June 16, 2017
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President Trump threw himself into prodding the House to pass the American Health Care Act, then rewarded House Republicans with effusive praise at a White House ceremony directly after they pushed through the health-care overhaul with the narrowest of margins. So Trump's widely reported comments to Senate Republicans that the House version of the bill is "mean" and lacking in generosity bruised some feelings. Trump's comments are "having a lingering, and potentially devastating, effect on his credibility among House Republicans," reports Jonathan Swan at Axios. "Members are still talking about Trump's comment, and their frustration that he'd throw them under the bus is likely to damage his ability to negotiate on major items like infrastructure and tax reform."

Democrats are apparently rubbing salt in the wounds, with one Ways and Means Committee member ribbing GOP colleagues that Trump now agrees with the Democrats about their bill. Trump lobbied them an incredible amount, pushing them to gamble with an unpopular vote, one Republican tells Swan, so "for him to turn around and do this, it's stunning. I can't believe it." Peter Weber

June 8, 2017
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On Wednesday, Senate Majority Leader Mitch McConnell formally began a process to bypass committee hearings and send a Senate Republican health-care bill directly to the floor for a vote by the July 4 recess, Tierney Sneed reports at Talking Points Memo. Republicans are writing their version of the House GOP's American Health Care Act in secret, and they emerged from a meeting on Tuesday more optimistic that they will have a plan that can attract at least 50 of 52 Republican votes, enough to pass the bill under budget reconciliation rules. On Tuesday, Sen. Mike Enzi (R-Wy.) said that the Senate parliamentarian cleared the House version of the AHCA to be considered under reconciliation, removing one obstacle for Republicans.

Senate Republicans plan to submit a preliminary framework of their health-care plan to the Congressional Budget Office by the end of the week, which would allow a floor vote by the end of June, Politico reports. If they pass a health-care bill, it would be merged with the House version in a conference committee, and both chambers would have to vote again on the package that emerged. There was some speculation that McConnell would put up a vote on a bill he thought would fail, just to move on to other legislative priorities, but Sen. Pat Roberts (R-Kan.) said no, "he sure as hell doesn't want to do that." Republicans are "in the back seat with Thelma and Louise and we need to get out of the car," he said. "So details matter, but we need to get out of the car. That was the pre-eminent message." Peter Weber

May 11, 2017

Rep. Tom MacArthur (R-N.J.) held his first town hall on Wednesday night since his amendment on pre-existing conditions revived the GOP health-care bill, leading to its passage in the House. He took questions from his constituents for nearly five hours in Willingboro, and it was not a friendly crowd — not that he'd expected it to be. Before the town hall, his office had noted that Willingboro is 73 percent black and had only given him 12 percent of its vote last fall, points he reiterated during the town hall.

MacArthur fielded a series of questions about President Trump's firing of FBI Director James Comey (he said he wasn't in favor of an independent investigation, yet, but he also said "I didn't come here to defend the president tonight"), but most of his constituents wanted to talk about health care. Many of them blamed him for, as one man put it, bringing the American Health Care Act "back from death." One woman shouted, "My blood will be on your hands," and when MacArthur said he was happy that ObamaCare expanded insurance coverage but "I'm looking at an insurance market that is collapsing," a man yelled out, "That's because you drilled holes in it!" There were a lot of calls for switching to a single-payer system.

Another constituent noted the AHCA includes big cuts to Medicaid and slightly bigger tax cuts that primarily benefit the super wealthy, giving as an example the $37,000 a year MacArthur, a former insurance executive, would save under the law. MacArthur disagreed with the assessment of the bill. "This isn't tax cuts for the rich — this is tax cuts for everybody!" he said, explaining that it zeroes out taxes and income on profits from stock investments. You can get a flavor of what The Washington Post's David Weigel called the "toxic" environment in the CNN report below. Peter Weber

May 9, 2017

After narrowly voting to approve the American Health Care Act last Thursday, House Republicans (and their Democratic colleagues) returned home to their districts for an 11-day break. While GOP leaders and the Trump administration are trying to beat back the narrative that their health-care bill would cost millions of Americans their health insurance and sharply raise prices for people with pre-existing conditions, some House Republicans faced more local versions of that battle back home. On Monday, the most high-profile AHCA clash was in Dubuque, Iowa, the home of Rep. Rod Blum (R).

On Monday afternoon, Blum sat down for an interview with reporter Josh Scheinblum of KCRG-TV Dubuque, but it didn't last long. When Scheinblum asked Blum why he was prescreening attendees to his four town halls this week, Blum explained he only wanted people to attend from his district, and when Scheinblum followed up with a question about out-of-district donors, Blum, 62, walked out.

Soon after that clip aired on local TV, Blum held his first town hall meeting in the gym of Dubuque Senior High School, and it was not a friendly crowd. Blum, a member of the far-right House Freedom Caucus, fielded a lot of questions about the AHCA, which he voted for. He actually agreed with many constituents that the bill was rushed through and flawed, though his complaint was that it wouldn't kill off the Affordable Care Act comprehensively enough — he referred to the AHCA as TrumpCare several times, and also ObamaCare 2.0.

"The way Blum struggled Monday night to explain his vote — through the loud boos of rowdy, impolite, and infuriated constituents — is just a narrow sampling of the growing concern and confusion caused by Republican plans to revamp the nation's health-care system," says Ed O'Keefe at The Washington Post. You can read more about Blum's town hall at The Washington Post and watch some footage of the waving red signs at KCRG-TV9. Peter Weber

May 9, 2017

Senate Majority Leader Mitch McConnell has chosen his team to write the Senate Republican version of the American Health Care Act, and senators will apparently scrap the House version and start over. "This process will not be quick or simple or easy," McConnell said Monday. But the group of 13 senators McConnell has tapped for the task — including himself and his top two deputies — has raised eyebrows because, among other things, it includes 13 men and no women.

Robert Pear at The New York Times suggests that McConnell, a shrewd tactician, chose to include only men, including far-right Sens. Ted Cruz (R-Texas) and Mike Lee (R-Utah), "to placate the right." But his picks "may have inadvertently created a dangerous alliance," Pear adds, between Republicans who are more moderate on health care, especially Sen. Susan Collins (R-Maine) and Sen. Bill Cassidy (R-La.), who came up with the "Jimmy Kimmel Test" for health-care legislation. If they band together, they just need one more Republican to effectively veto any bill — and between Medicaid and pre-existing conditions, there are AHCA skeptics in the Senate GOP caucus.

But it isn't just the homogeneity that has people talking; McConnell also left out several senators with potentially useful experience. Collins, for example, notes that she "spent five years in state government overseeing the Bureau of Insurance many years ago, and I think I can bring some experience to the debate that will be helpful." Sen. Tim Scott (R-S.C.), the only black Republican in the Senate, owned one of the most successful Allstate insurance branches in South Carolina before running for Congress, Pear says.

And, of course, health care is an important topic for women as well as men, and the House AHCA would have some sticker shock for women in particular — if pregnancy were deemed a pre-existing condition, as allowed in the bill, a healthy 40-year-old woman could pay $17,060 more in premiums for her pregnancy, or up to 425 percent more than under ObamaCare, according to an analysis by the liberal Center for American Progress. The AHCA also bans federal funding for Planned Parenthood for at least one year, and prohibits federal tax credits to be used on any insurance plan to covers abortion. Michelle Wolf took an acerbic look at the GOP's all-male health-care panel on Monday's Daily Show, and you can hear her thoughts below. Peter Weber

May 5, 2017
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House Republicans scored a sort of hat trick of disapproval on Thursday, when the health industry's main two lobbying groups joined the major organizations for doctors and hospitals in urging significant changes to the health-care bill they just passed. This opposition from doctors, hospitals, and insurers is "a rare unifying moment," says The New York Times.

Insurers said they were concerned about the sharp cuts to Medicaid, reduced financial support for elderly people who buy their own insurance, as well as uncertainty over payments to help insurance companies cover low-income customers. "The American Health Care Act needs important improvements to better protect low- and moderate-income families who rely on Medicaid or buy their own coverage," Marilyn B. Tavenner, CEO of America's Health Insurance Plans (AHIP), said in a statement.

The large majority of health-related industries wanted changes to the AHCA — medical device manufacturers support the bill and the pharmaceutical industry hasn't weighed in — because they'll lose customers and thus money, especially from the cuts to Medicaid and other changes that will lead to employers scaling back or dropping coverage for their employees. But they also expressed deep concerns about patients and the unintended consequences of some 24 million fewer people having health insurance, under Congressional Budget Office estimates.

"To me, this is not a reform," Michael Dowling, CEO of New York's Northwell Health system, tells The New York Times. "This is just a debacle." When lots of people suddenly lose their insurance at the same time the government cuts payments to cover lower-income patients, hospitals that server poorer patients "will just be drowning completely when this happens." The American Medical Association, AARP, American Hospital Association & Federation of American Hospitals, and associations focusing on specific diseases also oppose the law as written. The U.S. Chamber of Commerce, National Retail Federation, and National Federation of Independent Business support the AHCA, while another group representing small-business owners, the Main Street Alliance, opposes it. Peter Weber

May 5, 2017

Conservative columnist and Fox News regular Charles Krauthammer is not a fan of the Affordable Care Act, but after House Republicans voted to partially repeal and replace it on Thursday, he said he thinks, ironically, ObamaCare won the day. "I think what conservatives and Republicans are beginning to understand is how the fundamental view of health care among the American people has changed," he told Tucker Carlson Thursday night.

"ObamaCare is a disaster on the ground," he said, "and politically it ruined the Democrats. However, there's an irony and a hidden victory here: Over these past seven years, people's expectations have changed. You watched the debate over the last three months, Tucker. What are the grounds? The grounds are all liberal grounds: How many people are going to lose their coverage? How can you leave people out in the cold? The Jimmy Kimmel thing. It's showing that the country is at a point where I think it believes in universal coverage."

"I saw a piece this week entitled 'The conservative case for single-payer,'" Carlson said. "I'm not sure most conservatives are there yet, but do you think that's where it's going?" Krauthammer said yes. "Whether it will end up single-payer, like in the Canadian system, or not, I'm not sure, but I will guarantee you this," he said: "Within a few years there won't even be an argument about whether or not government has an obligation to ensure that everybody gets health coverage."

Krauthammer had made a similar argument earlier on Fox News, and was more specific in his predictions. "I think, historically speaking, we're at the midpoint," he told Chris Wallace. "We had seven years of ObamaCare, a change in expectations, and I would predict in less than seven years we'll be in a single-payer system." He said the Senate will scrap the House bill, pass its own, and the two will be reconciled in a conference committee. "Who knows where it will end up, but it will be a rickety arrangement, it's likely that Republicans are going to suffer at the polls, and as a result of that — if that happens — you're going to get a sea-change in opinion," he concluded. "Then there's only two ways to go: to a radically individualist system, where the market rules, or to single-payer. And the country is not going to go back to radically individualist." Watch below. Peter Weber

May 5, 2017

On Thursday, House Republicans passed a deeply unpopular health-care bill that will affect all Americans and one-sixth of the U.S. economy, while Democrats taunted them with the Steam song "Na Na Hey Hey Kiss Him Goodbye" — as you probably already knew if you were watching cable news on Thursday:

Democrats are working off the assumption that since they lost big in the 2010 midterms after passing the Affordable Care Act — Nate Silver runs through how much ObamaCare hurt them — Republicans put their majority at risk on Thursday, with a special eye toward the yes votes from 46 House Republicans in districts that Hillary Clinton or President Obama won at least once since 2008, and more specifically the 14 in districts Clinton won in November. GOP strategist Tom Davis, a former Virginia congressman and ex-chairman of the National Republican Congressional Committee, disagrees with that political assessment.

Generally, Davis told The Atlantic that as unpopular as the American Health Care Act is nationally, including among swing voters, House Republicans faced a higher electoral risk from opposing it, since "the Democratic base is going to be spiked no matter what" and "a dispirited base going into the midterms" is more dangerous for Republicans than losing independents.

More specifically, the House Republicans in districts Clinton won are insulated because they tend to be "higher-income suburban districts" where President Trump is unpopular but so is ObamaCare, Davis argued. "You're not taking their stuff away, they are not the people who are getting punished" under the GOP plan, he said. And the House Republicans representing lower-income and rural Trump voters will be protected by cultural issues and Trump's nationalist bent. Unsurprisingly, Democratic strategists disagree with Davis. You can read their counterargument at The Atlantic. Peter Weber

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