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Office of Management and Budget Director Mick Mulvaney speaks at the White House on Tuesday in Washington.

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How do you sell a health care bill that cuts insurance for the poor, allows states to waive essential health benefits like maternity care, and allows insurers to charge impossible sums to people with pre-existing conditions, all to cut taxes for the richest 2 percent of Americans?

Jamelle Bouie isSlates chief political correspondent.

On Sunday, Republican leaders and White House officials took to news shows to promote the American Health Care Act, their bill to repeal and replace Obamacare (ne the Affordable Care Act). Roundly condemned by health policy experts, industry stakeholders, and even conservative observers, the AHCA is a Frankensteins monster of ideas and provisions stitched together in a rushed effort to pass a bill. Trumpcare restores the worst of the pre-Obamacare status quo, exacerbating problems in the American health care system instead of solving them.

An honest pitch for this bill, which passed in the House of Representatives on Thursday, would admit that its tough medicine. In this hypothetical, Republicans would own and defend their actual position: that health care is an individual concern, and universal coverage lies outside the governments power and authority. But that view is unpopular; majorities of Americans believe just the opposite, and the sitting Republican president campaigned on the promise that his health law would cover everyone at lower costs with better plans.

Rather than acknowledge that their proposal does nothing of the sort, Republican leaders have opted to talk up the virtues of a plan that looks nothing like the one they just voted for. The American Health Care Act cuts $880 billion from Medicaid over a 10-year period. The Congressional Budget Office estimates that as a result, 14 million fewer people would have Medicaid coverage by 2026. On CNNs State of the Union, host Jake Tapper pressed Health and Human Services Secretary Tom Price for answers on these cuts. Price, unphased, denied that the cuts even existed. Remember that there are no cuts to the Medicaid program. There are increases in spending, said the secretary. When an incredulous Tapper pressed againAre you actually saying that $880 billion in cuts is actually not going to result in millions of Americans not getting Medicaid?Price went further, insisting that the Medicaid population will be cared for in a better way.

In reality, Trumpcare does the literal opposite of what Price claims. The AHCA doesnt just cut from Medicaid. It turns the remaining funding into a block grant and frees states from federal requirements. This would allow states to cut benefits to children and adults, charge unlimited premiums, deductibles, and co-payments, and deny coverage to eligible individuals.

You cant square the rhetoric of Republican leaders and officials with the bill they crafted and passed.

As misleading as Price was, the elisions and misstatements in his interview paled next to Paul Ryans brazen performance on ABCs This Week. The House speaker started with a falsehoodObamacare is collapsingand powered on from there, telling George Stephanopuolos that under the AHCA you cannot be denied coverage if you have a pre-existing condition and you cant charge people more if they keep continuous coverage. Both claims are technically true, but Ryan leaves out critical information.

Under the AHCA, states can obtain waivers for the Affordable Care Acts requirement that insurers must both accept people with pre-existing conditions and charge them the same as healthy people of the same age. Someone who has a pre-existing condition could see their premiums skyrocket if she lives in a state that takes that waiver. If that person were to drop their insurance as a result, she would lose the protections that come with continuous coverage. And while Ryan says the bill provides for high-risk pools to cover those with conditions that make them uninsurable in the normal individual market, the funds at hand are paltry and inadequate to meet the likely demand. Ryan insists that his bill ensures access to health care, but access means little when insurance is unaffordable.

Ryan and Price werent the only Republicans making the rounds. On CBS Face the Nation, Office of Management and Budget Director Mick Mulvaney sat with host John Dickerson to defend the health bill. When pressed on the Congressional Budget Offices score for an earlier iteration of the ball, which said Trumpcare would drop coverage for 24 million people by 2026 (an updated score is expected to be released this week), Mulvaney attempted to pooh-pooh the office itself. They missed the mark a couple of years ago on how many people would sign up. And I think they have missed the mark again on how many people will lose coverage. This, again, isnt true. The CBOs projection for coverage under the Affordable Care Act was close to the mark, overestimating how many people would get covered by the exchanges but underestimating how many would gain coverage under Medicaid.

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Regardless, Mulvaney refused to address the question of lost coverage. When pressed with comments from conservative critics of the bill, who argue that it prices older Americans out of the market, breaking a key promise from the president, the OMB director went off the rails, essentially saying that the plan wasnt finished so who knows what will happen. But face it, we are all sort of guessing right now because the negotiation is ongoing. The negotiations will continue again, so I think it is important we reserve judgment on what the president will or won't sign until we know what is in front of him. And when asked about President Trumps promise to cover everyone in the nation, something even Obamacare couldnt accomplish, Mulvaney retreated to this notion of access, promising to give people the care that they want, the quality that they need, the affordability they deserve.

Its simple: You cant square the rhetoric of Republican leaders and officials with the bill they crafted and passed. Theyve either made promises they cant keep, or theyre lying, full stop. This works well enough as a PR strategy, but Republicans should remember that there is a reality, and it matters.

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Will Americans Believe the GOP's Lies About Trumpcare? - Slate Magazine

As House Republicans turn their attention toward a sweeping overhaul of the tax code, they're struggling with two things: how much the package will cost and how much of that expense should be covered up front.

The answers will drive how deep rate cuts can go and whether they carry an expiration date or remain embedded in a newly streamlined tax code. The debate over how to get there exposes a long-simmering tension in the Republican Party over which deserves higher priority lower taxes or a balanced budget.

For now, House Republicans leading the process say they are committed to an overhaul package that doesn't add to the deficit. They intend to cover the price of lower individual and corporate rates by raising revenue from a new levy on imports and eliminating costly deductions. "We're going for the greatest growth for the greatest number of years," House Ways and Means Chairman Kevin Brady, R-Texas, said Thursday. "That happens when tax reform is bold, when it is balanced within the budget, counting on economic growth, and when it's built to last."

That puts the tax-writing committee at odds with the White House, which rolled out a plan in late April that relies on slashed tax rates unleashing explosive and, most economists say, unachievable economic growth to largely pay for themselves. The Committee for a Responsible Federal Budget estimated the proposal would drain federal coffers by $5.5 trillion over 10years.

To meet Brady's goal of permanence, Republicans would need to find a way to compensate for the revenue they'd lose from lowering tax rates. That's because party leaders in both chambers want to use a budget tool called reconciliation that allows them to pass the package with a simple majority and without Democratic support. But under the strategy, Senate rules require lawmakers pay for the cuts if they add to the deficit, typically after 10 years, or make them temporary.

Big businesses, which prize predictability for planning purposes, likewise want Congress to make the tax cuts lasting. "We agree with Chairman Brady that tax reform needs to be permanent to have the best impact on the economy and offer the greatest certainty to businesses," said Caroline Harris, vice president for tax policy and chief tax counsel at the U.S. Chamber of Commerce.

Some key Republicans disagree, arguing Congress should focus on driving rates as low as possible without worrying first about the price tag. Paying for the package up front "doesn't have to be the top priority," said Rep. Mark Meadows, R-N.C., chairman of the hard-line House Freedom Caucus. "Deficits do matter, but we're willing to consider growing the deficit in the short run, hopefully to be outweighed with strong GDP growth in the long run."

That theory that lower rates encourages businesses to invest and hire, thereby expanding the tax base and returning a growing pile of money to the government has been a bedrock of the supply-side economic model that many conservative policymakers have embraced for decades. "I'm a big believer that tax cuts don't have to be paid for because they pay for themselves," said Sen. Sen. Tim Scott, R-S.C., a member of the tax-writing Senate Finance Committee.

Most experts, however, are skeptical. Out of 42 top economists surveyed by the Initiative on Global Markets at the University of Chicago Booth School of Business, 37 said Trump's proposal would not pay for itself through added growth. The other five did not answer the question.

The administration's plan calls for cutting the corporate tax rate to 15 percent from 35 percent and collapsing the seven personal income tax brackets into three, with rates of 10 percent, 25 percent and 35 percent. Firms that pay taxes through the individual side of the code would also see their rate slashed to 15 percent.

House Republicans have proposed slightly less ambitious though still aggressive targets: A 20 percent corporate rate; individual rates of 12 percent, 25 percent and 33 percent; and a 25 percent rate for so-called "pass through" businesses. Each percentage-point cut from the corporate rate alone costs the federal government $100 billion over a decade in lost revenue, according to estimates by the Joint Committee on Taxation.

Brady said Thursday he wants to iron out those differences before introducing legislation. But Republicans on and off Capitol Hill aren't waiting for a bill to start gaming out how they could pass the biggest possible tax cut with bare majorities in Congress. Sen. Patrick J. Toomey, R-Pa., in a Bloomberg editorial on Thursday, called for extending the traditional 10-year budgeting window to 20 or 30 years, to keep steep rate cuts on the books for that much longer.

And Grover Norquist, president of Americans for Tax Reform, said lawmakers should consider marrying paid-for, permanent cuts with temporary ones they could extend or pay for later. "This is the beginning of a marathon, not the end of a 100-yard dash," he said in an interview.

In fact, House Republicans took their first crack at the tax code in the health-care reform bill they narrowly approved last week. The bill repeals roughly $600 billion in taxes on upper-income earners, insurers, drug companies and others that the Affordable Care Act imposed to fund expanded insurance coverage. The full deficit impact of the legislation isn't known because the Congressional Budget Office hasn't issued its final analysis yet.

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House Republicans struggle with costs of tax overhaul - Chicago Tribune

Wisconsin Republicans worrythat a crowded Senate primary could make it harder for them to beatDemocratic Sen. Tammy Baldwin.

Republicans feel that Baldwin is vulnerable President Donald Trump became the first Republican to win Wisconsin since Ronald Reagan in 1984. And Republican Sen. Ron Johnsonalso won re-election against former Sen. Russ Feingoldlast year in a rematch of their 2010 Senate race.

But Republicans worry that they might make the same mistake they made in 2012 when too many candidatesweakened eventual nominee former Gov. Tommy Thompson against Baldwin, The Associated Press reported.

You talk to the grassroots and theyre still riding high from the last election, Brian Westrate, chairman of the Wisconsins 3rd Congressional District Republican Party told the AP. Those of us who have seen the sausage get made a lot of times are pragmatically concerned about the Senate race.

Westrate saidhe would feel better if there was a generally agreed-upon candidatebut instead, there at leastfour Republicans are making movesto get into the race, including millionairesEric Hovde and Nicole Schneider, andKevin Nicholson, backed bymega donorRichard Uihlein, and at least four others being recruited or thinking about it.

Any one of them could be a fine candidate, Westrate told the AP. Its just unfortunate as it stands now there isnt any one of them. Theres six of them.

Meanwhile, theincumbenthas already raised $2.2 million in the first quarter of 2017 and has $2.4 million in cash on hand.

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Republicans Concerned About Crowded Primary Against Baldwin - Roll Call

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Republicans ponder possible defeat in red Georgia Sacramento Bee Republican anxiety is mounting about a runoff election in a typically red Georgia House districta race that will offer an early test of Democratic motivation just weeks after Donald Trump's health care repeal bill passed the House. Republicans in ... Ga. special election Republican accuses Dem of voter registration 'trick'The Hill all 10 news articles »

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Republicans ponder possible defeat in red Georgia - Sacramento Bee

Ad will collapse in seconds CLOSE May 8, 2017 05/08/2017 12:44 pm By Jonathan Chait Share Republicans celebrate the House passage of Trumpcare. Photo: Mark Wilson/Getty Images

Last week, after a nearly all-male group of Republicans celebrated the passage of a House bill that would, they boast, enable men to stop having to pay for womens health care, and as a completely male Senate Republican working group gets to work on the upper chambers bill, a Republican aide told CNN that gender is a nonissue: We have no interest in playing the games of identity politics, thats not what this is about; its about getting a job done. Just a bunch of gender-neutral human beings making gender-neutral decisions about public policy!

Except there happens to be the coincidental factor that the policy in question is inextricably linked to gender. The health-care debate revolves around whether, and to what degree, the medically and economically fortunate should have to subsidize the medically and economically unfortunate. Women have, on average, higher lifetime medical costs than men, which means a market-based insurance system, where every individual plan is priced based on that persons expected medical costs, will charge women on average higher premiums.

Republicans have been dancing around this implication for years with their argument that people who dont need prenatal care should not have to buy insurance that covers it. (This means, of course, that the costs of prenatal care would be borne entirely by those who do need it, i.e., women of childbearing age.) National Review columnist Kevin Williamson comes right out and makes the case that charging women higher rates for insurance is the natural order of things. Why Shouldnt Women Pay More for Health Insurance? asks his headline. Williamsons answer turns out to be Science:

Its worth noting that the vast majority of American health insurance operates on the principle of gender parity. If you get standard employer-based insurance, then your firm divides the cost of insurance among employees without regard to gender. Likewise, Medicare, Medicaid, and the VA are financed without regard to fact that women absorb more medical care. We certainly could change those systems to reflect actuarial science. Employer insurance could charge female employees higher premiums and deductibles than male ones, and Medicare could change its financing so that women pay more than men. Oddly, nobody not even Williamson is proposing these changes. The non-group insurance market is the only segment of American health care in which anybody proposes to make women pay proportionately more.

Conservatives have made all kinds of practical arguments for the Republican health-care bill. They have made a smattering of moral arguments, too, such as the principle that people with more expensive medical needs have failed to make healthy choices and deserve financial punishment for their failings. What is telling about the gender debate is that it lacks even the pretext of personal responsibility. There is no case to be made that women ought to pay more for insurance because they chose to be female. There is no principle at all except that people who have more ought to keep it.

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Why Republicans Want to Make Women Pay More Than Men for Health Insurance - New York Magazine