Open Thread

The Open Thread for April 23, 2017

New York Times: “Barack Obama’s extended post-presidential vacation is about to end. After spending weeks in French Polynesia — including time on the yacht of the movie mogul David Geffen along with Bruce Springsteen, Tom Hanks and Oprah Winfrey — Mr. Obama will return to Chicago on Monday for his first public event as a former president.”

“His self-imposed silence since Inauguration Day will end with a series of events over the next four weeks. A Monday town hall-style meeting with students at the University of Chicago will be followed by an awards ceremony in Boston; a series of public remarks as well as private paid speeches in the United States and Europe; and an appearance at the Brandenburg Gate in Germany with Chancellor Angela Merkel.”

Eugene Robinson dives into Zombie Trumpcare and finds it is worse that Living Trumpcareis plan even worse than the last one:  “House Republicans are apparently ready for yet another attempt to snatch health insurance away from constituents who need it. Someone should remind Speaker Paul Ryan of a saying often attributed to his legendary predecessor Sam Rayburn: “There’s no education in the second kick of the mule.” […]  The new proposal — brokered by Rep. Tom MacArthur (R-N.J.), of the moderate Tuesday Group, and Rep. Mark Meadows (R-N.C.), of the far-right Freedom Caucus — is like a parody, as if life-or-death access to health care were fodder for a “Saturday Night Live” sketch. […]

We would go back to the pre-ACA situation in which serious illness could mean losing a home or filing for bankruptcy. This may satisfy GOP ideological imperatives — Ayn Rand would be so proud — but it is atrocious policy, even if you put aside considerations such as compassion and community.”

Jeff Spross at The Week: “First off, here’s what hasn’t changed: As far as I can tell, the new proposal would still massively cut Medicaid. It would also offer the same inadequate subsidies — which were much lower than ObamaCare’s already-underpowered subsidies — to help customers on the insurance exchanges afford their premiums.  The new twist is that states can opt out of two key ObamaCare regulations: The essential health benefits, and the law against charging people different premiums based on pre-existing conditions.”

Jennifer Rubin points out the new plan is essentially still a big tax cut for the rich:  “The GOP 2.0 version of the American Health Care Act has about as much appeal as the original AHCA, or maybe less. It’s still a big tax cut for the rich, a hit to pocketbooks of older and more rural voters, and less generous than what recipients had received under Obamacare. Would a moderate in a district Hillary Clinton carried overwhelmingly go for this? It’d be a high-risk proposition. Would a conservative who sees more regulation (the essential benefits) going back into the deal be thrilled? Probably not. Moreover, it’s clear the Senate would reject the bill, because moderates previously said they’d refuse to go along with a Medicaid rollback.”

Adam Gopnik: “Our problem is not Trump Derangement Syndrome; our problem is Deranged Trump Self-Delusion. This is the habit of willfully substituting, as a motive for Trump’s latest action, a conventional political or geostrategic ambition, rather than recognizing the action as the daily spasm of narcissistic gratification and episodic vanity that it truly is…

There is, perhaps, something not exactly reassuring but in its way tolerable about this delusion. It explains the real reason for the sudden willingness to imagine that Trump is capable of being “Presidential.” People who have acts and actions that add up to some coherent plan—or even to an evil scheme—tend to have an ideology. It possesses them, or they are possessed by it. With Trump, it is perfectly clear that he only has a series of episodic wounds and reactions—it’s all fears and fits.”

Ed Kilgore on Zombie Trumpcare: “The much-bruited MacArthur Amendment to the earlier bill, with its provision for state waivers to sidestep comprehensive insurance-plan requirements and protections for people with preexisting conditions, may or may not attract some additional House Freedom Caucus votes. But it is very, very unlikely to sway those among MacArthur’s fellow moderates who refused to vote for the original bill. Yes, it would allow blue states to keep something like the original Obamacare individual-health-insurance markets in place, assuming insurers were willing to go along. But it keeps in place AHCA’s quick phaseout of the Affordable Care Act’s Medicaid expansion, hammering those same states.

Prospects in the Senate, where Republican moderates have much more leverage due to the GOP’s narrow two-vote majority, are much worse. On top of the substantive health care policy concerns House moderates have articulated (particularly over Medicaid), there are now three GOP senators who are not necessarily onboard for the defunding of Planned Parenthood that is part of the package. And there remain real problems with the Senate rules, since the state waiver provisions that are central to the MacArthur Amendment could easily be ruled non-germane to the budget process by the Senate parliamentarian, exposing the whole bill to a Senate filibuster.

So why the rush toward an apparent abyss? From the White House point of view, it’s apparently all about Trump’s panic over not having big accomplishments to boast of when the 100-day mark of his presidency arrives, on April 29.”

Zombie Trumpcare would take people who have illnesses (i.e. pre-existing conditions) out of the regular pool of insured people and relegate them to higher risk pools. This inevitably jacks up insurance costs for the sickest people because insurers must spend more money on their health care—an expense they pass on to the insured.  So here’s a look from the Center for American Progress at just how much more we’re talking about, and it ain’t chump change.

Screen_Shot_2017-04-20_at_3.59.37_PM

Playbook: “Republicans have been promising to repeal and replace Obamacare for almost a decade. But if they jam an Obamacare bill through the House, it could seriously complicate their chances for tax reform. Why? Because they are using reconciliation — a budgetary tool — to gut Obamacare. And if they are successful at passing the repeal with reconciliation, they’d need to pass another budget to allow them to begin tax reform. Do you think passing a 2018 budget will be easy? No. It will be very difficult. And that’s basically the only way for Congress to pass a tax-reform bill. White House insiders say this obvious — and critical — dynamic hasn’t been discussed much.”

“Despite all of that, the White House seems hell bent on trying to push through a health care package when Congress returns. And in a city that rarely can walk and chew gum at the same time, Trump’s decision to announce that he would unveil of his tax plan next week in the middle a government shutdown fight is aggressive, to say the least. At worst, it could hurt his support among Republican lawmakers frustrated by the lack of direction from the White House.”

President Trump “has emerged as the wildcard as congressional leaders clamber to reach agreement on a package to keep the government funded and prevent a shutdown,” The Hill reports.

“Republican leaders are keenly aware which ‘poison pill’ provisions are non-starters with the Democrats, whose votes will be needed to send a spending bill to the president. But Trump, who is closing in quickly on his first 100 days in office, is hungry for legislative victories after a rocky start that included the stunning failure of the Republicans’ Obamacare repeal-and-replace bill.”

“Not a single member of Congress who represents the territory on the southwest border said they support President Donald Trump’s request for $1.4 billion to begin construction of his promised wall, according to a Wall Street Journal survey, testing the administration’s ability to reach a deal on government funding next week.”

“Most lawmakers representing the region—both Democrats and Republicans—said they are opposed and many said they have unanswered questions. A few were noncommittal, but not a single member of the House or Senate representing the region expressed support for the funding request.

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