a repeal bill so monumental in its cruelty that they feel they have no choice but to draft it in secret, not let the public know what it does, hold not a single hearing or committee markup, slip it in a brown paper package to the Congressional Budget Office, then push it through to a vote before the July 4th recess before the inevitable backlash gets too loud.
“We aren’t stupid,” one GOP Senate aide told Caitlin Owens — they know what would happen if they made their bill public.
.. Today, we learned that in a break with longstanding precedent, “Senate officials are cracking down on media access, informing reporters on Tuesday that they will no longer be allowed to film or record audio of interviews in the Senate side hallways of the Capitol without special permission.” Everyone assumes that it’s so those senators can avoid having to appear on camera being asked uncomfortable questions about a bill that is as likely to be as popular as Ebola.
.. This is how a party acts when it is ashamed of what it is about to do to the American people. Yet all it would take to stop this abomination is for three Republicans to stand up to their party’s leaders and say, “No — I won’t do this to my constituents.” With only a 52-48 majority in the Senate, that would kill the bill. But right now, it’s looking as though this Coward Caucus is going to be unable to muster the necessary courage.
.. Take Shelley Moore Capito of West Virginia, a state where over 175,000 people have gotten insurance thanks to the Medicaid expansion... Last week The Hill reported that Capito now supports eliminating the expansion after all — just doing it over seven years instead of the three years that the House bill required...Or how about Ohio’s Rob Portman? In his state, 700,000 people gained insurance as a result of the Medicaid expansion... They’d pay for the slower elimination of the expansion by cutting money out of the existing program, so they could get rid of all of the ACA’s tax increases.. — over half of Medicaid dollars go to the elderly and disabled... That means that they aren’t just undoing the ACA; they’re making things substantially worse for tens of millions of America’s most vulnerable citizens than they were even before the ACA passed... And they’re hoping they can do all this before anyone realizes what they’re up to, making this an act of both unconscionable heartlessness and epic cowardice. Their efforts to hide what they’re doing show that they are still capable of feeling some measure of shame. But it might not be enough to stop them.
Wrecking the Ship of State
as insurers themselves have been explaining, the problem is the uncertainty created by Trump and company, especially the failure to make clear whether crucial subsidies will be maintained. In North Carolina, for example, Blue Cross Blue Shield has filed for a 23 percent rise in premiums, but declared that it would have asked for only 9 percent if it were sure that cost-sharing subsidies would continue.
.. So why hasn’t it received that assurance? Is it because Trump believes his own assertions that he can cause Obamacare to collapse, then get voters to blame Democrats? Or is it because he’s too busy rage-tweeting and golfing to deal with the issue?
..Or take the remarkable decision to take Saudi Arabia’s side in its dispute with Qatar .. there are no good guys in this quarrel, but every reason for the U.S. to stay out of the middle.
.. So what was Trump doing? There’s no hint of a strategic vision; some sources suggest that he may not even have known about the large U.S. base in Qatar and its crucial role.
.. The most likely explanation of his actions .. is that the Saudis flattered him — the Ritz-Carlton projected a five-story image of his face on the side of its Riyadh property — and their lobbyists spent large sums at the Trump Washington hotel.
.. it’s worth considering that Trump apparently ranted to European Union leaders about the difficulty of setting up golf courses in their nations. So maybe it was sheer petulance.
Conservatives near revolt on Senate health care negotiations
Republicans are increasingly pessimistic that key conservative senators will vote for the eventual bill.
Conservative senators and allied outside groups are on the verge of rebellion against the Senate’s Obamacare repeal effort
.. the Senate bill continues to tilt toward more moderate members of the GOP on keeping some of Obamacare’s regulatory structure and providing a more generous wind-down of the law’s Medicaid expansion. The movement has made Republicans increasingly pessimistic that two critical conservative senators, Mike Lee of Utah and Rand Paul of Kentucky, will be able to vote for the GOP’s ultimate agreement
.. it keeps “90 percent” of Obamacare, said he opposes the creation of high-risk pools favored by many Republicans, and urged Republicans to abandon attempts to save the individual marketplace with an infusion of cash.
.. “We promised the voters that we’d repeal Obamacare,” Paul said. “Instead, we want to repeal sort of a tiny bit of it and replace it with something that looks a lot like Obamacare.”
.. The outline leadership has presented isn’t Obamacare repeal, in fact it isn’t even reform. It’s a tax cut and a corporate bailout masquerading as health legislation,” said a conservative Senate aide.
.. The original plan was to pass a 2015 bill, vetoed by President Barack Obama, that would essentially have scrapped much of the law with no replacement.
.. they know an ideological reckoning is upon the party
Health Care in Iowa Shows Peril for Both Political Parties
At his town-hall meeting in Guthrie Center, Mr. Grassley got an earful from residents whose premiums have risen and choices dwindled as insurers that offer plans in the state’s ACA marketplace have fled, potentially leaving Iowa without any major companies offering plans in 2018.
The defections have turned Iowa into a poster child for Republicans who assert that former President Barack Obama’s health law has failed and must be replaced.
“Iowa is in a world of hurt, and something has to be done because Obamacare is a total disaster,” said Guthrie County resident Vinita Smith, a Republican retiree who used to work as a clerk in the state legislature.
.. Democrats, meanwhile, argue that Iowa’s coverage gains under the Medicaid expansion that took place under the Affordable Care Act—about 150,000 Iowans were added to the program— could be swept away by the GOP effort to slash billions from the program.
.. Iowa insurers had particular trouble setting up networks with low prices because there are few providers and hospitals to compete against one another in the state’s many rural areas.
Insurers who participated in the Iowa exchange expected to be reimbursed by under what is know as a risk-corridor program set up by the ACA. But Republicans limited funding for the payments, and insurers received a fraction of the money they requested.
Meanwhile, an Obama administration decision to allow states to let people keep insurance plans they already had—even if they didn’t comply with ACA requirements—permitted younger and healthier people to stay on those less-robust plans. That drove older and sicker people to plans that did comply, leaving those insurers with higher costs and heavier financial losses.
.. “The individual market was broken before the ACA