Make no mistake. Republicans can still succeed in destroying Obamacare. – Washington Post (blog)
The Congressional Budget Office has released its score on the revised American Health Care Act. Here's what's in the report. (Daron Taylor/The Washington Post)
THE MORNING PLUM:
In recent days, a procession of GOP senators has paraded forth and declared in somber tones that the effort to repeal and replace Obamacare may be failing. Mitch McConnell, the GOP Senate leader from Kentucky, recently said he didnt see a path yet. Or, as GOP Sen. Lindsey O. Graham put it:I just dont think we can put it together among ourselves.
But some Democratic Senate aides dont buy it. With a Senate vote now expected this month, they are bracing for several scenarios in which Republicans produce surprise tactics at the last minute that enable them to pass something. This would then get them through to the next stage negotiations between the House and Senate which would have the virtue of increasing the pressure on reluctant holdouts to pass the final bill, pulling the trigger and destroying the Affordable Care Act for good.
One such scenario involves writing a bill that defers dealing with some of the tough details just to get through to conference committee, where the Senate and House bills would be reconciled, a Democratic aide tells me. In this rendering, the aide says, McConnell puts together something very limited to go to conference, putting off hard decisions until the final bill is written with the White House at the table.
Right now, Republicans face several obstacles. One is that some senators from states that have expanded Medicaid there are 20 GOP senators from such states are balking at the Medicaid cuts in the House bill. The measure that passed the House would cut more than $800 billion from Medicaid and restructure the program to transfer more control to the states (which means more cuts and more draconian conditions, and fewer covered) and do away with the ACAs Medicaid expansion. Senate Republicans are mulling a version that would roll back the Medicaid expansion a bit more slowly. This would create a smoother glide path,claims Sen. John Barrasso (R-Wyo.), in a bit of very smooth rhetoric that glides over the likelihood that the Senate version will still cut Medicaid for untold numbers of poor people.
Senate Republicans are also mulling subsidies that are somewhat more generous than the House bill (which overall would leave 23 million additional people uninsured, according to the Congressional Budget Office). And Axios reports that the Senate version might also soften the House bill by allowing states to waive the requirement that insurers cover essential health benefits while not allowing them to waive the prohibition on jacking up premiums for people with preexisting conditions, a provision in the House bill. But we simply dont know what the Senate bill will look like just yet.
Democratic aides are preparing for several tactics that Senate Republicans could employ toget moderates to support the bill. One is to create a placeholder or shell bill that does not work out too many details of the Medicaid cuts, allowing moderates to say they will protect Medicaid in conference negotiations, a senior Democratic aide tells me. If they try this route, Democrats will absolutely hold every single Republican senator accountable for that vote, the aide says. Republicans will be voting to dismantle our health-care system, and well make sure people understand that.
Republicans are dead-set on getting to 50 votes so they can jam some version of Trumpcare through the Senate,Sen. Patty Murray (D-Wash.) told me in an emailed statement. So Democrats are looking at every possible scenario.
Conceptually, they could leave unaddressed many of the details of the Medicaid cuts and work them out in conference, Sarah Binder, a congressional expert at George Washington University, tells me, while cautioning that this is speculative. They can deal with a vague Senate provision and a detailed House provision in conference.
A second scenario might be to insert language into the bill that obfuscates its true legislative impact. They could put language in the bill that would make a political statement about, say, protecting those with preexisting conditions, even as the policy consequences would be different, Binder says. Or, Binder suggests, it could include weaselly language on Medicaid cuts, such as: Nothing in this bill should be construed to limit people entitled under the law to Medicaid coverage. Binder explains: The goal would be to insulate themselves from criticism that they are throwing people off Medicaid.
Of course, all of this is a reminder of a basic fact about this whole debate: The GOPs massively regressive designs on the ACA which at bottom constitute rolling back health coverage for untold millions of people to finance a huge tax cut for the rich are deeply unpopular. By exposing those true designs to the public, this debate has succeeded in making Obamacare more popular and has underscored public opposition to rolling back the historic coverage expansion it has achieved, despite all its real flaws and need for improvement.
And so, the CBO could do serious damage to any such GOP tactic by releasing a score of the Senate bill (when it is done) that shines a harsh light on what the bill would actually do. But Andy Slavitt, a former acting administrator for the Centers for Medicare and Medicaid Services in the Obama administration, unleashed a tweet storm pointing out that, by keeping their bill behind closed doors for as long as possible, Republicans might limit the time that the public and the press have to absorb the CBO scores implications before holding a vote.
The bottom line is that whatever tactics Republicans use, if they can get something passed in the Senate, and get Senate and House Republicans into some form of negotiations designed to reconcile the two versions, the prospects of final success go up substantially.
The virtue of getting everyone into the same room is to get them out of the public eye, where they can come to a final agreement that then would be put to an up or down vote in both chambers, Binder tells me, adding that at that point, the situation would be, this is it: Are you for or against getting rid of Obamacare? This would increase the pressure on individual Republicans who are skittish. To be sure, its possible that Republicans could still fail. But success is also a very real possibility.
* COMEY FEARED BEING LEFT ALONE WITH TRUMP: The New York Times reports that then-FBI Director James B. Comey privately told Attorney General Jeff Sessions that he didnt want to be left alone with President Trump, after the president pushed him to end the Michael Flynn probe:
His unwillingness to be alone with the president reflected how deeply Mr. Comey distrusted Mr. Trump, who Mr. Comey believed was trying to undermine the F.B.I.s independence as it conducted a highly sensitive investigation into links between Mr. Trumps associates and Russia, the officials said. Current and former law enforcement officials say Mr. Comey kept his interactions with Mr. Trump a secret in part because he was not sure whom at the Justice Department he could trust.
That last bit previews how Comey will probably answer questions at tomorrows hearing about why he did not disclose his concerns earlier about Trumps efforts to influence the probe.
* COMEY WILL REFUTE TRUMP: CNN reports that at the hearing, Comey will refute Trumps claim that Comey repeatedly told him he is not under investigation:
One source said Comey is expected to explain to senators that those were much more nuanced conversations from which Trump concluded that he was not under investigation. Another source hinted that the President may have misunderstood the exact meaning of Comeys words, especially regarding the FBIs ongoing counterintelligence investigation.
Trump would neverbotch or distort the nuances of an extremely consequential conversation involving his own culpability. Would he?
* WHY TRUMP TURNED ON SESSIONS: It has been widely reported that Trump has grown furious with Sessions after he recused himself from the Russia probe. The Wall Street Journal adds a telling detail:
He privately berated several top aides in the Oval Office after learning of Mr. Sessions recusal, and he has since then repeatedly expressed frustration about that decision, one White House official said. The president, who has denied any involvement with Russias alleged hacking of Democratic and other political organizations during the election, viewed Mr. Sessions decision as a sign of weakness, the official said.
A sign of weakness! As I suggested yesterday, Trump, in true autocratic fashion, simply cannot brook any prioritization of process and law over loyalty to Trump.
* GET READY FOR DAN COATSS TESTIMONY TODAY: The Post reports that Director of National Intelligence Dan Coats has told associates that Trump asked him to intervene to get Comey to back off the probe of Michael Flynns Russia ties:
After the encounter, Coats discussed the conversation with other officials and decided that intervening with Comey as Trump had suggested would be inappropriate, according to officials who spoke on condition of anonymity to discuss sensitive internal matters.
Coats is set to testify today before the Senate Intelligence Committee, and hell surely be asked for more details on why he viewed Trumps intervention as inappropriate.
* LARGE MAJORITY GETS WHY TRUMP FIRED COMEY: A new Post-ABC News poll finds that 61 percent say Trump fired Comey to protect himself, rather than for the good of the country. Fifty-sixpercent say Trump is not cooperating with probes into Russian meddling. But:
Large majorities of Republicans say Trump fired Comey for the good of the country (71 percent) and that he is cooperating with investigations into Russias election influence (77 percent).
Also: 55 percent have low trust in what Comey is saying about all this, but an even higher 72 percent distrust what Trump is saying, so Comey may have the credibility edge tomorrow.
* DEMOCRATIC PARTY ID ADVANTAGE EXPANDS: Gallup finds the Democratic advantage in party identification over Republicans has grown, with 45 percent self-identifying as Dems or Dem-leaners, while 38 percent self-identify as Republicans or GOP-leaners:
The growing Democratic advantage in recent months is mostly attributable to a decline in Republican affiliation rather than an increase in Democratic affiliation. Since November, the percentage of Republicans and Republican leaners has fallen four percentage points, while there has been a one-point rise in Democratic identification or leaning.
Gallup adds that Trumps unpopularity may be a key factor in the drop in people self-identifying as Republicans, and that this could boost Dem chances in 2018.
* AND THE QUOTE OF THE DAY, KINSLEY-GAFFE EDITION: At last nights debate in the special election for a House seat in the Atlanta suburbs, GOP candidate Karen Handel answered a question about the minimum wage this way:
This is an example of a fundamental difference between a liberal and a conservative. I do not support a livable wage.
A Kinsley Gaffe, for you young uns out there, refers to Michael Kinsleys well-known formulation that a gaffe is when apolitician tells some obvious truth he isnt supposed to say.
See the original post here:
Make no mistake. Republicans can still succeed in destroying Obamacare. - Washington Post (blog)
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