An evidently frustrated President Donald Trump went on another signature tweetstorm all day long on Saturday, threatening to end federal subsidies for health insurance that benefits both the poorest Americans and members of Congress. After a week in which the Senate Republican majority pointedly failed to repeal parts of the Affordable Care Act, Trump tweeted that if a new bill isn’t approved “quickly” then “BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!”
David Nather: “The other part of President Trump’s tweet this morning that will get a lot of attention from members of Congress: he hinted he might overturn an Obama-era rule that allows members of Congress and their staffers to get subsidies for their health insurance, which they have to get through an Affordable Care Act health exchange. That’s what he meant by ‘BAILOUTS for Members of Congress.’”
“The ACA requires members of Congress and their staffs to get health coverage through its exchanges, but it was never clear on whether they should get subsidies to pay for most of their premiums, the way employers pay for most of their workers’ health premiums. The Obama administration issued a rule that allowed them to get those subsidies — because if it hadn’t, members of Congress worried that talented staffers would leave rather than pay the full cost of the premiums.”
Martin Longman says Trump’s real crises are coming: “As I’ve been saying, the real problems haven’t hit yet. Wait until the Republicans discover that they can’t raise the debt ceiling and the country is about to default on its debts and cause a global recession. Wait until the Republicans can’t pass a budget or can’t pass a continuing resolution and the government shuts down. Or, more accurately, watch what happens to the party when its leaders need to go to the Democrats for help and get no help or cover from a White House that has no understanding of practical reality. Wait until we’re asked to follow Trump’s leadership during a crisis on the Korean peninsula or he inadvertently starts a crisis there by making careless tweets.
The failures so far have been spectacular, but they’re just the warm up act. The real consequences are just on the horizon, and all queued up to hit us between Labor Day and Halloween.”
America's democracy is in shambles, just as in the pre-Civil War period. Similar alliance instigating problems. https://t.co/R44nlXDrBd
— Maximilien Guerrero (@Centurion480) July 30, 2017
President Trump “enters a new phase of his presidency on Monday with a new chief of staff but an old set of challenges as he seeks to get back on course after enduring one of the worst weeks that any modern occupant of the Oval Office has experienced in his inaugural year in power,” the New York Times reports.
“The shake-up followed a week that saw the bombastic, with-me-or-against-me president defied as never before by Washington and its institutions, including Republicans in Congress, his own attorney general, the uniformed military leadership, police officers and even the Boy Scouts. No longer daunted by a president with a Twitter account that he uses like a Gatling gun, members of his own party made clear that they were increasingly willing to stand against him on issues like health care and Russia.”
Amazing analysis – stick with it to the end. Chilling. https://t.co/REF3r38hM9
— Tweet L. Dee (@geekteach65) July 30, 2017
Anthony Scaramucci’s wife demanded a divorce three weeks ago, while she was nine months pregnant, sources told the New York Post.
“Deidre Scaramucci, 38, fed up with her three-year marriage to the new White House communication director, filed divorce papers on July 6… On Monday, while Anthony was in West Virginia with President Trump for the Boy Scouts Jamboree, Deidre gave birth to the couple’s baby boy James. As of Friday evening, a full four days after delivery, her 53-year-old husband had yet to meet his newborn son.”
Boston Globe: “The Republican-controlled Congress is in a tailspin of unproductivity, and that’s even before the Senate GOP’s failure last week to pass a long-promised repeal of the Affordable Care Act. By almost every objective measure — especially compared with 2009, the last time one party had control of the White House and both congressional chambers — it is off to a dismal start.”
“Not only have lawmakers been unable to notch major accomplishments on health care or tax reform, but there are also fewer votes, fewer nominees confirmed, and fewer bills passed.”
On health care, Republicans didn't just lack a plan. They lacked a plan to come up with a plan. https://t.co/AJfendULCK
— Peter Suderman (@petersuderman) July 28, 2017
Peggy Noonan: “The president’s primary problem as a leader is not that he is impetuous, brash or naive. It’s not that he is inexperienced, crude, an outsider. It is that he is weak and sniveling. It is that he undermines himself almost daily by ignoring traditional norms and forms of American masculinity.”
“He’s not strong and self-controlled, not cool and tough, not low-key and determined; he’s whiny, weepy and self-pitying. He throws himself, sobbing, on the body politic. He’s a drama queen. It was once said, sarcastically, of George H.W. Bush that he reminded everyone of her first husband. Trump must remind people of their first wife. Actually his wife, Melania, is tougher than he is with her stoicism and grace, her self-discipline and desire to show the world respect by presenting herself with dignity.”
Politico: “Trump, increasingly impatient with the long-stalled repeal effort, met with three Senate Republicans about a new plan to roll back the health care law on Friday, signaling some lawmakers — as well as the president — are not ready to ditch their seven-year campaign promise.”
“The group is trying to write legislation that could get 50 Republican votes… The proposal from Sen. Lindsey Graham (R-SC) would block grant federal health care funding to the states and keep much of Obamacare’s tax regime… White House officials also met with House Freedom Caucus chairman Mark Meadows (R-NC) to brainstorm how to make the idea palatable to conservatives.”
Stan Collender: “The legislative effort on health care may be barely breathing, but it’s definitely still alive. Contrary to the common wisdom that developed after the Affordable Care Act repeal and replace effort failed last week, the Senate still has the opportunity if it wants to revive the debate and pass something.”
Ryan-Priebus ally to me: next phase of Trump presidency will be warfare against GOP Congress
— John Harwood (@JohnJHarwood) July 28, 2017
The Wall Street Journal editorial page lets loose on President Trump: “Presidents get the White House operations they want, and Mr. Trump has a chaotic mess because he seems to like it. He likes pitting faction against faction, as if his advisers are competing casino operators from his Atlantic City days. But a presidential Administration is a larger undertaking than a family business, and the infighting and competing leaks have created a dysfunctional White House.
The reason Mr. Priebus wasn’t as effective as he could have been is because Mr. Trump wouldn’t listen to him and wouldn’t let him establish a normal decision-making process. Mr. Trump has a soft spot for military men so perhaps he’ll listen more to Mr. Kelly. He’d better, because on present course his Presidency is careening toward a historic reputation where names like Jimmy Carter and Richard Nixon reside.”
Sen. Lindsey Graham (R-SC) told CNN that it’s “hard for me to believe” that once the Trump campaign said it wanted help from the Russian lawyer “that the meeting was one-and-done.”
Said Graham: “The likelihood that that was the last contact needs to be looked into because the Trump campaign expressed a desire to be helped.”
Here's the moment the crowd outside the Capitol learned Republicans didn't have the votes. pic.twitter.com/vawKkdygoY
— Emma Roller (@emmaroller) July 28, 2017
In announcing his ban on transgender people in the military, President Trump said that taxpayers “cannot be burdened with the tremendous medical costs and disruption that transgender in the military would entail.
Except that USA Today points out that trans troops don’t really cost that much: “A report for the Pentagon last year found that transition-related care would cost between about $2.4 and $8.4 million per year — less than 0.14% of the military’s medical budget. That’s roughly the cost of four of Trump’s trips to Mar-A-Lago.”
Brookings: “As of the end of June, 209 Democratic challengers had registered with the FEC and raised at least $5,000. That more than doubled the previous high mark since 2003. In 2009, the Republicans had 78 challengers with at least $5,000. The early GOP challengers in 2009 foreshadowed the party’s regaining majority control. The question is whether the same will hold true for the Democrats in 2018.”
“The number of challengers at six months is truly remarkable. And the candidates are not simply bunching up in a few primaries. Yes, there is some doubling up: six Democrats have filed so far against John Faso in New York’s 19th congressional district. But there is also a good spread. So far, 105 different Republican incumbents have Democratic challengers with $5,000.”
‘Medicare for All” is a simple enough rallying cry for Democrats and progressives, in that many voters likely associate it with a single-payer system. But actually, that’s not the case, as Ed Kilgore explains in his post, “Why ‘Medicare for All’ Is a Misleading Term for Single-Payer Health Care” at New York: “Medicare is by design an “acute care” program. It does not cover long-term hospital stays or nursing-home care, and excludes some routine care (e.g., dental and vision care). Presumably a single-payer program designed to replace all or most private insurance would be more comprehensive than Medicare. Perhaps more importantly, from a political point of view, Medicare is neither free nor easy for beneficiaries,” since parts A, B, C and D have substantial out-of-pocket costs for beneficiaries. “The more you look at it,” writes Kilgore, “the more “Medicare for all” is, well, misleading. And it is politically perilous to mislead people about sweeping new health-care programs…Maybe it’s time for single-payer advocates to place less emphasis on alleged simplicity, and more on health care as a right that Americans should enjoy universally and equally. It might avoid some hard feelings down the road.”
Kind of forgotten right now: Dem senators in states Trump won by landslides stayed w Schumer on the ACA, w no political backlash.
— Dave Weigel (@daveweigel) July 28, 2017
Believe Trump’s war on congress is already underway and likely to hit fever pitch in coming weeks, especially in the senate. Rich old white men don’t appreciate being denigrated via tweet and ill considered statements, and that’s both parties. I agree with Martin Longman, the fun has yet to begin as the famed debt ceiling approaches and politicians scurry like rats to avoid the consequences. Also believe that at some point the wisdom of the founders will prevail and that dreaded word, compromise, will rear it’s ugly head, Trump excluded. Also agree about Medicare for all as, at best, a partial measure. Medicare runs about $200 a month, a crushing burden for many myself included. As noted Medicare does not cover many things like dental, vision or the biggie, nursing homes. I see Trump as a one man road block to not only adult behavior but the entire Republican agenda, even if it puts us but a tweet away from nuclear war.
Agreed!
And I’m thinking the GOP won’t be able to raise the debt ceiling and we’ll default. Bet the government shuts down, too. And these two things won’t be Trump’s fault (Oh, he’ll add to the chaos by tweet). Republicans in Congress will do this on their own. Because as awful and incompetent as Trump is, he would sign whatever the Republican Congress put on his desk – and the GOP seems incapable of legislating. Word to the wise… electing idealogues has its pitfalls.
Raising the debt ceiling (something that was always routine until Republicans decided to politicize it in its war against all things President Obama) has all the makings of a nightmare. How do Republicans suddenly say this is okay when they’ve trained their voters to only see the word “debt” in debt ceiling and grossly misunderstand its meaning and function? (Psst… it’s not only their base that doesn’t understand. Just listen to some GOP congresspeople.) Guess the only way they could do this is to say, “We are forced to do this because… Obama!” Not sure what happens the next time they need to raise it, but long-term thinking isn’t their strong suit.
I also agree with Ed Kilgore. Medicare for all is as misleading as Free College. I get why some Dems latch onto these easily relatable phrases, but that’s a mistake. Having gone through Medicare crisis situations with my father and father-in-law, I can tell you that after the 28 days (I think that was the #) of rehabilitation/nursing home care the next step is to 1) go on medicaid, or 2) let the nursing home bankrupt you and then go on Medicaid. What’s really awful? When I think of my Dad’s death I realize that his dying quickly was the best thing that could have happened for my Mom financially. How sick is that? How sick is it that I had to worry about a nursing home taking all of their assets and leaving my Mom in a financial mess? But those are very real choices – and unless you are wealthy almost all of us are on that path. (And long term care insurance is expensive and limiting. That probably deserves its own post!)
I think that Medicaid is the model that should be used — with some kind of sliding scale for premiums based on income. People like to bash Medicaid, but it provides all the essential health benefits, covers medications, and covers eye and dental for kids (not adults, if I remember correctly, though it might cover one medical eye exam a year — glaucoma check, but not glasses?). If it were the only game in town, doctors would have to accept it and systems would have to be updated to make it run more smoothly.
On the other hand, if Medicare’s risk pool is expanded to younger, presumably healthier, members, then maybe premiums can be reduced. The reason people like the Medicare model (I think) is that there is room for supplemental insurance in it, so it’s a bone to insurance companies. I imagine insurance products can be devised to meet new or increased need, especially for nursing home care and in-home care and rehab. Maybe some kind of before-tax HSA specifically for future nursing home or in-home health aide expenses? Like college savings accounts, but in reverse, where kids could also contribute pre-tax $$ for their parents.
“The reason people like the Medicare model (I think) is that there is room for supplemental insurance in it, so it’s a bone to insurance companies.” – Paula
The supplemental insurance is what the insurance companies like about the Medicare model,… Medicare recipients having to pay supplemental premiums on top of their Medicare Parts B and D…. not so much.
There is much to like about Medicare, such as monopsony purchasing(except Part D), but insurance companies still have their fingers in it.
“…some kind of before-tax HSA specifically for future nursing home…expenses” ….where kids could also contribute… – Paula
Google “nursing home costs in delaware”. Average is $300 / day. Assume you’re in a nursing home for a year, that’s $108,000. That’s a lot to put in an HSA. And if you don’t have kids, unburdened with student loans, willing and able to contribute, too bad.
You can find a home in the 4K per month range, if (big if) the person does not have a severe disability or dementia, if that’s the case your looking at 7K a month and up. Know far too much about it from personal experience. Really, really wish I did not.
My father-in-law’s nursing home bill was quoted at 15,000.00 a month! He has Alzheimer’s disease, complicated by a brain injury twenty years ago. He’s also in great physical shape and has amazing strength. He required 24 hour surveillance. He’s on Medicaid and has to wear an ankle monitor because he walks out of the home.
Add any condition – can they feed themselves? take medication? Use the bathroom without assistance? Need some form of physical therapy? – and the cost rises dramatically.
It’s the National Review, but worth the read today: Death of a F***ing Salesman