobs report at the precise moment it reflected positively on him, White House press secretary Sean Spicer laid it to rest Friday afternoon, telling reporters: “I talked to the president prior to this, and he said to quote him very clearly: ‘They may have been phony in the past, but it’s very real now.’ ””

“I talked to the president prior to this, and he said to quote him very clearly: ‘They may have been phony in the past, but it’s very real now.’ ” WTF. Is he trolling us? Because Trump is either suggesting that the unemployment rate dropped from 42 percent to 4.7 percent in the first month, which would indeed be pretty impressive, or he thinks that the entire world is stupid. Dementia perhaps? Only Trump knows. Unless it’s dementia in which case maybe not.

But something very weird and very ominous is going on with Trump and the unemployment rate. It’s possible the Trumnp administration is merely going to shift the “official” rate from the “U-3” to “U-5” rate the way Steve Mnuchin recommended expand it to include everyone who would like to find work, even the long-term unemployed who are so discouraged they’ve stopped looking.

But when we look at all the clues available it’s becoming increasingly clear that Donald Trump’s repeated references to a 42 percent unemployment rate with 94 million Americans out of the labor force isn’t dementia. It’s laying the rhetorical groundwork to redefine who is considered “unemployed” in order to lay down the conceptual groundwork required to replace the US safety-net with a “work for a pittance to receive a government pittance” safety-net. And including retirees in that potential workforce. That’s where all the clues are pointing.

Although when you consider that in implementing this agenda Donald Trump is basically setting himself up to be Paul Ryan’s ghoulish and super-villain stand-in who will be loathed for generations to comes. As conservative columnist Reihan Salam recently wrote in Slate, if Donald Trump listens to Paul Ryan he’s committing political suicide. And it’s hard to see why Salam isn’t correct. What Paul Ryan and the GOP want to do – make almost all poor American adults a new serfs-for-welfare class of desperate low-wage employees – is beyond cruel and just bad policy that’s going to end up harming the entire economy and make living in America that much more stressful for almost everyone. The idea of losing your job in America is already scary enough. It’s about to become terrifying. And Donald Trump, when he used that “94 million Americans out of the labor force” line during his first address to Congress, gave a very strong indication that he’s willing to lead America into Paul Ryan’s vision of the future. As his policy agenda unfolds and becomes more and more aligned with the Paul Ryan ‘granny starver’ agenda that really does appear to be Trump’s plan . And Trump increasingly appears willing to take the bulk of the public blame for making it a reality. So while it’s unclear what exactly Trump meant when he had his spokesperson troll the world, you know, maybe it really is dementia.

Discussion

22 comments for “Trumplandian Feudalism: Employ the Unemployed While Still Starving Them”

  1. Mick Mulvaney, the Trump administration’s director of Office of Management and Budget (OMB), added a new twist to the general the confusion over the White House’s sudden celebration of a job report after dismissing all previous reports as fraudulent during an appearance on CNN today. When asked by Jake Tapper about how Mulvaney makes sense of Trump’s past dismissals of the official Bureau of Labor Statistics (BLS) unemployment numbers he first gave a response notably similar to the argument Treasury Secretary Steve Mnuchin gave to Congress when Mnuchin argued that the “official” unemployment rate should be the “U-5” rate instead of the current “U-3” rate. Mulvaney went a bit further in arguing that the official rate should be a “U-6” rate (you should actually look at all the rates) and then immediately concluded that the unemployment rate isn’t really what you should look at at all. Instead, it’s the number of new jobs that’s really important:

    “What I think changed is you start to look at some of the underlying numbers you look at the U6 number, already boring your audience. There are things like U3, U6, what you should really look at is the number of jobs created.”

    So that’s the first part of Mulvaney’s nonsense answer to Tapper’s question and could give us a clue as to how the Trump administration is going to proceed in its attempt to redefine who is truly “unemployed”: constantly assert that there’s a conspiracy to underreport the unemployment rate and then when questioned on the details deflect and assert that the unemployment rate doesn’t matter. It’s only the number of new jobs that matter. Keep an eye out for that kind of spin.

    But right after that in the interview Mulvaney goes on to to charge the BLS with cooking the books on the jobs reports during the Obama administration. But it wasn’t the same kind of charge Trump frequently made that the unemployment rate was artificially low due to an undercounting of the number of people who are truly unemployed (like Trump’s “94 million Americans are out of the workforce” line that he kept using, including in his first address to Congress). Instead, Mulvaney seemed to be suggesting the BLS during the Obama administration was faking the number of new jobs created:

    “We thought for a long time, I did, that the Obama administration was manipulating the number in terms of the number of people in the workforce to make the unemployment rate that percentage rate look smaller than it actually was. We used to tell people back home the only thing you should look at is the number of jobs created.”

    And that all was just in the first minute of Mulvaney’s interview with Tapper. He then goes on to make all sorts of laughably deceptive deflections for the growing number of questions about the Trump/Paul Ryan Obamacare replacement plan and how its poised to lead to millions losing health care coverage to pay for tax cuts for the rich. Mulvaney’s basic response what that they aren’t really cuts to health care because the market was going to magically make health care so much more cost effective that the same levels of service were going to be available despite the massive cuts to actual government spending on health care.

    It was a revealing interview overall and just one of the Sunday morning interviews he did today:

    The Fiscal Times

    OMB Director Mulvaney Blowing Smoke on Health Law’s Impact

    By Rob Garver
    March 12, 2017

    The director of the Trump administration’s Office of Management and Budget, former South Carolina Rep. Mick Mulvaney, sat for a pair of interviews on Sunday morning, in which he questioned the credibility of three of the federal government’s most respected non-partisan agencies and twisted himself into verbal knots in explaining how the proposed replacement for the Affordable Care Act currently being considered by Congress would improve the nation’s health care system.

    Mulvaney, appearing on CNN, was asked by host Jake Tapper to comment on the job growth numbers put out by the Bureau of Labor Statistics on Friday, which showed unemployment shrinking to 4.7 percent even as wages increased and the economy created an estimated 235,000 jobs.

    Tapper pointed out that during the campaign, Trump had repeatedly called the BLS statistics “fake” and insisted that the “real” rate of unemployment was actually as high as 40 percent. But on Friday, the White House celebrated the numbers. What changed?

    Mulvaney began with some hand-waving about the alternative measure of unemployment known as the U6, which, unlike the more broadly cited U3, accounts for people marginally attached to the workforce and people involuntarily working only part-time.

    “What I think changed is you start to look at some of the underlying numbers you look at the U6 number, already boring your audience. There are things like U3, U6, what you should really look at is the number of jobs created.”

    It should be noted here that there was absolutely nothing remarkable in Friday’s U6 number. It was well within the range it has occupied since prior to the election.

    Then, Mulvaney accused the BLS, which is staffed by career professionals, of cooking the books during the Obama administration.

    “We thought for a long time, I did, that the Obama administration was manipulating the number in terms of the number of people in the workforce to make the unemployment rate that percentage rate look smaller than it actually was. We used to tell people back home the only thing you should look at is the number of jobs created.”

    But if there were something magical about the number of jobs created in February, 235,000, Trump certainly wasn’t acting like it when the economy added that many jobs or more in multiple months during his presidential campaign.

    Mulvaney was forced, in the end, to admit that, despite the administration’s change in attitude toward the BLS numbers, there is actually nothing really different about them. “The BLS did not change the way they count, I don’t think, but you can have a long conversation when you’ve got a numerator and a denominator how to arrive at a percentage.

    Tapper then asked if President Trump was breaking his campaign promise not to touch Medicaid by supporting the House Republicans’ American Health Care Act, which would strip hundreds of millions of dollars from the program and repeal the expansion it underwent through the Affordable Care Act.

    “Just because you spend less money on something doesn’t mean it can’t get better,” Mulvaney said, insisting that improvements in efficiency and increased state-level control would improve the system for those using it.

    When Tapper pointed out that the ACHA’s changes would result in many million fewer Americans being enrolled in the program, Mulvaney tried to thread the needle by insisting that because people currently covered under the expansion would be allowed to remain — but new enrollees would not be accepted — that the bill isn’t really reducing anyone’s access to healthcare.

    “It doesn’t kick anybody off,” he said.

    In an interview on ABC, Mulvaney took the opportunity to criticize the well-respected Congressional Budget Office in advance of its expected release of an analysis of the ACHA’s impact on healthcare markets, expected on Monday.

    Asked by host George Stephanopoulos about expert analysts who expect CBO to report that as many as 15 million Americans could lose coverage under ACHA, Mulvaney joined others in the White House, like Press Secretary Sean Spicer, who have challenged the competency of the agency.

    “We continue to think and have for a long time that CBO is scoring the wrong thing,” he said. The congressional budget watchdog, he said, fails to consider the benefits of market competition, which he insisted the ACHA would generate, and also didn’t take into account what he predicted as the “collapse” of Obamacare.

    He also took a swipe at the Joint Committee on Taxation, which last week released a report that found the repeal of multiple taxes related to the ACA would greatly benefit the wealthy, and another from the AARP, which found that it would increase costs for seniors by thousands of dollars a year.

    “I seriously doubt that any of those analyses take into account the fact that the use of Health Savings Accounts and the lower premiums that come from competition. Look, everybody’s got skin in this game. Everybody has an interested party and they’re trying to protect their own.”

    In fact, Health Savings Accounts, which allow individuals to set aside income tax free to pay for health-related expenses, are being asked to do an awful lot of the heavy lifting when it comes to the purported “improvements” to that ACHA proponents are promising.

    Again addressing the changes to the Medicaid program, Mulvaney insisted, “What we’re doing is making sure that the truly indigent have care. Medicaid is still there. In fact, we think it’s going to be even better. The people who are just above Medicaid but still have difficulty buying their own premiums will not only have the refundable tax credit but they will have the ability to use HSA’s to pay for their health care on a tax-advantaged basis just like you and I get. So I don’t understand the criticisms lobbed in that fashion.”

    There’s a lot to unpack here:

    First, the tax credits being offered under the proposed ACHA would provide much, much less money for premium payments than the existing subsidy system under the ACA.

    Second, the idea that people on the cusp of qualifying for Medicaid are somehow going to find enough spare income to fund an HSA at the level needed to pay for a decent health insurance policy is laughable on its face. (Not to mention that “tax advantaged” savings for people with income too low to trigger significant tax liability is not much of a benefit.)

    Finally, Mulvaney presents HSAs as though they are something new and innovative when in fact they have been around in their current form since 2003, and in different manifestations since the 1990s. If they were some sort of magic bullet to help the poor pay for care, they’d have solved the health care affordability problem years ago.

    “Just because you spend less money on something doesn’t mean it can’t get better,” Mulvaney said, insisting that improvements in efficiency and increased state-level control would improve the system for those using it.”

    “Just because you spend less money on something doesn’t mean it can’t get better,”: And that, right there, is going to be one of the big meta-messages going forward coming from the White House and the rest of the GOP. Something like:

    Just because we’re cutting funding for these programs doesn’t mean we’re cutting services. Because we’re block granting and voucherizing programs like Medicaid that magically means new “efficiencies” will be found. Forever as we perpetually cut back on these programs. Also, we’re making health care more ‘patient focused’ and ‘consumer driven’ (euphemisms for transferring health care costs from insurers to consumers) and that will make things more efficient. Any reduction in health care services is merely a reduction in the wasteful and unnecessary medical services that our reforms (budget cuts) encourage. Not the helpful services people need.

    That’s the gist of the GOP’s meta-meme that it’s going to be using: the cuts to these programs merely encourage greater efficiencies that make up for the cuts! Isn’t that great? That’s the meta-meme. At least one of them.

    But there’s clearly going to be an “everyone is lying about the numbers but the GOP” meme too. Not only did Mulvaney add the conspiracy theory that the Obama BLS was rigging the new jobs numbers in the past to their public worldview, but he then went on to ABC to assert that the Congressional Budget Office (CBO), which isn’t too enthusiastic about the Big Numeric Lies in the GOP’s health care proposals, wasn’t fairly assess the cost and likely impact of the GOP’s American Health Care Act replacement for Obamacare because the CBO doesn’t take into account “the benefits of competition”:


    Asked by host George Stephanopoulos about expert analysts who expect CBO to report that as many as 15 million Americans could lose coverage under ACHA, Mulvaney joined others in the White House, like Press Secretary Sean Spicer, who have challenged the competency of the agency.

    “We continue to think and have for a long time that CBO is scoring the wrong thing,” he said. The congressional budget watchdog, he said, fails to consider the benefits of market competition, which he insisted the ACHA would generate, and also didn’t take into account what he predicted as the “collapse” of Obamacare.

    ““We continue to think and have for a long time that CBO is scoring the wrong thing,” he said. The congressional budget watchdog, he said, fails to consider the benefits of market competition”

    Don’t trust the CBO because it doesn’t appreciate the awesomeness of the market. That’s the other big meme Trump and the GOP are clearly pushing. So it’s going to be important to keep in mind that the CBO can indeed use “dynamic scoring” factor in the magic of “the market” and the current head of the CBO is a conservative who was nominated for that position in 2015 by Tom Price, the head of Health and Human Services. And this conservative head of the CBO doesn’t appear to think the GOP’s “American Health Care Act” dynamically scores very high:

    Politico

    Budget referee may call foul on Obamacare repeal

    A market-oriented Republican economist could prove to be a formidable obstacle for the GOP lawmakers who appointed him.

    By Rachana Pradhan

    03/10/17 05:09 AM EST

    The fate of Obamacare may lie in the hands of a number-crunching Republican appointee whose bottom line might single-handedly blow up the GOP quest to repeal and replace it.

    Congressional Budget Office Director Keith Hall was handpicked two years ago by top Republicans in Congress— including now Health and Human Service Secretary Tom Price — to lead a nonpartisan office that will soon release its estimate of how many Americans the Republican health care bill will cover and whether it shrinks or balloons the federal deficit.

    With the House repeal bill under attack by Republican moderates worrying about coverage and conservatives fuming about entitlements and spending, the CBO assessment will matter. It’s widely expected early next week.

    Hall, in the post for two years, has signaled that his office won’t soft-pedal the coverage assessments. If a health plan doesn’t have comprehensive benefits, it won’t count as coverage. Fearing a bad CBO “score,” Republicans facing backlash in their drive to gut Obamacare are turning the budget agency and its team of professional economic analysts into a punching bag as they try to discredit it.

    President Donald Trump hasn’t directed any of his tweet fury — #FAKESCORES? — at Hall. But the White House press secretary has landed jabs.

    “If you’re looking to the CBO for accuracy, you’re looking in the wrong place,” Sean Spicer said Wednesday at a briefing where the CBO came up repeatedly. “They were way, way off last time in every aspect of how they scored and projected Obamacare.”

    The political limelight is not Hall’s natural milieu, and his professional history didn’t set him up to be a GOP foil. He’s a measured, conservative labor economist who worked at the White House Council of Economic Advisers and the Bureau of Labor Statistics under President George W. Bush. He also did a stint at the right-leaning Mercatus Center think tank.

    Liberals were frosty when congressional Republicans — including Price, then chairman of the House Budget Committee — selected him to lead CBO in February 2015. He was on record as arguing that Obamacare was detrimental to the U.S. labor market, and also criticized proposals to raise the minimum wage.

    “Based on Mr. Hall’s writings, it appears that we have very different views on a range of issues, and he would not have been my first choice,” Sen. Bernie Sanders said at the time. “His opposition to increasing the minimum wage and his resistance to sound strategies for eliminating poverty place him outside the mainstream.”

    But Hall has sometimes surprised.

    He was appointed to head CBO as Republicans in Congress revised rules for how the office would assess the impacts of legislation — a switch to what’s known as “dynamic scoring,” which lets CBO incorporate broader economic effects of proposed policy changes. Yet Hall’s use of that technique hasn’t always resulted in estimates that help the GOP agenda.

    Notably, the CBO two years ago said fully repealing Obamacare would boost the federal deficit by $353 billion over 10 years. Even with “dynamic scoring,” the office still put the repeal price tag at $137 billion. That’s not the message Republicans were looking for as they attacked the law as money-guzzling big government.

    And in one highly significant report in December — which set up the possible upcoming clash with the Republican Congress — Hall’s CBO said it wouldn’t count skimpy health plans as coverage in its scores. In other words, people with limited health care benefits that are unlikely to protect them against expensive or catastrophic medical events won’t meet the CBO standards for health coverage.

    That means the CBO score of a Republican plan is almost certain to be less favorable than that of Obamacare.

    “Members of Congress are often frustrated with CBO’s estimates of the effects of legislation because those estimates sometimes make it more difficult for those members to advance legislation they believe in,” said Elmendorf, who led the CBO from 2009 to 2015.

    Under Elmendorf, the CBO also ruffled Democratic lawmakers’ feathers, in particular when it said the labor market would have 2 million fewer workers in 2025 because of the health care law. Republicans immediately used those findings to claim that Obamacare killed 2 million jobs.

    Further back, a tough assessment — including a blunt statement about the expanded role of government in health care — by CBO Director Robert Reischauer in 1994 was one of many events that doomed the health reform initiative of President Bill Clinton and Hillary Clinton.

    But Hall so far seems unperturbed by the repeal-and-replace fuss. Two former colleagues both described himj as “unflappable,” and noted that though he has free-market economic views, he’s never been partisan in any of his Washington roles.

    “This is just a time when you need someone like Keith who is calm and steady,” said Charles Blahous, a senior research fellow at Mercatus and a former Social Security and Medicare trustee. “That doesn’t mean that CBO’s going to get everything perfect. But I think it would be very, very bad for the current debate if the CBO director were viewed as an advocate. Then you’d really have a problem.”

    Benjamin Page, whose work for the CBO spanned from Reischauer in the 1990s to Hall and who is now at the Urban Institute, stressed the professionalism of his former colleagues, no matter who is running Congress.

    “I can’t say enough about the analysts,” Page said. “People really care there about getting the answer right.”

    “Hall, in the post for two years, has signaled that his office won’t soft-pedal the coverage assessments. If a health plan doesn’t have comprehensive benefits, it won’t count as coverage. Fearing a bad CBO “score,” Republicans facing backlash in their drive to gut Obamacare are turning the budget agency and its team of professional economic analysts into a punching bag as they try to discredit it.

    Fearing a bad score from the Congressional Budget Office, the GOP is already trying to discredit the Congressional Budget Office. Despite the fact that CBO Director Keith Hall is quite conservative and was selected by HHS Secretary Tom Price to lead the CBO just two years ago. And Hall isn’t an Obamacare fan either. This is the guy getting discredited as not being right-wing enough in his analysis of the GOP’s plans:


    Liberals were frosty when congressional Republicans — including Price, then chairman of the House Budget Committee — selected him to lead CBO in February 2015. He was on record as arguing that Obamacare was detrimental to the U.S. labor market, and also criticized proposals to raise the minimum wage.

    “Based on Mr. Hall’s writings, it appears that we have very different views on a range of issues, and he would not have been my first choice,” Sen. Bernie Sanders said at the time. “His opposition to increasing the minimum wage and his resistance to sound strategies for eliminating poverty place him outside the mainstream.”

    So that gives us a taste of just how bad the Trump/Ryan plan really is and why the the Trump administration and rest of the GOP apparently feel the need to launch a preemptive attack on the CBO.

    And note how in Mick Mulvaney’s response in the prior interview, his attacks on the CBO include the charge that the CBO wasn’t factoring in the magic of competition and the magic of things like tax cuts for the rich (otherwise known as “dynamic scoring). But as we just saw, the CBO has been “dynamic scoring” since 2015 (and still is likely to say the GOP’s plan is a disaster):


    But Hall has sometimes surprised.

    He was appointed to head CBO as Republicans in Congress revised rules for how the office would assess the impacts of legislation — a switch to what’s known as “dynamic scoring,” which lets CBO incorporate broader economic effects of proposed policy changes. Yet Hall’s use of that technique hasn’t always resulted in estimates that help the GOP agenda.

    Notably, the CBO two years ago said fully repealing Obamacare would boost the federal deficit by $353 billion over 10 years. Even with “dynamic scoring,” the office still put the repeal price tag at $137 billion. That’s not the message Republicans were looking for as they attacked the law as money-guzzling big government.

    So if the GOP is going to use dynamic scoring to justify supply-side junk policy to push tax cuts for the rich and austerity for public programs, it’s going to need to subvert the CBO and complaining about dynamic scoring models how the CBO won’t subscribe to their junk supply-side models enough is going to be one of the vehicles for carrying out that subversion. That’s becoming increasingly clear.

    And note how the CBO under Hall has taken the position that the CBO won’t allow “junk” insurance plans that cover almost nothing to count as actual insurance coverage:

    And in one highly significant report in December — which set up the possible upcoming clash with the Republican Congress — Hall’s CBO said it wouldn’t count skimpy health plans as coverage in its scores. In other words, people with limited health care benefits that are unlikely to protect them against expensive or catastrophic medical events won’t meet the CBO standards for health coverage.

    That means the CBO score of a Republican plan is almost certain to be less favorable than that of Obamacare.

    “In other words, people with limited health care benefits that are unlikely to protect them against expensive or catastrophic medical events won’t meet the CBO standards for health coverage”

    Uh oh. There goes the GOP’s plan to give “everyone access” to health insurance by deregulating insurance so cheap crap plans with minimal coverage are legal again. Then the GOP’s “patient centric” markets, where you pay directly for the rest of your medical services, will be the norm: crap insurance and individuals pay for the rest. That’s the baseline plan. It’s a core pillar of the GOP’s plan for claiming high insurance coverage rates and transferring health care costs away from government programs and employer sponsored plans and onto individual consumers. So you can see why the GOP is so pissed at the CBO. And also see why the White House is trying to undermine the CBO by discrediting it by having people like Mick Mulvaney go out there and claim that the CBO isn’t factoring in dynamic scoring even though it is (and probably shouldn’t because it’s generally a bad model). But it’s still hard to see why the White House is using such self-discrediting arguments in their attempts to discredit the CBO, but you can see why they’re doing it.

    Posted by Pterrafractyl | March 12, 2017, 10:07 pm
  2. The Congressional Budget Office came out with its projection of the impact the GOP’s “American Health Care Act” replacement for Obamacare will have. With the expectations that the CBO would project roughly 20 million people losing their health care over the next decade it wasn’t going to be too hard for the GOP’s plan to exceed expectations. And sure enough it did exceed those expectations. In the wrong direction:

    Talking Points Memo DC

    CBO: 24 Million More Uninsured By 2026 Under GOP Health Care Bill.

    By Tierney Sneed
    Published March 13, 2017, 4:13 PM EDT

    Twenty-four million people would lose their insurance over the next 10 years under Republican legislation being pushed to repeal Obamacare, the non-partisan Congressional Budget Office said Monday.

    “In 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law,” the CBO said.

    Many of the provisions in the Republican bill, the American Health Care Act, would not take effect until 2020. But according to Monday’s CBO score, its effects on coverage would be felt almost immediately. The agency projected that in 2018, just in time for mid-term elections, 14 million more people would be uninsured than under current law, if the GOP bill was implemented. The difference would grow to 21 million in 2020, which is when the Republicans’ massive overhaul of Medicaid would kick in, and then to 24 million in 2026.

    The initial drop-off in coverage would be the result of the individual mandate being repealed immediately under the Republican legislation. The CBO also predicted that premiums would rise in that period.

    However, in 2020, premiums would begin to go down compared to current, according CBO’s analysis, as other provisions in the Republican bill took effect. The CBO predicted that some shifting of enrollment back into the individual market would also begin in 2020, as the GOP proposed tax credits became available.

    “Roughly 9 million fewer people, on net, would obtain coverage through the
    nongroup market in 2020; that number would fall to 2 million in 2026,” the CBO said.

    The legislation’s transformation of Medicaid — by freezing the expansion and turning the entire program into a form of block grants — would kick in 2020. “Roughly 9 million fewer people would enroll in Medicaid in 2020; that figure would rise to 14 million in 2026,” as a result of those changes, the CBO said.

    The amount of individuals who get their insurance through employer-based plans would decrease under the Republicans bill, as its repeals the employer mandate as well.

    “Roughly 2 million fewer people, on net, would enroll in employment-based
    coverage in 2020, and that number would grow to roughly 7 million in 2026,” the CBO said.

    There is one finding that Republicans will be able to tout from the CBO report. It found that the legislation would begin curbing premium growth starting in 2020, when the bulk of the legislation would take effect, so that by 2026 average premiums would be 10 percent lower than what they’re projected to be under the Affordable Care Act. That shift would be preceded by two years of higher premiums, however, which will be politically painful for Republicans as they head into mid-terms and then the 2020 election. There is also a major caveat in who benefits the most from the premium changes that result under the Republican legislation, because it would permit insurers to charge older people more when compared to younger people than the current law allows.

    “By 2026, CBO and JCT project, premiums in the nongroup market would be 20 percent to 25 percent lower for a 21-year-old and 8 percent to 10 percent lower for a 40-year-old—but 20 percent to 25 percent higher for a 64-year-old,” the report said.

    “Many of the provisions in the Republican bill, the American Health Care Act, would not take effect until 2020. But according to Monday’s CBO score, its effects on coverage would be felt almost immediately. The agency projected that in 2018, just in time for mid-term elections, 14 million more people would be uninsured than under current law, if the GOP bill was implemented. The difference would grow to 21 million in 2020, which is when the Republicans’ massive overhaul of Medicaid would kick in, and then to 24 million in 2026.”

    14 million poised to lose their insurance coverage by 2018: that’s almost impressive. And 24 million by 2026. And the eventually lowered premiums are concentrated for younger people who are less likely to get coverage anyway now that the individual mandate is gone. And last but not least, don’t forget that these projections don’t even include the long-term death spiral that the GOP is sending Medicaid into with this bill.

    Of course, those are CBO numbers, not Trump administration numbers. And as the Trump administration has stressed over and over, you can’t any numbers that don’t come from the Trump administration. Especially if those numbers came from the CBO. That was the GOP’s message in the lead up to this much anticipated CBO report. So, surprise, it was still the message from HHS Secretary Tom Price, although he acknowledged he hadn’t actually read the report:

    Talking Points Memo
    Livewire

    HHS Secretary Price: CBO Report Numbers Are ‘Not Believable’

    By Matt Shuham
    Published March 13, 2017, 5:37 PM EDT

    The Secretary of Health and Human Services characterized as “not believable” a Congressional Budget Office report that estimated 14 million people would lose health coverage through 2018 under the House GOP’s proposed health care bill.

    HHS Secretary Tom Price said the CBO report “ignored completely the other legislative activities that we’ll be putting into place that will make certain that we have an insurance market that actually works,” in addition to the American Health Care Act, which Republicans have described as “phase one” of health care reform.

    “So we disagree strenuously with the report that was put out. We believe that our plan will cover more individuals at a lower cost and give them the choices they want for the coverage that they want for themselves and their families, not that the government forces them to buy,” he told reporters outside the White House.

    One reporter asked if he was implying the CBO was wrong in their estimates. Price responded that, while he hadn’t yet read the report, its estimates were “virtually impossible.”

    “The fact of the matter is, if you look at that, it’s virtually impossible to have that number occur. We are not certain – again, we haven’t been able to read the report –“

    “The CBO is wrong?” the reporter asked again.

    “Just look at the numbers,” Price replied. “There are 8 million people, 8, 9 million people who are on the exchange currently. I’m not sure how they’re going to get to 14 million people uninsured if that’s what they say, with only 8 million people on the exchange. There are individuals I guess that they assume that are on Medicaid who aren’t paying anything in the Medicaid system who are going to not take the Medicaid policy just because the mandate ended, or something happened. It’s just not believable is what we would suggest. We’ll look at the numbers and see.”

    In its report, the CBO estimates that, of the 14 million fewer people it estimates would have insurance by 2018, “[t]hat increase would consist of about 6 million fewer people with coverage obtained in the nongroup market, roughly 5 million fewer people with coverage under Medicaid, and about 2 million fewer people with employment-based coverage.”

    “One reporter asked if he was implying the CBO was wrong in their estimates. Price responded that, while he hadn’t yet read the report, its estimates were “virtually impossible.””

    So according to the Secretary of Health and Human Services, it’s “virtually impossible” that the CBO’s projections could be accurate. Hopefully once Price actually reads the report it will make more sense. Although it sounds like Price could just ask House Speaker Paul Ryan to explain how those projections could be accurate since Ryan had no problem at all accepting the CBO projections and actually saw them as a “validation” of his envisioned reforms:

    Talking Points Memo
    Livewire

    Ryan: CBO Report Predicting Huge Drop In Coverage ‘Validated’ GOP Repeal Bill

    By Esme Cribb
    Published March 13, 2017, 6:57 PM EDT

    House Speaker Paul Ryan (R-WI) said Monday that the non-partisan Congressional Budget Office “validated” House Republicans’ bill to repeal Obamacare with a report estimating that the bill would reduce the federal deficit while leaving millions more people uninsured.

    “I think if you read this entire report, I’m pretty encouraged by it and it actually exceeded my expectations,” Ryan told Fox’s Bret Baier.

    He said that the CBO’s score for the bill is “encouraging” and gives legislators “even more room to work on, to make good fine-tuning finishing touches” on the legislation.

    “Of course the CBO is going to say, if you’re not going to force people to buy something they don’t want to buy, they won’t buy it,” Ryan said. “That’s why you have those uninsured numbers, which we all expected.”

    He called the bill “a good work in progress.”

    “The point I’m saying is, what CBO did was they validated,” Ryan said. “We’re extremely excited about this and I’m really actually frankly encouraged.”

    In its report released Monday, the CBO estimated that 24 million people would lose their insurance over the next 10 years under the repeal bill. It also estimated that the bill would save the government $6 billion dollars and reduce the federal deficit by $337 billion dollars over the next 10 years.

    On Sunday, Ryan predicted that the report would estimate a drop in coverage, but agreed with President Donald Trump’s comment that the 2018 midterm elections will be a “bloodbath” for Republicans if they don’t pass the bill.

    “”Of course the CBO is going to say, if you’re not going to force people to buy something they don’t want to buy, they won’t buy it,” Ryan said. “That’s why you have those uninsured numbers, which we all expected.“”

    Yes, Paul Ryan was expecting these projections. And why not? He basically designed the whole plan. So as Paul Ryan made abundantly clear, the loss of health insurance coverage for tens of millions of people was the plan. The way Ryan spins it, those tens of millions will consist entirely of young people who didn’t want plans any. As Ryan recently put it, the number of people who will lose coverage under his plan ‘is up to the people’. As he put it, “You get it if you want it. That’s freedom.”

    So, according to Ryan, those 24 million people who are about to lose their health care insurance want to lose it. That actually happened. And then the CBO projections came out even worse than expected and Paul Ryan acted downright excited. That also happened. So you have to wonder how giddy Ryan is acting in secret after learning about the secret analysis by the White House that actually exceeded the CBO’s projections of lost coverage:

    Politico

    White House analysis of Obamacare repeal sees even deeper insurance losses than CBO

    By Paul Demko

    03/13/17 09:38 PM EDT

    The White House’s own internal analysis of the GOP plan to repeal and replace Obamacare show even steeper coverage losses than the projections by the Congressional Budget Office, according to a document viewed by POLITICO on Monday.

    The executive branch analysis forecast that 26 million people would lose coverage over the next decade, versus the 24 million CBO estimate — a finding that undermines White House efforts to discredit the forecasts from the nonpartisan CBO.

    The analysis found that under the American Health Care Act the coverage losses would include 17 million for Medicaid, six million in the individual market and three million in employer-based plans.

    A total of 54 million individuals would be uninsured in 2026 under the GOP plan, according to the White House analysis. That’s nearly double the number projected under current law.

    The White House and congressional Republicans have aggressively sought to undercut the CBO projection by pointing to how far off its coverage estimates for the Affordable Care Act ultimately proved. The nonpartisan budget office predicted that 21 million individuals would gain coverage through the exchange markets in 2016, but only about half that many actually enrolled.

    “We disagree strenuously with the report that was put out,” HHS Secretary Tom Price told reporters about the CBO after leaving a Cabinet meeting with Trump at the White House. “It’s just not believable is what we would suggest.” While serving as the House Budget Committee chairman, Price had a role in appointing the current head of the CBO who is a conservative economist.

    But that effort to discredit CBO’s projections is undermined by the fact that the White House’s own analysis reached a similar — and slightly bleaker — conclusion about how the GOP plan would increase the number of uninsured Americans.

    The document was not dated, but clearly referred to the bill currently being considered in the House. The bill was already under attack from both very conservative members who wanted it to go further, as well as moderates worried about coverage erosion particularly in Medicaid. The CBO number made the task of passing it even more challenging.

    “The executive branch analysis forecast that 26 million people would lose coverage over the next decade, versus the 24 million CBO estimate — a finding that undermines White House efforts to discredit the forecasts from the nonpartisan CBO.”

    Well that’s awkward.

    Of course, there’s one obvious path out of this trap of words that the White House has created for itself. And it’s the same path it’s been using all along when dealing with the CBO, BLS, and anything or anyone else that contradicts the spoken Truth of Trump: just declare that the White House’s secret internal projections were totally false and can’t be believed. Maybe a bunch of Obama moles were behind it! Or perhaps the CIA hacked the document and switched all the numbers. And don’t forget that George Soros could be secretly paying the White House’s analysts. There’s all sorts of implausibly plausible explanations. As long as you accept the underlining explanation: You can’t believe the Trump White House…except when you can.

    Is the Trump team ready to do what it takes and spin its way out of this situation by truly taking its public mind games to the next level? Do we even need to ask? Of course. They’re more than ready.

    Posted by Pterrafractyl | March 13, 2017, 8:21 pm
  3. One of the more interesting and alarming aspects of the increasingly feudal nature of the Trump/GOP agenda is how the GOP transitioned from Trump leading the public like a political Pied Piper peddling “you can have your cake and eat it too” campaign rhetoric seamlessly and effectively into the political reality of the Paul Ryan “let them eat cake” real agenda. And now we have the White House leading the assault against the Congressional Budget Office’s credibility after the CBO’s dire projections of the impact Ryan/Trump Obamacare replacement plan while Paul Ryan celebrates the CBO findings as a everything going to plan. Some sort of Orwell award is clearly warranted at this point, and it looks like the Senate GOP would like to share in that award:

    Talking Points Memo
    DC

    Senate GOP: CBO Is Terrible, Except When It Makes Us Look Good

    By Alice Ollstein
    Published March 14, 2017, 3:32 PM EDT

    The Republican response to the highly-anticipated Congressional Budget Office report on the GOP health care bill—which found it would cause 24 million people to lose their health insurance over a decade—has been all over the map.

    Some trumpeted the CBO’s estimate that the bill would lower the deficit by hundreds of billions of dollars and bring health insurance premiums down over time. Others questioned the office’s credibility, calling the report incomplete, or rejecting the findings all together.

    On Tuesday, the Senate’s Republican leaders did a little of each.

    After a closed-door lunch with Vice President Mike Pence and Health and Human Services Secretary Tom Price, Majority Leader Mitch McConnell (R-KY) told reporters that the CBO score vindicated Republicans’ fiscal promises for the repeal of the Affordable Care Act.

    “It shows we have a pathway to lower premiums, lower taxes, lower deficits, and the most significant entitlement reform in history,” McConnell said.

    Minutes later, from the same podium, with McConnell standing by his side, Sen. Roy Blunt (D-MO) said the CBO is not a credible source of information.

    “The Congressional Budget Office is notoriously bad at anticipating what’s going to happen in the marketplace,” he said. “They’re sometimes not even good at adding and subtracting.”

    Reporters pressed the Senate leadership on this dual message, noting that they are treating the parts of the CBO report that they like as trustworthy while dismissing as flawed the parts that make them look bad.

    McConnell responded by doubling down. “The part I think is an accurate reflection is the tax reduction, the likelihood of premiums going down, and the Medicaid reforms,” he said. “What Senator Blunt pointed out that it’s pretty hard to predict coverage when the government stops telling you that you have to buy something you may not want.”

    Cost and coverage, however, are inextricably intertwined. You can’t dismiss one and accept the other, because the total number of people covered by the AHCA would have a huge impact on the cost to the federal government. The lower health insurance premiums McConnell is celebrating are also linked to millions of people losing their health insurance. If older, sicker people can’t afford coverage and opt to go without it, premiums will go down for those who remain in the health insurance pool.

    “McConnell responded by doubling down. “The part I think is an accurate reflection is the tax reduction, the likelihood of premiums going down, and the Medicaid reforms,” he said. “What Senator Blunt pointed out that it’s pretty hard to predict coverage when the government stops telling you that you have to buy something you may not want.””

    So that dual message the Senate GOP leadership is putting forward is that the fiscal savings the CBO projects are indeed accurate and should be trusted. But the projections of tens of millions of people losing their insurance coverage? That’s all bogus and you should trust it because the CBO is an untrustworthy source. Also, many of those people who are going to lose coverage want to lose that coverage. That’s the message.

    It’s a message very similar to Paul Ryan’s celebration of the CBO report coupled with his assertion that anyone who wants health insurance coverage will be able to get it under Trumpcare (so if you lose coverage it’s because you didn’t really want it. You wanted to lose it). It’s also a message designed to obscure the fact that the lower premiums projected by the CBO are inextricably intertwined with CBO’s projected loss of coverage…specifically loss of coverage for older and sicker people who simply won’t be afford to afford coverage once the GOP pulls the Obamacare subsidies rug out from under them:


    Cost and coverage, however, are inextricably intertwined. You can’t dismiss one and accept the other, because the total number of people covered by the AHCA would have a huge impact on the cost to the federal government. The lower health insurance premiums McConnell is celebrating are also linked to millions of people losing their health insurance. If older, sicker people can’t afford coverage and opt to go without it, premiums will go down for those who remain in the health insurance pool.

    Just remember: those older and sicker people who can’t afford coverage and opt to go with out it didn’t really want that coverage anyway and they’re very thankful that there’s no more Obamacare individual mandate. Yep.

    So it looks like the GOP is settling on a general rhetorical framework that will allow the party to frame the massive upcoming loss of health insurance as a celebration of freedom. The freedom to not have health insurance and buy an iPhone instead. That’s going to be the underlying message, and not just in the medium-term as the GOP tries to push its Trumpcare package through Congress. That’s going to be the GOP’s message for years and years to come. Is there a massive spike in the uninsured? Great! Everything is going according to plan. At least it seems like that’s going to be the message for years to come because it’s unclear what else they’re going to come with and it’s very clear that those years to come is going to include millions and millions of people involuntarily losing their insurance coverage. The GOP is going to have to say something, and “they wanted to lose their insurance” is about as good a fraud answer as anything else they’ve come up with.

    But as the House leadership scrambles to wrangle the support it needs from its far-right “Freedom Caucus” faction which wants Obamacare repealed with no subsidies or help for the poor at all, there’s another message emerging that could also be both a party unifier now and politically effective in coming years too as the health care coverage crisis the GOP is about to unleash specifically upon the Medicaid population grow and grows: Hey, look at how many people we’ve kicked off Medicaid after creating a mandatory work-requirement! All these people we kicked off Medicaid were clearly lazy layabouts who don’t want to work and now we’re going punish them for being so poor and lazy. Isn’t that great!:

    Talking Points Memo
    DC

    House Conservatives Say They’re Close To Winning Concessions On Repeal Bill

    By Alice Ollstein
    Published March 15, 2017, 5:01 PM EDT

    Dozens of conservative lawmakers in the House’s Republican Study Committee huddled behind closed doors in the basement of the Capitol Wednesday with Vice President Mike Pence to discuss their imperiled Obamacare repeal bill—which has been lambasted by moderates and conservatives alike.

    When the lawmakers emerged, they expressed confidence that the White House supports the changes they are demanding: freezing the Medicaid expansion in 2018 instead of 2020, and imposing a work requirement on low-income Americans receiving Medicaid.

    “Ultimately, we were told today that we should be hopeful as far as having some of this incorporated into the bill,” RSC chairman Rep. Mark Walker (R-NC) (pictured) told reporters. “We’re as hopeful as we’ve ever been.”

    Even as hardline conservatives, moderate Republicans, and Trump loyalists continue to come out against the bill, Walker said the changes to its Medicaid provisions would bring his 170-member group on board. The RSC includes many of the the most conservative Republicans in the House.

    “The RSC in general is very close to signing off,” he said. “Our ultimate goal is a unanimous vote of support.”

    Walker and several other members of the RSC emphasized their desire to amend the bill—either in the Rules Committee or on the House floor—to make any able-bodied adult currently enrolled in Medicaid have to prove employment in order to qualify for health insurance.

    “We’re trying to make sure we’re weeding out those with upward mobility,” Walker told reporters. “It’s very crucial that this has some teeth to it, because what you don’t want is for the money to be rationed out among a larger amount of people.”

    Citing the example of his own brother, who is blind, Walker said throwing people off Medicaid who are able to work but don’t leaves the program with more funding “to take care of the aged and disabled.”

    Rep. Barry Loudermilk (R-GA) was one of several members to voice support for the work requirement. “If we can add that, I believe it will help pass the bill and make Americans more comfortable with it,” he said.

    A study released in 2016 by the Center for Budget and Policy Priorities found that most Medicaid recipients who are physically able to work already do so, and imposing a work requirement for enrollees would do nothing to increase the work force in the long term. “Its main effect likely would be the loss of health coverage for substantial numbers of people who are unable to work or face major barriers to finding and retaining employment,” the study found.

    The Kaiser Family Foundation estimates that only 27 percent of Medicaid recipients are adults without disabilities, and 60 percent of that group are already working. Many of those not employed care for a family member full-time, have a criminal record, live in an area without job opportunities, or face other “major impediments” to employment.

    This week, the Trump administration announced it will allow individual states, if they wish, to impose some form of a work requirement on their Medicaid recipients. The members of the Republican Study Committee hope to make this policy mandatory, and national.

    “A work requirement would gather support from a lot of conservatives,” Rep. Phil Roe (R-TN) told reporters.

    Rep. Glen Grothman (R-WI) added that it “wouldn’t shock” him if the provision was soon added to the House bill.

    As is, the House bill would cut nearly $900 billion dollars from Medicaid and drop more than 14 million people from its rolls over 10 years, according to the Congressional Budget Office. If conservatives win the concessions of imposing a work requirement and speeding the conversion of the program into block grants handed out to state, those numbers could increase substantially.

    Walker said he believes moderate Republicans in the House, particularly those in the Tuesday Group, can be coaxed on board with their proposals. He added that while his colleagues originally wanted to push for more extreme changes to the bill, such as gutting the Essential Health Benefits requirement that insurance plans cover a set of basic services, including contraception and maternity care, but decided to focus on “easier and quicker” Medicaid reforms first.

    Loudermilk also admitted that that he will not get his full wish list in this bill.

    “America is not ready for the health care reform I want, which is to get this city totally out of the health care business altogether,” he told reporters. “Because you even have conservatives out there asking us to do things like arrange insurance sales across state lines, cover pre-existing conditions, and keep children on their parents’ plan until they’re 26. So even conservatives want some federal interventions. But we still have to shift the needle in the right direction.”

    “Walker and several other members of the RSC emphasized their desire to amend the bill—either in the Rules Committee or on the House floor—to make any able-bodied adult currently enrolled in Medicaid have to prove employment in order to qualify for health insurance.

    And note that the proposed Medicaid proof-of-employment requirement isn’t just for the people covered under the Medicaid expansion. This would be for everyone on Medicaid. At least those that are deemed able-bodied (even if their bodies are barely able to function or heal). And if the Republican Study Committee gets what it wants, this proof-of-employment requirement isn’t going to be simply optional for states. It’ll be a national mandate for all Medicaid recipients:


    This week, the Trump administration announced it will allow individual states, if they wish, to impose some form of a work requirement on their Medicaid recipients. The members of the Republican Study Committee hope to make this policy mandatory, and national

    So the big gift to the House GOP’s faction of far-right Trumnpcare hold outs is going to be putting in place a system that will make it easier to kick people off Medicaid. A LOT easier because for many of the unemployed on Medicaid employment isn’t really an option for a variety of reasons:


    A study released in 2016 by the Center for Budget and Policy Priorities found that most Medicaid recipients who are physically able to work already do so, and imposing a work requirement for enrollees would do nothing to increase the work force in the long term. “Its main effect likely would be the loss of health coverage for substantial numbers of people who are unable to work or face major barriers to finding and retaining employment,” the study found.

    The Kaiser Family Foundation estimates that only 27 percent of Medicaid recipients are adults without disabilities, and 60 percent of that group are already working. Many of those not employed care for a family member full-time, have a criminal record, live in an area without job opportunities, or face other “major impediments” to employment.

    “Many of those not employed care for a family member full-time, have a criminal record, live in an area without job opportunities, or face other “major impediments” to employment.”

    Got a major impediment to employment? That’s nice. Please go die in a ditch somewhere. You’re free now.” That’s going to be the GOP message to poor Americans, to be paired with a “look at how many horrible lazy people we kicked off Medicaid! Doesn’t it feel great to know all these horrible people aren’t getting a dime of your tax-dollars? Also, they didn’t really want health insurance…otherwise they would have gotten a job” message for everyone else.

    Well, almost everyone else. The GOP’s real constituency will get an additional message.

    Posted by Pterrafractyl | March 15, 2017, 8:18 pm
  4. Now that the Trump Administration officially proposed a budget apparently designed to kick the poor to death and the GOP continues to rally around the idea of creating a national work-requirement for Medicaid recipients, one of the many questions worth asking at this point has to do with one of the cruelest comments made by an elected GOPer thus far in our Trumpian era: Rep. Jason Chaffetz’s suggestions that poor people who won’t be able to afford health care under Trumpcare can blame themselves because they splurge all their money on new iPhones. So are all those “Obamaphones” – cell phones provided by the federal government to the poor through a program started by Ronald Reagan that continues today – that the GOP spent years fraudulently whining going away too under a Trump administration? Because if work requirements for the unemployed poor are going to be required just to get basic government assistance for things like health care, all those unemployed people are going to need, you know, jobs. And it’s not easy to get a job without getting a phone first:

    The Washington Post

    Jason Chaffetz’s iPhone comment revives the ‘poverty is a choice’ argument

    By Philip Bump
    March 7, 2017

    It’s much easier to deal with poverty if you can convince yourself that the impoverished brought it on themselves. Nearly everyone would concur that those who suffer from poverty through no fault of their own deserve support from others, either through nonprofit or public sector assistance. But if they’re poor because of their own bad decisions? They have to fend for themselves.

    Coupled with guilt about the struggles of poor Americans, that instinct leads to an awkward place. There’s a psychological reward to looking for reasons that the poor aren’t really poor: It allows you to then more easily leave those less fortunate to their fate. For those disinclined to want the government to spend resources addressing poverty, the same reward is in effect. Drug-testing welfare recipients, stories about those on food stamps splurging on high-cost items, even reports from the Heritage Foundation pointing out that most poor people own televisions — all have the same net effect. To some extent, the poor are responsible for their own poverty, and therefore, it’s less urgent or unnecessary for us to be.

    On Tuesday morning, Rep. Jason Chaffetz (R-Utah) appeared on CNN’s “New Day” program to discuss the Republicans’ proposed alternative to the Affordable Care Act and made a variant on that argument.

    GOP Rep. Chaffetz: Americans may need to choose between "new iphone… they just love" and investing in health care https://t.co/5Hxwn2uOl5— New Day (@NewDay) March 7, 2017

    Asked by host Alisyn Camerota if people would lose coverage under the proposal, Chaffetz responded:

    “We are getting rid of the individual mandate. We are getting rid of those things that people said that they don’t want. And, you know what? Americans have choices. And they’ve got to make a choice. So maybe, rather than getting that new iPhone that they just love and they want to go spend hundreds of dollars on, maybe they should invest that in health care. They’ve got to make those decisions themselves.”

    Interestingly, the first part of Chaffetz’s claim was undercut by new polling from CNN itself. With its polling partner ORC, the network found that Americans are split on the mandate that individuals have health coverage. Fifty percent oppose the stipulation and 48 percent favor it. Even 45 percent of Republicans support keeping the mandate, which makes some sense given that that aspect of what we now call Obamacare evolved from a conservative proposal.

    But it was Chaffetz’s next statement that curdled social media: “Rather than getting that new iPhone … maybe they should invest that in health care.” Chaffetz doesn’t specifically say “the poor should make better choices,” but the implication is clear. If you have only limited money to spend, you should spend it more wisely.

    There are a lot of problems with the choice that Chaffetz presents. For one, an iPhone can be a one-time cost, while health-care spending is recurring. For another, the cost of a new phone pales in comparison to the cost of health care or health insurance. He intentionally uses “iPhone” instead of cellphone, since a new, unsubsidized iPhone is at the pricier end of the cellphone cost scale, at about $700. But a year of health insurance for an individual is over $6,000. Put another way, an iPhone is only slightly more than a month of insurance. And that gap has increased. In 2014, the New York Times pointed out that costs for consumer goods had decreased over time, while costs for things like health care have risen.

    Chaffetz also falls into the trap that we outlined at the beginning. He’s judging one particular luxury cost against something that he positions as more important and responsible. One can pit health insurance costs against other spending, too, by reframing Chaffetz’s quote: Rather than paying rent, maybe they should invest that in health care. Rather than paying for a tutor, maybe they should invest that in health care. Rather than visiting family, maybe they should invest that in health care. Rather than paying for cable, maybe they should invest that in health care.

    A key challenge to poverty is that decisions about how to spend money and the struggles of prioritizing are constant. Some of those decisions are bad ones over the long-term, certainly, as are some of anyone’s. But some are nearly existential.

    Chaffetz is framing his choice on terms that position the poor as ignorant and wasteful so that he can bolster the case for revamping health care policy. But “iPhone” is a particularly weird foil for that argument. A smartphone is not a luxury, it’s a critical tool of modern society. The newest iPhone isn’t critical, but some smartphone is, particularly in households without Internet access otherwise. Recognizing that necessity, the government provides subsidies for phone and Internet service to those who participate in welfare programs. This, of course, was the much-derided “Obamaphone” program — actually called “Lifeline” — which originated under President Reagan.

    The pejorative “Obamaphone” formulation often ran alongside another aspect of the debate over supporting poor Americans: The presumption that most of the poor are black. While poverty rates are higher among black Americans, far more poor Americans are white. They are often, in a real sense, the base of demographic support that pushed President Trump to the White House: whites without college educations. Chaffetz is implicitly chastising this group for making bad economic choices.

    “Chaffetz is framing his choice on terms that position the poor as ignorant and wasteful so that he can bolster the case for revamping health care policy. But “iPhone” is a particularly weird foil for that argument. A smartphone is not a luxury, it’s a critical tool of modern society. The newest iPhone isn’t critical, but some smartphone is, particularly in households without Internet access otherwise. Recognizing that necessity, the government provides subsidies for phone and Internet service to those who participate in welfare programs. This, of course, was the much-derided “Obamaphone” program — actually called “Lifeline” — which originated under President Reagan.

    Want all those unemployed poor people to find work before they can get Medicaid (or any other government assistance, which is the Paul Ryan end game)? Want them to be able to email those resumes and send emails back and forth with potential employers? Well, that’s going to require a very specific kind of assistance: “Obamaphones” a.k.a “Reaganphones”.

    So what’s the status of the “Obamaphone”/”Reaganphone” program under Trump? Do we even need to ask?

    Salon

    From “Obamaphones” to an attack on internet access: The strange afterlife of a right-wing meme
    Under Trump, a program subsidizing internet access for low-income Americans may be threatened. Thanks, Obama!

    Amanda Marcotte
    Tuesday, Feb 7, 2017 9:59 AM UTC

    This past summer the United Nations declared that internet access is a human right, releasing a nonbinding resolution that unequivocally condemns “measures to intentionally prevent or disrupt access to or dissemination of information online in violation of international human rights law” This resolution came after Barack Obama had said in 2015 that “high-speed broadband is not a luxury, it’s a necessity.”

    While many nations — including Russia, China and Saudi Arabia — refused to sign last summer’s U.N. resolution, the United States did sign it and Obama’s administration made a number of moves to expand internet access to low-income Americans, as many of them struggle to pay for even the most basic level of service.

    Last March the Federal Communications Commission made an important move to help achieve Obama’s goals, approving a plan to make broadband more affordable for low-income households. But now Ajit Pai, whom Donald Trump picked to chair the Federal Communications Commission, appears to be making moves to take away the affordable internet access plans.

    Late Friday in a move Democratic FCC Commissioner Mignon Clyburn characterized as a “Friday news dump,” Pai told nine internet companies they are no longer allowed to provide low-cost internet service to people who qualify.

    In a defensive statement, Pai justified cutting poor people off from internet access by declaring that the original program was “controversial” and characterizing it as one of many “midnight regulations” authorized by his Obama-appointed predecessor, Tom Wheeler.

    “Access to broadband is increasingly critical for all Americans, no matter who they are or where they live,” Pai wrote last week, in one of his first statements as FCC chair. But blocking nine companies from providing subsidized internet access to poor people casts real doubt on his sincerity.

    Pai’s own past suggests that he has been a longtime skeptic of efforts to expand broadband access to lower-income people. Pai also appears to have developed an unsubtle bitterness toward Wheeler and anyone who worked to make internet affordable for the working poor in this country.

    First, some history: The program that Wheeler was using to expand internet access is called Lifeline and was started in 1985, when Ronald Reagan was president. Lifeline was initially intended for making telephone service available to low-income people. Throughout multiple presidential administrations, it was a little-known, inexpensive and uncontroversial program.

    Then Matt Drudge, one-man disseminator of race-baiting urban legends, stepped in.

    As Think Progress editor-in-chief Judd Legum chronicled in 2012, the Drudge Report ran a racist headline portraying black people as ignorant welfare cheats.

    Rush Limbaugh soon joined in, claiming, “She may not know who George Washington is or Abraham Lincoln, but she knows how to get an Obama phone.”

    And with that, the right-wing legend of the “Obamaphone” — this supposed program of free government phones for supposed welfare leeches — was born.

    As Legum pointed out, the whole “Obamaphone” thing was pure, uncut nonsense. Yes, lower-income people could apply for the Lifeline program that made it easier to obtain more affordable service — but the program was begun during a Republican presidency and continued through three subsequent administrations of both parties. Yes, the Lifeline program had been changed so that people could opt for cellphones instead of landlines — a commonsense innovation reflecting how modern people use phones — but that change was instituted in 2008, during the presidency of George W. Bush.

    As we ought to understand by now, truth can never be allowed to stand in the way of a racist right-wing legend. Conservative outrage over the Lifeline program exploded. And in 2016, when the Obama administration actually did make a move to expand the Lifeline program to cover internet as well as phone service, conservatives like Pai — who was then an FCC commissioner — were ready to put up a fight.

    Pai and his fellow Republican commissioner, Mike O’Rielly, immediately tried to kneecap Wheeler’s efforts. Pai proposed setting a spending cap of $1.75 billion on the Lifeline program, which Phillip Berenbroick and Meredith Filak Rose at Public Knowledge, an organization that promotes expanding internet access, argued would have crippled its ability to provide adequate phone and internet access to low-income people.

    “If one wanted to design a Lifeline plan that leaves tens-of-millions of the most vulnerable Americans without access to basic telephone service in the near term, without line of sight to Lifeline-supported broadband service in the long term,” Berenbroick and Rose wrote, “Commissioner Pai’s plan is a blueprint for what to do.”

    They noted that providing the telephone service has in some years cost more than $1.75 billion on its own, so Pai’s cap would have made it impossible to provide help to everyone who needs it. In addition, Pai attempted to set the pricing for Lifeline plans so high that they probably would not be affordable to most low-income families, even with the subsidy.

    Pai and his fellow commissioner, Clyburn, worked out an initial compromise, but under pressure from Democrats, Clyburn dropped the compromise and voted for a more expansive program. Now millions of people who make $16,281 a year or less can get a subsidy of $9.25 a month to help pay for broadband or phone service but not for both.

    Yep, this program gives low-income people less than 10 bucks a month. Pai threw a massive tantrum anyway, complaining that pressure from “the usual gaggle of left-wing, Beltway special interests” had led to “failure to clean up the waste, fraud and abuse” in a program that makes it slightly less expensive for poor people to receive internet access and phone service.

    Now Pai is the FCC’s chairman and already he’s blocking companies from offering these subsidized plans. Pai has claimed that his move is about reducing — you guessed it! — “waste, fraud, and abuse.” Considering his history, there’s reason to believe this is the opening shot in a longer-term plan to make it more difficult for low-income people to go online.

    Internet access makes it easier for lower-income Americans to obtain jobs, keep up with the news, participate in politics, maintain social networks and even just pay bills and run other errands that can suck up precious time, a commodity in short supply for the working poor. There might, of course, be reasons why conservatives don’t want them doing all those things.

    “They noted that providing the telephone service has in some years cost more than $1.75 billion on its own, so Pai’s cap would have made it impossible to provide help to everyone who needs it. In addition, Pai attempted to set the pricing for Lifeline plans so high that they probably would not be affordable to most low-income families, even with the subsidy.

    Yep, Trump’s FCC chief has a plan for the “Obamaphone”/”Reaganphone” program: price the poorest out of the phone market even with subsidies Pai wants to cut.

    So if you’re really poor and scrambling for employment so you don’t die from a lack of health care get ready to spend more than you can afford on one of the basic services required to get a job these days: cell phone service. It’ll be a de facto government mandate in our Trumpian future so presumably Jason Chaffetz won’t complain.

    Posted by Pterrafractyl | March 17, 2017, 6:55 pm
  5. With the Trump administration’s scorched earth budget proposal – which decimates almost all federal discretionary spending and slashes programs vital to rural poor voters who make up a key segment of the Trump/GOP electoral base to pay for increased defense spending – facing opposition even from some congressional GOPers who fear the backlash from these cuts and other GOPers who don’t feel it increases defense spending enough, it’s worth keeping in mind that it was already clear that there was going to be a major showdown between the Trump White House and his congressional colleagues well before this budget proposal was released. Specifically, a showdown over how Trump was going to keep his pledge to not cut Social Security and Medicare despite the fact that Congress writes the actual budget and the GOP has long made “entitlement reform” (cuts to Social Security and Medicare) a top policy objective:

    The New York Times

    Trump and Paul Ryan Head for a Clash Over the Budget, and Ideology

    By JENNIFER STEINHAUER
    FEB. 27, 2017

    WASHINGTON — President Trump’s proposal to slash domestic spending in order to preserve the two biggest drains on the federal government — Social Security and Medicare — has set up a battle to determine who now controls the Republican Party’s ideology.

    The outcome could map the course of major challenges to come, including a revision of the tax code, a huge increase in infrastructure spending and any effort to balance the budget.

    Since the start of his insurgent campaign, Mr. Trump has opposed his party’s long-held positions on a range of policies, including free trade, how to deal with Russia and the future of government entitlement programs.

    Mr. Trump’s budget blueprint — which is expected to be central to his address to Congress on Tuesday night — sets up a striking clash with the House speaker, Paul D. Ryan, who has made a career out of pressing difficult truths on federal spending. For years, Mr. Ryan has maintained that to tame the budget deficit without tax increases and prevent draconian cuts to federal programs, Congress must be willing to change, and cut, the programs that spend the most money — Social Security, Medicare and Medicaid.

    But Mr. Trump, in a dogged effort to fulfill his campaign promises, has turned that logic on its head in the budget outline he is expected to present to Congress this week. That blueprint would make good on his promise to increase spending on the military and law enforcement by $100 billion over the next 18 months. And it would extract all of the savings he can from the one part of the budget already most squeezed, domestic discretionary spending, potentially decimating programs in education, poverty alleviation, science and health.

    “For Paul Ryan, this seems to be the opportunity he has been waiting for and working for for years,” said Douglas Elmendorf, the recently departed director of the Congressional Budget Office and current dean of Harvard’s John F. Kennedy School of Government. “But Paul Ryan’s budget plans with cuts to Social Security and Medicare are not that popular with most voters, and what helped elect Donald Trump was the promise not to cut benefits and programs, and that is an unresolved tension.”

    None of this should be a real surprise: Mr. Trump repeatedly said during the campaign that Republican promises to transform Medicare, and slash entitlement spending, were the reason the party lost the White House in 2012, helpfully name-checking Mr. Ryan, who sat at the bottom of the ticket that year, in his analysis.

    But Republicans in Congress had hoped that reality, combined with the influence of the two former Republican House members in Mr. Trump’s cabinet — Tom Price, now head of health and human services, and Mick Mulvaney, his budget director — would have led to new conclusions. Social Security, health care and net interest now comprise nearly 60 percent of all federal spending, and that figure is expected to soar to 82 percent over the next 10 years; Mr. Mulvaney and Mr. Price have long been advocates for pruning.

    This is not simply a fight for an ideological core — it is a question of what can pass Congress. A budget with no entitlement cuts and one that does not balance most likely has no chance of passing the House, and could be rejected by Senate Republicans, as well. Mr. Trump’s proposals are too far to the right in terms of domestic cuts and too far to the left in terms of balance.

    If Congress fails to pass a budget blueprint for the fiscal year that begins in October, Mr. Trump’s promise to drastically rewrite the tax code could also die because the president was counting on that budget resolution to include special parliamentary language that would shield his tax cuts from a Democratic filibuster. Without it, any tax legislation would have to be bipartisan enough to clear the Senate with 60 votes.

    “President Trump has talked about deeper domestic spending cuts than even House and Senate Republicans have talked about,” said Brian Riedl, a senior fellow at the Manhattan Institute and federal budget expert who recently worked for Senator Rob Portman, Republican of Ohio.

    “I think to a certain degree congressional Republicans understand they are going to have to drive the train on balancing the budget,” Mr. Riedl said. “The question is how far they can go with Trump in the White House. They certainly don’t expect him to barnstorm the country talking about how to rein in federal spending.”

    Good luck with that, Mr. Elmendorf said. “The Republican establishment has consistently overestimated its ability to move Donald Trump to the positions it supports,” he said.

    Democrats, of course, will be no friend to these proposals, and may be needed for some of them such as major military spending increases.

    “Democrats will make crystal clear the misplaced priorities of the administration and the Republican majority,” said Representative Nita M. Lowey of New York, the highest-ranking Democrat on the Appropriations Committee, “and we will fight tooth and nail to protect services and investments that are critical to hardworking American families and communities across the country.”

    The one thing that might get Republicans off the hook: big tax cuts. Should they find a way to do that without Democrats by employing a procedural maneuver that requires a mere majority vote in the Senate, the whole question of cuts in spending or programs may be pushed to another day.

    “This is not simply a fight for an ideological core — it is a question of what can pass Congress. A budget with no entitlement cuts and one that does not balance most likely has no chance of passing the House, and could be rejected by Senate Republicans, as well. Mr. Trump’s proposals are too far to the right in terms of domestic cuts and too far to the left in terms of balance

    Yep, in addition to the tensions within the GOP between elected officials fearing a voter backlash over cuts that could seriously harm their constituents and those fearing a voter backlash for budget not increasing military spending more (which is also an argument for more cuts in spending elsewhere) the Trump budget is also going to facing widespread GOP opposition to the fact that it doesn’t include entitlement cuts too. And as the article noted, Paul Ryan himself has long championed entitlement cuts as an alternative to exactly the kind of draconian cuts to discretionary programs that the Trump budget proposes:


    Mr. Trump’s budget blueprint — which is expected to be central to his address to Congress on Tuesday night — sets up a striking clash with the House speaker, Paul D. Ryan, who has made a career out of pressing difficult truths on federal spending. For years, Mr. Ryan has maintained that to tame the budget deficit without tax increases and prevent draconian cuts to federal programs, Congress must be willing to change, and cut, the programs that spend the most money — Social Security, Medicare and Medicaid.

    If there’s one thing that can unify the two dueling factions of the GOP – those wanting fewer cuts to discretionary programs and those wanting more cuts to pay for higher military spending – it’s entitlement cuts. That’s the grand unifyer for a Trump budget. Instead of devastating almost every discretionary federal program just cut entitlments instead. Paul Ryan is already on board with that idea and it’s hard to see why the rest of the GOP wouldn’t be more than happy to come around to that kind of ‘compromise’.

    But, of course, there’s the many campaign promises Trump made about no cuts to Social Security at all. So what’s going to yield? Well, it turns out Trump’s Budget Chief, Mick Mulvaney, gave us an idea shortly before the unveiling of Trump’s budget. All Trump needs to do is tweak his ‘saving Social Security and Medicare without any cuts’ pledge in a couple simple ways: Make it a ‘save Social Security and Medicare with no cuts to current Social Security and Medicare recipients or those about to qualify in the near future but cuts for everyone else’ pledge.

    Could that approach work in terms of unifying Trump with the congressional GOP for his first budget? We’ll find out soon since Mulvaney already said he’s going to propose exactly that kind of ‘entitlement reform’ tweak to Trump’s campaign pledges just as soon as the first budget proposal is done (and it’s now done):

    The Hill

    Budget chief: Trump could review entitlement reform after first budget

    By Sylvan Lane – 03/06/17 11:39 AM EST

    Office of Management and Budget Director Mick Mulvaney said Monday that President Trump could soon review potential reforms to Social Security and Medicare — but he stressed that the reforms under consideration wouldn’t touch payments for current beneficiaries.

    Mulvaney said he plans to prepare several entitlement reform proposals for Trump after finishing the White House’s first budget outline proposal this week. Mulvaney previously said the top-line budget proposal wouldn’t address entitlements.

    Mulvaney, a fiscal hawk, said he’s trying to garner support for entitlement reform that follows Trump’s campaign promise not to touch Social Security and Medicare payments for current recipients.

    “I’ve already started to socialize the discussion around here in the West Wing about how important the mandatory spending is to the drivers of our debt,” Mulvaney told radio host Hugh Hewitt in a Monday interview. “People are starting to grab it.”

    “There are ways that we can not only allow the president to keep his promise, but to help him keep his promise by fixing some of these mandatory programs.”

    Mulvaney has been expected to clash with Trump over federal spending. Democrats claimed Mulvaney’s past efforts in Congress of seeking sweeping budget cuts and entitlement reform conflicted with Trump’s promise not to cut Social Security and Medicare benefits, boost military spending and spend billions on infrastructure.

    Social Security and Medicare are the two biggest federal expenditures. The U.S. federal debt is close to $20 trillion.

    Mulvaney said Trump wasn’t likely to propose raising the age at which someone could retire and receive full entitlement benefits. Instead, he floated changes to Social Security disability payments, which Mulvaney called “one of the fastest growing and probably one of the most abused mandatory programs in the country.”

    “Mulvaney, a fiscal hawk, said he’s trying to garner support for entitlement reform that follows Trump’s campaign promise not to touch Social Security and Medicare payments for current recipients.”

    And that’s the plan. At least all signs are pointing towards that being the plan. Soon:


    Mulvaney said he plans to prepare several entitlement reform proposals for Trump after finishing the White House’s first budget outline proposal this week. Mulvaney previously said the top-line budget proposal wouldn’t address entitlements.

    “I’ve already started to socialize the discussion around here in the West Wing about how important the mandatory spending is to the drivers of our debt,” Mulvaney told radio host Hugh Hewitt in a Monday interview. “People are starting to grab it.”

    There are ways that we can not only allow the president to keep his promise, but to help him keep his promise by fixing some of these mandatory programs.”

    That sure sounds like those discussions are already happening which means talk about gutting Social Security and Medicare for ‘younger Americans’ is probably going to be coming soon. Although note Mulvaney’s example of the kind of cuts to Social Security Trump could apparently make while still sticking to his campaign ‘no cuts’ pledge: cutting Social Security disability fund (presumably by declaring people not actually disabled and kicking them off of it):


    Mulvaney said Trump wasn’t likely to propose raising the age at which someone could retire and receive full entitlement benefits. Instead, he floated changes to Social Security disability payments, which Mulvaney called “one of the fastest growing and probably one of the most abused mandatory programs in the country.”

    So could kicking people off of it under the banner of ending ‘abuse’ of the program be the kind of start to first step in the GOP’s long-held dreams of rolling back Social Security and Medicare? Well, let’s not forget that on the first day of Congress in 2015 the GOP threatened to hold the disability fund hostage unless Congress and President Obama agreed to a much larger Social Security reform package. Might cuts to the Social Security disability program, in exchange for fewer cuts to other discretionary programs and more defense spending, be the GOP compromise that eventually unifies the GOP? Perhaps, but don’t be surprised if cuts to the general Social Security retirement fund are also part of the package since GOPers, including Trump’s budget chief Mick Mulvaney, are already trying to come up with rationalizations for how cuting Social Security and Medicare actually counts as sticking to Trump’s campaign pledges:

    The Washington Post

    White House Budget Director Mulvaney: I’m getting president to ‘look at’ entitlement reform

    By David Weigel
    March 6, 2017

    Mick Mulvaney, the new director of the Office of Management and Budget, told a conservative radio host today that he is looking for ways to reform Social Security, Medicare and Medicaid, working around President Trump’s campaign trail promise to leave the programs untouched.

    “I’ve already started to socialize the discussion around here in the West Wing about how important the mandatory spending is to the drivers of our debt,” Mulvaney told Hugh Hewitt on Monday morning. “I think people are starting to grab it. There are ways that we can not only allow the president to keep his promise, but to help him keep his promise by fixing some of these mandatory programs.”

    Mulvaney, a budget hawk elected to Congress in the 2010 tea party wave, came to OMB with ideas about entitlement spending that diverged widely from Trump’s. At his January hearing, he told senators that he still favored raising the Social Security retirement age to 70, and supported means-testing to reduce Medicare spending. As a congressman, he was the main supporter of the unsuccessful Cut, Cap and Balance Act, which would have raised the debt limit only if it came with the passage of a balanced-budget amendment.

    At the hearing, Mulvaney acknowledged that he disagreed with Trump on entitlement reform. “I have no reason to believe the president has changed his mind,” he said. “My job is to be completely and brutally honest with him.”

    In the interview with Hewitt, who is also a Washington Post op-ed contributor, Mulvaney suggested that his education campaign was well underway. “As soon as the 2018 spending budget is done at the end of next week, I’m hoping to put together something for the president to look at on the other pieces of entitlement spending, or mandatory spending,” he said. “Some people don’t like the word ‘entitlement.’ I use that simply because we are entitled to that under law. It doesn’t mean it’s, some people misinterpret what that means, but try and lay out for the president what’s driving the deficit, and what we can do while still keeping his promise.”

    During the campaign, as he made significant breakthroughs with working-class white voters who had voted for Barack Obama for president, Trump repeatedly bucked the conservative consensus on entitlement reform. “It is my intention to leave Social Security as it is,” Trump said at a March 2016 Republican debate. In the past two months, members of the Democratic caucus, led by Sen. Bernie Sanders (I-Vt.), have thrown Trump’s quotes back at Republicans, arguing that any reforms that reduce payouts will break the president’s promise.

    “Trump said, ‘I will save Medicare and Medicaid and Social Security, without cuts. We have to do it,’ ” Sanders said last month at an event commemorating Social Security’s anniversary. “I think Trump was as clear as he can be, and if he goes back on that, he was lying to the American people.”

    But Republicans, who generally favor deep cuts to entitlements, have increasingly argued that Trump could make good on his promises by signing on to reform.

    “He did talk about saving Medicare and Social Security, and as someone who was on the campaign trail with him in November, it was really about making sure that people who were getting benefits, or about to get benefits, are protected,” Rep. Mark Meadows (R-N.C.), the chairman of the conservative House Freedom Caucus, said in a roundtable discussion with reporters last month. “That is consistent with where we are; that’s consistent with where the president not only has been, but is. If we do nothing, we will not save Medicare and Social Security.”

    Mulvaney, too, has said that any Republican reform would be consistent with Trump’s promise, by defining the act of “saving” Social Security and Medicare as anything that allows them to meet obligations — even and especially if those obligations are reduced. On Monday, pushed for details by Hewitt, Mulvaney suggested that the replacement of sections of the Affordable Care Act could begin the process of unwinding entitlement spending.

    “Clearly, you can help fix and solve Medicaid as part of this larger Obamacare replacement, right, that the two things are tied together. So if we get Obamacare replacement right, it might also allow us to fix Medicaid,” Mulvaney said. “I don’t think you’re going to see this president have any interest in raising the retirement age anytime soon. But we need to address things like Social Security disability, which you and I both know is one of the fastest growing and probably one of the most abused mandatory programs in the country.”

    “But Republicans, who generally favor deep cuts to entitlements, have increasingly argued that Trump could make good on his promises by signing on to reform.”

    That sure sounds like benefit cuts are potentially on the table. Especially with Mulvaney backing it:


    “He did talk about saving Medicare and Social Security, and as someone who was on the campaign trail with him in November, it was really about making sure that people who were getting benefits, or about to get benefits, are protected,” Rep. Mark Meadows (R-N.C.), the chairman of the conservative House Freedom Caucus, said in a roundtable discussion with reporters last month. “That is consistent with where we are; that’s consistent with where the president not only has been, but is. If we do nothing, we will not save Medicare and Social Security.”

    Mulvaney, too, has said that any Republican reform would be consistent with Trump’s promise, by defining the act of “saving” Social Security and Medicare as anything that allows them to meet obligations — even and especially if those obligations are reduced. On Monday, pushed for details by Hewitt, Mulvaney suggested that the replacement of sections of the Affordable Care Act could begin the process of unwinding entitlement spending.

    So, all in all, if you were wondering what on earth the White House was thinking when it released its scorched earth seemingly bloodthirsty budget proposal that would gut almost all federal programs designed to help people in need, keep in mind that it may have been done with the intent of eventually rolling back some of those proposed cuts as part of a big entitlement reform ‘grand bargain’. Maybe it will just start off with kicking people off Social Security disability. Or perhaps it will involve benefit cuts for the retirement fund too. Heck, maybe Medicare cuts will be involved. Who knows.

    And if it seems like it would just be too politically risky and toxic for Trump to go back on a signature campaign pledge, keep in mind that since Congress actually holds the purse strings it’s possible for the GOP to create a situation where they can at least attempt to say “We didn’t have a choice!”. Especially if, for instance, the GOP can’t actually come to an agreement over the 2018 budget and ends up facing the ‘fiscal cliff’ that risks defaulting of the US debt because Congress refuses to raise the debt ceiling. Under that kind of scenario the White House could potentially blame the ‘Freedom Caucus’ of far-right GOPers who come from ultra-conservative districts and face minimal political risk for creating a budget showdown with Trump. And of course they would all blame the Democrats. The GOP made debt ceiling showdowns with demands for entitlement cuts routine under President Obama. Could it happen with Trump in the White House? Well, considering that Mick Mulvaney was actually an advocate of exactly these kinds of ‘fiscal cliff’ budget showdowns while he was in Congress, as long as the GOP appears to be unable to come to any sort of consensus with itself it’s unclear why the GOP couldn’t hold itself hostage to demand entitlements cuts couldn’t happen:

    US News & World Report

    A Budget Crisis This Way Comes

    If you like Trump’s chaotic, mismanaged White House, you’ll love his pick for budget director.

    By Pat Garofalo | Assistant Managing Editor for Opinion
    Feb. 15, 2017, at 4:30 p.m.

    The first month or so of the Donald Trump administration has been, shall we say, messy. And with South Carolina Rep. Mick Mulvaney at the reins in the Office of Management and Budget, the White House’s in-house budget shop, expect that chaos to be imported to the nation’s finances, too.

    Between haphazardly constructed executive orders, unnecessary squabbles with American companies over the Trump brand and whatever happened regarding former national security advisor Michael Flynn playing footsie with Russia, the administration has pinballed from one self-inflicted crisis to the next. In every instance, the mess could have easily been avoided had the Trump team any idea what it was doing or basic grasp of the consequences its decisions entailed.

    Enter Mulvaney, who is scheduled to face a final Senate confirmation vote on Thursday. Elected to Congress as part of the tea party wave in 2010, Mulvaney has been smack in the middle of the GOP movement to hold the nation’s debt ceiling – its very creditworthiness – hostage in an attempt to achieve other policy goals.

    To review, in both 2011 and 2013, congressional Republicans threatened to refuse to raise the debt ceiling should then-President Barack Obama not accede to their demands for deep spending cuts. Both times, cooler heads eventually prevailed, but at a substantial cost: According to the Government Accountability Office, the mere threat that the debt ceiling might not go up cost taxpayers $1.3 billion in higher borrowing costs in the 2011 fiscal year, and tens of millions of dollars in 2013 too. U.S. credit was downgraded for the first time ever simply because the whole tragicomedy took place.

    Remember, raising the debt ceiling doesn’t authorize new spending – it merely confirms that Congress will pay the bills it has already racked up. Failure to raise it, though, would lead to a host of consequences for the government, financial markets and the wider economy.

    Mulvaney, however, was unconcerned about the debt ceiling brinkmanship. In 2010, he said, “I have heard people say that if we don’t do it it will be the end of the world … I have yet to meet someone who can articulate the negative consequences.”

    He apparently didn’t look very hard for someone to explain it to him, though, because a month later he said he didn’t actually know what the consequences of such a move would be. But he was sure that the debt ceiling wasn’t worth raising absent other actions.

    One could certainly brush this off as the bloviating of a backbench congressman, especially since scoring points by caterwauling about the debt limit is a long bipartisan practice. But in his recent confirmation hearing, Mulvaney didn’t sound like a man who had learned many lessons from crises past.

    When asked about explaining the merits of the debt ceiling to a president who is very much not a details guy, Mulvaney said, “I will counsel the president as to the ramifications of raising the debt ceiling and of not raising the debt ceiling. … [I] look forward to conveying both – all of the arguments to him.” He also said the debt limit has “regularly been used” as a reason to reassess budget priorities, which sure sounds like an endorsement of using it to extract other policy promises.

    Keeping the specter of debt limit brinkmanship alive is a problem for Mulvaney because, first, it puts him on the opposite side of the issue from new Treasury Secretary Steven Mnuchin, who unambiguously said that the ceiling shouldn’t be a political football. But it’s also in line with Trump’s own flip-floppy treatment on the sanctity of the national debt, providing no confidence that the administration writ large understands with what it is dealing. During the 2016 campaign, Trump flirted with the idea of the U.S. intentionally defaulting on its debt, only to walk it back later – and, as is his wont, blame the media for not understanding that words have different meanings in his head than they do in the dictionary. And then he did it again.

    So the administration’s stance on whether the U.S. should honor its financial commitments is already as clear as mud, a problem which Mulvaney would do nothing to ameliorate. And he would be advising a famously malleable president, susceptible to parroting the position of whomever he spoke with last.

    Clarity, this is not.

    “Mulvaney, however, was unconcerned about the debt ceiling brinkmanship. In 2010, he said, “I have heard people say that if we don’t do it it will be the end of the world … I have yet to meet someone who can articulate the negative consequences.””

    That was Mulvaney’s justification for the GOP’s past threats to force a default on US debt unless Obama and the Democrats agreed to some sort of bipartisan (via hostage taking) entitlement cuts back when he was still in Congress. And it didn’t sound like becoming Trump’s budget director changed his views:


    When asked about explaining the merits of the debt ceiling to a president who is very much not a details guy, Mulvaney said, “I will counsel the president as to the ramifications of raising the debt ceiling and of not raising the debt ceiling. … [I] look forward to conveying both – all of the arguments to him.” He also said the debt limit has “regularly been used” as a reason to reassess budget priorities, which sure sounds like an endorsement of using it to extract other policy promises.

    Yeah, that definitely sounds like Mulvaney was basically saying, “well, there are some good points and bad points to debt ceiling hostage taking showdowns…I’ll be sure to explain that to President Trump.” And that was just a couple months ago. Now here we are with the Trump administration putting out a budget so brutal that even some GOPers can’t support it while other GOPers are demanding even more cuts. They’ve literally created a crisis where the only ‘fix’ that meets GOP orthodoxy is to cut entitlements instead.

    And this intra-GOP paralysis is all happening as the countdown for next debt ceiling has already begun, although the real debt ceiling deadline doesn’t hit until the Fall, so the looming debt showdown probably won’t be a factor. But as the article below reminds us, the debt ceiling showdown isn’t the only showdown worry about this year. Thanks to the fact that a budget resolution was never passed in 2016 for the 2017 year and a partial funding extension was passed in December that would only fund the federal government for its 2017 spending through April as a solution to the last budget showdown, there is now a looming April 28 deadline for Congress to come to an agreement to simply fund the federal government for the rest of 2017 and if that agreement isn’t reached by the end of next month a partial shutdown ensues. And that’s only two weeks after the April 15 deadline for Congress to arrive at its 2018 budget proposal and it’s not uncommon fro Congress to miss that April 15 deadline. So it’s not inconceivable that the April 28 deadline for avoiding a partial government shutdown for the rest of 2017 could overlap with the congressional negotiations over the 2018 budgets. It’s like a GOP hostage-taking eclipse:

    The Hill

    GOP faces daunting deadlines in 2017

    By Cristina Marcos – 12/14/16 06:00 AM EST

    Republicans and President-elect Donald Trump will face a slew of tough legislative deadlines next year.

    It will be an abrupt change from 2016, when lawmakers faced few make-or-break dates except for avoiding a government shutdown.

    One informal deadline for the GOP Congress is April 30, which would be Trump’s 100th full day in office, not including Inauguration Day.

    GOP lawmakers are eager to move as many top policy priorities for Trump as possible in his first 100 days, including repealing ObamaCare on his first day as president.

    Tax reform and an infrastructure investment bill are two other possible priorities for the new administration.

    The Senate will also be kept busy voting to confirm dozens of nominees to Trump’s administration.

    Beyond that informal deadline, Congress faces a number of specific deadlines that will require action.

    The first big one comes on March 16, when the current debt-limit deal expires.

    It’s the first time Congress will have to raise the $20 trillion debt ceiling since the 2015 budget deal brokered by then-Speaker John Boehner (R-Ohio) and President Obama. That agreement suspended the debt limit for more than a year.

    The Treasury Department will likely use “extraordinary measures” to push the deadline for raising the ceiling until at least midsummer.

    It will be the first time since before the Tea Party movement that Republicans will deal with a debt-ceiling vote while they control both chambers of Congress and the White House.

    As a result, the responsibility will fall on their shoulders to raise the ceiling.

    Conservative Republicans repeatedly pushed the Obama White House to agree to spending cuts in exchange for raising the debt ceiling.

    This time, they’ll have to negotiate with Trump. And Democrats will have little incentive to offer any help.

    Congress also faces an April 28 deadline to fund the government after it approved legislation last week to prevent a government shutdown.

    The negotiations over a spending package could consume valuable time and political capital when Republicans will be eager to move as many conservative policy initiatives as possible before the 100-day mark.

    Two other issues could play into the spending fight.

    Sen. Joe Manchin (D-W.Va.), who’s up for reelection in 2018 in a state that voted overwhelmingly for Trump, is sure to reprise his push for extending health benefits for coal miners that held up this month’s stopgap measure.

    New York lawmakers are also pushing for additional funds to reimburse New York City for the costs of securing Trump Tower.

    Republicans face an April 15 deadline for passing a budget.

    The congressional budget law directs that Congress agree to a concurrent budget resolution by mid-April.

    Republicans are indicating they’ll pass two budgets this year: one right out of the gate in January as a vehicle for repealing the healthcare law, and another to focus on tax reform. In order to use the legislative procedure known as reconciliation, which can’t be filibustered in the Senate, Congress must pass a budget resolution first.

    GOP leaders are aiming to conduct votes to undo ObamaCare during the opening days of the new Congress in January.

    “The congressional budget law directs that Congress agree to a concurrent budget resolution by mid-April.”

    Congressional law directs that Congress agree to a budget resolution by mid-April. That’s the law. Congress wrote it. And if the GOP abides by its own law this year it means we’re going to have two deperate showdowns two weeks apart, the April 15th budget resolution intra-GOP showdown and the April 28 showdown to finally resolve last year’s budget resolution (this is sad). And if the April 15th deadline isn’t met, that budget resolution debate could easily become another bargaining chip in the April 28th negotiations to avoid a partial shutdown of the federal government potentially for the rest of the year. All that has to happen is for the budget resolution not to be resolved by April 28 like what happened last year when the ‘Freedom Caucus’ refused to let Paul Ryan’s budget out of the Budget Committee as of April 29:

    Politico

    Ryan calls members-only meeting to hash out budget

    The speaker tries to break a stalemate with the Freedom Caucus.

    By John Bresnahan and Rachael Bade

    04/29/16 11:26 AM EDT

    House Republicans made progress toward a budget deal before skipping town for a weeklong recess Friday — though no agreement has been reached between GOP leaders and hardline conservative eager to cut tens of billions of dollars in spending.

    Speaker Paul Ryan (R-Wis.) called a members-only meeting Friday morning, clearing a room in the Capitol basement of all staff to allow lawmakers to hash out their differences.

    Conservatives want to cut $30 billion from a bipartisan budget agreement that outgoing Speaker John Boehner (R-Ohio) struck with the White House last fall before his resignation. Ryan, however, knows that funding bills at that level will never pass the Senate, let alone win Obama’s signature.

    The internal dispute has led to a lengthy stalemate, with Ryan unable to move a proposal out of the Budget Committee because the right flank of his party refused to back those spending numbers — a problem that constantly plagued Boehner.

    It’s proved a huge embarrassment for the speaker, who as Budget Committee chairman harped on the need for the government to pass a budget and lay out its priorities to the country. Should the House fail to pass such a spending blueprint, they’d be the first Republican majority not to do so in the past two decades.

    So Ryan called Friday’s meeting in a last-ditch effort to do something to save the budget.

    During the 90-minute-plus session, lawmakers floated several ideas to grease the wheels for passage, though none were new and no overall deal was reached.

    Yet rank-and-file members were encouraged by the chance to hash out the issue, and senior Republicans predicted that passage of a budget resolution was far closer than it had been.

    It would also be a big boost for Ryan. The speaker has talked about House Republicans providing a “positive agenda” as an alternative to the bitter GOP presidential fight yet has been unable to execute one of the most basic functions of governance: proposing a budget plan. Ryan has been unwilling to force a showdown with the Freedom Caucus and budget hardliners, and is instead trying to persuade his colleagues to find a solution among themselves instead of having it imposed on them by leadership.

    One idea discussed in detail was what lawmakers are calling a “sidecar” package that would cut $30 billion — a sum identical to new spending tacked on in last year’s bipartisan budget deal — from mandatory programs like Medicare and Medicaid. Budget Committee Chairman Tom Price (R-Ga.) has crafted a bill based on proposals already approved by other panels and said he was ready to move on it.

    Conservatives like the idea. Rep. Andy Barr, a deputy in the conservative Republican Study Committee, said there is “actually some consensus that I feel is building about obviously doing a budget, but working on some ‘sidecar’ provision on mandatory spending reform… or a balanced budget amendment.”

    “I think a lot of people are less concerned about the individual number and more concerned about the broader issue of this mandatory spending,” the Kentucky Republican added. “What is more important than the distinction between [$1.04 trillion and $1.07 trillion] is: Are we making the reforms necessary to, in the long run, reduce the deficit?”

    “One idea discussed in detail was what lawmakers are calling a “sidecar” package that would cut $30 billion — a sum identical to new spending tacked on in last year’s bipartisan budget deal — from mandatory programs like Medicare and Medicaid. Budget Committee Chairman Tom Price (R-Ga.) has crafted a bill based on proposals already approved by other panels and said he was ready to move on it.”

    As of April 29th, 2016, Paul Ryan hadn’t been able to even get a bill out of the House Budget Committee because he couldn’t placate the ‘Freedom Caucus’ of extra-far-right GOPers who wanted deeper spending cuts. Despite offering Medicaid and Medicare cuts as a deal sweetener:


    During the 90-minute-plus session, lawmakers floated several ideas to grease the wheels for passage, though none were new and no overall deal was reached.

    Yet rank-and-file members were encouraged by the chance to hash out the issue, and senior Republicans predicted that passage of a budget resolution was far closer than it had been.

    It would also be a big boost for Ryan. The speaker has talked about House Republicans providing a “positive agenda” as an alternative to the bitter GOP presidential fight yet has been unable to execute one of the most basic functions of governance: proposing a budget plan. Ryan has been unwilling to force a showdown with the Freedom Caucus and budget hardliners, and is instead trying to persuade his colleagues to find a solution among themselves instead of having it imposed on them by leadership.

    One idea discussed in detail was what lawmakers are calling a “sidecar” package that would cut $30 billion — a sum identical to new spending tacked on in last year’s bipartisan budget deal — from mandatory programs like Medicare and Medicaid. Budget Committee Chairman Tom Price (R-Ga.) has crafted a bill based on proposals already approved by other panels and said he was ready to move on it.

    That was the dynamic last year, and it’s shaping up to be the same so far this year despite across-the-board GOP control.

    And don’t forget that Tom Price, the guy who crafted Paul Ryan’s budget proposal last year, is now the secretary of Health and Human Services. And that means HHS will be ready and very able to facilitate any last-minute Medicare and Medicaid cut proposals that might be made in the midst of the intra-GOP’s ’emergency negotiations’ (theatrics) should the April 15 budget resolution deadline once again get missed and bleed into the April 28 deferred budget resolution showdown from last year (sad!).

    All in all it’s looking like the tensions in the GOP for this budget resolution are roughly falling into a Trump/Ryan vs Freedom Caucus vs GOPers terrified of the electoral consequences of the Trump/Ryan plan dynamic. And while some of those tensions might be organic and non-theatrical, it’s the perfect situation for some intra-GOP budget showdown theatrics. They control all the levers of power and basically get to write the script. A script where somehow everyone and no one is to blame for the GOP suddenly cutting entitlements as the only solution to the crisis, something the GOP has long championed doing with the notable exception of Trump. And specific blame is placed on Freedom Caucus members who can lead the hostage taking like they do every year these days (or they try to blame Obama). And then Trump removes some of his draconian cuts and acts like he’s not a psycho as part of the deal sweetener.

    In other words, Trump’s budget proposal could be the opening bid in a negotiation showdown between Trump/Ryan and the Freedom Caucus acting as bad cop/worse cop in a twin budget standoff that predictably culminates in a crisis on April 28 that leads the US to the brink of a partial government shutdown. This is the kind of crap the GOP always does and now Steve Bannon is writing the script. A script where they have a Freedom Caucus vs Trump/Ryan squabble leads into a government shutdown and Trump uses his amazing ‘Art of the Deal’ skills to negotiate less extreme entitlement cuts than what the Freedom Caucus demands as a grand compromise that saves the day and lets him return a few dollars to Meals on Wheels. This is the kind of crap the GOP does.

    So don’t be super surprised if Steve Bannon is writing a script where they have a Freedom Caucus vs Trump/Ryan squabble that leads into a government shutdown and they save the day by agreeing to only some of the Freedom Caucus’s entitlement cut demands.

    Also don’t be surprised if a bunch of disable people get thrown off Social Security disability. They’ll presumably go on Medicaid. Block-granted Medicaid that’s turned into personal vouchers. And then be forced to work for that voucher at minimum wage. Still disabled of course. Because making life worse for people in need and acting like it was an act of compassion and responsibility is a key element of any GOP script written for maximal exploitation of the twin 2017/2018 budget crisis. It’s what the GOP does, Trump or not.

    Posted by Pterrafractyl | March 18, 2017, 9:23 pm
  6. We’re now getting reports about tweaks to Paul Ryan’s Obamacare replacement bill designed to lesson the impact on older people. Although it sounds like the tweaks Ryan is pushing for mostly just involve expanded tax credits for older people, presumably on Medicare, who want to buy extra private insurance. Which means it’s actually a plan to make the Obamacare replacement better for wealthy older people while setting up a tax credit structure for people to flee to after Ryan puts in motion his eventual plan to send Medicare into a death spiral and voucherize it. So those kinds of tweaks are apparently still coming and despite the nice tax credit for people who can afford extra insurance, they aren’t the kinds of tweaks design to help older people:

    Bloomberg Politics

    Ryan Plans Tweaks to Health-Care Bill to Help Older People

    by Ben Brody
    and Anna Edney
    March 19, 2017, 9:45 AM CDT March 19, 2017, 10:44 AM CDT

    * House Speaker seeks to increase tax credits for older buyers
    * Cotton said he doubts bill as is will lower insurance premiums

    House Speaker Paul Ryan said he would “most likely” bring a health-care bill forward for a floor vote on Thursday, even as he seeks to increase tax credits to help older people buy insurance to tamp down concerns about moderate Republicans.

    “We believe that we do need to add some additional assistance to people in those older cohorts,” Ryan said of the bill, known as the American Health Care Act, on “Fox News Sunday.” “That’s one of the things we’re looking at.”

    Ryan defined the group as people in their 50s and 60s who typically face higher health care costs than those in their 20s or 30s. A Congressional Budget Office review of the bill released on March 13 suggested there would be increases in out-of-pocket costs, especially for older people.

    The nonpartisan CBO estimated that 14 million Americans could lose their insurance next year under the Republican’s Obamacare-replacement plan, a dire picture of the bill’s effects that could hurt the party heading into the 2018 congressional elections.

    At the same time, insurance premiums will continue to rise in the near term, especially for older Americans. As the bill now stands, older, poorer Americans will have far less help from Republican tax credits starting in 2020 than they get through Obamacare subsidies.

    ‘Older, Rural Americans’

    “We have to do something about the fact that the House bill disproportionately affects older, rural Americans,” Republican Senator Susan Collins of Maine said on NBC’s “Meet the Press” on Sunday.

    Ryan didn’t say whether he had the 218 votes necessary to pass the bill, which would replace President Barack Obama’s signature Affordable Care Act, but he said he feels “very good about where we are.”

    “We’re still having conversations with our members,” Ryan said. “We’re making fine-tuning improvements to the bill to reflect people’s concerns.”

    Asked on Fox News Channel’s “Sunday Morning Futures” whether the bill would pass the House on Thursday, Republican Representative Cathy McMorris Rodgers of Washington said, “We’re definitely moving in the right direction” and “I am confident we will come together.”

    Ryan said that proposed changes to the health-care system that would occur outside of the bill also would lower payments. Health and Human Services Secretary Tom Price also said regulatory changes in particular could increase competition in markets.

    “We’ve had insurers tell us not only will we stay in the market, we’ll get back in the market,” Price said Sunday on ABC’s “This Week.”

    But Senator Tom Cotton of Arkansas, a Republican critic of the bill who’s said voting for the measure as written may imperil the party’s majority in the house in the 2018 midterm elections, said he didn’t believe the bill would lower premiums for working people.

    “It’s fixable, but it’s going to take a lot of work,” Cotton said on CNN’s “State of the Union.” “We need to roll up our sleeves and focus on fixing those problems, rather than trying to rush to some arbitrary deadline.”

    House Democratic Leader Nancy Pelosi said Obamacare can be improved and Republicans could work with Democrats to do that. Instead, she said, the bill championed by Republicans would hurt “millions of people who are benefiting” from the current law who also voted for Trump, and hand tax breaks to wealthy people in regions that voted for Democrat Hillary Clinton.

    “That money will be taken from red areas, and many of the people who will be advantaged by the money going to the high end will be in blue areas,” the California lawmaker said on CBS News’s “Face the Nation.” “How’s that? It’s so wrong.”

    Mick Mulvaney, the White House budget director, said Trump voters and everyone else would be better off under the Republican bill. It provides tax-credit assistance and would spur increased competition to reduce costs, he said.

    “At the same time, insurance premiums will continue to rise in the near term, especially for older Americans. As the bill now stands, older, poorer Americans will have far less help from Republican tax credits starting in 2020 than they get through Obamacare subsidies.

    So as the bill stands now, older, poorer Americans are about to get extra screwed by 2020. But Paul Ryan wants to assure us that he’s on the case. With tax credits for private insurance. That should do the trick:

    Slate

    The Republican Health Care Plan Is a Nightmare for the Old and Nearly Poor

    By Jordan Weissmann
    March 13 2017 7:05 PM

    There are lots of losers under the Republican plan to replace Obamacare, but perhaps nobody would suffer as badly as older Americans who live just above or around the poverty line. According to the new estimates from the Congressional Budget Office, that group could see its insurance premiums rise by 750 percent within a decade under the House GOP’s American Health Care Act, compared with what they’d pay under current law for more comprehensive coverage.

    Yes, 750 percent. That’s not a typo. That devastating increase is spelled out in the table below, in which the CBO models how premiums might change for Americans of different ages and incomes under the legislation Republicans have proposed. With Obamacare, a 64-year-old earning $26,500 per year in 2026—175 percent of the poverty line—would have to pay $1,700 for insurance, after tax credits. That plan would cover 87 percent of their medical costs, on average. Under the AHCA, or Trumpcare, that same person would owe a full $14,600 after tax credits for a plan that only covers 65 percent of their medical costs.

    [see chart]

    Why the drastic increase? There are two main reasons: Under Trumpcare, insurers would be allowed to charge older Americans more, while the government would give lower-income Americans smaller subsidies to pay for coverage. Currently, insurers are only allowed to charge older customers three times what they charge younger individuals. The Republican plan would allow them to charge five times as much. Meanwhile, under the Affordable Care Act, the federal government gives people tax credits based on their income and the cost of insurance, which cap premiums as a percentage of their earnings. Trumpcare’s premiums are only based on age—they don’t take income or cost coverage into account—so poorer households tend to lose out. They’re also set to grow more slowly, which doesn’t help matters.

    There are some winners in this bargain. Obamacare doesn’t offer premiums subsidies for households that earn more than 400 percent of the poverty line. So some middle- and upper-middle-income Americans may come out ahead. A 40-year-old making $68,200 in 2026 would pay $6,500 under Obamacare; with Trumpcare’s tax credit, he’d pay just $2,400 for an insurance plan that was only slightly less comprehensive. A 21-year-old with the same salary would benefit similarly, while a 64-year-old would pay slightly less than under Obamacare.

    The CBO has often been criticized—perhaps unfairly—for its estimates about Obamacare’s coverage effects. But its budgeteers were largely on target regarding the Affordable Care Act’s effects on premiums. Republicans are already objecting that the office’s estimate did not account for the way deregulation through the executive branch will bring down costs, by allowing insurers to sell less expansive policies. But that doesn’t help older Americans with significant medical costs much. And as I mentioned before, these premium comparisons assume customers will buy far less comprehensive coverage. There’s every reason to believe the projections on this table are at least directionally correct about what the effects of Trumpcare would be.

    So you could call it a trade-off. Younger, higher-income Americans pay less, while older, poorer Americans—many of whom are likely Trump supporters—pay far, far more for less useful insurance. This is part of a bill, mind you, that would force many of these lower-income households into the individual market by cutting hundreds of billions from Medicaid. These trade-offs might be less severe if Republicans weren’t determined to turn their legislation bill into a vehicle for massive, regressive tax cuts. But hey, everybody has their priorities.

    “So you could call it a trade-off. Younger, higher-income Americans pay less, while older, poorer Americans—many of whom are likely Trump supporters—pay far, far more for less useful insurance. This is part of a bill, mind you, that would force many of these lower-income households into the individual market by cutting hundreds of billions from Medicaid. These trade-offs might be less severe if Republicans weren’t determined to turn their legislation bill into a vehicle for massive, regressive tax cuts. But hey, everybody has their priorities.”

    Older, poorer Americans are going to pay far, far more for less useful insurance. That’s Trumpcare/Ryancare!


    Yes, 750 percent. That’s not a typo. That devastating increase is spelled out in the table below, in which the CBO models how premiums might change for Americans of different ages and incomes under the legislation Republicans have proposed. With Obamacare, a 64-year-old earning $26,500 per year in 2026—175 percent of the poverty line—would have to pay $1,700 for insurance, after tax credits. That plan would cover 87 percent of their medical costs, on average. Under the AHCA, or Trumpcare, that same person would owe a full $14,600 after tax credits for a plan that only covers 65 percent of their medical costs.

    A 64 yr old making $26,500 might owe $14,600 vs $1,700 under Obamacare. For a crappier plan. But at least there might be tax credits for them to purchase extra private insurance. Isn’t TRyancare grand?

    And as the article notes, this is specifically talking about all those older people about to be kicked off/denies access to the expanded Medicaid coverage, so that gives us a sense of what the status is going to be for the older Americans who lose out on access to the Medicaid expansion: they’re totally screwed.

    Also keep in mind that a lot of those people about to be kicked off the Medicaid expansion because they make just over the poverty-line are probably going to qualify for non-expanded Medicaid just as soon as they’re bankrupted by their soon-to-spike medical costs. So that’s a horrible trend that has yet to be unleashed.

    But at least hopefully most of the people who fall into that TRyumpian crack won’t be forced to work for their Medicaid after the GOP imposes a Medicaid work requirement because most talk around that involve the work requirement for people under 50. Then again, don’t forget that Paul Ryan wants to eventually turn Medicaid (and the safety-net in general) into a voucher. And that’s a recipe for expecting holder Americans to work until the day they drop dead or are too disable for the GOP to kick off of disability. When you consider how much of a poorer American’s individual medical costs are going to get gobbled up once the TRyancare plan is put in place and they do the same to entitlements, extreme poverty in old age is going to be the norm. Along with no retirement until you physically break or die. So there’s no reason to impose a work requirement on older Americans. Unless they’re unusually healthy, the costs of healthcare passed along to older Americans under TRyancare is going to be it’s own work requirement.

    Posted by Pterrafractyl | March 19, 2017, 9:39 pm
  7. The House is scheduled to vote in their big Obamacare replacement bill on Thursday. Unfortunately for Paul Ryan and Donald Trump, the two key champions of this plan, it’s looking like the House is scheduled to vote, but not necessarily pass, the Trump/Ryan “American Health Care Act” thanks in to the combined resistance of “moderate” GOPers who want to see more government assistance to help people buy insurance and the extra-far-right “Freedom Caucus” who don’t think the bill cuts that government assistance enough. More “Yes” votes need to be found somewhere. Soon. So what are Paul Ryan and Trump going to do? Well, as the article below points out, they’ve already tried a combination of threats and goodies for the holdouts, but so far that’s not enough (Sad!).

    There is however one approach that might work: caving to the “Freedom Caucus” demands. Specifically, their demand that Trumpcare stripping out the Essential Health Benefits (EHB) rule – the Obamacare rule that creates a minimum level of services covered by insurance and basically outlawed super cheap insurance policies – and let those joke policies that covered almost nothing be legal again. But there’s a problem with this plan: if those super cheap plans are legal again, the skimpy subsidies to low-income Americans under Trumpcare that aren’t currently useful for low-income Americans (because the subsidies aren’t nearly enough to make insurance affordable) might suddenly become useful…useful for buying the super cheap crap insurance. And if those subsidies are suddenly used by low-income Americans the projected costs of the bill will go up. And if that happens, the GOP can no longer depend on using the “budget reconciliation” rule that lets bills avoid a filibuster in the Senate as long as the bill is budget neutral.

    So the last minute attempt to get the “Freedom Caucus” on board with the Trumpcare plan to move it through the House just might end up blocking it in the Senate all because the change required to get the Freedom Caucus on board will end up wasting federal funds to subsidize crap insurance:

    Talking Points Memo
    DC

    GOP Leaders Promise Dissenters That Senate Will Gut Essential Health Benefits

    By Alice Ollstein
    Published March 22, 2017, 5:37 PM EDT

    As Thursday’s House vote on the bill to repeal the Affordable Care Act looms, the pressure is ramping up on GOP lawmakers who remain undecided or opposed to the legislation. Even after threats to their careers, invitations to the White House, special carve-outs for their states, amendments on their pet issues, and other tactics, critics of the bill still say enough members are holding strong to ensure the bill will fail on the House floor.

    As the clock ticked down on Wednesday, Republican leaders made a new promise to the dissenters: that the Senate will add a provision gutting Obamacare’s Essential Health Benefits (EHB) rule once the House passes the bill and sends it their way.

    The EHB rule, which the current House GOP repeal bill retains, requires that insurance plans have to cover a basic minimum of health care services, including emergency room visits, hospitalization, outpatient services, maternity care, mental health and substance abuse services, prescription drugs, rehabilitative and habilitative services, lab tests, preventive care like vaccines, and vision and dental care for children.

    Rep. Richard Hudson (R-NC), the deputy whip in the House, told TPM he received assurances Wednesday from Senate Majority Leader Mitch McConnell (R-KY) that he would amend the bill when it comes to the Senate to include a provision stripping out EHBs. McConnell’s office did not respond to TPM’s attempt to confirm Hudson’s account.

    Hudson said he was further promised that the White House would back the move. “The president personally guaranteed that he would publicly call for it,” he said. Politico later reported that White House budget director Mick Mulvaney is working with the House Freedom Caucus on the details.

    This new promise was already winning over many previously dissenting conservatives, said Hudson, who is part of the team charged with securing the votes for passage—enough that he’s confident the bill will pass the House Thursday night.

    Asked if the EHB provision could pass the Senate’s reconciliation rules, which allow certain budget bills to pass with a simple majority and avoid a filibuster, Hudson was unsure.

    “It’s a gamble,” he admitted. “The [Senate Parliamentarian] says it can’t [be included]. That’s pretty definitive to me, but there are other conservatives out there who think it can be. So it’s a safer gamble to let McConnell do it so we don’t lose our entire bill if we’re wrong.”

    Bill critic Sen. Mike Lee (R-UT) is one of those “other conservatives.” He said Wednesday that the Senate Parliamentarian told him it “may be possible” to repeal EHBs through reconciliation.

    “What I understood her to be saying is that there’s no reason why an Obamacare repeal bill necessarily could not have provisions repealing the health insurance regulations,” he told the Washington Examiner.

    Democrats in the Senate disagree. Matt House, the spokesperson for Senate Minority Leader Chuck Schumer (D-NY) wrote on Twitter that trying to pass a repeal of EHBs through the reconciliation process “violates the Senate rules and won’t happen.”

    “This is merely a plot to get the bill out of the House,” he said. “Provision won’t ultimately survive in the Senate.”

    As the health care debate has roiled Capitol Hill over the past couple weeks, some conservatives have been demanding the elimination of the EHB rule, arguing that insurers should be once again be allowed to offer dirt-cheap, bare-bones plans to consumers who prefer them.

    Allowing this change, however, would cost the federal government dearly.

    Expert analysts say more people would use their federal tax credits to purchase these skimpy plans rather than going entirely uninsured, meaning the legislation would not achieve anywhere near the $337 billion in deficit reduction originally predicted. The health care consulting firm Milliman also argues that gutting the benefits would also do far less to lower insurance premiums than supporters of the move claim.

    As of Wednesday afternoon, the bill’s passage was still not a given, as other lawmakers told TPM they have other problems with the current bill that are not addressed by the EHB offer.

    “I’ve got some serious concerns still,” Rep. Mario Diaz Balart (R-FL) said. “I think the 50- to 65-year-old population will have a more difficult time getting insurance and it will be more expensive. They are not being dealt with in a way that’s giving me a lot of comfort.”

    “Asked if the EHB provision could pass the Senate’s reconciliation rules, which allow certain budget bills to pass with a simple majority and avoid a filibuster, Hudson was unsure.”

    It’s quite a gamble. A legislative gamble and, of course, a gamble with people’s lives since the removal if the EHB rule is recipe for millions of personal medical disasters. And subsidizing all those cheap crap plans isn’t going to be cheap


    As the health care debate has roiled Capitol Hill over the past couple weeks, some conservatives have been demanding the elimination of the EHB rule, arguing that insurers should be once again be allowed to offer dirt-cheap, bare-bones plans to consumers who prefer them.

    Allowing this change, however, would cost the federal government dearly.

    Expert analysts say more people would use their federal tax credits to purchase these skimpy plans rather than going entirely uninsured, meaning the legislation would not achieve anywhere near the $337 billion in deficit reduction originally predicted. The health care consulting firm Milliman also argues that gutting the benefits would also do far less to lower insurance premiums than supporters of the move claim.

    So the GOP is in quite a bind. But that doesn’t mean there aren’t other options. For instance, as “Freedom Caucus” member Trent Franks suggests below, how about the Senate gets rid of the filibuster? Or maybe just slash the overall subsidies enough to make it all budget neutral again:

    Slate

    Why Fixing Trumpcare Is Impossible

    There’s a secret, cynical reason Paul Ryan can’t give conservatives what they want on the American Health Care Act.

    By Jim Newell
    March 22 2017 1:59 PM

    You cannot fault House conservative holdouts for a lack of clarity in their refusal to support the American Health Care Act. Each one I spoke with on Tuesday made the same point: If policy provisions were added to the bill deregulating health insurance markets—especially repealing the Obamacare requirement that qualifying insurance plans cover 10 essential health benefits—they would not just vote for it but do so enthusiastically. They would think it was even a good bill—gasp!—and House leaders could unlock roughly 20 to 25 votes to put them over the top for passage while also presenting something resembling an ideologically coherent vision of health policy.

    These conservatives have made this point repeatedly to the press, to Republican whips, to White House aides, and to the president himself. The stated reason leaders have not given into this is that Senate rules would not allow for such provisions. The Byrd Rule only allows reconciliation bills—ones that require a bare majority for passage—to include provisions directly affecting the budget, and not regulatory reform. The Senate has advised House Republicans that eliminating the essential health benefit requirements would not pass muster, and so that is apparently that.

    Leaders plan, instead, for Health and Human Services Secretary Tom Price to use his discretion through the rule-writing process to water down these requirements. As some conservatives point out, though, even if the rule writing passes legal muster—an open question—the next time the White House goes Democratic, those rules could be reversed again. It’s not an ideal long-term solution for conservatives to leave these regulations on the books.

    There’s another related reason leaders may not be so keen on eliminating the essential health benefits in this bill, though. It’s a cynical one.

    Eliminating the essential health benefits was part of a leaked early repeal and replace proposal, dated Feb. 10. By the time leaders debuted the bill weeks later, that provision had been struck. Calling its removal “the biggest puzzle about Ryan’s Obamacare repeal,” Investor’s Business Daily reporter Jed Graham suggested the following:

    The decision to preserve ObamaCare’s coverage restrictions may go a very long way in lowering the cost of providing subsidies under the American Health Care Act. That’s because, realistically, the only way that most low-income shoppers would be able to use their much smaller tax subsidy under the GOP plan would be to buy low-value insurance that isn’t available under ObamaCare and won’t protect them from a real health emergency.

    In other words: If you loosen regulations, more people might actually find it worthwhile to use the dinky tax credits offered them to purchase dinky insurance, driving up the cost to the federal government. It’s quite the conundrum. Republicans want to deregulate, but they also feel they have to offer some refundable tax credit to sell the bill to moderates and the public. If they deregulate through law, though, the policy analyzers will show that more people might actually use the tax credit and the Congressional Budget Office spending score would blow up.

    Arizona Rep. Trent Franks, a Freedom Caucus member who wants Senate Republicans to gut the filibuster if that’s what it takes to get their reforms through, told me Tuesday that this is indeed something leadership is worried about. (A leadership aide insisted that Senate reconciliation rules are still the reason they’re not addressing essential health benefits in this bill.) I had been asking him why, according to what he had heard, there was still so much resistance from leaders about doing whatever’s necessary to unlock their votes.

    “I think there’s a secondary concern here,” Franks told me. He paused for a while. “I’ll go ahead, I haven’t explained this to anybody very much, I just don’t want to complicate this debate …”

    But?

    “I think there’s some concern on [the] part of leadership, that I fully understand, of seeing a tax credit get out of control. And they’re afraid that if you [take] away some of these mandates, that it will upset the CBO budget [score].”

    If the tax credits were to “get out of control,” it could cause another serious Senate reconciliation problem for the bill: The bill has to be a long-term deficit reducer for it to be permanent.

    As Franks pointed out, the solution would be to just adjust the tax credits to match lower average premium projections. If leaders were to do that now, though, they’d have a whole new political problem. After the mess we’ve already seen, “House Leaders Slash Subsidies While Eliminating Essential Health Benefit Protections” would not be a helpful headline to sell the bill to the public—or to House moderates.

    In other words: If you loosen regulations, more people might actually find it worthwhile to use the dinky tax credits offered them to purchase dinky insurance, driving up the cost to the federal government. It’s quite the conundrum. Republicans want to deregulate, but they also feel they have to offer some refundable tax credit to sell the bill to moderates and the public. If they deregulate through law, though, the policy analyzers will show that more people might actually use the tax credit and the Congressional Budget Office spending score would blow up.”

    Yes, that’s quite a conundrum. But not a conundrum without solutions. Solutions like ditching the filibuster or slash the subsidies. They might be politically toxic solutions, but they’re solutions:


    Arizona Rep. Trent Franks, a Freedom Caucus member who wants Senate Republicans to gut the filibuster if that’s what it takes to get their reforms through, told me Tuesday that this is indeed something leadership is worried about. (A leadership aide insisted that Senate reconciliation rules are still the reason they’re not addressing essential health benefits in this bill.) I had been asking him why, according to what he had heard, there was still so much resistance from leaders about doing whatever’s necessary to unlock their votes

    If the tax credits were to “get out of control,” it could cause another serious Senate reconciliation problem for the bill: The bill has to be a long-term deficit reducer for it to be permanent.

    As Franks pointed out, the solution would be to just adjust the tax credits to match lower average premium projections. If leaders were to do that now, though, they’d have a whole new political problem. After the mess we’ve already seen, “House Leaders Slash Subsidies While Eliminating Essential Health Benefit Protections” would not be a helpful headline to sell the bill to the public—or to House moderates.

    Yes, now the GOP is in a position where it gets to choose between the following headlines:

    “House Leaders Slash Subsidies While Eliminating Essential Health Benefit Protections”

    or maybe:

    “Senate Leaders Eliminate Filibuster to Eliminate Essential Health Benefit Protections”

    or how about:

    “GOP Fails to Repeal Obamacare”

    So which headline is the least politically toxic? That’s the question of the hour of the GOP. Although when you look at how physically and financially toxic the American Health Care Act is going to be to all these GOPers’ actual constituents, headline #3 is clearly the least toxic in the long run. At least in most congressional districts. Headline #1 is probably fine for the really wealthy districts. Not fine morally, but it could work politically.

    Posted by Pterrafractyl | March 22, 2017, 7:10 pm
  8. There is no shortage of questions raised by the GOP’s seemingly unthinkable failure to to repeal and replace Obamacare with Paul Ryan’s Nightmarecare, but perhaps the most immediate question whether or not the GOP just did the least bad thing it could have done to itself. After all, while totally flailing and destroying Trump’s leadership cred looked pretty bad, it’s not like making Trumpcare law was a better alternative:

    ABC News

    GOP health care plan would hit people in counties Trump won hardest

    By RYAN STRUYK

    Mar 23, 2017, 6:49 PM ET

    Areas that voted for Donald Trump in the 2016 election by the widest margins could see significantly larger cuts in health care subsidies than other Americans, according to a new ABC News analysis of data provided by the Kaiser Family Foundation and the 2016 election results.

    The numbers show that voters who are older and low-income would get hit hardest by the American Health Care Act, but those aren’t the only reasons many Trump voters could fare worse than other Americans if the bill becomes law.

    A look at the how the law would change health care policy in different parts of the country shows that people of the same age and same income could see thousands of dollars more or less in tax credits based on where they live.

    The areas that voted for Trump — especially those where Trump won big — could be hit hardest.

    The new numbers show that geography, cost of living, family income, rural/urban divides and state-by-state healthcare rules mean people in areas that voted for Trump would get less in tax credits than those who voted for Clinton under the new legislation — even with the exact same age and income.

    That’s according to a new ABC News analysis of the data from the Kaiser Family Foundation, a non-profit focusing on national health issues, and Associated Press election results.

    Fox example, a 40-year-old making $30,000 per year under the new plan would get $138 more in tax credits, on average, in counties where Clinton won. But in counties where Trump won, this person would get an average of $353 less in tax credits.

    Similarly, a 60-year-old making $40,000 per year would get $2,747 less in tax credits in counties Clinton won, but would get $4,181 less in tax credits in counties that Trump won.

    And for a 27-year-old making $30,000 per year, tax credits would rise by $16 on average in counties that Clinton won but would decrease by an average of $329 in counties that Trump won.

    This analysis does not take into account changes the House made on March 20 that would potentially allow for larger tax credits under the AHCA for people over age 50, according to Kaiser.

    The margin by which Trump or Clinton won each county also makes a difference. People in counties that most overwhelmingly voted for Trump — by a margin of more than 30 percent — would see their tax credits go down more than a person with the exact same age and income who lives in a county Clinton won by similar margins.

    And for older Americans, these difference could amount to thousands of dollars. A 60-year-old making $40,000 per year who lives in a county that strongly favored Trump would see their tax credit cut by almost twice the amount as would be the case in a county where Clinton dominated.

    A 60-year-old making $40,000 per year in a strong Trump county could lose double the same person in a strong Clinton county under #AHCA. pic.twitter.com/BRubsFMuvY— Ryan Struyk (@ryanstruyk) March 23, 2017

    For other people, the difference could be between receiving more or less in tax credits under the new plan. Take a look at this chart for a 40-year-old making $30,000 per year:

    Who gets hit hardest by #AHCA? Areas that voted for Donald Trump by the widest margins via @ABC analysis of @KaiserFamFound and @AP data. pic.twitter.com/kXhCjqnxge— Ryan Struyk (@ryanstruyk) March 23, 2017

    The differences are even more stark in terms of the tax credits each person would receive.

    “The new numbers show that geography, cost of living, family income, rural/urban divides and state-by-state healthcare rules mean people in areas that voted for Trump would get less in tax credits than those who voted for Clinton under the new legislation — even with the exact same age and income.”

    Yep, the new health care law the GOP failed to pass wasn’t just going to be nightmare for Americans in general. The GOP’s voters were about to get extra screwed by a plan designed exclusively by the GOP. Imagine how they would feel after figuring that one out. So as bad as the GOP’s failure was politically speaking, it’s unclear that actually passing that plan wouldn’t have been a far, far worse political disaster that lasts years.

    Given all that, one of other the questions raised is who should Trump thank for his fortuitous massive fail? The “Freedom Caucus” of far-right GOPers who voted ‘No’ is the obvious answer, although a more complete answer is probably “whoever Trump’s team is blaming for his disaster,” which at this point is everyone but Trump:

    CNN

    Trump’s art of no deal: Find someone to blame

    By Jeremy Diamond and Dana Bash,
    Updated 10:46 PM ET, Fri March 24, 2017

    Washington (CNN)President Donald Trump likes winning. But on Friday he failed.

    Lacking sufficient support, Republicans were forced to pull their bill to replace Obamacare from the floor of the GOP-controlled House. Speaking soon after accepting defeat, Trump didn’t shoulder the responsibility himself, nor did he pin the blame on House GOP leadership or any of the warring Republican factions’ whose competing demands ultimately sunk any chance of a consensus bill.

    Instead, he blamed Democrats and vowed to let Obamacare “explode.”

    “We had no Democrat support. We had no votes from the Democrats. They weren’t going to give us a single vote, so it’s a very very difficult thing to do,” Trump said. “I think the losers are (House Minority Leader) Nancy Pelosi and (Senate Minority Leader) Chuck Schumer because now they own Obamacare. 100% own it.”

    The words flew in the face of Trump’s intense and personal engagement in lobbying members of Congress to support the House bill, efforts the White House touted in recent days as they hinted at Trump’s negotiating expertise.

    That tune changed on Friday after Trump’s first legislative failure, when Trump dubbed himself a mere “team player.”

    But while Trump publicly declined to level any criticism against House Speaker Paul Ryan — who Trump said “really worked hard” — or the House Freedom Caucus, which withheld support even after Trump made major changes to the bill in their favor, he and his advisers had begun the finger-pointing a day earlier.

    Standing on the precipice of a legislative failure likely to damage the political capital he will need to steer the priorities he truly cares about through Congress, Trump was “pissed” Thursday night, one source close to the President said, and so were his advisers. Blame fell everywhere but in the Oval Office.

    Several senior administration officials on Thursday night began blaming a flawed strategy pushed by Ryan and former House member Tom Price, now Health and Human Services secretary, for the embarrassing debacle. It was a strategy Trump signed up for when top aides and Ryan presented him with the plan to make good on his Obamacare repeal campaign promise so he could swiftly move on to issues he is more passionate about and familiar with like tax reform and infrastructure spending.

    “This was all Ryan and Price,” said one senior administration official. “They agreed upon this plan the day (Trump) hired Price.”

    Nevertheless, Trump himself answered affirmatively when asked Friday morning if Ryan should stay on as speaker in the face of failure.

    A second senior administration official concurred while a third instead pinned the blame on the House Freedom Caucus, the group of hardline conservatives who have held out support for the bill, demanding a slew of 11th-hour changes that sent the House GOP jigsaw puzzle into disarray.

    “There is a growing frustration in the White House over how the Freedom Caucus has handled the negotiations. The President has tried to address their concerns and they keep moving the goal posts,” said a senior White House official. “If this bill goes down, I don’t think the President is going to have any appetite to work with them.”

    But a source close to Trump described the President as more frustrated with his staff for convincing him to back the House GOP leadership plan in the first place.

    Painting the President as a political neophyte who has only been in Washington for two months, the source said Trump has become “frustrated with his staff’s inability to get this done” and argued that Trump was misled by those staffers who urged him to tackle Obamacare head first and hitch himself to Ryan’s plan.

    “He was talked into doing this bill first. It was not negotiated well on his behalf,” the source said. “He’s relied on his staff to give him good information and they haven’t. And that’s the problem.”

    The source close to Trump described a president who felt bamboozled by Ryan and his own staff, duped into thinking that passing health care would be the quick victory he needed to make good on a campaign promise central to his election and push forward on other policy fronts.

    Trump is likely to blame Ryan and his chief of staff, Reince Priebus, the source said, since he “bought” into Ryan’s plan and helped convince Trump to get on board, according to another senior administration official.

    Trump also blames staff for his own late personal engagement in lobbying members of Congress and the lack of presidential travel to key districts that would help flip votes rather than himself, one source said.

    But there is plenty of blame to go around, as all factions within the West Wing worked arduously to help craft and sell the bill.

    As Trump headed to Mar-a-Lago the first Friday of this month, both Priebus and White House chief strategist Steve Bannon stayed at the White House, working late into the night on tweaks to the bill, according to one senior administration official.

    The White House deployed its top conservatives to corral the House Freedom Caucus, with Bannon, counselor Kellyanne Conway and senior White House policy adviser Steven Miller joining Vice President Mike Pence’s already longstanding engagement in the legislative push.

    And weeks after Trump pledged the full weight of his presidency and White House officials touted Trump’s personal engagement in selling the bill, the President appears prepared to accept none of the blame if his gambit fails.

    In two rallies in the last two weeks, he barely talked about health care and failed to build a consensus among disparate Republican factions.

    Talked up as a “closer,” the President who ascended to the presidency on the merits of his negotiating prowess only became intimately involved in the work of wooing and grappling with members of Congress to win their support in the last 10 days.

    By that point, Republican senators were becoming increasingly vocal in their objections to the bill while the House Freedom Caucus ramped up its calls for major changes that would unsettle the bill’s delicate balance aimed at appealing to all factions of the GOP.

    Now, some Republicans have begun to direct at least some of the blame toward the Oval Office, arguing that Trump failed to follow through on his pledge to put sustained pressure on Republican members of Congress in order to pass the bill.

    For that, senior administration officials pinned the blame on the House speaker, who, along with his leadership team, crafted the bulk of the House bill months before Trump even took office.

    But as one senior administration official argued to CNN that hardline conservative members needed to pass the bill were not brought into the process until too late, Ryan’s office quickly responded with prepared pushback.

    “The speaker and his staff have met with conservative members of our conference nearly every week as the bill has made its way through the four-committee process,” a Ryan aide said in a statement. “The speaker maintains an open door policy for members in his office … He regularly texts with members, including (Rep. Mark) Meadows. The speaker’s senior staff are always available, including our chief of staff.”

    Still, more blame is likely to fall. One source wondered late Thursday night why Jared Kushner, Trump’s son-in-law and one of the most powerful West Wing forces, was away on a ski vacation with his wife, Ivanka Trump, while other White House staffers toiled away at an increasingly fraught mission.

    Trump, though, appeared to press for victory even Friday morning, making calls to House members despite the pre-emptive finger pointing from the White House.
    The President is “determined” to pass the bill, a senior administration official said.

    “Standing on the precipice of a legislative failure likely to damage the political capital he will need to steer the priorities he truly cares about through Congress, Trump was “pissed” Thursday night, one source close to the President said, and so were his advisers. Blame fell everywhere but in the Oval Office.”

    Well, it sounds like it’s “good job” for almost everyone on Capital Hill: the Freedom Caucus, HHS Secretary Tom Price, House Speaker Paul Ryan, Trump’s staffers who convinced him to listen to Paul Ryan, Democrats, and even perhaps Jared Kushner and Ivanka. If we listen to who the Oval Office is blaming it’s everyone but Trump, although given his lackluster attempts to actually sell the bill it seems like he should be taking some credit too.

    So it’s congrats all around for GOP at replacing the long-term slow motion political disaster that would have been Trumpcare with the immediate political disaster of looking like a bunch of incompetent jokes. It could be worse! It could be Trumpcare.

    It’s a rather ironic blame game dynamic. Although perhaps not as ironic as the blame game dynamic that Trump has already signaled he’s going to be pursuing for the next attempt at health care “reform”: intentionally letting Obamacare “explode” before they try again and blaming it all on the Democrats while coaxing them into a bipartisan Trumpcare reattempt:

    USA Today

    ‘Do not worry!’ Trump tweets, ‘Obamacare will explode’

    Maureen Groppe
    11:41 a.m. ET March 25, 2017

    When President Trump woke up Saturday to the fact that Republicans couldn’t meet their seven-year promise to get rid of Obamacare, what was his reaction? It will go away on its own.

    “ObamaCare will explode and we will all get together and piece together a great healthcare plan for THE PEOPLE. Do not worry!” Trump tweeted before playing golf.

    ObamaCare will explode and we will all get together and piece together a great healthcare plan for THE PEOPLE. Do not worry!— Donald J. Trump (@realDonaldTrump) March 25, 2017

    Senate Minority Leader Charles Schumer, D-N.Y., said Friday that Democrats are willing to work with Republicans to improve Obamacare, but only if Republicans stop trying to gut the law.

    “If they take repeal off the table, we’re willing to sit down with them and improve Obamacare,” Schumer told CNN. “It’s doing a good job, but there are places that it can be improved. No question about it.”

    ““ObamaCare will explode and we will all get together and piece together a great healthcare plan for THE PEOPLE. Do not worry!” Trump tweeted before playing golf.”

    Don’t worry about letting Obamacare explode! It’ll be just fine (but don’t die in the meant time)! He actually tweeted that.

    And while it’s unclear what exactly Trump’s team is planning for their next health care reform attempt, it looks like he’s at least going to go through the theatrics of trying to coax Democrats into joining into a bipartisan health care plan. It’s a strategy that makes sense on one level since any health care plan Trump and GOP sign onto would almost certainly be politically toxic enough that the party will surely want to share the political blame with the Democrats if that’s an option. But it’s also a rather strange strategy since the Democrats have already signaled that they’re more than happy to play that game by agreeing to improve and strengthen Obamacare now, before it actually ‘explodes’:


    Senate Minority Leader Charles Schumer, D-N.Y., said Friday that Democrats are willing to work with Republicans to improve Obamacare, but only if Republicans stop trying to gut the law.

    “If they take repeal off the table, we’re willing to sit down with them and improve Obamacare,” Schumer told CNN. “It’s doing a good job, but there are places that it can be improved. No question about it.”

    Trump just handed the Democrats a free talking point: they’re ready to fix Obamacare now…why wait for things to get worse so Trump and the GOP can dismantle the entire thing and replace it with something worse? And it’s a pretty compelling talking point because it naturally leads into a discussion for all sorts of proposals that actually would improve the US health care system.

    It’s also a risky rather strategy since Trump also handed the Democrats an excuse to do something the should have been doing all along but haven’t yet had much success in doing: explaining to the US public the myriad of ways the GOP has sabotaged Obamacare is ways that reduced healthcare access and drove up premiums. For instance, what about the change the GOP snuck in in late December 2015 that killed the “risk sharing corridors” provision designed to help keep premiums for spiking? Or how about how one major insurer, Aetna, pulled out of Obamacare exchanges not due to a “business decision” as the company claimed but instead as retribution for the Obama administration’s refusal to allow them to do a mega-merger with Humana. The public hasn’t heard much about that yet. The public barely has any awareness of that sabotage but they’re going to have plenty of opportunities to learn about it now.

    That’s all part of what’s going to make Trump’s threat to let Obamacare “explode” while simultaneously blaming the Democrats for not participating in the reform process so grimly fascinating to watch play out: it’s a really risky strategy, but it’s a strategy that could have a high payout for the GOP in the long run if it can somehow create a situation where the Democrats end up sharing in the blame for whatever Obamacare replacement the GOP comes up with.

    And don’t forget that none other than GOP spinmeister guru Frank Luntz told the GOP back in February that ditching the “repeal” plan and replacing it with a “repair” plan for Obamacare is what the public wants. So if Trump and the GOP managed to keep the “Obamacare” label on their program while still radically overhauling it and making it horrible that could be an effective way to transfer future blame.

    In other words, while Trump threatened to just let Obamacare “explode” to somehow force the Democrats to the bargaining table, perhaps the real strategy the GOP is planning on pursuing is to keep Obamacare around and just making it crappier and crappier. And as it gets worse, the GOP will use that as an excuse to make various “fixes” that by and large make it even worse. A nice slow motion death spiral. Done long enough and Obamacare could eventually become Trumpcare via a thousand little cuts and tweaks. Some done at the regulatory level and some through changes in law. Changes that can be made step by step over the next decade or so. Or by the Supreme Court.

    Yes, it would take a lot longer than simply “repealing and replacing” Obamacare now, but a time penalty for is a “Obamacare to Trumpcare” slow motion health care transition is a pretty small price to pay as long as the Democrats eventually share the blame for the health care nightmare the GOP is trying to create. Don’t forget that Trumpcare is sort of like slow motion mass denial of vital health care while the GOP denies that will be the case and sell some sort of ponies and rainbows version of what will happen. That’s politically toxic. Eventually. As long as it’s brand “Trumpcare”. So slowly turning Obamacare into Trumpcare really might be the best path for the GOP even if it comes at the cost of embarrassments like what Trump and the GOP had to go through on Friday.

    Keep in mind that a key ingredient for such an “Obamacare becomes Trumpcare” scheme to work is, of course, that the public never really learns about all the ways the GOP will sabotage Obamacare to create a crisis that it can use as an excuse to move it closer to Trumpcare. The GOP has done a good job on that so far, but we’ll see how they do going forward. Trump has certainly made a review of past GOP sabotage (or Supreme Court sabotage) much more likely now that he pledge to let it explode to bring everyone together. And as Chuck Schumer pointed out, there’s no shortage of improvements that can be proposed for Obamacare. So if it does end up being a slow motion “Obmacare to Trumpcare” transition there’s no reason to believe it won’t be very awkward for the GOP. But that still might not be as bad as passing Trump/Ryancare. Because it was just that awful.

    And yet TRyancare wasn’t awful enough for the Freedom Caucus. Or, it’s important to note, the Koch brothers, who had their networks launch a “grassroots” campaign called “You Promise” that called the Trump/Ryan plan “Obamacare 2.0” and demanded Trump repeal Obamacare. Then days before the vote they promised millions of dollars in ads to protect House GOPers who vote against the bill. Don’t forget that Paul Ryan is a wholely owned subsidiary of the Koch brothers so the fact that they detest a bill he created is quite amazing.

    Another key ingredient required for an “Obamacare becomes Trumpcare” scheme to work is a continuation of the GOP’s domination of Congress. And lots of time in the White House to have people like Tom Price sabotage the system from the executive branch. And for that to happen, the key ingredient is not actually passing a Trumpcare bill. Horribleness like Trumpcare shouldn’t be done too quickly by a single party. It was political doom. And in its first big Trump Era test of “how to use power to do horrible things, but not too quickly”, the GOP has so far managed to do exactly that. Or rather, managed to not do that. They chose political mockery over political doom. Job well done. Forget assigning blame, Trump should be giving someone a reward.

    All that said, even if it really is the case that not passing a Trumpcare law is less politically damaging than passing one, there’s still the question of how this defeat will affect the rest of the Trump agenda. And as the article below notes, it just might end up thwarting the thing people like the Koch brother care most about: tax cuts. Why? Because Trumpcare made changes to the tax code that were going to made the budget estimates for the long-term costs of the GOP’s big tax cut plan allow for bigger tax cuts. As Grover Norquist put it, they will soon realize that “they didn’t shoot and wound health-care reform, they shot and killed permanent tax reform.”:

    The Washington Post

    Trump’s path forward only gets tougher after health-care fiasco

    By John Wagner, Damian Paletta and Sean Sullivan March 25 at 2:24 PM

    The stunning collapse of the Republican health-care bill now imperils the rest of President Trump’s ambitious congressional agenda, with few prospects for quick victory on tax reform, construction projects or a host of other issues in the months ahead despite complete GOP control of government.

    While Republicans broadly share the goal of Trump’s promised “big tax cuts,” the president will have to bridge many of the same divides within his own party that sunk the attempted overhaul of the Affordable Care Act. And without savings anticipated from the health-care bill, paying for the “massive” cuts Trump has promised for corporations and middle-class families becomes considerably more complicated.

    Trump and Republican leaders continued Saturday in their attempts to put a brave face on the health-care debacle. “ObamaCare will explode and we will all get together and piece together a great healthcare plan for THE PEOPLE,” Trump wrote in a morning tweet. “Do not worry!”

    Trump has said he would have preferred to start his term by cutting “the hell out of taxes.” Even before the health-care bill was pulled Friday, the president was already starting to turn the page.

    Determined to highlight other priorities, Trump staged two announcements in the White House meant to underscore his commitment to creating jobs: granting a construction permit for the Keystone XL pipeline and appearing with executives of a telecom giant as they pledged to hire thousands of new employees, although the company’s plans had already been announced in October.

    Separately, Treasury Secretary Steven Mnuchin said at an event Friday that he will push Congress to enact comprehensive tax reform by its August recess, though he acknowledged that the timetable might slip.

    The White House signaled Saturday that it was eager to move on. Trump’s weekly address made no mention of the health-care fight, instead focusing on his signing of legislation authorizing funding for NASA and his commitment to space exploration.

    “We’re going to roll our sleeves up, and we’re going to cut taxes across the board for working families, small businesses and family farms,” Vice President Pence said Saturday at an appearance in Scott Depot, W.Va.

    A senior White House official, however, said it was unlikely that Trump would ramp up a major sales effort on tax reform immediately, given that his team had been planning on using the coming days to push for Senate action on the health-care bill.

    Trump’s top advisers had envisioned a three-step legislative agenda this year, starting with scaling back President Barack Obama’s signature domestic initiative. After that was complete, they wanted to move to a comprehensive overhaul of the tax code, followed by the creation of a $1?trillion infrastructure package.

    The implosion of the health-care effort complicates the tax overhaul both logistically and politically.

    House Republicans leaders had been counting on changes to the tax code included in the health-care bill to make the task of paying for future tax cuts easier.

    Americans for Tax Reform President Grover Norquist said the bloc of hard line Republicans who helped stymie the health-care overhaul were guilty of “ripping the lungs out of tax reform.” If they don’t revisit the health-care bill immediately, Norquist said, they will soon realize that “they didn’t shoot and wound health-care reform, they shot and killed permanent tax reform.”

    House Speaker Paul D. Ryan (R-Wis.) acknowledged Friday that the health-care defeat “does make tax reform more difficult, but it does not make it impossible.”

    “We are going to proceed with tax reform,” Ryan said.

    Hours before the health bill was pulled, Mnuchin said a “comprehensive” overhaul of the tax code should prove less complex. “Health care is a very, very complicated issue,” he said at a Friday event hosted by Axios. “In a way, [tax reform is] a lot simpler. It really is.”

    Trump has proposed cutting the corporate tax rate from 35 percent to 15 percent, though many Republicans on Capitol Hill have been aiming for a 20 percent rate. Trump has also proposed consolidating the existing seven individual income-tax brackets into three brackets of 10 percent, 20 percent and 25 percent.

    Trump’s advisers have argued that these changes would trigger a big expansion of economic growth, but some budget analysts have said the changes would widen the deficit by anywhere from $2.6 trillion to $7 trillion over 10 years, depending on the measurement method used.

    Many Republicans have long vowed that an overhaul of the tax code must be “revenue neutral,” which means they need to find new revenue to offset the reduction in rates. Trump’s advisers have not identified specific tax breaks they would eliminate to raise new revenue, and Trump himself often waved away debt concerns during the campaign.

    Meanwhile, House and Senate Republicans are at odds over the wisdom of a key component of tax reform.

    Ryan has proposed a border-adjustment tax that would essentially create new taxes on items imported into the United States as a way to raise close to $1 trillion in new revenue while also providing incentives for companies to move operations to the United States.

    Many other Republicans oppose this idea, though, and the fight probably will only intensify now. Some Republicans, including Sen. Lindsey O. Graham (S.C.), argue that the scheme would drive up prices on consumer goods and many large retailers are strongly opposed.

    Given such divides, as well as the mechanics of the budget process, it’s highly unlikely that lawmakers will produce a comprehensive tax bill by the August recess, if at all, said Jim Manley, a former longtime aide to former Senate majority leader Harry M. Reid (D-Nev.).

    “It’s clearly not realistic, and it’s not going to happen, on policy and political grounds,” Manley said, adding that the Republican agenda is also undercut by “a president who’s out of his league and doesn’t know how to legislate.”

    Republicans had planned to use a budget procedure called “reconciliation” for both the health-care overhaul and for the tax changes, as that would allow them to pass their plans with a simple majority in the Senate and make it impossible for Democrats to block the changes through a filibuster.

    That’s still the plan with tax reform.

    Democratic leaders said Republicans would be doomed to failure in future debates if they didn’t seek to build more consensus.

    “We don’t know what they’ll do with tax reform,” said Senate Minority Leader Charles E. Schumer (D-N.Y.), who warned, “if it’s huge tax cuts for the wealthy … it won’t fly.”

    Trump, on Friday and in the days leading up to the vote, seemed undaunted by the challenges ahead.

    “I hope that it’s going to all work out,” he told a House Republican dinner before the collapse of the health-care bill. “Then we immediately start on the tax cuts, and they’re going to be really fantastic, and I am looking forward to that one. That one’s going to be fun.”

    “Americans for Tax Reform President Grover Norquist said the bloc of hard line Republicans who helped stymie the health-care overhaul were guilty of “ripping the lungs out of tax reform.” If they don’t revisit the health-care bill immediately, Norquist said, they will soon realize that “they didn’t shoot and wound health-care reform, they shot and killed permanent tax reform.”

    Uh oh! It looks like Trumpcare had a bunch of tax code accounting changes and tax cuts for the rich in it that were necessary to pull off the kind of tax cut dream that Paul Ryan and Grover Norquist were about to make reality at Donald Trump’s behest:


    While Republicans broadly share the goal of Trump’s promised “big tax cuts,” the president will have to bridge many of the same divides within his own party that sunk the attempted overhaul of the Affordable Care Act. And without savings anticipated from the health-care bill, paying for the “massive” cuts Trump has promised for corporations and middle-class families becomes considerably more complicated.

    Did the collapse of Trumpcare’s savings (cuts to health care services) “shoot and kill permanent tax reform” like Grover Norquist suggest? Well, considering Trumpcare included a bunch of tax cuts for the rich it certainly didn’t help Grover’s crusade.

    We’ll find out relatively soon if the collapse of Trumpcare leads to a collapse of Trumptax. But considering that Trumptax is a steaming pile of fiscal garbage that is only somewhat less politically toxic than Trumpcare – because people won’t die as a consequence as directly from Trumptax’s toxic effects – it may not be all that bad for Trump and the GOP if Trumptax really does suffer a mortal wound. Donald Trump is the biggest beneficiary. It’s a horrible plan. And as with Trumpcare, something that horrible should be done slowly over time instead. It’s just too horrible to do all at once. So if the collapse of Trumpcare collapses Trumptax, that might be ok for Trump and the GOP too.

    And since one of the horrible elements of Trump’s tax plan is that it makes the tax code far less capable of being progressive by reducing the number of tax brackets from seven to three(it’s not quite a flat tax, but it’s getting there), it’s worth noting that one of the changes the Democrats should probably propose in the next health care reform package is a progressive tax to help pay for health care that is so progressive with so many brackets (like one for millionaires, ten millionaires, hundred millionaires, etc) that it has the highest tax rate for ten of billionaires. A tax scaled to our Trump/Koch reality. Because why shouldn’t they pay the most? They damn near run the country. Obamacare’s taxes on the wealthy kicked in around $250,000, but why shouldn’t a billionaire like Trump or the Kochs pay a MUCH higher rate for health care related taxes than someone making. That only makes sense given the incredibly screwed income distribution. And with Trump trying to pass Paul Ryan’s tax plan as his next big policy project that cuts the number of tax brackets from seven to three, why not call for a Bigly tax on billionaires for health care. A very progressive tax that is bigly on billionaires but not so bigly on everyone else. Because that’s how a progressive tax with lots of brackets can work. Since Trump and the rest of the GOP are about to obliterate the government and the job of the Democrats is going to include rebuilding large chunks of the how government operate we’re probably going to need to raise taxes a fair amount to do that rebuilding and it’s going to be important to keep in mind that much of the policy madness that Trump and the GOP almost unleashed on health care and are going to unleash on the rest of the government being done to pay for tax cuts for Trump and the Kochs. So the rebuilding tax cuts should be really, really progressive. Perhaps starting with a really, really progressive health care tax to improve Obamacare.

    Posted by Pterrafractyl | March 25, 2017, 11:44 pm
  9. One of the obvious questions raised by the collapse of the Trump/Ryan Obamacare replacement scheme is when are they going to try again. Paul Ryan declared that Obamacare is going to remain the law of the land “for the foreseeable future” in the immediate wake of the collapsed negotiations, but that didn’t stop House Majority Whip Steve Scalise from declaring a few days ago that the GOP leadership was still working on a repeal and was “closer than ever” to making that happen (despite Paul Ryan’s refusal to give a timeline).

    And as we’re going to see, while we shouldn’t really take seriously the suggestions/threats to the ‘Freedom Caucus’ of GOP holdouts that Trump will end up working with the Democrats if the ‘Freedom Caucus’ won’t come around to Trumpcare 2.0 and while it’s very unclear how the GOP would go about making Trumpcare 2.0 law any time soon anyway, that doesn’t mean we aren’t going to see plenty of future suggestions that Trumpcare 2.0 is just around the corner. Why? Because the threat of Trumpcare 2.0 becoming law soon is absolutely vital for one of the GOP’s top legislative priorities: preventing the Obamacare Medicaid expansions in the 19 states that have yet to do it. Since Obamacare mandates that the federal government cover 90 percent of the of the cost the expansion indefinitely, the argument that the Obamacare was going to repealed, and repealed soon, has long been a central argument for GOP governors to refuse the expansion. So if GOP governors are going to continue refusing the Medicaid expansion, an ongoing threat from the GOP leadership at the federal level is going to be very handy.

    But as we’ll also see below, Government Sam Brownback points us towards another argument against the Medicaid expansion that some states can use that sort of apply even if you assume the Medicaid expansion, with its 90 percent federal cost coverage, will be around forever: thanks to Sam Brownback’s massive tax cuts for the rich which effectively bankrupted the state, that 10 percent that Kansas will still have to pay really is too much for Kansas to afford. Ok, maybe not for real, but that’s the argument Brownback made. Right after vetoing a bill by the GOP-controlled Kansas state legislature to finally accept the Medicaid expansion (while governors normally can accept the expansion on their own, Brownback pushed for a law that required the legislature to approve it first). So if states manage to preemptively bankrupt themselves with massive tax cuts for the rich they’ll still have a quasi-excuse to refuse the expansion. But without that preemptive bankrupting, those 19 states are going to need the threat of an imminent future Obamacare repeal to keep up the ‘no Medicaid expansion’ charade.

    Although it’s worth noting that Brownback did have an addition argument he used to justify the veto: he didn’t want the state to waste money expanding Medicaid for able-bodied adults. First, keep in mind that the able-bodied adults he was referring to are people making 100-138 percent of the Medicaid income cutoff, so they’re most likely already working. Also keep in mind that the prize that the entire GOP was super excited about the Trumpcare 1.0 plan to get states to impose work-requirements for Medicaid recipients. Including traditional Medicaid recipients (those making below the 100 percent Medicaid income cutoff). Not the Medicaid expansion recipients since the plan was going to phase out the expansion entirely.

    And yet here we have Governor Sam Brownback saying the working poor who aren’t poor enough to qualify for traditional Medicaid don’t deserve the Medicaid expansion (of which the Federal government would cover 90 percent of the costs). Why? Because they’re able-bodied. So while we should probably expect plenty of GOP chatter about how Obamacare’s doom is just around the corner so don’t bother expanding Medicaid, keep in mind that for states with governors like Sam Brownback they won’t need that excuse. Just being really, really spiteful towards the working poor will be adequate enough excuse to not expand Medicaid:

    The Los Angeles Times
    Column

    Despite evidence that Medicaid works, Kansas Gov. Sam Brownback vetoes expansion

    By Miachel Hiltzik
    March 31, 2017, 1:15 PM

    Republicans in Congress and statehouses across the country harbor an antipathy to Medicaid that is impossible to explain, except as hostility to the poor families that are its chief beneficiaries.

    Sam Brownback, the GOP governor of Kansas, translated ideology into action on Thursday when he vetoed a bill that would have made Kansas the 32nd state to expand Medicaid under the Affordable Care Act. The measure would have brought health coverage to as many as 180,000 of his state’s residents, with the federal government picking up 95% of the tab this year. Yet in his veto message Brownback called the expansion an “irresponsible” budget-buster.

    That’s not the only flaw in Brownback’s statement. He calls Medicaid a “welfare” program, which isn’t true, and alludes to “restarted negotiations” in Washington, D.C., to repeal the ACA, which already have broken down. He gripes that the expansion bill passed by the Kansas legislature doesn’t cut off funding for Planned Parenthood, which of course is a Republican blind spot that no medical treatment can probably cure. He also took a coded swipe increasingly heard from the GOP by identifying the expansion beneficiaries as the “able-bodied.” More on that in a moment.

    Conservatives love to assert that Medicaid does little to improve the health and well-being of its enrollees. That’s also contradicted by the facts. A study led by Benjamin Sommers of Harvard’s school of public health compared health statistics in Kentucky and Arkansas, which expanded Medicaid, with Texas, which did not. It found that in the expansion states, enrollees were far less likely to skip medications because of cost, spent much less out-of-pocket on care, and had fewer visits to the emergency room. Diabetes screening was improved, as was regular care for chronic conditions. Medicaid enrollees reported improved healthcare quality and described their own health as better.

    Nevertheless, expansion opponents continue to rely on these myths, as well as the argument that Medicaid expansion is somehow a handout to “able-bodied” Americans at the expense of enrollees in traditional Medicaid. Traditional Medicaid targets children and their parents, while the expansion brought in childless adults with household incomes up to 138% of the federal poverty line. Among the subtexts here is that the federal government pays less of the cost of the traditional program than it does of the expansion. The government’s share of the latter will drift down to 90% in 2020 and remain there, unless Congress changes it.

    The notion that able-bodied Americans are getting away with something is what animates the crusade to add work requirements to expansion Medicaid. The flaw here is that Medicaid is not a welfare program for the jobless, but a healthcare program. Its benefits never have been predicated on recipients’ seeking or holding a job, in part because that’s unnecessary: About 80% of all Medicaid recipients already are members of working households, and 60% are working themselves. Of the others, according to a 2016 survey by the Kaiser Family Foundation, all but 3% are ill or disabled, going to school, are family caregivers at home, retired, or unable to find a job. In other words, work requirements appear to be more an ideologically punitive step than a practical one.

    Brownback isn’t the only state-level Republican to continue opposing Medicaid expansion. The North Carolina legislature is still trying to thwart the efforts of the newly elected Democratic governor, Roy Cooper, to implement expansion. They’ve filed a lawsuit asserting that his effort to do so unilaterally would violate a 2013 law that requires legislative approval; Cooper’s position is that the law infringes on his constitutional prerogatives as governor. Coverage for as many as 500,000 low-income residents hangs in the balance.

    The Idaho Senate earlier this month rejected a Democratic plan that would have brought an estimated 78,000 residents under Medicaid’s umbrella, and the idea appears to be dead for the year. Republican Gov. Butch Otter has said that expansion “would mean subordinating our Idaho priorities to the siren song of federal dollars.” In Missouri, Gov. Eric Greitens has blown off a Democratic legislative effort to expand Medicaid. Republican legislators in Virginia remain united against Democratic Gov. Terry McAuliffe’s drive to cover as many as 400,000 Virginians.

    Elsewhere, the collapse of House Republicans’ ACA repeal measure has prompted Republican-dominated statehouses to reconsider their long opposition to Medicaid expansion. That includes Georgia, where Gov. Nathan Deal said he would consider some form of expansion, possibly through a federal waiver that would allow the state to fashion its own version of expanded Medicaid. But that probably won’t happen this year, and opposition remains strong in the legislature.

    Supporters of expansion have reason to find Brownback’s veto message especially irksome. That’s because he contends that the expansion would place a burden on the state budget. “The cost of expanding Medicaid under ObamaCare is irresponsible and unsustainable,” he wrote. The major burden on the Kansas budget comes from Brownback’s own policies, which encompassed huge tax cuts that brought great benefits to the state’s higher-income residents while leading to ruinous budget cuts for state services and schools. Brownback defended the tax cuts as the key to supercharged job growth, but that hasn’t happened. Instead, economic growth in Kansas has fallen behind the country as a whole, its neighbor Missouri, and states that pursued a more rational budget policy such as California, which has left Kansas in the dust.

    Given Brownback’s insistence on the wisdom of his policy despite its obvious failure, no one had a right to expect he would take a smarter line on Medicaid expansion. Nor have the other Republican state leaders who are clinging to their dead-end notion that they should turn up their nose at billions of dollars in federal funds to bring healthcare to hundreds of thousands of their residents. If the failure of the House GOP’s repeal measure doesn’t show them that it’s time to get on board with Medicaid, what will?

    The notion that able-bodied Americans are getting away with something is what animates the crusade to add work requirements to expansion Medicaid. The flaw here is that Medicaid is not a welfare program for the jobless, but a healthcare program. Its benefits never have been predicated on recipients’ seeking or holding a job, in part because that’s unnecessary: About 80% of all Medicaid recipients already are members of working households, and 60% are working themselves. Of the others, according to a 2016 survey by the Kaiser Family Foundation, all but 3% are ill or disabled, going to school, are family caregivers at home, retired, or unable to find a job. In other words, work requirements appear to be more an ideologically punitive step than a practical one.”

    If farcical fears over the Medicaid expansion busting Kansas’s budget aren’t enough, there’s always an ideological desire to kick the poor as being lazy and unworthy of help…even the working poor (not that kicking the non-working poor isn’t scummy). But thanks to Brownback’s decision to make Kansas a giant failed experiment in supply-side economics, the “we can’t afford the 10 percent of the Medicaid expansion” argument is there too:


    Sam Brownback, the GOP governor of Kansas, translated ideology into action on Thursday when he vetoed a bill that would have made Kansas the 32nd state to expand Medicaid under the Affordable Care Act. The measure would have brought health coverage to as many as 180,000 of his state’s residents, with the federal government picking up 95% of the tab this year. Yet in his veto message Brownback called the expansion an “irresponsible” budget-buster.

    Supporters of expansion have reason to find Brownback’s veto message especially irksome. That’s because he contends that the expansion would place a burden on the state budget. “The cost of expanding Medicaid under ObamaCare is irresponsible and unsustainable,” he wrote. The major burden on the Kansas budget comes from Brownback’s own policies, which encompassed huge tax cuts that brought great benefits to the state’s higher-income residents while leading to ruinous budget cuts for state services and schools. Brownback defended the tax cuts as the key to supercharged job growth, but that hasn’t happened. Instead, economic growth in Kansas has fallen behind the country as a whole, its neighbor Missouri, and states that pursued a more rational budget policy such as California, which has left Kansas in the dust.

    Thanks to Brownback’s failed economic experiment Kansas can’t even afford the 10 percent of the Medicaid expansion that the state would have to cover. Sure, Brownback doesn’t make that exact argument, but that’s basically the argument he’s making. And here’s the kicker: even if Brownback approved the Medicaid expansion but then Obamacare gets repealed and the federal government stops coverage 90 percent of the cost (or keeps the expansion but cuts the amount of federal coverage below 90 percent), Brownback can’t claim that as a reason not to approve the expansion at this point because the Medicaid expansion bill passed by Kansas state legislature has a provision that explicitly repeals the expansion if federal burden sharing drops below 90 percent:

    The Kansas City Star

    Brownback’s office criticizes Medicaid expansion as Kansas Senate begins debate

    By Hunter Woodall and Bryan Lowry
    March 27, 2017 12:44 PM

    Gov. Sam Brownback’s office voiced strong opposition to expanding Medicaid Monday as the Kansas Senate began debate on a bill to expand the program three days after a congressional plan that would have barred more states from doing so fell apart.

    “To expand ObamaCare when the program is in a death spiral is not responsible policy,” Melika Willoughby, Brownback’s spokeswoman, said in a statement as the Senate kicked off debate on the bill, which would expand Medicaid to cover roughly 150,000 uninsured Kansans.

    The Affordable Care Act, also known as Obamacare, enabled states to expand Medicaid, which provides health coverage to the disabled and low-income families, to cover people who earn too little to buy insurance through the federal health care exchange but also earn too much to otherwise qualify for Medicaid.

    “Kansas must prioritize the care and service of vulnerable Kansans, addressing their health care needs in a sustainable way, not expanding a failing entitlement program to able-bodied adults,” Willoughby said.

    The Kansas debate takes place three days after U.S. House Speaker Paul Ryan, a Wisconsin Republican, canceled a vote on a controversial bill that would have repealed the Affordable Care Act and barred states from expanding the program beyond March 1 due to a lack of GOP support. The bill, which had been pushed by President Donald Trump, appears to be dead for the time being.

    The uncertainty of the future of Medicaid had been a major talking point used by opponents of expansion. State Sen. Laura Kelly, a Topeka Democrat, said the collapse of the congressional bill “takes away a huge argument against” expansion in Kansas.

    The Kansas House passed expansion by a margin of 81-44 earlier this session. That is still three votes shy of a veto-proof majority.

    Kelly said she doubts the Senate, which is more conservative by comparison, will pass the bill with a veto-proof majority but she does expect the legislation to pass and advance to Gov. Sam Brownback’s desk.

    “It’ll be close, but I’m optimistic that we can get there and the failure of Trumpcare doesn’t hurt,” Kelly said, noting that she still thinks Brownback remains the biggest obstacle to Medicaid expansion in Kansas.

    David Jordan, the executive director of the Alliance for a Healthy Kansas, said that Ryan’s decision to pull the congressional bill “removes any doubt that Medicaid expansion will remain in place.”

    Senate President Susan Wagle, a Wichita Republican, has previously predicted that the Kansas bill will pass the Senate, but she’s also questioned the wisdom of the policy.

    “We’d be entering into a contract with an unreliable partner,” Wagle said, referring to the federal government.

    State Sen. Barbara Bollier, a Mission Hills Republican and retired physician who supports expansion, said that it could be several years before Congress makes significant changes to health care law and “until that happens we need to move forward with what Kansans need.”

    Brownback could have expanded Medicaid on his own to cover an additional 150,000 Kansans, but in 2014 he signed a bill that required legislative approval before the program could expand. Supporters now say that Brownback should weigh that heavily if the Senate passes the bill.

    “If the Legislature passes this, the governor needs to listen,” Bollier said.

    The vote comes amid speculation that Brownback could be tapped for a post in the Trump administration. “It’s become a very difficult time to figure out where Gov. Brownback wants to go both figuratively and literally,” Beatty said.

    Conservative Republicans said Monday morning that they still plan to oppose the bill even after the federal changes failed Friday.

    State Sen. Dennis Pyle, a Hiawatha Republican, acknowledged that the congressional bill’s failure to even get a vote did take an argument away from expansion opponents, but said that he would still vote against expansion because he opposes growing government.

    “I just think it’s more government,” Pyle said. “We have to look at things from that standpoint.”

    Sen. Julia Lynn, an Olathe Republican, said that the time isn’t right to expand Medicaid given the state’s financial problems. The Kansas Department of Health and Environment has previously projected that expanding the program would increase costs for the state.

    “It has nothing to do with not having sympathy and empathy for the people affected,” Lynn said. “This is just a fiduciary question. I don’t think we’re in a position to answer that call right now.”

    A key provision of the Kansas bill meant to address financial concerns would end expansion if federal funding for expansion falls below 90 percent.

    Brownback highlighted concerns that federal funding for expansion would not last in his 2017 State of the State address.

    “Promises of limitless ‘free’ money from Washington to cover expanded populations were never going to be kept, but that reality might now arrive sooner than later. For states who took the expansion path, the reckoning could be severe,” Brownback said in his January speech.

    “A key provision of the Kansas bill meant to address financial concerns would end expansion if federal funding for expansion falls below 90 percent.”

    Even with an escape clause built in, Governor Brownback vetos an expansion backed by his own party. For reasons that are probably best explained by fellow GOPers State Senator Dennis Pyle: even though Pyle admits the failure of Trumpcare 1.0 remove one of the arguments against Medicaid expansion, he’ll still vote against it anyway. Because ‘Big Government’ or something…


    Conservative Republicans said Monday morning that they still plan to oppose the bill even after the federal changes failed Friday.

    State Sen. Dennis Pyle, a Hiawatha Republican, acknowledged that the congressional bill’s failure to even get a vote did take an argument away from expansion opponents, but said that he would still vote against expansion because he opposes growing government.

    “I just think it’s more government,” Pyle said. “We have to look at things from that standpoint.”

    “I just think it’s more government…We have to look at things from that standpoint.”

    That’s the Brownbackian mentality. Poor people, especially the working poor, shouldn’t get government assistance for health care because government is bad. And yet that mentality, which reigned supreme in the Kansas GOP back when Brownback was passing massive tax cuts, reigns supreme no more. Instead, it’s been replaced with an anti-Brownback mentality, a mentality that’s been a proven winner at the ballot box of late. Even within Brownback’s own Kansas GOP:

    The New Yorker

    How Moderates Took Back Kansas

    By Benjamin Wallace-Wells March 31, 2017

    This week, the Kansas Senate voted by a wide margin to expand the state’s Medicaid coverage. A majority of Democrats supported the bill, as might be expected, but so did a majority of Republicans. That the vote was both bipartisan and decisive is a modest but promising sign for the future of public health insurance. But the vote had an added significance because it took place in Kansas. For the six years that Sam Brownback has been Governor, the state has been the scene of what may be the nation’s most extreme experiment in conservatism. The Medicaid vote capped an extraordinary year-long turn against Brownback, in which many of his allies in the legislature were defeated in primary and general elections, and, in the legislative session now coming to a close, his budget and priorities were rejected. The political history of the past quarter century has been one of deepening polarization. The reaction in Kansas suggests that it is still possible for a party to go too far—that there is still a center in American life which may yet hold.

    Brownback, who has a law degree from the University of Kansas, is possessed of a low-key personal style and a high-intensity conservative politics. He has been the defining figure in Kansas political life for two decades, since he won Bob Dole’s Senate seat in the 1996 election. In the mid-aughts, when evangelical conservatives were understood to be the country’s most powerful political bloc, Brownback had seemed a plausible representative for the G.O.P.’s future—a rigid social conservative who found some ways to appeal to moderates. He made increasing American aid to Africa his cause, and cited the example of William Wilberforce, the Christian abolitionist who helped lead the campaign to end the slave trade in the British Parliament, so often that there was a rash of editorials about the rise of “Wilberforce Republicans.” But national politics grew more liberal and optimistic, and after a brief bid for the 2008 Republican Presidential nomination Brownback returned to Kansas, where he won the Governor’s office in 2010. In his first term as Governor, he focussed on a different kind of problem. People were leaving his state for “faraway places that entice our children to abandon the communities that nurtured them,” he wrote, in 2012. “I don’t have oceans and I don’t have mountains,” he pointed out to an interviewer last year. “Just got mountains of grain.”

    Brownback decided to remake Kansas by radically cutting taxes, an experiment to draw new business and people to the state. “We can no longer afford to view our current economic crisis as something distinct and apart from the crisis of family and community decay,” he wrote in an op-ed, in 2012. Brownback persuaded the legislature to adopt budgets that would eventually eliminate taxes on three hundred and thirty thousand small businesses, and cut the state’s top income-tax rate by a third. Brownback chose to opt out of Obamacare’s Medicaid expansion, which denied coverage to more than seventy-five thousand Kansans.

    But the flight out of Kansas did not reverse, and as revenues diminished even basic state functions began to erode. Budget shortfalls were so severe that Kansas turned to raiding its highway-construction fund, which meant that highways were not repaired. Without Medicaid patients, a large rural hospital in Independence had to close. Public schools saw their performance on standardized tests decline, as the state contributed less to their budgets; the Kansas Supreme Court held in two different cases that the state’s underfunding of education was in violation of its own constitution. Brownback became the least popular governor in the country—last September, his approval rating was at twenty-three per cent. Seven separate organizations were founded with the goal of electing moderates, and one of them, the Save Kansas Coalition, persuaded the four living former governors of the state—two Democrats and two Republicans—to denounce Brownback and endorse moderate candidates for legislative offices. Mike Hayden, a former Republican Governor, said that Brownback and his allies “should be ashamed” of what their tax cuts had done to the state. “We virtually don’t have a penny in our pocket,” Hayden said. “The experiment is failing.”

    In the Republican primaries last year, moderates ousted more than a dozen Brownback supporters, most of them explicitly declaring their opposition to the Governor. In the general election, more than a dozen more Brownback Republicans lost to Democrats. When the legislature reconvened, in January, a moderate coalition rejected Brownback’s budget and voted to expand Medicaid. (Yesterday, Brownback vetoed the legislation; the moderates may be a few votes short of overriding him.) At a forum after the election, the executive director of the Kansas Republican Party suggested that there were “some voters who were anti-Brownback and there were others whose main motivation was they didn’t like the status quo.” He conceded, “They had this uncomfortable feeling about Kansas.”

    For all its excess, the Brownback era obeyed a certain logic, which also helped fuel the rural support for the Trump campaign. If you believed that your home was under existential threat, then an extreme politics made sense. In 2015, the Times Magazine published a moving story by Chris Suellentrop, a journalist and Kansas native, whose uncle, a state legislator with a serious and temperate disposition, had joined the Brownback movement. Gene Suellentrop was sensitive to his fellow-Kansans’ plight. Without an aggressive effort like Brownback’s to draw business and attention, he told his nephew, “everyone else will see us as flyover country.” In retrospect, voters’ perceptions of the state’s precariousness and Brownback’s radical politics acted as mutual accelerants. The question now is whether those levers can act in reverse—whether moderate politicians can persuade residents that no social precipice is near, that Kansas is not dying.

    In the Republican primaries last year, moderates ousted more than a dozen Brownback supporters, most of them explicitly declaring their opposition to the Governor. In the general election, more than a dozen more Brownback Republicans lost to Democrats. When the legislature reconvened, in January, a moderate coalition rejected Brownback’s budget and voted to expand Medicaid. (Yesterday, Brownback vetoed the legislation; the moderates may be a few votes short of overriding him.) At a forum after the election, the executive director of the Kansas Republican Party suggested that there were “some voters who were anti-Brownback and there were others whose main motivation was they didn’t like the status quo.” He conceded, “They had this uncomfortable feeling about Kansas.”

    Yep, even the executive director of the Kansas Republican Party admitted that a lot of Kansas voters imply have “this uncomfortable feeling about Kansas” amidst a wave of anti-Brownback sentiment. And why shouldn’t there be an uncomfortable feeling about Kansas amidst a wave of anti-Brownback sentiment? His policies have been such a massive failure that it’s entirely possible that Kansas really can’t afford that 10 percent of the Medicaid expansion costs that it would have to cover. It can’t even afford to fund public education.

    But despite all that, Brownback vetoed the Medicaid expansion laughable citing the state’s budget crisis but also the expectation that Obamacare would be repealed at some point in the future and the Medicaid expansion along with it. And that’s the political dynamic around the Medicaid expansion in just one of the 19 states that has yet to accept it which raises the question of just how much the failure of Trump and Ryan to pass Trumpcare will impact state-level politics in coming years. Sure, it’s possible that Trumpcare 2.0 is just around the corner, but it’s very unclear how likely that is given how unpopular a proposal Trumpcare 1.0 was – 17 percent approval – and given how Trumpcare 2.0 is almost certainly going to have to become even more unpopular to get the required ‘Freedom Caucus’ support.

    But beyond the possible political impact that the Medicaid expansion’s increased viability could have at the state-level now that Trumpcare 1.0 went down in flames, part of what makes the political situation in Kansas so fascinating is that if you look at Trump’s tax cut proposal he’s basically proposing to do the entire US what Sam Brownback did to Kansas and it was so loathed even Kansas’s GOP tried (unsuccessfully, but just barely) to reverse Brownback’s tax cuts just a couple months ago. And what’s the big agenda item that Trump is apparently planning on doing next move past the Great Trumpcare Flail? Those Brownbackian tax cuts. Yes, Trump’s next big move is tax plan is based on a tax plan that was such a spectacular failure in Kansas that the GOP had its own ‘revolt of the moderates’ and almost reversed them with a veto-proof majority less than two months ago:

    Money

    This State’s Drastic Tax Cuts Inspired Trump. Now It Admits the Experiment Has Failed

    Ian Salisbury
    Updated: Feb 22, 2017 10:14 AM ET | Originally published: Feb 21, 2017

    President Donald Trump rode to the White House promising a giant cut in federal taxes. Last week, his job got a bit harder — thanks to some Republican state legislators in Topeka, Kansas.

    Kansas, whose economy ranks 30th among states, may not drive the national economic conversation as frequently California or Texas do. But the state’s dramatic 2012 tax overhaul was heralded as a model for the nation, with a number of provisions later adapted for the national tax plans proposed by President Trump and other Republicans.

    Now, however, the legislature has voted to backtrack — setting the stage for a showdown with Gov. Sam Brownback, who said on Tuesday that he would veto the measure, according to The Wichita Eagle. While the outcome for Kansas is still in doubt, the Republican-led legislature’s reversal makes it trickier for Kansas to serve as a template for national tax reform.

    Five years ago, the Sunflower State embarked on an economic experiment: Sharply cut taxes — especially on business owners — in hopes of driving economic growth. The Brownback-led overhaul consolidated the state’s income-tax brackets from three to two and exempted non-wage small business income from state income tax altogether. The changes were controversial, especially because the legislature declined to offset some lost revenue by curbing tax breaks, raising the prospect of large budget deficits. But Brownback insisted the plan would act as a “shot of adrenaline into the heart of the Kansas economy,” and later touted it as blueprint for the nation.

    On the latter front, he’s largely succeeded. As a number of observers have noted, tax-cut plans put forward by both Donald Trump and House Republicans echo a number of features features from the Kansas plan, including consolidating federal income-tax brackets — the national plans reduce the number from seven to three — and taxing small business income at sharply lower rates.

    And like Brownback, Trump has put spending cuts, which could help balance the budget in face of lost revenue, on the back burner — preferring to focus on the more hopeful notion that tax cuts will “unleash America’s economy, creating millions of new jobs and boosting economic growth.”

    Unfortunately, that part of the plan — what Brownback called an economic “shot of adrenaline ” — hasn’t materialized. The state’s budget deficit ballooned to $350 million. And the small-business provision also created new ways for residents to avoid taxes, meaning more lost tax revenue and compliance headaches for the state. University of Kansas basketball coach Bill Self, the state’s highest-paid state employee, created a local media frenzy when it came out that he had evaded state income tax on the vast majority of his income by having the state direct $2.7 million of his compensation to a small business he created.

    Last week, the Kansas state legislature cried uncle. Both the state house and senate passed bills on Friday that would restore the state’s third income tax bracket and eliminate the special income-tax exemption, which has been used by more than 300,000 business owners, according to The Wichita Eagle. If Brownback makes good on his threat to veto the law, the legislature could try to override him, or send him the same bill a second time, in an effort to heighten political pressure on the governor, the paper reported.

    Kansas’ woes — and the recent reversal — are likely to deliver new artillery to liberals eager to derail Trump’s tax plans. Some have already been holding the state up as an example of tax-cut overreach.

    “Kansas, whose economy ranks 30th among states, may not drive the national economic conversation as frequently California or Texas do. But the state’s dramatic 2012 tax overhaul was heralded as a model for the nation, with a number of provisions later adapted for the national tax plans proposed by President Trump and other Republicans.”

    Kansas really was turned into a GOP fever-dream not that long ago. And now it’s a nightmare. But still the GOP fever-dream. It’s one of the big problems with the contemporary GOP. The nightmare is the fever dream:


    Five years ago, the Sunflower State embarked on an economic experiment: Sharply cut taxes — especially on business owners — in hopes of driving economic growth. The Brownback-led overhaul consolidated the state’s income-tax brackets from three to two and exempted non-wage small business income from state income tax altogether. The changes were controversial, especially because the legislature declined to offset some lost revenue by curbing tax breaks, raising the prospect of large budget deficits. But Brownback insisted the plan would act as a “shot of adrenaline into the heart of the Kansas economy,” and later touted it as blueprint for the nation.

    On the latter front, he’s largely succeeded. As a number of observers have noted, tax-cut plans put forward by both Donald Trump and House Republicans echo a number of features features from the Kansas plan, including consolidating federal income-tax brackets — the national plans reduce the number from seven to three — and taxing small business income at sharply lower rates.

    And like Brownback, Trump has put spending cuts, which could help balance the budget in face of lost revenue, on the back burner — preferring to focus on the more hopeful notion that tax cuts will “unleash America’s economy, creating millions of new jobs and boosting economic growth.”

    Unfortunately, that part of the plan — what Brownback called an economic “shot of adrenaline ” — hasn’t materialized. The state’s budget deficit ballooned to $350 million. And the small-business provision also created new ways for residents to avoid taxes, meaning more lost tax revenue and compliance headaches for the state. University of Kansas basketball coach Bill Self, the state’s highest-paid state employee, created a local media frenzy when it came out that he had evaded state income tax on the vast majority of his income by having the state direct $2.7 million of his compensation to a small business he created.

    Not only did the GOP’s dream experiment not lead to the economic “shot of adrenaline,” it created a state-wide emergency where basic services aren’t being maintained. And the deficits are up and everything is a giant disaster. Because of course because that’s what the GOP fever dream always ends with. Take a look at the aftermath of Bobby Jindal’s recent experiment in GOP fever dreaming in Louisiana. It’s a recipe for disaster and also the template for Trump’s overall tax and cut-everything policy. And also a recipe to get almost everyone to Trump after he trashes the government to pay for his tax cuts. At least, it’s hard to see how his tax cuts are going to win him many fans:

    Money

    Only 14% of Americans Want to Give the Wealthy a Tax Cut

    Ian Salisbury
    Mar 30, 2017

    A new study from the University of Maryland’s Program for Public Consultation suggests that the Republican tax plans, which call for cutting tax rates on the wealthy, is seriously out of whack with public opinion.

    The tax overhaul plan put forward last fall by Trump, as well as a separate one designed by House Speaker Paul Ryan, would both cut taxes across the board, but would deliver the biggest savings by far to the wealthy. In fact, the Trump plan gives roughly half the savings to the top 1%, according to the nonpartisan Tax Policy Center.

    By contrast, a majority of Americans — and of Republicans — would prefer to see taxes raised on top earners, according to new data released by the Program for Public Consultation on Americans’ budget preferences. The Maryland researchers, who have conducted similar studies going back to the Clinton administration, quizzed 1,800 registered voters on whether they would raise or lower taxes for a range different income cohorts; they also gave respondents information about current tax rates and the possible effects on the budget.

    A majority of voters actually favored raising income taxes, at least slightly, on those earning $100,000 to $200,000. And for those earning $200,000 to $500,000, 64% of the total group — and 51% of Republicans — favored a tax hike, while 20% favored no change and 14% wanted a tax cut. (The rest didn’t know or didn’t answer the question.)

    Other GOP tax proposals were similarly unpopular. Researchers found that about two-thirds of voters and more than 60% of Republicans opposed a Trump plan to created a special 15% rate for business owners, for instance. And only 22% of voters and 36% of Republicans favored eliminating the estate tax — an element of both the Trump and Ryan plans.

    In other words, while voters may like President Trump, they are wary of tax changes that appear tilted toward the rich — much as they were wary of the GOP’s health plan, once it became clear millions could lose their insurance. That could again make it difficult for Trump and Ryan to shepherd their plans into law, says PPC Director Steven Kull. “A lot of members of Congress won’t to go on record supporting tax cuts for the rich.”

    “The tax overhaul plan put forward last fall by Trump, as well as a separate one designed by House Speaker Paul Ryan, would both cut taxes across the board, but would deliver the biggest savings by far to the wealthy. In fact, the Trump plan gives roughly half the savings to the top 1%, according to the nonpartisan Tax Policy Center.”

    Roughly half of the savings in Trump’s tax plan is for the top 1 percent. And the public prefers the exact opposite, including a majority of Republicans:


    A majority of voters actually favored raising income taxes, at least slightly, on those earning $100,000 to $200,000. And for those earning $200,000 to $500,000, 64% of the total group — and 51% of Republicans — favored a tax hike, while 20% favored no change and 14% wanted a tax cut. (The rest didn’t know or didn’t answer the question.)

    Other GOP tax proposals were similarly unpopular. Researchers found that about two-thirds of voters and more than 60% of Republicans opposed a Trump plan to created a special 15% rate for business owners, for instance. And only 22% of voters and 36% of Republicans favored eliminating the estate tax — an element of both the Trump and Ryan plans.

    Trump’s big tax cut bonanza that’s supposed to help him rebound from the collapse of Trumpcare is set to be another dud with the public at large and that’s before people actually experience it. Just imagine what it’s going to be like after Trump ‘Brownbacks’ the US. The consequences will be way worse than they were for Kansas because at least Brownback’s tax cuts were taking place within the context of the relatively stable Obama years. Trumptax is national shock therapy which makes it far, far riskier than anything Brownback could do. Brownback could only risk Kansas and have the rest of the US to fall back on. Trumptax could sink the ship. Including sinking things like Medicaid, starting with the expansion and slowing killing the rest off under block grants and perpetual cuts. And then eventually sink Medicare and Social Security.

    That’s all part of why it’s going to be critical during the upcoming tax cut debates to keep in mind that he tax cut debate is actually deeply intertwined with the previous Trumpcare/Medicaid negotiation that just collapsed and also deeply intertwined with the Medicaid expansion debates in the 19 states that haven’t accepted it yet because that Trump tax cut is a plan to turn the US into Brownbackistan and Brownbackistan doesn’t get Medicaid expansions. Or anything else nice. We know what Paul Ryan’s fever dream looks like. Brownbackistan looks like what Sam Brownback did to Kansas. And that GOP fever dream nightmare that Sam Brownback just unleashed upon Kansas over the last few years is about to be unleashed nationally because Trump’s tax cuts require it and his budget does it. Deep long-term cuts to almost everything including all the unpopular cuts to Medicaid and an end/freeze to the Medicaid expansion in Trumpcare. That’s what you get in Brownbackistan as Sam Brownback made clear with his recent veto of the Medicaid expansion and clear throughout his six year run. We know how this ends.

    And we also know it ends with a very unhappy electorate. And that’s part of what makes the Medicaid expansion debate extra fascinating when you view it in the frame of the Brownbackization of America: if Trump’s precipitous drop in popularity and general out of control behavior doesn’t end he just might become as unpopular as Sam Brownback. Which is pretty damn unpopular (23 percent approval in September), although not as unpopular as Trumpcare or tax cuts for the rich. Just imagine how unpopular Trump will be if he ‘Brownbacks’ the nation with massive tax cuts for the rich and massive cuts to everything else. Paul Ryan’s dream. And Sam Brownback’s dismal reality. Trump’s voters didn’t vote for that by and large. So could the GOP ‘revolt of the moderates’ happening to Sam Brownback right now just might start happening in the 19 states where the Medicaid expansion hasn’t happened yet if the rest of Trump’s agenda comes to pass? Because that’s exactly that kind of environment that could make Trump and the GOP in general deeply unpopular as the grim reality of their agenda sets in at the same time they slash taxes for the rich. And don’t forget the infrastructure privatization agenda. All at once. That’s the kind of national shock therapy that’s going to prompt some sort of general negative response in the public, so it will be interesting to see if the fight for the Medicaid expansion in the remaining 19 states as Trumpcare 2.0 and the presumed end of the Medicaid expansion looms ends up fueling the fight to both stop Trumpcare and save the Medicaid expansion and Medicaid in general.

    In other words, while the failure to pass Trumpcare complicated the upcoming Trumptax negotiations don’t forget that the actual passage of Trumptax would probably make the future passage of Trumpcare 2.0 much more difficult. Because it would be clear at that point that things like the end of the Medicaid expansion in Trumpcare 2.0 are happening to pay for those tax cuts for the rich. And that makes it all extra dickish.

    And in Brownbackistan we’re seeing what happens to Sam Brownback after he was extra dickish. There’s almost a veto-proof bipartisan majority ready to overturn his agenda. The Brownback template, which is really the Paul Ryan/GOP dream template, is so bad so fast so completely that it creates the seeds of its own political demise almost immediately. So that’s at least one positive aspect of Brownbackistan template that Trump is basing his agenda on. One positive aspect of what is still a horrible situation.

    So if the GOP is going to dangle the threat of the GOP eventually cutting the Medicaid expansion in their eventual Trumpcare 2.0 attempt as a reason for states not to accept the Medicaid expansion while it’s still available we should be clear on the total package the GOP offering with that Medicaid expansion refusal. It’s not just Brownbackistan-style kicking the poor. It’s the Brownbackistan-style tax cuts too. It’s Sam Brownback’s vision for Kansas applied to America that Trump and the GOP are pushing. And especially in those 19 state-level Medicaid expansion debates. It’s a critical new political context for the Medicaid expansion and health care debate in general now that Trump is in the White House and the GOP has total control. Trumplandia is Brownbackistan Bigly. And refusing to expand Medicaid is a key part of turning us into the United Brownbackistans of America. It’s all part of the same awful package. And an extremely unpopular package too so there’s not actually a good excuse for making this agenda a reality. And the best solution is the solution Americans have been clamoring for forever. Bipartisanship. Specifically a bipartisan Brownbackistan-style: a veto-proof bipartisan super-majority to stop the Trump agenda. Hopefully that will become a possible form of bipartisan healing now that it’s increasingly clear that Trump’s agenda is less popular than Sam Brownback.

    Posted by Pterrafractyl | April 2, 2017, 2:27 am
  10. The Daily Signal, a publication of the far-right Heritage Foundation, has glowing piece on a new proposed ‘reform’ for Social Security Disability Insurance (SSDI) moving through the House and Senate. It’s about a GOP proposal to change the SSDI rules in a way that encourages people to heal from their disability and go back to work. And as the Heritage Foundation would like you to believe it’s totally not about kicking people off disability once they’re not ‘disabled enough’. No, it’s about being positive and encouraging healing and a return to the rewards of work:

    The Daily Signal

    A Pathway to Work for Social Security Disability Beneficiaries

    Romina Boccia
    March 27, 2017

    Social Security Disability Insurance beneficiaries who recover should be on a pathway to return fully to the workforce, as soon as they are able. A new bill in Congress would pave the way for them to do so.

    This month, Rep. French Hill, R-Ark., introduced the Social Security Disability Insurance Return to Work Act of 2017 (H.R.1540) in the House of Representatives. Sens. Tom Cotton, R-Ark.; Mike Lee, R-Utah; and Marco Rubio, R-Fla.; introduced the companion bill (S. 654) in the Senate. The previous Congress first introduced the bill.

    The approach is compassionate and straightforward. Individuals who qualify for disability insurance with temporary conditions that are expected to improve with time and treatment would receive a needs-based benefit for a limited time, coupled with incentives to help them smoothly transition back to the labor force.

    Such a time-limited benefit is long overdue. The current permanent benefit structure serves neither individuals with disabilities nor taxpayers well. By encouraging individuals to stay on the disability rolls longer than necessary, the benefit fosters dependence on government.
    Previous attempts to encourage individuals to return to the labor force, like the Ticket to Work program, have been largely ineffective. A new approach is needed, and the Return to Work Act moves in the right direction.

    Broader reforms are also necessary to address the problems facing the program. This includes improving the Social Security Disability Insurance application and adjudication processes for better consistency and timeliness of benefit decision, and shifting from a sole focus on benefit provision to one that seriously considers individual abilities and potential accommodations that can help to keep workers in their jobs.

    Greater availability of short-term, targeted benefits from the private sector could help both workers with disabilities and taxpayers.

    The Social Security Disability Insurance Return to Work Act sets the firm expectation that individuals with temporary or marginal conditions who are expected to, or likely to, improve will return to work. It also allows them to re-enter the workforce before their benefits expire, enabling a smooth transition out of the program.

    “The Social Security Disability Insurance Return to Work Act sets the firm expectation that individuals with temporary or marginal conditions who are expected to, or likely to, improve will return to work. It also allows them to re-enter the workforce before their benefits expire, enabling a smooth transition out of the program.”

    The GOP wants to set up a “firm expectation” that people with “temporary” disabilities will heal enough to return to work within a predetermined amount of time. So that’s one additional incentive to get health care insurance: you’re going to need to heal fast if you ever need to go on disability. Or at least not heal too slow. So hopefully anxiety about this won’t harm your healing. It’s supposed to be a positive incentive:


    The approach is compassionate and straightforward. Individuals who qualify for disability insurance with temporary conditions that are expected to improve with time and treatment would receive a needs-based benefit for a limited time, coupled with incentives to help them smoothly transition back to the labor force.

    Planning on being disabled in the future? Well, get ready for needs-based SSDI benefits, for a limited time, if you’re suddenly disabled by an injury or condition that *might* be something you can rebound from. If you never heal you’ll presumably be able to prove it over and over and keep your benefits. Hopefully. So as long as there’s no hope of recovery you’ll have nothing to worry about in terms of keeping your SSDI benefits. It’s a complicated incentive structure:

    The Orlando Political Observer

    Marco Rubio bill pushes healthy Social Security Disability Recipients to get back to work

    March 15, 2017 By Frank Torres

    On Wednesday, Florida Senator Marco Rubio introduced legislation that would encourage Social Security recipients who have recovered form an illness or injury to get back to work. Rubio along with Senators Tom Cotton from Arkansas and Mike Lee from Utah says it’s a measure to save Social Security from Bankruptcy.

    The Return to Work Act of 2017 would requires disability determiners to classify new beneficiaries based on whether medical improvement is expected. Beneficiaries who are expected to recover would be given a timeline and additional resources to obtain employment while on Disability. Those same beneficiaries would also be able to re-apply if they have not recovered. Beneficiaries who are not expected to recover will have no timeline for program participation.

    “Social Security Disability Insurance is supposed to be a safety net for people with disabilities,” said Rubio. “However, rampant abuse, lax enforcement and insufficient accountability have enabled this program to grow unchecked and prevented many people from going back to work.”

    “We can’t keep stealing from the Social Security Trust Fund to bail out the Social Security Disability Insurance system,” said Lee. “We need real reforms that will both make it easier for recovering americans to return to work and make the program solvent.”

    “The Return to Work Act of 2017 would requires disability determiners to classify new beneficiaries based on whether medical improvement is expected. Beneficiaries who are expected to recover would be given a timeline and additional resources to obtain employment while on Disability. Those same beneficiaries would also be able to re-apply if they have not recovered. Beneficiaries who are not expected to recover will have no timeline for program participation.

    As we can see, if you’re going to fake being disabled in the future, you’re going to have to fake a disability where recovery isn’t expected. What a money-saving incentive.

    And, of course, for the vast majority of people on SSDI who really are disabled enough to not be able to find work and who *might* recover will have to keep proving that they’re still disabled enough to not be able to work or risk getting auto-kicked off according to some sort of generic [insert-disability-here] time-limit algorithm. At which point they had better find a job. Especially if there’s more recovering to do. How compassionate.

    Also note that setting SSDI time-limits within which someone is “expected” to recover is probably going to require hiring a lot more people working for the Social Security system involved with the assessment of whether or not someone is disabled. At least a lot more people will have to be required if a massive backlog of cases isn’t a problem. And who knows whether or not a massive backlog of SSDI cases to processed will be deemed acceptable given the chronic backlog of SSDI cases to be processed that is caused, in part, by a shortage of staff but also how stringent the criteria for qualifying for SSDI already is:

    The Kansas City Star

    Social Security failing to keep up with disabled population in Kansas and beyond

    Posted March 27, 2017 10:55 am
    By Eric Adler

    KANSAS CITY, Mo. — The tumors and cysts that blinded Barbara Sales in her left eye and, years ago, lodged in her brain have robbed her of far more than her sight and memory.

    “I have photos of her face all bruised up because she got up in the middle of the night, had a seizure and fell into the dresser,” said her daughter Alicia Kroll, 25, who is a surgical nurse.

    Three seizures forced Sales, 53, a former Lenexa resident, to lose a job she’d hoped to get full time. Her maladies and medications, treatments for a rare genetic disease, have made her short-term memory so faulty that she once drove 100 miles in the wrong direction before realizing her mistake.

    “She’s not normal, that’s all there is to it,” said her uncle, Charles McVey, 81, of Raytown, Mo.

    Despite these difficulties, one question has for four years consumed the thoughts of this college-educated woman who worked full time for 25 years while raising her daughter as a divorced, single mom.

    Why is it taking the government so long to decide whether she is eligible to receive Social Security disability?

    “This is not right,” Sales said, coming to tears. “This is not what we pay into Social Security for. This is not the American dream. This is certainly not what I went to college for.”

    Sales’ situation goes to the heart of problems that have plagued the Social Security Administration for years: Underfunded and overwhelmed, it operates with a workforce that has remained all but flat for more than 20 years in the face of a rising population and an explosion of disability applications.

    “The situation is really bad for the claimants right now. . The bottom line is inadequate funding of Social Security,” said Lisa Ekman, director of governmental affairs for the National Organization of Social Security Claimants’ Representatives. It is an association of attorneys representing people with disabilities.

    “Eight thousand people died during fiscal year 2016 who were waiting for a (disability) hearing,” Ekman said. “That’s 23 people a day, almost one an hour to get a hearing. . We see people who lose their homes. We see people who are evicted. We see people who can’t afford to pay for medications, who become very debilitated while they wait. It creates people who are homeless.”

    Some good news came this month when union officials representing federal workers were told that despite a federal hiring freeze, the Social Security Administration would be allowed to hire 100 extra workers to authorize benefits.

    “One hundred new hires nationally won’t make a huge dent, but it is certainly better than nothing,” said Benji King, union steward for the American Federation of Government Employees Local 1336, which is based in Kansas City and represents some 2,200 employees in four states. “It is a recognition that SSA is understaffed and needs people.”

    Numbers, experts say, tell part of the story.

    The Kansas City Star reports that Social Security operates two prime disability programs. One is SSI, or Supplemental Security Income. It is a “means tested” program, meaning it is based on income. It currently pays a monthly benefit averaging about $542 to some 8.3 million recipients who are blind, disabled, adults or minors and who have little to no income.

    The somewhat larger program is SSDI, or Social Security Disability Insurance. It pays a monthly benefit to individuals (and certain family members) who were substantially employed — and, as such, have paid into the federal disability insurance program — and who meet a strict standard of disability.

    Some 10.5 million people currently draw a monthly SSDI check averaging about $1,030.

    The problem: An overwhelming number of applications for disability — about 2.3 million in 2016, up from 1.7 million in 2002 but down from a peak in 2010 — flow into a system in which 77 percent of initial claims have, over the last decade, been denied. Moreover, the backlog of decisions on first-time claims is massive.

    When fiscal 2017 began in October, the number of first-time claims that had not been processed from the year before stood at more than 560,000, according to the Office of the Inspector General’s semi-annual report to Congress.

    The backlog of cases being reconsidered, waiting to be heard by an administrative law judge, ballooned from 700,000 in 2010 to more than 1.1 million cases at the end of June 2016, the report showed.

    In that same period, the average processing time it takes to see and get a decision from a judge has stretched from 426 days to more than 530 days. (At 513 days, Kansas City is the best among the nine offices in its region, which include Topeka; Omaha, Neb.; and West Des Moines, Iowa. St. Louis, at 643 days, is the worst.)

    Even then, for those who persist, the odds of being approved by a judge are worse than a coin toss — 44 percent nationally. In Kansas, it’s 40 percent. In Missouri, 38 percent.

    “It’s always been the case that’s it not easy to get benefits,” said Edward Berkowitz, a professor of history who writes on social welfare policy at George Washington University.

    The reasons are many, he said, having to do with politics and personalities, policies as well as perceptions, including one on fraud that, fair or not, is long lasting.

    “People have always complained,” Berkowitz said, “about how hard it is for worthy people to get benefits, but how easy it seems for malingerers to get benefits.”

    The highest obstacle to receiving benefits, experts said, is meeting Social Security’s strict standard of disability.

    “The definition of disability under Social Security is different from other programs,” Jewell Colbert, the administration’s regional communications director in Kansas City, said by email. “.While some programs give money to people with partial disability or short-term disability, Social Security does not.”

    For Social Security disability, he said, people must be unable to work because of a medical condition that’s expected to last at least one year or result in death.

    In determining eligibility, Colbert said, Social Security looks at multiple factors including the nature of the disability or disease and one’s medical history, age, education and work experience. Does the person have the capacity to work at another job?

    If someone is working now and making more than about $1,130 per month, Social Security generally does not consider him or her disabled.

    Social Security also keeps a list of “disabling ailments.” Those with an ailment not on the list will have a harder time winning approval.

    It’s a process, Berkowitz said, that is highly subjective. A manual laborer with an eighth-grade education and a serious muscular back injury, he said, is more likely to be approved than a worker, say, with an advanced degree who could be trained to do something else.

    Younger workers, he said, are more likely to be turned down than workers ages 50 and up. Just as the Americans with Disabilities Act has transformed workplaces, it’s also transformed attitudes about what individuals with disabilities can achieve.

    “Who is to say that someone with an impairment is disabled?” Berkowitz said. “The classic example is someone gets infantile paralysis and (as Franklin Roosevelt did) becomes president of the United States. Someone else gets infantile paralysis and is out for life.”

    Barbara Sales didn’t think getting benefits would be easy. She just didn’t think it would be wrenching.

    “The whole process stinks,” she said recently. “And I’m putting it mildly.”

    The way Sales sees it, she paid into a system for more than 25 years — longer if she counts high school.

    “I worked from the time I was 15,” she said.

    A graduate with a bachelor of science degree from Central Missouri State University in Warrensburg (now the University of Central Missouri), Sales went on to a series of mostly office or sales jobs.

    They included stints at Purdue University in West Lafayette, Ind., and at Alcoa, the aluminum manufacturer, also in Indiana. Back in the Kansas City area, she worked from 2003 to 2010 for two for-profit colleges, National American University and Grantham University.

    “Growing up, my mom was really independent,” said Sales’ daughter, who now lives in Houston. “She worked in business. She had an office job 9 to 5. She paid all the bills on her own and everything.”

    Sales said that if she could work, she would. But a rare hereditary disease has complicated matters.

    Sales suffers von Hippel-Lindau syndrome, a genetic disorder that affects about 8,000 people in the United States. It is not included on Social Security’s list of ailments.

    Its primary hallmark: tumors and cysts in tissues and organ systems all over the body. Most of the time, they are not cancerous, but occasionally they can be, especially in the kidneys. Even when they’re not cancerous, the masses can wreak havoc, as they have with Sales.

    In the brain and spinal cord, they can cause headaches, vomiting, loss of muscle control, persistent dizziness and seizures. In the eyes (Sales estimates she’s had more than two dozen eye surgeries) they can cause blindness.

    “Some people will have their eyes removed,” said Hadley Wyre, a urologist at the University of Kansas Health System who works with von Hippel patients, having operated on them for repeated cases of kidney cysts, tumors and cancers.

    The masses can grow inside the pancreas, in the genital tract and in adrenal glands, where they can prompt surges in blood pressure, heart attacks or strokes.

    That the disease can be a killer is undeniable. For Sales, the knowledge is intimate.

    Complications from von Hippel killed her father, Robert Siercks, when he was only 41.

    The disease killed her sister, Vicky Siercks Prince, when she was 42.

    It killed her aunt Rae Donna (Siercks) McVey — her uncle Charles McVey’s late wife — at age 59 in 1998. And it also killed her first cousin, Charles McVey’s daughter Rhonda McVey, in 2001, when she was only 41.

    Barbara Sales’ daughter has also been diagnosed as having it.

    After 2010, Sales started a temporary job that she hoped might turn permanent. But then she suffered three seizures, including one while shopping at Wal-Mart.

    “I didn’t get hired,” she said.

    Her salary and savings dried up. She lost her Lenexa house to foreclosure and went on Medicaid and food stamps. Family members moved her to a cabin in Calhoun, Mo., where a friend pays her to occasionally pick up around his house.

    Sales said she used to bring in about $43,000 a year. No more.

    “I live on $200 or $300 a month,” she said.

    Sales’ initial application for disability was passed over in 2012 and denied by a judge in 2013. Some two years passed before she tried again and, again, she was denied by a judge in July 2015. The next time she appealed, she tried with an attorney, who backed out of her case in November 2016 just before her scheduled hearing.

    The hearing was reset. In late April, with a new attorney, she is set to go before a judge in Springfield.

    Sales is hoping for the best. Her attorney gets paid (25 percent of the amount she is awarded, up to $6,000) only if she wins. Winning could mean receiving a check that includes months or even years of disability payments dating as far back as the first time she applied.

    Between now and then, Sales has another worry: Doctors recently found a fast-growing cyst on her right kidney with cells that may be cancerous. Her surgery is scheduled at University of Kansas Hospital on March 24.

    “I just have never wanted to be seen as a pity party,” Sales said. “I never thought I’d be getting food stamps or Medicaid. That’s why I put myself through college.”

    Her ankles are so swollen with fluid she has a hard time standing and walking.

    Her short-term memory has withered. Her uncle thinks there are signs now of some early dementia.

    Sales doesn’t know what will happen at her disability hearing. Her uncle is convinced that his niece not only is incapable of working, but also, given her problems with memory and seizures, that no one would hire her.

    “I wouldn’t hire her,” McVey said.

    But if she is ultimately told by a judge that she’s not too disabled to work, Sales said her response will be direct.

    “Doing what?” she said. “Tell me. What do you think I can do?”

    “The problem: An overwhelming number of applications for disability — about 2.3 million in 2016, up from 1.7 million in 2002 but down from a peak in 2010 — flow into a system in which 77 percent of initial claims have, over the last decade, been denied. Moreover, the backlog of decisions on first-time claims is massive.”

    77 percent of initial claims for SSDI have been denied over the last decade and there’s a massive backlog and people with a genetic disorder like Barbara Sales that killed her mother and sister just might fall in that 77 percent group of denied people. And now a bill moving through Congress will add the category of built-in preset time-limits for classes of disabilities that will have to be enforced with the threat of kicking people off who don’t seem disabled enough. Which means a lot more claims to be assessed by the SSDI people so hopefully this proposed scheme involves hiring a lot more SSDI employees, although since the underlying goal appears to be reducing claims at all costs a mega backlog of claims doesn’t seem like the kind of the backers of this bill would mind. The backlog is an austerity bonus if that’s how you roll.

    So since means testing the poor and disabled is increasingly a major theme in American politics, it’s probably worth noting that this is a theme that centers around the meta-question of “how many innocent men would you send to prison to ensure a guilty one doesn’t get away,” just applied to everything else. And the answer appears to be “many, many innocent men.” based on American politics. It’s kind of the opposite of a ‘graceful’ society if you think of grace as being an attitude of routing benefit of the doubt and forgiveness.

    So be sure to move with grace…so you don’t slip and fall. And don’t do anything else that might get you injured. Mild injuries are ok. But don’t have any serious injuries unless they’re REALLY serious and you are super disabled and it’s very obvious you’re not recovering, in which case you’ll get like $1000/month. Maybe. For a very limited period of time.

    Posted by Pterrafractyl | April 3, 2017, 10:59 pm
  11. With the March US jobs report scheduled to be released this week, here’s something that should make the upcoming US jobs report extra interesting: Donald Trump reversed his sudden embrace of the official unemployment rate after spending years suggesting it was a fake statistic during a town hall with CEOs where Trump instead reiterated his old claims that every single American adult not currently employed is in reality “unemployed”, including students and retirees. He also raised that number of unemployed from his previous claim of 94 million to a whole 100 million American adults. And then he added a new twist to his alt-understanding of how the unemployment rate is calculated by suggesting that once people stop looking for work they’re now considered “employed” by the government. And, yes, people who give up looking for work aren’t actually considered “employed” – they’re considered “out of the labor force” – but that’s apparently how it works in Donald Trump’s mind.

    So we’re back to Trump declaring that every single American adult should be factored into the unemployment rate regardless of whether they’re retired, a student, or not looking for work for whatever reason which, again, should make future jobs reports extra interesting:

    Politifact

    Donald Trump flubs how unemployment is calculated

    By Louis Jacobson on Tuesday, April 4th, 2017 at 2:59 p.m.

    At a town hall with CEOs, President Donald Trump revived some of his longstanding concerns about how the nation’s unemployment statistics are calculated.

    Appearing to reference the number of Americans out of work, Trump said, “We have 100 million people if you look. You know, the real number’s not 4.6 percent (for the unemployment rate). They told me I had 4.6 percent last month. I’m doing great. I said yeah, but what about the hundred million people? A lot of those people came out and voted for me. I call them the forgotten man, the forgotten woman. But a lot of those people — a good percentage of them would like to have jobs and they don’t. You know, one of the statistics that, to me, is just ridiculous — so, the 4.6 sounds good. But when you look for a job, you can’t find it and you give up. You are now considered statistically employed. But I don’t consider those people employed.

    Is Trump right that “when you look for a job, you can’t find it and you give up. You are now considered statistically employed”? Not at all.

    Trump seems to suggest that government statisticians are performing something like medieval alchemy, turning lead (unemployment) into gold (employment) with the flick of a wand.

    That’s not the case. Broadly speaking, if someone is already considered unemployed and they give up looking for a job, they would be counted as “not in the labor force” — not as “employed.”

    In fact, there is an official statistical category for a person in this situation. If someone wants and looks for a job but then gives up, they are called “discouraged workers.” Specifically, these people “want and are available for a job and who have looked for work sometime in the past 12 months” but are “not currently looking because they believe there are no jobs available or there are none for which they would qualify.”

    The problem for Trump is that “discouraged workers” are relatively rare — in the most recent month, there were 522,000 of them. That’s just one-fourteenth the number of unemployed workers, and only about one-half of 1 percent of the “out of work” Americans Trump seems to have been referring to.

    Speaking of which, as we have noted previously, Trump’s 100-million figure of “out of work” Americans is highly misleading.

    This number — in reality, a bit lower at 94 million — includes any American age 16 and over who isn’t institutionalized and who isn’t either working or actively looking for work. This means the figure includes retirees, high school students over 16, undergraduate and graduate students, stay-at-home parents, disabled people, adults who are engaged in full-time education or training, and even trust-fund kids and those wealthy enough to be living off investments.

    In other words, the figure includes a lot of people who wouldn’t be expected to be working, or who are engaged in other pursuits. We have previously estimated that no more than a quarter of the 94 million people not in the labor market are either out of work, looking for a job, or eager to get back in the job hunt if labor-market conditions were to improve.

    “Appearing to reference the number of Americans out of work, Trump said, “We have 100 million people if you look. You know, the real number’s not 4.6 percent (for the unemployment rate). They told me I had 4.6 percent last month. I’m doing great. I said yeah, but what about the hundred million people? A lot of those people came out and voted for me. I call them the forgotten man, the forgotten woman. But a lot of those people — a good percentage of them would like to have jobs and they don’t. You know, one of the statistics that, to me, is just ridiculous — so, the 4.6 sounds good. But when you look for a job, you can’t find it and you give up. You are now considered statistically employed. But I don’t consider those people employed.””

    Yes, 100 million Americans are unemployed according to Trump. That stat is back. So while we’ll eventually find out what the implications are of Trump’s enduring insistence that the unemployment rate is somewhere around 42 percent (and closer to 45 percent if we go with the new 100 million figure), one thing is pretty clear: The message Trump had his spokesman make right after the March jobs report about how how the that 4.7 percent numbers was “very real now ” and not phony like all the past unemployment reports was phony. Well, ok, the message itself was true in the sense that the March jobs report was indeed “very real now” (mostly). But the message Trump wanted to send that he suddenly accepted the unemployment rate calculated by the Bureau of Labor Statistics was phony. Unless he suddenly changed his opinion on how the unemployment rate is calculated after the jobs report and later changed it back. Or maybe he doesn’t actually have a real view on the matter in which case we can’t say he changed his view because he doesn’t possess one. That seems possible. And, of course, there’s always ‘option D’.

    Posted by Pterrafractyl | April 5, 2017, 7:32 pm
  12. Donald Trump appears to have drawn a line in the sand in the upcoming budget negotiations. A nasty line. A line that appears to hold the premium subsidies Obamacare provides to low income people hostage unless the Democrats agree to fund Trump’s wall with Mexico. To reiterate, Trump is reportedly considering holding Obamacare subsidies hostage unless the Democrats agree to fund his wall in the upcoming budget negotiations. And if this isn’t resolved, the government might shutdown because the the budget negotiations are coinciding with the left-over unresolved budget negotiations from last year. So, one more time, Donald Trump is apparently seriously considering holding Obamacare subsidies that people need to pay their health insurance premiums hostage unless Democrats agree to fund the wall with Mexico in next year’s budget. And if the Democrats don’t agree the government could shut down. Friday. Again, it’s a nasty line in the sand:

    The Washington Post

    Trump and his aides take hard line on border wall, as threat of government shutdown looms

    By Sean Sullivan
    April 23, 2017 at 1:22 PM

    President Trump and his top aides applied new pressure Sunday on lawmakers to include money for a wall on the U.S.-Mexico border in a must-pass government funding bill, raising the possibility of a federal government shutdown this week.

    In a pair of tweets, Trump attacked Democrats for opposing the wall and insisted that Mexico would pay for it “at a later date,” despite his repeated campaign promises not including that qualifier. And top administration officials appeared on Sunday morning news shows to press for wall funding, including White House budget director Mick Mulvaney, who said Trump might refuse to sign a spending bill that does not include any.

    Democrats said they vigorously oppose any money for the border wall in a new spending bill, setting the stage for a last-minute showdown as the White House and lawmakers scramble to pass a stopgap bill to fund the government beyond the end of Friday, when funding will run out.

    Trump’s position could also put him at odds with Republican congressional leaders, some of whom have voiced skepticism about including wall funding in the most immediate spending bill. House Speaker Paul D. Ryan (Wis.) made clear to rank-and-file GOP lawmakers on Saturday that his top priority was to pass a bill to keep government open.

    On “Fox News Sunday,” host Chris Wallace asked Mulvaney, “Will he [Trump] sign a government funding bill that does not include funding for the border wall?”

    “Yeah, and I think you saw his answer just in your little lead-in, which is: We don’t know yet,” Mulvaney said in the interview. He was referring to comments Trump recently made to the Associated Press.

    In an interview on NBC’s “Meet the Press,” White House Chief of Staff Reince Priebus appeared to take a slightly less rigid approach to getting money for the border wall, repeatedly talking more generally about the need for “border security.” Still, he mentioned the wall in the context of the president’s goals.

    “I think that as long as the president’s priorities are adequately reflected … and there’s enough as far as flexibility for the border wall and border security, I think we’ll be okay with that,” he said.

    Democrats took a hard stance against the wall.

    “The wall is, in my view, immoral, expensive, unwise, and when the president says, ‘Well, I promised a wall during my campaign,’ I don’t think he said he was going to pass billions of dollars of cost of the wall on to the taxpayer,” House Minority Leader Nancy Pelosi (D-Calif.) said on “Meet the Press.”

    Trump campaigned heavily on the promise of building a wall, which he said would curb illegal immigration and the flow of drugs into the United States. Mexico’s president has said his country will not pay for the wall.

    “I don’t think anybody is trying to get to a shutdown,” Mulvaney said. “A shutdown is not a desired end. It’s not a tool. It’s not something we want to have. We want our priorities funded. And one of the biggest priorities during the campaign was border security — keeping Americans safe. And part of that was a border wall.”

    Asked recently by the Associated Press whether he would sign a bill without border funding, Trump replied: “I don’t know yet. People want the border wall. My base definitely wants the border wall. My base really wants it.”

    Trump administration officials have steadily advocated for funding the wall in recent days.

    “I think it goes without saying that the president has been pretty straightforward about his desire and the need for a border wall,” Homeland Security Secretary John F. Kelly said in an interview with CNN’s “State of the Union” that aired Sunday. “So I would suspect, he’ll do the right thing for sure, but I would suspect he will be insistent on the funding.”

    Mulvaney has said that the administration is willing to negotiate with Democrats — funding insurance subsidies under the Affordable Care Act (ACA) in exchange for support for wall funding.

    But Democratic leaders say they are not open to that.

    “The White House gambit to hold hostage health care for millions of Americans, in order to force American taxpayers to foot the bill for a wall that the President said would be paid for by Mexico is a complete non-starter,” Matt House, a spokesman for Senate Minority Leader Charles E. Schumer (D-N.Y.), said in a statement Friday. House said Sunday that statement still stands.

    “ObamaCare is in serious trouble. The Dems need big money to keep it going — otherwise it dies far sooner than anyone would have thought,” Trump tweeted Sunday. It was unclear whether his tweet was meant to bolster Mulvaney’s negotiating position.

    Republicans hold a 52-to-48 advantage over the Democratic caucus in the Senate. But Senate rules protecting the minority give Democrats some leverage. Senate Republicans must get 60 votes to pass legislation, meaning it is impossible to do so without some Democratic support.

    Further complicating matters for the White House, some Republicans in Congress say they don’t view wall funding as a must-have item in a short term spending bill.

    “We’re just trying to finish out the current cycle, the current budget year,” said Sen. Marco Rubio (R-Fla.) on CBS’s “Face The Nation.” “And so I think that’s a fight worth having and a conversation and a debate worth having for 2018. And if we can do some of that now, that would be great. But we cannot shut down the government right now.”

    The spending showdown comes as Congress prepares to return from a two-week recess with a busy to-do list. Trump and some other Republicans have been pressing to revive work on health-care legislation, which stalled last month because Republicans could not agree on a strategy for repealing and replacing the ACA.

    On Sunday, Republicans from Congress and the administration sounded less than confident lawmakers would pass a revamped health-care bill this week.

    “Health care may happen next week. It may not. We’re hopeful it will,” said Priebus.

    Meanwhile, the Trump administration plans to release a very general sketch of its tax reform plan this week, Mulvaney said.

    “I think what are you going to see Wednesday is some specific governing principles, some guidance,” he said, explaining that the White House will not release specific legislative text. “Also some indications of what the rates are going to be.”

    Asked whether the plan will be revenue-neutral, Mulvaney replied, “I don’t think we’ve decided that part yet.”

    “Mulvaney has said that the administration is willing to negotiate with Democrats — funding insurance subsidies under the Affordable Care Act (ACA) in exchange for support for wall funding.”

    And that right there is the language the Trump administration is using for its remarkably audacious hostage taking plan: no border wall funds, no funding insurance subsidies. In terms of the politics you also couldn’t have come up with a worse line in the sand to draw: holding health care hostage and taking responsibility for undercutting Obamacare all to pay for an unpopular border wall, and yet here we are.

    Maybe. There were still signs that the White House might back down, amidst the signs that it might not. But the fact that congressional GOP leaders don’t seem to be on board Trump’s health-care-for-border-wall hostage taking scheme suggests this hostage taking talk could have all been Trumpian bluster. As of now, the message for the White House is a solid yes, no, maybe:


    Trump’s position could also put him at odds with Republican congressional leaders, some of whom have voiced skepticism about including wall funding in the most immediate spending bill. House Speaker Paul D. Ryan (Wis.) made clear to rank-and-file GOP lawmakers on Saturday that his top priority was to pass a bill to keep government open.

    On “Fox News Sunday,” host Chris Wallace asked Mulvaney, “Will he [Trump] sign a government funding bill that does not include funding for the border wall?”

    “Yeah, and I think you saw his answer just in your little lead-in, which is: We don’t know yet,” Mulvaney said in the interview. He was referring to comments Trump recently made to the Associated Press.

    In an interview on NBC’s “Meet the Press,” White House Chief of Staff Reince Priebus appeared to take a slightly less rigid approach to getting money for the border wall, repeatedly talking more generally about the need for “border security.” Still, he mentioned the wall in the context of the president’s goals.

    “I think that as long as the president’s priorities are adequately reflected … and there’s enough as far as flexibility for the border wall and border security, I think we’ll be okay with that,” he said.

    That’s a solid ‘maybe’ from the OMB Chief and a solid ‘maybe not’ from the Chief of Staff. So is Trump really going take the health care subsidies of low income people hostage in order to get his wall funded? Or might Trump show ‘flexibility’, settle for something symbolic, and avoid a government shutdown showdown with the Democrats that’s just makes Trump look awful? Given the horrible politics of Trump’s threat, it’s definitely looking like ‘maybe not’:

    Talking Points Memo
    Editor’s Blog

    Trump Hostage Drama Already Ending?

    By Josh Marshall
    Published April 23, 2017, 6:30 PM EDT

    Is the President already pre-failing his “border wall or the your annual physical gets it” hostage drama shakedown? As I noted on Friday, the President is or was setting up a government shutdown drama drama in which he threatens to deprive people of coverage from the Obamacare exchanges if Democrats don’t agree to fund his border wall. As explained here, this is not only an egregious bit of legislative hostage taking and mafia-like shakedown, it also shows a pretty poor grasp of the politics of the moment.

    Now it seems that the White House may be trying to moonwalk away from the threat.

    This from Jonathan Swan’s Axios newsletter

    Chuck Todd, host of NBC’s “Meet the Press,” asked Priebus whether the administration would veto a government funding bill if there’s not money in it to fund Trump’s border wall. Priebus’ response here was telling:

    “It will be enough in the negotiation for us to move forward with either the construction or the planning, or enough for us to move forward through the end of September to get going on the border wall and border security in regard to border patrol…”

    Between the lines: By refusing to demand funding for the bricks-and-mortar “wall,” Reince tipped his hand. Trump can’t stomach a shutdown on his watch, so he’ll likely take a “win” on some form of funding for border security, even if it’s not specifically for building the wall.

    The issue here or rather the driver is, I suspect, less the Democrats than Republicans who won’t go along with it either.

    “Between the lines: By refusing to demand funding for the bricks-and-mortar “wall,” Reince tipped his hand. Trump can’t stomach a shutdown on his watch, so he’ll likely take a “win” on some form of funding for border security, even if it’s not specifically for building the wall.”

    Figuring out how to turn Trump’s hostage threat idea they kinda sorta floated into a symbolic ‘win’ is now part of the budget negotiations. And it just might include something as lame as touting ‘border security’ funding or some generic planning as a big legislative victory that keeps Trump’s campaign promises. We’ll see. But what we likely won’t see is the Democrats caving in the event of Trump really carrying through with his threat and shutting down the government. Because, again, it’s one of the worst political threats you could have conceived of given Trump’s options:

    Talking Points Memo
    Editor’s Blog

    To Scare Dems, Trump Threatens to Light Himself On Fire

    By Josh Marshall
    Published April 22, 2017, 10:55 AM EDT

    It now seems clear that next week President Trump plans to provoke a spending showdown that could well lead to a shutdown of the federal government. This is strange for so many reasons. The modern government shutdown goes back to the mid-90s. There were technically government shutdowns in earlier decades. But these were brief spending gaps in the context of on-going negotiations. It didn’t occur to anyone to take the federal government hostage to extort policy changes from political opponents until the advent of the Newt Gingrich Speakership.

    Before they become notorious reputational debacles, Gingrich was quite clear about what he was doing. He would shut the government down, break President Bill Clinton’s will with the pressure and bend Clinton to his will and policy dictation. There were two shutdowns under Clinton and the Republican Congress. There was one under President Obama in 2013 and a debt ceiling crisis in 2011 which wasn’t a shutdown but had the same legislative hostage taking dynamics. The one recurring pattern is that shutdowns happen in the context of divided government. To be more specific, they happen when there is a Democratic President and Republicans in control of one or two houses of Congress. It simply never occurred to anyone before now that there would be a shutdown crisis when one party had unified control of the entire government still less that a President whose party controlled Congress would threaten to shut the government down to extort policy concessions from a party that controls nothing.

    And yet, here we are.

    OMB Director Mick Mulvaney explained  the plan on Thursday. The details became clear on Friday. The White House will cut off Obamacare subsidies unless Democrats agree to fund Trump’s Wall.

    You may ask, what do the Democrats even have to do with this? The Republicans control everything. Well, they do. And there’s no problem in the House. But this kind of budgetary bill requires a 60 vote threshold in the Senate. That’s where the Democrats come into play. According to Mulvaney, Democrats can have $1 of Obamacare subsidies for every $1 they pony up for the wall.

    For the moment, let’s observe and pass over the fact that this whole effort has a distinctly mafia feel to it, even down for the dollar for dollar semantics. Legislative hostage taking which appears to have become habitual for Republicans has a certain general logic when it is about budget cutting. But here there’s no apparent opposition to the subsidies. Democrats can have as much of them as they want. As long as they agree to fund Trump’s wall. It’s straight up extortion, without even the pretense of ideological opposition to the policies being threatened.

    Will it work?

    I very much doubt it.

    Here’s why.

    In conflicts between states, countries tend not to go to war with each other if they are not evenly matched and each side has a realistic and relatively full grasp of each side’s relative power. If the outcome is clear, why go through the death and destruction to arrive at a foregone conclusion? Needless to say, this is far from an absolute rule. There are reasons of honor, national pride, refusal to accept onerous terms, simple misunderstandings, called bluffs and more that lead to conflict. Still, as a general matter, it’s a helpful way to understand how conflicts do or do not arise. When the sides are evenly matched or when the two sides’ relative power is hard to evaluate, there are lots of opportunities for conflict. Because both sides think they may prevail and neither side feels able or inclined to buckle under to avoid a fight it might win.

    Perhaps here Trump is simply bluffing. Maybe he’ll get distracted and move on to something else next week. But I get the sense that this is a serious threat. And I get the sense the White House might go through with the threat because I think they believe they are in a strong position even though they’re in a weak position.

    Here’s why.

    The President’s Wall is not popular. For much of the country it is a divisive, bad idea. Even those who do not oppose it per se, do not view it as a high priority. One illustrative data point: a late March AP/NORC poll found that 58 percent opposed new funding for a wall while only 28 percent support it. It’s very unpopular. Notably this is about spending. Remember, “who’s gonna pay for the wall?” Mexico!

    So what happened to Mexico paying? Trump continues to pretend that he is somehow compelling Mexico to pay for the wall on some sort of inter-state layaway plan. But clearly this is nonsense. That central premise of the campaign, impose a national humiliation on Mexico by forcing them to pay for a wall on the border is out the door, forgotten. Americans are going to pay for it and it is not popular.

    Meanwhile, on the other side of the equation, Obamacare is more popular than it has ever been. Indeed, the failed repeal attempt has made it more popular. The repeal debacle also solidified key elements of how the public sees the law. Popularity of the law called Obamacare has become unfastened from the fate of those who receive care under it.

    Let’s discuss what this means.

    Obamacare provides coverage for more than 20 million people. Any replacement or change to the law will be and was this spring evaluated in terms of the numbers of people who lost or gained coverage. House Republican arguments about gaining the freedom to lose or abandon your coverage went nowhere. Moderate Republicans and many non-moderates (Tom Cotton, for example) were stung by the public backlash against changes that would lose people coverage. What the White House is threatening is a cut off of subsidies which would destabilize and possibly collapse Obamacare exchanges leading to loss of coverage or higher premiums.

    In other words, President Trump is now threatening the Democrats with doing the thing that terrified many Republicans out of repealing Obamacare only a month ago.

    We have already seen from the repeal fight that those developments are politically toxic. President Trump and his aides appear to view Obamacare beneficiaries as Democrats’ charges, something akin to family members the President can take hostage and threaten to injure or kill to extort concessions. This is a rather dire miscalculation of the politics of the situation. Democrats have made great political sacrifices to maintain coverage under Obamacare. But the people who are likely to suffer political damage by this action are not Democrats but rather congressional Republicans, indeed Trump himself. After all, that’s why Obamacare repeal went down in flames in the first place. One might say that the eventual harm is to beneficiaries. But there’s little reason for Democrats to think they’d lose this fight. Indeed, a fair analysis of the situation suggests the best way to protect beneficiaries is to call the President’s bluff. After all, they just won basically the same fight a month ago. The simple reality is that the President is threatening to set himself and his party on fire unless Democrats relent.

    It’s scarcely a strong position.

    So, let’s review. The President is demanding Democrats vote funds for his deeply unpopular wall which he promised Mexico would pay for or he’ll try to sabotage Obamacare exchanges in a way likely to damage him and congressional Republicans. This is an almost comically weak political hand. The relative popularity of each policy makes that so. The ruthless and cynical effort to threaten harm to ordinary beneficiaries as a way to extort money for the wall makes it only more so.

    But, some Republicans say, now it’s the Democrats who are withholding consent for legislation. They’re shutting the government down! The liberal media has always said its the people in Congress who are at fault.

    Here for instance, purported serious person Hugh Hewitt claims that if the Democrats shut down the government it will not only be a disaster for the Democrats but for the press too, which will be exposed for its hypocrisy in always blaming shutdowns on Republicans.

    If Dems shut down govt over border wall funding –the central campaign promise of @POTUS @realDonaldTrump— all of the combined forces of— Hugh Hewitt (@hughhewitt) April 21, 2017

    This is really quite silly.

    Of course, one can say the President isn’t shutting everything down. He’s simply stating his conditions and if the Democrats refuse, they’re shutting the government down. You can cast the blame any way you want.

    But even though you can say either side is doing the deed, the public, not surprisingly, tends to blame the party which orchestrated the stand-off. In every case in the last quarter century, that’s been the GOP, as it is here.

    But there’s another reason the Republicans will get the blame in addition to all these other reasons – a reason that seldom gets discussed. The Democrats are the party of government. This is a reality that all sides concede, whether they see it as an honor or a stain. Republicans are the ones who talk about shrinking the government until it’s small enough that it can be strangled in a bathtub. It’s Republicans who talk about government being the problem not the solution. It’s Republicans who rail against big government and often government workers. When the public sees that someone is shutting down the government, cutting government services, furloughing employees, Republicans will always tend to get the blame. This would mostly be the case even if it weren’t the case that it’s always Republicans who are in fact engineering the shutdowns or threatening them. It’s no different from the widely understood reality that the public tends to credit Republicans more on national security issues because they believe Republicans are the more bellicose, war-fighting party. On the question of continuity in government services, caring if the government gets shut down, Democrats have inherent credibility Republicans simply lack.

    Now, the logical question is “Josh, why do you assume they don’t understand what you find so obvious? Are you sure they don’t know something you don’t? Or maybe they know more than you realize?”

    Really? C’mon. Can the Trump White House be this legislatively inept? This self-deluding? Of course, they can. It’s an empirical reality we see everyday. It’s how we got to three months into the administration with no major legislation at all getting passed. With any other White House we’d need to posit some grounded strategy. Here positing that goes against really all evidence.

    Now, are we going to have a government shutdown. I would say probably not. My colleague David Kurtz reminded me today how many shutdown scares and build-ups we’ve had that didn’t end up happening. Like with Obamacare repeal, maybe they’ll go low energy at the last minute and pull the plug on the whole idea. Maybe Trump will get bored and move on to something else. Maybe – this seems the most likely failsafe – congressional Republicans will refuse to go along realizing it’s a political loser. Apart from the particulars of a shutdown fight, there are many Republicans, particularly in the Senate who don’t like the wall either.

    I will simply say that I think a shutdown is more likely than people think for this simple reason. The President has a very weak hand in this confrontation. But he doesn’t seem to know it. That’s a set of circumstances that is bound to lead to trouble.

    “We have already seen from the repeal fight that those developments are politically toxic. President Trump and his aides appear to view Obamacare beneficiaries as Democrats’ charges, something akin to family members the President can take hostage and threaten to injure or kill to extort concessions. This is a rather dire miscalculation of the politics of the situation. Democrats have made great political sacrifices to maintain coverage under Obamacare. But the people who are likely to suffer political damage by this action are not Democrats but rather congressional Republicans, indeed Trump himself. After all, that’s why Obamacare repeal went down in flames in the first place. One might say that the eventual harm is to beneficiaries. But there’s little reason for Democrats to think they’d lose this fight. Indeed, a fair analysis of the situation suggests the best way to protect beneficiaries is to call the President’s bluff. After all, they just won basically the same fight a month ago. The simple reality is that the President is threatening to set himself and his party on fire unless Democrats relent.”

    So…yeah, we’re probably not going to see Trump actually threaten a government shutdown as a result of Trump’s threat to hold low income people’s health care hostage to get funding for ‘The Wall’. It’s too self-destructive for even Trump’s congressional allies to play along with and the Democrats will have no reason to cave. And Reince Priebus is already signaling Trump will back down. Still, it’s pretty amazing that this whole episode actually happened. And given the ham-handedness of the whole scheme it raises a rather significant question for the next week: What are the terms of the next hostage-taking scheme. Because they are clearly interesting in these kinds of tactics. It was just too stupid in this instance. But Team Trump appears to be up for some budget-negotiating hostage-taking.

    What’s the next ‘line in the sand’ from Team Trump? We’ll find out. There’s a broad spectrum of vulnerable groups that could be held hostage. But one thing is increasingly clear in terms of what to expect from Trump in the various negotiations: Until he’s able to cajole the Democrats into overturning Obamacare he’s going to to be undercutting it. Burning down Obamacare is the ends and the means. So those subsidies probably probably aren’t surviving too many more negotiations.

    Posted by Pterrafractyl | April 23, 2017, 10:05 pm
  13. With the release of a one page ‘tax plan’ just days before Trump’s “first 100 days” milestone, one of the big questions facing the entire Trump agenda at this point is whether or not any of Trump’s major legislative agenda items will actually become reality. But perhaps an even more important related question is whether or not any of Trump’s major legislative agenda items will actually be popular with the American public. After all, if Trump and the GOP-controlled Congress pass Trump’s agenda but it’s a super unpopular agenda, Trump and the GOP aren’t going to be setting the agenda for very long. So it’s a pretty important question. And given that the ‘tax plan’ was simply a vague document of bullet points that that left almost everything to the imagine and yielded just enough information to belittle it as unfeasible but little else and given that ‘Trumpcare’ was stunningly unpopular (only 17 percent of Americans supported it), it looks like the answer to that question is that it probably depends on whether or not Trump’s infrastructure plan is popular because this Trumptax plan is probably going to be about as popular as Trumpcare once the public learns the details:

    US News & World Report

    A Promise-Breaking Tax Plan

    The president’s new tax plan is as harmful as the GOP’s latest attempt to reform health care.

    By Chad Stone | Opinion Contributor
    April 28, 2017, at 11:30 a.m.

    My CBPP colleagues have been on a tear lately, issuing a raft of pithy two-page tax reform briefs and other short papers that will help you see why President Trump’s tax plan, which Treasury Secretary Steven Mnuchin and National Economic Council Chair Gary Cohn outlined this week, will be no more popular than the GOP health plan. You’ll find lots of good material for fact-checking as the tax reform debate unfolds.

    Recall that the public’s problem with the GOP health plan was that it didn’t meet its stated purpose of making health care better, more available and more affordable than Obamacare. The latest effort to bring the failed bill back to life fixes none of those flaws, while adding provisions that would gut protections for people with pre-existing health conditions in an appeal to the House GOP’s most conservative members.

    GOP tax reform proposals face the same problem. Americans want their tax system to be simple and fair and they don’t want their elected leaders recklessly running up more debt. GOP tax plans don’t deliver.

    Secretary Mnuchin has repeatedly stated that the Trump tax plan will have a big tax cut for the middle class and that any cuts for high-income households will be offset by cuts in their tax credits, deductions and other write-offs. Yet two major Republican tax proposals – President Trump’s campaign-era tax plan and the House GOP’s “Better Way” tax plan spearheaded by Speaker Paul Ryan – violate this Mnuchin rule, providing most of their benefits, and by far the largest increases in after-tax income, to millionaires.

    So does the president’s new plan.

    The Trump administration and GOP lawmakers pay lip service to the idea that tax reform shouldn’t lose revenue and increase deficits. In fact, tax reform should raise revenue. Yet both the Trump and House GOP tax proposals lose substantial revenues. Proponents claim that much of the revenue lost by cutting taxes for businesses and wealthy individuals will be recouped with new revenue generated by higher economic growth that the tax cuts will unleash. Mnuchin has said repeatedly that the Trump economic plan “will pay for itself with growth.” Not even the Tax Foundation, whose analysis typically finds much larger economic growth effects from tax cuts than other analysts, thinks the Trump tax cuts alone pay for themselves.

    Exaggerated claims for the economic growth benefits of large tax cuts have been around since "supply-side economics" emerged in the late 1970s, and they persist to this day. But there’s scant evidence that tax cuts for the rich have these large effects (or that tax increases preclude economic growth).

    In fact, the evidence shows that tax cuts – particularly for high-income people – are an ineffective way to spur economic growth, and they’ll likely harm the economy if they add to the deficit or are paired with cuts to public investments that support the economy and working families. Sound investments in infrastructure, for instance, complement private investments in making the economy more productive. A growing body of research suggests as well that investments in children in low-income families not only reduce poverty and hardship in the near term, but can have long-lasting positive effects on their health, education and earnings as adults.

    I’ve only scratched the surface of what this treasure trove of tax policy briefs has to offer. There’s lots more. Think the top U.S. corporate tax rate is way out of line with that of other countries or that corporate tax rate cuts are a great way to grow the economy and help workers? Think again. How many Americans would benefit from repealing the estate tax? Only heirs of the wealthiest two of every 1,000 estates. Want a cautionary tale about what GOP tax plans mean for the budget and the economy? Look what happened in Kansas.

    “GOP tax reform proposals face the same problem. Americans want their tax system to be simple and fair and they don’t want their elected leaders recklessly running up more debt. GOP tax plans don’t deliver.”

    A simple and fair tax system that doesn’t blow up the deficit. That’s what Americans by and large want. And it’s hard to see the GOP passing a tax plan like that ever. No matter how many iterations they go through. Kind of like the GOP and health care. The GOP doesn’t do good legislation. It does good cons. Or, rather, effective cons.

    So if Trump’s tax plan ends up being as popular as ‘Trumpcare’ and runs into resistance do to its blatant unfairness and the reality that it’s just a giant con designed to extend the larger “supply-side/tax cuts for the rich help everyone” con that the GOP has been running for decades, what’s the plan to push this through Congress and make it a reality? Another con? Perhaps, but how about blackmailing the country instead: do you like a big infrastructure program? Well, no tax cuts (for the rich), no infrastructure. Issuing an ultimatum like that is an option. An option Trump was reportedly considering just last month as a way to ensure he gets a big ‘win’ in the wake of his Trumpcare debacle:

    US News & World Report

    Trump Weighs Pairing Tax, Infrastructure Overhauls
    After the GOP’s stumble on health care, the president reportedly is considering pursuing tax and infrastructure legislation simultaneously.

    By Andrew Soergel, Economy Reporter
    March 28, 2017, at 11:56 a.m.

    President Donald Trump reportedly is weighing the idea of pursuing infrastructure investments and tax reform concurrently this year as he seeks a triumph following the apparent demise of a GOP-led plan to overhaul the nation’s health care system.

    Among Trump’s campaign promises, tax tweaks and infrastructure investment ranked with health care reform and regulatory repeal as some of his most repeated talking points.

    But even as Trump has incrementally begun peeling away government regulations, infrastructure had for weeks been perceived as a third-tier priority behind health care reform and tax code adjustments, with Treasury Secretary Steven Mnuchin hoping to have the latter knocked out by lawmakers’ August recess.

    There was even some talk that Trump’s infrastructure package – what now looks like a combination of public and private investment of up to $1 trillion – wouldn’t be a priority for lawmakers until 2018 with so many other pieces of legislation up in the air.

    But Axios reported Monday night that Trump’s team is considering pursuing tax and infrastructure legislation concurrently in what the publication dubbed “a major strategic shift” that’s “only possible because of last week’s health care debacle.” The report followed a conversation with Rep. Bill Shuster, a Pennsylvania Republican who leads the House Transportation and Infrastructure Committee and would likely be responsible for guiding Trump’s infrastructure package in the House.

    Shuster told Axios that the “calculus of the timing” had changed “with the defeat of health care,” and suggested it would be helpful to lawmakers up for reelection to be able to tell their constituencies they’d been a part of a successful infrastructure overhaul.

    In theory, running infrastructure along with tax reform gives Trump bargaining chips with Democrats and Republicans. Both parties have recognized the importance of infrastructure investment in recent years, and both have independently crafted their own pieces of ideal legislation laying out plans to prioritize and fund spending on roads, bridges, airports, water systems and the litany of other building blocks that make up the country’s infrastructure grid.

    The American Society of Civil Engineers earlier this month estimated the U.S. needs to invest around $4.6 trillion in its infrastructure simply to get it up to speed over the course of the next 10 years. Such a steep investment generally isn’t expected to come from Capitol Hill anytime soon, but the issue is generally considered to be bipartisan.

    Republicans haven’t historically been eager to sign on to plans that ramp up government spending, but the promise of tax reform could help sway budget hard-liners. In turn, Democrats who aren’t fond of a GOP-led tax push could be brought to the negotiating table by promises of infrastructure funding.

    There could also be some opportunity to partially fund infrastructure improvements through tax reform. For example, the idea of lowering taxes to encourage corporations to repatriate offshore holdings could spark an influx of billions of dollars into the U.S. tax system, and using that money for infrastructure improvements has been floated on Capitol Hill in recent years.

    But lawmakers have yet to reach consensus on how to go about that process. And for as much common ground as certain infrastructure and corporate tax proposals seem to share, Mnuchin indicated last week that the Trump team plans to knock out business and personal tax reform all in one go – the latter of which raises party-fueled differences of opinion over, for example, the tax rate paid by particularly wealthy Americans.

    In the end, the failure of the Affordable Health Care Act to get through the House last week suggests Trump’s team will need to focus even more heavily on the art of the deal for his priorities to get a green light on Capitol Hill.

    In theory, running infrastructure along with tax reform gives Trump bargaining chips with Democrats and Republicans. Both parties have recognized the importance of infrastructure investment in recent years, and both have independently crafted their own pieces of ideal legislation laying out plans to prioritize and fund spending on roads, bridges, airports, water systems and the litany of other building blocks that make up the country’s infrastructure grid.”

    Trump’s popular pledge to do a big trillion dollar infrastructure package can be turned into a bargaining chip to pass a tax plan that’s dominated by tax cuts for the rich despite the fact that most Trump voters don’t want to see tax cuts for the richand more people are convinced Trump’s plan will raise, and not lower, their taxes. That certainly seems like the kind of plan Trump could be seriously contemplating. Especially since all signs indicate that Trump’s infrastructure plan is in reality going to just be a couple hundred billion dollars in tax-credits to help catalyze a mass privatization scheme. So if the infrastructure package is just a bunch of tax cuts, it sort of makes sense to do it with the tax reform plan at the same time. It’s all the same scam:


    Republicans haven’t historically been eager to sign on to plans that ramp up government spending, but the promise of tax reform could help sway budget hard-liners. In turn, Democrats who aren’t fond of a GOP-led tax push could be brought to the negotiating table by promises of infrastructure funding.

    There could also be some opportunity to partially fund infrastructure improvements through tax reform. For example, the idea of lowering taxes to encourage corporations to repatriate offshore holdings could spark an influx of billions of dollars into the U.S. tax system, and using that money for infrastructure improvements has been floated on Capitol Hill in recent years.

    The synergy is undeniable. Trump’s tax plan is primarily a tax-cuts for the rich plan and in infrastructure plan is a tax-cuts-for-corporate-investors plan. So why not bundle them together? It makes sense even of the plans themselves don’t make sense.

    Although the underlying logic of how tying the tax plan to the infrastructure plan does sort of break down if it turns out the public ends up souring on the infrastructure plan after everyone learns that it’s just a bunch of tax cuts to help finance a mass privatization scheme (e.g. the infrastructure plan is a toll road plan). And that raises the question of what happens if Trump attempts this, ties the two plans together, and then ends up with two big unpopular plans he can’t pass. Simultaneously. Is there another con or blackmail scheme he could try? Well, how about tying infrastructure and taxes to Trumpcare too:

    US News & World Report

    Trump: Infrastructure and Health Care ‘Perhaps’ a Package Deal
    The president in a new interview expressed interest in pairing health care reform and infrastructure investments.

    By Andrew Soergel, Economy Reporter
    April 12, 2017, at 8:20 a.m.

    President Donald Trump hinted during a Tuesday interview that a broad infrastructure package could be looped into the health care reform discussion as the president hopes to gain bipartisan traction for his legislative agenda.

    During an interview with Fox Business Network’s Maria Bartiromo, Trump said his tax reform plans would ultimately “be better” if he could first get his desired Affordable Care Act repeal and replace legislation through Capitol Hill.

    One way to do that might be linking health care and tax reform, he said.

    “I see it as part, perhaps, of the health care plan,” Trump said of his promised infrastructure overhaul. “Because phase 2 of the health care plan, in order to get the votes, I need 60 percent for that. And if I put that in, the Democrats are actually going to love the infrastructure plan.”

    Trump has called for steep tax cuts – both for individual Americans and for U.S. corporations – as part of his legislative agenda, but his plan as it stands would significantly deplete the government’s tax revenue coffers. In order to maintain a degree of revenue neutrality, some have argued that he’ll need to have savings associated with health care reform – which proponents say could eventually amount to nearly $1 trillion – locked in before pursuing taxes.

    “Everything in the present plan requires the health part – the tax increases of Obamacare – to be eliminated. And that gives you the plan – 20 percent corporate rate, has the business adjustable, full business expensing, three individual rates, no death tax, no AMT, all of the good stuff in the package,” Grover Norquist, the president and founder of the Americans for Tax Reform conservative advocacy group, said last month in an interview with CNBC. “But without doing health care first, you can double the size of border adjustable or you give up on any meaningful corporate rate reform.”

    Trump seemed to acknowledge as much during the interview that aired Tuesday, indicating he and his allies “have to do health care first so we can pick up additional money” for tax reform.”

    “I’m saving a tremendous amount, hundreds and hundreds of millions of dollars we’re saving on health care … we’re saving tremendous amounts on health care when we get this done,” he said. “All of that saving goes into the tax.”

    Democrats and Republicans alike have pushed for greater infrastructure investments to repair America’s underfunded roads, bridges and ports. Trump has championed a $1 trillion infrastructure investment plan that could draw on both public and private funds. It was previously rumored Trump was aiming to package tax reform and infrastructure, using the latter as a bargaining chip.

    He now appears willing to reposition that chip to better serve his legislative interests.

    But health care reform discussions are still ongoing after the initial version of the American Health Care Act failed to make it to a congressional vote once it became clear there were not the GOP votes to pass it.

    Trump said he believes it’s been “misreported that we failed on health care” and that his administration and lawmakers are still “negotiating.”

    “I don’t want to put deadlines. Health care’s going to happen at some point. Now, if it doesn’t happen fast enough, I’ll start the taxes. But the tax reform and the tax cuts are better if I can do health care first,” he said.

    “Everything in the present plan requires the health part – the tax increases of Obamacare – to be eliminated. And that gives you the plan – 20 percent corporate rate, has the business adjustable, full business expensing, three individual rates, no death tax, no AMT, all of the good stuff in the package,” Grover Norquist, the president and founder of the Americans for Tax Reform conservative advocacy group, said last month in an interview with CNBC. “But without doing health care first, you can double the size of border adjustable or you give up on any meaningful corporate rate reform.””

    Yep, as none other than Grover Norquist gripes, Trumpcare – being a stealth tax cut for the rich coupled with a massive divestment in public spending on American healthcare – really was an critical element of Trump’s tax plan. All that money for the tax cuts for the rich has to come from somewhere:


    Trump has called for steep tax cuts – both for individual Americans and for U.S. corporations – as part of his legislative agenda, but his plan as it stands would significantly deplete the government’s tax revenue coffers. In order to maintain a degree of revenue neutrality, some have argued that he’ll need to have savings associated with health care reform – which proponents say could eventually amount to nearly $1 trillion – locked in before pursuing taxes.

    So as with the infrastructure package, why not bundle health care reform into the infrastructure/tax cut bundle? It’s a question the White House is undoubtedly asking:


    During an interview with Fox Business Network’s Maria Bartiromo, Trump said his tax reform plans would ultimately “be better” if he could first get his desired Affordable Care Act repeal and replace legislation through Capitol Hill.

    One way to do that might be linking health care and tax reform, he said.

    “I see it as part, perhaps, of the health care plan,” Trump said of his promised infrastructure overhaul. “Because phase 2 of the health care plan, in order to get the votes, I need 60 percent for that. And if I put that in, the Democrats are actually going to love the infrastructure plan.”

    “I see it as part, perhaps, of the health care plan,” Trump said of his promised infrastructure overhaul. “Because phase 2 of the health care plan, in order to get the votes, I need 60 percent for that. And if I put that in, the Democrats are actually going to love the infrastructure plan.”

    That’s apparently the plan. Bundle all of Trump’s unpopular signature legislative agenda items into one giant horrible package. And while the pitch is going to be that bundling them together is all part of scheme to ensure the passage of Trump’s agenda, as we can see there’s parallel incentive to bundle them together: maximizing the potential for tax cuts for the rich.

    And who knows how much larger this bundle will get. Like, how about ‘The Wall’ with Mexico? Could that be part of the bundle? Given the need to find funding for the wall it’s not inconceivable. Who’s going to pay for the wall? Mexico! Obamacare and Medicaid beneficiaries. And all the people impacted by the cuts to almost everything helpful from the federal budget. And the future. That’s who’s going to pay for the ‘The Wall’. Much like they’re paying for tax cuts for the rich. And probably some corporate tax credits to privatize infrastructure. It’s a package deal.

    So as we can see, while it remains unclear how the Trump/GOP legislative agenda will actually become reality, in part because it’s still unclear on what that agenda actually is given the lack of details, there’s an abundance of hints at this point that part of the plan to make that whole agenda reality is bundling. Blackmail bundling. Because three or more wrongs make a right in Trumplandia.

    Posted by Pterrafractyl | April 29, 2017, 7:01 pm
  14. Party time! It’s a celebration. A celebration of a dream. Paul Ryan’s dream. A dream he’s had since college. A dream to cast a vote in Congress capping Medicaid expenses and dramatically reduce health care spending on the poor and needed. And a dream that’s suddenly become a reality now that the House GOP just barely passed its revised American Health Care Act (AHCA/Trumpcare) that’s even more miserly and cruel than the failed Trumpcare 1.0 attempt that went down in flames and will undoubtedly be even more unpopular, which is no easy feat given the 17 percent approval rating the American public gave the first Trumpcare attempt. So yeah, it’s apparently time for the GOP to have a celebration. A twisted, macabre celebration:

    RawStory

    Republicans plan massive beer bash as they take healthcare away from women, the disabled and the poor

    Brad Reed
    04 May 2017 at 14:12 ET

    Republicans on Thursday passed legislation that would rip away health care from an estimated 24 million Americans — and they plan to celebrate it with a massive keg party.

    Vice News’ Alexandra Jaffe reports that large quantities of beer are being wheeled into the Capitol building in anticipation of the House of Representatives passing the American Health Care Act on Thursday afternoon.

    “Cases upon cases of beer just rolled into the Capitol on a cart covered in a sheet,” she writes on Twitter. “Spotted Bud Light peeking out from the sheet.”

    Cases upon cases of beer just rolled into the Capitol on a cart covered in a sheet. Spotted Bud Light peeking out from the sheet— Alexandra Jaffe (@ajjaffe) May 4, 2017

    Earlier this year, House Speaker Paul Ryan told National Review editor Rich Lowry that he has been “dreaming” of capping Medicaid expenses ever since he and Lowry “were drinking at a keg” in college. Ryan said on Thursday ahead of the vote that he had been eagerly waiting for seven years to cast his vote in favor of a bill that is expected to deprive 24 million people of their insurance.

    “Earlier this year, House Speaker Paul Ryan told National Review editor Rich Lowry that he has been “dreaming” of capping Medicaid expenses ever since he and Lowry “were drinking at a keg” in college. Ryan said on Thursday ahead of the vote that he had been eagerly waiting for seven years to cast his vote in favor of a bill that is expected to deprive 24 million people of their insurance.”

    Now we know what Paul Ryan would say if he ever had to give an “I have a dream…” speech. And part of Paul’s dream is now a reality. College Republicans everywhere must be getting a little teary-eyed.

    Except that dream isn’t actually a reality. Not even close. Because passing the bill through the House is just the first step in making this a law and passing the House was the easy part. Relatively speeaking. The Senate still needs to come up with its own version and then both the House and Senate need to agree on a consensus bill. That’s quite a few steps and they aren’t going to be nearly as easy as this first step. It’s only seemed difficult because the bill was/is so horrible and politically toxic due to it being literally lethal for millions of GOP constituents.

    So while a mini macabre celebration might have been appropriate, a full on Congressional kegger seems a bit much. Especially given the widely held expectations that it’s going to die in the Senate. And maybe that’s what some GOPers in the House are celebrating: that they can claim they tried to overturn Obamacare, but that pesky Senate got in the way, thus avoiding the politically damaging real-world consequences that would be inevitable if this bill became law. Heck, maybe most House GOPers are hoping for that outcome. It would make sense politically.

    But as the following piece by Josh Marshall reminds us, any hope that ‘moderate’ GOPers in the Senate are going to kill this bill and allow the GOP to dodge its own bullet has to be squared with an unsettling reality: ‘moderate’ GOPers always cave in the end. And if that rule holds true, the common wisdom that this bill is DOA in the Senate isn’t a wise assumption. And as Marshall also points out, if the bill passes the House by just one vote, every ‘moderate’ GOPer who voted for it is going to be facing waves of attack ads in the 2018 elections about how they were the one that made this horrible law a reality. Well, the bill passed by two votes (217-213).

    And while the 2018 attack ads against the ‘moderate’ GOPers who supporting this mess might not be quite as bad as they would have been if it passed by a one vote margin, those attack ads are still going to write themselves. Passing a bill by a super-tight margin isn’t necessarily a major political risk, but it is if it’s a bill that’s guaranteed to be very unpopular for the foreseeable future. All of the ‘moderates’ who voted suddenly shifted to support the bill after rejection Trumpcare 1.0 can effectively be cast as the member who voted one of the two deciding votes that tipped the balance. That’s the attack ad the ‘moderate’ GOP House members just wrote for themselves in order to pass a bill that many are undoubtedly hoping will die in the Senate. But it probably won’t because in the Senate because , as Josh Marshall reminds us, ‘moderate’ GOPers always cave. When you view today’s Trumpcare vote in the House from that perspective, it’s a pretty poor reason for a kegger:

    Talking Points Memo
    Editor’s Blog

    What to Expect and What You Can Do. Right Now.

    By Josh Marshall
    Published May 4, 2017 11:45 am

    David has the basic overview below of what is coming today. I wanted to add a few more points about what to expect and just as, or perhaps more, importantly what you can do now.

    First, this should remind us of what I’ve previously called the Iron Law of Republican Politics. That is, the ‘GOP moderates’ will always cave. I learned this law back in 1998-99 during the impeachment drama. Lots of Republicans thought impeachment was insanity. They warned against it. Said it shouldn’t happen. Said it would be a disaster. Every Republican in the House but four ended up voting for it.

    That’s the Iron Law: the ‘GOP moderates’ will always cave.

    I confess that after the first debacle and the sharp move of public opinion in favor of Obamacare, I thought Ryan would have a much harder time pulling this off. After all, the GOP moderates in the House didn’t get anything. The bill moved further to the right, further to gutting coverage on the second round. They caved anyway.

    This brings me to the First Corollary of the Iron Law of Republican Politics: Josh should never doubt the Iron Law of Republican Politics.

    Okay, fine.

    What happens next after this bill passes the House, as we assume it will this afternoon? Then it goes to the Senate where it should face much longer odds. The GOP majority is smaller in the Senate and a substantial number of Senators have already said they can’t support this bill or really anything like it. But the Iron Law of Republican Politics should sober anyone who thinks that a bill can’t get through the Senate or that the kind of bill that can get through the Senate will be too far from anything that can pass again in the House.

    I don’t see how it can get through the Senate. But remember The Iron Law of Republican Politics.

    ‘Nuff Said.

    Now, what can you do? Actually, a lot.

    Needless to say, if you’re in a district represented by a Republican in Congress, call them. The most obvious people to call are the ones who are still wavering or the ones who were noes until a day or so ago and turned yes. That’s the one way this could still go down in flames: if a few of those folks flip back.

    But here’s what you often won’t hear.

    It matters just as much if your GOP rep is voting against this bill. To call and say “Hey thanks”? Not remotely.

    If your Republican Rep is voting ‘no’, it’s still their vote and their seat which makes Paul Ryan the Speaker. That’s making this possible. If their seat was held by a Democrat (and obviously a number of seats more, not just that one) this wouldn’t be happening. So it’s not just about their vote. They make the majority possible. And that’s why this is happening. So really, they are just as responsible as the Republicans are voting “yes”. That’s true as a factual matter. As a matter of political strategy, if you want to protect the coverage of those 24 million people, you should let them know that you plan to hold them responsible for this. The heat on them will matter a lot because they have little real incentive to try to stop the train if they think they’re off the hook because they voted “no”. This is very important.

    Another point to consider is that this seems likely to pass by maybe as little as one or two votes. What does that mean? That means that every Republican “yes” on their own could have made the difference. Let’s say this literally passes by one vote. That means your Republican Rep, alone, could have saved coverage for 24 million people. And so could that other Republican Rep who represents your cousin in other state. Funny how that works, isn’t it? But it’s true. That’s powerful. That’s the making of 30 seconds ads.

    I could rattle off a list of other scenarios. But the point is that you should call basically no matter what. The utility and impact may not be as obvious. But often, the impact is almost as great as it would be if you were calling someone who was actually wavering. Sometimes greater. The over-arching point is don’t fall for the silliness of vote count literalism. Call. It matters.

    “I don’t see how it can get through the Senate. But remember The Iron Law of Republican Politics.”

    And what is that The Iron Law of Republican Politics?


    First, this should remind us of what I’ve previously called the Iron Law of Republican Politics. That is, the ‘GOP moderates’ will always cave. I learned this law back in 1998-99 during the impeachment drama. Lots of Republicans thought impeachment was insanity. They warned against it. Said it shouldn’t happen. Said it would be a disaster. Every Republican in the House but four ended up voting for it.

    That’s the Iron Law: the ‘GOP moderates’ will always cave.

    I confess that after the first debacle and the sharp move of public opinion in favor of Obamacare, I thought Ryan would have a much harder time pulling this off. After all, the GOP moderates in the House didn’t get anything. The bill moved further to the right, further to gutting coverage on the second round. They caved anyway.

    This brings me to the First Corollary of the Iron Law of Republican Politics: Josh should never doubt the Iron Law of Republican Politics.

    “That’s the Iron Law: the ‘GOP moderates’ will always cave.”

    It’s not a law of physics, but it’s an Iron Law of our contemporary political reality: GOP ‘moderates’ cave. Eventually. It’s what they do. And the whole premise behind the notion that this bill is dead in the Senate is based on the assumption that the Senate GOP ‘moderates’ won’t cave. And they won’t instead come up with some sort of horrible Senate version of the Trumpcare that’s maybe not quite as horrible as the House’s version but still totally horrible. That’s what people are expecting to happen in the Senate despite the fact the House GOP ‘moderates’ just caved to version of Trumpcare that’s more extreme than the one they initially rejected.

    So we’ll see if Josh’s Marshall’s Iron Law of Republican Politics once again holds up. But it’s hard to see why the GOP’s House kegger isn’t like a kegger that your horrible fraternity throws right before a finals week that you all know is going to flunk out and expel half the members. Getting blotto one last time before reality hits. In that sense, the GOP’s kegger is quite understandable. It’s not a bad idea for people with pre-existing conditions either, although people with pre-existing conditions should probably consult their doctors before getting blotto. And just consult them in general. While they still can.

    If there’s one group that should be unambiguously pleased with this whole situation it’s the millionaires billionaires about to get a BIG tax cut since Trumpcare gets rid of all those billions in Obamacare taxes on the rich. But if there’s another group that should be pretty pleased with the GOP’s health care reform agenda, especially with the provision that will make pre-existing conditions A LOT more expensive, it’s the bankruptcy lawyers. Of course. Because, surprise!, if the pre-existing conditions provision that got added on to the House GOP’s AHCA/’Trumpcare’ bill to get the ‘Freedom Caucus’ on board makes it into the final version that Trump signs (after a lot of ‘moderate’ caving that we should expect) medical bankruptcies are back! Bigly:

    Consumer Reports

    How the Affordable Care Act Drove Down Personal Bankruptcy
    Expanded health insurance helped cut the number of filings by half

    By Allen St. John
    May 02, 2017

    As legislators and the executive branch renew their efforts to repeal and replace the Affordable Care Act this week, they might want to keep in mind a little-known financial consequence of the ACA: Since its adoption, far fewer Americans have taken the extreme step of filing for personal bankruptcy.

    Filings have dropped about 50 percent, from 1,536,799 in 2010 to 770,846 in 2016 (see chart, below). Those years also represent the time frame when the ACA took effect. Although courts never ask people to declare why they’re filing, many bankruptcy and legal experts agree that medical bills had been a leading cause of personal bankruptcy before public healthcare coverage expanded under the ACA. Unlike other causes of debt, medical bills are often unexpected, involuntary, and large.

    “If you’re uninsured or underinsured, you can run up a huge debt in a short period of time,” says Lois Lupica, a bankruptcy expert and Maine Law Foundation Professor of Law at the University of Maine School of Law.

    So did the rise of the ACA—which helped some 20 million more Americans get health insurance—cause the decline in bankruptcies?

    The many experts we interviewed also pointed to two other contributing factors: an improving economy and changes to bankruptcy laws in 2005 that made it more difficult and costly to file. However, they almost all agreed that expanded health coverage played a major role in the marked, recent decline.

    [see chart showing how the number of personal bankruptcy cases dropped after the ACA was introduced.]

    Some of the most important financial protections of the ACA apply to all consumers, whether they get their coverage through ACA exchanges or the private insurance marketplace. These provisions include mandated coverage for pre-existing conditions and, on most covered benefits, an end to annual and lifetime coverage caps. Aspects of the law, including provisions for young people to be covered by a family policy until age 26, went into effect in 2010 and 2011, before the full rollout of the ACA in 2014.

    “It’s absolutely remarkable,” says Jim Molleur, a Maine-based bankruptcy attorney with 20 years of experience. “We’re not getting people with big medical bills, chronically sick people who would hit those lifetime caps or be denied because of pre-existing conditions. They seemed to disappear almost overnight once ACA kicked in.”

    A Rare and Costly Diagnosis

    Since the start of the year, more than 2,000 consumers have answered an online questionnaire from Consumer Reports’ advocacy and mobilization team, sharing their experiences with the ACA. Katie Weber of Seattle was one of them.

    In 2011, she had just landed her first job out of college, as a teacher with AmeriCorps, she explains in a phone interview. That’s when the unusual numbness in her hand began, which she—and her doctor—at first mistook for a pinched nerve. Then came debilitating headaches and nausea and, ultimately, a diagnosis of medulloblastoma, a fast-growing cancerous brain tumor.

    The treatment for her tumor was straightforward: surgery, radiation, then chemotherapy. Figuring out how to pay for it was much less clear. She worried that the insurance she had through AmeriCorps wouldn’t cover enough of her bills.

    “My dad said to me, ‘Your health is the most important thing. If you have to declare bankruptcy at age 23, it’s no big deal,’” Weber says.

    Because of the ACA, she says, it never came to that. After her year with AmeriCorps, the new healthcare law enabled her to get coverage under her parents’ insurance plan.

    The ACA provisions required that the family’s insurance company cover her even though she had already been diagnosed with cancer. That would not have been the case before the ACA, which mandates the coverage of pre-existing conditions for all consumers.

    Later, when she aged out of her parents’ insurance, Weber was able to enroll in Apple Health, Washington state’s version of Medicaid, a program that was expanded once the ACA was passed. That coverage, she says, has been crucial to her financial and medical well-being, especially once the cancer returned last fall.

    Weber says she now spends more time discussing treatment options and less time worrying how she’ll pay for MRIs and drugs. These are covered in full under her Apple Health policy.

    “Cancer is really expensive,” she says. “My insurance saved my life.”

    Numbers Plummet

    If you want further testimony about how much personal bankruptcies have dropped over the past decade, talk to Susan Grossberg, a Springfield, Mass., attorney.

    For more than 20 years she has helped consumers push the financial reset button when debt triggered by divorce, unemployment, or a costly illness or medical episode became too much to handle. “Medical debt can get really big really quickly,” Grossberg says. “When you’re in the emergency room they’re not checking your credit score while they’re caring for you.”

    With the advent of the ACA—and before that, expanded state healthcare in Massachusetts—she says fewer clients with large medical debts walked through her door.

    Grossberg adds that her bankruptcy business has slowed so much that she has been forced to take on other kinds of legal work—landlord-tenant and housing discrimination cases—to cover her own bills.

    ““It’s absolutely remarkable,” says Jim Molleur, a Maine-based bankruptcy attorney with 20 years of experience. “We’re not getting people with big medical bills, chronically sick people who would hit those lifetime caps or be denied because of pre-existing conditions. They seemed to disappear almost overnight once ACA kicked in.””

    Ka-ching! Not for the bankrupted people, but for the bankruptcy lawyers, Ka-ching! Obamacare killed the medical bankruptcy market and the GOP is in the processes of killing Obamacare. Good news! For bankruptcy lawyers:


    If you want further testimony about how much personal bankruptcies have dropped over the past decade, talk to Susan Grossberg, a Springfield, Mass., attorney.

    For more than 20 years she has helped consumers push the financial reset button when debt triggered by divorce, unemployment, or a costly illness or medical episode became too much to handle. “Medical debt can get really big really quickly,” Grossberg says. “When you’re in the emergency room they’re not checking your credit score while they’re caring for you.”

    With the advent of the ACA—and before that, expanded state healthcare in Massachusetts—she says fewer clients with large medical debts walked through her door.

    Grossberg adds that her bankruptcy business has slowed so much that she has been forced to take on other kinds of legal work—landlord-tenant and housing discrimination cases—to cover her own bills.

    Lawyers can finally return to the field of medical bankruptcy that they were driven out of by Obamacare’s pesky pre-existing conditions protections. That alone warrants a kegger.

    But other than the bankruptcy lawyers, it’s still hard to see what Trump and the GOP are all excited about. Because before they passed this bill, they were trapped in a choose-your-own-adventure health care dilemma, largely of their own creation, that provided them no non-disastrous paths forward. They chose to go down a horrible path and now they’re at a dead end with only horrible options. Will they never overturn Obamacare and keep getting mocked for their ineptness? Pass a mild ‘reform’ package that doesn’t do nearly as much harm as the far-right wants and ends up pissing off the ideological base? Or pass the law and inflict mass harm to both public health and their own electoral prospects? That was the choose-your-own-adventure health care dilemma. So now we’re finding out which disastrous route they chose: Mass harm. The worst choice, of course.

    It’s unclear why today’s vote, and this whole situation, warrants a kegger. Unless it’s a despair kegger. Or a wake. A GOP wake would be a reasonable use of kegger-league congressional beer deliveries. And thematically appropriate. There’s going to be a lot more tragically avoidable wakes in our Trumpian future.

    Posted by Pterrafractyl | May 4, 2017, 9:08 pm
  15. Yowza! According to a new report in Axios, Trump is considering a “huge reboot” of his White House team in response to the spontaneous combustion dumpster fire his administration has been thus far. And it really does appear to be pretty huge if the reports are accurate. Let’s just say Sean Spicer has company. It sounds like the advice Trump is getting from longtime friends and outside advisors is to do a mass firing that affects almost everyone but Jared, Ivanka, and Rex Tillerson. Reince Priebus and Steve Bannon are on the chopping block. And maybe even Jeff Session too. So there’s about to be a lot more job openings for Jared. Heh Seriously, it actually kind of sounds like this is going to create a lot of job openings for Jared:

    Axios

    Scoop: Trump, irked at cabinet and staff, mulls sweeping shake-up

    Mike Allen
    5/14/2017

    At the urging of longtime friends and outside advisers, most of whom he consults after dark, President Trump is considering a “huge reboot” that could take out everyone from Chief of Staff Reince Priebus and chief strategist Steve Bannon, to counsel Don McGahn and press secretary Sean Spicer, White House sources tell me.

    Trump is also irritated with several Cabinet members, the sources said.

    “He’s frustrated, and angry at everyone,” said one of the confidants.

    The conversations intensified this week as the aftermath of the Comey firing pushed the White House from chaos into crisis. Trump’s friends are telling him that many of his top aides don’t know how to work with him, and point out that his approval ratings aren’t rising, but the leaks are.

    “The advice he’s getting is to go big — that he has nothing to lose,” the confidant said. “The question now is how big and how bold. I’m not sure he knows the answer to that yet.”

    If Trump follows through, his innermost White House circle would shrink from a loop to a straight line of mid-30s family members with scant governing experience: Jared and Ivanka. So while the fighting and leaking might ease, the problems may not because it’s the president, not the staff, calling the shots.

    One note of caution: Trump often talks about firing people when things go south and does not follow through on it. So it’s possible these conversations are his way of venting, and seeking reassurance.

    And it all could take a while: Trump heads out on his first international trip at the end of the week. Also, there’s an internal argument for minimizing drama by cutting people out of the information flow rather than firing them. So the existing structure may get “one more college try,” a trusted adviser said.,

    The sources say Trump feels ill-served by not just his staff but also by several of his Cabinet officials. Trump has two complaints about Cabinet members: Either they’re tooting their own horns too much, or they’re insufficiently effusive in praising him as a brilliant diplomat, etc. Among the cross-currents:

    * His friend Wilbur Ross at Commerce this week took what was perceived as a victory lap on a China trade announcement that does little new in actuality.

    * Attorney General Jeff Sessions made a big announcement about increasing prison sentences, at the same time that Jared is working on criminal-justice reform.

    * HHS Secretary Tom Price shares the blame for the glacial pace of health-care legislation..

    No Cabinet member is expected to go this soon, but a West Wing shuffle looks likely. One obstacle to recruiting new top aides is finding people who would have real clout with a president not prone to enforced order.

    One of the few top officials winning Trump’s praise is SecState Rex Tillerson, who’s on “Meet The Press” this morning (taped yesterday in Texas) defending his boss.

    If Trump follows through, his innermost White House circle would shrink from a loop to a straight line of mid-30s family members with scant governing experience: Jared and Ivanka. So while the fighting and leaking might ease, the problems may not because it’s the president, not the staff, calling the shots.”

    Jared and Ivanka are the final two survivors left on the island. Plus Rex:


    One of the few top officials winning Trump’s praise is SecState Rex Tillerson, who’s on “Meet The Press” this morning (taped yesterday in Texas) defending his boss.

    But that appears to largely be it in terms of those still left in Trump’s good favor. It’s Almost All in the Family.

    Who knows how seriously Trump is considering this, but if this is true and Jared and Ivanka (and Rex) and the only ones left with Trump’s ear, the Alt-Right’s snuff nightmare – that Jared Kushner would end up Trump’s biggest influences – could sort of be coming to fruition. This wouldn’t mean that Trump is abandoning his far-right agenda…just that it would have a very different face. And probably better public relations.

    And if this report is true, and there really is a “huge reboot” that Trump is planning to get himself out of the quagmire of scandals he’s found himself in, it’s probably worth noting that one of the most effective ways he could do that just might be to embrace that fear that so many right-wingers had about Trump: that he would campaign like Republican but was secretly a Democrat at heart. Like, just imagine of Trump really did drop the Paul Ryan agenda of destroying the health care saftey-net to pay for tax cuts for billionaires? And what if, instead of “trillion dollar infrastructure package” that’s just a bunch of corporate tax cuts and privatizations, it was an actual trillion-ish dollar massive government stimulus package? And what if Trump’s tax cut package wasn’t a just a giant recipe for bankrupting the government but actually focused on closing loopholes for billionaires to pay for that infrastructure spending. And how about taking Joe Biden’s “Cancer Moonshot” and expanding on it to include a “Green Energy Moonshot”? Sure, this would all be antithetical to the Trump agenda we’ve seen thus far, but if Trump is serious about a “huge reboot”, there’s no reason that can’t include a reboot his policy vision to make him that ‘different kind of Republican’ that so many of his voters thought he was going to be. Think of all the people who voted for Trump thinking he was a secret moderate? Shouldn’t they get represented too?

    Don’t forget that the biggest threat to Trump is probably the eventual erosion of support from Trump’s GOP base of support. With the GOP in control of Congress, and therefore control of any congressional investigations, Trump’s support with his GOP base of voters is basically his shield of protection against serious investigations. So if Trump is intent on not getting hounded out of office, either by investigators or eventually at the ballot box, why not just seriously hand policy over Jared and Ivanka? It’s probably smart politics. At least smarter than the Bannon/Ryan hybrid nightmare of corporatist white nationalism.

    For instance, just take a look at the latest version of Trumpcare that just passed the House and the intertwined Trump tax cut proposal. According to a recent poll, only 21 percent of American voters support it, with less than a majority of Republicans supporting this latest version of the proposed Obamacare replacement and 59 percent of those GOP voters opposing the options to opt-out of pre-existing conditions protections. And 74 percent of respondents disapproved of a tax reform package that added to the national debt, including 66 percent of GOP voters (and boy would Trump’s tax package add to the national debt). With numbers of like, and given how critical popular support for his health care and tax reform packages is for the overall legacy of Trump’s administration, isn’t this a good time for Trump ask W.W.J.D (What Would Jared Do)?:

    Politico

    Poll: Just 21 percent approve of House’s Obamacare repeal bill

    By Louis Nelson
    05/11/17 01:47 PM EDT

    Less than a quarter of American voters surveyed in a new poll released Thursday by Quinnipiac University approve of the legislation passed last week by the House of Representatives to repeal and replace the Affordable Care Act.

    Fifty-six percent of those polled said they disapprove of the legislation, dubbed the American Health Care Act, while just 21 percent said they support it. The support for the legislation represents an improvement over the 17 percent who said they supported the iteration of the bill that failed to pass the House in March.

    Overall 66 percent said they disapprove of President Donald Trump’s handling of healthcare, while 32 percent said they approve of it.

    Forty-nine percent of respondents said the AHCA will hurt the nation, while 29 percent said it will help it and 13 percent said it will have no impact. Republican voters – 48 percent of whom supported the AHCA in the poll – were the only group with a positive view of the bill. Every other gender, party, age, educational and racial group opposed the legislation.

    The legislation has proven especially controversial because it offers states the option to pull out of an Obamacare provision mandating that insurers not charge individuals with preexisting conditions more for coverage. Both Trump and GOP leadership had promised than any Obamacare replacement leave intact protections for those with preexisting conditions.

    The repeal-and-replace legislation removes the mandate that all Americans purchase health insurance or else pay a penalty and also undoes a requirement that insurers cover certain services and conditions.

    Seventy-five percent of respondents – and 59 percent of Republicans – said it is a “bad idea” to allow states to opt out of cost-lowering protections for those with preexisting conditions. Sixty-four percent of those polled said they approved of the current Obamacare provision that stops insurance companies from charging more for those with preexisting conditions.

    Asked about the president’s proposal to reform the tax code, 74 percent of respondents and 66 percent of Republicans said they would disapprove of it if it “significantly” increases the national debt, something Trump told The Economist in an interview released Thursday could be possible in the short term. Forty-six percent said they would approve of the tax plan if it resulted in spending cuts, while 45 percent said they would disapprove in such a scenario.

    Among those polled, 49 percent said Trump’s tax plan would hurt the nation while 29 percent said it will help it and 13 percent said it will not have an impact. Sixty-three percent said the wealthy will benefit the most under the president’s proposal, while 27 percent said the same of the middle class.

    “Seventy-five percent of respondents – and 59 percent of Republicans – said it is a “bad idea” to allow states to opt out of cost-lowering protections for those with preexisting conditions. Sixty-four percent of those polled said they approved of the current Obamacare provision that stops insurance companies from charging more for those with preexisting conditions.”

    W.W.J.D? Well, Jared probably wouldn’t do Paul Ryan’s incredibly unpopular agenda. Why would he? That’s just stupid. So why not throw health care reform on Jared’s to-do list? Maybe Ivanka can handle it? How about a Jared and Ivanka couples project? Heck, maybe he could make a reality TV show about their quest to come up with a health care package that doesn’t horrify most of the nation. That seems like a Trumpian approach to things and it’s not like it would be any more unpopular than what he’s currently doing.

    Or take, for example, Jeff Sessions’ agenda. As the above article noted, Trump wasn’t too happy about the Attorney General reversing the previous ‘smart sentencing’ approach to non-violent drug-related crimes, and especially marijuana crimes, at the same time Jared is working on a big, and popular, criminal-justice reform project:


    * Attorney General Jeff Sessions made a big announcement about increasing prison sentences, at the same time that Jared is working on criminal-justice reform.

    W.W.J.D? How about medical marijuana decriminalization? At least at the federal level. Let the states decide! If ever there was an issue that would allow Trump to rebrand himself as a sensible, genuinely populist Republican, it’s this issue. Not only would it create a surge in youth support for Trump, or at least youth open-mindedness, but if you were looking for a stand-alone policy that simultaneously threads of needle of improving health care, the opioid epidemic, prison overcrowding, dehumanizing draconian sentencing, economic stimulus, empowering states over the federal government, and really reignite the kind of national discussion about how to heal a frayed civic police/minority community relations (in part by by highlighting the critical role politicians, not police, played in spoiling those relations with misguided laws) you almost couldn’t ask for a better issue for a politician of Trump’s variety than medical marijuana reform. Plus, it’s not like the libertarians or Alt-Right are going to complain. It’s a giant gimme sitting right there ready to confound Trumnp’s critics! Thread that needle! Would Jared recommend Trump thread the needle? It seems like it so maybe Trump should ask him after he’s done with his “reboot”.

    Or, you know, he could stick with the Bannon/Ryan agenda and let people like Richard Spencer define his public identity. After all, there’s plenty more to do the Paul Ryan agenda. The incredibly unpopular Paul Ryan agenda:

    Talking Points Memo
    DC

    Paul Ryan Still Talking Up The Idea Of Privatizing Medicare

    By Tierney Sneed
    Published May 12, 2017 5:59 pm

    House Speaker Paul Ryan hasn’t let go of his cherished idea of privatizing Medicare and in an interview with a local Wisconsin radio station Friday, suggested that a blueprint for overhauling Medicare would advance in the Budget Committee again this year.

    “The question is, can we get everyone else to agree” Ryan said on the Vicki McKenna Show.

    Earlier in the interview Ryan said overhauling Social Security and Medicare — two programs President Trump vowed not to touch on the campaign trail — has “long” been his “plan.”

    “That’s a discussion we’re having ongoing with the administration,” he said, later adding, “I do really believe we need to do Medicare reform.”

    Ryan has released various versions of his so-called “Path to Prosperity” budget blueprint that have included a privatization of Medicare. The general idea he has promoted is turning Medicare into a so-called “premium support” system — i.e. a voucher system — in which seniors would get a set amount of money to shop around for private health care plans. Earlier versions of his proposal would have lead to a phase-out of Medicare altogether. Some experts have argued that even the most recent iteration of his blueprint, which ostensibly leaves some form of traditional Medicare available, would eventually lead to its phase-out as well.

    Trump, while running for President, promised time and time again not to cut Medicare, Medicaid and Social Security, arguing, “It’s not fair to the people that have been paying in for years and now all of the sudden they want to be cut.” Trump already appears poised to violate his promise to preserve Medicaid with his support of a GOP Obamacare repeal bill that would slash $880 billion in federal funding for the program over 10 years, according to the CBO..

    It’s not just Ryan that’s trying to make Medicare privatization happen. Trump’s Office of Management and Budget Director Mick Mulvaney, a former House member with a reputation as a budget hawk, said last month that it was his “guess is the House will do either that or something similar to that.”

    “Let them pass that and let’s talk about it,”Mulvaney said, when asked about Trump’s pledges not to touch Medicare.

    “It’s not just Ryan that’s trying to make Medicare privatization happen. Trump’s Office of Management and Budget Director Mick Mulvaney, a former House member with a reputation as a budget hawk, said last month that it was his “guess is the House will do either that or something similar to that.”

    Is OMB chief Mick Mulvaney on Trumnp’s sh#t list yet? If not, why not? Either way, privatizing Medicare and Social Security are clearly s still on the Paul Ryan/Mulvaney agenda:


    Earlier in the interview Ryan said overhauling Social Security and Medicare — two programs President Trump vowed not to touch on the campaign trail — has “long” been his “plan.”

    “That’s a discussion we’re having ongoing with the administration,” he said, later adding, “I do really believe we need to do Medicare reform.”

    Ryan has released various versions of his so-called “Path to Prosperity” budget blueprint that have included a privatization of Medicare. The general idea he has promoted is turning Medicare into a so-called “premium support” system — i.e. a voucher system — in which seniors would get a set amount of money to shop around for private health care plans. Earlier versions of his proposal would have lead to a phase-out of Medicare altogether. Some experts have argued that even the most recent iteration of his blueprint, which ostensibly leaves some form of traditional Medicare available, would eventually lead to its phase-out as well.

    So does Donald Trump seriously want to become the most unpopular president in modern American history? Well, just keep sticking with Paul Ryan and Congressional Republicans. That should do the trick. Being super unpopular should do wonders for all those Congressional investigations.

    But if he doesn’t want to be the most unpopular president in modern American history there is always another option: W.W.J.D. Sure, we don’t really know Jared’s politics, but what are the odds they’re less popular than the Trump/Bannon/Sessions agenda Trump has been pushing so far? Plus, if this pans out and the W.W.J.D. approach saves Trump from presidential infamy, it will probably go a long ways towards excusing all the nepotism stuff.

    W.W.J.D.? #MakeNepotismGreatAgain. That’s what.

    Posted by Pterrafractyl | May 14, 2017, 7:27 pm
  16. Remember how, in the wake of the House GOP’s initial failure to repeal Obamacare and replace it with Trumpcare, Donald Trump tweeted “ObamaCare will explode and we will all get together and piece together a great healthcare plan for THE PEOPLE. Do not worry!” Well, now that the House GOP passed an even more draconian version of Trumpcare it looks like Donald Trump is starting to worry. Worry that Obamacare isn’t exploding fast enough. And he’s got a plan to address that worry: end the Obamacare insurance subsidies which will force an almost immediate collapse in the Obamacare individual insurance market.

    And this isn’t just some random Trumpian whim. Thanks to a lawsuit filed by House Republicans against the Obama administration charging that Obamacare’s insurance subsidies were never approved by Congress, the Trump administration has to inform the U.S. Court of Appeals for the District of Columbia by Monday how it wants to resolve the case. And Trump’s senior advisors are scrambling to convince him not to use this opportunity to end those subsidies and cause an immediate crisis in the US private insurance market. Presumably Trump is assuming a synthetic crisis of Trump’s own doing will force the Democrats to sign on to Trumpcare and give the GOP bipartisan cover for the disaster they’re about to unleash. And presumably his advisors think this is crazy. And presumably they’re correct because it’s a crazy idea. But that’s what’s reportedly under consideration. Specifically by Trump.

    So, yeah, Trump appears to seriously want to create an immediate national health care crisis. And he apparently thinks this is good politics:

    Politico

    Trump tells advisers he wants to end key Obamacare subsidies
    Many senior aides oppose the move for fear it will backfire politically.

    By Josh Dawsey , Jennifer Haberkorn and Paul Demko

    05/19/2017 03:06 PM EDT
    Updated 05/19/2017 09:15 PM EDT

    President Donald Trump has told advisers he wants to end payments of key Obamacare subsidies, a move that could send the health law’s insurance markets into a tailspin, according to several sources familiar with the conversations.

    Many advisers oppose the move because they worry it would backfire politically if people lose their insurance or see huge premium spikes and blame the White House, the sources said. Trump has said that the bold move could force Congressional Democrats to the table to negotiate an Obamacare replacement.

    Lawyers and other administration officials are trying to thread the needle.

    Trump told aides in a Tuesday Oval Office meeting that he wants to end the payments to insurers because he doesn’t gain anything by continuing them, according to a senior White House adviser. “Why the hell would we?” he asked about continuing the payments, according to the adviser. Trump added that if Congress wants the subsidies, lawmakers would find a way to pay for them, the adviser said.

    Trump has previously expressed conflicting opinions on the issue. Insurers have been pressing for certainty as they plan for next year.

    The payments, estimated at $7 billion for this year, go to insurance companies to reduce deductibles and other out-of-pocket costs for low-income consumers — an estimated 7 million people in 2017. Insurers are on the hook under the health law to keep paying even if the federal money stops.

    Many senior administration officials, including Health and Human Services Secretary Tom Price, are leery of ending the payments, however, because doing so could immediately unravel the Obamacare insurance markets and strongly discourage insurers from participating next year. Insurance companies in many states would be allowed to pull out of the Obamacare markets, which in many states already have scant competition.

    Several polls show that the public would blame the administration and the Republican-controlled Congress if the markets collapsed.

    The issue is coming to a head: On Monday, the Trump administration has to inform the U.S. Court of Appeals for the District of Columbia how it wants to resolve a lawsuit the House Republicans brought against the Obama administration saying the White House was making the payments without congressional approval. The White House and House could also ask for a 90-day hold on the case.

    Some in the administration are hoping to persuade Trump to change his mind. Mick Mulvaney, the administration’s budget director, is more “agnostic” on the issue, according to a person close to him, and has presented Trump with options other than immediately suspending the funding.

    The lawsuit is moving ahead against the backdrop of the effort on Capitol Hill to repeal the Affordable Care Act. Any bill would be expected to unwind the health law over at least a year. But defunding the cost-sharing program could destabilize the market immediately.

    In a statement, the administration said the White House has told Congress it will continue the payments through May but no commitment has been made beyond that.

    “No final decisions have been made at this time, and all options are on the table,” the statement said.

    The administration has said in the past it would continue to make the payments while the lawsuit, House v. Price, is pending. The D.C. District Court ruled in 2016 that the Obama administration had been illegally funding the program. The Obama administration appealed that decision, but the court did not rule on the issue before Trump was sworn in.

    ———-

    “Trump tells advisers he wants to end key Obamacare subsidies”bBy Josh Dawsey, Jennifer Haberkorn and Paul Demko; Politico; 05/19/2017

    Trump told aides in a Tuesday Oval Office meeting that he wants to end the payments to insurers because he doesn’t gain anything by continuing them, according to a senior White House adviser. “Why the hell would we?” he asked about continuing the payments, according to the adviser. Trump added that if Congress wants the subsidies, lawmakers would find a way to pay for them, the adviser said.”

    Trump thinks creating a giant individual health insurance crisis that could be easily blamed on him would be a political “gain”. Are we sure he isn’t demented? Although the blame wouldn’t be exclusively placed on Trump since the House GOP was the group that filed this lawsuit in the first place:


    The issue is coming to a head: On Monday, the Trump administration has to inform the U.S. Court of Appeals for the District of Columbia how it wants to resolve a lawsuit the House Republicans brought against the Obama administration saying the White House was making the payments without congressional approval. The White House and House could also ask for a 90-day hold on the case.

    Some in the administration are hoping to persuade Trump to change his mind. Mick Mulvaney, the administration’s budget director, is more “agnostic” on the issue, according to a person close to him, and has presented Trump with options other than immediately suspending the funding.

    The lawsuit is moving ahead against the backdrop of the effort on Capitol Hill to repeal the Affordable Care Act. Any bill would be expected to unwind the health law over at least a year. But defunding the cost-sharing program could destabilize the market immediately.

    Is the GOP sure it doesn’t want to impeach Trump? Really sure?

    And for that matter, is the GOP really sure it actually wants to pass its horrible Obamacare replacement law which will reverse the Medicaid expansion and steadily erode and eventually destroy Medicaid itself? If so, then, yeah, they might as well just blow up Obamacare because it’s a party that clearly isn’t trying to win any popularity contests. Or elections. Especially future elections. Replacing Obamacare with Trumpcare isn’t going to help with the GOP’s youth deficit:

    Forbes

    Trumpcare Hits Children’s Hospitals Hard

    By Bruce Japsen
    May 14, 2017 @ 09:00 AM

    The nation’s children’s hospitals may see a harsh reduction in funding and reduced care for their patients should the American Health Care Act, also known as Trumpcare, replace the Affordable Care Act, new analyses show.

    The ACA expanded Medicaid in 31 states that opted to do so, particularly for children who tend to qualify for such coverage in greater numbers than adults. The AHCA, which narrowly passed the Republican-controlled House of Representatives, would roll back the ACA’s Medicaid expansion and lead to 14 million fewer Americans with insurance by 2018; eventually, 24 million would lose coverage by 2026, the nonpartisan Congressional Budget Office said in March.

    “While only approximately one-fifth of Medicaid spending is for children, about half of Medicaid and CHIP [Children’s Health Insurance Program] enrollees are children, even following Medicaid expansion for lower-income adults in many states,” a new report from the Chartis Group says.

    Of the 74.5 million Medicaid and CHIP enrollees, 35.9 million are children, according to February statistics gathered by Chartis. “Assuming they will not change their patient bases sufficiently to compensate for potential Medicaid reductions, children’s hospitals will need to evolve their care models,” the report said.

    The AHCA is backed by President Donald Trump and House Speaker Paul Ryan. Its fate in the U.S. Senate is unclear.

    If enacted, AHCA would create credit risks and related financial concerns for children’s hospitals, Fitch Ratings said in a report last week. “Proposed reductions to Medicaid and other supplemental healthcare funding cuts currently contemplated in Congress are likely to pressure these hospital providers over the longer term if enacted,” said Fitch director Emily Wadhwani.

    The AHCA cuts more than $800 billion from state Medicaid budgets over more than a decade, hitting children’s hospitals particularly hard. “Children could see their healthcare cut by tens of billions of dollars,” the Children’s Hospital Association, which represents more than 220 hospitals, said. “Other changes contained in the bill would make the healthcare system worse for children, not better.”

    In Illinois alone, the state could lose $40 billion in Medicaid funding over the next decade, the Illinois Hospital Association says.

    For hospitals like Ann & Robert H. Lurie Children’s Hospital of Chicago,, the cuts will be “massive,” executives say. It is the largest hospital provider of pediatric Medicaid services in Illinois.

    “Half of our pediatric patients are insured by Medicaid, many of whom are disabled or medically complex,” Lurie Children’s CEO Patrick Magoon said. “It would be very difficult for our hospital to absorb such massive cuts. We opposed these cuts in the House-passed legislation, and certainly hope the Senate bill under development will maintain Medicaid’s 50-year commitment to caring for our nation’s most vulnerable children.”

    Children and the hospitals that treat them will also be hurt by potentially skimpier coverage that the AHCA allows in the individual market, particularly since the MacArthur Amendment. The AHCA allows states to gut protections for preexisting conditions and allows states the opportunity to eliminate certain essential health benefits, leaving coverage for children particularly vulnerable.

    “The MacArthur amendment might have a significant impact for children because pediatric vision and dental coverage were included in the essential health benefits, and thus can be waived under the version of AHCA that passed in the House,” RAND policy analysis Christine Eibner said.

    With such cuts on the table, children’s hospitals may have to reduce services if the Senate doesn’t make changes before the law reaches President Donald Trump’s desk.

    “As the debate on the next wave of healthcare legislation moves on from the House and into the Senate, significant uncertainty remains,” the Chartis Group report shows. “Yet irrespective of the specific changes to come, children’s hospital reimbursement is at risk. Children’s hospitals will have to wrestle with and balance these strategies and interventions to sustain performance and uphold their commitments to serve all children–regardless of income.”

    ———-

    “Trumpcare Hits Children’s Hospitals Hard” by Bruce Japsen; Forbes; 05/14/2017

    “If enacted, AHCA would create credit risks and related financial concerns for children’s hospitals, Fitch Ratings said in a report last week. “Proposed reductions to Medicaid and other supplemental healthcare funding cuts currently contemplated in Congress are likely to pressure these hospital providers over the longer term if enacted,” said Fitch director Emily Wadhwani.”

    Those greedy children’s hospitals will just need to cut costs. For a long, long time. Same with the greedy sick kids. Especially those greedy sick kids with vision and dental issues. Or pre-existing conditions, which hopefully won’t be an issue since they haven’t existed that long:


    Children and the hospitals that treat them will also be hurt by potentially skimpier coverage that the AHCA allows in the individual market, particularly since the MacArthur Amendment. The AHCA allows states to gut protections for preexisting conditions and allows states the opportunity to eliminate certain essential health benefits, leaving coverage for children particularly vulnerable.

    “The MacArthur amendment might have a significant impact for children because pediatric vision and dental coverage were included in the essential health benefits, and thus can be waived under the version of AHCA that passed in the House,” RAND policy analysis Christine Eibner said.

    With such cuts on the table, children’s hospitals may have to reduce services if the Senate doesn’t make changes before the law reaches President Donald Trump’s desk.

    Take that greedy sick kids!

    But those greedy sick kids won’t get their comeuppance until Obamacare is repealed. Hence, blowing up Obamacare. Because those greedy sick kids can’t get their comeuppance soon enough.

    So that’s all part of what Trump and the GOP are fighting for in their quest to make Trumpcare a reality and part of what Trump is hoping to catalyze by immediately blowing up Obamacare: long-term austerity for children’s hospitals. And medium-term health care austerity for sick kids. It’s not long-term austerity because they’ll become adults in the long-term. Assuming they, you know, make it to adulthood.

    If it seems unbelievable that Trump would intentionally blow up Obamacare so as to speed up the implementation of a health care plan that could devastate health care for millions of children, keep in mind that that’s the plan anyway. Just not quite so quickly. In Trumplandia anything is possible. As long as it involves the exploitation of the poor.

    Also keep in mind that there were some early hints that the Trump administration already has a solution in mind. Ok, not really, but since children’s hospitals are apparently on the GOP chopping block, it’s worth noting that there was one possible solution someone from the Acton Institute put forth just days before the 2016 election. And the Acton Institute happens to be a right-wing think-tank that Trump’s education secretary and GOP billionaire mega-donor Betsy DeVos sat on the board of for a decade, so it at least gives is a sense of the kind of ideas getting bandied about by the Education Secretary’s think-tank: We should relax child-labor laws and promote child labor because a job would be good for kids character. So, you know, don’t be shocked if the Trumplandian replacement for government assisted children’s health care coverage is a child job to help the kids cover their soon-to-be out-of-pocket health care costs:

    The Huffington Post

    Group Funded By Trump’s Education Secretary Pick: ‘Bring Back Child Labor’
    This raises serious questions about the woman who would potentially be in charge of U.S. public schools.

    By Alana Horowitz Satlin
    11/24/2016 09:30 am ET

    A think tank funded by Donald Trump’s Secretary of Education pick recently advocated for putting kids back in the workforce.

    The Acton Institute, a conservative nonprofit that is said to have received thousands of dollars in donations from Betsy DeVos and her family, posted an essay to its blog this month that called child labor “a gift our kids can handle.”

    “Let us not just teach our children to play hard and study well, shuffling them through a long line of hobbies and electives and educational activities,” said the post’s author, Joseph Sunde. “A long day’s work and a load of sweat have plenty to teach as well.”

    Child labor isn’t universally forbidden in the U.S. – actors and newspaper deliverers are two exceptions – but it is tightly regulated.

    Betsy DeVos-funded Acton Institute argues for abolition of child labor laws, says mining wld be "exciting life" for poor kids. Seriously.— Jeff Sharlet (@JeffSharlet) November 23, 2016

    DeVos was a member of Acton’s Board of Directors for 10 years and while it’s unclear how much influence she currently has on the organization, its homepage now prominently features a message congratulating DeVos on her nomination.

    The essay raises serious questions about the woman who would potentially be in charge of U.S. public schools. Education advocates have already expressed concern about DeVos’ history of supporting school voucher programs.

    ———-

    “Group Funded By Trump’s Education Secretary Pick: ‘Bring Back Child Labor’” by Alana Horowitz Satlin; The Huffington Post; 11/24/2016

    ““Let us not just teach our children to play hard and study well, shuffling them through a long line of hobbies and electives and educational activities,” said the post’s author, Joseph Sunde. “A long day’s work and a load of sweat have plenty to teach as well.”

    Yes, let’s teach our children to play hard, study well, and also weaken child labor laws so its easier for our children to get hired by random companies spending days sweating at the workplace. Let’s do it for the children (and all the adult employees who will now be competing with children for those jobs). That was the grand idea put out by the Acton Institute, an ‘institute’ Trump’s Education Secretary (and major GOP donor) Betsy DeVos is pretty familiar with since she spent a decade sitting on its board:


    DeVos was a member of Acton’s Board of Directors for 10 years and while it’s unclear how much influence she currently has on the organization, its homepage now prominently features a message congratulating DeVos on her nomination.

    And if it seems like there’s no way these kids are going to be able to make enough money to cover their medical costs, note that the Acton Institute essay was specifically citing a passage from another study from the Foundation for Economic Education that called for ending compulsory education too. So, you know, there might be time. Not enough time, but more time.

    Of course, there’s no way Trump and the GOP could seriously have in mind the weakening of child labor laws at the same time they’re planning on gutting the medical safety-net for children, right? Of course. There’s no way they’re actually pro-child labor Well, actually…:

    Raw Story

    Trump budget kills funding for agency that polices international child labor and slavery

    David Ferguson
    28 Apr 2017 at 13:58 ET

    President Donald Trump’s new budget guts funding for the federal agency that oversees and polices the exploitation of child laborers and forced workers around the world.

    Reveal News reported Friday that Trump plans to cut $60 million from the Department of Labor’s Bureau of International Labor Affairs, which fights child labor, human trafficking and slavery around the world.

    “The preliminary budget of President Donald Trump’s administration would eliminate $60 million in grants from the bureau’s budget, calling them ‘largely noncompetitive and unproven,’” wrote Reveal News’ Jennifer Gollan. “It suggested that the agency instead focus its efforts ‘on ensuring that U.S. trade agreements are fair for American workers.’”

    The cuts would cripple the government’s ability to monitor child exploitation around the world and potentially interfere with tenets of 13 separate trade agreements. Furthermore, the measures would ultimately have the opposite effect of what the president intends. By allowing other countries to exploit child workers and other laborers, U.S. workers will be put at a disadvantage for using fair labor practices.

    Obama-era director Labor Secretary Carol Pier said that there is a “huge logical disconnect” between Trump’s stated desire to protect U.S. workers and the actual outcome of the law.

    “These programs help to level the global playing field,” Pier said.

    ———-

    “Trump budget kills funding for agency that polices international child labor and slavery” by David Ferguson; Raw Story; 04/28/2017

    “The cuts would cripple the government’s ability to monitor child exploitation around the world and potentially interfere with tenets of 13 separate trade agreements. Furthermore, the measures would ultimately have the opposite effect of what the president intends. By allowing other countries to exploit child workers and other laborers, U.S. workers will be put at a disadvantage for using fair labor practices.

    That’s right, when the Trump Administration’s proposed a budget, it basically gutted the pittance of funding for the federal agencies that monitors the globe for labor violations like child exploitation. And while Congress actually creates budget, the Trump budget proposal is still a reflection priorities. Priorities that, in this instance, put pretty much everything at a lower priority than tax cuts for the rich. So, you know, don’t be super shocked if getting Jr a second job a second job becomes part of Jr’s health insurance plan. Especially after personally bankruptcy, due to medical costs, once again skyrocket when Trumpcare kicks in.

    Hopefully the kids won’t be forced to buy their insurance on the individual market but since Trumpncare is getting rid of the employer mandate so, you know, It’s a distinct possibility. Which is extra scary. Because as the GOP has repeatedly taught us with all its successful attempts to hobble Obamacare’s ability to function – the Supreme Court ruling that made the Medicaid expansion optional, Marco Rubio’s elimination of the “risk-corridor” subsidies that drove insurers out of the market, the GOP lawsuits like the one now that allows for Trump to implode Obamacare’s individual markets next week if he wants to – the biggest problem with government playing a role in the health care market is the GOP. And the GOP isn’t going anywhere. Unless people stop voting for it.

    And they might stop voting for the GOP enough to throw it out of the majority in short order if the GOP’s policies are actually put in place. They’re demonstrably bad for the masses. Which, of course, is a big reason why Trump might be seriously thinking about blowing up Obamacare to force the Democrats to come to the table and make Trumpcare a bipartisan nightmare. Another reason is that he appears to be crazy, or at least plays the part well. But the political poison that is Trumpcare really is so toxic that blowing up Obamacare as part of some sort of tragicruel gambit to force the Democrats to the bargaining table does make a bit of sense. If it works and the Democrats sign on to some sort of not-quite-as-bad-Trumpcare that would be massive win for Trump and the GOP, in the short, medium, and long-run.

    It doesn’t quite make sense why such a scheme would play out the way Trump says since the Democrats can probably win the politics by simply pointing out that Trump just destroyed the independent health insurance market as a means of holding people hostage to force the Democrats to sign on to Trumpcare. But if Trump and the GOP has such a scheme that could allow them to come out ahead after such a horrid gambit that would allow for such a horrid gambit to make political sense. Once the GOP gets all the power it has nothing to lose because it’s bound to become super unpopular due to its horrible policies anyway. So why not take a gamble on blowing up Obamacare now in order to force the Democrats to table? That’s what Trumpcare is anyway. Blowing up Obamacare and replacing it with mostly crap and tax cuts for the rich. That’s seriously the situation. So while it’s becoming increasingly tempting to simply assume that Trump is kind of mentally losing it (Trumpcare doesn’t do great things for children’s mental health care, BTW), it’s also possible he’s doing it because the GOP’s agenda is so crazy that Trump already has nothing to lose. Obamacare blows up now or a year from now right before the mid-terms.

    So keep in mind if Trump does decide to go against the advice of most of his advisors and blow up Obamacare, while it’s very possible he’s crazy, it’s also possible someone in the GOP has thought this through and realized that Trumpcare is crazy enough and non-child-friendly enough that the blowback will be almost immediate when it comes into effect so some sort of Obamacare-subsidy-blackmail-for-bipartisan-cover gambit kinds of starts making sense because at least there’s a chance they’ll somehow spin it into a victory or at least confuse the GOP base. In other words, a lot of Trump’s apparent madness might just be the madness required to shepherd through the GOP’s crazy agenda without blowing up the GOP.

    Posted by Pterrafractyl | May 20, 2017, 11:24 pm
  17. Here’s a bit of good news: Donald Trump isn’t going to immediately trigger the implosion of Obamacare by pulling the Obamacare insurance subsidies and sending the individual insurance markets into a tailspin. He’s going to take 90 days to think about it. So the Obamacare markets might not immediately implode due to Trump’s actions. At the same time, by maintaining the threat to do so 90 days from now, Trump is still destabilizing Obamacare by greatly contributing to uncertainty and basically incentivizing insurers to pull out of the market because insurers have to tell the federal government if they’re going to participate in the health care exchanges in 2018 by next month. So the Obamacare destabilization continues, it’s just more of a stealth destabilization:

    New York Magazine
    Daily Intelligencer

    Trump Pulls Back on Threat to Kill Obamacare Subsidies – For Now

    By Ed Kilgore
    May 22, 2017 6:18 pm

    To anxious insurers trying to decide whether to continue participation in the Obamacare exchanges for 2018 (assuming they still exist!), it is very much a glass-half-empty solution. But the reported request by the Trump administration and House Republicans for a 90-day delay of a D.C. Court of Appeals’ deadline for deciding whether the Obama administration’s appeal of a decision that would have ended CSR (cost-sharing reduction) subsidies would continue is better than the abrupt termination of subsidies the president would prefer. The Washington Examiner has the story:

    “We feel payments should continue while we figure out a solution,” a GOP source said. “The Justice Department is working with House Republicans in good faith to achieve this.”

    The CSRs, officially transfers to insurance companies who provide lower-cost health insurance plans on Affordable Care Act exchanges, have been under legal challenge by House Republicans who believed that former President Barack Obama didn’t have the legal authority to pay them.

    Trump has indicated a desire to halt the subsidies.

    To put it bluntly, ending the subsidies would make Trump’s prophecy of an Obamacare “implosion” self-fulfilling.

    That won’t happen for at least another 90 days. But that’s a problem, too, since insurers have to notify the feds of their 2018 Obamacare rates by next month. So the extended uncertainty over the CSR subsidies — the absence of which could terminate coverage for an estimated 7 million low-income people — will continue to hang over the insurers, aggravated by the knowledge Donald Trump personally wants to kill them.

    Since the policy implications and the consequences involved in this decision have been clear for a long time, you have to figure the “delay” is a thinly veiled effort to mess with Obamacare without admitting it.

    ———-

    “Trump Pulls Back on Threat to Kill Obamacare Subsidies – For Now” by Ed Kilgore; New York Magazine; 05/22/2017

    “That won’t happen for at least another 90 days. But that’s a problem, too, since insurers have to notify the feds of their 2018 Obamacare rates by next month. So the extended uncertainty over the CSR subsidies — the absence of which could terminate coverage for an estimated 7 million low-income people — will continue to hang over the insurers, aggravated by the knowledge Donald Trump personally wants to kill them.”

    Do you want to sign up to provide insurance in a market the president really, really, really wants to kill? That’s the question Trump and the GOP are presenting to private insurers. Which is less of a question and more of a strong suggestion:


    Since the policy implications and the consequences involved in this decision have been clear for a long time, is a thinly veiled effort to mess with Obamacare without admitting it.

    So that the bit of good news for Obamacare today. Coming on the same day we got an update on the the Trump budget proposal.

    So remember Trump’s “skinny budget” that was proposed back in March, a budget that basically horrified the nation in how it slashed almost all non-military spending federal to pay for tax cuts for the rich? Well, here’s the update from the Trump team on their new budget: It’s just as bad as before, but with more options for states to impose work requires on almost all entitlement and welfare programs. Social Security and Medicare for retirees is basically the only program not slashed and without additional work-requirements/restrictions added. Social security disability and Medicaid are slated to be slashed. Almost all welfare, especially food stamps, is to be severely restricted. And the official underlining premise of it all is that the tax cuts for the rich will replace the need for any social safety-net because the economy will be so incredible:

    The Washington Post

    Trump to propose big cuts to safety net in new budget, slashing Medicaid and opening door to other limits

    By Damian Paletta
    May 21, 2017 at 6:54 PM

    President Trump’s first major budget proposal on Tuesday will include massive cuts to Medicaid and call for changes to anti-poverty programs that would give states new power to limit a range of benefits, people familiar with the planning said, despite growing unease in Congress about cutting the safety net.

    For Medicaid, the state-federal program that provides health care to low-income Americans, Trump’s budget plan would follow through on a bill passed by House Republicans to cut more than $800 billion over 10 years. The Congressional Budget Office has estimated that this could cut off Medicaid benefits for about 10 million people over the next decade.

    The White House also will call for giving states more flexibility to impose work requirements for people in different kinds of anti-poverty programs, people familiar with the budget plan said, potentially leading to a flood of changes in states led by conservative governors. Many anti-poverty programs have elements that are run by both the states and federal government, and a federal order allowing states to stiffen work requirements “for able-bodied Americans” could have a broad impact in terms of limiting who can access anti-poverty payments — and for how long.

    Numerous social-welfare programs grew after the financial crisis, leading to complaints from many Republicans that more should be done to shift people out of these programs and back into the workforce. Shortly after he was sworn in, Trump said, “We want to get our people off welfare and back to work. … It’s out of control.”

    Trump’s decision to include the Medicaid cuts is significant because it shows he is rejecting calls from a number of Senate Republicans not to reverse the expansion of Medicaid that President Barack Obama achieved as part of the Affordable Care Act. The House has voted to cut the Medicaid funding, but Senate Republicans have signaled they are likely to start from scratch.

    The proposed changes will be a central feature of Trump’s first comprehensive budget plan, which will be the most detailed look at how he aims to change government spending and taxes over his presidency. Although Trump and his aides have discussed their vision in broad brushes, this will be the first time they attempt to put specific numbers on many aspects of those plans, shedding light on which proposals they see making the biggest difference in reshaping government. Congress must approve of most changes in the plan before it is enacted into law.

    Trump offered a streamlined version of the budget plan in March, but it dealt only with the 30 percent of government spending that is appropriated each year. In that budget, he sought a big increase in military and border spending combined with major cuts to housing, environmental protection, foreign aid, research and development.

    But Tuesday’s budget will be more significant, because it will seek changes to entitlements — programs that are essentially on auto­pilot and don’t need annual authorization from Congress. The people describing the proposals spoke on the condition of anonymity because the budget had not been released publicly and the White House is closely guarding details.

    The proposed changes include the big cuts to Medicaid. The White House also is expected to propose changes to the Supplemental Nutrition Assistance Program, though precise details couldn’t be learned. SNAP is the modern version of food stamps, and it swelled following the financial crisis as the Obama administration eased policies to make it easier for people to qualify for benefits. As the economy has improved, enrollment in the program hasn’t changed as much as many had forecast.

    An average of 44 million people received SNAP benefits in 2016, down from a peak of 47 million in 2013. Just 28 million people received the benefits in 2008.

    SNAP could be one of numerous programs impacted by changes in work requirements.

    Josh Archambault, a senior fellow at the Foundation for Government Accountability, a conservative think tank, said that giving states the flexibility to impose work requirements could lead to a raft of changes to programs ranging from Medicaid to public housing assistance.

    “One of the encouraging things about putting this in the budget is that states will see if it works,” he said. “States will try it.”

    SNAP already has a work requirement, which typically cuts benefits for most able-bodied adults who don’t have children. But states were given more flexibility during the recent economic downturn to extend the benefits for a longer period, something that split conservatives at the time.

    Michael Tanner, a welfare expert at the libertarian Cato Institute, said the U.S. government spends between $680 billion and $800 billion a year on anti-poverty programs, and considering wholesale changes to many of these initiatives is worthwhile, given questions about the effectiveness of how the money is spent.

    ‘We’re not seeing the type of gains we should be seeing for all that spending, and that would suggest its time to reform the system,” he said.

    Many critics have said work requirements can include blanket ultimatums that don’t take into account someone’s age, physical or cognitive ability, or limitations put in place by the local economy. Benefits from these programs are often low, and hardly replace the income someone would earn from a job. And critics of stricter work requirements also believe it could pave the way for states to pursue even stricter restrictions, such as drug tests, that courts have often rejected.

    After The Washington Post reported some of the cuts Sunday evening, Senate Minority Leader Charles E. Schumer (D-N.Y.) said Trump was pulling “the rug out from so many who need help.”

    “This budget continues to reveal President Trump’s true colors: His populist campaign rhetoric was just a Trojan horse to execute long-held, hard-right policies that benefit the ultra wealthy at the expense of the middle class,” he said.

    The proposed changes to Medicaid and SNAP will be just some of several anti-poverty programs that the White House will look to change. In March, the White House signaled that it wanted to eliminate money for a range of other programs that are funded each year by Congress. This included federal funding for Habitat for Humanity, subsidized school lunches and the U.S. Interagency Council on Homelessness, which coordinates the federal response to homelessness across 19 federal agencies.

    Leaked budget documents, obtained by the think tank Third Way, suggested other ways the White House plans to change anti-poverty funding. These documents show a change in the funding for Social Security’s Supplemental Security Income program, which provide cash benefits for the poor and disabled. It’s unclear, though, what those changes might look like. A White House official said the Third Way document was out-of-date and would not comment on specifics in their files.

    Medicaid, SNAP and the SSI program are now classified as “mandatory” spending because they are funded each year without congressional approval.

    Trump has instructed his budget director, former South Carolina congressman Mick Mulvaney, that he does not want cuts to Medicare and Social Security’s retirement program in this budget, Mulvaney recently said, but the plan may call for changes to Social Security Disability Insurance, seeking ideas for ways to move people who are able out of this program and back into the workforce.

    A key element of the budget plan will be the assumption that huge tax cuts will result in an unprecedented level of economic growth. Trump recently unveiled the broad principles of what he has said will be the biggest in U.S. history, and Treasury Secretary Steven Mnuchin told a Senate panel last week that these tax cuts would end up creating trillions of dollars in new revenue, something budget experts from both parties have disputed.

    The tax cuts would particularly benefit the wealthiest Americans, as Trump has proposing cutting the estate tax, capital gains and business tax rates.

    “The indications are strong this budget will feature Robin-Hood-in-reverse policies in an unprecedented scale,” said Robert Greenstein, president of the Center on Budget and Policy Priorities, a left-leaning think tank.

    The White House will use its presumed new revenue from the tax cuts combined with broad spending cuts to claim that its changes would eliminate the budget deficit over 10 years. The budget deficit is the gap between government spending and tax revenue, and there has been a deficit in the United States every year since the end of the Clinton administration.

    But the Trump administration on Tuesday will say its plan to cut spending, roll back regulations and cut taxes will bring the United States back to economic growth levels that represent about 3 percent of gross domestic product.

    Mulvaney told the Federalist Society last week that the economic growth is needed to balance the budget, because spending cuts alone would be seen as too draconian.

    “I think we’ve trained people to be immune to the true costs of government,” Mulvaney said. “People think government is cheaper than it is because we’ve allowed ourselves to borrow money for a long period of time and not worry about paying it back.”

    Combined, the tax cuts and spending cuts on anti-poverty programs would signal a sharp reversal of Obama’s legacy by pursuing big tax cuts for the wealthiest Americans, a large increase in military spending and major changes to anti-poverty programs.

    Its premise is that the creation of more wealth will help all Americans succeed, and the Trump administration believes that some anti-poverty programs have created a culture of dependency that prevents people from re-entering the workforce.

    White House budget proposals are a way for an administration to spell out its priorities and goals, setting benchmarks for Congress to work with as they decide how much spending to authorize. Trump has an advantage working with two chambers of Congress controlled by his own party, but even many Republicans have said they won’t back the severity of some of the cuts he has proposed, particularly in the areas of foreign aid.

    Ron Haskins, a senior fellow at the Brookings Institution, who played a lead role in drafting the 1997 welfare changes in Congress, said Trump will need to find new support from Republicans in Congress if he is going to achieve the welfare-related overhauls he’s seeking.

    “I don’t think the Republicans on the Hill are going to feel a strong compulsion to follow the president,” Haskins said. “They are not afraid of him.”

    ———-

    “Trump to propose big cuts to safety net in new budget, slashing Medicaid and opening door to other limits” by Damian Paletta; The Washington Post; 05/21/2017

    A key element of the budget plan will be the assumption that huge tax cuts will result in an unprecedented level of economic growth. Trump recently unveiled the broad principles of what he has said will be the biggest in U.S. history, and Treasury Secretary Steven Mnuchin told a Senate panel last week that these tax cuts would end up creating trillions of dollars in new revenue, something budget experts from both parties have disputed.”

    Magical tax cuts for the rich that somehow pay fore themselves and create such a strong economy that there’s simply no need for a safety-net. The key element of the whole plan to slash almost every federal program designed to help those in need is to give to those with the most.

    And while the Trump proposals don’t mandate work requirements for almost all programs but instead gives states the right to do so if they choose, don’t forget that the GOP controls almost all states so, you know, the shredding of the safety-net is sort of a given:


    The White House also will call for giving states more flexibility to impose work requirements for people in different kinds of anti-poverty programs, people familiar with the budget plan said, potentially leading to a flood of changes in states led by conservative governors. Many anti-poverty programs have elements that are run by both the states and federal government, and a federal order allowing states to stiffen work requirements “for able-bodied Americans” could have a broad impact in terms of limiting who can access anti-poverty payments — and for how long.

    And if you’re assuming that, since the draconian measures are merely optional for states, and therefore maybe the GOP-controlled states will soon learn from their mistakes and eventually pull back from draconian restrictions on welfare programs and entitlements after they see the damage this causes, don’t forget, for that scenario to play out we’d have to be the kind of society that learns from its mistakes. At least in a timely fashion and not after we’ve collectively made the same horrible blunder over and over for generations. So, you know, considering that this horrid experiment in work-requirements-for-almost-all-help is part of a package centered around tax cuts for the rich as a universal cure for all ills, if it turns out be a social disaster it is possible states will realize this and reverse this policies. In about 50 years or so if ever. Quite possibly never. At least that’s what we should expect if we use history as our guide about how we use history as a guide.

    So that was the news from the Trump team today on its plans for the safety-net. Yes, it was almost uniformly horrific, but, hey, at least Obamacare won’t be overtly artificially imploded. For another 90 days. It will still be stealth-imploded. But not directly imploded. It wasn’t all bad news. At least not overtly.

    Posted by Pterrafractyl | May 22, 2017, 7:37 pm
  18. Here’s something to watch in the ongoing GOP health care reform follies. Or rather, here’s a someone to watch: Given the extremist nature of the GOP agenda, almost all the major legislation Trump signs into law is going to have to be legislation passed exclusively by Republicans. And that means a heavy reliance on the “reconciliation”, the special rule in the Senate that allows for the passage of a bill by a simple majority without the threat of a filibuster. But only as law as the changes involved in the new law only impacts federal spending and don’t fundamentally change the nature of existing programs.

    And the person who decides whether or not proposed legislation meets that “reconciliation” criteria is the Senate parliamentarian. Currently, that person is Elizabeth MacDonough – someone who appears to have broad bipartisan support as being both fair and non-partisan. So someone widely considered fair and non-partisan has to the power to grant her blessing to Trumpcare or tank it. And that’s what makes her someone to watch. Especially now that some GOPers, including Ted Cruz, are murmering about replacing her or just ignoring her if she doesn’t give Trumpcare her stamp of approval:

    The Washington Post

    This Senate staffer could change the course of the health-care debate

    By Paige Winfield Cunningham
    May 29, 2017

    Sometime in the next few weeks, 4ble Care Act.

    They’ll sit at a long table before someone unknown to most Americans but with singular power to influence whether Republicans can follow through on their seven-year quest to remake President Barack Obama’s signature domestic achievement.

    That person is Elizabeth MacDonough — the Senate parliamentarian, who is charged with acting as Congress’s version of a referee in the contentious health-care debate. MacDonough and her small staff will decide whether the Republican-crafted bill sent over from the House meets the requirements allowing it to be considered under special budget rules designed to protect it from Democratic defeat.

    Before MacDonough, Democrats will argue that the GOP measure known as the American Health Care Act (ACHA) bleeds over the boundaries of what can be accomplished under budget rules known as “reconciliation.” Republicans will insist that the ACHA complies with those rules by containing only provisions that affect federal spending.

    MacDonough will listen carefully to both sides. She’ll ask questions. She won’t appear to favor one side. And when she makes a decision, it will be based on her best understanding of Senate rules and precedent — not on whether she approves or disapproves of the Affordable Care Act or the effort to repeal it, multiple friends and former co-workers say.

    MacDonough’s rulings on past ACA repeal efforts suggest that she may side with Republicans in some instances. But the new GOP bill is different in that it tackles ACA repeal and attempts to replace portions of it.

    MacDonough “is in my view completely unbiased and she cares about the institution and she follows the precedent that has been established,” said David Schiappa, who for years worked closely with her as secretary for Senate Republicans.

    Bill Dauster, a longtime counsel to Senate Democrats, said: “I’ve always felt I could get a fair hearing.”

    MacDonough declined a request for an interview.

    Washington is filled with people who talk much but affect little. MacDonough is the opposite — she intentionally stays out of the spotlight, but wields enormous influence in proceedings on the Senate floor, where she, her deputy and several assistants continually advise senators on arcane procedure and a complex set of rules that few people really comprehend.

    Observers say it is a stressful role, especially as the environment in Congress has grown more partisan and toxic. Although past Senate leaders have ousted parliamentarians for decisions they didn’t like — and the Senate majority leader has the ability to do the same to MacDonough — the job is still widely considered nonpartisan. Part of being perceived as fair to both sides means that MacDonough keeps her political views to herself.

    “My experience with her is that she is fair,” said Sen. Bernie Sanders (I-Vt.), who acts as the ranking Democrat on the Budget Committee, which has had extensive interaction with MacDonough and her team. “She has a lot of responsibility on her shoulders.”

    Don Stewart, deputy chief of staff to Majority Leader Mitch McConnell (R-Ky.), said the Senate is “fortunate” to have MacDonough’s guidance.

    “The parliamentarian is a brilliant lawyer, a thorough and fair referee, and a walking encyclopedia of Senate precedent and procedure,” Stewart said.

    But the health-care debate into which MacDonough is about to step could challenge even her reputation for fairness.

    A budget reconciliation bill needs just a simple majority in the Senate to be approved — not the 60 votes typically required to overcome a filibuster. That permits Republicans to pass their health-care legislation with just 50 of their 52 members, with tiebreaking help from Vice President Pence.

    But strings are attached, and MacDonough is the one who can pull them. Each piece of such a bill must be directly related to federal spending, such as a tax or expenditure. Repealing certain parts of the ACA, such as its taxes, for example, fits easily under this standard. But other parts, such as rolling back the law’s insurance regulations, don’t necessarily qualify.

    MacDonough’s primary task over the next few weeks will be to rule on whether the AHCA qualifies as a budget reconciliation bill. If she finds that individual parts of the bill wouldn’t have a direct budgetary impact through a process known as a “Byrd bath,” those parts would be stripped out. That doesn’t mean, however, that the House would have to vote again on its measure — just that lawmakers could consider only a pared-back version.

    Most health-care experts think MacDonough will strip some parts of the House bill — indeed, many House Republicans are holding their breath regarding some of the AHCA’s riskier elements.

    The parts most vulnerable to rejection include waivers for states to opt out of protections for people with preexisting conditions, or its provision raising the ratio for how much insurers can charge older people relative to younger ones. Those elements are insurer regulations not directly related to federal spending, but some Republicans have argued an indirect link by noting that premiums would be affected and therefore the amount of subsidies the government must pay out.

    Another questionable part of the House bill is its language banning federally subsidized insurance plans from covering abortions. Abortion opponents insisted that such a ban must be included, even though that, too, might raise MacDonough’s eyebrows.

    Republicans already have a sense of how MacDonough might rule. A year and a half ago, she and her deputies analyzed a measure aimed at repealing some of the ACA but not replacing it. Although Obama ultimately vetoed that bill, House and Senate Republicans passed it partly as a readiness exercise should they eventually win the White House.

    Staffers writing that 2015 House measure didn’t attempt to repeal large parts of the ACA, fearing a challenge by MacDonough. But under pressure from conservatives, the Senate added provisions to eliminate the insurance subsidies, Medicaid expansion and small- business tax credits. Notably, MacDonough went along with those changes.

    Heartening conservatives, MacDonough ruled that a section in that measure banning Planned Parenthood from receiving Medicaid reimbursements could remain. The measure said Medicaid money couldn’t go to certain abortion providers, without explicitly mentioning the group.

    But MacDonough didn’t give the 2015 legislation an entirely free pass.

    Under her guidance, the Senate was forced to tweak language repealing the individual and employer mandates, technically leaving the requirements in place but eliminating the penalties.

    There are those preparing preemptive plans should MacDonough disappoint them.

    A few of the more conservative senators — including Ted Cruz (Tex.) — have suggested that McConnell could replace MacDonough if she rules against them — or at least allow the Senate president to overrule her.

    But that lack of support isn’t widespread. Those who know MacDonough say they’re not surprised that she doesn’t give interviews or speak publicly because she takes her job as an unbiased adjudicator seriously.

    Even some outside conservatives who argue for a more expansive interpretation of budget rules say they are not worried about MacDonough judging health care.

    “I have complete confidence in her ability to interpret Senate rules,” said Michael Cannon, a health-policy expert at the libertarian Cato Institute.

    ———-

    “This Senate staffer could change the course of the health-care debate” by Paige Winfield Cunningham; The Washington Post
    ; 05/29/2017

    “MacDonough’s primary task over the next few weeks will be to rule on whether the AHCA qualifies as a budget reconciliation bill. If she finds that individual parts of the bill wouldn’t have a direct budgetary impact through a process known as a “Byrd bath,” those parts would be stripped out. That doesn’t mean, however, that the House would have to vote again on its measure — just that lawmakers could consider only a pared-back version.”

    When (or if) the Senate actually tries to pass its own version of Trumpcare, all eyes are going to be on MacDonough. And since she has the power to strip out just specific portions of the bill, without leading to the whole thing getting rejected, that means those interests behind the portions of the bill most likely to be potentially stripped are going to be keeping a very close eye. Including one of the most powerful factions of the GOP. The anti-abortion lobby:


    The parts most vulnerable to rejection include waivers for states to opt out of protections for people with preexisting conditions, or its provision raising the ratio for how much insurers can charge older people relative to younger ones. Those elements are insurer regulations not directly related to federal spending, but some Republicans have argued an indirect link by noting that premiums would be affected and therefore the amount of subsidies the government must pay out.

    Another questionable part of the House bill is its language banning federally subsidized insurance plans from covering abortions. Abortion opponents insisted that such a ban must be included, even though that, too, might raise MacDonough’s eyebrows.

    Republicans already have a sense of how MacDonough might rule. A year and a half ago, she and her deputies analyzed a measure aimed at repealing some of the ACA but not replacing it. Although Obama ultimately vetoed that bill, House and Senate Republicans passed it partly as a readiness exercise should they eventually win the White House.

    Staffers writing that 2015 House measure didn’t attempt to repeal large parts of the ACA, fearing a challenge by MacDonough. But under pressure from conservatives, the Senate added provisions to eliminate the insurance subsidies, Medicaid expansion and small- business tax credits. Notably, MacDonough went along with those changes.

    Heartening conservatives, MacDonough ruled that a section in that measure banning Planned Parenthood from receiving Medicaid reimbursements could remain. The measure said Medicaid money couldn’t go to certain abortion providers, without explicitly mentioning the group.

    “Another questionable part of the House bill is its language banning federally subsidized insurance plans from covering abortions. Abortion opponents insisted that such a ban must be included, even though that, too, might raise MacDonough’s eyebrows.”

    Will the GOP be allowed to provide federal health care subsidies that are banned for use for plans that cover abortions? That’s one of the big questions MacDonough gets to answer. And while she has shown leniency towards the GOP’s previous proposals to prevent Planned Parenthood from receiving Medicaid reimbursements, that doesn’t mean she’ll make the same ruling for Trumpcare’s federal subsidy abortion clause. Something some GOPers are already planning to deal with:


    There are those preparing preemptive plans should MacDonough disappoint them.

    A few of the more conservative senators — including Ted Cruz (Tex.) — have suggested that McConnell could replace MacDonough if she rules against them — or at least allow the Senate president to overrule her.

    Yep, Ted Cruz and others are apparently talking about not just replacing MacDonough if she doesn’t rule in their favor but just overruling her. And if that happens, wouldn’t the GOP simply overule her on the rest of their legislative agenda? In other words, could we be on the verge of seeing the filibuster effectively break, not by getting rid of the filibuster, but by getting rid of any meaningful restrictions on the “reconciliation” process?

    Or are Ted Cruz and his merry band of far-right Senators outliers in the Senate GOP caucus? We’ll find out. Probably very soon now that MacDonough has told the GOP its no-subsidies-for-abortion-coverage provision probably won’t be allowed, potentially sinking the bill:

    The Hill

    Parliamentarian threatens deadly blow to GOP healthcare bill

    By Alexander Bolton
    06/08/17 06:30 PM EDT

    The Senate parliamentarian has warned Republicans that a provision in their healthcare reform bill related to abortion is unlikely to be allowed, raising a serious threat to the legislation.

    The parliamentarian, Elizabeth MacDonough, has flagged language that would bar people from using new refundable tax credits for private insurance plans that cover abortion, according to Senate sources.

    If Republicans are forced to strip the so-called Hyde Amendment language from the legislation, which essentially bars federal funds from being used to pay for abortions except to save the life of a mother or in cases of rape and incest, it may doom the bill.

    MacDonough declined to comment for this article.

    Unless a workaround can be found, conservative senators and groups that advocate against abortion rights are likely to oppose the legislation.

    Republicans control 52 seats in the Senate; they can afford only two defections and still pass the bill, assuming Democrats are united against it. Vice President Pence would break a 50-50 tie.

    Normally, controversial legislation requires 60 votes to pass the Senate, but Republicans hope to pass the ObamaCare repeal-and-replace bill with a simple majority vote under a special budgetary process known as reconciliation.

    The catch is that the legislation must pass a six-part test known as the Byrd Rule, and it’s up to the parliamentarian to advise whether legislative provisions meet its requirements.

    The toughest requirement states that a provision cannot produce changes in government outlays or revenues that are merely incidental to the nonbudgetary components of the provision.

    In other words, a provision passed under reconciliation cannot be primarily oriented toward making policy change instead of affecting the budget. Arguably, attaching Hyde language to the refundable tax credits is designed more to shape abortion policy than affect how much money is spent to subsidize healthcare coverage.

    The abortion language that conservatives want in the healthcare bill may run afoul of a precedent set in 1995, when then-Senate Parliamentarian Robert Dove ruled that an abortion provision affecting a state block grant program failed to meet reconciliation requirements, according to a source briefed on internal Senate discussions.

    One GOP source identified the parliamentarian’s objection to the Hyde language along with Republican infighting over how to cap ObamaCare’s Medicaid expansion as two of the biggest obstacles to passing a bill.

    A Republican senator confirmed that negotiators have wrestled with the procedural obstacle facing the anti-abortion language.

    “That has come up, and there well could be a challenge,” the lawmaker said.

    The lawmaker, however, said that the problem is surmountable, arguing, “There are ways around it.”

    One possibility would be to change the form of assistance to low-income people by changing it from a refundable tax credit to a subsidy filtered through an already-existing government program that restricts abortion services, such as the Federal Employee Health Benefits program or Medicaid.

    A second Republican senator said discussions on the topic are ongoing.

    If GOP leaders are forced to strip the Hyde language from the healthcare bill and cannot find an alternative way to seal off insurance tax credits or subsidies from being used for abortion services, they would lose the support of anti-abortion rights groups, a devastating blow.

    “We’ve made it clear in a lot of conversations and some letters that any GOP replacement plan has to be consistent with the principles of the Hyde Amendment,” said David Christensen, vice president of government affairs at Family Research Council, a conservative group that promotes Christian values.

    “Abortion is not healthcare and the government should not be subsidizing elective abortion,” he added.

    Christensen predicted that activists would be up in arms if abortion services aren’t barred under the bill.

    “If the Byrd Rule were to be an obstacle to ensuring the GOP replacement plan in the Senate does not subsidize abortion, that’s something that would be a serious problem for us and the pro-life community,” he said.

    Republican senators who are thought to be safe votes to support the GOP leadership’s ObamaCare repeal-and-replace plan may suddenly shift to undecided or opposed.

    “Would that be a deal killer? I’d have to think about it. I’m inclined to think it would [be],” said Sen. James Inhofe (R-Okla.).

    Senate Finance Committee Chairman Orrin Hatch (R-Utah), who has jurisdiction over the tax credits in the healthcare bill, acknowledged it could be tough to pass the bill without the anti-abortion language.

    “I think a lot of people do think that’s essential,” he said.

    “The parliamentarian, Elizabeth MacDonough, has flagged language that would bar people from using new refundable tax credits for private insurance plans that cover abortion, according to Senate sources.”

    Uh oh. Yeah, that just might doom the bill. Ted Cruz is going to be pissed. Along with potentially the rest of the GOP after this enrages one of the most influential factions of their base:

    ———-

    “Parliamentarian threatens deadly blow to GOP healthcare bill” by Alexander Bolton; The Hill; 06/08/17


    If GOP leaders are forced to strip the Hyde language from the healthcare bill and cannot find an alternative way to seal off insurance tax credits or subsidies from being used for abortion services, they would lose the support of anti-abortion rights groups, a devastating blow.

    “We’ve made it clear in a lot of conversations and some letters that any GOP replacement plan has to be consistent with the principles of the Hyde Amendment,” said David Christensen, vice president of government affairs at Family Research Council, a conservative group that promotes Christian values.

    “Abortion is not healthcare and the government should not be subsidizing elective abortion,” he added.

    Christensen predicted that activists would be up in arms if abortion services aren’t barred under the bill.

    “If the Byrd Rule were to be an obstacle to ensuring the GOP replacement plan in the Senate does not subsidize abortion, that’s something that would be a serious problem for us and the pro-life community,” he said.

    Republican senators who are thought to be safe votes to support the GOP leadership’s ObamaCare repeal-and-replace plan may suddenly shift to undecided or opposed.

    “Would that be a deal killer? I’d have to think about it. I’m inclined to think it would [be],” said Sen. James Inhofe (R-Okla.).

    Ted Cruz’s little ‘let’s ignore MacDonough’ idea is probably sounding a lot more tantalizing right now.

    But note the rather remarkable backup plan also under consideration: since Medicaid already bans the use of federal funds going towards abortion services, one way to get around MacDonough’s ruling is to make those federal health care subsidies paid through a program that already bans funding for abortion services. Like the Federal Employee Health Benefits program. Or Medicaid:


    A Republican senator confirmed that negotiators have wrestled with the procedural obstacle facing the anti-abortion language.

    “That has come up, and there well could be a challenge,” the lawmaker said.

    The lawmaker, however, said that the problem is surmountable, arguing, “There are ways around it.”

    One possibility would be to change the form of assistance to low-income people by changing it from a refundable tax credit to a subsidy filtered through an already-existing government program that restricts abortion services, such as the Federal Employee Health Benefits program or Medicaid.

    After years of trying to undoing the Medicaid expansion, could the GOP seriously be considering expanding the number of people who receive funds through Medicaid? It sounds like it. Or maybe they’ll do it though the Federal Employee Health Benefits program. But if this happens, it’ll probably happen though Medicaid. Why? Well, keep in mind that turning Medicaid (and Medicare) into a crappy, insufficient voucher program is basically the GOP’s long-term plan anyway. So if those crappy insufficient federal subsidies in Trumpcare for lower-income Americans who earn too much to qualify for Medicaid have to be processed through an existing federal program that already bans abortion funding there’s a logic to running it through Medicaid. It could possibly speed up the process of voucherizing the rest of Medicaid. Plus, all those new restrictions on Medicaid that states are going to be allowed to create will probably to all the new Trumpcare Medicaid recipients that get added by this move too.

    At the same time, the more people there are on the Medicaid, the more people there are that will personally care about the quality of the program. So if the GOP does end up doing a ‘Medicaid expansion’ of its own, that will at least increase the inevitable political backlash to Medicaid’s gutting.

    And that’s why the seeming good news that the Senate parliamentarian just sowed serious seeds of doubt about the prospects of Trumpcare making it through the Senate is really mixed news. Or perhaps even bad news: It’s possible the GOP will turn the Senate parliamentarian into a purely symbolic position and the “reconciliation” process will become whatever the GOP wants it to be. Or maybe Trumpcare will get a Medicaid expansion that doubles as a poison pill for the entire Medicaid program. That’s all yet to be determined. By really mean people.

    What we do know at this point is that if you’re planning on getting pregnant under Trumpcare, you better start saving now. The same presumably applies for unplanned pregnancies.

    Posted by Pterrafractyl | June 10, 2017, 7:46 pm
  19. Is someone using Whoville black magic to grow the shriveled heart of Donald Trump? Or maybe sort of rift in space and time brought us an anti-Trump from a parallel universe? Or is the inevitable personal infamy of the GOP’s horrific health care plan being nicknamed ‘Trumpcare’ finally dawning on him?

    We’ll likely never know, but something is making Donald Trump question the virtue of meanness. A rift in the space-time continuum is probably a safe bet:

    Associated Press

    AP sources: Trump tells senators House health bill ‘mean’

    By ALAN FRAM
    06/13/2017

    WASHINGTON (AP) — President Donald Trump told Republican senators Tuesday that the House-passed health care bill he helped revive is “mean” and urged them to craft a version that is “more generous,” congressional sources said.

    Trump’s remarks were a surprising slap at a Republican-written House measure that was shepherded by Speaker Paul Ryan, R-Wis., and whose passage the president lobbied for and praised. At a Rose Garden ceremony minutes after the bill’s narrow House passage on May 4, Trump called it “a great plan.”

    The president’s criticism, at a White House lunch with 15 GOP senators, also came as Senate Republican leaders’ attempts to write their own health care package have been slowed by disagreements between their party’s conservatives and moderates.

    Trump’s characterizations seemed to undercut attempts by Senate leaders to assuage conservatives who want restrictions in their chamber’s bill, such as cutting the Medicaid health care program for the poor and limiting the services insurers must cover. Moderate GOP senators have been pushing to ease those restrictions.

    Facing expected unanimous Democratic opposition, Republicans will be unable to pass a Senate bill if just three of the 52 GOP senators vote “no.” Alienating any of them could make approving the measure trickier for Senate Majority Leader Mitch McConnell, R-Ky., who’s been hoping for a vote before Congress’ July 4 recess.

    Trump’s comments were described by two GOP congressional sources who received accounts of Tuesday’s White House lunch. They spoke on condition of anonymity to reveal a closed-door conversation.

    Their descriptions of Trump’s words differed slightly.

    One source said Trump called the House bill “mean, mean, mean” and said, “We need to be more generous, more kind.” The other source said Trump used a vulgarity to describe the House bill and told the senators, “We need to be more generous.”

    Two other congressional GOP officials confirmed that the general descriptions of Trump’s words were accurate.

    The sources say the president did not specify what aspects of the bill he was characterizing.

    White House aides declined to talk on the record about Trump’s words. One said, “We aren’t going to comment on rumors about private conversations that may or may not have happened.”

    The remarks provided ammunition to Democrats who have unanimously opposed the Republican effort to dismantle President Barack Obama’s health care overhaul.

    “Americans won’t forget that @HouseGOP passed a ‘mean’ bill to rip healthcare from millions then celebrated @ the WH,” said Rep. Elijah Cummings, D-Md.

    In an embarrassing retreat, Ryan had to abruptly cancel a March vote on the House measure after a revolt by Republican conservatives and moderates that would have ensured its defeat.

    The measure’s final version reflected a compromise by conservative leader Rep. Mark Meadows, R-N.C., and centrist Rep. Tom MacArthur, R-N.J. They agreed to language letting states drop requirements under Obama’s health care law protecting people with pre-existing medical conditions from higher premiums and requiring insurers to cover specific services like maternity care.

    At the White House ceremony celebrating House passage, Trump and Ryan praised the legislation as the fulfillment of campaign promises Trump and GOP congressional candidates had long made to repeal Obama’s 2010 statute.

    “Many of you have been waiting seven years to cast this vote,” Ryan said to the scores of Republican House members present. “Many of you are here because you pledged to cast this vote.”

    Trump had not publicly criticized the House bill previously. But in a May 28 tweet that raised questions about his intent, he said: “I suggest that we add more dollars to Healthcare and make it the best anywhere. ObamaCare is dead – the Republicans will do much better!”

    ———-

    “AP sources: Trump tells senators House health bill ‘mean’” by ALAN FRAM; Associated Press; 06/13/2017

    “One source said Trump called the House bill “mean, mean, mean” and said, “We need to be more generous, more kind.” The other source said Trump used a vulgarity to describe the House bill and told the senators, “We need to be more generous.””

    Wow, what a difference five weeks makes:


    Trump’s remarks were a surprising slap at a Republican-written House measure that was shepherded by Speaker Paul Ryan, R-Wis., and whose passage the president lobbied for and praised. At a Rose Garden ceremony minutes after the bill’s narrow House passage on May 4, Trump called it “a great plan.”

    But credit where credit’s due: Parallel-universe Trump is right. That House GOP’s Trumpcare bill really is “mean, mean, mean.” Although according to a new analysis provided by the Centers for Medicare and Medicaid Services (CMS) – the federal agency that administers the programs – the House’s Trumpcare plan might not be quite a mean as the Congressional Budget Office’s (CBO) earlier projections. Both the CBO and CMS estimates still projects significantly higher health care costs for large numbers of Americans, especially sicker Americans. But the CMS only projects 4 million people will lose their coverage in the first year of the AHCA/Trumpcare whereas the CBO projected 14 million would immediately lose their coverage, so the CMS is only projecting 13 million few people will have health care coverage by the year 2026 compared to Obamacare’s projected coverage compared to 23 million people less people getting coverage under the CBO projection.

    So if the CMS’s projections turn out to be more accurate than the CBO’s – which we’ll mostly discover in the first year by looking at how many millions lose coverage – the AHCA/Trumpcare will still be much, much meaner than Obamacare, but it might not be as mean to people poised to lose their coverage right away compared to the the CBO projections…but also might be meaner to people who manage to keep their coverage with higher out-of-pocket expenses than the CBO projected. Especially sicker people. So while the net meanness of the House GOP bill is somewhat in question with this CMS report contrasting somewhat with the CBO report, it’s still definitely not a “generous” or “kind” bill no matter which estimate you look at:

    CNBC

    New analysis of GOP health-care bill says 13 million more would become uninsured, fewer than CBO estimate

    06/13/2017

    A new government analysis finds that the House’s Obamacare replacement bill would lead to 10 million fewer people lacking health insurance in the next decade than had been estimated by the Congressional Budget Officebut also projects higher premiums for many customers of individual health plans.

    The report was issued Tuesday, shortly after President Donald Trump reportedly told a group of 13 Republican senators that the House bill passed last month by the GOP majority was "mean," and that the version being drafted in the Senate should be "more generous."

    The report from the Office of the Chief Actuary of the federal Centers for Medicare and Medicaid Services says that by 2026 there would be 13 million more Americans without health insurance if it becomes law.

    In contrast, the CBO estimated in its own report that 23 million more people would become uninsured by 2026 if the House’s American Health Care Act is signed into law.

    Paul Spitalnic, chief actuary of CMS, the agency that oversees Obamacare, also projected that fewer people would become uninsured next year, the first year the AHCA would take effect.

    “In 2018, the number of uninsured is estimated to be about 4 million higher under the AHCA than under the current law, mainly due to the impact of repealing the individual mandate,” which requires most Americans to have some form of health coverage, wrote Spitalnic.

    CBO had estimated that 14 million more people would become uninsured next year if the Republican bill becomes law — 10 million more than estimated by the actuary for next year.

    Both CMS and CBO estimated how many more people would lack health insurance than would be the case if Obamacare remained intact.

    If Obamacare stays the law as is, an estimated 28 million people would be uninsured by 2026. In the actuary’s report, a total of 41 million would be uninsured by that year if the AHCA is passed. CBO estimated the total will be 51 million.

    Obamacare has been credited with expanding coverage to 20 million Americans in past several years. The House bill would remove the requirement that most people have some form of insurance or pay a fine, and reduce the amount of money the federal government spends on subsidies for insurance plans and Medicaid.

    The CMS actuary estimated that in the individual insurance plan market, “average gross premiums are estimated to be roughly 13 percent lower in 2026 under the AHCA than under current law.”

    But, he added, average net premiums, or the monthly cost of the insurance after government subsidies to customers are factored in, “are roughly 5 percent higher than under current law.”

    And the average amount of money customers would be liable to personally pay out of pocket for health services or prescriptions they receive are projected to be about 61 percent higher under the AHCA than if Obamacare remained in place.

    CBO’s estimate of the AHCA’s effect on premiums did not factor in subsidies. But it was more complicated than the actuary’s estimate because it calculated the effects of whether a state did or did not request waivers from Obamacare rules requiring insurers to not charge sicker customers higher premiums, and from rules requiring insurers to offer customers a certain minimum set of benefits.

    In some states that did not request waivers, CBO said, premiums would be about 4 percent lower than they would be if Obamacare stayed the law of the land. In other states that made moderate changes to regulations, average premiums would be about 20 percent lower than current laws.

    And premiums would be even lower in other states that were aggressive in obtaining waivers, but “less healthy people would face extremely high premiums,” CBO said.

    Elsewhere in his new report, CMS’s actuary estimated there would be an increase of direct out-of-pocket health spending by households of almost $221 billion under the AHCA. That increase in spending will be “almost entirely offset by lower spending because of declines in employer-sponsored coverage, a reduction in the additional Medicare tax for high-income earners, and the effect of the elimination of the health insurance tax on premiums” under the bill.

    Nicole Gill, executive director of the advocacy group Tax March, said, “The Trump Administration’s own Centers for Medicare and Medicaid Services released a report today proving that the American Health Care Act would be a disaster for American families as it increases their out-of-pocket health care costs by an astounding $221 billion over the next ten years.”

    “That is a stunning jump in cost-sharing that will be a heavy burden for American families, all to pay for tax cuts for the rich,” Gill said. “This report proves one thing: This bill literally takes money out of the pockets of working families to pad the wallets of millionaires and billionaires.”

    Despite that promise, and despite GOP control of both chambers of Congress, both Trump and Congressional Republicans have found it is taking longer than they had hoped to achieve that goal.

    The House bill passed that chamber by a margin of just a single vote in May.

    Since then, a group of GOP senators have been meeting, without any Democratic colleagues in attendance, to discuss the framework of their own Obamacare replacement bill.

    The secrecy of their discussions, and the refusal to date by GOP leader to publicly release details of their bill, has drawn scorn from Democrats.

    ———-

    “New analysis of GOP health-care bill says 13 million more would become uninsured, fewer than CBO estimate”; CNBC; 06/13/2017

    “If Obamacare stays the law as is, an estimated 28 million people would be uninsured by 2026. In the actuary’s report, a total of 41 million would be uninsured by that year if the AHCA is passed. CBO estimated the total will be 51 million.”

    Well, 41 million uninsured people is better than 51 million. Hooray for less projected meanness. And if the CMS’s reduced projected meanness is accurate, we’ll find out next year:


    Paul Spitalnic, chief actuary of CMS, the agency that oversees Obamacare, also projected that fewer people would become uninsured next year, the first year the AHCA would take effect.

    “In 2018, the number of uninsured is estimated to be about 4 million higher under the AHCA than under the current law, mainly due to the impact of repealing the individual mandate,” which requires most Americans to have some form of health coverage, wrote Spitalnic.

    CBO had estimated that 14 million more people would become uninsured next year if the Republican bill becomes law — 10 million more than estimated by the actuary for next year.

    4 or 14 million people. That’s the projected range of people potentially impacted by near-term extreme meanness under Trumpcare. So let’s hope it’s only 4 million (this is where we are)!

    And note the CMS still projects significant meanness even for those that keep their coverage, because they are going to be paying a lot more. Not necessarily more in terms of higher premiums. That will depend on whether or not they have a preexisting condition. What’s guaranteed is that everyone will be paying more in direct out-of-pocket expenses. Although the wealthy get a tax cut so they’ll be paying quite a bit less overall:


    The CMS actuary estimated that in the individual insurance plan market, “average gross premiums are estimated to be roughly 13 percent lower in 2026 under the AHCA than under current law.”

    But, he added, average net premiums, or the monthly cost of the insurance after government subsidies to customers are factored in, “are roughly 5 percent higher than under current law.”

    And the average amount of money customers would be liable to personally pay out of pocket for health services or prescriptions they receive are projected to be about 61 percent higher under the AHCA than if Obamacare remained in place.

    Elsewhere in his new report, CMS’s actuary estimated there would be an increase of direct out-of-pocket health spending by households of almost $221 billion under the AHCA. That increase in spending will be “almost entirely offset by lower spending because of declines in employer-sponsored coverage, a reduction in the additional Medicare tax for high-income earners, and the effect of the elimination of the health insurance tax on premiums” under the bill.

    “Elsewhere in his new report, CMS’s actuary estimated there would be an increase of direct out-of-pocket health spending by households of almost $221 billion under the AHCA. That increase in spending will be “almost entirely offset by lower spending because of declines in employer-sponsored coverage, a reduction in the additional Medicare tax for high-income earners, and the effect of the elimination of the health insurance tax on premiums” under the bill.”

    Trumpcare: At least it’s not mean to wealthy people!

    That’s Trumpcare’s meanness status under the House version. But that still leaves the Senate to weigh in and craft its own version. And it was GOP Senators who Trump was addressing when he called for less meanness.

    So will they do it? Well, if they do heed Trump’s words and engage in meanness-reduction on their Trumpcare bill, they better do it fast because the Senate GOPer are reportedly almost ready to send the Senate’s Trumpcare bill to the CBO for review. And it’s reportedly so bad (i.e. mean) that they’re keeping the bill secret from the public until the CBO gets done scoring it, and then planning on ramming it through the Senate (with minimum time for public review) a week later:

    Axios

    Senate GOP won’t release draft health care bill

    Caitlin Owens
    Jun 12, 2017

    Senate Republicans are working to finish their draft health care bill, but have no plans to publicly release it, according to two senior Senate GOP aides.

    “We aren’t stupid,” said one of the aides. One issue is that Senate Republicans plan to keep talking about it after the draft is done: “We are still in discussions about what will be in the final product so it is premature to release any draft absent further member conversations and consensus.”

    Why it matters: Democratic senators are already slamming Republicans for the secrecy of their bill writing process, and this isn’t going to help. Republicans are sure to release the bill at some point, but it’s unclear when — and they want to vote on it in the next three weeks, before the July 4 recess.

    What to watch: When the bill is finished, it’ll be sent to the Congressional Budget Office. It’ll take CBO about two weeks to evaluate and score a draft bill. Senate Republicans then want to vote on the bill before the July 4th recess. The draft bill had been expected to be finished tonight, but aides say the timing has slipped.

    This story has been updated to clarify that the bill is no longer likely to be finished tonight.

    ———-

    “Senate GOP won’t release draft health care bill” by Caitlin Owens; Axios; 06/12/2017

    “Senate Republicans are working to finish their draft health care bill, but have no plans to publicly release it, according to two senior Senate GOP aides.”

    And why isn’t the GOP planning on releasing its Trumpcare plans to public? Because “we aren’t stupid”:


    “We aren’t stupid,” said one of the aides. One issue is that Senate Republicans plan to keep talking about it after the draft is done: “We are still in discussions about what will be in the final product so it is premature to release any draft absent further member conversations and consensus.”

    Yep, the GOP Senators aren’t stupid. They’re mean. And they realize that their bill is so mean it will spark public outrage. You know, like what happened to House GOPers before and after they unleashed their mean, mean, mean Trumpcare bill. Why would the GOP Senators want all that public meanness directed at them? Better to hide all the meanness and them ram it through at the last minute and hope everyone gets distracted by one of the other debacles going on.

    So it appears that the meanness will proceed full steam ahead, but in stealth-mode for the time being. At some point they’ll have to make the Senate bill public, which apparently will be shortly followed by an actual vote. And then, who knows, maybe Trumpcare will become a reality. A very mean reality.

    Except for the rich. There will be significant niceness heading their way. With some notable exceptions.

    Posted by Pterrafractyl | June 13, 2017, 9:06 pm
  20. When James Hodgkinson – a Bernie-or-Buster driven violently mad by his anti-Trump/GOP feelings – attacked the GOP baseball team, part of what made the tragedy so tragic was the tragic response seen across the right-wing media landscape that almost immediately used the attack to feed into a narrative that had already taken hold since Trump’s electoral victory that the left was growing violent, with open promotion of violence against Trump by Democratic leadership. That’s been one of the primary memes that was already reverberating across Fox News, right-wing talk radio, and outlets like Brietbart well before the Hodgkinson attack thanks in part to ongoing scuffles between Alt-Rightists and ‘antifa’ groups typically affiliated with Black Bloc. Thanks to antifa and Black Bloc activities alone, the ‘violent left’ meme has been a staple of right-wing media in the Trump era.

    So when someone predictably snaps (as happens like sickening clockwork in America), a giant media campaign to decry the left as a violent threat to American society was already in full swing and kicking into overdrive. The ‘violent left’ meme is isn’t just an hourly meme on Fox News. It’s like every 15 minutes there’s a ‘violent, dangerous left!’ meme reminder.

    But the deranged nature of the right-wing media’s response to the Hodgkinson attack has been elevated to a whole new level with an attempt to push a meme that’s almost impressive in its audaciousness: we’re now being told that all the harsh criticism of Trump and the suggestion that he might not have the American people’s best interests in mind are creating a dangerous political environment and the US needs a period where everyone just kind of stops criticizing Trump so much and lay off the investigations. And to do otherwise is to promote political violence against Trump and Republicans. That’s seriously the new right-wing meme and it’s dominating conservative media.

    So get ready for the next phase of the Trump era lunacy thanks to the madness actions of James Hodgkinson: the period when dissent against the Trump agenda is literally harming the President in a way that shouldn’t be allowed. That’s where we are. Again, it’s been a pretty tragic response. Yowza:

    Slate

    Beware of GOP Calls to “Tamp Down” Criticism of Trump in Wake of Shooting

    By Jeremy Stahl
    June 14 2017 4:41 PM

    A lot of things about Wednesday’s shooting at a congressional Republican baseball practice felt reminiscent of the 2011 assassination attempt on Rep. Gabby Giffords that left six people dead including a congressional staffer. Like six years ago, the most prominent leaders of both parties issued a call for unity from both sides of the aisle, for example.

    Most notably, though, there was a vocal, immediate, and familiar outcry about political rhetoric. Specifically, there were sometimes vague assertions from conservatives that overheated political language—and media coverage—was to blame for James T. Hodgkinson’s assault that sent Rep. Steve Scalise, one congressional staffer, and multiple others to the hospital with injuries. These calls mirrored complaints from liberals at the time of the Giffords assault that overheated political rhetoric might be to blame for Jared Lee Loughner’s attack.

    Hodgkinson’s leanings—he posted liberally on social media about his hatred for Republicans and love of Bernie Sanders—are more obviously partisan than those of Loughner, a gold bug atheist. But now, even more than then, we should be wary of any attempt to use a tragic and horrible crime as a means for stifling legitimate political dissent.

    Some of the discussion from conservative circles on Wednesday was a complete 180-degree turn from their impassioned defenses of political speech following the Giffords shooting. There were, in fact, already hints that the episode would be used to try to attack speech critical of President Donald Trump.

    Former Speaker of the House and Trump ally Newt Gingrich said that the attack was part of a “pattern” of hostility toward the president on the left, comparing the shooting to Kathy Griffin’s dumb severed Trump head stunt, the controversial production of Shakespeare’s Julius Caesar that depicts a Trumpian version of Caesar, and Sen. Kirsten Gillibrand swearing.

    “Whether it’s a so-called comedian holding up the president’s head in blood, or it’s right here, in New York City, a play that shows the president being assassinated,” he said. “Or it’s Democratic leading national politicians who are so angry they have to use vulgarity because they can’t find any common language.”

    Donald Trump Jr. also sent out a tweet seeming to compare this assault to the staging of Julius Caesar.

    Politico pointed to other right-wing commentators who were explicitly comparing challenges of Trump—from those on the left and in the media—to this attempted murder:

    Conservative radio host Michael Savage tweeted “I warned America the Dems constant drumbeat of hatred would lead to violence!”

    Perhaps most disturbing was Rush Limbaugh’s description of Hodgkinson as the “personification” of the “deranged base” of the Democratic Party and his suggestion that the media, federal investigations, and Congressional investigations of Trump and his administration were somehow to blame for this violence:

    You can’t continue to enrage people the way the left, and predominantly the media, has been doing. The Democrat Party and the left for years have been feeding this. And particularly since the election of Trump they have virtually assured their supporters that Trump is guilty, guilty of treason. And every congressional hearing is going to provide the proof. Every one. Sessions yesterday, Comey a couple of times, Sally Yates, you name it.

    (Compare this with Limbaugh’s outrage after the Giffords shooting during which he accused Democrats of trying to clamp down on free speech and “profit out of murder.”)

    It wasn’t just conservative media voices, either. Republican legislators and officials spoke throughout the day of “tamping down” rhetoric, without explicitly describing how and what rhetoric. The hints, though, were that the rhetoric that needed to be tamped down was criticism of Trump and his Republican Party, both from Democrats and from a media that the president has called the “enemy” of the American people.

    “We’ve got to ratchet down the rhetoric that we’ve seen, not only on social media, but in the media in our 24-hour news cycle,” Rep. Rodney Davis told CNN. “These are the things that have to stop. This is a result of political rhetorical terrorism.”

    Rep. Dave Brat also criticized Gillibrand for “using the F-Bomb in public” as he called for “ramp[ing] down the language.”

    “It is OK to fight on policy. But the line should be no attacks on personalities going forward,” Brat told Fox News. “Just debate policy real hard, but ramp it down on the attacks on the personalities or the parties.

    Brat said that this extended to attacking Trump personally, without specifying what exactly that meant.

    “They’re free to attack his policy,” he said. “But they should not be attacking him personally, or as a party and raising the verbage.” (Trump was the one, if you’ll recall, who accused the last president of being a foreign and illegal usurper of the White House with his birther conspiracy theory.)

    I think the media is complicit if they keep inciting as opposed to informing,” Rep. Jack Bergman said on Fox News. “You need to make sure that you think twice about how your words and inflections and phrases might affect all the people who might see it.”

    Again, this echoes a debate that occurred immediately after the Giffords shooting. Pima County Sheriff Clarence Dupnik kicked off that discussion by saying that “vitriol that comes out of certain mouths, about tearing down the government, the anger, the hatred, the bigotry that goes on in this country” can influence “unbalanced people” who might commit violence.

    At the time, liberals also attacked Sarah Palin for having included Giffords’ district in the crosshairs of a “target map,” which some on the left equated to encouraging political violence. (Palin famously attacked these critics for “blood libel.”)

    “Dissent is the highest form of patriotism, and any move to imply that asking questions of public officials or engaging in criticism of government is somehow suspicious or indicative of a violent individual is a damning indictment of everything America is supposed to stand for,” InfoWars wrote at the time.

    Contrast that with the position of Alex Jones’ site on Wednesday that this latest attack was a case of “media-inspired terror attacks.”

    “We have been warning for months that the mainstream media’s hysterical anti-Trump narrative and the left’s insistence that Trump is illegitimate will radicalize demented social justice warriors and prompt them to lash out with violence,” the site wrote. “It looks like that’s exactly what happened today. The blood is on their hands.”

    With the empowerment of voices like Jones’ by the president and the Republican Party, it’s not unreasonable to wonder what the GOP means when it asks for toned down rhetoric. Should the media stop publishing stories about the congressional investigations into Trump, or the credibility gap between the president and his main accuser James Comey? Should those investigations be put to a halt, as Trump has suggested in deed with the Comey firing and reportedly in word with his reported desire for special counsel Robert Muelller to also lose his job?

    That should be the biggest concern now out of any of these criticisms of the media and calls to “ratchet down” free speech.

    As then Slate columnist Jack Shafer wrote at the time of the Giffords shooting: “Any call to cool ‘inflammatory’ speech is a call to police all speech, and I can’t think of anybody in government, politics, business, or the press that I would trust with that power.”

    The man at the top of the government has publicly said that he wants that power, which makes those words even truer now than they were six years ago.

    ———-

    “Beware of GOP Calls to “Tamp Down” Criticism of Trump in Wake of Shooting” by Jeremy Stahl; Slate; 06/14/2017

    “Perhaps most disturbing was Rush Limbaugh’s description of Hodgkinson as the “personification” of the “deranged base” of the Democratic Party and his suggestion that the media, federal investigations, and Congressional investigations of Trump and his administration were somehow to blame for this violence”

    And as we just saw, Limbaugh was just one voice in the right-wing din trying to make criticism of Trumnp dangerous. Especially Trump’s personality. His increasingly erratic personality. It’s a deeply trouble new phase of the Trump era because there’s no reason to assume this meme is going to end at all. It’ll just keep getting pushed as some sort of ‘truth’ that there’s a problem with left-wing violence in America. And if you had to come of up with a terrifying scenario to see unfold when someone like Steve Bannon is sitting where he’s sitting in the White House while the Trump continues to isolate and implicate himself and the Alt-Right continues to sell itself to American conservatives, the right-wing media complex spending the next four years trying to convince its audience that Democrats are promoting violence would have to be near the top of the list of terrifying scenarios.

    So it’s going to be worth keeping in mind that this new phase of trying to stifle criticism of Trumnp under the banner of ‘toning it down’ is actually a great excuse to do something the whole media, especially the right-wing media, should have been doing this whole time much more than it’s generally done so thanks to all the attention placed on Trump’s Russia probe and the subsequent self-inflicted obstruction of justice inquiries: covering the Trump/GOP policy agenda slowly winding its way through Congress. It’s a nightmare agenda that in other times would be making one headline after another as all the details drip out day by day. But in Trump’s era we just get a few brief periods when policy gets a lot of media coverage, like when the House fails to pass Trumpcare and finally does so and throws a kegger, and the rest of the time all eyes are on #TrumpRussia. So, how about in the spirit of bipartisan comradery, the media pledges to spend a lot more time cover the Trump/GOP nightmare policy agenda.

    For instance, as we saw in a recent debate in the Georgia special election between Republican Karen Handel and Democrat John Ossoff, much more attention to how the GOP Senate is refusing to provide the public any details on its Trumpcare plan is clearly required for Georgia voters to make an informed vote so how about a bipartisn focus on those details (which are secret because the GOP won’t reveal its Senate Trumnpcare bill to the public yet):

    NBC News

    How Health Care Is Playing in Georgia’s Special Election

    by Chuck Todd, Mark Murray and Carrie Dann

    First Read is your briefing from Meet the Press and the NBC Political Unit on the day’s most important political stories and why they matter.

    How health care is playing in Georgia’s special election

    The long-awaited congressional runoff in Georgia takes place on Tuesday, and one way to look at the contest is as a referendum of sorts on the health-care debate, especially now with Senate Republicans working on their own bill. Democrat Jon Ossoff opposes the repeal-and-replace legislation the House passed last month, while Republican Karen Handel supports it. Here’s an exchange from their debate earlier this month:

    Handel: The system we’re under now under Obamacare is collapsing. And I know because my husband and I get our insurance on the exchange. The premiums are skyrocketing and we are seeing a complete collapse in choice of plans, as well as physicians. Steve and I have seen our monthly premium go up from about $350 a month to nearly $1,200 a month. Our deductible from $2,500 to $10,000. So the status quo is unacceptable…

    Ossoff: I met a little boy about a month ago named Matt who came out to canvass with us, knock on some doors. He is 7 years old, and he was born with a heart condition — a pre-existing condition. And he is able to get coverage right now because there are protections for children like that with pre-existing conditions. But Secretary Handel supports a bill that would gut the protections for Americans with pre-existing conditions…

    Handel: My sister has a pre-existing condition; she was born without an esophagus, and for you to suggest that I would do anything that would negatively affect her is absolutely outrageous and unacceptable. The facts are, ladies and gentlemen, that the bill in the Senate right now it provides more protections for individuals with pre-existing conditions…

    Ossoff: When it comes to pre-existing conditions, I’m afraid you’re mistaken. The bill that passed the House guts protections for pre-existing conditions for Georgians.

    According to the recent Atlanta Journal-Constitution poll of this race, more than 80% of likely voters said health care is an “extremely important” or “very important” issue regarding their vote, and just 1-in-4 voters said they approved of the House health-care plan. And remember, this is the race to fill the seat vacated by Republican Tom Price, who is now Trump’s HHS secretary — and that’s another way health care is an issue in this contest.

    According to the recent Atlanta Journal-Constitution poll of this race, more than 80% of likely voters said health care is an “extremely important” or “very important” issue regarding their vote, and just 1-in-4 voters said they approved of the House health-care plan. And remember, this is the race to fill the seat vacated by Republican Tom Price, who is now Trump’s HHS secretary — and that’s another way health care is an issue in this contest.”

    Yep, 80 percent of the voters in this congressional district view health care as extremely important, and yet Karen Handel and John Ossoff are nearly tied while Handel stands up there during a debate defending a Trumpcare bill that will gut the vast majority of Obamacare’s most popular provisions. Like protections for people with pre-existing conditions. And at this point he GOP won’t even let the public see the bill its working on and appears to be planning on ramming the thing through a vote right after revealing the final product. So when Karen Handel suggested earlier this month to the public that the Senate GOP bill is going to have more generous pre-existing condition protections, she was asserting something she can’t really know at this point since those negotiations are ongoing and private, but it was also exactly the kind of information that the media and politicians should be following closely right now. Especially given the importance the public gives to this issue:


    Ossoff: I met a little boy about a month ago named Matt who came out to canvass with us, knock on some doors. He is 7 years old, and he was born with a heart condition — a pre-existing condition. And he is able to get coverage right now because there are protections for children like that with pre-existing conditions. But Secretary Handel supports a bill that would gut the protections for Americans with pre-existing conditions…

    Handel: My sister has a pre-existing condition; she was born without an esophagus, and for you to suggest that I would do anything that would negatively affect her is absolutely outrageous and unacceptable. The facts are, ladies and gentlemen, that the bill in the Senate right now it provides more protections for individuals with pre-existing conditions…

    Ossoff: When it comes to pre-existing conditions, I’m afraid you’re mistaken. The bill that passed the House guts protections for pre-existing conditions for Georgians.

    “The facts are, ladies and gentlemen, that the bill in the Senate right now it provides more protections for individuals with pre-existing conditions…”

    Well, no, the facts are not that the Senate the bill has more generous pre-existing conditions than the House bill (which is a low bar). We don’t know what’s in the Senate bill. But we should know. And it’s the kind of thing the public would really like to know. So how how, in the spirit of trans-partisan harmony, the American media pledge to spent much, much closer attention to the GOP agenda moving through Congress in order to extract from the politicians all the information the public needs. After all, if you look at much of what’s driving division in America, it’s misinformation. And if there’s one thing that can create a new spirit of coming together it’s correcting that misinformation. Yes, right now that misinformation campaign has taken an extremely dark turn by trying to push a ‘dissent promotes a violent left’ meme, but that’s just the latest in a long line lf misinformation campaigns promoted primarily be right-wing media and politicians. So how about a bipartisan commitment to correcting misinformation about the GOP policy agenda and focusing on the agenda’s actual winners and losers from the agenda.

    No personal attacks are required…unless misinformation is being peddled in which case there’s a ‘you’re lying’ personal attack that’s required at a minimum. But other than that, a focus on policy really could be a great way to reset the nation dialogue on a more constructive path. A sustained closer look at the Trump/GOP agenda could be shockingly unifying.

    Posted by Pterrafractyl | June 18, 2017, 4:40 am
  21. The big secret Senate Trumpcare bill is finally being revealed to the public. And finally being revealed to the Senate Democrats too since the entire thing was written behind closed doors by 13 Republicans. And while we didn’t actually have to see all the details to know that this was going to be a horrible bill, at least we get to finally see the details. Hooray/Uh oh!

    So did the bill avoid being “mean”, as Donald Trump requested? And does it have “heart”, as Trump recently predicted? Well, maybe, but only if we add the provisions that the bill’s “heart” was at some point in the past a decent heart that is now suffering from significant heart failure:

    NBC News

    Inside the Health Care Bill: Trump Wanted ‘Heart.’ He Didn’t Get It

    by Benjy Sarlin
    Jun 22 2017, 4:49 pm ET

    WASHINGTON — The 142-page Senate health care bill released on Thursday is easy to summarize: It cuts health care spending for low-income and middle-income Americans and uses the savings to finance large tax cuts for the wealthy and the medical industry.

    How it accomplishes this is simple as well: It makes large cuts to Medicaid and to subsidies for private insurance, meaning large chunks of money that the government would have spent on helping Americans afford coverage, pay for long-term care and reduce their out-of-pocket costs would instead be paid either by states or by the customers themselves.

    In this regard, the bill, which is called the Better Care Reconciliation Act, is broadly similar to the American Health Care Act that passed the House in May. There are some significant differences within that framework, however, especially when it comes to private insurance subsidies.

    Let’s go through the main planks of the Senate plan:

    Medicaid cuts

    Medicaid covers about 70 million Americans, including low-income residents, seniors in nursing homes (over 60 percent of whom are on Medicaid) and people with disabilities.

    The Senate bill would restructure the program, cap its spending and reduce its funding significantly over time.

    First, the Senate GOP bill would eliminate a major expansion of Medicaid under Obamacare.

    The Affordable Care Act gave states federal funding to expand Medicaid coverage to people whose incomes were between 100 percent and 138 percent of the federal poverty line (the current cap is about $34,000 for a family of four). The Supreme Court later made the funding optional, but 30 states and the District of Columbia accepted it. The Senate bill would gradually end this expansion between 2020 and 2024.

    But it would go a lot further than repealing Obamacare’s changes. It would also cap the amount of funding states can get on a per-recipient basis rather than continue the current system, in which states decide how much to spend and then have the federal government match their contribution.

    Starting in 2025, the plan would then grow those per-recipient caps at a rate that’s unlikely to keep pace with increasing medical costs. A similar change in the House bill was projected to reduce Medicaid spending by $839 billion over a decade and cover 14 million fewer people. The Senate bill kicks in later, but its cuts would be even deeper than the House plan.

    To make up the difference, states would either have to raise taxes, cut programs elsewhere or reduce benefits and coverage for recipients. That prospect has governors, including some Republicans like Ohio Gov. John Kasich, nervous that the reduced funding will hamper their ability to respond to health crises like the current opioid epidemic. The bill provides an extra $2 billion next year for substance-abuse treatment, a small number compared to its looming cuts.

    But the Medicaid cuts also have small-government conservatives nervous. Congress has a history of passing cuts to services or tax increases and then delaying them down the line. The more time before they kick in, the greater the chance that government control might change hands or public opposition could prompt a reversal.

    Private insurance subsidies

    When it comes to Obamacare’s subsidies to buy private insurance, the Senate bill keeps the same basic structure, but provides less money for fewer people to purchase insurance that is less generous. These changes would also raise premiums for older people.

    Under the current system, people who don’t get health insurance through work or a government program can qualify for help buying a private plan on Obamacare’s exchanges. The maximum amount you’re expected to contribute is capped based on your income.

    There are limits, though. If your income is higher than 400 percent of the federal poverty line — about $98,000 for a family of four — you don’t get those subsidies. This is one of the biggest gripes about Obamacare: While most people qualify for aid, those who miss the cutoff have to pay full price, which can be difficult to afford.

    The Senate bill would expand this complaint to a wider group. It would cut the subsidies off at 350 percent of the federal poverty line instead, about $86,000 for the same family. On the other hand, it would also cover some lower-income people who currently fall in the “Medicaid gap” in states that didn’t take the federal expansion.

    Those who qualify for subsidies could also pay higher premiums. Under current law, no Obamacare recipients are expected to contribute more than 9.5 percent of their income in premiums. But the Senate bill changes this and make the caps more generous for younger customers and less generous for older customers. A 60-year-old making $42,000 would now have to contribute as much as 16 percent of their income to premiums.

    In addition, the subsidies would be pegged to less comprehensive insurance. Under the current law, they’re calculated based on a “silver plan” that covers an average of around 70 percent of medical costs. The new bill would peg them to plans that cover only 58 percent of costs. That means higher deductibles, which have also been a major complaint among Obamacare users.

    Out-of-pocket expenses would actually go up even higher for many Americans. Obamacare provided “cost-sharing reduction” payments to insurers, which they used to lower expenses for customers making up to 250 percent of the federal poverty line (about $61,500 for a family of four). For those at 150 percent of the line, these payments reduced the average deductible from $3,609 to just $255, according to the Kaiser Family Foundation. But the Senate bill ends those subsidies starting in 2019.

    This is still a big difference from the House bill, which would have offered only fixed tax credits. Those credits would have likely fallen far short for many people, especially older, lower-income customers in places with high health care costs, which are often rural areas. Now the subsidies will scale up to meet the costs in their area, even if they fall short of current levels.

    In addition to the subsidies, the bill provides significant funding to help stabilize insurance markets in the short-term (which have been jittery, partly due to the health care debate) and a $62 billion fund over eight years to help states potentially cover more expensive patients. But the funding is temporary, making the future uncertain.

    Pre-existing conditions

    The Senate bill does not let insurers deny people coverage based on a pre-existing condition or charge them more based on their health, which keeps two core pieces of Obamacare in place.

    However, this doesn’t mean those with pre-existing conditions won’t potentially be affected. The bill does give states flexibility to waive Obamacare’s “essential health benefits,” a list of 10 broad categories of coverage every insurance plan needs.

    Republicans argue states should be able to eliminate those requirements in order to lower overall premiums and provide more flexibility to insurers and customers. In the pre-Obamacare era, insurance companies often didn’t cover items like maternity care or mental health treatment, two categories that are included in “essential health benefits.”

    Some health experts fear that insurers will try to shepherd healthier patients into cheaper plans that cover fewer items, leaving patients with pre-existing conditions struggling to find an affordable option that covers their treatment. So even though insurers will not be able to discriminate based on pre-existing conditions, the effect could be to make their care less affordable.

    “This, in many instances, means that plans will become less comprehensive and cover less, which in turn means that if you’re an individual or family needing a certain type of care, you’ll be digging into your own pockets,” said Arthur Tacchino, chief innovation officer at SyncStream Solutions, which specializes in health care compliance.

    Importantly, items that aren’t considered essential health benefits could be subjected to lifetime or annual limits by insurers, a practice that Obamacare eliminated.

    The individual mandate

    There would be no individual mandate requiring that people buy insurance, which penalized people who went without coverage.

    This bill eliminates the penalties entirely, though, and instead counts on healthier people deciding coverage is affordable enough for them to purchase. That could be a problem if they conclude that the new insurance, which could have higher deductibles, is not worth the trouble.

    “I just don’t see why people would sign up,” Joe Antos, a fellow at the American Enterprise Institute, told NBC News.

    If they don’t come off the sidelines, or if they drop their existing coverage, premiums could rise for everyone as markets become dominated by sicker customers. Rebecca Owen, health research actuary at the Society of Actuaries, said in a statement on Thursday that she was concerned the bill could create “anti-selection” and would be watching this issue closely.

    Taxes

    Unless you were paying a penalty for not carrying insurance, it’s unlikely you’ll notice any change in your taxes as a result of the Senate bill.

    For rich people, though, the Senate bill is a nice income boost. It eliminates a surtax on income and investment gains for individuals making over $200,000 a year and married couples making over $250,000 a year. The bill also cuts taxes on health companies like medical device manufacturers and prescription drug companies.

    Abortion and reproductive health

    The Senate bill cuts off federal money to Planned Parenthood. Federal money is already barred from going toward abortion, but the group receives reimbursement for providing other services.

    The bill also bars plans that are eligible for tax credits from covering abortion, with exceptions for rape, incest or the health of the mother.

    Abortion was one of the last obstacles to passing health care in 2009 and 2010 as well. To help assuage pro-life Democrats, the Senate bill included language that allowed insurers on the new exchanges to sell plans that cover abortion, but required that any money for abortion services came out of customers’ premiums.

    The Senate version goes further. Women on the individual market will likely no longer be able to find plans that cover abortion services. But there’s a catch: Odds are high that the language violates procedural rules in the Senate and will not make it into a final version of the bill as a result.

    Does it have ‘heart?’

    President Donald Trump said recently that the Senate bill should be “something with heart.”

    “Heart” is a subjective idea, but Trump laid out very specific standards as a candidate and as president. By those standards, the bill falls short.

    Trump explicitly pledged he would make no cuts to Medicaid. Instead, the bill will cut Medicaid by hundreds of billions of dollars. He promised “insurance for everybody” backed by federal spending: Instead the bill will likely cover millions fewer people than current law. He repeatedly promised lower deductibles: Instead a core feature of the bill pushes customers towards higher deductible plans. He argued his dedication to providing more generous health care distinguished him from conservative Republicans who sought smaller government.

    “This bottom line is that this bill will result in a very significant reduction in insurance coverage, as well as large increases in premium and out-of-pocket costs for those who manage to retain coverage,” Matthew Fiedler, a fellow at the Brookings Institute, told NBC News.

    Should the bill become law, these will be unambiguous broken promises.

    ———-

    “Inside the Health Care Bill: Trump Wanted ‘Heart.’ He Didn’t Get It” by Benjy Sarlin; NBC News; 06/22/2017

    “Trump explicitly pledged he would make no cuts to Medicaid. Instead, the bill will cut Medicaid by hundreds of billions of dollars. He promised “insurance for everybody” backed by federal spending: Instead the bill will likely cover millions fewer people than current law. He repeatedly promised lower deductibles: Instead a core feature of the bill pushes customers towards higher deductible plans. He argued his dedication to providing more generous health care distinguished him from conservative Republicans who sought smaller government.”

    Wow, almost every health care-related pledge Trump made on the campaign trail is broken by the Senate’s bill. That’s almost impressive. But don’t assume passage of the bill is a done deal. Because as was the case with the House version of Trumpcare, the Senate bill is suffering from the same problem of some GOP Senators saying it’s too heartless and others saying it’s not heartless enough.

    But as we also saw with the House version of the bill, it’s really just a matter of time before the ‘moderates’ cave. So if you were hoping that this bill might be stopped by GOP ‘moderate’ senators searching their hearts and suddenly having an epiphany, don’t forget that ‘heart’ isn’t the only symbolic organ required in this this instance. A spine is needed too which means nothing is stopping this bill:

    Talking Points Memo DC

    Don’t Assume Conservative Defections Will Sink Senate TrumpCare Bill

    By Tierney Sneed
    Published June 22, 2017 4:55 pm

    Within a few hours of the release of the Senate legislation to dismantle the Affordable Care Act and overhaul Medicaid, four conservatives came out against the bill, putting Majority Leader Mitch McConnell (R-KY) two votes short of what he will need to pass it.

    But this is not, by any means, the death knell for the bill, dubbed the Better Care Reconciliation Act, and it might not be even a major obstacle.

    A key phrase in the statement from Sens. Ted Cruz (R-TX), Rand Paul (R-KY), Mike Lee (R-UT) and Ron Johnson (R-WI) criticizing bill is that they are not ready to vote for it but “are open to negotiation.” And there’s plenty of reason to believe McConnell left himself some wiggle room, even in the expedited timeline he has set to vote on the bill next week, to win their votes.

    Anyone who watched the House dynamics around the passage of their version of a Obamacare repeal bill will remember this old song and dance well. A tantrum by the conservatives there led to the bill being pulled farther to the right. When some House GOP moderates then revolted, some money was thrown at their problems with the bill —namely its rollback of Obamacare protections for pre-existing conditions—and House GOP leadership got enough moderate Republicans back on board to assure its narrow passage.

    If anything, McConnell has set up a scenario that is a cleaner and quicker version of this kabuki theatre.

    Conservatives aren’t saying yet what exactly they want changed about the bill in exchange from their support, other than that the current bill fails “to repeal Obamacare and lower … healthcare costs.”

    “We continue to have positive, productive conversations,” Cruz told reporters Thursday afternoon.

    Paul was more vocal in airing his grievances and he might be long gone. But Cruz and Lee were members of the health care working group tasked with negotiating the original discussions, and Johnson was a frequent cameo attendee of their meetings. It stands to reason that McConnell and his staff, who were usually present at working group meetings, have a pretty good idea of exactly what it would take to win them over.

    Members of the Senate GOP’s leadership team seemed optimistic there were changes that could be made to get Senate Republicans to 50 votes in support of their bill.

    A concession to conservatives would put the ball back in the court of the moderates, who at the very least are uncomfortable with the initial working draft of the legislation. So far, they have stopped short of taking any dramatic stands, but some are cautiously beginning to raise their concerns. If changing the bill to appease the conservatives ends up costing some of the moderate votes, it’s not hard to see where else in the legislation McConnell has created space to throw them some bones.

    For instance, the current version of the draft contains only $2 billion in funding for opioid addiction, which Sen. Shelley Moore Capito (R-WV) has already called an “area of concern” given the way slashing Medicaid guts substance abuse programs. One could imagine McConnell eventually upping that number closer to the $45 billion she and Sen. Rob Portman (R-OH) were previously lobbying for. Or he can provide a transition period for the phaseout of Medicaid expansion closer to seven years, what they asked for, instead of the three years allotted in the current bill.

    To pay for these sort of extra measures for moderates, there’s room for some tinkering with the tax cuts included in the Senate bill. Some of the taxes that are eliminated by the Senate bill are currently repealed retroactively. The retroactive year can be put back in to raise some extra revenue.

    How long it will take for this public bargaining to unfold is another question. Senate GOP leaders are hopeful for a vote by next Friday before Congress leaves for its July 4 recess.

    Cornyn suggested that McConnell could file a final bill Tuesday that looks a little different than the “discussion draft” unveiled Thursday morning. That would require additional analysis by the CBO, on top of the score of the current bill expected early next week. “We’ll be talking to them about individual tweaks and changes if there are any,” Cornyn said.

    ———–

    “Don’t Assume Conservative Defections Will Sink Senate TrumpCare Bill” by Tierney Sneed; Talking Points Memo DC; 06/22/2017

    “Anyone who watched the House dynamics around the passage of their version of a Obamacare repeal bill will remember this old song and dance well. A tantrum by the conservatives there led to the bill being pulled farther to the right. When some House GOP moderates then revolted, some money was thrown at their problems with the bill —namely its rollback of Obamacare protections for pre-existing conditions—and House GOP leadership got enough moderate Republicans back on board to assure its narrow passage.”

    Don’t forget, the GOP ‘moderates’ aren’t interested in actually crafting a bill that improves health care for their constituents. If they were they wouldn’t be Republicans. They’re interested in political cover for heartlessly ruining the future health and finances of their constituents. And there’s no shortage of bones the GOP leadership can throw them:


    A concession to conservatives would put the ball back in the court of the moderates, who at the very least are uncomfortable with the initial working draft of the legislation. So far, they have stopped short of taking any dramatic stands, but some are cautiously beginning to raise their concerns. If changing the bill to appease the conservatives ends up costing some of the moderate votes, it’s not hard to see where else in the legislation McConnell has created space to throw them some bones.

    For instance, the current version of the draft contains only $2 billion in funding for opioid addiction, which Sen. Shelley Moore Capito (R-WV) has already called an “area of concern” given the way slashing Medicaid guts substance abuse programs. One could imagine McConnell eventually upping that number closer to the $45 billion she and Sen. Rob Portman (R-OH) were previously lobbying for. Or he can provide a transition period for the phaseout of Medicaid expansion closer to seven years, what they asked for, instead of the three years allotted in the current bill.

    To pay for these sort of extra measures for moderates, there’s room for some tinkering with the tax cuts included in the Senate bill. Some of the taxes that are eliminated by the Senate bill are currently repealed retroactively. The retroactive year can be put back in to raise some extra revenue.

    Yep, the GOP Senate’s bill is so focused on tax cuts for the wealthy that it even includes retroactive tax cuts. So why not repeal some of those retroactive cuts to placate the moderates while making even deeper future cuts to get the four far-right holdouts like Ted Cruz on board? Sure, a reasonable answer for “why not?” would be “because that’s a mean, heartless thing to do.” But since we’re dealing with mean, heartless people it’s hard to see why they won’t eventually agree to such a deal. This bill fulfills long-held GOP goals: tax-cuts for the rich, repudiating Obama, and gutting entitlements. The only possible obstacle left is a lack of the political cover needed to get away with it.

    And that’s what this final phase where the GOP negotiates with itself is all about: establishing political cover. That’s basically the only phase left:

    I am very supportive of the Senate #HealthcareBill. Look forward to making it really special! Remember, ObamaCare is dead.— Donald J. Trump (@realDonaldTrump) June 22, 2017

    And what’s the “really special” political cover going to be? Well, that’s sort of up to the American public because the cover is going to come in the form of whatever bones the GOP has determined it can throw to each Senator so that Senator can throw that bone to their constituents. That’s how this kind of grift is supposed to work. So we’ll get to see what sort of “really special” political cover gets inserted into the bill at the last minute. Which means at this point we can say with confidence that the final bill isn’t going to have any ‘heart’ at all, but it’s going to have an abundance of ‘bones’.

    Posted by Pterrafractyl | June 22, 2017, 3:49 pm
  22. Well that’s a relief: the Democrats just experienced a mini-wave election in Tuesday’s 2017 off-year elections that includes a sweep in Virginia’s elections after the GOP went into full Trump/Bannon nativist mode for Ed Gillespie’s gubernatorial campaign. And while it’s probably in part a backlash against Trump’s low ratings due to his white nationalist agenda and highly unpresidential behavior, and it’s worth keeping in mind that Trump’s appeal to a lot of cross-over voters who aren’t die-hard Republicans came from his portrayal of himself as someone who isn’t a Republican on economic and entitlement issues like Medicare and Medicaid in addition to his white nationalism. At least that’s the language he used and it was part of this appeal.

    So while the GOP’s losses are undoubtedly going to generate a lot intra-party finger-pointing, including the Trump administration pointing at the congressional GOP over their inability to pass any major legislation initiatives like Trumpcare for Trump to sign, it’s important not to forget that one of the big reasons voters might be turning away from Trump is that the GOP almost did pass major legislation and it was horrifying legislation. And where the GOP has failed, Trump has succeeded where his executive powers allowed.

    In other words, and as the following article makes clear, if there’s going to be a backlash against Trump, it almost certainly includes a backlash against his classic GOP agenda of cutting entitlements, starting with Medicaid:

    Talking Points Memo DC

    Trump’s HHS Unveils Medicaid Overhaul That Will Mean Fewer People Covered

    By Alice Ollstein
    Published November 7, 2017 10:27 am

    On Tuesday morning, the Department of Health and Human Services (HHS) unveiled new criteria for evaluating pitches from states to tweak their Medicaid programs, a significant departure from the Obama administration’s approach to such requests.

    Whereas in the past states had to prove that proposed changes would “increase and strengthen” health coverage of their low-income population, that requirement is gone, replaced with language that welcomes proposals for work requirements, drug tests and other hurdles that experts predict would reduce the Medicaid rolls by hundreds of thousands of people.

    In a statement distributed to reporters Tuesday morning, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma called the goal of covering more people a “hollow victory of numbers,” and instead called for changes that “reduce federal regulatory burdens, increase efficiency, and promote transparency and accountability.”

    The announcement also promises to fast-track approval of states’ proposed Medicaid changes (which HHS grants in the form of waivers from existing Medicaid requirements) and to scrap some of the requirements that states report back to the federal government whether the changes improve health outcomes for recipients.

    One of the biggest changes Verma signaled Tuesday was a rule change allowing states to impose work requirements on their Medicaid recipients and kick people out of the program who cannot find gainful employment.

    “Every American deserves the dignity and respect of high expectations and as public officials we should deliver programs that instill hope and say to each beneficiary that we believe in their potential,” Verma said. “CMS believes that meaningful work is essential to beneficiaries’ economic self-sufficiency, self-esteem, well-being, and health of Americans.”

    Several states have already submitted requests to CMS to impose work requirements on their Medicaid programs, and Tuesday’s announcement is expected to open the floodgates to many more. The Obama administration had flatly denied such requests, arguing that they do not serve the purpose of Medicaid.

    “I’m not sure how denying coverage for people based on their inability to find work really meets the objective of providing health insurance to low-income individuals,” said Jessica Schubel, a senior advisor for CMS during the Obama administration.

    A 2017 study by the Kaiser Family Foundation found that only 27 percent of Medicaid recipients are adults without disabilities, and 60 percent of that group are already working. Most of those not employed are either caring for a family member full-time, have a criminal record, live in an area without job opportunities, or face other “major impediments” to employment.

    HHS’ new criteria for the Medicaid waivers is as follows:

    * Improve access to high-quality, person-centered services that produce positive health outcomes for individuals;
    * Promote efficiencies that ensure Medicaid’s sustainability for beneficiaries over the long term;
    * Support coordinated strategies to address certain health determinants that promote upward mobility, greater independence, and improved quality of life among individuals;
    * Strengthen beneficiary engagement in their personal healthcare plan, including incentive structures that promote responsible decision-making;
    * Enhance alignment between Medicaid policies and commercial health insurance products to facilitate smoother beneficiary transition; and
    * Advance innovative delivery system and payment models to strengthen provider network capacity and drive greater value for Medicaid.

    The criteria under the Obama administration, however, was quite different:

    * increase and strengthen overall coverage of low-income individuals in the state;
    * increase access to, stabilize, and strengthen providers and provider networks available to serve Medicaid and low-income populations in the state;
    * improve health outcomes for Medicaid and other low-income populations in the state; or
    * increase the efficiency and quality of care for Medicaid and other low-income populations through initiatives to transform service delivery networks.

    ———-

    “Trump’s HHS Unveils Medicaid Overhaul That Will Mean Fewer People Covered by Alice Ollstein; Talking Points Memo; 11/07/2017

    “Whereas in the past states had to prove that proposed changes would “increase and strengthen” health coverage of their low-income population, that requirement is gone, replaced with language that welcomes proposals for work requirements, drug tests and other hurdles that experts predict would reduce the Medicaid rolls by hundreds of thousands of people.

    The goal of expanding health coverage for the poor has been replaced by the goal of kicking as many people off Medicaid as possible. Which, again, isn’t a Trumpian agenda based on Trump the candidate. It’s classic cruel GOP agenda. But it’s Trump’s agenda now that he’s in office, which probably doesn’t help with his popularity:


    In a statement distributed to reporters Tuesday morning, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma called the goal of covering more people a “hollow victory of numbers,” and instead called for changes that “reduce federal regulatory burdens, increase efficiency, and promote transparency and accountability.”

    A 2017 study by the Kaiser Family Foundation found that only 27 percent of Medicaid recipients are adults without disabilities, and 60 percent of that group are already working. Most of those not employed are either caring for a family member full-time, have a criminal record, live in an area without job opportunities, or face other “major impediments” to employment.

    “Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma called the goal of covering more people a “hollow victory of numbers””

    Yep, Trump’s Centers for Medicare & Medicaid Services Administrator thinks the expanded health care coverage for poor people is just a “hollow victory”. Instead, adding work requirements that include kicking people off if they can’t find work is the real victory. Which, again, is classic GOP and probably not super popular with a lot of Trump’s voters:


    One of the biggest changes Verma signaled Tuesday was a rule change allowing states to impose work requirements on their Medicaid recipients and kick people out of the program who cannot find gainful employment.

    “Every American deserves the dignity and respect of high expectations and as public officials we should deliver programs that instill hope and say to each beneficiary that we believe in their potential,” Verma said. “CMS believes that meaningful work is essential to beneficiaries’ economic self-sufficiency, self-esteem, well-being, and health of Americans.”

    Several states have already submitted requests to CMS to impose work requirements on their Medicaid programs, and Tuesday’s announcement is expected to open the floodgates to many more. The Obama administration had flatly denied such requests, arguing that they do not serve the purpose of Medicaid.

    The floodgate for dismantling Medicaid were just opened up by the Trump administration. On Tuesday, the morning of the 2017 November special elections. Perhaps experiences like that played a role in the surprisingly strong Democratic results.

    And in related news, the state of Maine had a referendum on expanding Medicaid that was also part of Tuesday’s elections. It was approved. Maine expanded Medicaid over the objections of its Trumpian governor, making Maine the first state to expand Medicaid via a a popular vote. Or as the GOP would put it, another “hollow victory.” And if Trump and the GOP succeed in their quest to destroy Medicaid and the Obamacare Medicaid expansion that really will be true. Maine’s Medicaid expansion really will have been a hollow victory. Which, again, might have something to do with the Democratic off-year mini-wave.

    Posted by Pterrafractyl | November 7, 2017, 11:26 pm

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