Trump Endorses Repeal-First Strategy if Health Care Deal Not Reached

As Senate negotiations continue over the stalled Republican health care bill, President Donald Trump Friday morning called on senators to pass a simple repeal of Obamacare now and focus on replacing it later this year if no deal is reached.

Trump’s tweet came just after Sen. Ben Sasse, R-Neb., sent a letter to the White House urging the president to support a repeal-first, replace-later strategy if there is no agreement by the time senators return from their week-long Fourth of July recess on July 10.

The idea has been floated by some Republicans since a planned Senate vote on the GOP Better Care Reconciliation Act was postponed Tuesday because leaders were unable to secure the 50 GOP votes needed to pass it.

Sasse has been working quietly with the White House on the idea, according to a Senate Republican aide who said the administration was receptive to the idea.

“You campaigned and won on the repeal of Obamacare. So did every Republican senator. We should keep our word,” Sasse wrote in the letter.

“On the current path, it looks like Republicans will either fail to pass any meaningful bill at all, or will instead pass a bill that attempts to prop up much of the crumbling Obamacare structures,” he added. We can and must do better than either of these — both because the American people deserve better, and because we promised better.”

Sasse also asked the president to call on Congress to cancel its scheduled month-long August recess to work on a replacement bill for a Labor Day vote. “After we gave our word to repeal and replace Obamacare’s monstrosity,” he said, “we should not go back to our states during August as the American people struggle under fewer choices and skyrocketing costs. We should remain in D.C. at work.”

Sen. Rand Paul, R-Ky., who has publicly been advocating starting the idea of starting with a full Obamacare repeal publicly for two weeks, quickly retweeted the president and added his support.

Sasse has kept a low profile throughout the negotiations on health care, refusing to comment or publicly engage on the bill.

The idea was considered by Republican leaders at the beginning of this year when Trump took office but it was quickly dropped when they realized it would be too politically difficult to replace Obamacare outside the reconciliation process where the Senate would need the support of Democrats to pass a replacement.

Senate Republicans continue to discuss a way forward in the health care bill, considering changes to appear both moderates and conservatives to get the support of 50 of 52 Republicans.

[NBC News]


Trump posts misleading tweet about Medicaid spending under the Senate Republican healthcare bill

President Donald Trump took exception Wednesday with a Democratic argument regarding Medicaid funding in the new GOP healthcare bill.

“Democrats purposely misstated Medicaid under new Senate bill – actually goes up,” Trump tweeted with a chart.

One of the biggest criticisms of the Senate healthcare bill, the Better Care Reconciliation Act (BCRA), has been the projected cuts to future Medicaid spending under the legislation, which the Congressional Budget Office said would lead to 22 million fewer Americans being insured by 2026.

Trump’s tweet echoes an argument from Republicans that says the legislation doesn’t cut Medicaid spending.

But critics of the legislation note that the projected increase in funding from the federal government will be lower than the current projected rate of increase. This could have serious consequences for Medicaid recipients and state budgets.

Currently, the federal government provides states with a percentage of their Medicaid funding based on a formula of how much a state actually spends. Under the BCRA, states would receive a set amount of money based on the number of people on Medicaid in that state.

In other words, federal funding would grow in raw terms as the US population grows and the total number of people on Medicaid increases, but the amount per person would not be as generous as the current system.

The chart below shows the difference:

Also, the BCRA would end the Medicaid expansion program under the Affordable Care Act, the law better known as Obamacare, which would represent another significant decrease from the current path of funding.

The Congressional Budget Office projected that federal funding for Medicaid would decrease by $772 billion over the next 10 years compared to the current system.

According to analyses from The Brookings Institution, The Kaiser Family Foundation, and the CBO, the formula for the Medicaid growth rate under the BCRA would lead to increased financial stress on states and detrimental outcomes for Medicaid recipients.

[Business Insider]


Vox fixed the chart:



Mick Mulvaney: The Day of the CBO ‘Has Probably Come and Gone’

During an interview with the Washington Examiner on Wednesday, Office of Management and Budget Director Mick Mulvaney trashed the Congressional Budget Office (CBO) as partisan and made a case that the country would be better off without it.

“At some point, you’ve got to ask yourself, has the day of the CBO come and gone?” Mulvaney said. “Certainly there is value in having that information, especially if they could return to their nonpartisan roots. But at the same time you can function, you can have a government, without a Congressional Budget Office.”

Mulvaney honed in on the CBO’s recently released analysis of the American Health Care Act (AHCA), passed by House Republicans last month and vociferously supported by President Trump. The nonpartisan office estimated that the AHCA will cost 23 million Americans their health insurance while dramatically increasing costs for older Americans and people with pre-existing conditions, in part because of the bill’s $834 billion cut to Medicaid over the next decade.

“Did you see the methodology on that 23 million people getting kicked off their health insurance?” Mulvaney said. “You recognize of course that they assume that people voluntarily get off of Medicaid? That’s just not defensible. It’s almost as if they went into it and said, ‘Okay, we need this score to look bad. How do we do it?’”

Mulvaney characterized the CBO’s analysis of coverage losses as “just absurd” and said, “ To think that you would give up a free Medicaid program and choose instead to be uninsured is counterintuitive.”

The CBO, however, doesn’t assume that people will “give up Medicaid.” Instead, it assumes people will lose Medicaid coverage nonvoluntarily because of eligibility lapses, raises at their jobs, and other developments that under the House Republican plan will cause them to become ineligible. Vox explains:

The AHCA would effectively end the Affordable Care Act’s Medicaid expansion by freezing federal support for it starting in 2020. Under current law, the federal government initially paid 100 percent of costs of Medicaid expansion beneficiaries, a percentage set to wind down to 90 percent in 2020 and stay at that level permanently. Under the AHCA, the federal government would keep paying for people who signed up for Medicaid expansion coverage before January 1, 2020, but not anyone who signs up after that.

Over time, this would also lead people currently enrolled to lose their benefits, and they wouldn’t be able to go back on the program thereafter. The AHCA drops funding for enrollees whose eligibility lapses for two or more months, and many working poor people cycle in and out of Medicaid as their income changes: They get a raise and no longer qualify for Medicaid; then they lose that job or take a pay cut and enroll again.

Mulvaney’s vision for a post-CBO America would involve his office taking the lead on estimating the impacts of major legislation — “I would do my own studies here at OMB as to what the cost and benefits of that reg would be,” he said.

But the danger of that approach was illustrated just last week by Trump’s budget proposal, which included a glaringly basic arithmetic error involving double-counting the estimated economic impact of tax cuts. Instead of acknowledging that double-counting the $2 trillion in savings was a mistake, Mulvaney told reporters that he and other Trump administration officials who worked on the budget did it on purpose.

When the first version of the AHCA was unveiled in March, Mulvaney tried to discredit the CBO before it even had a chance to release its analysis of the bill, arguing on ABC’s This Week that the CBO’s analysis of the Affordable Care Act (ACA) was off.

It wasn’t. concluded that despite overestimating the number of people who who get subsidized insurance through ACA exchanges, the CBO “actually nailed the overall impact of the law on the uninsured pretty closely.”

The CBO “predicted a big drop in the percentage of people under age 65 who would lack insurance, and that turned out to be the case,” wrote. “CBO projected that in 2016 that nonelderly rate would fall to 11 percent, and the latest figure put the actual rate at 10.3 percent.”

In short, Mulvaney, Health and Human Services Director Tom Price, and other AHCA-supporting Republicans are attacking the CBO simply because of its tough assessment of their preferred health care plan, which involves a huge tax cut for the rich.

What Republicans like Mulvaney are saying about the CBO during the Trump era is the opposite of what GOP members of Congress said when Bill Clinton was president. In the 1990s, Congressional Republicans demanded that the CBO score President Clinton’s budgets, dismissing his Office of Management and Budget as partisan.

During congressional testimony last week, Mulvaney, defending Trump’s budget proposal, made a case that the fiscal interests of the unborn should take precedence over the lives of present-day Americans — or at least those who rely on food stamps to eat or public schools to educate their children.



Mick Mulvaney trashed the CBO because they scored Trumpcare saying it would kick 24 million people off of their healthcare. That’s totally crazy because Mulvaney’s Office of Budget Management did their own calculations and came to the exact same conclusion.

It would be nice if The Washington Examiner called Mulvaney on his bullshit.

Trump: Senate Republicans Should Use the ‘Nuclear Option’ to Pass Healthcare and Tax Cuts

President Donald Trump on Tuesday said the Senate should get rid of the legislative filibuster so that it could pass healthcare and tax-cut bills.

“The U.S. Senate should switch to 51 votes, immediately, and get Healthcare and TAX CUTS approved, fast and easy,” Trump tweeted. “Dems would do it, no doubt!”

The filibuster allows senators to hold up legislation without a 60-vote threshold.

Changing the floor rules to end the filibuster has been considered a “nuclear option” for lawmakers, as it could come back to bite the GOP if the Democrats were to retake the Senate.

In recent years, however, the party in control of the Senate has done away with other filibusters in an attempt to circumvent the opposition. Democrats eliminated the filibuster for executive and judicial nominees in 2013. And in April, Senate Majority Leader Mitch McConnell scrapped the filibuster for Supreme Court nominees to confirm Trump’s nominee, Neil Gorsuch.

The GOP is circumventing a possible filibuster for its healthcare bill by introducing it using a process known as budget reconciliation. As long as the bill cuts the federal deficit, it is not subject to a 60-vote threshold.

Both the GOP healthcare bill, the American Health Care Act, and Trump’s tax proposals have faced unanimous opposition from Democrats.

Trump’s suggestions followed a series of tweets Tuesday in which he criticized Germany and attacked reports on ties between his campaign and Russian officials.

[Business Insider]

Trump Attacks News Media Over ObamaCare Repeal Coverage

President Trump attacked the news media Friday night on Twitter over perceived negative coverage of the House GOP’s passage of legislation aimed at repealing and replacing ObamaCare.

“Wow,the Fake News media did everything in its power to make the Republican Healthcare victory look as bad as possible,” Trump tweeted. He also predicted the Republican plan would be “far better” than the Affordable Care Act.

In a second tweet, Trump questioned why the news media “rarely reports” that ObamaCare “is on its last legs and that insurance companies are fleeing for their lives?”

“It’s dead!” Trump declared, reiterating a longstanding position.

(h/t The Hill)


Maybe the Republicans should have put forth a bill that didn’t kick 24 million people off of healthcare, raise rates for the elderly, and allow insurance companies to discriminate based on preexisting conditions?

The reality is, when the CBO had a chance to score the first version of Trumpcare, it was very clear the insurance markets are stable. This idea that Obamacare is in a “death spiral” is pure fiction.




House Passes American Health Care Act

I think today is a good day to have a conversation with our friends and family who vote Republican, and find out why they would support such a heartless effort to remove healthcare for 24 million people, allow insurance companies to deny coverage for preexisting conditions, push the sickest of us to underfunded high-risk pools, while giving a massive tax break to the millionaires and billionaires.

Ask them why they think that making the AHCA even more cruel, by removing protections for preexisting conditions, was the only way Republicans in the House were able pass an Obamacare repeal?

Do they know that if they are over 50 years old, Obamacare regulated the insurance industries so they could only charge 3 times more than the lowest bronze plan, and now the Republicans made a change so insurance companies can charge them 5 times more than a bronze pan? Why would they want to support Republicans who just raised they insurance premiums?

Do they know without preexisting condition protections, it will be inevitable that a percentage of people without healthcare will die. That’s right, they won’t be able to have access to insurance and will die. Did they cheer? Were they happy?

Do they know Obamacare is funded mostly by millionaires and billionaires? If they make $250,000/year or more they’ll pay about $250/year for Obamacare, otherwise they pay right now $0 in taxes for Obamacare. That’s right. All of those protections are free!

Obamacare was debated on for 18 months, had a transparent and open debate. Republicans had no plan after 8 years, cobbled together pieces of Paul Ryan’s 2012 health care reform in a secret room that fellow Republican Rand Paul couldn’t even get in to, and they rushed the legislation through so fast the Congressional Budget Office did not have time to score it. Did they know Republicans were so sure of the negative effects of their plan they shielded themselves with exemptions?

The Senate will now take up the bill and only 2 Republicans need to say “no” in order to kill this bill, and send it back to the House. But once it returns, the House Republicans will no longer have the budget reconciliation process used to shove the ACHA through. There is a limited time between now and that Senate vote. And it would be nice to know where your Republican friends and family stand on the health of their friends and family.

Trump Sunday Morning Tweet Promises ‘Love and Strength’ of GOP Will Eventually Take Away Obamacare

President Donald Trump was off and running on Twitter Sunday morning, once again attacking the media for saying his plan to repeal and replace Obamacare is “dead.”

Ten days after House Majority leader Paul Ryan (R-WI) pulled his Trumpcare bill in the face of certain defeat and Trump administration officials said the president was moving on to budget and tax matters, Trump declared on Sunday that he still intends to get rid on Obamacare.

The president then asserted the real story the press should be covering is “surveillance and leaking.”

“Anybody (especially Fake News media) who thinks that Repeal & Replace of ObamaCare is dead does not know the love and strength in R Party!” Trump tweeted before adding, “Talks on Repealing and Replacing ObamaCare are, and have been, going on, and will continue until such time as a deal is hopefully struck.”

Trump’s mention of “love and strength in the R party” strikes a conciliatory tone from his recent Twitter attacks on the hard right Republican Freedom Caucus that torpedoed Trumpcare.

On Saturday, Trump’s social media director Dan Scavino called for the defeat of Freedom Caucus Rep. Justin Amash (R-MI) to be defeated at the polls.

You can see Trump’s Sunday tweets below:

(h/t Raw Story)