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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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’.

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.

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.

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.

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.

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.

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.

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.

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 Office — but 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.

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.

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’.

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.

So the ques­tion of whether or not to impose a work require­ments is, on some lev­el, a ques­tion of which mis­takes soci­ety is com­fort­able know­ing­ly mak­ing: the ‘mis­take’ of grant­i­ng able bod­ied unem­ployed poor peo­ple health care? Or the mis­take of forc­ing peo­ple to find work when they can’t real­is­ti­cal­ly do so — either because they real­ly aren’t able bod­ied or because there are no jobs avail­able — and then kick­ing them off the only pro­gram that can keep them alive? Which type of guar­an­teed mis­take is soci­ety most com­fort­able mak­ing? We’ll find out, one state at a time.

It’s the first Mar­tin Luther King Day with Don­ald Trump as Pres­i­dent, so where do we start? Well, giv­en the fact that the GOP con­trol all branch­es of the fed­er­al gov­ern­ment after Trump won the pres­i­den­cy with a cam­paign pred­i­cat­ed on race-bait­ing and ‘Alt-Right’ white suprema­cist dog-whistling only to imple­ment an agen­da of mas­sive tax cuts and gut­ting the safe­ty-net, it’s prob­a­bly a good time to remind our­selves that MLK was­n’t just lead­ing a civ­il rights move­ment. Labor and the fight for a fair and just eco­nom­ic envi­ron­ment was seen as insep­a­ra­ble from that civ­il rights vision. And that means MLK was­n’t only fight­ing for a bet­ter future for oppressed minori­ties. He was fight­ing for a bet­ter future eco­nom­ic future for the big­ots too. Big­ots need eco­nom­ic secu­ri­ty and fair­ness too and MLK was fight­ing for that. That seems like some­thing more Amer­i­cans learn more about.

And that his­to­ry of a mul­ti-racial civ­il rights coali­tion that was also fight­ing to labor rights and eco­nom­ic jus­tice isn’t just an impor­tant his­tor­i­cal fact that peo­ple should know because it’s impor­tant to know your his­to­ry. It’s an extreme­ly rel­e­vant his­tor­i­cal fact because one of the biggest ele­ments of right-wing pro­pa­gan­da in the post-Civ­il Rights era that real­ly needs to be ‘unlearned’ by GOP-lean­ing vot­ers is the notion the GOP has been ham­mer­ing into white vot­ers’ minds for decades now: that gov­ern­ment pro­grams are all just ‘give­aways to lazy minori­ties.’ Because that meme has­n’t just been a con­ve­nient racist dog whis­tle the GOP has been using to com­mu­ni­cate an anti-black sen­ti­ment to vot­ers with­out sound­ing open­ly racist. That meme has also been a cen­tral ele­ment is con­vinc­ing poor and mid­dle-class con­ser­v­a­tive white vot­ers to hate and resent the kinds of gov­ern­ment pro­grams that ben­e­fit peo­ple of all back­grounds.

So, sad­ly, per­haps one of the most use­ful speech­es for Amer­i­cans to hear on MLK day isn’t an inspir­ing speech by MLK (although they should hear that too). It’s the fol­low­ing inter­view by Lee Atwa­ter about how the GOP has been win­ning elec­tions by sys­tem­at­i­cal­ly teach­ing white Amer­i­cans to chan­nel their racial ani­mus into hatred of gov­ern­ment:

The Nation

Exclu­sive: Lee Atwater’s Infa­mous 1981 Inter­view on the South­ern Strat­e­gy

The forty-two-minute record­ing, acquired by James Carter IV, con­firms Atwater’s incen­di­ary remarks and places them in con­text.

By Rick Perl­stein
Novem­ber 13, 2012

It has become, for lib­er­als and left­ists enraged by the way Repub­li­cans nev­er suf­fer the con­se­quences for turn­ing elec­toral pol­i­tics into a cesspool, a kind of smok­ing gun. The late, leg­en­dar­i­ly bru­tal cam­paign con­sul­tant Lee Atwa­ter explains how Repub­li­cans can win the vote of racists with­out sound­ing racist them­selves:

You start out in 1954 by say­ing, “Nig­ger, nig­ger, nig­ger.” By 1968 you can’t say “nigger”—that hurts you, back­fires. So you say stuff like, uh, forced bus­ing, states’ rights, and all that stuff, and you’re get­ting so abstract. Now, you’re talk­ing about cut­ting tax­es, and all these things you’re talk­ing about are total­ly eco­nom­ic things and a byprod­uct of them is, blacks get hurt worse than whites.… “We want to cut this,” is much more abstract than even the bus­ing thing, uh, and a hell of a lot more abstract than “Nig­ger, nig­ger.”

Now, the same inde­fati­ga­ble researcher who brought us Mitt Romney’s “47 per­cent” remarks, James Carter IV, has dug up the entire forty-two-minute inter­view from which that quote derives. Here, The Nation pub­lish­es it in its entire­ty for the very first time.

The back-sto­ry goes like this. In 1981, Atwa­ter, after a decade as South Car­oli­na’s most effec­tive Repub­li­can oper­a­tive, was work­ing in Ronald Rea­gan’s White House when he was inter­viewed by Alexan­der Lamis, a polit­i­cal sci­en­tist at Case West­ern Reserve Uni­ver­si­ty. Lamis pub­lished the inter­view with­out using Atwa­ter’s name in his 1984 book The Two-Par­ty South. Fif­teen years later—and eight years after Atwa­ter passed away from cancer—Lamis repub­lished the inter­view in anoth­er book using Atwater’s name. For sev­en years no one paid much atten­tion. Then the New York Times’ Bob Her­bert, a bit of an Atwa­ter obses­sive, quot­ed it in an Octo­ber 6, 2005 col­umn—then five more times over the next four years.

Those words soon became legend—quoted in both screeds (The GOP-Haters Hand­book, 2007) and schol­ar­ship (Corey Robin’s 2011 clas­sic work of polit­i­cal the­o­ry, The Reac­tionary Mind). Google Books records its use in ten books pub­lished so far this year alone. Curi­ous about the remarks’ con­text, Carter, who learned Lamis had died in 2012, asked his wid­ow if she would con­sid­er releas­ing the audio of the inter­view, espe­cial­ly in light of the use of race-bait­ing dog-whis­tles (lies about Oba­ma end­ing work require­ments for wel­fare; “jokes” about his sup­posed Kenyan prove­nance) in the Rom­ney pres­i­den­tial cam­paign. Renée Lamis, an Oba­ma donor, agreed that very same night. For one thing she was “upset,” Carter told me, that “for some time, con­ser­v­a­tives believed [her] hus­band made up the Atwa­ter inter­view.” For anoth­er, she was eager to illus­trate that her hus­band’s use of the Atwa­ter quote was schol­ar­ly, not polit­i­cal.

...

In the lead-up to the infa­mous remarks, it is fas­ci­nat­ing to wit­ness the con­fi­dence with which Atwa­ter believes him­self to be estab­lish­ing the racial inno­cence of lat­ter-day Repub­li­can cam­paign­ing: “My gen­er­a­tion,” he insists, “will be the first gen­er­a­tion of South­ern­ers that won’t be prej­u­diced.” He pro­ceeds to devel­op the argu­ment that by drop­ping talk about civ­il rights gains like the Vot­ing Rights Act and stick­ing to the now-main­stream tropes of fis­cal con­ser­vatism and nation­al defense, con­sul­tants like him were prov­ing “peo­ple in the South are just like any peo­ple in the his­to­ry of the world.”

It is only upon Pro­fes­sor Lamis’s gen­tly Socrat­ic fol­low-ups, and those of a co-inter­view­er named “Saul” (Carter has­n’t been able to con­firm his iden­ti­ty, but sus­pects it was the late White House cor­re­spon­dent Saul Fried­man), that Atwa­ter begins to loosen up—prefacing his reflec­tions, with a plain­ly guilty con­science, “Now, y’all aren’t quot­ing me on this?” (Appar­ent­ly , this is the rea­son why Atwater’s name wasn’t pub­lished in 1984 but was in 1999, after his death).

He then utters his infa­mous words. The inter­locu­tors go on to kib­itz about Huey Long and bar­be­cue. Then Atwa­ter, appar­ent­ly sat­is­fied that he’d absolved the South­ern Repub­li­can Par­ty of racism once and for all, fol­lows up with a pre­dic­tion based on a study he claims demon­strates that Strom Thur­mond won 38 per­cent of South Carolina’s mid­dle-class black vote in his 1978 Sen­ate cam­paign (run by Atwa­ter).

“That vot­er, in my judg­ment,” he claims, “will be more like­ly to vote his eco­nom­ic inter­ests than he will any­thing else. And that is the vot­er that I think through a fair­ly slow but very steady process, will go Repub­li­can.” Because race no longer mat­ters: “In my judg­ment Karl Marx [is right]… the real issues ulti­mate­ly will be the eco­nom­ic issues.” He con­tin­ues, in words that uncan­ni­ly echo the “47 per­cent tape” (noth­ing new under the wingnut sun), that “sta­tis­ti­cal­ly, as the num­ber of non-pro­duc­ers in the sys­tem moves toward fifty per­cent,” the con­ser­v­a­tive coali­tion can­not but expand. Voila: a new Repub­li­can major­i­ty. Racism won’t have any­thing to do with it.

Not bloody like­ly. In 2005, the polit­i­cal sci­en­tists Nicholas Valenti­no and David Sears demon­strat­ed that a South­ern man hold­ing con­ser­v­a­tive posi­tions on issues oth­er than race is no more like­ly than a con­ser­v­a­tive North­ern­er to vote for a Demo­c­rat. But when the rel­e­vant iden­ti­fi­er is anti-black answers to sur­vey questions—like whether one agrees “If blacks would only try hard­er they could be just as well off as whites”—white South­ern­ers were twice as like­ly than white North­ern­ers to refuse to vote Demo­c­ra­t­ic. As anoth­er polit­i­cal sci­en­tist, Thomas Schaller, wrote in his 2006 book Whistling Past Dix­ie (which nat­u­ral­ly quotes the infa­mous Atwa­ter lines), “Despite the best efforts of Repub­li­can spinmeisters…the par­ti­san impact of racial atti­tudes in the South is stronger today than in the past.”

Which one par­tic­u­lar Repub­li­can spin­meis­ter, when he was­n’t preen­ing before polit­i­cal sci­en­tists, knew ful­ly well—which was why, sev­en years after that inter­view, in his stat­ed goal to “rip the bark off the lit­tle bas­tard [Michael Dukakis]” on behalf of his can­di­date George H.W. Bush, Atwa­ter ran the infa­mous ad blam­ing Dukakis for an escaped Mass­a­chu­setts con­vict, Willie Hor­ton, “repeat­ed­ly rap­ing” an appar­ent­ly white girl. Indeed, Atwa­ter pledged to make “Willie Hor­ton his run­ning mate.” The com­mer­cial was spon­sored by a dum­my out­fit called the Nation­al Secu­ri­ty Polit­i­cal Action Com­mit­tee—which it is true, was a whole lot more abstract than say­ing “nig­ger, nig­ger, nig­ger.”

———-

“Exclu­sive: Lee Atwater’s Infa­mous 1981 Inter­view on the South­ern Strat­e­gy” by Rick Perl­stein; The Nation; 11/13/2012

“You start out in 1954 by say­ing, “Nig­ger, nig­ger, nig­ger.” By 1968 you can’t say “nigger”—that hurts you, back­fires. So you say stuff like, uh, forced bus­ing, states’ rights, and all that stuff, and you’re get­ting so abstract. Now, you’re talk­ing about cut­ting tax­es, and all these things you’re talk­ing about are total­ly eco­nom­ic things and a byprod­uct of them is, blacks get hurt worse than whites.… “We want to cut this,” is much more abstract than even the bus­ing thing, uh, and a hell of a lot more abstract than “Nig­ger, nig­ger.””

It’s amaz­ing what you can learn when some­one opens up. And note the spin Atwa­ter ini­tial­ly had dur­ing this inter­view. He was actu­al­ly try­ing to argue that the GOP had moved com­plete­ly past racial ani­mos­i­ty by shift­ing the par­ty’s mes­sag­ing empha­sis to eco­nom­ic issues:

...
In the lead-up to the infa­mous remarks, it is fas­ci­nat­ing to wit­ness the con­fi­dence with which Atwa­ter believes him­self to be estab­lish­ing the racial inno­cence of lat­ter-day Repub­li­can cam­paign­ing: “My gen­er­a­tion,” he insists, “will be the first gen­er­a­tion of South­ern­ers that won’t be prej­u­diced.” He pro­ceeds to devel­op the argu­ment that by drop­ping talk about civ­il rights gains like the Vot­ing Rights Act and stick­ing to the now-main­stream tropes of fis­cal con­ser­vatism and nation­al defense, con­sul­tants like him were prov­ing “peo­ple in the South are just like any peo­ple in the his­to­ry of the world.”

It is only upon Pro­fes­sor Lamis’s gen­tly Socrat­ic fol­low-ups, and those of a co-inter­view­er named “Saul” (Carter has­n’t been able to con­firm his iden­ti­ty, but sus­pects it was the late White House cor­re­spon­dent Saul Fried­man), that Atwa­ter begins to loosen up—prefacing his reflec­tions, with a plain­ly guilty con­science, “Now, y’all aren’t quot­ing me on this?” (Appar­ent­ly , this is the rea­son why Atwater’s name wasn’t pub­lished in 1984 but was in 1999, after his death).

He then utters his infa­mous words. The inter­locu­tors go on to kib­itz about Huey Long and bar­be­cue. Then Atwa­ter, appar­ent­ly sat­is­fied that he’d absolved the South­ern Repub­li­can Par­ty of racism once and for all, fol­lows up with a pre­dic­tion based on a study he claims demon­strates that Strom Thur­mond won 38 per­cent of South Carolina’s mid­dle-class black vote in his 1978 Sen­ate cam­paign (run by Atwa­ter).

“That vot­er, in my judg­ment,” he claims, “will be more like­ly to vote his eco­nom­ic inter­ests than he will any­thing else. And that is the vot­er that I think through a fair­ly slow but very steady process, will go Repub­li­can.” Because race no longer mat­ters: “In my judg­ment Karl Marx [is right]… the real issues ulti­mate­ly will be the eco­nom­ic issues.” He con­tin­ues, in words that uncan­ni­ly echo the “47 per­cent tape” (noth­ing new under the wingnut sun), that “sta­tis­ti­cal­ly, as the num­ber of non-pro­duc­ers in the sys­tem moves toward fifty per­cent,” the con­ser­v­a­tive coali­tion can­not but expand. Voila: a new Repub­li­can major­i­ty. Racism won’t have any­thing to do with it.
...

“Now, y’all aren’t quot­ing me on this?”

Yes, Atwa­ter was indeed quot­ed. And that’s to that quote this inter­view is one of the most infa­mous and reveal­ing inter­views about polit­i­cal strat­e­gy in Amer­i­can his­to­ry. Whoops!

And thanks to that long-stand­ing GOP ‘South Strat­e­gy’ mes­sag­ing cam­paign (a strat­e­gy applied to the entire US and not just the South) designed to fuel and exac­er­bate exist­ing sen­ti­ments, a gen­er­a­tion of Amer­i­cans has been taught that the ‘Great Soci­ety’ of pub­lic safe­ty-net pro­grams was just about giv­ing ‘those peo­ple’ (black Amer­i­cans) a bunch of gov­ern­ment hand­outs so they don’t have to work. It’s a sick and con­temptible smear, but it’s what a lot of Amer­i­can real­ly do seem to believe. Includ­ing very promi­nent Amer­i­cans with enor­mous pow­er over gov­ern­ment pol­i­cy:

Newsweek

Trump Thinks Only Black Peo­ple Are on Wel­fare, but, Real­ly, White Amer­i­cans Receive Most Ben­e­fits

By Ryan Sit
On 1/12/18 at 3:53 PM

Pres­i­dent Don­ald Trump was appar­ent­ly unaware that not all—in fact, the vast majority—of wel­fare ben­e­fi­cia­ries are not black as recent­ly as last March, accord­ing to a new report.

In the spring of 2017, the new­ly elect­ed pres­i­dent met with mem­bers of the Con­gres­sion­al Black Cau­cus. Dur­ing that meet­ing, one of the mem­bers men­tioned to Trump that wel­fare reform would be detri­men­tal to her con­stituents— adding, “Not all of whom are black,” accord­ing to NBC News.

The pres­i­dent was incred­u­lous. “Real­ly? Then what are they?”

...

In fact, whites are the biggest ben­e­fi­cia­ries when it comes to gov­ern­ment safe­ty-net pro­grams like the Tem­po­rary Assis­tance for Needy Fam­i­lies, com­mon­ly referred to as wel­fare.

White peo­ple with­out a col­lege degree ages 18 to 64 are the largest class of adults lift­ed out of pover­ty by such pro­grams, accord­ing to the Cen­ter on Bud­get and Pol­i­cy Pri­or­i­ties. The think tank’s 2017 report stat­ed that 6.2 mil­lion work­ing-age whites were lift­ed above the pover­ty line in 2014 com­pared to 2.8 mil­lion blacks and 2.4 mil­lion His­pan­ics.

When it comes the Sup­ple­men­tal Nutri­tion Assis­tance Pro­gram, or SNAP—the ini­tia­tive for­mer­ly known as food stamps—the num­bers look sim­i­lar.

Just over 40 per­cent of SNAP recip­i­ents are white. Anoth­er 25.7 per­cent are black, 10.3 per­cent are His­pan­ic, 2.1 per­cent are Asian and 1.2 per­cent are Native Amer­i­can, accord­ing to a 2015 Depart­ment of Agri­cul­ture report.

Despite Trump’s new­ly gleaned infor­ma­tion, wel­fare reform remains one of his top goals for 2018. His admin­is­tra­tion and Con­gres­sion­al Repub­li­cans are look­ing to over­haul fed­er­al safe­ty-net pro­grams like SNAP, Med­ic­aid and hous­ing ben­e­fits.

News of Trump’s wel­fare com­ment arrived as he’s deal­ing with the back­lash of report­ed­ly call­ing African coun­tries a “shit­hole” dur­ing a bipar­ti­san meet­ing on immi­gra­tion Thurs­day. Trump has denied using such lan­guage.

———-

“Trump Thinks Only Black Peo­ple Are on Wel­fare, but, Real­ly, White Amer­i­cans Receive Most Ben­e­fits” by Ryan Sit; Newsweek; 01/12/2018

“The pres­i­dent was incred­u­lous. “Real­ly? Then what are they?””

Yep, the pres­i­dent was incred­u­lous about the idea that ‘wel­fare reform’ (cut­ting safe­ty-net pro­grams) would­n’t pre­dom­i­nant­ly harm black Ame­ri­ans. That’s where we are. Still. And giv­en how much time Pres­i­dent Trump spends con­sum­ing right-wing media it’s not remote­ly sur­pris­ing that he would hold such views. This smear against black Amer­i­cans, that they’re all ‘Cadil­lac-dri­ving wel­fare queens’ has been a GOP-refrain for decades. Don’t for­get, that Lee Atwa­ter inter­view was from 1981.

While Pres­i­dent Trump isn’t exact­ly the tar­get audi­ence for a mes­sag­ing cam­paign ded­i­cat­ed to teach­ing work­ing-class white Amer­i­cans about how the GOP has been inten­tion­al­ly mis­lead­ing them about who uses ‘wel­fare’ (it’s most­ly the work­ing poor) and why (because they are work­ing and still poor), the real­i­ty is that Trump’s views reflect an atti­tude wide­ly held by white Amer­i­cans, rich and poor. And that’s part of what’s going to make the cur­rent GOP assault on the safe­ty-net so fas­ci­nat­ing to watch play out in terms of those atti­tudes towards the safe­ty-net, because the way the GOP strat­e­gy has been for­mu­lat­ed — trans­fer­ring safe­ty-net pro­grams from the fed­er­al gov­ern­ment to states and then encour­ag­ing the states to do the the big cuts — the next wave of enti­tle­ment gut­ting is going to hap­pen at the state-lev­el. And that’s going to make it much hard­er for vot­ers to assume that all the cuts are just going to be cuts for minori­ties liv­ing in big urban cen­ters like Chica­go or New York.

Take, for exam­ple Ken­tucky, a state that’s 88 per­cent white, very poor, and one of the prime ben­e­fi­cia­ries of the Oba­macare Med­ic­aid expan­sion. It’s also the state that’s the first to impose work require­ments for Med­ic­aid recip­i­ents. But beyond that, Ken­tucky is set to impose all sorts of new require­ments for Med­ic­aid access are clear­ly designed to find excus­es to cut off access. Require­ments like a new pre­mi­um that has to be paid and re-enroll­ment require­ment. And if you don’t meet these require­ments, you get cut off from Med­ic­aid for 6‑months. Which means a whole bunch of poor peo­ple in Ken­tucky are in for a very rude awak­en­ing and almost all the peo­ple get­ting cut off are going to be poor whites. Because it’s Ken­tucky:

Talk­ing Points Memo
DC

BREAKING: Trump Admin Okays First Med­ic­aid Work Require­ment

By Alice Oll­stein | Jan­u­ary 12, 2018 12:34 pm

The Trump admin­is­tra­tion has swift­ly fol­lowed through on its promise Thurs­day to grant approval for states to impose work require­ments on their Med­ic­aid pro­grams, giv­ing Ken­tucky a green light Fri­day after­noon.

Nine oth­er states have sim­i­lar waiv­er requests sit­ting before Trump’s Depart­ment of Health and Human Ser­vices, and more approvals are expect­ed in the com­ing weeks.

...

Ken­tucky applied for the waiv­er back in the sum­mer of 2016, ask­ing for per­mis­sion to make Med­ic­aid only avail­able to non-dis­abled adult res­i­dents who work at least 20 hours per week, vol­un­teer, study, or take care of a fam­i­ly mem­ber. Addi­tion­al­ly, Ken­tucky has got­ten the abil­i­ty to charge low-income Med­ic­aid recip­i­ents health care pre­mi­ums, imple­ment a six-month lock­out peri­od for peo­ple who fail to re-enroll in time, and elim­i­nate full cov­er­age of den­tal care, vision ser­vices, and over the counter med­ica­tions for many adults. For­mer fos­ter care youth, preg­nant women, and full-time stu­dents are exempt.

As the gov­er­nor him­self stat­ed in the waiv­er appli­ca­tion, a full third of Kentucky’s pop­u­la­tion is on Med­ic­aid, and a main goal of the new work require­ment and oth­er restric­tions is to cut down that num­ber. “This is an expense Ken­tucky can­not afford,” Bevin wrote.

A chart includ­ed in the waiv­er appli­ca­tion shows the state expects enroll­ment to drop by tens of thou­sands of peo­ple over the course of five years due to the new rules.
[see chart pro­ject­ing drops in enroll­ment due to the new rules]

The Nation­al Health Law Pro­gram said in a state­ment to TPM that the waiv­er approval vio­lates fed­er­al law, and that lit­i­ga­tion will soon be filed.

“The action appears designed to achieve sig­nif­i­cant cuts in Med­ic­aid enroll­ment rather than Medicaid’s stat­ed pur­pose of fur­nish­ing med­ical assis­tance to low-income peo­ple,” NHeLP Legal Direc­tor Jane Perkins said.

———-

“BREAKING: Trump Admin Okays First Med­ic­aid Work Require­ment” by Alice Oll­stein; Talk­ing Points Memo; 01/12/2018

“As the gov­er­nor him­self stat­ed in the waiv­er appli­ca­tion, a full third of Kentucky’s pop­u­la­tion is on Med­ic­aid, and a main goal of the new work require­ment and oth­er restric­tions is to cut down that num­ber. “This is an expense Ken­tucky can­not afford,” Bevin wrote.”

Yep, Ken­tuck­y’s GOP gov­ern­ment has straight up said the pur­pose of these new Med­ic­aid rules is to cut down the num­ber of peo­ple on Med­ic­aid. And that’s almost entire­ly going to be poor white peo­ple. Because, again, it’s Ken­tucky.

And look at the fun new rea­son to kick peo­ple off Med­ic­aid that go beyond find­ing a job: pre­mi­ums and re-enroll­ment rules that appear to be set up sole­ly to give a rea­son to kick some­one off:

...
Ken­tucky applied for the waiv­er back in the sum­mer of 2016, ask­ing for per­mis­sion to make Med­ic­aid only avail­able to non-dis­abled adult res­i­dents who work at least 20 hours per week, vol­un­teer, study, or take care of a fam­i­ly mem­ber. Addi­tion­al­ly, Ken­tucky has got­ten the abil­i­ty to charge low-income Med­ic­aid recip­i­ents health care pre­mi­ums, imple­ment a six-month lock­out peri­od for peo­ple who fail to re-enroll in time, and elim­i­nate full cov­er­age of den­tal care, vision ser­vices, and over the counter med­ica­tions for many adults. For­mer fos­ter care youth, preg­nant women, and full-time stu­dents are exempt.
...

So how is the upcom­ing health care night­mare that’s about to be unleashed on poor Ken­tuck­ians by their GOP gov­er­nor going to impact that long held GOP mes­sag­ing strat­e­gy of telling poor whites that all those gov­ern­ment cuts are pri­mar­i­ly going to harm blacks and oth­er minori­ties? Sure, cuts of this nature have been hap­pen­ing at the state lev­el for a long time, but the Med­ic­aid cuts are a very high-pro­file round of cuts and just the begin­ning of the GOP’s ‘wel­fare reform’ agen­da. A whole lot of poor white rur­al Repub­li­can-vot­ing Amer­i­cans are going to be learn­ing a lot of nasty lessons about the GOP’s will­ing­ness to cut gov­ern­ment sup­port for them in com­ing years. Not cuts for the hypo­thet­i­cal ‘wel­fare-queen in Chica­go.’ Cuts for them. Com­pli­ments of the GOP.

Will Lee Atwa­ter’s rep­re­hen­si­ble meme sur­vive the GOP’s pol­i­cy agen­da intact when a cen­tral ele­ment of that agen­da is state-lev­el cuts? We’ll see, but giv­en that the GOP’s gov­ern­ment-slash­ing agen­da is set to be unleashed and grow in com­ing years it seems like MLK Day will be a very good day to remind work­ing-class whites that the GOP does­n’t just hate poor and work­ing-class blacks. The GOP hates poor and work­ing-class every­one. Could a grow­ing recog­ni­tion that the GOP was using neg­a­tive sen­ti­ments towards minori­ties to trick poor and work­ing-class whites into slit­ting their eco­nom­ic throats help jos­tle some­one out of their ‘my race vs the world’ world­view? Hope­ful­ly. It’s not the best source for sol­i­dar­i­ty — it would be far bet­ter if we could achieve a sense of cross-racial uni­ty out of a gen­er­al sense of enlight­ened decen­cy — but beg­gars can’t be choosers.

And here it is, the next phase of the GOP’s nev­er-end­ing War on the Poor: The Depart­ment of Hous­ing and Urban Devel­op­ment (HUD) is get ready to impose work require­ments for pubic hous­ing assis­tance for all ‘able-bod­ied’ adults, accord­ing to leaked doc­u­ments. And this is the kind of pol­i­cy change the Trump admin­is­tra­tion can poten­tial­ly do on its own. Con­gress isn’t required.

And it’s actu­al­ly much mean­er than it sounds because when you look at the details it just gets mean­er and mean­er. For starters, it’s not just work require­ments for pub­lic hous­ing. Pri­vate land­lords who own Sec­tion 8 hous­ing (gov­ern­ment sub­si­dized pri­vate­ly-own hous­ing) will also have the option of impos­ing the work-require­ment on their ten­ants, which clear­ly cre­ates a scary pow­er dynam­ic. Imag­ine the kind of alter­na­tive ‘work’ unscrupu­lous land­lords will come up under threat of impos­ing the require­ment.

And unlike the new Med­ic­aid work require­ments, which can be up to 20 hours a week, the HUD work require­ments can be up to 32 hours a week. That is a much, much hard­er require­ment to reach than 20 hours, espe­cial­ly if the local econ­o­my is weak.

Oh but there’s more mean­ness. Much more. If you’re a par­ent who needs child-care there’s no pro­vi­sion to help cov­er the costs. And if you’re tak­ing care of a fam­i­ly mem­ber who’s ill or has a dis­abil­i­ty there’s no pro­vi­sion that either. You’re just . You night still have to work those 32 hours , there’s no pro­vi­sion for that. And new rules are actu­al­ly elim­i­nat­ing an exist­ing pro­vi­sion to help with child-care that’s already part of the rent for­mu­la.

But the mean­ness isn’t over. Peo­ple strug­gling with opi­oid or oth­er sub­stance use addic­tions would face the risk of los­ing assis­tance even if they’re seek­ing treat­ment. And agen­cies and own­ers won’t have to count time spent in treat­ment toward the work-require­ment hours.

There’s also going to be some hikes in the ‘rent’ that peo­ple have to peo­ple. Hikes that will be on top of all the new fees get­ting tacked on to pro­grams like the Med­ic­aid pre­mi­ums intro­duced in Ken­tucky and Indi­ana. The gov­ern­ment is about to use the anti-pover­ty pro­grams to nick­le and dime the poor­est peo­ple off of them.

Elder­ly and fam­i­lies with dis­abled peo­ple don’t escape the GOP’s wrath either. They would have to con­tribute 30 per­cent of their month­ly income, with a min­i­mum rent of at least $50 per month. The min­i­mum rent cur­rent for most house­holds on pub­lic hous­ing assis­tance ranges from $25 to $50 per month. And some of the poor­est fam­i­lies pay no rent.

And the Trump admin­is­tra­tion is con­fi­dent that this all won’t lead to peo­ple in need get­ting kicked out of their homes. They point to a recent study of a pilot work-require­ment pro­gram in Char­lotte, NC, that did­n’t find an increase in evic­tion rates. This pilot pro­gram, of course, hap­pened dur­ing a peri­od of low unem­ploy­ment in the US. But more impor­tant­ly, it was a 15 hour a week require­ment, not 32 hours, which is rad­i­cal­ly dif­fer­ent in terms of fea­si­bil­i­ty of reg­u­lar­ly attain­ing. And that’s pret­ty much the only evi­dence the admin­is­tra­tion is point­ing towards as evi­dence that this is a safe and sound new pol­i­cy to imple­ment because there’s almost no oth­er research into the wis­dom of this which is some­thing the study authors point­ed out. The paper actu­al­ly points out that it’s the first study to empir­i­cal­ly exam­ine the impact of work-require­ments on employ­ment. So there’s been one study, done dur­ing a time of his­tor­i­cal­ly low unem­ploy­ment lev­els.

Oh, and foods stamps are also going to get increased work-require­ment rules. In addi­tion the new Med­ic­aid work-require­ments and pre­mi­ums pop­ping up now that states are free to do so. It’s an all you can eat buf­fet of kick­ing the poor designed to cre­ate hun­gry home­less peo­ple

NBC News

Trump may push work require­ments for fed­er­al hous­ing assis­tance

Feb 6 2018, 4:50 pm ET

WASHINGTON — The Trump admin­is­tra­tion may push for new work require­ments and rent hikes for peo­ple in fed­er­al­ly sub­si­dized hous­ing, accord­ing to a draft pro­pos­al from the Depart­ment of Hous­ing and Urban Devel­op­ment obtained by NBC News.

The pro­pos­al under con­sid­er­a­tion would allow pub­lic hous­ing agen­cies and pri­vate own­ers of Sec­tion 8 rentals to impose new work require­ments on ten­ants who receive fed­er­al hous­ing sub­si­dies, accord­ing to the draft, which was pro­vid­ed to NBC News by two out­side hous­ing experts.

The changes detailed in the draft could have sweep­ing con­se­quences for the esti­mat­ed 5 mil­lion low-income house­holds receiv­ing fed­er­al rental assis­tance, reflect­ing the White House’s broad­er effort to tight­en the fed­er­al safe­ty net. Last month, the Trump admin­is­tra­tion invit­ed states to intro­duce work require­ments to Med­ic­aid and has approved Ken­tucky and Indiana’s plans to do so. The admin­is­tra­tion is also aim­ing to bol­ster work require­ments for food stamps.

The draft pro­pos­al, which is dat­ed Jan­u­ary 17, was first report­ed by The Inter­cept. The Depart­ment of Hous­ing and Urban Devel­op­ment declined to com­ment, and the White House’s Office of Man­age­ment and Bud­get did not respond to a request for com­ment.

Accord­ing to the draft leg­is­la­tion, which would require Congress’s approval, pub­lic hous­ing author­i­ties and pri­vate own­ers could require up to 32 hours of work per week, on aver­age, for each adult in a house­hold who is not elder­ly or dis­abled. Voca­tion­al train­ing and edu­ca­tion could also count toward the require­ment, along with employ­ment, but not vol­un­teer ser­vice.

The pro­pos­al would also open the way for states to make work a con­di­tion for rental assis­tance, says Will Fis­ch­er, a pol­i­cy ana­lyst at the Cen­ter on Bud­get and Pol­i­cy Pri­or­i­ties, a cen­ter-left think tank: “States have legal author­i­ty over hous­ing agen­cies, so once fed­er­al law allows work require­ments states could choose to direct hous­ing agen­cies to impose them.”

While HUD Sec­re­tary Ben Car­son has long preached about the impor­tance of self-suf­fi­cien­cy, the draft is the first detailed pro­pos­al for work require­ments that has sur­faced at HUD since the begin­ning of the Trump admin­is­tra­tion.

...

House Speak­er Paul Ryan, R‑Wis., also pro­mot­ed work require­ments for fed­er­al rental assis­tance in his 2016 pro­pos­al to com­bat pover­ty.

Low-income hous­ing advo­cates, how­ev­er, say that work require­ments for rental assis­tance will harm fam­i­lies who are already vul­ner­a­ble. “The issue isn’t that peo­ple aren’t work­ing — it’s that there are too few well-pay­ing jobs, and rents are too high,” said Diane Yen­tel, pres­i­dent and CEO of the Nation­al Low Income Hous­ing Coali­tion, an advo­ca­cy group. “What these pro­pos­als do is leave even more low-income peo­ple with­out an afford­able home, and that will hurt their abil­i­ty to retain a job.”

The work require­ments, as detailed in the draft, would only apply to a small frac­tion of those receiv­ing fed­er­al hous­ing aid. Accord­ing to the CBPP, 55 per­cent of those receiv­ing fed­er­al rental assis­tance are elder­ly or dis­abled, and 26 per­cent are already work­ing. Of the remain­der who are not work­ing, a sig­nif­i­cant per­cent­age are care­givers for preschool chil­dren or a dis­abled per­son.

The work require­ments could also pun­ish those who are already in the work­force if they are sub­ject­ed to a 32-hour week­ly min­i­mum, said Fis­ch­er of the CBPP. “Many peo­ple can’t count on get­ting 32 hours,” he said. “These are work­ers doing the best they can to earn a liv­ing, and they could get their assis­tance cut off.”

The draft also pro­pos­es across-the-board rent increas­es for those receiv­ing hous­ing aid. Ten­ants’ rental con­tri­bu­tion would rise to 35 per­cent from 30 per­cent of month­ly income, and they would no longer be able to deduct med­ical and child care expens­es from their total income,

The Trump admin­is­tra­tion pushed for sim­i­lar rent increas­es in last year’s bud­get, which nev­er passed. The new draft pro­pos­al, how­ev­er, includes a sig­nif­i­cant­ly high­er manda­to­ry min­i­mum rent based on the fed­er­al min­i­mum wage, cal­cu­lat­ed to be about $150 per month. Last year, Trump’s bud­get pro­posed min­i­mum rents of $50 per month.

Elder­ly and dis­abled fam­i­lies who receive rental assis­tance would have to con­tribute 30 per­cent of their month­ly income, with a min­i­mum rent of at least $50 per month. Cur­rent­ly, the min­i­mum rent for most house­holds receiv­ing rental assis­tance ranges from $25 to $50 per month, and some of the poor­est fam­i­lies pay no rent.

There has been some bipar­ti­san sup­port for rent hikes in recent years: In his 2013 bud­get, Pres­i­dent Barack Oba­ma pro­posed rais­ing min­i­mum rents to $75 per month for HUD-assist­ed ten­ants, explain­ing that it would reduce costs and adjust the pol­i­cy for infla­tion. The reforms out­lined in HUD’s new draft leg­is­la­tion, how­ev­er, go sig­nif­i­cant­ly fur­ther, Fis­ch­er said. “I don’t think there’s been a pro­pos­al as broad as this, rais­ing rents in so many dif­fer­ent ways.”

Yen­tel says the rent increas­es that the Trump admin­is­tra­tion have pre­vi­ous­ly pro­posed, and that are out­lined in the draft, would have the great­est impact on seniors, the dis­abled and fam­i­lies with young chil­dren, who would no longer be able to deduct med­ical costs and child care from the income used to cal­cu­late their rent pay­ments. “That means less mon­ey they have of their very lim­it­ed income to pay for med­ica­tion, healthy food, clothes for kids to go to school,” she said.

Democ­rats also pushed back on the idea. “Only this admin­is­tra­tion would respond to ris­ing home­less­ness by try­ing to increase the evic­tion rate,” Sen. Sher­rod Brown of Ohio,said in a state­ment. “Just weeks after giv­ing mas­sive tax breaks to bil­lion­aires and spe­cial inter­ests, you would think this admin­is­tra­tion would be embar­rassed to pro­pose rais­ing fees on the small share of low-income Amer­i­cans who get fed­er­al help to keep a roof over their heads.”

Hous­ing experts and advo­cates antic­i­pate that the Trump admin­is­tra­tion will try to move for­ward with these pro­pos­als when it releas­es its bud­get, which is expect­ed in the next few weeks. The admin­is­tra­tion could also push for work require­ments with­out pass­ing new leg­is­la­tion through a demon­stra­tion pro­gram that Con­gress vot­ed to expand in late 2015, but which has yet to be imple­ment­ed ful­ly.

Under the demon­stra­tion pro­gram, a small hand­ful of pub­lic hous­ing author­i­ties have already exper­i­ment­ed with work require­ments, as well as rent increas­es. In Char­lotte, North Car­oli­na, researchers found that work require­ments increased employ­ment with­out increas­ing ten­ant evic­tions, though they cau­tioned against impos­ing the require­ments more broad­ly with­out fur­ther study.

Diane Levy, a researcher at the Urban Insti­tute, an eco­nom­ic and social pol­i­cy think tank in Wash­ing­ton, agreed, point­ing out that very very lit­tle is known about some of the most basic ques­tions involved, such as whether work require­ments do ulti­mate­ly help move ten­ants off assis­tance.

“Are they able to keep jobs, and is it mak­ing a dif­fer­ence in their abil­i­ty to have a sta­ble income?” she said. “We don’t know.”

———-

“Trump may push work require­ments for fed­er­al hous­ing assis­tance”; NBC News; 02/06/2018

“The changes detailed in the draft could have sweep­ing con­se­quences for the esti­mat­ed 5 mil­lion low-income house­holds receiv­ing fed­er­al rental assis­tance, reflect­ing the White House’s broad­er effort to tight­en the fed­er­al safe­ty net. Last month, the Trump admin­is­tra­tion invit­ed states to intro­duce work require­ments to Med­ic­aid and has approved Ken­tucky and Indiana’s plans to do so. The admin­is­tra­tion is also aim­ing to bol­ster work require­ments for food stamps.”

5 mil­lion low-income house­holds are about to get a new bureau­crat­ic Sword of Damo­cles hang­ing over their heads. If you can’t find a job that will let you work for 32 hours a week you might find your­self evict­ed. And maybe go hun­gry at the same time. And it might be a pri­vate land­lord hold­ing this Sword of Damo­cles over you:

...
The pro­pos­al under con­sid­er­a­tion would allow pub­lic hous­ing agen­cies and pri­vate own­ers of Sec­tion 8 rentals to impose new work require­ments on ten­ants who receive fed­er­al hous­ing sub­si­dies, accord­ing to the draft, which was pro­vid­ed to NBC News by two out­side hous­ing experts.
...

And each adult in the house­hold who is not elder­ly or dis­able will poten­tial­ly have to work 32 hours a week. Job train­ing will count towards those hours, but not vol­un­teer ser­vice:

...
Accord­ing to the draft leg­is­la­tion, which would require Congress’s approval, pub­lic hous­ing author­i­ties and pri­vate own­ers could require up to 32 hours of work per week, on aver­age, for each adult in a house­hold who is not elder­ly or dis­abled. Voca­tion­al train­ing and edu­ca­tion could also count toward the require­ment, along with employ­ment, but not vol­un­teer ser­vice.

The pro­pos­al would also open the way for states to make work a con­di­tion for rental assis­tance, says Will Fis­ch­er, a pol­i­cy ana­lyst at the Cen­ter on Bud­get and Pol­i­cy Pri­or­i­ties, a cen­ter-left think tank: “States have legal author­i­ty over hous­ing agen­cies, so once fed­er­al law allows work require­ments states could choose to direct hous­ing agen­cies to impose them.”
...

Keep in mind that vol­un­teer­ing is poten­tial­ly an option for things like Med­ic­aid work-require­ments. But if hous­ing assis­tance does­n’t allow vol­un­teer­ing to count and requires 32 hours of work, that more or less pre­cludes peo­ple for going with the vol­un­teer­ing option for their oth­er pub­lic ser­vice work-require­ment.

And, of course, like almost all of these new work-require­ments for pub­lic assis­tance, it’s real­ly only impact­ing a rel­a­tive­ly small per­cent­age of peo­ple using the pro­gram because a major­i­ty of the non-elder­ly recip­i­ents already work (despite the pub­lic atti­tude that peo­ple on pub­lic assis­tance are lazy and unde­serv­ing). And of the remain­ing non-elder­ly non-dis­abled adults, a sig­nif­i­cant per­cent are care­givers for preschool chil­dren or a dis­abled per­son. But they’ll have to work now too on top of care­giv­ing:

...
The work require­ments, as detailed in the draft, would only apply to a small frac­tion of those receiv­ing fed­er­al hous­ing aid. Accord­ing to the CBPP, 55 per­cent of those receiv­ing fed­er­al rental assis­tance are elder­ly or dis­abled, and 26 per­cent are already work­ing. Of the remain­der who are not work­ing, a sig­nif­i­cant per­cent­age are care­givers for preschool chil­dren or a dis­abled per­son.

The work require­ments could also pun­ish those who are already in the work­force if they are sub­ject­ed to a 32-hour week­ly min­i­mum, said Fis­ch­er of the CBPP. “Many peo­ple can’t count on get­ting 32 hours,” he said. “These are work­ers doing the best they can to earn a liv­ing, and they could get their assis­tance cut off.”
...

An then there’s the across-the-board rent increas­es. Oh, and elder­ly and dis­abled fam­i­lies would have to con­tribute 30 per­cent of their month­ly income, with a min­i­mum rent of at least $50 per month:

...
The draft also pro­pos­es across-the-board rent increas­es for those receiv­ing hous­ing aid. Ten­ants’ rental con­tri­bu­tion would rise to 35 per­cent from 30 per­cent of month­ly income, and they would no longer be able to deduct med­ical and child care expens­es from their total income,

The Trump admin­is­tra­tion pushed for sim­i­lar rent increas­es in last year’s bud­get, which nev­er passed. The new draft pro­pos­al, how­ev­er, includes a sig­nif­i­cant­ly high­er manda­to­ry min­i­mum rent based on the fed­er­al min­i­mum wage, cal­cu­lat­ed to be about $150 per month. Last year, Trump’s bud­get pro­posed min­i­mum rents of $50 per month.

Elder­ly and dis­abled fam­i­lies who receive rental assis­tance would have to con­tribute 30 per­cent of their month­ly income, with a min­i­mum rent of at least $50 per month. Cur­rent­ly, the min­i­mum rent for most house­holds receiv­ing rental assis­tance ranges from $25 to $50 per month, and some of the poor­est fam­i­lies pay no rent.

There has been some bipar­ti­san sup­port for rent hikes in recent years: In his 2013 bud­get, Pres­i­dent Barack Oba­ma pro­posed rais­ing min­i­mum rents to $75 per month for HUD-assist­ed ten­ants, explain­ing that it would reduce costs and adjust the pol­i­cy for infla­tion. The reforms out­lined in HUD’s new draft leg­is­la­tion, how­ev­er, go sig­nif­i­cant­ly fur­ther, Fis­ch­er said. “I don’t think there’s been a pro­pos­al as broad as this, rais­ing rents in so many dif­fer­ent ways.”

Yen­tel says the rent increas­es that the Trump admin­is­tra­tion have pre­vi­ous­ly pro­posed, and that are out­lined in the draft, would have the great­est impact on seniors, the dis­abled and fam­i­lies with young chil­dren, who would no longer be able to deduct med­ical costs and child care from the income used to cal­cu­late their rent pay­ments. “That means less mon­ey they have of their very lim­it­ed income to pay for med­ica­tion, healthy food, clothes for kids to go to school,” she said.
...

“Yen­tel says the rent increas­es that the Trump admin­is­tra­tion have pre­vi­ous­ly pro­posed, and that are out­lined in the draft, would have the great­est impact on seniors, the dis­abled and fam­i­lies with young chil­dren, who would no longer be able to deduct med­ical costs and child care from the income used to cal­cu­late their rent pay­ments. “That means less mon­ey they have of their very lim­it­ed income to pay for med­ica­tion, healthy food, clothes for kids to go to school,” she said.”

Yep, as opposed to these poli­cies pri­mar­i­ly impact­ing ‘those peo­ple’ — the arche­typ­al lazy able-bod­ied per­son who does­n’t work and fuels pub­lic back­ing for these kinds of poli­cies — the real tar­gets are like­ly seniors, the dis­abled and fam­i­lies with young chil­dren.

And this all can hap­pen with­out Con­gress’s approval. The Trump White House can sim­ply expand a ‘demon­stra­tion pro­gram’ that’s been around since 2015:

...
Hous­ing experts and advo­cates antic­i­pate that the Trump admin­is­tra­tion will try to move for­ward with these pro­pos­als when it releas­es its bud­get, which is expect­ed in the next few weeks. The admin­is­tra­tion could also push for work require­ments with­out pass­ing new leg­is­la­tion through a demon­stra­tion pro­gram that Con­gress vot­ed to expand in late 2015, but which has yet to be imple­ment­ed ful­ly.
...

And what did those demon­stra­tion pro­grams demon­strate? They found “work require­ments increased employ­ment with­out increas­ing ten­ant evic­tions”, which, again is dur­ing a time of his­tor­i­cal­ly low US unem­ploy­ment:

...
Under the demon­stra­tion pro­gram, a small hand­ful of pub­lic hous­ing author­i­ties have already exper­i­ment­ed with work require­ments, as well as rent increas­es. In Char­lotte, North Car­oli­na, researchers found that work require­ments increased employ­ment with­out increas­ing ten­ant evic­tions, though they cau­tioned against impos­ing the require­ments more broad­ly with­out fur­ther study.

Diane Levy, a researcher at the Urban Insti­tute, an eco­nom­ic and social pol­i­cy think tank in Wash­ing­ton, agreed, point­ing out that very very lit­tle is known about some of the most basic ques­tions involved, such as whether work require­ments do ulti­mate­ly help move ten­ants off assis­tance.

“Are they able to keep jobs, and is it mak­ing a dif­fer­ence in their abil­i­ty to have a sta­ble income?” she said. “We don’t know.”
...

Also note that the North Car­oli­na study found that a 15 hour per week work-require­ment had a “mod­est” pos­i­tive impact and had a small sam­ple (read the study, it has an abun­dance of lim­i­ta­tions).

And what addi­tion­al help is there for par­ents who need child­care ser­vices? As the Cen­ter for Bud­get Pol­i­cy Pri­or­i­ties points out, there’s no addi­tion­al help. And actu­al­ly less help because exist­ing child-care sub­si­dies are get­ting cut. And as they also point out, while the stud­ies on the impact of work-require­ments for hous­ing sub­si­dies are slim, it’s not like there haven’t been stud­ies on work-require­ments for oth­er pub­lic safe­ty-net ser­vices. And what we’ve learned from those oth­er work require­ment pro­grams is that they have gen­er­at­ed lit­tle or no long-term increase in earn­ings and employ­ment and have caused many fam­i­lies — often those with the great­est dis­ad­van­tages — to lose assis­tance. Of course:

Cen­ter for Bud­get Pol­i­cy Pri­or­i­ties

Trump Plan to Con­di­tion Rental Assis­tance on Work Will Hurt Fam­i­lies, Not Sup­port Work

Will Fis­ch­er
Senior Pol­i­cy Ana­lyst
Feb­ru­ary 7, 2018 at 5:15 PM

A draft plan from the Trump Admin­is­tra­tion leaked last week would let hous­ing agen­cies and pri­vate own­ers end rental assis­tance for peo­ple who don’t meet new work require­ments — putting low-income peo­ple, includ­ing many who now work, at risk of hard­ship but like­ly doing lit­tle to help them find and keep jobs or raise their earn­ings. (The plan would also raise rents for work­ing fam­i­lies and oth­er house­holds, as we’ll dis­cuss in anoth­er blog post.)

The leaked plan would let state and local hous­ing agen­cies that admin­is­ter Hous­ing Choice Vouch­ers and Pub­lic Hous­ing and pri­vate own­ers of prop­er­ties with Project-Based Rental Assis­tance end sub­si­dies for house­holds that include non-elder­ly adults with­out dis­abil­i­ties if they don’t work or par­tic­i­pate in voca­tion­al train­ing or edu­ca­tion for a set num­ber of hours, which could be as high as 32 hours a week. Most par­tic­i­pants in these pro­grams would strug­gle to afford hous­ing with­out assis­tance. Con­se­quent­ly, those who lose their assis­tance would face the risk of evic­tion and even home­less­ness, caus­ing seri­ous hard­ship and mak­ing it hard­er for them to find or keep a job.

Many of those harmed would be peo­ple who already work. (See chart.) Low-wage jobs often have unpre­dictable hours, rang­ing from 40 hours in some weeks to just a frac­tion of that amount in oth­ers. As a result, work­ers who are doing their best to earn a liv­ing could lose rental assis­tance because their employ­ers don’t give them enough hours to meet the require­ment. In addi­tion, work­ers could strug­gle to keep up with the paper­work need­ed to prove they worked a set num­ber of hours each week or see their assis­tance end due to admin­is­tra­tive mix-ups.

More­over, the Administration’s plan doesn’t pro­pose any mea­sures to help peo­ple over­come bar­ri­ers that make it hard to work the required hours. The Admin­is­tra­tion did not indi­cate that it will pro­vide new resources for sub­si­dies to help cov­er the cost of car­ing for chil­dren or for fam­i­ly mem­bers who are ill or have dis­abil­i­ties and, indeed, the plan would elim­i­nate a sub­sidy for child care costs that’s now part of the rent for­mu­la. Recip­i­ents with men­tal or phys­i­cal health con­di­tions that lim­it their abil­i­ty to work — but don’t qual­i­fy as ful­ly dis­abled — could lose their assis­tance. And peo­ple strug­gling with opi­oid or oth­er sub­stance use addic­tions would face the risk of los­ing assis­tance even if they’re seek­ing treat­ment, espe­cial­ly since agen­cies and own­ers wouldn’t have to count time spent in treat­ment toward the hours require­ment.

The Admin­is­tra­tion presents its plan as an option for local agen­cies, but those agen­cies wouldn’t nec­es­sar­i­ly be free to decide whether to impose work require­ments. Once fed­er­al law per­mits work require­ments, state leg­is­la­tures could direct local agen­cies to impose them even though that would raise agen­cies’ admin­is­tra­tive costs and under­cut local ini­tia­tives such as cam­paigns to end home­less­ness. In addi­tion, the Depart­ment of Hous­ing and Urban Devel­op­ment (HUD) could pres­sure agen­cies by giv­ing those that refrain from impos­ing work require­ments low­er per­for­mance rat­ings and less access to cer­tain fed­er­al grants.

The evi­dence on the impact of rental assis­tance work require­ments is lim­it­ed, but such require­ments in oth­er pro­grams have gen­er­at­ed lit­tle or no long-term increase in earn­ings and employ­ment and have caused many fam­i­lies — often those with the great­est dis­ad­van­tages — to lose assis­tance. Noth­ing about the Administration’s plan sug­gests it would pro­duce bet­ter out­comes. Two small-scale HUD ini­tia­tives (Jobs Plus and the Fam­i­ly Self-Suf­fi­cien­cy pro­gram) that sup­port work through ser­vice coor­di­na­tion and finan­cial incen­tives have shown promis­ing results — with­out the risks that puni­tive work require­ments pose. Pol­i­cy­mak­ers who want to help rental assis­tance recip­i­ents suc­ceed in today’s econ­o­my should focus on expand­ing and strength­en­ing those ini­tia­tives and sim­i­lar efforts.

———-

“Trump Plan to Con­di­tion Rental Assis­tance on Work Will Hurt Fam­i­lies, Not Sup­port Work” by Will Fis­ch­er; Cen­ter for Bud­get Pol­i­cy Pri­or­i­ties; 02/07/2018

“Many of those harmed would be peo­ple who already work. (See chart.) Low-wage jobs often have unpre­dictable hours, rang­ing from 40 hours in some weeks to just a frac­tion of that amount in oth­ers. As a result, work­ers who are doing their best to earn a liv­ing could lose rental assis­tance because their employ­ers don’t give them enough hours to meet the require­ment. In addi­tion, work­ers could strug­gle to keep up with the paper­work need­ed to prove they worked a set num­ber of hours each week or see their assis­tance end due to admin­is­tra­tive mix-ups.”

An admin­is­tra­tive mix-up might get you kicked out of our home and/or kick off Med­ic­aid and/or kicked off of the food stamp pro­gram. Or maybe it won’t be an admin­is­tra­tive mix-up but instead just a real­ly bad month when every­thing goes wrong in your life. Maybe you sud­den­ly need to pay for a car repair pay­ment so you can keep your job, and that means you miss one of the new fees or pre­mi­ums. Or a sud­den health prob­lem gob­bles up most of your income and what lit­tle sav­ings you have. It’s real­ly aston­ish­ing just how much the new sys­tem is designed to ensure peo­ple fall through the cracks by widen­ing them and push­ing peo­ple into them. But that’s the sys­tem they’re about to put a place. A sys­tem designed to fail the peo­ple its intend­ed to serve.

And, again, when work-require­ments have been imposed for oth­er pub­lic ser­vices they did­n’t actu­al­ly work. And the poor­est got kicked the hard­est:

...
The evi­dence on the impact of rental assis­tance work require­ments is lim­it­ed, but such require­ments in oth­er pro­grams have gen­er­at­ed lit­tle or no long-term increase in earn­ings and employ­ment and have caused many fam­i­lies — often those with the great­est dis­ad­van­tages — to lose assis­tance. Noth­ing about the Administration’s plan sug­gests it would pro­duce bet­ter out­comes. Two small-scale HUD ini­tia­tives (Jobs Plus and the Fam­i­ly Self-Suf­fi­cien­cy pro­gram) that sup­port work through ser­vice coor­di­na­tion and finan­cial incen­tives have shown promis­ing results — with­out the risks that puni­tive work require­ments pose. Pol­i­cy­mak­ers who want to help rental assis­tance recip­i­ents suc­ceed in today’s econ­o­my should focus on expand­ing and strength­en­ing those ini­tia­tives and sim­i­lar efforts.

And for those who need help wit child­care and tak­ing care of a dis­abled rel­a­tive? Noth­ing. Same with opi­oid and drug addicts. Treat­ment does­n’t count towards work (and good luck find­ing work while in treat­ment):

...
More­over, the Administration’s plan doesn’t pro­pose any mea­sures to help peo­ple over­come bar­ri­ers that make it hard to work the required hours. The Admin­is­tra­tion did not indi­cate that it will pro­vide new resources for sub­si­dies to help cov­er the cost of car­ing for chil­dren or for fam­i­ly mem­bers who are ill or have dis­abil­i­ties and, indeed, the plan would elim­i­nate a sub­sidy for child care costs that’s now part of the rent for­mu­la. Recip­i­ents with men­tal or phys­i­cal health con­di­tions that lim­it their abil­i­ty to work — but don’t qual­i­fy as ful­ly dis­abled — could lose their assis­tance. And peo­ple strug­gling with opi­oid or oth­er sub­stance use addic­tions would face the risk of los­ing assis­tance even if they’re seek­ing treat­ment, espe­cial­ly since agen­cies and own­ers wouldn’t have to count time spent in treat­ment toward the hours require­ment.
...

Also note how this all works syn­er­gis­ti­cal­ly with the new work require­ments and pre­mi­ums being intro­duced for Med­ic­aid by states like Ken­tucky and Indi­ana. Because the peo­ple fac­ing the new month­ly Med­ic­aid pre­mi­ums are prob­a­bly the same peo­ple who need to pay the new rent increas­es for pub­lic hous­ing sub­si­dies. So all these new fees could hit the poor­est Amer­i­cans in com­ing years and if they can’t afford to pay they fall through the cracks. And pos­si­bly fall into a grave. Because we’re talk­ing about set­ting peo­ple up to lose sub­si­dies for food, shel­ter, and med­i­cine if they don’t suc­cess­ful­ly nav­i­gate the new maze of require­ments.

And let’s not for­get that there are plen­ty of peo­ple who are on the edge of being ‘able-bod­ied’ peo­ple who aren’t actu­al­ly able-bod­ied but get clas­si­fied as such by mis­take by the bureau­cra­cy set up to estab­lish able-bod­ied­ness. These rules could destroy the lives of peo­ple in that group. Home­less­ness isn’t a ‘kick in the pants’. It’s an anchor that can drown peo­ple.

It’s a reminder that while these new poli­cies are going to be sold as not impact­ing the ‘tru­ly needy’ but just ‘those peo­ple deserve it’, it’s actu­al­ly designed to impact peo­ple like those tak­ing care of rel­a­tives. Or peo­ple where the local econ­o­my does­n’t make a 32 hour a work week a real­is­tic prospect for an indi­vid­ual.

And all these fees are syn­er­gis­tic when it comes to kick­ing peo­ple off of these pro­grams. It’s the peo­ple who can’t work the 32 hours a week and get kicked out off the hous­ing sub­sidy who won’t be able to pay the high­er hous­ing fees and will also get kicked off of Med­ic­aid for not pay­ing their new Med­ic­aid pre­mi­ums. It’s a

Part of what makes this issue so poignant is that its a high­ly illus­tri­ous exam­ple of this meta-issue that plagues Amer­i­can soci­ety: at the root of the desire to kick ‘able-bod­ied’ peo­ple off of pub­lic ser­vices like sub­si­dized hous­ing for the poor is sen­ti­ment that ‘some lazy bas­tards just need to be allowed to die in a ditch’. A desire to pun­ish ‘those peo­ple’ real­ly is a major pol­i­cy-dri­ver in Amer­i­can soci­ety because things like work require­ments are fool­ish­ly pop­u­lar among Amer­i­cans. Kick­ing the poor and feel­ing like the poor have some­how failed or deserve their cir­cum­stances (a per­spec­tive that indi­cates a pro­found lack of under­stand­ing of socioe­co­nom­ic real­i­ties) real­ly is almost Amer­i­can ortho­doxy from the his­tor­i­cal cap­i­tal­ist social Dar­win­ism per­spec­tive that per­me­ates the Koch-dom­i­nat­ed GOP of today. Peo­ple who know some­one they think is super lazy and should be home­less if they don’t ‘turn them­selves around’ might feel like gov­ern­ment pol­i­cy should pun­ish peo­ple ‘like that’ and that’s clear­ly a major sen­ti­ment behind the pub­lic sup­port for poli­cies that focus on ensur­ing all ‘able-bod­ied’ per­sons have to work 32 hours a week. Peo­ple want ‘those peo­ple’ to pay. That arche­typ­al ‘lazy bas­tard’. And set­ting up a giant bureau­cra­cy to assess their ‘able-bod­ied­ness’ is worth it for large chunk of the Amer­i­cans pub­lic.

It’s real­ly quite a trag­i­cal­ly vin­dic­tive sen­ti­ment because it cas­cades through­out a soci­ety and cre­ates all sorts of oth­er hor­ri­ble things. The kinds of hor­ri­ble things that one might expect if you ask the ques­tion “how many inno­cent men should be sent to prison in order to avoid a guilty man going free?” and the answer is “as many as it takes!” When that’s the guid­ing spir­it for pub­lic pol­i­cy you’re going to have mass dis­as­ters. Like the prison indus­tri­al com­plex. The prison indus­tri­al com­plex was cre­at­ed, in part, by pop­u­lar demand and there’s a BIG dose of ‘those peo­ple deserve it’ sen­ti­ment behind. And that sen­ti­ment is the kind of sen­ti­ment that feeds on itself. Because the destruc­tive forces unleashed impov­er­ish a soci­ety in ways that aren’t mea­sured in dol­lars and cents. They’re felt in the lost human poten­tial and dam­aged or lost lives caused by bad pol­i­cy deci­sions.

But there is hope. Because as the fol­low­ing recent arti­cle in Vox point­ed dis­cuss­es, there was a recent poll that showed a sur­pris­ing oppo­si­tion to work-require­ments for Med­ic­aid, with 57 per­cent oppos­ing it. This is in stark con­trast to most US polling on pub­lic sup­port for work-require­ments. So what explains this recent polls? Well, as the arti­cle sug­gests, it could have to do with how this poll framed the ques­tion. Because the poll asks whether or not peo­ple should actu­al­ly lose their Med­ic­aid cov­er­age if they don’t meet a work require­ment. As opposed to how the ques­tion is asked in oth­er polls which is often like “do you sup­port work-require­ments for Med­ic­aid?” which is phras­ing that does­n’t point out that you would lose your Med­ic­aid if you don’t meet that require­ment. So it’s pos­si­ble that Amer­i­cans don’t actu­al­ly sup­port let­ting peo­ple fall through the cracks if they don’t meet all the new rules the GOP is set­ting up. Rules that appear to be designed to throw peo­ple through the cracks:

Vox

America’s Med­ic­aid work require­ment para­dox, explained by 2 polls

By Dylan Scott
Feb 5, 2018, 3:50pm EST

The Trump admin­is­tra­tion is mov­ing full speed ahead on Med­ic­aid work require­ments: On Fri­day, the Cen­ters for Medicare and Med­ic­aid approved Indiana’s request that allows the state to revoke cov­er­age for peo­ple who don’t meet cer­tain employ­ment or job train­ing stan­dards. Two states have now received approval with more to come.

There is a con­ven­tion­al wis­dom that, even as Med­ic­aid has shown its polit­i­cal resilience, the pub­lic is pret­ty open to work require­ments. But some new polling, shared exclu­sive­ly with Vox, com­pli­cates that pic­ture.

The lib­er­al Cen­ter for Amer­i­can Progress (CAP) released a poll on Repub­li­can pro­pos­als to cut Med­ic­aid and oth­er safe­ty-net pro­grams. They found that, broad­ly, any plans to cut gov­ern­ment wel­fare spend­ing are unpop­u­lar:

* 80 per­cent of Amer­i­cans said they opposed cut­ting Med­ic­aid,
* 78 per­cent said they opposed cut­ting Social Secu­ri­ty dis­abil­i­ty insur­ance,
* 66 per­cent said they opposed cut­ting food stamps.

...

(Con­sid­er the source, of course. These are the details on the CAP poll: 2,350 reg­is­tered vot­ers, weight­ed to reflect nation­al demo­graph­ics, sur­veyed online late last month. It was con­duct­ed by GBA Strate­gies.)

Accord­ing to the CAP poll, the pub­lic isn’t enam­ored with Med­ic­aid work require­ments either: 57 per­cent said they opposed allow­ing states “to deny Med­ic­aid health cov­er­age to recip­i­ents ages 18 to 64 who do not have a job with a cer­tain amount of hours and do not par­tic­i­pate in state-approved work pro­grams.”

That find­ing sort of shocked me, because we’ve seen oth­er polling recent­ly that sug­gest­ed Amer­i­cans were on board with work require­ments. The Kaiser Fam­i­ly Foun­da­tion (KFF), the gold stan­dard of health pol­i­cy polling, found in June that 70 per­cent of respon­dents said that they would sup­port a work require­ment.

There are a cou­ple of ways to rec­on­cile those find­ings. First, the Kaiser sur­vey came out when there were oth­er big­ger health care sto­ries in the news; CAP’s poll arrived on the heels of a big Med­ic­aid work require­ment announce­ment, which was like­ly accom­pa­nied by crit­i­cal news cov­er­age.

But I’d look at the word­ing of the ques­tions. KFF asked about allow­ing states to impose work require­ments on peo­ple “in order to get health insur­ance through Med­ic­aid.” CAP asked about deny­ing peo­ple health insur­ance if they didn’t meet the require­ments set by their state.

I’m not a poll­ster and I’m not inter­est­ed in lit­i­gat­ing which is the more appro­pri­ate ques­tion. KFF is the gold stan­dard for a rea­son. But I think this dis­par­i­ty — a huge major­i­ty sup­ports work require­ments if you frame them one way; a sol­id major­i­ty oppos­es them if you use a dif­fer­ent frame — is telling in the odd rela­tion­ship Amer­i­cans have with the social safe­ty net.

On the one hand, we believe in work — Max Weber’s Protes­tant work eth­ic is so cru­cial to under­stand­ing the Amer­i­can psy­che for good rea­son. Work is treat­ed as an inher­ent good. That might help explain why we col­lec­tive­ly are so sus­cep­ti­ble to sto­ries about peo­ple tak­ing advan­tage of Med­ic­aid or dis­abil­i­ty insur­ance, even if there isn’t evi­dence of a pan­dem­ic of fraud.

But on the oth­er hand, Amer­i­cans do believe in a social safe­ty net. Accord­ing to the CAP poll, more than 70 per­cent of peo­ple said they opposed cut­ting home heat­ing assis­tance for low-income Amer­i­cans, unem­ploy­ment insur­ance, and afford­able hous­ing pro­grams.

Medicare and Social Secu­ri­ty have long been third rails of Amer­i­can pol­i­tics. Med­ic­aid may have joined them after Repub­li­cans proved unable to over­haul it dur­ing the Oba­macare repeal debate. We aren’t a Euro­pean social democ­ra­cy by any stretch, but there is a con­sen­sus that we should sup­port the least advan­taged among us.

So the way these issues are framed is key. Amer­i­cans are okay with requir­ing work as a prin­ci­ple — though, as we’ve cov­ered, there don’t seem to be many peo­ple on Med­ic­aid who can work but aren’t. But if you then explain the con­se­quences in vivid terms, that peo­ple could be denied health insur­ance as a result, they’re less com­fort­able with it.

This is some­thing to keep an eye on as House Speak­er Paul Ryan looks to keep wel­fare reform alive.

Ryan, as the Wall Street Jour­nal report­ed over the week­end, is look­ing to reframe the debate as “get­ting peo­ple the skills and oppor­tu­ni­ties to get into the work­force.” That is the kind of rhetoric, as this Med­ic­aid polling sug­gests, that can get Amer­i­cans onboard.

But if the actu­al result is fund­ing and enroll­ment cuts — and peo­ple under­stand that — these pro­pos­als rapid­ly become much less pop­u­lar.

———-

“America’s Med­ic­aid work require­ment para­dox, explained by 2 polls” by Dylan Scott; Vox; 02/05/2018

“There is a con­ven­tion­al wis­dom that, even as Med­ic­aid has shown its polit­i­cal resilience, the pub­lic is pret­ty open to work require­ments. But some new polling, shared exclu­sive­ly with Vox, com­pli­cates that pic­ture.”

Yep, the Amer­i­can ethos that fetishizes work as the high­est call­ing in life has long been reflect­ed in pub­lic opin­ion polls about things like work-require­ments for a safe­ty-net. But as the recent Cen­ter for Amer­i­can Progress poll sug­gests, Amer­i­cans might be more con­flict­ed on the top­ic than is wide­ly assumed. When asked whether states should be allowed “to deny Med­ic­aid health cov­er­age to recip­i­ents ages 18 to 64 who do not have a job with a cer­tain amount of hours and do not par­tic­i­pate in state-approved work pro­grams”, 57 per­cent of Amer­i­cans oppose the idea:

...
The lib­er­al Cen­ter for Amer­i­can Progress (CAP) released a poll on Repub­li­can pro­pos­als to cut Med­ic­aid and oth­er safe­ty-net pro­grams. They found that, broad­ly, any plans to cut gov­ern­ment wel­fare spend­ing are unpop­u­lar:

* 80 per­cent of Amer­i­cans said they opposed cut­ting Med­ic­aid,
* 78 per­cent said they opposed cut­ting Social Secu­ri­ty dis­abil­i­ty insur­ance,
* 66 per­cent said they opposed cut­ting food stamps.

...

Accord­ing to the CAP poll, the pub­lic isn’t enam­ored with Med­ic­aid work require­ments either: 57 per­cent said they opposed allow­ing states “to deny Med­ic­aid health cov­er­age to recip­i­ents ages 18 to 64 who do not have a job with a cer­tain amount of hours and do not par­tic­i­pate in state-approved work pro­grams.”
...

So is this new poll a sta­tis­ti­cal blip or oth­er­wise flawed and unre­li­able? Well, as the arti­cle points out, there’s a very plau­si­ble expla­na­tion that incor­po­rates both the long-stand­ing Amer­i­can pub­lic sup­port for things like work-require­ments as well as the long-stand­ing pub­lic sup­port for a safe­ty-net: This poll asked the ques­tion in a way that high­lights the loss of Med­ic­aid cov­er­age for peo­ple who did­n’t meet the require­ment, where­as the Kaiser poll which showed 70 sup­port for work require­ments phrased the ques­tion in a way that empha­sized need­ed to work to qual­i­fy for Med­ic­aid. So when Amer­i­cans were remind­ed that work require­ments mean peo­ple who don’t meet them lose access, a major­i­ty of Amer­i­cans did­n’t sup­port them. In oth­er words, it’s entire­ly pos­si­ble that the pri­ma­ry rea­son there’s has been so much sup­port for work require­ments for pub­lic safe­ty-net ser­vices by the Amer­i­can pub­lic is because the Amer­i­can pub­lic has­n’t actu­al­ly thought this through which might be why the phras­ing of the ques­tion could impact polling results so much:

...
But I’d look at the word­ing of the ques­tions. KFF asked about allow­ing states to impose work require­ments on peo­ple “in order to get health insur­ance through Med­ic­aid.” CAP asked about deny­ing peo­ple health insur­ance if they didn’t meet the require­ments set by their state.

I’m not a poll­ster and I’m not inter­est­ed in lit­i­gat­ing which is the more appro­pri­ate ques­tion. KFF is the gold stan­dard for a rea­son. But I think this dis­par­i­ty — a huge major­i­ty sup­ports work require­ments if you frame them one way; a sol­id major­i­ty oppos­es them if you use a dif­fer­ent frame — is telling in the odd rela­tion­ship Amer­i­cans have with the social safe­ty net.

On the one hand, we believe in work — Max Weber’s Protes­tant work eth­ic is so cru­cial to under­stand­ing the Amer­i­can psy­che for good rea­son. Work is treat­ed as an inher­ent good. That might help explain why we col­lec­tive­ly are so sus­cep­ti­ble to sto­ries about peo­ple tak­ing advan­tage of Med­ic­aid or dis­abil­i­ty insur­ance, even if there isn’t evi­dence of a pan­dem­ic of fraud.

But on the oth­er hand, Amer­i­cans do believe in a social safe­ty net. Accord­ing to the CAP poll, more than 70 per­cent of peo­ple said they opposed cut­ting home heat­ing assis­tance for low-income Amer­i­cans, unem­ploy­ment insur­ance, and afford­able hous­ing pro­grams.
...

Is it pos­si­ble that Amer­i­cans lit­er­al­ly aren’t con­scious­ly think­ing about the fact that work require­ments aren’t just about work but also about throw­ing peo­ple off ser­vices? Let’s hope so, because it would be nice if the tur­bo-charged night­mare gov­ern­ment sur­veil­lance regime that’s con­stant­ly mea­sur­ing the poor to assess their wor­thi­ness for ser­vices is all just a mis­un­der­stand­ing. A giant hor­ri­ble mis­un­der­stand­ing.

But it’s hard to ignore the recog­ni­tion that there’s still sig­nif­i­cant sup­port in the US for the idea that there’s a seg­ment of soci­ety that falls into the cat­e­go­ry of ‘those lazy bas­tard peo­ple who need to be allowed to die in a ditch’ and that sen­ti­ment is undoubt­ed­ly ani­mat­ing a lot of Amer­i­ca’s sup­port for these kinds of poli­cies. But who knows, maybe when Amer­i­cans are faced with the actu­al con­se­quences of putting such sen­ti­ments into pol­i­cy — con­se­quences like ‘those lazy bas­tards’ actu­al­ly becom­ing home­less and dying in ditch­es — maybe the pub­lic sup­port won’t be there. Is that pos­si­ble? It at least seems pos­si­ble Amer­i­cans won’t actu­al­ly sup­port the con­se­quences of the GOP’s unfold­ing War on the Poor. Trag­i­cal­ly, we’ll prob­a­bly get an answer to that ques­tion but only after all these new rules are put in place and cre­ate a human cat­a­stro­phe after the next big reces­sion.

It’s all a reminder that, at the same time the GOP is hold­ing the ‘Dream­ers’ hostage to extract an immi­gra­tion reform plan that is more or less a refu­ta­tion of the ‘Give me your tired, your poor, Your hud­dled mass­es yearn­ing to breathe free’ line on the Stat­ue of Lib­er­ty (which would­n’t be the first time this admin­is­tra­tion has refut­ed that line), the GOP is busi­ly work­ing on cre­at­ing a fresh new sup­ply of tired, poor, hud­dled mass­es.

And they’ll free all right. Free to die in a ditch. Which, in the con­text of the GOP’s War on the Poor, is be a fea­ture, not a bug. A bru­tal fea­ture that will hope­ful­ly become unpop­u­lar if and when peo­ple actu­al­ly stop and think about it.

Mis­sion Accom­plished! Specif­i­cal­ly, the White House mis­sion to troll the nation with a new out­landish­ly cru­el pro­pos­al in the GOP’s expand­ing War on the Poor. And trolling was seri­ous­ly their mis­sion. They admit it:

The White House just pro­posed replac­ing half of the food assis­tance peo­ple cur­rent­ly receive in food stamps — gov­ern­ment funds pro­vid­ed to the poor specif­i­cal­ly for buy­ing food — with a “Har­vest Box” of gov­ern­ment-pro­vid­ed food that will be deliv­ered to peo­ple instead. What’s the state moti­va­tion behind this plan? Increas­ing access to fresh, health foods that often aren’t avail­able in low-income ‘food deserts’? No, that’s not the goal. The box­es won’t con­tain any fresh food. Only non-per­ish­able goods.

Instead, the goal is the same goal the GOP always has for any pro­gram that helps the poor. Gut­ting them. In this case, the goal is shrink­ing the food assis­tance pro­grams for the poor by $21 bil­lion dol­lars over the next decade. Yep, after that giant tax cut for the super-rich some­one has to help pay the nation’s bills.

But accord­ing to White House offi­cials, this pro­pos­al was­n’t seri­ous at all. It was just trolling. That’s lit­er­al­ly the expla­na­tion two White House sources give in the fol­low­ing arti­cle. The real plan, accord­ing to these insid­ers, was to enrage pro­gres­sives with the “Har­vest Box” idea and “stir up” Repub­li­cans in Con­gress as a way of “lay­ing down a mark­er” so show that the admin­is­tra­tion is seri­ous about a dif­fer­ent pro­pos­al it has for food stamps: new food assis­tance work require­ments and numer­ous oth­er cuts designed to cut anoth­er $85 bil­lion from food assis­tance pro­grams over the next decade.

And this $21 bil­lion in pro­posed “Har­vest Box” cuts and the pro­ject­ed $85 bil­lion from the new work require­ment and oth­er cuts are mere­ly a frac­tion of the self-imposed admin­is­tra­tion goal of reduc­ing fed­er­al food assis­tance pro­grams by $214 bil­lion over the next decade. Yep, they’re seri­ous­ly call­ing for $214 bil­lion in cuts to food assis­tance for the poor over the next decade.

So while the “Har­vest Box” pro­pos­al may have been trolling, it was the kind of trolling that actu­al­ly under­stat­ed the admin­is­tra­tion’s cru­el­ty. It was high­ly strate­gic trolling. As right-wing trolling so often is these days. A giant trolling dis­trac­tion that is designed to draw atten­tion away from the cuts to food assis­tance pro­grams that are 10 times larg­er than the “Har­vest Box” cuts and draw atten­tion away from the $85 bil­lion in addi­tion­al cuts.

In oth­er words, the “Har­vest Box” idea is just the fake appe­tiz­er for the feast of cuts the White House just pro­posed. Because, again, some­one has to pay for that tax cut for the super-rich. And that ‘some­one’ who will pay is peo­ple too poor to eat. And they will pay BIGLY. Bigly mal­nu­tri­tion:

The New York Times

A ‘Har­vest Box’ for Low-Income Amer­i­cans? Not Any­time Soon, Offi­cials Say

By GLENN THRUSH
FEB. 13, 2018

WASHINGTON — The Sup­ple­men­tal Nutri­tion Assis­tance Pro­gram offers about 46 mil­lion low-income Amer­i­cans both sus­te­nance and eco­nom­ic choice by pro­vid­ing an allowance to buy the fruit, meat, fresh veg­eta­bles, soda, ice cream and kind of bread they want to eat.

But on Mon­day, the Trump admin­is­tra­tion sprung a sur­prise: Under a pro­pos­al in the president’s bud­get many par­tic­i­pants in the pro­gram would be giv­en half their ben­e­fits in the form of a “Har­vest Box” full of food pre­s­e­lect­ed for nutri­tion­al val­ue and eco­nom­ic ben­e­fit to Amer­i­can farm­ers. The cache of cheap­er peanut but­ter, canned goods, pas­ta, cere­al, “shelf sta­ble” milk and oth­er prod­ucts would now be select­ed by the fed­er­al gov­ern­ment, not by the peo­ple actu­al­ly eat­ing it.

The pro­pos­al seemed like a rad­i­cal over­haul of the country’s core food assis­tance pro­gram — once called food stamps but now com­mon­ly known as SNAP. The idea was to shave about $21 bil­lion a year from the fed­er­al deficit over the next 10 years. But the reac­tion was imme­di­ate, and large­ly neg­a­tive.

Democ­rats claimed the plan shack­led the poor while busi­ness groups, led by big food retail­ers, would stand to lose bil­lions of dol­lars in lost SNAP busi­ness. The head of one trade asso­ci­a­tion typ­i­cal­ly sup­port­ive of Pres­i­dent Trump’s eco­nom­ic poli­cies accused the admin­is­tra­tion of reneg­ing on its pledge to cut “red tape and reg­u­la­tions.”

In real­i­ty, admin­is­tra­tion offi­cials on Tues­day admit­ted that the food-box plan — which the president’s bud­get direc­tor Mick Mul­vaney com­pared to the Blue Apron gro­cery deliv­ery ser­vice — had vir­tu­al­ly no chance of being imple­ment­ed any­time soon.

Instead, the idea, accord­ing to two admin­is­tra­tion offi­cials who worked on the pro­pos­al, was a polit­i­cal gam­bit by fis­cal hawks in the admin­is­tra­tion aimed at spark­ing out­rage among lib­er­als and stir­ring up mem­bers of the president’s own par­ty work­ing on the lat­est ver­sion of the farm bill. The move, they said, was intend­ed to lay down a mark­er that the admin­is­tra­tion is seri­ous about press­ing for about $85 bil­lion in oth­er cuts to food assis­tance pro­grams that will be achieved, in part, by impos­ing strict new work require­ments on recip­i­ents.

“I don’t think there’s real­ly any sup­port for their box plan. And, I wor­ry that it’s a dis­trac­tion from the budget’s pro­pos­al to cut SNAP by some 30 per­cent. That’s the real bat­tle.” said Sta­cy Dean, vice pres­i­dent for food assis­tance pol­i­cy at the Cen­ter on Bud­get and Pol­i­cy Pri­or­i­ties, a pro­gres­sive Wash­ing­ton think tank. “The dan­ger are these oth­er pro­pos­als to cut ben­e­fits. But all any­one is talk­ing about today are the box­es.”

Sen­a­tor Deb­bie Stabenow, the rank­ing Demo­c­rat on the agri­cul­ture com­mit­tee, doubt­ed the motives behind the plan.

“This isn’t a seri­ous pro­pos­al and is clear­ly meant to be a dis­trac­tion,” Ms. Stabenow said.

Agri­cul­ture Sec­re­tary Son­ny Per­due stealth­ily pitched the idea over the last few weeks to the White House’s Domes­tic Pol­i­cy Coun­cil as a nov­el way to reach the administration’s self-imposed goal of slash­ing fed­er­al food assis­tance pro­grams by $214 bil­lion over the next decade. It was quick­ly embraced by Mr. Mul­vaney, a fis­cal hawk who is seek­ing to steer a debate increas­ing­ly dom­i­nat­ed by free-spend­ing Repub­li­cans and Mr. Trump, who has insist­ed on major bud­get increas­es for the Pen­ta­gon and Home­land Secu­ri­ty.

Nei­ther man had any illu­sions that the plan would be imme­di­ate­ly embraced by con­gres­sion­al Repub­li­cans, who were not giv­en advance notice of the pro­pos­al, the offi­cials said.

That the food-box approach has been tried only in small demon­stra­tion projects and nev­er been seri­ous­ly dis­cussed dur­ing dozens of con­gres­sion­al hear­ings on the SNAP pro­gram in recent years did not stop admin­is­tra­tion offi­cials from putting the force of Mr. Trump’s pres­i­den­cy behind it.

The bud­get doc­u­ments released on Mon­day omit­ted oth­er impor­tant details, includ­ing the real costs of cre­at­ing a nation­wide dis­tri­b­u­tion net­work for the box­es, espe­cial­ly in rur­al areas hard hit by the eco­nom­ic down­turn and the opi­oid cri­sis.

“We have had like 25 hear­ings on SNAP. The wit­ness list was con­trolled by Repub­li­cans and this idea was nev­er, ever broached,” said Rep­re­sen­ta­tive Jim McGov­ern of Mass­a­chu­setts, rank­ing Demo­c­rat on the House sub­com­mit­tee that over­sees fed­er­al food assis­tance pro­grams. “I think it’s dead on arrival — I hope it is — but either way it’s a cru­el joke. My god, these peo­ple are awful. In addi­tion to being total­ly mis­in­formed on pol­i­cy, they are real­ly just not nice peo­ple.”

In a state­ment, Mr. Per­due defend­ed the pro­pos­al as humane and cost effec­tive, say­ing his plan offered the “same lev­el of food val­ue” pro­vid­ed by the SNAP pro­gram, which replaced the food stamp pro­gram in the late 1990s.

He described the box­es as “a bold, inno­v­a­tive approach to pro­vid­ing nutri­tious food to peo­ple who need assis­tance feed­ing them­selves and their fam­i­lies — and all of it is grown by Amer­i­can farm­ers and pro­duc­ers.”

Still, the idea land­ed with a thud. It was quick­ly dis­missed by two Repub­li­can com­mit­tee chair­men, Sen­a­tor Pat Roberts of Kansas, who leads the Sen­ate agri­cul­ture com­mit­tee, and his coun­ter­part in the House, Rep­re­sen­ta­tive K. Michael Conaway of Texas.

Mr. Conaway is draft­ing a farm bill that is expect­ed to slash bil­lions in spend­ing in the SNAP pro­gram through the tight­en­ing of some eli­gi­bil­i­ty require­ments. Mr. Roberts is over­see­ing an effort to craft a ver­sion of the bill that is expect­ed to include few­er cuts in hopes of gain­ing the bipar­ti­san sup­port need­ed to push the mea­sure through the Sen­ate.

SNAP, like many oth­er safe­ty net pro­grams, is designed to expand dur­ing hard eco­nom­ic times and con­tract when the econ­o­my improves. Nonethe­less, the program’s rolls have remained at his­tor­i­cal­ly ele­vat­ed lev­els, reach­ing a peak of 47.8 mil­lion recip­i­ents in 2012 before edg­ing down to 45.6 mil­lion last year, accord­ing to fed­er­al esti­mates.

Mr. Per­due, in par­tic­u­lar, has been out­spo­ken in his call to reduce its rolls, crit­i­ciz­ing what he calls a cul­ture of depen­den­cy among SNAP recip­i­ents.

But Mr. McGov­ern said the admin­is­tra­tion was paint­ing “a dis­tort­ed pic­ture” of the poor and ignor­ing the fact that most SNAP recip­i­ents are employed and more than a quar­ter are dis­abled and unable to seek work.

...

———-

“A ‘Har­vest Box’ for Low-Income Amer­i­cans? Not Any­time Soon, Offi­cials Say” by GLENN THRUSH; The New York Times; 02/13/2018

“But on Mon­day, the Trump admin­is­tra­tion sprung a sur­prise: Under a pro­pos­al in the president’s bud­get many par­tic­i­pants in the pro­gram would be giv­en half their ben­e­fits in the form of a “Har­vest Box” full of food pre­s­e­lect­ed for nutri­tion­al val­ue and eco­nom­ic ben­e­fit to Amer­i­can farm­ers. The cache of cheap­er peanut but­ter, canned goods, pas­ta, cere­al, “shelf sta­ble” milk and oth­er prod­ucts would now be select­ed by the fed­er­al gov­ern­ment, not by the peo­ple actu­al­ly eat­ing it.”

Note how, because the fed­er­al gov­ern­ment would be choos­ing what Amer­i­ca’s poor eat, the ‘kick­ing the poor’ polit­i­cal dynam­ic would sud­den­ly shift to com­ing up with the most unpalat­able food choice peo­ple can come up with. Because that’s how pol­i­tics in Amer­i­ca works these days. Trag­i­cal­ly. But that’s the can of worms the Trump admin­is­tra­tion just floated...the kind of ‘can of worms’ that would like­ly even­tu­al­ly result in Repub­li­cans sug­gest­ing we should be send­ing poor peo­ple nutri­tious cans of worms. As moti­va­tion to stop being so poor. Because, again, that’s how pol­i­tics in Amer­i­ca works these days.

And the $21 bil­lion in cuts that the “Har­vest Box” idea was pro­ject­ed to gen­er­ate were just a quar­ter of the $85 bil­lion in pro­ject­ed cuts from work require­ments and a slew of oth­er pro­posed cuts. Cuts that will fre­quent­ly come form of just kick­ing peo­ple off of food assis­tance if they can’t find a job and let­ting them head to the food banks or die in a ditch:

...
The pro­pos­al seemed like a rad­i­cal over­haul of the country’s core food assis­tance pro­gram — once called food stamps but now com­mon­ly known as SNAP. The idea was to shave about $21 bil­lion a year from the fed­er­al deficit over the next 10 years. But the reac­tion was imme­di­ate, and large­ly neg­a­tive.

Democ­rats claimed the plan shack­led the poor while busi­ness groups, led by big food retail­ers, would stand to lose bil­lions of dol­lars in lost SNAP busi­ness. The head of one trade asso­ci­a­tion typ­i­cal­ly sup­port­ive of Pres­i­dent Trump’s eco­nom­ic poli­cies accused the admin­is­tra­tion of reneg­ing on its pledge to cut “red tape and reg­u­la­tions.”

In real­i­ty, admin­is­tra­tion offi­cials on Tues­day admit­ted that the food-box plan — which the president’s bud­get direc­tor Mick Mul­vaney com­pared to the Blue Apron gro­cery deliv­ery ser­vice — had vir­tu­al­ly no chance of being imple­ment­ed any­time soon.

Instead, the idea, accord­ing to two admin­is­tra­tion offi­cials who worked on the pro­pos­al, was a polit­i­cal gam­bit by fis­cal hawks in the admin­is­tra­tion aimed at spark­ing out­rage among lib­er­als and stir­ring up mem­bers of the president’s own par­ty work­ing on the lat­est ver­sion of the farm bill. The move, they said, was intend­ed to lay down a mark­er that the admin­is­tra­tion is seri­ous about press­ing for about $85 bil­lion in oth­er cuts to food assis­tance pro­grams that will be achieved, in part, by impos­ing strict new work require­ments on recip­i­ents.

“I don’t think there’s real­ly any sup­port for their box plan. And, I wor­ry that it’s a dis­trac­tion from the budget’s pro­pos­al to cut SNAP by some 30 per­cent. That’s the real bat­tle.” said Sta­cy Dean, vice pres­i­dent for food assis­tance pol­i­cy at the Cen­ter on Bud­get and Pol­i­cy Pri­or­i­ties, a pro­gres­sive Wash­ing­ton think tank. “The dan­ger are these oth­er pro­pos­als to cut ben­e­fits. But all any­one is talk­ing about today are the box­es.”
...

And let’s pause for a moment and imag­ine a sce­nario of “Har­vest Box­es” and new work require­ments for food assis­tance. So you have to work at least 20 hours a week, often at jobs with hard to pre­dict hours, and you also have to receive a box car­ry­ing half your week­ly food sup­ply. So what hap­pens if you have to be at work when the Har­vest Box arrives? Won’t pret­ty much every­one poten­tial porch thief know which day of the week the “Har­vest Box­es” arrive and day and run around pick­ing up all box­es left on porch­es? Will peo­ple be expect­ed to dri­ve to a Har­vest Box pick-up loca­tion if they aren’t home to receive it? That will be fun in rur­al areas. Lots of dri­ving and lots of unnec­es­sary car repairs.

And if the local gro­cery stores in poor areas go out of busi­ness, will every­one else in that area be able to sign up for a Har­vest Box? Or will they just have to dri­ve to the clos­est Wal­mart? These are the kinds of ques­tions that led the Democ­rats in Con­gress to open­ly assume this was trolling and a dis­trac­tion. It was bad even by Trump admin­is­tra­tion stan­dards.

But note how the White House offi­cials who admit­ted this plan was­n’t seri­ous­ly being pro­posed did­n’t sug­gest that it could nev­er hap­pen. Just that it was­n’t going to hap­pen any­time soon. And when you look at the self-imposed Trump Admin­is­tra­tion goal of shav­ing $214 bil­lion off of food assis­tance pro­grams over the next decade, it’s not hard to imag­ine that the “Har­vest Box” might even­tu­al­ly become a real­i­ty. Because $21 bil­lion + $85 bil­lion is rough­ly half of the $214 bil­lion goal:

...
Agri­cul­ture Sec­re­tary Son­ny Per­due stealth­ily pitched the idea over the last few weeks to the White House’s Domes­tic Pol­i­cy Coun­cil as a nov­el way to reach the administration’s self-imposed goal of slash­ing fed­er­al food assis­tance pro­grams by $214 bil­lion over the next decade. It was quick­ly embraced by Mr. Mul­vaney, a fis­cal hawk who is seek­ing to steer a debate increas­ing­ly dom­i­nat­ed by free-spend­ing Repub­li­cans and Mr. Trump, who has insist­ed on major bud­get increas­es for the Pen­ta­gon and Home­land Secu­ri­ty.
...

“Agri­cul­ture Sec­re­tary Son­ny Per­due stealth­ily pitched the idea over the last few weeks to the White House’s Domes­tic Pol­i­cy Coun­cil as a nov­el way to reach the administration’s self-imposed goal of slash­ing fed­er­al food assis­tance pro­grams by $214 bil­lion over the next decade.”

Whether or not the Trump admin­is­tra­tion is act­ing like it thinks these kinds of pro­posed cuts are real­is­tic, they are clear­ly desired. These guys real­ly do want to hit that $214 bil­lion goal by evis­cer­at­ing these pro­grams. So this “Har­vest Box” idea was both a $21 bil­lion dis­trac­tion from the rest of the $214 bil­lion in cuts and also a zany scheme that would only achieve 10 per­cent of that $214 bil­lion goal.

And notice how the “Har­vest Box” idea would replace rough­ly half of the over­all assis­tance peo­ple get (not all recip­i­ents, only the need­i­est half), and yet the $21 bil­lion in sav­ings expect­ed from the “Har­vest Box” is 1/10th of the goal of $214 bil­lion in cuts. So 90 per­cent of the ‘sav­ings’ are expect­ed to be found from the remain­ing half of the pro­gram that remain a tra­di­tion­al ‘food stamps’ and don’t get con­vert­ed into a deliv­ered “Har­vest Box”. And as the fol­low­ing arti­cle makes clear, those ‘sav­ings’, at least the $85 bil­lion that have been pro­posed so far, will almost entire­ly come in the form of more cuts to eli­gi­bil­i­ty — includ­ing 4 mil­lion house­holds that would be kicked off entire­ly — and cuts to assis­tance for those who remain. So when we’re told that the “Har­vest Box” would cov­er about half the food for recip­i­ents, it would prob­a­bly be a lot more than half of what recip­i­ents receive giv­en the plans to evis­cer­ate the oth­er half of the pro­gram:

Cen­ter for Bud­get Pol­i­cy Pri­or­i­ties

President’s Bud­get Would Cut and Rad­i­cal­ly Restruc­ture SNAP Food Ben­e­fits

Sta­cy Dean
Vice Pres­i­dent for Food Assis­tance Pol­i­cy
Feb­ru­ary 12, 2018 at 5:15 PM

Pres­i­dent Trump’s 2019 bud­get pro­pos­es to cut the Sup­ple­men­tal Nutri­tion Assis­tance Pro­gram (SNAP, for­mer­ly food stamps) by more than $213 bil­lion over the next ten years — or by near­ly 30 per­cent. It calls for rad­i­cal­ly restruc­tur­ing the deliv­ery of ben­e­fits, which would cut ben­e­fits for the over­whelm­ing major­i­ty of house­holds, and oth­er ben­e­fit and eli­gi­bil­i­ty changes that would leave at least 4 mil­lion peo­ple los­ing SNAP ben­e­fits alto­geth­er. The cuts would affect every type of SNAP par­tic­i­pant, includ­ing the unem­ployed, the elder­ly, indi­vid­u­als with dis­abil­i­ties, and low-income work­ing fam­i­lies with chil­dren. The pro­posed cuts would come on top of oth­er Admin­is­tra­tion pro­pos­als to shrink the safe­ty net, par­tic­u­lar­ly health cov­er­age, and on the heels of a tax law that will main­ly ben­e­fit the wealthy and cor­po­ra­tions and is expect­ed to add $1.5 tril­lion to deficits over ten years.

Among oth­er SNAP cuts, the President’s bud­get would:

* Shift more than $260 bil­lion in food pur­chas­ing from indi­vid­ual house­holds to the gov­ern­ment. The bud­get pro­pos­es rad­i­cal­ly restruc­tur­ing how SNAP ben­e­fits are pro­vid­ed, upend­ing SNAP’s suc­cess­ful and effi­cient pub­lic-pri­vate part­ner­ship with some 260,000 retail stores around the coun­try in favor a new gov­ern­ment-dri­ven approach. Instead of let­ting house­holds that receive more than $90 a month con­tin­ue to use their SNAP ben­e­fit to buy food at their local gro­cery store, the Agri­cul­ture Depart­ment (USDA) would hold back an esti­mat­ed $24 to $29 bil­lion per year in house­hold ben­e­fits (about 40 per­cent of the ben­e­fits issued to such house­holds). The agency would use about half of these funds — $130 bil­lion over ten years, or about 20 per­cent of all SNAP ben­e­fits — to give the house­holds a box of non-per­ish­able foods such as shelf-sta­ble milk, ready-to-eat cere­als, pas­ta, peanut but­ter, beans, and canned foods. The oth­er half of the held-back funds would be cut, thus rep­re­sent­ing USDA’s esti­mat­ed ten-year SNAP sav­ings. This would affect some 34 mil­lion peo­ple in 16 mil­lion house­holds in 2019 — almost 90 per­cent of SNAP par­tic­i­pants.

While USDA rou­tine­ly buys and dis­trib­utes com­modi­ties to enti­ties that run and oper­ate gov­ern­ment food pro­grams (such as school dis­tricts or state agen­cies that work with local food banks), this new pro­pos­al to sup­port indi­vid­ual house­holds would require oper­a­tional capac­i­ty and infra­struc­ture that nei­ther USDA nor states now have. This unprece­dent­ed pro­pos­al puts access to food at risk for 1 in 10 Amer­i­cans on the faulty assump­tion that gov­ern­ment can buy and pro­vide food more effi­cient­ly than mil­lions of Amer­i­can house­holds.

...

* Oth­er eli­gi­bil­i­ty and ben­e­fit cuts. The bud­get also pro­pos­es about anoth­er $85 bil­lion in SNAP cuts over ten years, includ­ing all of the cuts includ­ed in the President’s 2018 bud­get plus sev­er­al addi­tion­al cuts. For exam­ple, the bud­get would:

* Force states to time-lim­it food assis­tance to cer­tain indi­vid­u­als who are not work­ing at least 20 hours a week, but live in high unem­ploy­ment areas or who have good cause for need­ing to con­tin­ue receiv­ing SNAP, as deter­mined by the state;

* Apply SNAP’s three-month time lim­it — for unem­ployed adults who aren’t dis­abled or rais­ing minor chil­dren — to peo­ple up to age 62, ver­sus 49 under cur­rent law;

* Elim­i­nate a state option that sup­ports work­ing fam­i­lies, address­es a ben­e­fit cliff that would oth­er­wise cause work­ing fam­i­lies to lose ben­e­fits as their earn­ings rise, and encour­ages house­holds to save for the future;

* Elim­i­nate the min­i­mum ben­e­fit, which would cut ben­e­fits to 2 mil­lion indi­vid­u­als, main­ly low-income seniors and peo­ple with dis­abil­i­ties;

* Penal­ize large fam­i­lies by cap­ping SNAP ben­e­fits at the lev­el for a house­hold of six, effec­tive­ly elim­i­nat­ing SNAP to the addi­tion­al house­hold mem­bers; and

* Elim­i­nate all spend­ing for SNAP nutri­tion edu­ca­tion.

SNAP is a high­ly effec­tive pro­gram tar­get­ed to house­holds that need its help to meet their basic food needs. With a small aver­age ben­e­fit of just $1.40 per per­son per meal, it lifts mil­lions out of pover­ty, and it has demon­strat­ed long-term ben­e­fits for chil­dren that par­tic­i­pate, includ­ing bet­ter health and edu­ca­tion out­comes. The President’s SNAP pro­pos­als remain as ill-advised and harm­ful as they were last year.

———-
“President’s Bud­get Would Cut and Rad­i­cal­ly Restruc­ture SNAP Food Ben­e­fits” by Sta­cy Dean; Cen­ter for Bud­get Pol­i­cy Pri­or­i­ties; 02/12/2018

“Pres­i­dent Trump’s 2019 bud­get pro­pos­es to cut the Sup­ple­men­tal Nutri­tion Assis­tance Pro­gram (SNAP, for­mer­ly food stamps) by more than $213 bil­lion over the next ten years — or by near­ly 30 per­cent. It calls for rad­i­cal­ly restruc­tur­ing the deliv­ery of ben­e­fits, which would cut ben­e­fits for the over­whelm­ing major­i­ty of house­holds, and oth­er ben­e­fit and eli­gi­bil­i­ty changes that would leave at least 4 mil­lion peo­ple los­ing SNAP ben­e­fits alto­geth­er. The cuts would affect every type of SNAP par­tic­i­pant, includ­ing the unem­ployed, the elder­ly, indi­vid­u­als with dis­abil­i­ties, and low-income work­ing fam­i­lies with chil­dren. The pro­posed cuts would come on top of oth­er Admin­is­tra­tion pro­pos­als to shrink the safe­ty net, par­tic­u­lar­ly health cov­er­age, and on the heels of a tax law that will main­ly ben­e­fit the wealthy and cor­po­ra­tions and is expect­ed to add $1.5 tril­lion to deficits over ten years.”

Almost 30 per­cent. That’s what a $214 cut would do. And that’s the Trump admin­is­tra­tion’s goal for cut­ting food assis­tance for the poor in Amer­i­ca.

The pro­posed cuts so far will result in 4 mil­lion house­holds los­ing access to those SNAP ben­e­fits entire­ly. But don’t for­get that they’ve only giv­en details on $106 bil­lion of the $214 bil­lion desired cuts. So that 4 mil­lion house­hold num­ber will prob­a­bly sky­rock­et.

And as the piece made clear, almost all of the $85 bil­lion in cuts are in the form of kick­ing peo­ple off of the SNAP pro­gram. Through one new bureau­crat­ic hur­dle or anoth­er:

...
* Oth­er eli­gi­bil­i­ty and ben­e­fit cuts. The bud­get also pro­pos­es about anoth­er $85 bil­lion in SNAP cuts over ten years, includ­ing all of the cuts includ­ed in the President’s 2018 bud­get plus sev­er­al addi­tion­al cuts. For exam­ple, the bud­get would:

* Force states to time-lim­it food assis­tance to cer­tain indi­vid­u­als who are not work­ing at least 20 hours a week, but live in high unem­ploy­ment areas or who have good cause for need­ing to con­tin­ue receiv­ing SNAP, as deter­mined by the state;

* Apply SNAP’s three-month time lim­it — for unem­ployed adults who aren’t dis­abled or rais­ing minor chil­dren — to peo­ple up to age 62, ver­sus 49 under cur­rent law;

* Elim­i­nate a state option that sup­ports work­ing fam­i­lies, address­es a ben­e­fit cliff that would oth­er­wise cause work­ing fam­i­lies to lose ben­e­fits as their earn­ings rise, and encour­ages house­holds to save for the future;

* Elim­i­nate the min­i­mum ben­e­fit, which would cut ben­e­fits to 2 mil­lion indi­vid­u­als, main­ly low-income seniors and peo­ple with dis­abil­i­ties;

* Penal­ize large fam­i­lies by cap­ping SNAP ben­e­fits at the lev­el for a house­hold of six, effec­tive­ly elim­i­nat­ing SNAP to the addi­tion­al house­hold mem­bers; and

* Elim­i­nate all spend­ing for SNAP nutri­tion edu­ca­tion.

...

“Penal­ize large fam­i­lies by cap­ping SNAP ben­e­fits at the lev­el for a house­hold of six, effec­tive­ly elim­i­nat­ing SNAP to the addi­tion­al house­hold mem­bers.”

That’s your pro-fam­i­ly GOP: cap­ping the food assis­tance lev­els to 6 peo­ple in a house­hold. Now, it’s true that large fam­i­lies don’t want to be encour­aged because the world can’t afford end­less­ly grow­ing human pop­u­la­tions. But starv­ing large fam­i­lies prob­a­bly isn’t the way to achieve that. But that’s our GOP.

And that fam­i­ly cap is just one of the many cuts that are obvi­ous­ly going to lead to hunger. So when you look at the cal­lous and grim nature of those cuts, it’s not hard to see what the admin­is­tra­tion was more than hap­py to dis­tract from all those oth­er cuts. The “Har­vest Box” is unique in the pro­posed cuts in that it’s a cut that does­n’t involve direct­ly kick­ing peo­ple off the pro­gram. Instead it pur­ports to be a more effi­cient way to deliv­er food which is very dif­fer­ent from the rest of the pro­posed $85 bil­lion in cuts as we just saw. The “Har­vest Box” at least pre­tends to give ‘more for less’ as opposed to the rest of the cuts which are unam­bigu­ous­ly ‘less for less’.

Will the “Har­vest Box” suc­cess­ful­ly dis­tract from the rest of the pro­posed cuts? We’ll see. Odds are the many oth­er dai­ly Trump scan­dals will pro­vide any addi­tion­al dis­trac­tion if that’s required, but it would be nice if the Amer­i­can pub­lic learned about what the Trump admin­is­tra­tion is propos­ing. Because when a democ­ra­cy is about to start starv­ing itself, it should know about that. Not only because the GOP War on the Poor is cru­el but also because it’s stu­pid and dan­ger­ous. Weak safe­ty-nets don’t cre­ate strong soci­eties. They cre­ate dys­func­tion­al trou­bled soci­eties filled with des­per­a­tion and tur­moil. And when the safe­ty-net is being shred­ded to pay for tax cuts for the rich that’s just sick.

It’s a reminder that poli­cies sold as ‘pro­mot­ing rugged-indi­vid­u­al­ism’ (which is the meta-sales-pitch/brand­ing for the GOP’s ‘kick the poor’ poli­cies) are typ­i­cal­ly the kinds of poli­cies that actu­al­ly make soci­ety col­lec­tive­ly more frag­ile and dis­turbed. And the fact that this is done large­ly for the ben­e­fit of bil­lion­aires in con­trol of vast per­son­al empires sup­port­ing their every action is, of course, the oppo­site of sup­port­ing ‘rugged indi­vid­u­al­ism’.

It’s also a reminder that, with the Trump admin­is­tra­tion, as bad as things appear they could be worse and prob­a­bly are worse because the bad things are prob­a­bly just a Machi­avel­lian dis­trac­tions designed to obscure worse Machi­avel­lian actions.

Here’s a sto­ry that’s a reminder that the GOP is going to have to start get­ting extra cre­ative in how it wages its War on the Poor, because we’re run­ning out of things they haven’t already pro­posed: Guess what peo­ple on Med­ic­aid are about to start get­ting in GOP-con­trolled ‘Red states’ in addi­tion to the new work require­ments the Trump admin­is­tra­tion has already start­ed approv­ing. Life­time Med­ic­aid time lim­its that still apply even if you’re work­ing. Yep, even if you’re work­ing you’re entire adult life, you can still get kicked off of Med­ic­aid under the pro­pos­als mul­ti­ple states are sub­mit­ting the Trump admin­is­tra­tion for approval. Utah wants a 5 year lim­it, Wis­con­sin a 4 year, and Kansas a 3 year life­time lim­it. Even if you work.

So a real-life mass death pan­el was just sub­mit­ted by these three states. And Con­gress’s approval isn’t required. This can all be approved with a state waiv­er and that makes it exclu­sive­ly a Trump admin­is­tra­tion deci­sion:

McClatchy

After approv­ing Med­ic­aid work require­ments, Trump’s HHS aims for life­time cov­er­age lim­its

By Tony Pugh
Feb­ru­ary 05, 2018 06:58 PM
Updat­ed Feb­ru­ary 07, 2018 06:08 PM

Wash­ing­ton

After allow­ing states to impose work require­ments for Med­ic­aid enrollees, the Trump admin­is­tra­tion is now pon­der­ing life­time lim­its on adults’ access to cov­er­age.

Cap­ping health care ben­e­fits — like fed­er­al wel­fare ben­e­fits — would be a first for Med­ic­aid, the joint state-and-fed­er­al health plan for low-income and dis­abled Amer­i­cans.

If approved, the dra­mat­ic pol­i­cy change would recast gov­ern­ment-sub­si­dized health cov­er­age as tem­po­rary assis­tance by plac­ing a lim­it on the num­ber of months adults have access to Med­ic­aid ben­e­fits.

The move would con­tin­ue the Trump administration’s push to inject con­ser­v­a­tive poli­cies into the Med­ic­aid pro­gram through the use of fed­er­al waivers, which allow states more flex­i­bil­i­ty to cre­ate poli­cies designed to pro­mote per­son­al and finan­cial respon­si­bil­i­ty among enrollees.

How­ev­er, advo­cates say cap­ping Med­ic­aid ben­e­fits would amount to a mas­sive breach of the nation’s social safe­ty net designed to pro­tect chil­dren, the elder­ly and the impov­er­ished.

In Jan­u­ary, the Trump admin­is­tra­tion approved waiv­er requests from Ken­tucky and Indi­ana to ter­mi­nate Med­ic­aid cov­er­age for able-bod­ied enrollees who do not meet new pro­gram work require­ments. Ten oth­er states have asked to do the same.

“We must allow states, who know the unique needs of their cit­i­zens, to design pro­grams that don’t mere­ly pro­vide a Med­ic­aid card but pro­vide care that allows peo­ple to rise out of pover­ty and no longer need pub­lic assis­tance,” said a state­ment post­ed on Twit­ter on Mon­day by Med­ic­aid admin­is­tra­tor Seema Ver­ma.

At least five states — Ari­zona, Kansas, Utah, Maine and Wis­con­sin — are seek­ing waivers from the Trump admin­is­tra­tion to impose life­time Med­ic­aid cov­er­age lim­its. The Depart­ment of Health and Human Ser­vices said it could not com­ment on the pend­ing appli­ca­tions.

But the pro­pos­als appear to reflect the administration’s posi­tion that Med­ic­aid cov­er­age should be retained for vul­ner­a­ble pop­u­la­tions like chil­dren, preg­nant women and those with dis­abil­i­ties. The admin­is­tra­tion has been open, how­ev­er, to cov­er­age lim­its for healthy adults, par­tic­u­lar­ly those with no depen­dent chil­dren who gained cov­er­age under Obamacare’s Med­ic­aid expan­sion.

Crit­ics say Med­ic­aid time lim­its will pose an enor­mous admin­is­tra­tive bur­den by requir­ing states to track recip­i­ents’ employ­ment, eli­gi­bil­i­ty and dis­abil­i­ty sta­tus. It could also shave valu­able cov­er­age months from peo­ple with health prob­lems that impede their abil­i­ty to work.

In addi­tion, low-wage work­ers who may not get health cov­er­age through their jobs could also reach their Med­ic­aid cov­er­age lim­it “as if it’s their fault that their job isn’t offer­ing insur­ance,” said Leonar­do Cuel­lo, direc­tor of health pol­i­cy at the Nation­al Health Law Cen­ter. “And this would hap­pen to thou­sands upon thou­sands of peo­ple across the coun­try,” if the pol­i­cy catch­es on nation­wide.

Oth­ers argue that attach­ing time lim­its and work require­ments to Med­ic­aid cov­er­age does not meet a basic require­ment of HHS waiv­er exper­i­ments and demon­stra­tion projects: to fur­ther the objec­tives of the Med­ic­aid pro­gram, such as improv­ing cov­er­age, health out­comes and access to providers.

“All of these poli­cies that we are see­ing are incon­sis­tent with the objec­tives of Med­ic­aid. They don’t seem to seem to have a legal basis and, as such, our stance is that they should not be approved. And we will work very hard with our part­ners to make that opin­ion well known,” said Suzanne Wik­le, a senior pol­i­cy ana­lyst at the Cen­ter for Law and Social Pol­i­cy.

Time lim­its, work require­ments, eli­gi­bil­i­ty lock­outs and sim­i­lar poli­cies are part of a new wave of Med­ic­aid restric­tions that appear to have gained favor with the Trump admin­is­tra­tion. In a March 2017 let­ter to the nation’s gov­er­nors, Ver­ma said HHS would review and approve “mer­i­to­ri­ous inno­va­tions” for Med­ic­aid “that build on the human dig­ni­ty that comes with train­ing, employ­ment and inde­pen­dence.”

They also pledged to stream­line and expe­dite the waiv­er process, which can take more than six months.

But unlike cap­ping cash wel­fare assis­tance or food stamp ben­e­fits, time-lim­it­ing health cov­er­age runs the risk of push­ing sick peo­ple into cost­ly emer­gency rooms where they’ll receive indi­gent care paid for by tax­pay­ers.

“I think you have to be very thought­ful here in a way that’s quite dif­fer­ent from cash assis­tance,” said Gail Wilen­sky, a senior fel­low at Project HOPE who ran the Med­ic­aid pro­gram from 1990 to 1992 under Pres­i­dent George H.W. Bush. “It depends on what the safe­guards and defaults are in a pro­gram like this. Oth­er­wise it does not make a lot of sense and seems to be cru­el and inap­pro­pri­ate.”

Ari­zona and Utah both want a 5‑year life­time lim­it on cov­er­age. Utah’s would apply only to child­less adults and would come “with the expec­ta­tion that they do every­thing they can to help them­selves before they lose cov­er­age,” accord­ing to the state’s waiv­er appli­ca­tion.

In Ari­zona, time-lim­it­ed cov­er­age would only accrue dur­ing months when enrollees don’t meet their work require­ments, which the state is also seek­ing in their waiv­er appli­ca­tion. Wis­con­sin wants to lim­it life­time cov­er­age for child­less adults to 48 months. Kansas would lim­it cov­er­age to 36 months.

In Utah, Wis­con­sin and Kansas, the time-lim­it­ed cov­er­age would apply even to Med­ic­aid enrollees who meet employ­ment and work require­ments.

In Maine, Med­ic­aid enrollees who don’t meet pro­gram work require­ments could only get up to three months of cov­er­age in a 36-month peri­od. And only in spe­cial cir­cum­stances could these enrollees get an extra month of cov­er­age.

The Oba­ma admin­is­tra­tion pre­vi­ous­ly denied Arizona’s request for Med­ic­aid cov­er­age lim­its and work require­ments, say­ing they didn’t meet the program’s goal of ensur­ing cov­er­age for vul­ner­a­ble pop­u­la­tions.

Jes­si­ca Schubel, a senior pol­i­cy ana­lyst at the Cen­ter on Bud­get and Pol­i­cy Pri­or­i­ties, said there’s a “50–50 chance” that the Trump admin­is­tra­tion approves the time lim­its.

“I feel like the Trump admin­is­tra­tion is hell-bent on try­ing to keep peo­ple out of cov­er­age … So, I don’t know. I hope not, but I’m not hold­ing my breath. And I guess I wouldn’t be too ter­ri­bly sur­prised to see it approved,” said Schubel, a for­mer senior pol­i­cy advi­sor at HHS’ Cen­ter for Medicare and Med­ic­aid Ser­vices dur­ing the Oba­ma admin­is­tra­tion.

...

———-

“After approv­ing Med­ic­aid work require­ments, Trump’s HHS aims for life­time cov­er­age lim­its” by Tony Pugh; McClatchy; 02/05/2018

“Jes­si­ca Schubel, a senior pol­i­cy ana­lyst at the Cen­ter on Bud­get and Pol­i­cy Pri­or­i­ties, said there’s a “50–50 chance” that the Trump admin­is­tra­tion approves the time lim­its.”

50–50 chance of the Trump admin­is­tra­tion mak­ing this a real­i­ty. That’s per­haps the scari­est fact in an arti­cle filled with very scary facts. Because as the arti­cle notes, this is one of those changes to Amer­i­ca’s safe­ty-net that does­n’t require con­gres­sion­al approval. All the Trump admin­is­tra­tion has to do is issue a waiv­er for a state:

...
The move would con­tin­ue the Trump administration’s push to inject con­ser­v­a­tive poli­cies into the Med­ic­aid pro­gram through the use of fed­er­al waivers, which allow states more flex­i­bil­i­ty to cre­ate poli­cies designed to pro­mote per­son­al and finan­cial respon­si­bil­i­ty among enrollees.
...

So that 50–50 esti­mate of this hap­pen­ing was­n’t out­landish. If any­thing it’s not pes­simistic enough. This is exact­ly the kind of thing the Trump admin­is­tra­tion would love. Because as the arti­cle also not­ed, the Trump admin­is­tra­tion has made it pret­ty clear that it would like to lim­it Med­ic­aid to chil­dren, preg­nant women, and those with dis­abil­i­ties. That’s it:

...
But the pro­pos­als appear to reflect the administration’s posi­tion that Med­ic­aid cov­er­age should be retained for vul­ner­a­ble pop­u­la­tions like chil­dren, preg­nant women and those with dis­abil­i­ties. The admin­is­tra­tion has been open, how­ev­er, to cov­er­age lim­its for healthy adults, par­tic­u­lar­ly those with no depen­dent chil­dren who gained cov­er­age under Obamacare’s Med­ic­aid expan­sion.
...

So it seems like the odds of these new life­time lim­its get­ting Trump admin­is­tra­tion approval should be a lot high­er than 50–50. They must be sali­vat­ing over these plans.

Anoth­er very scary fact in this arti­cle is that we no longer have to ask the ques­tion if any states would be so heart­less enough to actu­al­ly do some­thing like this. We are have answer: Yes, plen­ty of GOP-run states will jump at the chance to do this. Even when it’s going to cause a surge of peo­ple going to emer­gency rooms and get­ting much, much more expen­sive care there that the pub­lic has to pay for:

...
But unlike cap­ping cash wel­fare assis­tance or food stamp ben­e­fits, time-lim­it­ing health cov­er­age runs the risk of push­ing sick peo­ple into cost­ly emer­gency rooms where they’ll receive indi­gent care paid for by tax­pay­ers.
...

Of course the GOP will pre­sum­ably try to change the laws and let emer­gency rooms turn peo­ple away (they’re work­ing on it!).

And behold the range of cru­el­ty on dis­play in the state pro­pos­als: Ari­zona and Utah want a 5‑year life­time lim­it, Wis­con­sin wants 4 years, and Kansas 3 years. And for Utah, Wis­con­sin and Kansas, the time-lim­it­ed cov­er­age would apply even to Med­ic­aid enrollees who meet employ­ment and work require­ments. Don’t for­get that a major­i­ty of Med­ic­aid recip­i­ents work, they just work at jobs that don’t pro­vide health insur­ance and don’t pay them enough to buy their own. So this real­ly is a plan to set up mas­sive indis­crim­i­nate death pan­els for the poor:

...
In addi­tion, low-wage work­ers who may not get health cov­er­age through their jobs could also reach their Med­ic­aid cov­er­age lim­it “as if it’s their fault that their job isn’t offer­ing insur­ance,” said Leonar­do Cuel­lo, direc­tor of health pol­i­cy at the Nation­al Health Law Cen­ter. “And this would hap­pen to thou­sands upon thou­sands of peo­ple across the coun­try,” if the pol­i­cy catch­es on nation­wide.

...

Ari­zona and Utah both want a 5‑year life­time lim­it on cov­er­age. Utah’s would apply only to child­less adults and would come “with the expec­ta­tion that they do every­thing they can to help them­selves before they lose cov­er­age,” accord­ing to the state’s waiv­er appli­ca­tion.

In Ari­zona, time-lim­it­ed cov­er­age would only accrue dur­ing months when enrollees don’t meet their work require­ments, which the state is also seek­ing in their waiv­er appli­ca­tion. Wis­con­sin wants to lim­it life­time cov­er­age for child­less adults to 48 months. Kansas would lim­it cov­er­age to 36 months.

In Utah, Wis­con­sin and Kansas, the time-lim­it­ed cov­er­age would apply even to Med­ic­aid enrollees who meet employ­ment and work require­ments.
...

And look at Maine’s bizarro sug­ges­tion: work­ing age adults with­out a job could get up to three months of cov­er­age in a giv­en 36-month peri­od. Got dia­betes in Maine? Get ready to die after you lose your job and can’t afford the insulin:

...
In Maine, Med­ic­aid enrollees who don’t meet pro­gram work require­ments could only get up to three months of cov­er­age in a 36-month peri­od. And only in spe­cial cir­cum­stances could these enrollees get an extra month of cov­er­age.
...

And, while all these new­ly unin­sured peo­ple will flood emer­gency rooms and end up cost­ing the pub­lic much more, we can be guar­an­teed that part of the sales pitch for these state plans will be the argu­ment that this will just encour­age the poor to just up and move to ‘Blue’ states who choose not to impose life­times with lots of ghast­ly snick­er­ing. Along with lots of sug­ges­tions about how this will allow states to become more ‘com­pet­i­tive’ by allow­ing for low­er tax­es. And chortling. Lots of chortling.

So you have to won­der how that’s going to affect the cur­rent polit­i­cal polar­iza­tion grip­ping the US if a whole bunch of poor peo­ple from ‘Red states’ are basi­cal­ly forced to move to ‘Blue states’ just to live. How will that change Amer­i­can pol­i­tics? Because that seems like a big deal that could shape opin­ions on things like pub­lic sup­port for uni­ver­sal health care poli­cies. When peo­ple in Utah learn that that their poor cousin or uncle just had to move to Cal­i­for­nia to get the med­i­cine they need to live, how will that change Amer­i­can pol­i­tics? Because that kind of sit­u­a­tion isn’t unimag­in­able. In Kansas it could start hap­pen­ing in about three years. And then Wis­con­sin, and then Utah. An inter-state med­ical refugee cri­sis where ‘Blue’ state safe­ty-nets start becom­ing life rafts for the ‘Red’ states’ poor could all start hap­pen­ing in the next 3–5 years.

How like­ly is this night­mare mass death pan­el sce­nario? Well, this pol­i­cy is more or less guar­an­teed to be a dis­as­ter if imple­ment­ed, and there’s about a 50–50 chance of it get­ting imple­ment­ed soon. So about 50–50.

Here’s a series of arti­cle that hint at a new dark twist in the GOP’s plans to use state waiv­er to cut Med­ic­aid ser­vices and, more gen­er­al­ly, impose work require­ments on poten­tial­ly the entire US safe­ty-net:

First, it turns out that Uber is offer­ing a new ser­vice: Uber Health.

It’s the same taxi-like ser­vice Uber nor­mal­ly pro­vides, but it’s specif­i­cal­ly for the sick or elder­ly going to the doc­tor. That’s pret­ty much it.

And while that might sound like a nice new option for Med­ic­aid patients, as the fol­low­ing arti­cle notes, it also just hap­pens to be the same kind of ser­vice that the Trump admin­is­tra­tion is allow­ing states to cut from Med­ic­aid using a “waiv­er”:

Splin­ter News

Like Uber, But for Essen­tial Med­ic­aid Ser­vices Cut by the GOP

Mol­ly Osberg
3/02/18 12:46pm

Yes­ter­day Uber, a com­pa­ny launched under the premise that every under-employed American’s car could trans­form into a lucra­tive side-gig, announced Uber Health. The ser­vice is near­ly iden­ti­cal to Uber, in that it pairs dri­vers mak­ing $3.37 an hour with peo­ple who need a ride. It dif­fers in that those rid­ers are the sick or elder­ly on their way to see a doc­tor. In a con­ceit to “acces­si­bil­i­ty,” Uber has added a fea­ture allow­ing patients to print out dri­ver infor­ma­tion that would oth­er­wise appear on the app’s screen.

Unlike Apple’s forth­com­ing in-house health care cen­ters or Amazon’s explorato­ry health care con­sor­tium, Uber’s ser­vices won’t ben­e­fit its own workers—but Uber Health rep­re­sents a sim­i­lar con­ces­sion from the anti-reg­u­la­tion boy kings that helm these com­pa­nies: that the Amer­i­can health care and trans­porta­tion sys­tems are both bro­ken, and they, with their nim­ble inge­nu­ity, can break and reassem­ble it. Only one of these things is true.

Uber’s ser­vice aug­ments non-emer­gency trans­porta­tion, a patch­work of ser­vices for peo­ple who need assis­tance to get around, and one of the first Med­ic­aid ser­vices to dis­ap­pear in select states once the GOP grant­ed waivers and cut bud­gets.

...

As we live in a coun­try where reg­u­lar doctor’s vis­its and/or the abil­i­ty to recov­er from an ill­ness are con­sid­ered a lux­u­ry, Uber Health will be use­ful, in much the same way get­ting stitch­es when you’re gush­ing blood is use­ful. Amer­i­cans are already tak­ing ride-hail­ing ser­vices to the emer­gency room to off­set cost; one study found that once Uber comes to an area, EMS calls go down.

Of course, there are solu­tions besides let­ting Uber-for-ill­ness take over such essen­tial ser­vices. But with waivers elim­i­nat­ing trans­porta­tion ser­vices for the dis­abled, elder­ly, and sick already grant­ed to Iowa, Ken­tucky, and Indi­ana, it looks like the com­pa­ny will have quite a gap­ing cov­er­age hole to exploit.

———-

“Like Uber, But for Essen­tial Med­ic­aid Ser­vices Cut by the GOP” Mol­ly Osberg; Splin­ter News; 03/02/2018

“Yes­ter­day Uber, a com­pa­ny launched under the premise that every under-employed American’s car could trans­form into a lucra­tive side-gig, announced Uber Health. The ser­vice is near­ly iden­ti­cal to Uber, in that it pairs dri­vers mak­ing $3.37 an hour with peo­ple who need a ride. It dif­fers in that those rid­ers are the sick or elder­ly on their way to see a doc­tor. In a con­ceit to “acces­si­bil­i­ty,” Uber has added a fea­ture allow­ing patients to print out dri­ver infor­ma­tion that would oth­er­wise appear on the app’s screen.”

Uber Health: It’s Uber, but for a tar­get mar­ket. Behold the inno­va­tion!

And from a busi­ness sense it might be a real inno­va­tion. That inno­va­tion being pro­vid­ing the ser­vices the GOP is active­ly try­ing to cut. In this case, that would be Med­ic­aid’s non-emer­gency trans­porta­tion ser­vice:

...
Unlike Apple’s forth­com­ing in-house health care cen­ters or Amazon’s explorato­ry health care con­sor­tium, Uber’s ser­vices won’t ben­e­fit its own workers—but Uber Health rep­re­sents a sim­i­lar con­ces­sion from the anti-reg­u­la­tion boy kings that helm these com­pa­nies: that the Amer­i­can health care and trans­porta­tion sys­tems are both bro­ken, and they, with their nim­ble inge­nu­ity, can break and reassem­ble it. Only one of these things is true.

Uber’s ser­vice aug­ments non-emer­gency trans­porta­tion, a patch­work of ser­vices for peo­ple who need assis­tance to get around, and one of the first Med­ic­aid ser­vices to dis­ap­pear in select states once the GOP grant­ed waivers and cut bud­gets.
...

And we don’t have to aske whether or not GOP-led states are going to use the waivers to cut the non-emer­gency trans­porta­tion ser­vices. It’s already hap­pened in Iowa, Ken­tucky, and Indi­ana:

...
Of course, there are solu­tions besides let­ting Uber-for-ill­ness take over such essen­tial ser­vices. But with waivers elim­i­nat­ing trans­porta­tion ser­vices for the dis­abled, elder­ly, and sick already grant­ed to Iowa, Ken­tucky, and Indi­ana, it looks like the com­pa­ny will have quite a gap­ing cov­er­age hole to exploit.
...

So that’s a prob­a­bly a sign of things to come: Uber or Uber-like ser­vices offer­ing to off­set cuts on pub­lic ser­vices by offer­ing to adapt their low-pay/no-ben­e­fits busi­ness mod­el to fill in the gap. It’s both a cut in gov­ern­ment and a cut in work­er sta­tus, which is the kind of business/government mod­el the GOP and busi­ness­es are sure­ly go to embrace.

And that brings us to our next arti­cle that points towards a dif­fer­ent area of the econ­o­my tied into the social saftey-net that’s expe­ri­ence an Uber-iza­tion of its own: Wal­mart employ­ees.

Yep, Wal­mart has decid­ed it too is going to get into the ‘gig econ­o­my’. By turn­ing a large num­ber of its cur­rent jobs into gig jobs. It’s one of the strate­gies for how Wal­mart plans on rais­ing employ­ee wages: by turn­ing large num­bers of its employ­ees into non-employ­ee ‘gig’ work­ers.

Also, robots. Wal­mart wants a lot more robots to do the work that it’s employ­ees are cur­rent­ly doing.

And this shift towards robots and gig work is hap­pen­ing in the con­text of the ongo­ing dri­ve in the US by the GOP to impose a work require­ment on as many safe­ty-net ser­vices as pos­si­ble. So Wal­mart, one of the largest employ­ers in the US and the kind of employ­er that many of those fac­ing work require­ments will go to find entry-lev­el work when faced with those work require­ments, is plan­ning on sys­tem­at­i­cal­ly elim­i­nat­ing entry-lev­el jobs and replac­ing them with robots and gig work:

The Atlantic

Work­force: Robots and Free­lancers

Wal­mart is rais­ing wages, but its plans to use more gig labor and automa­tion put work­ers at a dis­ad­van­tage.

Amy Mer­rick
Apr 4, 2018

Over the past few weeks, Wal­mart exec­u­tives have sketched a pic­ture of the company’s future that fea­tures more self-check­outs and a gro­cery-deliv­ery busi­ness—soon esca­lat­ing to 100 cities from a pilot pro­gram in six cities. Per­son­al shop­pers will fill plas­tic totes with avo­ca­dos and paper tow­els from Wal­mart store shelves, and hand off pack­ages to crowd­sourced dri­vers idling in the park­ing lot. Assem­bly will be out­sourced, too: Work­ers on Handy, an online mar­ket­place for home ser­vices, will mount tele­vi­sions and assem­ble fur­ni­ture.

The Wal­mart of the future relies more heav­i­ly on the gig econ­o­my and automa­tion. This is an indi­ca­tion of the fierce com­pe­ti­tion between Wal­mart, the world’s largest pri­vate employ­er, and Ama­zon. A pair of recent stud­ies sug­gests that it’s also a sign that the U.S. econ­o­my is tilt­ing fur­ther toward jobs that give work­ers less mar­ket pow­er.

One study, by Arindra­jit Dube of the Uni­ver­si­ty of Mass­a­chu­setts at Amherst, Jeff Jacobs and Suresh Naidu of Colum­bia Uni­ver­si­ty, and Sid­dharth Suri of Microsoft Research, sought to learn whether crowd­sourced work­ers ben­e­fit from being able to choose their tasks and hours. The answer mat­ters to a lot of work­ers. Flex­i­ble work arrange­ments, which include crowd­sourc­ing plat­forms such as Uber, as well as free­lancers and inde­pen­dent con­trac­tors, increased about 50 per­cent from 2005 to 2015. These jobs account for 94 percent—nearly all—of the net employ­ment growth in the Unit­ed States over that time.

This shift could be good for work­ers, in the­o­ry, if the flex­i­bil­i­ty of the gig econ­o­my lets them switch more eas­i­ly between employ­ers to take advan­tage of high­er-pay­ing offers. Yet in their analy­sis of the online-task mar­ket­place Ama­zon Mechan­i­cal Turk, the researchers find that this isn’t nec­es­sar­i­ly hap­pen­ing. MTurk work­ers, or Turk­ers, get paid for repet­i­tive tasks, such as tag­ging objects found in images or ver­i­fy­ing restau­rant phone num­bers. Accord­ing to the study, Turk­ers’ wages amount to less than 20 per­cent of their productivity—in oth­er words, for every dol­lar of val­ue pro­duced on MTurk, work­ers receive less than 20 cents. The Turk­ers’ share com­pares with a share of 50 cents to 80 cents of every dol­lar for work­ers in the U.S. econ­o­my as a whole, Naidu says. “This sug­gests that much of the sur­plus cre­at­ed by this online labor-mar­ket plat­form is cap­tured by employ­ers,” the researchers write.

That doesn’t make intu­itive sense; since work­ers can eas­i­ly switch between tasks, it seems employ­ers would be forced to com­pete for them by offer­ing good wages. Why isn’t this gen­er­al­ly tak­ing place? One expla­na­tion is that while work­ers can shop around for a bet­ter deal, employ­ers can do the same. And it may be more impor­tant for Ama­zon to design a crowd­sourc­ing plat­form that keeps employ­ers hap­py; after all, Amazon’s rev­enue comes from charg­ing employ­ers a fee. If oth­er plat­forms such as Uber have a sim­i­lar design favor­ing buy­ers, then the dri­vers drop­ping off Walmart’s gro­ceries won’t have much bar­gain­ing pow­er.

“Wages are going to fall,” Naidu pre­dicts. “It’s inter­est­ing that Wal­mart is being so proac­tive in gig-ify­ing its own work­force. Retail is one of the sec­tors that you thought you couldn’t real­ly out­source, but maybe that was wrong.”

The sec­ond pil­lar of Walmart’s approach, automa­tion, could also be bad for work­ers. Wal­mart has dou­bled its use of self-check­outs in stores, accord­ing to a recent investor pre­sen­ta­tion, and new­ly remod­eled loca­tions have few­er lanes staffed with a cashier. What’s more, inside its Store No. 8 incu­ba­tor, which is exper­i­ment­ing with tech­nolo­gies such as robot­ics, vir­tu­al and aug­ment­ed real­i­ty, and arti­fi­cial intel­li­gence, Wal­mart is, accord­ing to Recode, devel­op­ing Project Kepler—a store sim­i­lar to Ama­zon Go with no check­out lines or cashiers.

In the­o­ry, automa­tion doesn’t have to elim­i­nate jobs, on bal­ance, or dri­ve down work­er pay. It could free up work­ers to do high­er val­ue, bet­ter-paid tasks. It could gen­er­ate con­sumer demand and cre­ate new cat­e­gories of jobs.

David Autor of MIT and Anna Salomons of Utrecht Uni­ver­si­ty recent­ly pub­lished a study on automa­tion that exam­ined data on 28 indus­tries in 18 coun­tries in the OECD. They find that, since 1970, automa­tion hasn’t reduced jobs—in fact, it has slight­ly increased them. But since the begin­ning of the 2000s, automa­tion has reduced work­ers’ share of nation­al income. “This find­ing is con­sis­tent with automa­tion hav­ing become in recent decades less labor-aug­ment­ing and more labor-dis­plac­ing,” they write.

Accord­ing to their research, work­ers’ employ­ment, hours, or wages haven’t fall­en. But wages have risen less rapid­ly than over­all eco­nom­ic growth, with own­ers get­ting an increas­ing­ly large share. Autor sug­gests this trend could con­tin­ue as automa­tion increas­es. “No, the robots will not take all of our jobs,” he says in a Brook­ings video. “The con­cern should not be about the num­ber of jobs, but whether those jobs are jobs that can sup­port a rea­son­able stan­dard of liv­ing.”

Wal­mart has been crit­i­cized for years for its low pay and skimpy health ben­e­fits. The com­pa­ny is also known for its obses­sion with hold­ing down costs, a fac­tor in its dri­ve toward automa­tion. “We’re mani­a­cal about expens­es,” said Brett Big­gs, Walmart’s chief finan­cial offi­cer, at an investor con­fer­ence in March. “I think we have lost some of the edge on that over the last year. You can feel it com­ing back.” Big­gs told atten­dees a nos­tal­gic tale about arriv­ing at Wal­mart and expe­ri­enc­ing his first “sup­plies roundup,” when he and his cowork­ers dug office sup­plies out of their desks and dropped them in a cen­tral loca­tion so they wouldn’t have to order more. Then he explained that Wal­mart employ­ees recent­ly got excit­ed about fig­ur­ing out ways to reduce the length of a receipt tape.

Still, in Jan­u­ary, Walmart—benefiting from an enor­mous cor­po­rate tax break under Don­ald Trump’s tax reform—said it would raise its start­ing hourly wage to $11 (around $19,000 a year for 34-hour weeks), hand out bonus­es, and pro­vide more ben­e­fits to full-time employ­ees. Low-wage work­ers seemed to be gain­ing pow­er amid a tight labor mar­ket.

In fact, as its strat­e­gy unfolds, it seems that Wal­mart may cul­ti­vate a rel­a­tive­ly small­er, bet­ter-com­pen­sat­ed core of employ­ees who are sup­ple­ment­ed by automa­tion and a flex­i­ble cadre of gig-econ­o­my work­ers. Ten years from now, “there will be few­er asso­ciates in the Wal­mart store ... and we will see the wage rate con­tin­ue to go up,” Walmart’s chief exec­u­tive Doug McMil­lon told The Eco­nom­ic Club of New York in Novem­ber. “What we would love, not just for Wal­mart but for retail, is to earn a bet­ter rep­u­ta­tion about the jobs them­selves.”

Giv­en high turnover in retail, McMil­lon said, Wal­mart expects to elim­i­nate jobs most­ly through attri­tion. As it auto­mates tedious tasks, such as find­ing inven­to­ry in the back room, it expects to offer jobs that pay more, such as cus­tomer ser­vice and mer­chan­dis­ing.

In all of this, Wal­mart is try­ing to adapt to the rapid growth of Ama­zon, which report­ed almost $178 bil­lion in rev­enue last year—about $315,000 per employ­ee. Wal­mart is much larg­er, with $500 bil­lion in annu­al rev­enue, but because it employs about four times as many peo­ple, that rev­enue amounts to just $217,000 per employ­ee. (Accord­ing to the Wall Street Jour­nal, Wal­mart is in ear­ly talks with the insur­er Humana about pos­si­ble busi­ness rela­tion­ships such as an acqui­si­tion, which would be a way to diver­si­fy away from the retail busi­ness where it com­petes with Ama­zon.)

The changes to Walmart’s busi­ness mod­el could be par­tic­u­lar­ly hard on young peo­ple who seek retail work. Peo­ple between the ages of 16 to 24 account for 23 per­cent of retail work­ers, near­ly dou­ble their over­all rep­re­sen­ta­tion in the U.S. work­force. Not all of them can make a seam­less shift into the gig econ­o­my; Uber, for exam­ple, requires work­ers to be at least 21 years old, and they have to use a four-door car that meets com­pa­ny stan­dards.

...

———-

“Work­force: Robots and Free­lancers” by Amy Mer­rick; The Atlantic; 04/04/2018

“Over the past few weeks, Wal­mart exec­u­tives have sketched a pic­ture of the company’s future that fea­tures more self-check­outs and a gro­cery-deliv­ery busi­ness—soon esca­lat­ing to 100 cities from a pilot pro­gram in six cities. Per­son­al shop­pers will fill plas­tic totes with avo­ca­dos and paper tow­els from Wal­mart store shelves, and hand off pack­ages to crowd­sourced dri­vers idling in the park­ing lot. Assem­bly will be out­sourced, too: Work­ers on Handy, an online mar­ket­place for home ser­vices, will mount tele­vi­sions and assem­ble fur­ni­ture.”

So long, under­paid Wal­mart employ­ees, and hel­lo more under­paid Wal­mart non-employ­ee gig work­ers!

And when a com­pa­ny as large and influ­en­tial as Wal­mart goes down this path, you can be sure oth­ers will fol­low. Of course, it’s a path that Wal­mart has fol­lowed oth­ers down. As the arti­cle notes, “flex­i­ble work arrange­ments”, which include plat­forms like Uber but also free­lancers and inde­pen­dent con­trac­tors, account­ed for 94 per­cent of the net employ­ment growth in the Unit­ed States between 2005 and 2015:

...
The Wal­mart of the future relies more heav­i­ly on the gig econ­o­my and automa­tion. This is an indi­ca­tion of the fierce com­pe­ti­tion between Wal­mart, the world’s largest pri­vate employ­er, and Ama­zon. A pair of recent stud­ies sug­gests that it’s also a sign that the U.S. econ­o­my is tilt­ing fur­ther toward jobs that give work­ers less mar­ket pow­er.

One study, by Arindra­jit Dube of the Uni­ver­si­ty of Mass­a­chu­setts at Amherst, Jeff Jacobs and Suresh Naidu of Colum­bia Uni­ver­si­ty, and Sid­dharth Suri of Microsoft Research, sought to learn whether crowd­sourced work­ers ben­e­fit from being able to choose their tasks and hours. The answer mat­ters to a lot of work­ers. Flex­i­ble work arrange­ments, which include crowd­sourc­ing plat­forms such as Uber, as well as free­lancers and inde­pen­dent con­trac­tors, increased about 50 per­cent from 2005 to 2015. These jobs account for 94 percent—nearly all—of the net employ­ment growth in the Unit­ed States over that time.
...

And as the arti­cle also notes, while “flex­i­ble work arrange­ments” could, in the­o­ry be good for work­ers, that’s not what’s actu­al­ly hap­pen­ing. Instead, this “flex­i­bil­i­ty” appears to have been large­ly used to expand employ­er prof­its:

...
This shift could be good for work­ers, in the­o­ry, if the flex­i­bil­i­ty of the gig econ­o­my lets them switch more eas­i­ly between employ­ers to take advan­tage of high­er-pay­ing offers. Yet in their analy­sis of the online-task mar­ket­place Ama­zon Mechan­i­cal Turk, the researchers find that this isn’t nec­es­sar­i­ly hap­pen­ing. MTurk work­ers, or Turk­ers, get paid for repet­i­tive tasks, such as tag­ging objects found in images or ver­i­fy­ing restau­rant phone num­bers. Accord­ing to the study, Turk­ers’ wages amount to less than 20 per­cent of their productivity—in oth­er words, for every dol­lar of val­ue pro­duced on MTurk, work­ers receive less than 20 cents. The Turk­ers’ share com­pares with a share of 50 cents to 80 cents of every dol­lar for work­ers in the U.S. econ­o­my as a whole, Naidu says. “This sug­gests that much of the sur­plus cre­at­ed by this online labor-mar­ket plat­form is cap­tured by employ­ers,” the researchers write.
...

And that’s why we should expect Wal­mart’s future gig employ­ees to be paid even less than their cur­rent employ­ees. Because Wal­mart obvi­ous­ly would­n’t be doing this if they thought it would cost them more:

...
That doesn’t make intu­itive sense; since work­ers can eas­i­ly switch between tasks, it seems employ­ers would be forced to com­pete for them by offer­ing good wages. Why isn’t this gen­er­al­ly tak­ing place? One expla­na­tion is that while work­ers can shop around for a bet­ter deal, employ­ers can do the same. And it may be more impor­tant for Ama­zon to design a crowd­sourc­ing plat­form that keeps employ­ers hap­py; after all, Amazon’s rev­enue comes from charg­ing employ­ers a fee. If oth­er plat­forms such as Uber have a sim­i­lar design favor­ing buy­ers, then the dri­vers drop­ping off Walmart’s gro­ceries won’t have much bar­gain­ing pow­er.

“Wages are going to fall,” Naidu pre­dicts. “It’s inter­est­ing that Wal­mart is being so proac­tive in gig-ify­ing its own work­force. Retail is one of the sec­tors that you thought you couldn’t real­ly out­source, but maybe that was wrong.”
...

And then there’s the oth­er side of Wal­mart’s vision for the future: robots and automa­tion. And much like the “flex­i­ble work arrange­ments” trend, automa­tion does­n’t nec­es­sar­i­ly have to lead to low­er pay. But low­er pay is indeed what automa­tion has led to in the form of low­er wage growth:

...
The sec­ond pil­lar of Walmart’s approach, automa­tion, could also be bad for work­ers. Wal­mart has dou­bled its use of self-check­outs in stores, accord­ing to a recent investor pre­sen­ta­tion, and new­ly remod­eled loca­tions have few­er lanes staffed with a cashier. What’s more, inside its Store No. 8 incu­ba­tor, which is exper­i­ment­ing with tech­nolo­gies such as robot­ics, vir­tu­al and aug­ment­ed real­i­ty, and arti­fi­cial intel­li­gence, Wal­mart is, accord­ing to Recode, devel­op­ing Project Kepler—a store sim­i­lar to Ama­zon Go with no check­out lines or cashiers.

In the­o­ry, automa­tion doesn’t have to elim­i­nate jobs, on bal­ance, or dri­ve down work­er pay. It could free up work­ers to do high­er val­ue, bet­ter-paid tasks. It could gen­er­ate con­sumer demand and cre­ate new cat­e­gories of jobs.

David Autor of MIT and Anna Salomons of Utrecht Uni­ver­si­ty recent­ly pub­lished a study on automa­tion that exam­ined data on 28 indus­tries in 18 coun­tries in the OECD. They find that, since 1970, automa­tion hasn’t reduced jobs—in fact, it has slight­ly increased them. But since the begin­ning of the 2000s, automa­tion has reduced work­ers’ share of nation­al income. “This find­ing is con­sis­tent with automa­tion hav­ing become in recent decades less labor-aug­ment­ing and more labor-dis­plac­ing,” they write.

Accord­ing to their research, work­ers’ employ­ment, hours, or wages haven’t fall­en. But wages have risen less rapid­ly than over­all eco­nom­ic growth, with own­ers get­ting an increas­ing­ly large share. Autor sug­gests this trend could con­tin­ue as automa­tion increas­es. “No, the robots will not take all of our jobs,” he says in a Brook­ings video. “The con­cern should not be about the num­ber of jobs, but whether those jobs are jobs that can sup­port a rea­son­able stan­dard of liv­ing.”
...

And this vision for Wal­mart’s future appear to how Wal­mart is plan­ning on ‘rais­ing wages’: by turn­ing its low­er paid employ­ees into low­er-paid non-employ­ee gig work­ers and hir­ing a rel­a­tive­ly small num­ber of high­er paid employ­ees to take care of all the robots and automa­tion:

...
Wal­mart has been crit­i­cized for years for its low pay and skimpy health ben­e­fits. The com­pa­ny is also known for its obses­sion with hold­ing down costs, a fac­tor in its dri­ve toward automa­tion. “We’re mani­a­cal about expens­es,” said Brett Big­gs, Walmart’s chief finan­cial offi­cer, at an investor con­fer­ence in March. “I think we have lost some of the edge on that over the last year. You can feel it com­ing back.” Big­gs told atten­dees a nos­tal­gic tale about arriv­ing at Wal­mart and expe­ri­enc­ing his first “sup­plies roundup,” when he and his cowork­ers dug office sup­plies out of their desks and dropped them in a cen­tral loca­tion so they wouldn’t have to order more. Then he explained that Wal­mart employ­ees recent­ly got excit­ed about fig­ur­ing out ways to reduce the length of a receipt tape.

Still, in Jan­u­ary, Walmart—benefiting from an enor­mous cor­po­rate tax break under Don­ald Trump’s tax reform—said it would raise its start­ing hourly wage to $11 (around $19,000 a year for 34-hour weeks), hand out bonus­es, and pro­vide more ben­e­fits to full-time employ­ees. Low-wage work­ers seemed to be gain­ing pow­er amid a tight labor mar­ket.

In fact, as its strat­e­gy unfolds, it seems that Wal­mart may cul­ti­vate a rel­a­tive­ly small­er, bet­ter-com­pen­sat­ed core of employ­ees who are sup­ple­ment­ed by automa­tion and a flex­i­ble cadre of gig-econ­o­my work­ers. Ten years from now, “there will be few­er asso­ciates in the Wal­mart store ... and we will see the wage rate con­tin­ue to go up,” Walmart’s chief exec­u­tive Doug McMil­lon told The Eco­nom­ic Club of New York in Novem­ber. “What we would love, not just for Wal­mart but for retail, is to earn a bet­ter rep­u­ta­tion about the jobs them­selves.”

Giv­en high turnover in retail, McMil­lon said, Wal­mart expects to elim­i­nate jobs most­ly through attri­tion. As it auto­mates tedious tasks, such as find­ing inven­to­ry in the back room, it expects to offer jobs that pay more, such as cus­tomer ser­vice and mer­chan­dis­ing.

In all of this, Wal­mart is try­ing to adapt to the rapid growth of Ama­zon, which report­ed almost $178 bil­lion in rev­enue last year—about $315,000 per employ­ee. Wal­mart is much larg­er, with $500 bil­lion in annu­al rev­enue, but because it employs about four times as many peo­ple, that rev­enue amounts to just $217,000 per employ­ee. (Accord­ing to the Wall Street Jour­nal, Wal­mart is in ear­ly talks with the insur­er Humana about pos­si­ble busi­ness rela­tion­ships such as an acqui­si­tion, which would be a way to diver­si­fy away from the retail busi­ness where it com­petes with Ama­zon.)
...

Final­ly, as the arti­cle, this tran­si­tion to the gig econ­o­my could be par­tic­u­lar­ly hard on young peo­ple between the ages of 16 and 24 seek­ing retail work since this demo­graph­ic is far more like­ly to find retail work than the rest of the US work­force:

...
The changes to Walmart’s busi­ness mod­el could be par­tic­u­lar­ly hard on young peo­ple who seek retail work. Peo­ple between the ages of 16 to 24 account for 23 per­cent of retail work­ers, near­ly dou­ble their over­all rep­re­sen­ta­tion in the U.S. work­force. Not all of them can make a seam­less shift into the gig econ­o­my; Uber, for exam­ple, requires work­ers to be at least 21 years old, and they have to use a four-door car that meets com­pa­ny stan­dards.
...

But, of course, as work require­ments for safe­ty-net ser­vices become the norm, it’s not just going to young peo­ple who are going to be pushed into the gig econ­o­my. It’s going to be any unem­ployed poor per­son.

And that’s part of what what’s so dis­turb­ing about this trend: it’s a trend seem­ing­ly designed to make the poor poor­er for the ben­e­fit of employ­ers. And Wal­mart is about tur­bo charge this trend.

But there’s anoth­er dis­turb­ing aspect about all this. And, of course, this dis­turb­ing aspect involves the GOP: It turns out
:

Alter­net

A Trou­bling Op-Ed Por­tends GOP Agen­da Absorb­ing the Worst Ideals of Sil­i­con Val­ley
Uh Oh — are we going to see right-wingers merge their agen­da with Sil­i­con Val­ley greed?

By Adam John­son / Alter­Net
Jan­u­ary 27, 2016, 10:09 PM GMT

The Wash­ing­ton insid­er pub­li­ca­tion Politi­co has a habit of pub­lish­ing reveal­ing op-eds by right-wingers in Wash­ing­ton that show their ide­ol­o­gy in an unvar­nished way. It’s a place you can see their true feel­ings about the poor and the Amer­i­can enti­tle­ment system—which is to say run­away con­tempt for both. One so-bad-it-bor­ders-on-self-par­o­dy op-ed dropped Jan­u­ary 27, and it wants to mas­sive­ly over­haul sev­er­al enti­tle­ments by sub­ject­ing those most in need to the Dick­en­sian night­mare of the “gig econ­o­my”: “Uber for wel­fare: A bold pro­pos­al to use the ‘gig econ­o­my’ to reboot the safe­ty net.”

There’s about 85 red flags in the head­line alone. Any­time some­one talks about “reboot­ing” essen­tial social covenants of democ­ra­cy you know there’s going to be a poor or work­ing-class per­son get­ting the shaft some­where. The actu­al text doesn’t dis­ap­point:

His­tor­i­cal­ly, some oppo­nents of work­fare have argued that work require­ments are unten­able because the gov­ern­ment can­not find a job for every wel­fare ben­e­fi­cia­ry. That may have been true years ago, when a “job” was bina­ry and full time, but today the gig econ­o­my offers the solu­tion: It can eas­i­ly and quick­ly put mil­lions of peo­ple back to work, allow­ing almost any­one to find a job with hours that are flex­i­ble with vir­tu­al loca­tions any­where.

The piece’s basic the­sis is that due to the hyper-liq­uid­i­ty of the exploita­tion econ­o­my (d/b/a “gig econ­o­my”) the work require­ments should be expand­ed to include audi­tion­ing for gig work, for exam­ple Uber or Fiv­er. One doesn’t need to think too long and hard to see the impli­ca­tions of this; name­ly, that in order to receive gov­ern­ment assis­tance, a poor per­son would have to spend all day and night look­ing to do one-off chores and tasks like dri­ving peo­ple around, clean­ing toi­lets and oth­er mis­cel­la­neous tasks.

Which brings us to the pri­ma­ry prob­lem of the piece: the def­i­n­i­tion of “work.” The word “work” is used 21 times in the op-ed but how the authors define it and how most peo­ple do isn’t the same. To most peo­ple, work is a job with at least a mod­icum of secu­ri­ty and pre­dictabil­i­ty. One goes to work, one likes their work, one does good work.

To the gig econ­o­my, work means a one-off task. One is viewed legal­ly as an “inde­pen­dent con­trac­tor” and thus stripped of the basic rights of an employ­ee and the “work” one ends up doing has no assur­ances or pre­dictabil­i­ty. In oth­er words, it’s not work, it’s a series of gigs sub­ject to the caprice of the free mar­ket. Alas, “wel­fare to gig” doesn’t sound too humane, so the def­i­n­i­tion is loos­ened to mean what­ev­er reme­di­al task one can do assum­ing they aren’t met with a low­er bid from some­one even more des­per­ate than they are.

The authors of the piece, Cesar Con­da and Derek Khan­na, are both heav­i­ly entrenched in the revolv­ing door of Sil­i­con Val­ley and con­ser­v­a­tive Wash­ing­ton. Con­da is a for­mer chief-of-staff of Mar­co Rubio and cur­rent found­ing prin­ci­ple of Nav­i­ga­tors Glob­al, a lob­by­ing firm that has rep­re­sent­ed every­thing from pri­vate pris­ons to casi­nos to large tech­nol­o­gy firms.

Khan­na is some­thing more of a guru, who has worked in the Rom­ney cam­paign and con­sults help­ing tech­nol­o­gy firms “nav­i­gate the pol­i­cy-mak­ing process in DC.” Put sim­ply, these two men work for polit­i­cal and cor­po­rate inter­ests that are both ide­o­log­i­cal­ly and finan­cial­ly moti­vat­ed not only to keep the poor poor but to par­lay their suf­fer­ing into cheap­er, less secure labor.

The authors insist “the aver­age Uber dri­ver makes about $19 an hour.” This line is mis­lead­ing to the point of an out­right lie because it omits the fine print that Uber dri­vers, as inde­pen­dent con­trac­tors, are required to pay for their own gas, insur­ance, and car upkeep, so that $19 an hour becomes con­sid­er­ably less when all is said and done. Indeed, this was a point of con­tention in a 2015 law­suit in Cal­i­for­nia where a judge ruled that Uber dri­ver Bar­bara Ann Berwick should be reim­bursed for cost incurred on the job total­ing $4,152.20 and that she was, in fact, an employ­ee, not a con­trac­tor.

Uber posi­tions itself as sim­ply an app that “con­nects dri­vers and pas­sen­gers,” but the labor office dis­agreed, rul­ing that Uber act­ed more like an employ­er than an app that con­nects peo­ple. The same log­ic used to exploit Berwick will be used to exploit the mil­lions on enti­tle­ment roles—workers will go from employ­ees with pro­tec­tions to per­ma-con­trac­tors with few rights and even less secu­ri­ty. This isn’t “get­ting peo­ple back to work,” it’s tak­ing the most vul­ner­a­ble and using them to under­cut an already com­pet­i­tive low-skill labor mar­ket to fur­ther dri­ve down wages and jus­ti­fy cut­ting wel­fare expen­di­tures.

What the wealthy and their Repub­li­can pro­pa­gan­dists fear above all is a work­ing class that has peace of mind; a work­ing class with a decent safe­ty net, job pro­tec­tion and the abil­i­ty to plan out its course with­out liv­ing in a con­stant state of ter­ror about their next pay­check. This, how­ev­er, makes exploit­ing them and play­ing them off each oth­er that much more dif­fi­cult. This rais­es labor costs and eats into their bot­tom line. It also makes the work­ing class, above all, more polit­i­cal threat­en­ing since peace of mind makes stok­ing fears of immi­grants and Mus­lims and social­ist takeovers that much more dif­fi­cult.

...

Lazy stereo­types and puri­tan­i­cal self-right­eous­ness are com­mon among much of the rich donor base; com­bine this with tech­no-woo woo of Sil­i­con Val­ley and laun­der it through slick PR spe­cial­ists like Con­da and Khan­na, and the result is a san­i­tized ver­sion of what is an unchecked “let them eat cake” indif­fer­ence to pover­ty. The poor can nev­er be too exploit­ed, the needs of the upper-mid­dle-class nev­er too mon­e­tized.

The gig econ­o­my is anoth­er name for snuff­ing out any notion of peace of mind. The idea that it should be used to gut what remains of America’s already razor-thin social safe­ty net is an idea so tox­ic that, if the left isn’t dili­gent, just may become main­stream.
———-

“A Trou­bling Op-Ed Por­tends GOP Agen­da Absorb­ing the Worst Ideals of Sil­i­con Val­ley” by Adam John­son; Alter­Net; 01/27/2016

“The Wash­ing­ton insid­er pub­li­ca­tion Politi­co has a habit of pub­lish­ing reveal­ing op-eds by right-wingers in Wash­ing­ton that show their ide­ol­o­gy in an unvar­nished way. It’s a place you can see their true feel­ings about the poor and the Amer­i­can enti­tle­ment system—which is to say run­away con­tempt for both. One so-bad-it-bor­ders-on-self-par­o­dy op-ed dropped Jan­u­ary 27, and it wants to mas­sive­ly over­haul sev­er­al enti­tle­ments by sub­ject­ing those most in need to the Dick­en­sian night­mare of the “gig econ­o­my”: “Uber for wel­fare: A bold pro­pos­al to use the ‘gig econ­o­my’ to reboot the safe­ty net.””

The ‘gig’ safe­ty-net: in order to get basic safe­ty-net ser­vices you’ll need to find ‘work’. One gig at a time. For what­ev­er pay the gig ‘mar­ket­place’ is offer­ing at that moment. And you’ll be com­pet­ing with all the oth­er peo­ple on the safe­ty-net (and every­one else not on the safe­ty-net in the gig econ­o­my) which should more or less guar­an­tee real­ly, real­ly low pay.

Low­er pay for the poor. That’s the plan. A plan that, of course, is brought to us by a pair of GOP oper­a­tives, Cesar Con­da, a for­mer chief-of-staff of Mar­co Rubio, and Derek Khan­na, described as a “guru” who worked for the Rom­ney cam­paign:

...
The authors of the piece, Cesar Con­da and Derek Khan­na, are both heav­i­ly entrenched in the revolv­ing door of Sil­i­con Val­ley and con­ser­v­a­tive Wash­ing­ton. Con­da is a for­mer chief-of-staff of Mar­co Rubio and cur­rent found­ing prin­ci­ple of Nav­i­ga­tors Glob­al, a lob­by­ing firm that has rep­re­sent­ed every­thing from pri­vate pris­ons to casi­nos to large tech­nol­o­gy firms.

Khan­na is some­thing more of a guru, who has worked in the Rom­ney cam­paign and con­sults help­ing tech­nol­o­gy firms “nav­i­gate the pol­i­cy-mak­ing process in DC.” Put sim­ply, these two men work for polit­i­cal and cor­po­rate inter­ests that are both ide­o­log­i­cal­ly and finan­cial­ly moti­vat­ed not only to keep the poor poor but to par­lay their suf­fer­ing into cheap­er, less secure labor.
...

And, of course, the authors of this piece tout the virtues of “flex­i­bil­i­ty” and how “almost any­one to find a job with hours that are flex­i­ble with vir­tu­al loca­tions any­where”:

...
There’s about 85 red flags in the head­line alone. Any­time some­one talks about “reboot­ing” essen­tial social covenants of democ­ra­cy you know there’s going to be a poor or work­ing-class per­son get­ting the shaft some­where. The actu­al text doesn’t dis­ap­point:

His­tor­i­cal­ly, some oppo­nents of work­fare have argued that work require­ments are unten­able because the gov­ern­ment can­not find a job for every wel­fare ben­e­fi­cia­ry. That may have been true years ago, when a “job” was bina­ry and full time, but today the gig econ­o­my offers the solu­tion: It can eas­i­ly and quick­ly put mil­lions of peo­ple back to work, allow­ing almost any­one to find a job with hours that are flex­i­ble with vir­tu­al loca­tions any­where.

The piece’s basic the­sis is that due to the hyper-liq­uid­i­ty of the exploita­tion econ­o­my (d/b/a “gig econ­o­my”) the work require­ments should be expand­ed to include audi­tion­ing for gig work, for exam­ple Uber or Fiv­er. One doesn’t need to think too long and hard to see the impli­ca­tions of this; name­ly, that in order to receive gov­ern­ment assis­tance, a poor per­son would have to spend all day and night look­ing to do one-off chores and tasks like dri­ving peo­ple around, clean­ing toi­lets and oth­er mis­cel­la­neous tasks.
...

But as the piece does­n’t point out, the gig econ­o­my does­n’t actu­al­ly offer jobs. It offers one-off tasks for what­ev­er pay the mar­ket will bear at that moment:

...
Which brings us to the pri­ma­ry prob­lem of the piece: the def­i­n­i­tion of “work.” The word “work” is used 21 times in the op-ed but how the authors define it and how most peo­ple do isn’t the same. To most peo­ple, work is a job with at least a mod­icum of secu­ri­ty and pre­dictabil­i­ty. One goes to work, one likes their work, one does good work.

To the gig econ­o­my, work means a one-off task. One is viewed legal­ly as an “inde­pen­dent con­trac­tor” and thus stripped of the basic rights of an employ­ee and the “work” one ends up doing has no assur­ances or pre­dictabil­i­ty. In oth­er words, it’s not work, it’s a series of gigs sub­ject to the caprice of the free mar­ket. Alas, “wel­fare to gig” doesn’t sound too humane, so the def­i­n­i­tion is loos­ened to mean what­ev­er reme­di­al task one can do assum­ing they aren’t met with a low­er bid from some­one even more des­per­ate than they are.
...

And don’t for­get, if Wal­mart and oth­er major retail­ers shift to a gig mod­el, we’ll basi­cal­ly be turn­ing peo­ple who use the safe­ty-net into a super-cheap work­force for Wal­mart. And any oth­er major employ­ers. It would be a way to not just low­er the min­i­mum wage but effec­tive­ly elim­i­nate it entire­ly. So, of course, the authors of this idea wild­ly over­state the aver­age hourly earn­ings of Uber dri­vers:

...
The authors insist “the aver­age Uber dri­ver makes about $19 an hour.” This line is mis­lead­ing to the point of an out­right lie because it omits the fine print that Uber dri­vers, as inde­pen­dent con­trac­tors, are required to pay for their own gas, insur­ance, and car upkeep, so that $19 an hour becomes con­sid­er­ably less when all is said and done. Indeed, this was a point of con­tention in a 2015 law­suit in Cal­i­for­nia where a judge ruled that Uber dri­ver Bar­bara Ann Berwick should be reim­bursed for cost incurred on the job total­ing $4,152.20 and that she was, in fact, an employ­ee, not a con­trac­tor.

Uber posi­tions itself as sim­ply an app that “con­nects dri­vers and pas­sen­gers,” but the labor office dis­agreed, rul­ing that Uber act­ed more like an employ­er than an app that con­nects peo­ple. The same log­ic used to exploit Berwick will be used to exploit the mil­lions on enti­tle­ment roles—workers will go from employ­ees with pro­tec­tions to per­ma-con­trac­tors with few rights and even less secu­ri­ty. This isn’t “get­ting peo­ple back to work,” it’s tak­ing the most vul­ner­a­ble and using them to under­cut an already com­pet­i­tive low-skill labor mar­ket to fur­ther dri­ve down wages and jus­ti­fy cut­ting wel­fare expen­di­tures.
...

So how like­ly is it that the GOP will embrace the idea of these two con­ser­v­a­tive oper­a­tives? Well, as the piece points out at the end, this ‘gig work for wel­fare’ idea is a GOP dream because what the far right fears most is a work­ing class that isn’t utter­ly des­per­ate and easy to exploit:

...
What the wealthy and their Repub­li­can pro­pa­gan­dists fear above all is a work­ing class that has peace of mind; a work­ing class with a decent safe­ty net, job pro­tec­tion and the abil­i­ty to plan out its course with­out liv­ing in a con­stant state of ter­ror about their next pay­check. This, how­ev­er, makes exploit­ing them and play­ing them off each oth­er that much more dif­fi­cult. This rais­es labor costs and eats into their bot­tom line. It also makes the work­ing class, above all, more polit­i­cal threat­en­ing since peace of mind makes stok­ing fears of immi­grants and Mus­lims and social­ist takeovers that much more dif­fi­cult.

...

Lazy stereo­types and puri­tan­i­cal self-right­eous­ness are com­mon among much of the rich donor base; com­bine this with tech­no-woo woo of Sil­i­con Val­ley and laun­der it through slick PR spe­cial­ists like Con­da and Khan­na, and the result is a san­i­tized ver­sion of what is an unchecked “let them eat cake” indif­fer­ence to pover­ty.. The poor can nev­er be too exploit­ed, the needs of the upper-mid­dle-class nev­er too mon­e­tized.

The gig econ­o­my is anoth­er name for snuff­ing out any notion of peace of mind. The idea that it should be used to gut what remains of America’s already razor-thin social safe­ty net is an idea so tox­ic that, if the left isn’t dili­gent, just may become main­stream.
...

So now that we’ve seen this overview of this vision for a gig safe­ty-net that GOP oper­a­tives Con­da and Khan­na laid out in their 2016 Politi­co piece, let’s take a look at the piece itself. Sur­prise! It gets even more dis­turb­ing. Not only to Con­da and Khan­na call for vir­tu­al­ly all safe­ty-net pro­grams to get a work require­ment for able-bod­ied adults, they also call for work require­ments for the dis­abled too. Yep, Social Secu­ri­ty Dis­abil­i­ty recip­i­ents should be expect­ed to find gig work too unless they’re so dis­abled that even that isn’t an option.

And that, of course, is the per­fect recipe for kick­ing peo­ple off of dis­abil­i­ty pro­grams: if some­one is cur­rent­ly too dis­abled to find gig work, all that will need to hap­pen is for some employ­er to come along and find a gig job for that pop­u­la­tion to do. Can you only move your left foot? Well, there just might be a gig employ­er out there with a task that pays 1 cent an hour and only requires the move­ment of your left foot. That’s the kind of night­mare they’re try­ing to unleash on the dis­abled: with min­i­mum wage and reg­u­lar work hours no longer a require­ment for employ­ers, there can be a race to the bot­tom in terms of the sin­gle tasks that some­one might be hired to do. And every time employ­ers find a new way to momen­tar­i­ly employ those still defined as dis­abled that will cre­ate a whole new pool of peo­ple who can be kicked off of dis­abil­i­ty for not meet­ing the work require­ment.

Con­da and Khan­na also give a gen­er­al descrip­tion for the types of tasks they have in mind: pret­ty much any­thing. For those who don’t dri­ve and can’t do Uber or Lyft, they could deliv­er goods and gro­ceries (like what Wal­mart is plan­ning), assem­ble fur­ni­ture (like Wal­mart is also plan­ning), or mow lawns and plow dri­ve­ways (like Wal­mart is prob­a­bly plan­ning). Plus any­thing on Amazon’s Mechan­i­cal­Turk, Fiv­er and oth­er com­pa­nies pay for gen­er­al tasks that can usu­al­ly be done on a com­put­er or phone any­where across the coun­try.

But they don’t stop there. They also have pret­ty much any skilled jobs in mind. Pho­to shoots, voice lessons, mur­al paint­ing, ten­nis lessons, or house paint­ing, com­put­er cod­ing, graph­ic design, and even legal ser­vices for unem­ployed lawyers.

They also call for a change in law so the Pres­i­dent would no longer have the option of tem­porar­i­ly waiv­ing work require­ments for a pro­gram. So the next time there’s a major reces­sion, employ­ers could lay­off as many work­ers as pos­si­ble and then rehire them as gig work­ers. In oth­er words, what they have in mind is a sys­tem that encour­ages every sec­tor of the econ­o­my to gig-ify itself dur­ing eco­nom­ic down­turns, lay­ing off as many peo­ple as pos­si­ble (send­ing them to wel­fare) and rehir­ing them as cheap gig work­ers. Just like Wal­mart is plan­ning. And eco­nom­ic reces­sions and depres­sions will be dri­ving forces behind this. It’s not exact­ly wise eco­nom­ic pol­i­cy but that’s what we should expect from the GOP.

So when Con­da and Khan­na say their idea could trans­form both gov­ern­ment ser­vices and the gen­er­al econ­o­my, they aren’t kid­ding. Enjoy your job while you have one:

Politi­co

Uber for wel­fare
A bold pro­pos­al to use the “gig econ­o­my” to reboot the safe­ty net.

By CESAR CONDA and DEREK KHANNA

01/27/2016 07:02 AM EST

In this pres­i­den­tial cycle, the “gig econ­o­my” has been under attack, notably from Democ­rats like Hillary Clin­ton, who said that it is “rais­ing hard ques­tions about work­place pro­tec­tions and what a good job will look like in the future.”

But far from being the labor prob­lem of our era, the gig econ­o­my is actu­al­ly a solu­tion — one with pow­er to change things far beyond car-shar­ing and odd jobs. It could help trans­form not just the pri­vate sec­tor, but gov­ern­ment as well, adding flex­i­bil­i­ty to unem­ploy­ment pro­grams and decreas­ing depen­dence on a wel­fare sys­tem get­ting out of con­trol.

Reform­ing our safe­ty net is back at the fore­front of the Repub­li­can Par­ty agen­da as evi­denced by the recent Kemp Foun­da­tion forum on pover­ty host­ed by Sen. Tim Scott (R‑S.C.) and House Speak­er Paul Ryan (R‑Wis.). And if con­ser­v­a­tives are imag­i­na­tive about their solu­tions, they’ll real­ize that the huge changes in the econ­o­my in the past decades actu­al­ly give us new tools to solve some of these prob­lems. The cur­rent safe­ty net is out­dat­ed, designed for an era when work was a 9‑to‑5 rit­u­al that required inter­views and a résumé. The mod­ern econ­o­my is much more com­plex, and the gig econ­o­my, in par­tic­u­lar, has dra­mat­i­cal­ly reduced the bar­ri­ers to find­ing work.

Social sci­ence data is clear that keep­ing safe­ty net ben­e­fi­cia­ries work­ing is bet­ter for their careers and long-term eco­nom­ic well-being. The val­ue of work can­not be over­stat­ed, and the 1996 wel­fare reform embraced this prin­ci­ple by tran­si­tion­ing wel­fare to a sys­tem of so-called work­fare, with able-bod­ied indi­vid­u­als who receive gov­ern­ment ben­e­fits being required to work in some capac­i­ty.

Since then, Washington’s com­mit­ment to work­fare has been dwin­dling. While the 1996 law required work par­tic­i­pa­tion to receive wel­fare and food stamps, in 2012, the Oba­ma admin­is­tra­tion announced it would issue waivers exempt­ing state gov­ern­ments from those work require­ments. And as part of the stim­u­lus in 2009, states were giv­en new abil­i­ties to waive work require­ments for food stamps.

Oth­er parts of the safe­ty net con­tain no work require­ments at all, includ­ing Social Secu­ri­ty dis­abil­i­ty ben­e­fits, a $140 bil­lion fed­er­al enti­tle­ment (SSDI is a pro­gram for those who are con­sid­ered dis­abled such that they are unable to work); the Sec­tion 8 Hous­ing Choice Vouch­er Pro­gram; Med­ic­aid, which some lawyers believe can­not have work require­ments because the Med­ic­aid Act requires states to pro­vide assis­tance to all indi­vid­u­als who qual­i­fy under fed­er­al law; and unem­ploy­ment ben­e­fits, which are designed for those unable to find work.

His­tor­i­cal­ly, some oppo­nents of work­fare have argued that work require­ments are unten­able because the gov­ern­ment can­not find a job for every wel­fare ben­e­fi­cia­ry. That may have been true years ago, when a “job” was bina­ry and full time, but today the gig econ­o­my offers the solu­tion: It can eas­i­ly and quick­ly put mil­lions of peo­ple back to work, allow­ing almost any­one to find a job with hours that are flex­i­ble with vir­tu­al loca­tions any­where. Much of this work is well above min­i­mum wage and it can fur­ther the careers of work­ers as well. With a wide array of dif­fer­ent employ­ment options, work­ers can choose jobs bet­ter tai­lored to their skill-sets and upgrade their skills, which can advance their careers.

What do these jobs look like? For those will­ing and able to dri­ve, Uber and Lyft enlist any­one to be a dri­ver — assum­ing they pass a back­ground check — and offers spe­cial financ­ing or rental dis­counts for vehi­cles. Cur­rent­ly, the aver­age Uber dri­ver makes about $19 an hour, and in cities like Los Ange­les and New York, their earn­ings are even high­er.

For those who don’t dri­ve, the options are near­ly end­less. They could deliv­er goods and gro­ceries for Post­mates and Instacart, assem­ble fur­ni­ture on TaskRab­bit or mow lawns and plow dri­ve­ways with PLOWZ & MOWZ. Or if they have the know-how they could offer pho­to shoots, voice lessons, mur­al paint­ing, ten­nis lessons, or paint­ing a house on Thumb­tack. Amazon’s Mechan­i­cal­Turk, Fiv­er and oth­er com­pa­nies pay for gen­er­al tasks that can usu­al­ly be done on a com­put­er or phone any­where across the coun­try. Those with par­tic­u­lar skill-sets have oth­er plat­forms avail­able: Coders can do free­lance work on Elance, Upwork, and Scal­able Path, house clean­ers can list them­selves on Handy, graph­ics design­ers can sub­mit bids and graph­ics on 99 Designs, and lawyers can draft legal con­tracts on UpCoun­sel. Peo­ple with gen­er­al inter­per­son­al skills could be a vir­tu­al per­son­al assis­tant on Zirtual.com. There’s an eas­i­ly avail­able job for just about every­one in the gig econ­o­my.

The gov­ern­ment should expect that able-bod­ied safe­ty net ben­e­fi­cia­ries be will­ing to engage in the gig econ­o­my before col­lect­ing ben­e­fits. But tran­si­tion­ing to such a sys­tem requires pol­i­cy­mak­ers to rethink the entire safe­ty net, affect­ing near­ly every fed­er­al enti­tle­ment pro­gram, so that it is ori­ent­ed around the gig econ­o­my. That’s no easy task, but there are some impor­tant deci­sions that law­mak­ers can make to move in that direc­tion.

First, Con­gress must take the les­son from the 1996 round of wel­fare reform and apply work require­ments to the rest of the safe­ty net. To do so, it should strength­en the Tem­po­rary Assis­tance for Needy Fam­i­lies pro­gram — com­mon­ly known as wel­fare— to clear­ly pro­hib­it any pres­i­dent from essen­tial­ly waiv­ing its work require­ments. Law­mak­ers also should restore work require­ments for food stamps and impose them for fed­er­al hous­ing assis­tance. Oth­er fed­er­al safe­ty-net pro­grams should be trans­ferred to the states, as has been pro­posed by Speak­er Ryan and Sen. Mar­co Rubio (R‑Fla.), and Con­gress should clar­i­fy that states are allowed to imple­ment work require­ments for adults on Med­ic­aid.

These work require­ments should ensure that every­one who is capa­ble of per­form­ing a job in the gig econ­o­my does so. To do that, the next pres­i­dent should direct the rel­e­vant agen­cies, or Con­gress, to rede­fine what it means to be unable “to engage insub­stan­tial gain­ful activ­i­ty”— the stan­dard required to deter­mine who is exempt from work require­ments — in light of the rise of the gig econ­o­my. Many peo­ple who qual­i­fy under the cur­rent def­i­n­i­tion of dis­abled may be fan­tas­tic can­di­dates for more flex­i­ble gig econ­o­my jobs.

Work require­ments, how­ev­er, should not unfair­ly pun­ish peo­ple who are phys­i­cal­ly or men­tal­ly unable to com­plete gig econ­o­my jobs. The gig econ­o­my can often pro­vide flex­i­ble work for those pre­vi­ous­ly con­sid­ered unable to work, but exemp­tions would still be avail­able as need­ed. For every­one else, safe­ty-net ben­e­fits should be con­di­tion­al upon the recip­i­ents pro­vid­ing proof that they are tak­ing gig econ­o­my jobs or mean­ing­ful­ly attempt­ing to engage in the gig econ­o­my (such as by list­ing avail­able ser­vices but not receiv­ing con­tract work).

We also rec­og­nize that not every­one is well-versed in the gig econ­o­my — if Con­gress bare­ly under­stands tech­nol­o­gy, we don’t assume that safe­ty-net ben­e­fi­cia­ries are any more adept. There­fore, gov­ern­ment offices admin­is­ter­ing safe­ty-net ben­e­fits should devel­op exper­tise through a pub­lic-pri­vate part­ner­ship to help indi­vid­u­als find and under­take jobs in the gig econ­o­my, including,for instance, keep­ing an updat­ed direc­to­ry of avail­able gig econ­o­my jobs in the area and pro­vid­ing infor­ma­tion on how low­er-skilled work­ers can become high­er-skilled work­ers in the gig econ­o­my. This direc­to­ry should be avail­able online and gov­ern­ment offices should help ben­e­fi­cia­ries nav­i­gate the gig econ­o­my, just as they already do in find­ing con­ven­tion­al 9‑to‑5 jobs.

In addi­tion, many gig econ­o­my jobs, espe­cial­ly remote jobs, require a com­put­er — some­thing many unem­ployed Amer­i­cans may not be able to access. In such cas­es, safe­ty-net ser­vices should facil­i­tate access to com­put­er ter­mi­nals or help uti­lize avail­able resources such as lap­tops at a local library. A por­tion of unem­ploy­ment com­pen­sa­tion funds should also be grant­ed to ben­e­fi­cia­ries as a vouch­er that they can use to pur­chase items nec­es­sary for gig econ­o­my jobs — lap­tops and cell­phones, for exam­ple.

Last­ly, we are mind­ful that while many of the jobs in the gig econ­o­my pay well — such as Lyft and Uber dri­vers — oth­er posi­tions may not nec­es­sar­i­ly pro­vide enough. In such cas­es, qual­i­fied indi­vid­u­als should still receive safe­ty-net ben­e­fits, struc­tured in away to incen­tivize work. To that end, the fed­er­al gov­ern­ment should also expand the Earned Income Tax Cred­it to include low-income sin­gle work­ers.

Polls show that 83 per­cent of Amer­i­cans favor work require­ments for wel­fare. But just as the gig econ­o­my has made work­fare sig­nif­i­cant­ly eas­i­er to imple­ment, thanks to an abun­dance of read­i­ly avail­able jobs, Wash­ing­ton has under­mined work require­ments through­out the safe­ty net. Now, the gov­ern­ment has the per­fect oppor­tu­ni­ty to reori­ent our safe­ty net around work. As long as Uber and Lyft will hire any­one who can pass a back­ground check, we can’t just give away a free check to any­one who choos­es not to work.

...

Derek Khan­na (@DerekKhanna) is a for­mer con­gres­sion­al staffer and IP lit­i­ga­tion lawyer in Sil­i­con Val­ley who spear­head­ed a cam­paign that enact­ed the last tech­nol­o­gy bill into law (P.L. 113–144), and Cesar Con­da (@CesarConda) is a for­mer Sen­ate chief of staff and White House pol­i­cy advis­er, found­ing prin­ci­pal and pol­i­cy advis­er of Nav­i­ga­tors Glob­al.

Update: My friend Mor­gan Warstler, CEO of Gov­Whiz, emailed to point out he’d pro­posed an idea called “Guar­an­teed Income & Choose Your Boss — Uber for Wel­fare” in 2014. The plan, described on his blog, sug­gests the gov­ern­ment pro­vide an appli­ca­tion to search for “sub­si­dized” labor-pools of indi­vid­u­als cur­rent­ly receiv­ing gov­ern­ment ben­e­fits; it’s anoth­er inter­est­ing approach to safe­ty net reform where using tech­nol­o­gy to put unem­ployed peo­ple to work is the larg­er prin­ci­ple they have in com­mon.

———-

“Uber for wel­fare” by CESAR CONDA and DEREK KHANNA; Politi­co; 01/27/2016

“The gov­ern­ment should expect that able-bod­ied safe­ty net ben­e­fi­cia­ries be will­ing to engage in the gig econ­o­my before col­lect­ing ben­e­fits. But tran­si­tion­ing to such a sys­tem requires pol­i­cy­mak­ers to rethink the entire safe­ty net, affect­ing near­ly every fed­er­al enti­tle­ment pro­gram, so that it is ori­ent­ed around the gig econ­o­my. That’s no easy task, but there are some impor­tant deci­sions that law­mak­ers can make to move in that direc­tion.”

Rethink­ing the entire safe­ty-net and ori­ent­ing every pro­gram around gig work require­ments. That’s the vision of these Repub­li­can oper­a­tives. Because of course it is, they’re Repub­li­can oper­a­tives.

And they are very explic­it that this vision includes vir­tu­al­ly all fed­er­al safe­ty-net pro­grams, includ­ing Social Secu­ri­ty dis­abil­i­ty ben­e­fits:

...
Since then, Washington’s com­mit­ment to work­fare has been dwin­dling. While the 1996 law required work par­tic­i­pa­tion to receive wel­fare and food stamps, in 2012, the Oba­ma admin­is­tra­tion announced it would issue waivers exempt­ing state gov­ern­ments from those work require­ments. And as part of the stim­u­lus in 2009, states were giv­en new abil­i­ties to waive work require­ments for food stamps.

Oth­er parts of the safe­ty net con­tain no work require­ments at all, includ­ing Social Secu­ri­ty dis­abil­i­ty ben­e­fits, a $140 bil­lion fed­er­al enti­tle­ment (SSDI is a pro­gram for those who are con­sid­ered dis­abled such that they are unable to work); the Sec­tion 8 Hous­ing Choice Vouch­er Pro­gram; Med­ic­aid, which some lawyers believe can­not have work require­ments because the Med­ic­aid Act requires states to pro­vide assis­tance to all indi­vid­u­als who qual­i­fy under fed­er­al law; and unem­ploy­ment ben­e­fits, which are designed for those unable to find work.
...

And they are very explic­it that this vision includes a rede­f­i­n­i­tion of what it means to be unable “to engage insub­stan­tial gain­ful activ­i­ty” due to a dis­abil­i­ty. Can you think of a ran­dom task you might hire a very dis­abled per­son to do for a few cents? Guess what, you will have effec­tive­ly low­ered the bar under Con­da and Khan­na’s vision for what it legal­ly means to be too dis­abled to work in the US:

...
These work require­ments should ensure that every­one who is capa­ble of per­form­ing a job in the gig econ­o­my does so. To do that, the next pres­i­dent should direct the rel­e­vant agen­cies, or Con­gress, to rede­fine what it means to be unable “to engage insub­stan­tial gain­ful activ­i­ty”— the stan­dard required to deter­mine who is exempt from work require­ments — in light of the rise of the gig econ­o­my. Many peo­ple who qual­i­fy under the cur­rent def­i­n­i­tion of dis­abled may be fan­tas­tic can­di­dates for more flex­i­ble gig econ­o­my jobs.

Work require­ments, how­ev­er, should not unfair­ly pun­ish peo­ple who are phys­i­cal­ly or men­tal­ly unable to com­plete gig econ­o­my jobs. The gig econ­o­my can often pro­vide flex­i­ble work for those pre­vi­ous­ly con­sid­ered unable to work, but exemp­tions would still be avail­able as need­ed. For every­one else, safe­ty-net ben­e­fits should be con­di­tion­al upon the recip­i­ents pro­vid­ing proof that they are tak­ing gig econ­o­my jobs or mean­ing­ful­ly attempt­ing to engage in the gig econ­o­my (such as by list­ing avail­able ser­vices but not receiv­ing con­tract work).
...

And they are very explic­it that this vision includes no tem­po­rary work require­ment waivers even dur­ing reces­sion, thus encour­ag­ing employ­ers to lay off their work­ers dur­ing reces­sion and rehire them as gig work­ers on wel­fare for a tiny frac­tion of the cost:

...
The gov­ern­ment should expect that able-bod­ied safe­ty net ben­e­fi­cia­ries be will­ing to engage in the gig econ­o­my before col­lect­ing ben­e­fits. But tran­si­tion­ing to such a sys­tem requires pol­i­cy­mak­ers to rethink the entire safe­ty net, affect­ing near­ly every fed­er­al enti­tle­ment pro­gram, so that it is ori­ent­ed around the gig econ­o­my. That’s no easy task, but there are some impor­tant deci­sions that law­mak­ers can make to move in that direc­tion.

First, Con­gress must take the les­son from the 1996 round of wel­fare reform and apply work require­ments to the rest of the safe­ty net. To do so, it should strength­en the Tem­po­rary Assis­tance for Needy Fam­i­lies pro­gram — com­mon­ly known as wel­fare— to clear­ly pro­hib­it any pres­i­dent from essen­tial­ly waiv­ing its work require­ments. Law­mak­ers also should restore work require­ments for food stamps and impose them for fed­er­al hous­ing assis­tance. Oth­er fed­er­al safe­ty-net pro­grams should be trans­ferred to the states, as has been pro­posed by Speak­er Ryan and Sen. Mar­co Rubio (R‑Fla.), and Con­gress should clar­i­fy that states are allowed to imple­ment work require­ments for adults on Med­ic­aid.
...

Col­laps­ing wages aren’t exact­ly great for reces­sions but it’s not like the GOP actu­al­ly cares about a healthy econ­o­my. It’s a par­ty run by and for bil­lion­aires look­ing for grow their grotesque­ly inflat­ed bank account. And unfor­tu­nate­ly these bil­lion­aires have deter­mined that cre­at­ing as much eco­nom­ic inse­cu­ri­ty for as many peo­ple as pos­si­ble is the best way to accom­plish that. Which is why is so dis­turb­ing to see that Con­da and Khan­na are call­ing for pret­ty much any skill to be offered under the gig econ­o­my, thus ensur­ing that almost all employ­ers dur­ing reces­sions will have large and grow­ing pool of unem­ployed gig work­ers to hire. It’s pol­i­cy seem­ing­ly designed to trig­ger a mas­sive Depres­sion that will turn almost every­one into cheap gig employ­ees:

...
What do these jobs look like? For those will­ing and able to dri­ve, Uber and Lyft enlist any­one to be a dri­ver — assum­ing they pass a back­ground check — and offers spe­cial financ­ing or rental dis­counts for vehi­cles. Cur­rent­ly, the aver­age Uber dri­ver makes about $19 an hour, and in cities like Los Ange­les and New York, their earn­ings are even high­er.

For those who don’t dri­ve, the options are near­ly end­less. They could deliv­er goods and gro­ceries for Post­mates and Instacart, assem­ble fur­ni­ture on TaskRab­bit or mow lawns and plow dri­ve­ways with PLOWZ & MOWZ. Or if they have the know-how they could offer pho­to shoots, voice lessons, mur­al paint­ing, ten­nis lessons, or paint­ing a house on Thumb­tack. Amazon’s Mechan­i­cal­Turk, Fiv­er and oth­er com­pa­nies pay for gen­er­al tasks that can usu­al­ly be done on a com­put­er or phone any­where across the coun­try. Those with par­tic­u­lar skill-sets have oth­er plat­forms avail­able: Coders can do free­lance work on Elance, Upwork, and Scal­able Path, house clean­ers can list them­selves on Handy, graph­ics design­ers can sub­mit bids and graph­ics on 99 Designs, and lawyers can draft legal con­tracts on UpCoun­sel. Peo­ple with gen­er­al inter­per­son­al skills could be a vir­tu­al per­son­al assis­tant on Zirtual.com. There’s an eas­i­ly avail­able job for just about every­one in the gig econ­o­my.
...

And to high­light the fact that this isn’t just about chang­ing wel­fare in Amer­i­ca but also chang­ing employ­ment in Amer­i­ca, Con­da and Khan­na call for gov­ern­ment pro­grams to ensure that those who can’t find gig work for some rea­son, like not hav­ing a car or com­put­er, get access to one. They also call for the gov­ern­ment to pro­vide infor­ma­tion to and pro­vid­ing infor­ma­tion on how low­er-skilled work­ers can become high­er-skilled work­ers in the gig econ­o­my. Not get out of the gig econ­o­my. They can remain in the gig econ­o­my but just pro­vide more skill­ful ser­vices to employ­ers. Because that’s their vision for Amer­i­ca: a gig work­force:

...
We also rec­og­nize that not every­one is well-versed in the gig econ­o­my — if Con­gress bare­ly under­stands tech­nol­o­gy, we don’t assume that safe­ty-net ben­e­fi­cia­ries are any more adept. There­fore, gov­ern­ment offices admin­is­ter­ing safe­ty-net ben­e­fits should devel­op exper­tise through a pub­lic-pri­vate part­ner­ship to help indi­vid­u­als find and under­take jobs in the gig econ­o­my, including,for instance, keep­ing an updat­ed direc­to­ry of avail­able gig econ­o­my jobs in the area and pro­vid­ing infor­ma­tion on how low­er-skilled work­ers can become high­er-skilled work­ers in the gig econ­o­my. This direc­to­ry should be avail­able online and gov­ern­ment offices should help ben­e­fi­cia­ries nav­i­gate the gig econ­o­my, just as they already do in find­ing con­ven­tion­al 9‑to‑5 jobs.

In addi­tion, many gig econ­o­my jobs, espe­cial­ly remote jobs, require a com­put­er — some­thing many unem­ployed Amer­i­cans may not be able to access. In such cas­es, safe­ty-net ser­vices should facil­i­tate access to com­put­er ter­mi­nals or help uti­lize avail­able resources such as lap­tops at a local library. A por­tion of unem­ploy­ment com­pen­sa­tion funds should also be grant­ed to ben­e­fi­cia­ries as a vouch­er that they can use to pur­chase items nec­es­sary for gig econ­o­my jobs — lap­tops and cell­phones, for exam­ple.
...

And to under­score how they are talk­ing about trans­form­ing the Amer­i­can work­force, and not just safe­ty-net pro­grams, Con­da and Khan­na sug­gest at the end that because some gig jobs may not pay enough for peo­ple to get buy, qual­i­fied gig employ­ees should still receive some sort of gov­ern­ment assis­tance. The implic­it idea being that they are propos­ing basi­cal­ly replac­ing the safe­ty-net with gig employ­ment, and to have a shriv­eled safe­ty-net left over for the poor­est of the poor gig econ­o­my work­ers. It’s meant to be a gig ‘work’ replace­ment for both the safe­ty-net and employ­ment in gen­er­al in Amer­i­ca:

...
Last­ly, we are mind­ful that while many of the jobs in the gig econ­o­my pay well — such as Lyft and Uber dri­vers — oth­er posi­tions may not nec­es­sar­i­ly pro­vide enough. In such cas­es, qual­i­fied indi­vid­u­als should still receive safe­ty-net ben­e­fits, struc­tured in away to incen­tivize work. To that end, the fed­er­al gov­ern­ment should also expand the Earned Income Tax Cred­it to include low-income sin­gle work­ers.
...

Now, this is just two con­ser­v­a­tive oper­a­tives, albeit notable ones (Mar­co Rubio’s for­mer chief-of-staff and the Rom­ney cam­paign pol­i­cy guru). But is there any­thing they wrote that does­n’t sound exact­ly like what the GOP as a whole would love to imple­ment? A pro­pos­al to shred the safe­ty-net by turn­ing the poor into vast poor of below-min­i­mum wage gig work­ers with no secu­ri­ty at all and using this to drag down wages across almost all sec­tors of the econ­o­my. Isn’t that the most GOP-ish wel­fare pro­pos­al you’ve ever heard? The main at this point is how could this not be what the GOP as a whole is plan­ning?

So should you find your­self on Med­ic­aid and in need of trans­porta­tion to the doc­tor, keep in mind that the per­son who picks you up as part of your Uber Health ride will prob­a­bly be on Med­ic­aid too. Along with being a part-time Wal­mart work­er. And what­ev­er oth­er job they’re expect­ed to do as part of the future gig Amer­i­ca. A coun­try where the only skill that won’t be gigged is the skill of being too wealthy to need to work.

And it begins: the era of work require­ments for Med­ic­aid recip­i­ents offi­cial began with Arkansas’s new work require­ment scheme com­ing into effect on June 1. And true to the spir­it of this work require­ment dri­ve, the pro­gram looks to be a human dis­as­ter designed to do lit­tle more than find excus­es to deny peo­ple med­ical care.

The spe­cif­ic rules are that peo­ple need to report at least 80 hours a month work­ing, search­ing for a job, or doing some oth­er approved activ­i­ty. If they don’t report meet­ing that require­ment three times in a year they lose cov­er­age and can’t reap­ply until the next year. Right now it’s just peo­ple aged 30–49 who fall under the work require­ment, but start­ing next year it will be every­one 19–49. Waivers include being a stu­dent, liv­ing with depen­dent chil­dren, or earn­ing at least $736/month (the equiv­a­lent of $8.50 an hour at 20 hours a week). So, for instance, if you had a job that paid you $736/hour and worked one hour a month you would qual­i­fy for a waiv­er. The work require­ment only applies to the poor­est of the poor.

The Human Ser­vices Depart­ment esti­mate a 20 per­cent drop in Med­ic­aid enrollees as a result of these new rules in the first year, giv­ing a cost sav­ings of $49 mil­lion. Notably, all but $3.4 mil­lion of that pro­ject­ed sav­ings goes to the fed­er­al gov­ern­ment accord­ing to one esti­mate. A more recent esti­mate, put the poten­tial sav­ings at $33.9 mil­lion, with only $2.3 mil­lion going to the state. So Arkansas’s GOP is basi­cal­ly kick­ing its own cit­i­zens off of Med­ic­aid to save the fed­er­al gov­ern­ment mon­ey.

But there’s anoth­er big prob­lem with this new plan. A large num­ber of Med­ic­aid enrollees don’t even know about it or under­stand it. And the state has only allo­cat­ed $800k to help inform peo­ple about this, lead­ing experts to pre­sume that a num­ber of peo­ple who do actu­al­ly qual­i­fy for a waiv­er will still get kicked off of Med­ic­aid due to not noti­fy­ing the state that they qual­i­fy. So it sounds like Arkansas is about to expe­ri­ence a cru­el self-inflict­ed med­ical cri­sis in about three months:

Arkansas Online

Arkansas’ Med­ic­aid-work rules start today

Ini­tial­ly, man­date to affect 27,000 enrollees ages 30–49

By Andy Davis
This arti­cle was orig­i­nal­ly pub­lished June 1, 2018 at 4:30 a.m. Updat­ed June 1, 2018 at 1:28 p.m.

Start­ing today, some peo­ple cov­ered by Arkansas’ expand­ed Med­ic­aid pro­gram will have to spend 80 hours a month on work or oth­er approved activ­i­ties if they want to keep their cov­er­age.

The require­ment went into effect for an ini­tial 27,000 enrollees between the ages of 30 and 49, state Depart­ment of Human Ser­vices spokesman Mar­ci Man­ley said in an email.

Of those, 16,000 qual­i­fied for auto­mat­ic exemp­tions based on infor­ma­tion in state records. Those auto­mat­i­cal­ly exempt­ed, for instance, include enrollees liv­ing with depen­dent chil­dren or who earn at least $736 a month. That cut­off is based on the aver­age month­ly income of some­one mak­ing the state’s min­i­mum wage of $8.50 an hour and work­ing 20 hours a week.

The remain­ing 11,000 enrollees will have to use a state web­site, http://www.access.arkansas.gov, to report whether they qual­i­fied for exemp­tions or spent the required amount of time on work or oth­er activ­i­ties.

About 4,000 of them have cre­at­ed accounts on the web­site allow­ing them to make the reports, Man­ley said.

Those who fail to meet the require­ment for three months dur­ing a year will lose their Med­ic­aid cov­er­age for the rest of the year.

The work require­ment will be phased in for oth­er enrollees ages 30–49 from July through Sep­tem­ber and next year for those ages 19–29.

When it is ful­ly imple­ment­ed, a total of about 167,000 enrollees in the expand­ed Med­ic­aid pro­gram, known as Arkansas Works, are expect­ed to be sub­ject to the work require­ment, which applies only to enrollees with incomes up to the pover­ty lev­el.

That amounts to about 98,000 enrollees ages 30–49 and 69,000 ages 19–29.

About 281,000 peo­ple were cov­ered by Arkansas Works as of April 1.

Despite notices and phone calls that have gone out to enrollees, not every­one has got­ten the mes­sage, said Mar­qui­ta Lit­tle, health pol­i­cy direc­tor at Arkansas Advo­cates for Chil­dren and Fam­i­lies.

“The biggest issue right now that we’re see­ing and hear­ing about is that peo­ple on the Arkansas Works pro­gram are not famil­iar with this new pol­i­cy and do not know about the work require­ment,” she said.

In March, Arkansas became the third state to receive fed­er­al approval to impose a work require­ment for its Med­ic­aid pro­gram. Today, it becomes the first state to imple­ment one.

Ken­tucky, the first state to be approved, will begin phas­ing in its work require­ment on July 1. Indi­ana’s require­ment will take effect next year.

New Hamp­shire received approval last month for its work require­ment, which will also start in 2019.

Arkansas Gov. Asa Hutchin­son has said the work require­ment will encour­age unem­ployed enrollees to find jobs and that the num­ber who lose cov­er­age will be “min­i­mal.”

In a let­ter approv­ing the require­ment, fed­er­al Cen­ters for Medicare and Med­ic­aid Ser­vices Admin­is­tra­tor Seema Ver­ma said it “is designed to encour­age ben­e­fi­cia­ries to obtain and main­tain employ­ment or under­take com­mu­ni­ty engage­ment activ­i­ties that research has shown to be cor­re­lat­ed with improved health and well­ness.”

The work require­ment goes into effect today. The Human Ser­vices Depart­ment has esti­mat­ed that if the work require­ment went into effect July 1 — the start of fis­cal 2019 — it would reduce the cost of the pro­gram that fis­cal year by about $49 mil­lion, and cause about 20 per­cent of enrollees who are sub­ject to it to lose cov­er­age dur­ing the year. All but $3.4 mil­lion of the pro­ject­ed sav­ings would go to the fed­er­al gov­ern­ment,

A more recent esti­mate, based on the require­ment start­ing today, put the poten­tial sav­ings at $33.9 mil­lion, with about $2.3 mil­lion going to the state.

Man­ley declined to answer ques­tions about the sav­ings esti­mates.

Set­ting up the web­site and oth­er tech­nol­o­gy cost about $6.8 mil­lion, with all but $678,627 com­ing from the fed­er­al gov­ern­ment, accord­ing to the Human Ser­vices Depart­ment.

The state is also spend­ing about $800,000 on out­reach to enrollees through the end of this month under a con­tract with the Arkansas Foun­da­tion for Med­ical Care, which oper­ates a call cen­ter and has been call­ing enrollees to tell them about the require­ment. The fed­er­al gov­ern­ment is pick­ing up half of that cost, accord­ing to the depart­ment.

The three insur­ance com­pa­nies that offer Arkansas Works plans have said they will have employ­ees who are trained to log onto the state web­site and fill out reports on behalf of enrollees.

...

Bo Ryall, chief exec­u­tive of the Arkansas Hos­pi­tal Asso­ci­a­tion, said he also expects hos­pi­tals to have work­ers who are trained to log onto the state web­site on behalf of enrollees.

Still, he said, hos­pi­tal offi­cials are wor­ried about the num­ber of enrollees who will lose cov­er­age and the result­ing impact on the amount of unre­im­bursed care that hos­pi­tals must pro­vide.

“For sure, we’re going to lose some peo­ple who don’t ful­fill the oblig­a­tions of the work require­ment pro­gram,” he said.

Lit­tle said she’s afraid that many peo­ple who qual­i­fy for exemp­tions don’t real­ize they must go to the web­site to report them.

For instance, enrollees who are full-time stu­dents qual­i­fy for exemp­tions, but must report on their sta­tus every six months.

“I think there will be a lot of peo­ple who prob­a­bly meet an exemp­tion but don’t meet the report­ing require­ment,” Lit­tle said. “We know it’s a small pop­u­la­tion of peo­ple who don’t qual­i­fy for an exemp­tion and are also not cur­rent­ly work­ing.”

———–

“Arkansas’ Med­ic­aid-work rules start today” by Andy Davis; Arkansas Online; 06/01/2018

“Start­ing today, some peo­ple cov­ered by Arkansas’ expand­ed Med­ic­aid pro­gram will have to spend 80 hours a month on work or oth­er approved activ­i­ties if they want to keep their cov­er­age.”

The clock is tick­ing for peo­ple on Med­ic­aid in Arkansas. At least for those in the ini­tial set of 27,000 peo­ple who fall under these require­ments. And note that those who do qual­i­fy for a waiv­er might not be auto­mat­i­cal­ly waivered accord­ing to state records and will still have to go to a new state web­site and fill out a form indi­cat­ing why they qual­i­fy for a waiv­er. So out of that ini­tial batch of 27,000 peo­ple, 16,000 qual­i­fied for auto­mat­ic waivers. But of the remain­ing 11,000 who need to got to the new web­site only 4,000 of them have actu­al­ly cre­at­ed account yet. If that’s a sign of what we can expect going for­ward there’s going to be a lot of peo­ple get­ting kicked off Med­ic­aid in Arkansas soon:

...
The require­ment went into effect for an ini­tial 27,000 enrollees between the ages of 30 and 49, state Depart­ment of Human Ser­vices spokesman Mar­ci Man­ley said in an email.

Of those, 16,000 qual­i­fied for auto­mat­ic exemp­tions based on infor­ma­tion in state records. Those auto­mat­i­cal­ly exempt­ed, for instance, include enrollees liv­ing with depen­dent chil­dren or who earn at least $736 a month. That cut­off is based on the aver­age month­ly income of some­one mak­ing the state’s min­i­mum wage of $8.50 an hour and work­ing 20 hours a week.

The remain­ing 11,000 enrollees will have to use a state web­site, http://www.access.arkansas.gov, to report whether they qual­i­fied for exemp­tions or spent the required amount of time on work or oth­er activ­i­ties.

About 4,000 of them have cre­at­ed accounts on the web­site allow­ing them to make the reports, Man­ley said.

Those who fail to meet the require­ment for three months dur­ing a year will lose their Med­ic­aid cov­er­age for the rest of the year.
...

And this ini­tial batch of 27,000 peo­ple is set to rapid­ly grow. More peo­ple ages 30–49 are get­ting phased in in com­ing months and it gets expand­ed to include 19–29 year olds next year, bring­ing the total num­ber of peo­ple to 167,000 who will be fac­ing this work require­ment in a year:

...
The work require­ment will be phased in for oth­er enrollees ages 30–49 from July through Sep­tem­ber and next year for those ages 19–29.

When it is ful­ly imple­ment­ed, a total of about 167,000 enrollees in the expand­ed Med­ic­aid pro­gram, known as Arkansas Works, are expect­ed to be sub­ject to the work require­ment, which applies only to enrollees with incomes up to the pover­ty lev­el.

That amounts to about 98,000 enrollees ages 30–49 and 69,000 ages 19–29.

About 281,000 peo­ple were cov­ered by Arkansas Works as of April 1.
...

Of that 167,000 peo­ple sub­ject to the new require­ments, the Human Ser­vices Depart­ment expects 20 per­cent of them to lose their cov­er­age dur­ing the year. And while that will obvi­ous­ly end up sav­ing some mon­ey (if you ignore the high­er emer­gency room costs and oth­er indi­rect costs of not pro­vid­ing health cov­er­age), almost all of the mon­ey is being saved at the fed­er­al lev­el. So Arkansas’s GOP real­ly is doing this pri­mar­i­ly out of a desire to kick peo­ple off of Med­ic­aid. That’s it:

...
The work require­ment goes into effect today. The Human Ser­vices Depart­ment has esti­mat­ed that if the work require­ment went into effect July 1 — the start of fis­cal 2019 — it would reduce the cost of the pro­gram that fis­cal year by about $49 mil­lion, and cause about 20 per­cent of enrollees who are sub­ject to it to lose cov­er­age dur­ing the year. All but $3.4 mil­lion of the pro­ject­ed sav­ings would go to the fed­er­al gov­ern­ment,

A more recent esti­mate, based on the require­ment start­ing today, put the poten­tial sav­ings at $33.9 mil­lion, with about $2.3 mil­lion going to the state.

Man­ley declined to answer ques­tions about the sav­ings esti­mates.

Set­ting up the web­site and oth­er tech­nol­o­gy cost about $6.8 mil­lion, with all but $678,627 com­ing from the fed­er­al gov­ern­ment, accord­ing to the Human Ser­vices Depart­ment.
...

And it’s not like the peo­ple who are going to get kicked off are all peo­ple who did­n’t meet the require­ments or qual­i­fy for a waiv­er. The state is spend­ing so lit­tle on inform­ing peo­ple of this new pro­gram that the biggest issue they’re fac­ing is that peo­ple sim­ply do not know about the new require­ments, mean­ing peo­ple who qual­i­fy could still get kicked of sim­ply by not sign­ing into the web­site and fill­ing out the form because they don’t know they have to:

...
Despite notices and phone calls that have gone out to enrollees, not every­one has got­ten the mes­sage, said Mar­qui­ta Lit­tle, health pol­i­cy direc­tor at Arkansas Advo­cates for Chil­dren and Fam­i­lies.

“The biggest issue right now that we’re see­ing and hear­ing about is that peo­ple on the Arkansas Works pro­gram are not famil­iar with this new pol­i­cy and do not know about the work require­ment,” she said.

...

The state is also spend­ing about $800,000 on out­reach to enrollees through the end of this month under a con­tract with the Arkansas Foun­da­tion for Med­ical Care, which oper­ates a call cen­ter and has been call­ing enrollees to tell them about the require­ment. The fed­er­al gov­ern­ment is pick­ing up half of that cost, accord­ing to the depart­ment.

The three insur­ance com­pa­nies that offer Arkansas Works plans have said they will have employ­ees who are trained to log onto the state web­site and fill out reports on behalf of enrollees.
...

Bo Ryall, chief exec­u­tive of the Arkansas Hos­pi­tal Asso­ci­a­tion, said he also expects hos­pi­tals to have work­ers who are trained to log onto the state web­site on behalf of enrollees.

Still, he said, hos­pi­tal offi­cials are wor­ried about the num­ber of enrollees who will lose cov­er­age and the result­ing impact on the amount of unre­im­bursed care that hos­pi­tals must pro­vide.

“For sure, we’re going to lose some peo­ple who don’t ful­fill the oblig­a­tions of the work require­ment pro­gram,” he said.

Lit­tle said she’s afraid that many peo­ple who qual­i­fy for exemp­tions don’t real­ize they must go to the web­site to report them.

For instance, enrollees who are full-time stu­dents qual­i­fy for exemp­tions, but must report on their sta­tus every six months.

“I think there will be a lot of peo­ple who prob­a­bly meet an exemp­tion but don’t meet the report­ing require­ment,” Lit­tle said. “We know it’s a small pop­u­la­tion of peo­ple who don’t qual­i­fy for an exemp­tion and are also not cur­rent­ly work­ing.”

A culling of poor is clear­ly on the agen­da for Arkansas. And it’s just the first state where this is going to hap­pen.

So giv­en the strict report­ing require­ments Arkansas set up and the fact that the state web­site is the only for enrollees to report, what’s the state’s response to crit­i­cism that it’s the state with the sec­ond low­est rates of home inter­net access in the US? Well, the state has a response: forc­ing every­one to have inter­net access in order to keep their Med­ic­aid will help peo­ple devel­op their com­put­ers skills. That was seri­ous­ly their answer:

Talk­ing Points Memo
DC

Arkansas Pulls The Trig­ger On Nation’s First-Ever Med­ic­aid Work Require­ment

By Alice Oll­stein | June 5, 2018 6:00 am

This week, Arkansas becomes the first state in the nation, and in the nation’s his­to­ry, to require its non-dis­abled adult Med­ic­aid expan­sion pop­u­la­tion to work or vol­un­teer 80 hours a month to main­tain their health care ben­e­fits.

Start­ing Tues­day, Arkansans on Med­ic­aid have to prove that they’ve worked 80 hours over the pre­vi­ous month or that they qual­i­fy for an exemp­tion. If they fail to do so, they’ll be boot­ed from the rolls after three months. Health care advo­cates in the state say they expect thou­sands of low-income peo­ple to lose cov­er­age — both those who can’t find work and those who can’t nav­i­gate the state’s online-only sys­tem for doc­u­ment­ing their hours. Health groups are also sound­ing the alarm about the pal­try fund­ing Arkansas has reserved for imple­ment­ing the pro­gram — a tiny frac­tion of what oth­er states are spend­ing to put Med­ic­aid work require­ments in place.

Arkansas’ Med­ic­aid work require­ments rule is the third approved by the Trump admin­is­tra­tion but the first to go into effect, and it has the harsh­est penal­ty for non-com­pli­ance out of any state so far. It’s akin to a three-strikes-and-you’re-out pol­i­cy, in which enrollees who fail to doc­u­ment their 80 hours per month of work three times dur­ing the year will lose cov­er­age and can’t apply again until the fol­low­ing year.

Arkansas also attempt­ed through the waiv­er to par­tial­ly roll back its Med­ic­aid expan­sion, cut­ting about 60,000 peo­ple from the rolls whose incomes were slight­ly over the fed­er­al pover­ty line. The Trump admin­is­tra­tion did not grant that piece of the pro­pos­al.

For the rest of 2018, enrollees under 30 years old will be exempt from the work require­ment, but that will end in 2019, and all enrollees between ages 18 and 50 will be sub­ject to the require­ment.

Access Denied

One wide­ly crit­i­cized aspect of Arkansas’ new rules is that every­one enrolled in Med­ic­aid has to doc­u­ment their work hours through an online por­tal cre­at­ed by the state — with no option to sub­mit infor­ma­tion in per­son, over the by phone, or by mail.

Accord­ing to the Cen­sus Bureau, Arkansas has the sec­ond-low­est rate of home inter­net access in the nation, only slight­ly above Mis­sis­sip­pi.

“It’s a very big con­cern,” Greg Led­ing, a Demo­c­ra­t­ic state rep­re­sen­ta­tive in the Fayet­teville area, told TPM. “It’s nat­ur­al and a good idea to do as many things as we can online, in terms of gov­ern­ment effi­cien­cy and because that’s where we’re head­ed in the world. But very large swaths of the state in rur­al areas don’t have access, so are peo­ple going to be able to do what they need to do to get online and keep their Med­ic­aid ben­e­fits?”

Pressed on this con­cern by local reporters, the direc­tor of the state’s Depart­ment of Health Ser­vices Cindy Gille­spie said that by requir­ing low-income Arkansas to sub­mit their infor­ma­tion online, the state is in fact help­ing them improve their tech­no­log­i­cal skills.

“Hav­ing that lit­tle bit of com­put­er or phone lit­er­a­cy is impor­tant if you are going to be able to be mov­ing up the income lad­der,” she said. “I mean, a 19- to 29-year-old who in this day and age can’t do that and is able-bod­ied? You know, they need — we need to help them learn to do that. We need to help them get an email and learn how to deal in that world, or they will nev­er be suc­cess­ful.”

She added that the web-only plat­form was cheap­er and more con­ve­nient for the state, say­ing: “If you imple­ment it in the old-fash­ioned way of ‘Come into our coun­ty office,’ we would have to hire so many peo­ple — and that just doesn’t make sense.”

A study by the Urban Insti­tute and the Robert Wood John­son Foun­da­tion released in May esti­mates that by next year as many as 39,000 peo­ple could lose Med­ic­aid cov­er­age under Arkansas’ new rules — 15 per­cent of all enrollees. More than 30 per­cent of that group, the study found, do not have inter­net access, and at least 8 per­cent have no access to a vehi­cle, mak­ing it dif­fi­cult to both find work and sub­mit infor­ma­tion online to the state. Many of those like­ly to be affect­ed also have less than a high school edu­ca­tion or a seri­ous health lim­i­ta­tion that doesn’t qual­i­fy as a dis­abil­i­ty.

Crit­ics of the new rules also say state res­i­dents who depend on sea­son­al work could be harmed by the strict month­ly require­ment of 80 hours, which doesn’t take into account fluc­tu­a­tions through­out the year.

“Agri­cul­ture is our largest state indus­try and there’s a lot of sea­son­al­i­ty there,” Led­ing said. “And in places where it’s more urban, retail work picks up around the hol­i­days and tapers off in oth­er months. Some­body might be a mod­el employ­ee, but if their job goes away, they’ve lost their health care.”

Advo­ca­cy groups are also con­cerned that the state has bud­get­ed just over $1 mil­lion in new fund­ing to imple­ment the work require­ment, mon­ey that will be used to send notices to hun­dreds of thou­sands of peo­ple in the state and help them nav­i­gate the new rules. In com­par­i­son, near­by Ken­tucky is spend­ing near­ly $190 mil­lion to imple­ment its Med­ic­aid work require­ment.

Led­ing told TPM that the pen­ny-pinch­ing is a result of the Repub­li­can majority’s zeal for slash­ing the state bud­get over the past sev­er­al years.

“We’re in a polit­i­cal cli­mate where we’ve already cut tax­es by tens of mil­lions of dol­lars and they want to pass anoth­er tax cut next year,” he said. “Any­time that’s on the hori­zon, they’re look­ing to spend less any­where else they can.”

South­ern suc­cess sto­ry

Under for­mer, Demo­c­ra­t­ic Gov. Mike Beebe, Arkansas was one of very few states in the South to embrace Med­ic­aid expan­sion under the Afford­able Care Act, extend­ing sub­si­dized cov­er­age to 280,000 addi­tion­al peo­ple begin­ning in 2013.

Since then, the state’s unin­sured rate has been cut in half.. Emer­gency room vis­its decreased by more than 35 per­cent, and the num­ber of unin­sured peo­ple admit­ted to hos­pi­tals dropped by more than 45 per­cent, sav­ing hos­pi­tals in the state more than $69.2 mil­lion.

“Med­ic­aid expan­sion in Arkansas has been an unqual­i­fied suc­cess,” Led­ing said. “Look at how many peo­ple were able to gain access to health care. Look at how we’ve dras­ti­cal­ly reduce our unin­sured rate.”

But the once solid­ly-blue state swung far to the right under the Oba­ma admin­is­tra­tion, with Repub­li­cans gain­ing seats in both cham­bers of the state leg­is­la­ture in 2014. Then, in 2015, Arkansans elect­ed Repub­li­can Gov. Asa Hutchin­son, who came into office vow­ing to over­haul the state’s Med­ic­aid expan­sion. Over the next two years, he and the Repub­li­can-con­trolled leg­is­la­ture imple­ment­ed a num­ber of changes, includ­ing the cre­ation of a pri­vate option for health insur­ance and charg­ing pre­mi­ums to peo­ple above the fed­er­al pover­ty lev­el. But that over­haul kicked into high gear under the Trump admin­is­tra­tion, who for the first time in the 50-plus year his­to­ry of Med­ic­aid gave a green light to work require­ments and oth­er con­tro­ver­sial restric­tions on enroll­ment.

...

Though Med­ic­aid has nev­er had a work require­ment in the program’s 50-plus year his­to­ry, oth­er fed­er­al ben­e­fits pro­grams that have imple­ment­ed work require­ments found that it failed to increase employ­ment.

“Work require­ments are a polit­i­cal move that do noth­ing to address the very real chal­lenge that many Arkansans face – a lack of mean­ing­ful employ­ment oppor­tu­ni­ties that offer a liv­able wage and ben­e­fits,” wrote Arkansas Advo­cates for Chil­dren and Fam­i­lies (AACF), one of the local orga­ni­za­tions vocal­ly opposed to the new rules. Even for the major­i­ty of enrollees who are work­ing, the group said, “com­pli­cat­ed report­ing require­ments will undoubt­ed­ly lead to many peo­ple falling through the cracks and los­ing cov­er­age.”

———-

“Arkansas Pulls The Trig­ger On Nation’s First-Ever Med­ic­aid Work Require­ment” by Alice Oll­stein; Talk­ing Points Memo; 06/05/2018

“One wide­ly crit­i­cized aspect of Arkansas’ new rules is that every­one enrolled in Med­ic­aid has to doc­u­ment their work hours through an online por­tal cre­at­ed by the state — with no option to sub­mit infor­ma­tion in per­son, over the by phone, or by mail.”

Yep, there is NO OPTION for enrollees oth­er than the new web­site. Which is rather remark­able for a state with the sec­ond low­er rates of home inter­net access in the US:

...
Accord­ing to the Cen­sus Bureau, Arkansas has the sec­ond-low­est rate of home inter­net access in the nation, only slight­ly above Mis­sis­sip­pi.

“It’s a very big con­cern,” Greg Led­ing, a Demo­c­ra­t­ic state rep­re­sen­ta­tive in the Fayet­teville area, told TPM. “It’s nat­ur­al and a good idea to do as many things as we can online, in terms of gov­ern­ment effi­cien­cy and because that’s where we’re head­ed in the world. But very large swaths of the state in rur­al areas don’t have access, so are peo­ple going to be able to do what they need to do to get online and keep their Med­ic­aid ben­e­fits?”
...

And what does the state gov­ern­ment have to say about this obvi­ous prob­lem? Well, the direc­tor of the Depart­ment of Health Ser­vices said that by requir­ing low-income Arkansas to sub­mit their infor­ma­tion online, the state is in fact help­ing them improve their tech­no­log­i­cal skills. In oth­er words, this inter­net-only man­date is appar­ent­ly some sort of job train­ing pro­gram: if you want health care you bet­ter fig­ure out how to access the inter­net. Or die try­ing:

...
Pressed on this con­cern by local reporters, the direc­tor of the state’s Depart­ment of Health Ser­vices Cindy Gille­spie said that by requir­ing low-income Arkansas to sub­mit their infor­ma­tion online, the state is in fact help­ing them improve their tech­no­log­i­cal skills.

“Hav­ing that lit­tle bit of com­put­er or phone lit­er­a­cy is impor­tant if you are going to be able to be mov­ing up the income lad­der,” she said. “I mean, a 19- to 29-year-old who in this day and age can’t do that and is able-bod­ied? You know, they need — we need to help them learn to do that. We need to help them get an email and learn how to deal in that world, or they will nev­er be suc­cess­ful.”

She added that the web-only plat­form was cheap­er and more con­ve­nient for the state, say­ing: “If you imple­ment it in the old-fash­ioned way of ‘Come into our coun­ty office,’ we would have to hire so many peo­ple — and that just doesn’t make sense.”
...

““Hav­ing that lit­tle bit of com­put­er or phone lit­er­a­cy is impor­tant if you are going to be able to be mov­ing up the income lad­der,” she said. “I mean, a 19- to 29-year-old who in this day and age can’t do that and is able-bod­ied? You know, they need — we need to help them learn to do that. We need to help them get an email and learn how to deal in that world, or they will nev­er be suc­cess­ful.””

Notice how there’s no men­tion of what the actu­al help is that Arkansas is offer­ing peo­ple with­out inter­net access.

And then there’s the Urban Insti­tute study that found that over 30 per­cent of the group of peo­ple expect­ed to lose their cov­er­age do not have inter­net access:

...
A study by the Urban Insti­tute and the Robert Wood John­son Foun­da­tion released in May esti­mates that by next year as many as 39,000 peo­ple could lose Med­ic­aid cov­er­age under Arkansas’ new rules — 15 per­cent of all enrollees. More than 30 per­cent of that group, the study found, do not have inter­net access, and at least 8 per­cent have no access to a vehi­cle, mak­ing it dif­fi­cult to both find work and sub­mit infor­ma­tion online to the state. Many of those like­ly to be affect­ed also have less than a high school edu­ca­tion or a seri­ous health lim­i­ta­tion that doesn’t qual­i­fy as a dis­abil­i­ty.
...

Beyond that, there’s the issue of sea­son­al work­ers who can’t nec­es­sar­i­ly count on hav­ing work every month. If those work­ers end up miss­ing three months they lose their cov­er­age. In oth­er words, the sea­son­al work­ers can’t afford to miss work for a sea­son. It’s quite a rule for an agri­cul­tur­al state but that’s how much Arkansas’s GOP hates its poor peo­ple:

...
Crit­ics of the new rules also say state res­i­dents who depend on sea­son­al work could be harmed by the strict month­ly require­ment of 80 hours, which doesn’t take into account fluc­tu­a­tions through­out the year.

“Agri­cul­ture is our largest state indus­try and there’s a lot of sea­son­al­i­ty there,” Led­ing said. “And in places where it’s more urban, retail work picks up around the hol­i­days and tapers off in oth­er months. Some­body might be a mod­el employ­ee, but if their job goes away, they’ve lost their health care.”

Advo­ca­cy groups are also con­cerned that the state has bud­get­ed just over $1 mil­lion in new fund­ing to imple­ment the work require­ment, mon­ey that will be used to send notices to hun­dreds of thou­sands of peo­ple in the state and help them nav­i­gate the new rules. In com­par­i­son, near­by Ken­tucky is spend­ing near­ly $190 mil­lion to imple­ment its Med­ic­aid work require­ment.

Led­ing told TPM that the pen­ny-pinch­ing is a result of the Repub­li­can majority’s zeal for slash­ing the state bud­get over the past sev­er­al years.

“We’re in a polit­i­cal cli­mate where we’ve already cut tax­es by tens of mil­lions of dol­lars and they want to pass anoth­er tax cut next year,” he said. “Any­time that’s on the hori­zon, they’re look­ing to spend less any­where else they can.”
...

And don’t for­get that Arkansas is one of the few South­ern states to actu­al­ly accept the Med­ic­aid expan­sion and saw its unin­sur­ance rate cut in half as a result. So we don’t have to won­der whether or not the Med­ic­aid expan­sion would have helped Arkansas if imple­ment­ed. It has already helped immense­ly and the fed­er­al gov­ern­ment paid for almost all of that help. And that’s clear­ly seen as too help­ful. More suf­fer­ing for the poor is clear­ly deemed nec­es­sary:

...
South­ern suc­cess sto­ry

Under for­mer, Demo­c­ra­t­ic Gov. Mike Beebe, Arkansas was one of very few states in the South to embrace Med­ic­aid expan­sion under the Afford­able Care Act, extend­ing sub­si­dized cov­er­age to 280,000 addi­tion­al peo­ple begin­ning in 2013.

Since then, the state’s unin­sured rate has been cut in half.. Emer­gency room vis­its decreased by more than 35 per­cent, and the num­ber of unin­sured peo­ple admit­ted to hos­pi­tals dropped by more than 45 per­cent, sav­ing hos­pi­tals in the state more than $69.2 mil­lion.
...

So we can see, Arkansas is mak­ing it clear that its poor­est res­i­dents need to acquire new skills if they want to health care. Specif­i­cal­ly, how to steal your neigh­bor’s wi-fi and pos­si­bly their entire com­put­er. Those are going to be some real­ly valu­able skills for Arkansas’ poor­est res­i­dents. Pos­si­bly even life-sav­ing.

The ques­tion of whether or not there’s some sort of well thought out dia­bol­i­cal plan at work or if they’re just wing­ing it has been one of the meta-ques­tions repeat­ed­ly raised dur­ing the first two years of the Trump admin­is­tra­tion. A ques­tion that the Amer­i­can peo­ple are once again forced to ask now that Pres­i­dent Trump has declared that the ongo­ing fed­er­al gov­ern­ment shut­down show­down over ‘the Wall’ could go on for months or even years. Did they real­ly plan for the pos­si­bil­i­ty of effec­tive­ly per­ma­nent­ly shut­ter­ing all ‘non-essen­tial’ fed­er­al gov­ern­ment? Or did Trump wake up one day recent­ly and just decide to do this?

Part of the rea­son we can’t dis­miss the pos­si­bil­i­ty that they have plans for a long-term shut­down is sim­ply because the right-wing media has been telling audi­ences for years that shut­ting the fed­er­al gov­ern­ment down is no big deal. This is typ­i­cal­ly the right-wing nar­ra­tive in the lead up to the now-annu­al poten­tial shut­down show­downs that have become a reg­u­lar fix­ture in Amer­i­can pol­i­tics over the last decade. A nar­ra­tive that simul­ta­ne­ous­ly assures the audi­ence that Amer­i­cans won’t care about keep­ing the gov­ern­ment shut­down because noth­ing is tru­ly shut down and at the same time the fed­er­al gov­ern­ment does­n’t do things Amer­i­cans val­ue any­way. As stu­pid as that meme is, it’s a real right-wing meme that audi­ences of fig­ures like Rush Lim­baugh have been hear­ing for years. And Pres­i­dent Trump is, of course, one of the biggest fans of right-wing media in exis­tence, so we can be sure he’s famil­iar these assur­ances.

But the fact that right-wing pun­dits have been lying to their audi­ences for years about the low-risk nature of long-term shut­downs still rais­es the ques­tion of whether or not the Trump admin­is­tra­tion has actu­al­ly planned on how to car­ry­ing such a thing out. Because it’s pos­si­ble they planned on start­ing a long-term shut­down with­out mak­ing any real plans on how to deal with all of the var­i­ous night­mare sto­ries that are inevitably going to erupt.

And based on the fol­low­ing Wash­ing­ton Post arti­cle, it does indeed appear to be the case that White House has no plans for how to deal with the real­i­ties of a shut­down because they did­n’t real­ize that pro­grams rang­ing from food stamps to the pro­cess­ing of tax returns real­ly do end. Yep, the White House appar­ent­ly did­n’t real­ize that a shut­down might actu­al­ly shut things down that peo­ple need. For real:

The Wash­ing­ton Post

Mil­lions face delayed tax refunds, cuts to food stamps as White House scram­bles to deal with shutdown’s con­se­quences

By Dami­an Palet­ta and
Eri­ca Wern­er
Jan­u­ary 4, 2019 at 6:17 PM

Food stamps for 38 mil­lion low-income Amer­i­cans would face severe reduc­tions and more than $140 bil­lion in tax refunds are at risk of being frozen or delayed if the gov­ern­ment shut­down stretch­es into Feb­ru­ary, wide­spread dis­rup­tions that threat­en to hurt the econ­o­my.

The Trump admin­is­tra­tion, which had not antic­i­pat­ed a long-term shut­down, rec­og­nized only this week the breadth of the poten­tial impact, sev­er­al senior admin­is­tra­tion offi­cials said. The offi­cials said they were focused now on under­stand­ing the scope of the con­se­quences and deter­min­ing whether there is any­thing they can do to inter­vene.

Thou­sands of fed­er­al pro­grams are affect­ed by the shut­down, but few inter­sect with the pub­lic as much as the tax sys­tem and the Depart­ment of Agriculture’s Sup­ple­men­tal Nutri­tion Assis­tance Pro­gram, the cur­rent ver­sion of food stamps.

The par­tial shut­down has cut off new fund­ing to the Trea­sury Depart­ment and the USDA, leav­ing them large­ly unstaffed and crip­pling both depart­ments’ abil­i­ty to ful­fill core func­tions.

The poten­tial cuts to food stamps and sus­pen­sion of tax refunds illus­trate the com­pound­ing con­se­quences of leav­ing large parts of the fed­er­al govern­ment unfund­ed indef­i­nite­ly — a ­sce­nario that became more like­ly Fri­day when Pres­i­dent Trump said he would leave the gov­ern­ment shut down for months or even years unless Democ­rats gave him mon­ey to build a wall along the U.S.-Mexico bor­der.

The SNAP pro­gram is rare among fed­er­al ini­tia­tives because it requires annu­al fund­ing from Con­gress, even though its exis­tence is auto­mat­i­cal­ly renewed.

Con­gress has not allo­cat­ed fund­ing for SNAP beyond Jan­u­ary, and the program’s emer­gency reserves would not cov­er even two-thirds of February’s pay­ments, accord­ing to past dis­burse­ments. Last Sep­tem­ber, the most recent month for which data is avail­able, SNAP dis­bursed $4.7 bil­lion in ben­e­fits to recip­i­ents across every U.S. state.

Law­mak­ers last year appro­pri­at­ed $3 bil­lion into a “con­tin­gency” fund for SNAP. USDA offi­cials would not com­ment on the sta­tus of the $3 bil­lion, but if all of that mon­ey is still avail­able, it would cov­er just 64 per­cent of February’s oblig­a­tions.

Agency offi­cials have not said how they would address the short­fall, includ­ing whether they would pri­or­i­tize who receives food aid or cut ben­e­fits for every­one across the board.

If the shut­down con­tin­ues through March, there would be no remain­ing mon­ey for ben­e­fits.

“We are cur­rent­ly look­ing at options for SNAP,” said Tim Mur­taugh, a spokesman for the Agri­cul­ture Depart­ment. “The best course of action would be for Con­gress to pass a legit­i­mate appro­pri­a­tions bill to the pres­i­dent to end the lapse in fund­ing.”

Dur­ing the shut­down, the USDA office that admin­is­ters SNAP has sent home 95 per­cent of its employ­ees with­out pay, accord­ing to a flow­chart on the department’s web­site.

“Peo­ple in this coun­try will go hun­gry,” said Rep. Rosa L. DeLau­ro (D‑Conn.). “It’s sim­ple. They go hun­gry. ... These are work­ing peo­ple. We’re not talk­ing about peo­ple who are dog­ging it.”

The dis­rup­tion would hurt not only the fam­i­lies that receive the assis­tance but also gro­cers and oth­er retail­ers where the mon­ey is spent.

Trea­sury Depart­ment offi­cials, mean­while, are try­ing to deter­mine what to do with the flood of requests for tax refunds that will come in next month.

The Inter­nal Rev­enue Ser­vice has sent home close to 90 per­cent of its staff with­out pay ahead of an extreme­ly busy time for the tax agency.

From late Jan­u­ary through March 2 of 2018, the IRS paid out $147.6 bil­lion in tax refunds to 48.5 mil­lion house­holds. That mon­ey could be frozen with­in the IRS if the refunds are stalled.

Ear­ly last year, as part of its con­tin­gency plan­ning for pos­si­ble gov­ern­ment shut­downs, the IRS said it would not issue any tax refunds dur­ing a shut­down. Trea­sury and IRS offi­cials have not said they will com­plete­ly sus­pend all tax refunds next month, but a senior admin­is­tra­tion offi­cial said such dis­burse­ments would be severe­ly affect­ed and like­ly slowed if they are paid.

...

This could have an imme­di­ate impact on the econ­o­my, as well as on the finances of mil­lions of Amer­i­cans who fre­quent­ly spend their tax refunds soon after receiv­ing them.

“The IRS will final­ize and release its fil­ing sea­son lapse plan in the com­ing days,” said a Trea­sury Depart­ment offi­cial, who, like oth­ers, spoke on the con­di­tion of anonymi­ty because he wasn’t autho­rized to dis­cuss the inter­nal plan­ning.

Under nor­mal sched­ules, tax returns for income earned in 2018 would be due April 15. Peo­ple who antic­i­pate receiv­ing a tax refund — mean­ing they over­paid their tax­es last year — tend to file their tax­es as ear­ly as pos­si­ble to recoup the funds quick­ly.

“It would be a huge polit­i­cal and eco­nom­ic hit for peo­ple who are expect­ing their $2,500 or $3,000 refund to not be able to get that mon­ey,” said Mark Mazur, a for­mer top IRS offi­cial who served at Trea­sury dur­ing the Oba­ma admin­is­tra­tion.

Trump has said he is will­ing to keep agen­cies shut down as long as nec­es­sary to force Democ­rats to appro­pri­ate sev­er­al bil­lion dol­lars for the con­struc­tion of walls along the Mex­i­co bor­der. But some Repub­li­cans have said they are uncom­fort­able with this approach, and sev­er­al this week sided with Democ­rats in their effort to reopen agen­cies imme­di­ate­ly.

The scale of the con­se­quences also reflects a deep dis­con­nect between Trump, who has large­ly cheered on a pro­longed shut­down, and the offi­cials run­ning fed­er­al agen­cies, who are try­ing to min­i­mize the fall­out.

“If we have to stay out for a very long peri­od of time, we’re going to do that,” Trump said Fri­day.

White House offi­cials have not ful­ly briefed law­mak­ers on the expand­ing con­se­quences of the gov­ern­ment shut­down, lead­ing to con­fu­sion about what hap­pens as each week goes by.

Neal said that the IRS is con­sid­er­ing bring­ing staffers back to work in the com­ing weeks to help deal with tax fil­ings but that it’s unclear how the agency will pro­ceed. These employ­ees would have to work with­out pay unless Con­gress passed an emer­gency fund­ing bill. He said delays in tax refunds would lead to “more anger, for some­thing that can be solved.”

Rep. Mark Mead­ows (R‑N.C.), a top House con­ser­v­a­tive who had cheered Trump’s approach in the polit­i­cal con­fronta­tion, said he was unaware that there would be any impact on SNAP ben­e­fits.

He said he was con­vinced this mon­ey was auto­mat­i­cal­ly appro­pri­at­ed by Con­gress: “Food stamps go on regard­less,” he said.

This is not the case, how­ev­er, accord­ing to sev­er­al senior admin­is­tra­tion offi­cials.

Mead­ows said he was “not down­play­ing the poten­tial con­se­quences of a shut­down,” but said the whole sit­u­a­tion could be eas­i­ly resolved if Democ­rats would appro­pri­ate sev­er­al bil­lion dol­lars for the bor­der wall.

The gov­ern­ment shut­down began Dec. 22 after Trump blocked a bipar­ti­san deal to fund numer­ous fed­er­al agen­cies through Feb. 8 because he wants more than $5 bil­lion to con­struct 200 miles of wall along the bor­der.

Dur­ing his cam­paign and ear­li­er in his pres­i­den­cy, Trump said the wall would be paid for by Mex­i­co. That has not hap­pened.

The shut­down began with an acute impact, cut­ting off fund­ing to pay 800,000 fed­er­al employ­ees, clos­ing nation­al parks and muse­ums, and lim­it­ing fed­er­al ser­vices. The work­ers are expect­ed to begin feel­ing the con­se­quences of the shut­down more sharply next week: They will miss their first pay­checks on Jan. 11 if a res­o­lu­tion isn’t reached.

“A month into this, we’re going to see peo­ple start to get evict­ed and their cars start to be repos­sessed,” said David Bor­er, gen­er­al coun­sel for the Amer­i­can Fed­er­a­tion of Gov­ern­ment Employ­ees, which rep­re­sents 750,000 fed­er­al employ­ees.

And a much broad­er part of the fed­er­al bureau­cra­cy is expect­ed to begin grind­ing to a halt in Feb­ru­ary, absent a res­o­lu­tion.

Non­prof­it groups have been able to patch togeth­er mon­ey to keep cer­tain parts of the gov­ern­ment open for sev­er­al weeks, but it’s unclear how much longer they can hold on. And none has sought to repli­cate the lev­el of fund­ing that would be lost if SNAP runs out of mon­ey or tax refunds are stalled.

“That’s scary, real­ly scary,” said Lyman Hafen, exec­u­tive direc­tor at Utah’s Zion Nation­al Park For­ev­er Project, a non­prof­it part­ner of one of the country’s most scenic parks. “It’s not a good sit­u­a­tion with­out that sup­port. We’re just tak­ing it a day at a time, a week at a time.”

The cumu­la­tive impact of these changes could have a major impact on the econ­o­my.

Joseph Brusue­las, chief econ­o­mist at RMS U.S., an account­ing and con­sult­ing firm, said a pro­longed shut­down would shave an entire per­cent­age point off the U.S.’s eco­nom­ic growth, in part because of an “uncer­tain­ty tax” that would freeze spend­ing by house­holds and busi­ness­es.

“If one doesn’t know what’s going to hap­pen with respect to their own income ... there will be a pull back on the pur­chase of big-tick­et items,” he said. “Large firms will pull back on out­lays on soft­ware, equip­ment and cap­i­tal.”

———-

“Mil­lions face delayed tax refunds, cuts to food stamps as White House scram­bles to deal with shutdown’s con­se­quences” by Dami­an Palet­ta and Eri­ca Wern­er; The Wash­ing­ton Post; 01/04/2019

“The Trump admin­is­tra­tion, which had not antic­i­pat­ed a long-term shut­down, rec­og­nized only this week the breadth of the poten­tial impact, sev­er­al senior admin­is­tra­tion offi­cials said. The offi­cials said they were focused now on under­stand­ing the scope of the con­se­quences and deter­min­ing whether there is any­thing they can do to inter­vene.”

Two weeks into the shut­down and the White House is only now rec­og­niz­ing the poten­tial impacts. Impacts like the shut­down of the food stamps pro­gram. So peo­ple could lit­er­al­ly start going hun­gry as a con­se­quence of this polit­i­cal stunt and the peo­ple who pulled this stunt did­n’t even real­ize it. And these peo­ple run the exec­u­tive branch. That’s not ter­ri­fy­ing or any­thing.

And start­ing in Feb­ru­ary, the USDA needs to decide whether or not they’ll be kick­ing spe­cif­ic peo­ple off of the SNAP pro­gram or just do across the board cuts for every­one. So a lit­tle bit of starv­ing for every­one or major starv­ing for a few. That’s the deci­sion they’ll have to make. For Feb­ru­ary. Start­ing in March all the mon­ey is gone so every­one starves:

...
The SNAP pro­gram is rare among fed­er­al ini­tia­tives because it requires annu­al fund­ing from Con­gress, even though its exis­tence is auto­mat­i­cal­ly renewed.

Con­gress has not allo­cat­ed fund­ing for SNAP beyond Jan­u­ary, and the program’s emer­gency reserves would not cov­er even two-thirds of February’s pay­ments, accord­ing to past dis­burse­ments. Last Sep­tem­ber, the most recent month for which data is avail­able, SNAP dis­bursed $4.7 bil­lion in ben­e­fits to recip­i­ents across every U.S. state.

Law­mak­ers last year appro­pri­at­ed $3 bil­lion into a “con­tin­gency” fund for SNAP. USDA offi­cials would not com­ment on the sta­tus of the $3 bil­lion, but if all of that mon­ey is still avail­able, it would cov­er just 64 per­cent of February’s oblig­a­tions.

Agency offi­cials have not said how they would address the short­fall, includ­ing whether they would pri­or­i­tize who receives food aid or cut ben­e­fits for every­one across the board.

If the shut­down con­tin­ues through March, there would be no remain­ing mon­ey for ben­e­fits.

...

The dis­rup­tion would hurt not only the fam­i­lies that receive the assis­tance but also gro­cers and oth­er retail­ers where the mon­ey is spent.
...

But in the White House­’s defense, they weren’t the only part of the Repub­li­can Par­ty demon­strat­ing pro­found neg­li­gence in this sit­u­a­tion. The head of the House Free­dom Cau­cus — the extra-far right wing of the GOP that’s always cheer­ing on these shut­downs — also claims he was unaware of issues like the loom­ing cuts to the SNAP pro­gram:

...
Rep. Mark Mead­ows (R‑N.C.), a top House con­ser­v­a­tive who had cheered Trump’s approach in the polit­i­cal con­fronta­tion, said he was unaware that there would be any impact on SNAP ben­e­fits.

He said he was con­vinced this mon­ey was auto­mat­i­cal­ly appro­pri­at­ed by Con­gress: “Food stamps go on regard­less,” he said.

This is not the case, how­ev­er, accord­ing to sev­er­al senior admin­is­tra­tion offi­cials.
...

And then there’s the impact on the IRS, which announced last year that it would­n’t be do any tax refunds dur­ing a shut­down. Appar­ent­ly this is also a sur­prise to the White House. And since the peo­ple who expect refunds tend to file their tax­es ear­li­er, that means there are refunds that could be spent stim­u­lat­ing the econ­o­my right now that aren’t hap­pen­ing:

...

Trea­sury Depart­ment offi­cials, mean­while, are try­ing to deter­mine what to do with the flood of requests for tax refunds that will come in next month.

...

From late Jan­u­ary through March 2 of 2018, the IRS paid out $147.6 bil­lion in tax refunds to 48.5 mil­lion house­holds. That mon­ey could be frozen with­in the IRS if the refunds are stalled.

Ear­ly last year, as part of its con­tin­gency plan­ning for pos­si­ble gov­ern­ment shut­downs, the IRS said it would not issue any tax refunds dur­ing a shut­down. Trea­sury and IRS offi­cials have not said they will com­plete­ly sus­pend all tax refunds next month, but a senior admin­is­tra­tion offi­cial said such dis­burse­ments would be severe­ly affect­ed and like­ly slowed if they are paid.

...

This could have an imme­di­ate impact on the econ­o­my, as well as on the finances of mil­lions of Amer­i­cans who fre­quent­ly spend their tax refunds soon after receiv­ing them.

...

Under nor­mal sched­ules, tax returns for income earned in 2018 would be due April 15. Peo­ple who antic­i­pate receiv­ing a tax refund — mean­ing they over­paid their tax­es last year — tend to file their tax­es as ear­ly as pos­si­ble to recoup the funds quick­ly.

“It would be a huge polit­i­cal and eco­nom­ic hit for peo­ple who are expect­ing their $2,500 or $3,000 refund to not be able to get that mon­ey,” said Mark Mazur, a for­mer top IRS offi­cial who served at Trea­sury dur­ing the Oba­ma admin­is­tra­tion.
...

And this whole night­mare is unfold­ing dur­ing a peri­od of tumult in the finan­cial mar­kets and grow­ing con­cerns over glob­al growth. Will the US econ­o­my be able to han­dle grow­ing uncer­tain­ty over the eco­nom­ic impact of this stunt? We’ll find out:

...
The cumu­la­tive impact of these changes could have a major impact on the econ­o­my.

Joseph Brusue­las, chief econ­o­mist at RMS U.S., an account­ing and con­sult­ing firm, said a pro­longed shut­down would shave an entire per­cent­age point off the U.S.’s eco­nom­ic growth, in part because of an “uncer­tain­ty tax” that would freeze spend­ing by house­holds and busi­ness­es.

“If one doesn’t know what’s going to hap­pen with respect to their own income ... there will be a pull back on the pur­chase of big-tick­et items,” he said. “Large firms will pull back on out­lays on soft­ware, equip­ment and cap­i­tal.”

...

And whether or not the broad­er eco­nom­ic impact ends up drag­ging the US into a reces­sion, there’s going to be a very per­son­al reces­sion for all the fed­er­al employ­ees sent home with­out pay. And by the end of the month those per­son­al reces­sions could start includ­ing evic­tions and car repos­ses­sions:

...
Dur­ing the shut­down, the USDA office that admin­is­ters SNAP has sent home 95 per­cent of its employ­ees with­out pay, accord­ing to a flow­chart on the department’s web­site.

...

The Inter­nal Rev­enue Ser­vice has sent home close to 90 per­cent of its staff with­out pay ahead of an extreme­ly busy time for the tax agency.

...

The shut­down began with an acute impact, cut­ting off fund­ing to pay 800,000 fed­er­al employ­ees, clos­ing nation­al parks and muse­ums, and lim­it­ing fed­er­al ser­vices. The work­ers are expect­ed to begin feel­ing the con­se­quences of the shut­down more sharply next week: They will miss their first pay­checks on Jan. 11 if a res­o­lu­tion isn’t reached.

“A month into this, we’re going to see peo­ple start to get evict­ed and their cars start to be repos­sessed,” said David Bor­er, gen­er­al coun­sel for the Amer­i­can Fed­er­a­tion of Gov­ern­ment Employ­ees, which rep­re­sents 750,000 fed­er­al employ­ees.

And a much broad­er part of the fed­er­al bureau­cra­cy is expect­ed to begin grind­ing to a halt in Feb­ru­ary, absent a res­o­lu­tion.
...

So, of course, Pres­i­dent Trump defend­ed the impact of the shut­down on fed­er­al employ­ees by assur­ing every­one that the fed­er­al employ­ees going with­out pay are actu­al­ly the biggest fans of the shut­down, declar­ing ““This real­ly does have a high­er pur­pose than next week’s pay...And the peo­ple that wouldn’t get next week’s pay or the fol­low­ing week’s pay, I think if you ever real­ly looked at those peo­ple, I think they’d say, ‘Mr. Pres­i­dent, keep going, this is far more impor­tant.’”” Yes, the fan­ta­sy fed­er­al employ­ees liv­ing in Trump’s head are all big fans of the going with­out pay. What about the real fed­er­al employ­ees? Well, as the fol­low­ing arti­cle describes, for the low­est paid fed­er­al employ­ees, who are often work­ing as con­trac­tors, they increas­ing­ly have to decide whether or not they’re going to eat or take their life-sav­ing med­ica­tions, so they’re pre­sum­ably not very big fans of the shut­down:

Buz­zFeed

The Gov­ern­ment Shut­down Is “Life And Death” For Low-Wage Sub­con­trac­tors Who Like­ly Won’t Be Repaid For Lost Time

“All I can do is pray that they open the gov­ern­ment soon,” a secu­ri­ty offi­cer for the shut­tered Smith­son­ian told Buz­zFeed News.

Ryan C. Brooks
Buz­zFeed News Reporter

Post­ed on Jan­u­ary 4, 2019, at 1:41 p.m. ET

On Day 14 of the par­tial gov­ern­ment shut­down, Don­na Kel­ly, a 63-year-old fed­er­al­ly sub­con­tract­ed secu­ri­ty offi­cer for the Smith­son­ian, is won­der­ing if her high blood pres­sure med­ica­tion will last through the end of the month — let alone the entire shut­down.

When the gov­ern­ment does reopen, Kel­ly and an esti­mat­ed 1,500 work­ers — accord­ing to two unions that rep­re­sent some of the jan­i­tors, secu­ri­ty guards, cafe­te­ria work­ers, and hos­pi­tal­i­ty work­ers who staff fed­er­al facil­i­ties — like­ly won’t receive any back pay from the dura­tion of the shut­down.

Gov­ern­ment employ­ees usu­al­ly receive back pay once shut­downs have con­clud­ed, but work­ers who are paid by com­pa­nies that have con­tracts with the gov­ern­ment don’t receive pay for ser­vices that can’t be billed to the gov­ern­ment while facil­i­ties are shut down.

“For work­ers who work for con­trac­tors, and who don’t work direct­ly for the gov­ern­ment, there’s no guar­an­tee that they’ll be paid,” Lenore Fried­laen­der, assis­tant to the pres­i­dent of 32BJ SEIU, said in an inter­view. “In past shut­downs, there hasn’t always been mon­ey giv­en to con­trac­tors to make them whole for what’s been lost. The increas­ing real­i­ty is that they have to be pre­pared for the fact that they may nev­er get that mon­ey.”

The gov­ern­ment has been par­tial­ly shut down since Dec. 22 after Pres­i­dent Don­ald Trump and con­gres­sion­al lead­ers couldn’t reach a fund­ing agree­ment over Democ­rats’ refusal to agree to $5 bil­lion in fund­ing to build a wall along the country’s south­ern bor­der. The House of Rep­re­sen­ta­tives passed leg­is­la­tion to ful­ly fund the gov­ern­ment Thurs­day, but the Sen­ate won’t con­sid­er the bill, and Trump has said he’ll refuse to sign the House pack­age because it doesn’t include fund­ing for the bor­der wall. Con­gres­sion­al lead­ers are meet­ing with Trump on Fri­day, but there’s no clear sign of a deal to end the shut­down, and the Sen­ate has already left Wash­ing­ton for a three-day week­end that will last through Tues­day.

The Smith­son­ian was able to con­tin­ue oper­at­ing after the shut­down began using mon­ey from the pre­vi­ous year’s bud­get, but the institute’s muse­ums closed their doors Jan. 2. Kel­ly told Buz­zFeed News she received her last full pay­check Thurs­day, and she’ll get a small­er check in the com­ing weeks for the par­tial week she worked before the Smith­son­ian closed.

“My com­pa­ny said we have to sit back and wait to return to work. Right now it’s been two days since I’ve been out of work,” Kel­ly told Buz­zFeed News on Thurs­day. “But the real­i­ty is we won’t receive any pay­ment. If we’re not work­ing we won’t be paid, and if it goes beyond two or three weeks, I don’t know how I’m going to pay any bills.”

Kel­ly, who receives sub­si­dized hous­ing assis­tance from Sec­tion 8, said that she’s wor­ried about pay­ing the util­i­ty bills for her apart­ment and explained that if she doesn’t, she could face evic­tion or lose her Sec­tion 8 vouch­er.

“My plan is to get up in the morn­ing and apply for food stamps and apply for Med­ic­aid — the cov­er­age I had through the gov­ern­ment end­ed at the end of the year,” Kel­ly explained. “They may rein­state my Med­ic­aid, but I’m not sure, and I’m going to try to get a list­ing of food pantries. Those are my plans, and with the lit­tle finances I do have, I’m try­ing to sit back and fig­ure out what’s the most impor­tant to pay and how they’ll work with me if I can’t pay it all.”

Unions like Unite Here and 32BJ SEIU said that they’ve heard from mem­bers who are con­cerned about rent and util­i­ties. And they’ve heard from some mem­bers strug­gling between buy­ing food and pay­ing for pre­scrip­tion med­i­cine, and that some are con­tem­plat­ing rationing or shar­ing med­ica­tions, like insulin.

“This is going to turn into a dire sit­u­a­tion short­ly,” D. Tay­lor, the inter­na­tion­al pres­i­dent of Unite Here, said in an inter­view. “We’re deal­ing with peo­ple that are going to be faced with going to pub­lic assis­tance. They’re wor­ried about rent, food, bill pay­ments, and it’s not like our folks are liv­ing exor­bi­tant lifestyles.”

“For these peo­ple, if you miss a pay­check or two it could mean evic­tion,” he added. “It all depends on whether a land­lord is going to be sym­pa­thet­ic to the gov­ern­ment being shut down, and you can’t buy gro­ceries on an ‘IOU.’”

...

Unite Here says it’s hold­ing an emer­gency meet­ing for affect­ed union mem­bers next week to deter­mine how the union could be help­ful and to help mem­bers sign up for pub­lic assis­tance if the shut­down con­tin­ues.

Kel­ly says she hasn’t been able to see a doc­tor to dis­cuss a plan if her high blood pres­sure med­ica­tion laps­es because she pays for health insur­ance out of pock­et.

“There’s no way I can get around not tak­ing that med­i­cine,” Kel­ly said. “It’s a mat­ter of life and death, and what can we do? If this thing con­tin­ues, I won’t have mon­ey to pay for any­thing.”

“All I can do is pray that they open the gov­ern­ment soon,” she added.

———-

“The Gov­ern­ment Shut­down Is “Life And Death” For Low-Wage Sub­con­trac­tors Who Like­ly Won’t Be Repaid For Lost Time” by Ryan C. Brooks; Buz­zFeed; 01/04/2019

“All I can do is pray that they open the gov­ern­ment soon.”

Prayers that the shut­down ends soon. That’s Don­na Kel­ly’s views of the sit­u­a­tion, which is high­ly under­stand­able since she’s a fed­er­al con­trac­tor who won’t be receiv­ing any back pay for missed days of work and who may not be able to afford her blood pres­sure med­ica­tion going for­ward:

...
On Day 14 of the par­tial gov­ern­ment shut­down, Don­na Kel­ly, a 63-year-old fed­er­al­ly sub­con­tract­ed secu­ri­ty offi­cer for the Smith­son­ian, is won­der­ing if her high blood pres­sure med­ica­tion will last through the end of the month — let alone the entire shut­down.

When the gov­ern­ment does reopen, Kel­ly and an esti­mat­ed 1,500 work­ers — accord­ing to two unions that rep­re­sent some of the jan­i­tors, secu­ri­ty guards, cafe­te­ria work­ers, and hos­pi­tal­i­ty work­ers who staff fed­er­al facil­i­ties — like­ly won’t receive any back pay from the dura­tion of the shut­down.

Gov­ern­ment employ­ees usu­al­ly receive back pay once shut­downs have con­clud­ed, but work­ers who are paid by com­pa­nies that have con­tracts with the gov­ern­ment don’t receive pay for ser­vices that can’t be billed to the gov­ern­ment while facil­i­ties are shut down.

“For work­ers who work for con­trac­tors, and who don’t work direct­ly for the gov­ern­ment, there’s no guar­an­tee that they’ll be paid,” Lenore Fried­laen­der, assis­tant to the pres­i­dent of 32BJ SEIU, said in an inter­view. “In past shut­downs, there hasn’t always been mon­ey giv­en to con­trac­tors to make them whole for what’s been lost. The increas­ing real­i­ty is that they have to be pre­pared for the fact that they may nev­er get that mon­ey.”

...

“My com­pa­ny said we have to sit back and wait to return to work. Right now it’s been two days since I’ve been out of work,” Kel­ly told Buz­zFeed News on Thurs­day. “But the real­i­ty is we won’t receive any pay­ment. If we’re not work­ing we won’t be paid, and if it goes beyond two or three weeks, I don’t know how I’m going to pay any bills.”

...

Kel­ly says she hasn’t been able to see a doc­tor to dis­cuss a plan if her high blood pres­sure med­ica­tion laps­es because she pays for health insur­ance out of pock­et.

“There’s no way I can get around not tak­ing that med­i­cine,” Kel­ly said. “It’s a mat­ter of life and death, and what can we do? If this thing con­tin­ues, I won’t have mon­ey to pay for any­thing.”
...

Adding to the dire nature of the sit­u­a­tion for peo­ple in Kel­ly’s sit­u­a­tion, we learn that she risks los­ing her fed­er­al hous­ing assis­tance if she can’t pay rent. What will Kel­ly and the many oth­ers in her sit­u­a­tion do when forced to choose between shel­ter and med­i­cine? Ration, or even share, med­ica­tions like insulin. Those are the kinds of sit­u­a­tions peo­ple like Don­na Kel­ly are going to find them­selves in:

...
Kel­ly, who receives sub­si­dized hous­ing assis­tance from Sec­tion 8, said that she’s wor­ried about pay­ing the util­i­ty bills for her apart­ment and explained that if she doesn’t, she could face evic­tion or lose her Sec­tion 8 vouch­er.

...

Unions like Unite Here and 32BJ SEIU said that they’ve heard from mem­bers who are con­cerned about rent and util­i­ties. And they’ve heard from some mem­bers strug­gling between buy­ing food and pay­ing for pre­scrip­tion med­i­cine, and that some are con­tem­plat­ing rationing or shar­ing med­ica­tions, like insulin.

“This is going to turn into a dire sit­u­a­tion short­ly,” D. Tay­lor, the inter­na­tion­al pres­i­dent of Unite Here, said in an inter­view. “We’re deal­ing with peo­ple that are going to be faced with going to pub­lic assis­tance. They’re wor­ried about rent, food, bill pay­ments, and it’s not like our folks are liv­ing exor­bi­tant lifestyles.”

“For these peo­ple, if you miss a pay­check or two it could mean evic­tion,” he added. “It all depends on whether a land­lord is going to be sym­pa­thet­ic to the gov­ern­ment being shut down, and you can’t buy gro­ceries on an ‘IOU.’”
...

And to top it all off, Kel­ly is plan­ning on apply­ing for food stamps. Ouch. That should go real­ly well with the SNAP pro­gram about to run out of funds:

...
“My plan is to get up in the morn­ing and apply for food stamps and apply for Med­ic­aid — the cov­er­age I had through the gov­ern­ment end­ed at the end of the year,” Kel­ly explained. “They may rein­state my Med­ic­aid, but I’m not sure, and I’m going to try to get a list­in