Five changes the Senate could make to the ObamaCare repeal bill

Five changes the Senate could make to the ObamaCare repeal bill
By Rachel Roubein - 05-05-17 17:44 PM EDT

GOP senators are making it crystal clear. The House's ObamaCare repeal-and-replace bill is getting changed.

Senators say the legislation can't pass the upper chamber in its current form, and they are looking to put their own stamp on the bill.

Here are five big changes that senators will be eyeing.

Tax credits

The Senate is likely to change the bill to provide more tax credits to better help low-income people afford health insurance.

Sen. John Thune (S.D.), the No. 3 Senate Republican, is already working on an amendment to ramp up the credits.

The issue was also raised Thursday during a meeting in Senate Majority Leader Mitch McConnell's (R-Ky.) office that was focused on possible changes to the bill.

Sen. John Barrasso (R-Wyo.), part of the leadership team, acknowledged afterwards that changes to tax credits were "part of the active discussion."

Under the House bill, a single 64-year-old making $26,500 would have to pay more than half his or her salary - $14, 600 per year - in premiums, according to the nonpartisan Congressional Budget Office. This stark datapoint made the rounds on social media after CBO scored the bill in March.

In part, this is because insurers can only charge older adults three times more than those who are younger and generally healthier under the Affordable Care Act. The House bill lets carriers charge older adults five times as much as young people. Also, tax credits are more generous for those with lower incomes under ObamaCare, and thus, lower premiums.

Medicaid

Medicaid has emerged as one of the thorniest issues of the ObamaCare repeal and replace debate.

ObamaCare allowed states to expand the healthcare program for low-income and disabled people. Washington, D.C. and 31 states have taken the federal help, according to the Kaiser Family Foundation. This has provided coverage to an estimated 9.6 million people, according to the American Action Forum. 

The House bill would undo that expansion in 2020.

Lawmakers from expansion states don't want to see their constituents lose coverage. Lawmakers from states that didn't expand don't want to be penalized for staying true to their conservative principles.

"We need to get a balance to make sure that states are treated fairly," Barrasso told The Hill.

After the House passed its bill, Sens. Rob Portman (R-Ohio) and Dean Heller (R-Nev.) quickly said they couldn't support the current version of the measure, citing Medicaid as a major concern.

One option for the Senate would be to delay the House bill's plan to eliminate the expansion in 2020. States can no longer choose to expand after 2020, and the federal government will cut off enhanced federal funding that same year.

"They're at least going to push out the date that it phases out maybe further," said Joe Antos, a resident scholar at the conservative-leaning American Enterprise Institute.

This would be easier than doing away with the provision altogether, as it would not greatly raise the cost of the bill, Antos said.

"It's that age-old gimmick that Congress always does when there's something that's unpleasant, they push it way out," Antos said.

Coverage

About 24 million more people could be without health coverage by 2026 under the House's bill, according to a March CBO analysis.

The House passed its latest bill before CBO could finish a new analysis.

This could be a big problem in the Senate, where a number of Republicans are worried about passing a measure that could leave more people in their states uninsured.

"That's not what President Trump promised," Sen. Bill Cassidy (R-La.) told CNN in March. "That's not what Republicans ran on."

The issue of ensuring people retain coverage was an important one in the House debate, but it is likely to be even more intense for senators representing entire states, not smaller districts.

Pre-existing conditions

Cassidy calls it the "Jimmy Kimmel test."

The talk show host gave an impassioned speech this week on his show, tearfully explaining how his child was born with a heart defect. In a video that went viral, Kimmel made the case for why people with pre-existing conditions should have health coverage.

Cassidy suggested a new litmus test for a Senate bill.

"I ask, does it pass the Jimmy Kimmel test?," Cassidy told CNN. "Will a child born with congenital heart disease be able to get everything she or he would need in the first year of life? I want it to pass the Jimmy Kimmel test."

Cassidy was answering a direct question about whether he would support a bill that imposed caps on the amount of money an insurer would have to spend on a policy, but the meaning of his remarks appeared broader.

He and other Republicans will want a bill that definitively ensures people who pre-existing conditions will not be left without coverage.

A key amendment in the House backed by Reps. Tom MacArthur (R-N.J.) and Mark Meadows (R-N.C.) lets states opt out of a core ObamaCare requirement called community rating, which prohibits insurers from charging sicker patients more money.

Critics of the House bill insist this will lead to higher costs or less coverage for those with pre-existing health conditions.

"We cannot pull the rug out from under states like Nevada that expanded Medicaid and we need assurances that people with pre-existing conditions will be protected," Sen. Dean Heller (R-Nev.), one of the most vulnerable senators in 2018,said in a statement.

Essential health benefits

ObamaCare requires insurers cover a list of services, such as maternity care and substance abuse and mental health treatment.

The MacArthur amendment lets states opt of this mandate, and it's unclear if this will fly in the upper chamber.

The Senate parliamentarian has control over the strict parameters of what can be in a reconciliation bill, the fast-track budget maneuver Republicans are using to repeal and replace ObamaCare because it only requires 51 votes to pass.

"I do think that the language of the MacArthur amendment allowing waivers from the essential health benefits and community ratings rules is definitely something that is going to be challenged under the Byrd rule and is definitely vulnerable," Ed Lorenzen, senior adviser for the Committee for a Responsible Federal Budget, said.

He cautioned, though, that it's hard to know for sure how the Senate parliamentarian will rule.

Jessie Hellman contributed.

Congress's Budget Bill Spends Billions on Useless Light Rail

reason.com  |34 minutes ago

Few lovers of government largesse are more ecstatic with the 2017 Omnibus Appropriations bill than those crazy devotees of huge public transit projects.

Following passage of the bill, the American Public Transportation Association (APTA) issued a statement applauding Congress for "acting in line with the wishes of the American people" and refusing to eliminate even one of the billions of dollars earmarked for light rail and street car projects across the country.

Just a month ago, these advocates and their supporters in Congress had been fretting about Trump's "devastating" skinny budget and a proposed cut 13 percent cut to the Department of Transportation. The federal government currently pays for some 43 percent of all capital spending on public transit.

But thanks to a steady stream of open letters, questionable economic studies, and advocacy from bi-partisan boosters of public transit within Congress, these cuts were jettisoned from the final budget deal struck on Monday.

The new spending plan gives the Department of Transportation (DOT) an overall discretionary budget of $19.3 billion, a $681 million increase over 2016 funding levels. Hardly the 13 percent cut initially proposed.

Given new life under these increased funding levels is the Transportation Investment Generating Economic Recovery (TIGER) grant program, which Trump's budget blueprint had eliminated in its entirety.

Initially created as an economic recovery program under the Obama Administration's stimulus plan, these TIGER grants have gone on to dole out $4.6 billion to transit projects in the years since the Great Recession has ended, and not without controversy.

A 2014 Government Accountability Office report found the Department of Transportation had violated its own internal control practices in administering the TIGER program, giving grants to projects that applied after deadlines or which were rated inferior to other applicants.

The GAO report also found that DOT failed to document the reasons for these violations of its internal controls which it warned could "give rise to challenges to the integrity of the evaluation process and the rationale for the decisions made." You don't say.

Monday's spending bill gives TIGER another $500 million.

Also living to spend another day is the Capital Investment Grants (CIG) program which, like TIGER, funnels money to state and local agencies and transit authorities for various public transit projects.

Trump's "skinny budget" proposed ending these grants for all projects but those in the final agreement stage with the Department of Transportation. "New transit projects," according to the budget document, "would be funded by the localities that use and benefit from these localized projects."

This provision panicked local transit authorities who had sold voters on infrastructure plans assuming those federal grants would be forthcoming. Seattle's Lynnwood light rail extension, Tempe, Arizona's new Streetcar project, and others faced cancellation without significant tax increases and borrowing at the state and local levels.

Thanks to a $2.4 billion appropriation to the CIG program, however, 18 public transit projects were spared. Lynnwood in Seattle will get a taxpayer gift of $125 million, while Tempe Streetcar will receive $50 million, almost a third of its overall cost.

Also included in the new congressional budget plan is another $1.5 billion for America's perennial transit loser, Amtrak.

The death of Trump's proposed cuts to wasteful light rail spending should hardly be a surprise. As APTA points out in their Monday press release, three of four Americans favor of increasing spending on public transportation. Their elected representatives in Washington are only too happy to give it to them.

Poll popularity aside, Congress's budget plan accounts for barely 3 percent of passenger miles traveled in urban areas. Public transit is the most expensive form of transportation, costing $1.15 per passenger mile, nearly five times the cost of the same mile by car.

Trump's proposed cuts to programs like CIG and TIGER offered a brief, tantalizing hope the federal government would step away from costly transit options that are actually used by fewer and fewer people.

Monday's transit deal is a reminder representatives of both major political parties will always spend your tax money - however ineffectively - in the hopes of remaining in office.

"FBI Report: Media Narrative Inspires Violence Against Police"

A Black Lives Matter activist confronts a member of the NYPD during a protest against U.S. President Donald Trump and New York Mayor Bill de Blasio in the Manhattan borough of New York, U.S., April 1, 2017. (PHOTO: REUTERS/Darren Ornitz)

FBI Report: Media Narrative Inspires Violence Against Police

By Will Racke

05 May 2017, 10:23 AM

A new report from the FBI says a one-sided media narrative against police is partly to blame for the growing hostility to law enforcement, which resulted in a sharp rise in officer killings in 2016.

The report, “Assailant Study — Mindsets and Behaviors,” saidconstant negative coveragein the aftermath of officer-involved shootings of minorities often inspired cop killers, beginning with the death of Michael Brown at the hands of a Ferguson, Mo., police officer in 2014.

“It appears that immediately following the incidents, assailants were exposed to a singular narrative by news organizations and social media of police misconduct and wrongdoing,” the report said. “In many cases, this singular narrative came from the subject’s friends and family, and witnesses who often knew the subject, long before law enforcement provided their findings to the public.”

The unclassified study, published in April, examined 50 incidents in which police officers were shot and killed in the line of duty in 2016. It was a particularly deadly year for law enforcement —64 officers were killed in direct attacks, a 56 percent jump from 2015, the Washington Times reported.

Assailants has several characteristics in common, the FBI said. Nearly all had prior criminal histories, and about 60 percent had a known history of drug use.

The FBI also found that 14 of the 50 attackers studied — 28 percent — had expressed a desire to kill police officers before carrying out their attacks. In those cases, assailants’ own personal experiences shaped their perceptions of police. What was being reported in the media about high-profile police shootings in Minnesota, Louisiana and other states contributed to their views.

“These assailants expressed that they were distrustful of the police due to their previous personal interactions with law enforcement and what they heard and read in the media about other incidents of law enforcement shootings,” the FBI said. “Specifically, in the Dallas, TX and Baton Rouge, LA attacks, the assailants said they were influenced by the Black Lives Matter movement, and their belief that law enforcement was targeting black males.”

Five officers were killed in the Dallas ambush, which coincided with a BLM protest against police shootings of black men in Louisiana and Minnesota, while three officers died in the Baton Rouge attack.

The intense scrutiny of police actions and sympathetic media coverage of anti-police movements has created a “de-policing” effect in law enforcement departments across the country, the FBI claimed.

As a result, many officers are either “scared or demoralized” and avoid interacting with the community because they feel proactively targeting criminals is not worth the potential social and professional risk, the report concluded.

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"Trump Praises Universal Health Care Hours After Obamacare Repeal Bill Passes House"

U.S. President Donald Trump meets with Australia's Prime Minister Malcolm Turnbull ahead of an event commemorating the 75th anniversary of the Battle of the Coral Sea, aboard the USS Intrepid Sea, Air and Space Museum in New York, U.S. May 4, 2017. REUTERS/Jonathan Ernst

Trump Praises Universal Health Care Hours After Obamacare Repeal Bill Passes House

By Alex Pfeiffer

05 May 2017, 09:06 AM

President Donald Trump praised government-funded universal health care Thursday just hours after Republicans in Congress passed an Obamacare replacement bill.

“Right now Obamacare is failing. We have a failing health care,” Trump said while seated next to Australian Prime Minister Malcolm Turnbull. “I shouldn’t say this to our great gentleman and my friend from Australia, because you have better health care than we do.”

The president was in New York with Turnbull to commemorate the 75th anniversary of the Battle of the Coral Sea. The visit to his hometown came hours after he celebrated the passage of a healthcare bill in the Rose Garden.

Australia has government-funded universal health care, and the legislation Trump praised earlier in the day would work to remove the government’s role in health care.

U.S. President Donald Trump (L) and Australia’s Prime Minister Malcolm Turnbull (R) deliver brief remarks to reporters as they meet ahead of an event commemorating the 75th anniversary of the Battle of the Coral Sea, aboard the USS Intrepid Sea, Air and Space Museum in New York, U.S. May 4, 2017. REUTERS/Jonathan Ernst

Sen. Bernie Sanders, who advocates for single-payer health care, reacted to Trump’s comments with laughter. “Thank you, Mr. President. Let us move to a Medicaid-for-all system that does what all other major countries do and guarantee health care to all at a fraction of the cost per capita that we spend,” Sanders added.

Trump has previously signaled support for universal coverage. He said in a January interview that he wants to replace Obamacare with “insurance for everybody.”

 

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Mark Levin: House bill repeals only 10 percent of Obamacare

Ed Straker

Conservative talk show host Mark Levin says the House "repeal" of Obamacare repeals only about 10%. He made the following points on his show on Thursday:

1) Some Obamacare taxes are repealed. Hooray!

2) The government will pay $138 billion to cover people with "pre-existing conditions," a fancy name for people who refuse to get health insurance until they get sick and then expect you, the taxpayer, to pay for their health care. One hundred thirty-eight billion dollars is a lot of money.

3) The federal government will continue to pay all costs of new Medicaid patients until 2020. That gives states incentives to continue to sign up more and more people for Medicaid, a program that is rapidly becoming unsustainable.

4) It is still illegal to sell insurance across state lines. Competition across state lines would have helped keep premiums down. Now that will not happen.

4) The insurance mandates are not repealed, but states can apply for a waiver.

This last point is the heart of the House bill. A lot of the increased costs of Obamacare stem from the requirements that insurance cover a whole bunch of so-called "essential benefits" like drug addiction and psychiatric services, which raises the cost for everyone who doesn't need or want such coverage.

Under the House bill, states can apply for a waiver so insurance companies can sell insurance without such "essential benefits." They can then offer policies at much lower costs since they are not offering to cover so many extra areas.

The problem with this is that consumers will see lower premiums only if they live in states that decide to allow insurance companies to sell policies without such "essential benefits." If you live in a blue state like New York or California or Illinois, you won't have this choice. The "repeal" bill puts the decision of what should be in the policies in the state's hands, not the consumer's.

But even if you live in a red state that decides to let insurers opt out of such expensive coverage, the federal government can still veto the opt-out and require insurers to offer only policies that cover everything. The Obamacare rules have not been lifted; they have been suspended, only if an individual state applies to the federal government for a waiver and only if the federal government does not deny the waiver. That means that the next time we get a Democrat president, he can deny the waivers and in this respect restore Obamacare to exactly the way it used to be. This is the Republicans' definition of "repealing" Obamacare.

President Trump calls this the "repeal and replacement" of Obamacare. That's simply not true. One wonders how the results might have been different if President Trump had proposed a bill repealing Obamacare. Despite his promise to do so, the president never once submitted a bill or even a proposal for repealing Obamacare. He simply waited for whatever emerged from the House and declared victory.

If President Trump had addressed the nation in a series of addresses, stressing the reasons why Obamacare should have been repealed, pressure might have been put on congressmen, and we might have gotten a better bill. That's how Ronald Reagan did it. But Trump preferred to sit back. His only contribution was stating that he wants pre-existing conditions covered, that people who refuse to get insurance should have their medical costs paid for by the rest of us.

What do you think? Is this the great "repeal" of Obamacare that President Trump says it is? Or is Mark Levin right, and this is more of a slimming down of Obamacare rather than the dissolution of it?

Ed Straker is the senior writer atNewsMachete.com.

© 2011 AmericanThinker

Repeal and Replace the Republican Party

Bruce Walker

In an American Thinker article on October 19 of last year, I argued that conservatives ought to consider strongly creating a National Conservative Party. In that article, I asked the question: "Does anyone seriously doubt that the Republican Party, which unlike the Democrat Party is supposed to actually stand for certain principles and values, is grievously and probably terminally broken?"

What are the possible solutions? We could recruit and run conservatives as Democrat candidates for elective offices right up to the presidential candidate. Few conservatives seem interested in this approach, and because it would take a major effort, it would be doomed to fail.

Conservatives could try, as we have been doing since Reagan, to vote out in primaries those Republicans who do not really want to fix the problems in Washington and to put into leadership positions principled conservatives who will do what they promise. This has not worked – and that is stating it mildly.

Conservatives could boycott elections or run independent candidates who have no realistic chance of winning an election. While this might cost Republicans elections, the winner would be not conservatives, but Democrats, who are at least as bad as Republicans. The idea would be to punish Republicans into being better, but there is no reason at all to believe that it would work.

Why not, instead, do what I suggested last October and create a new National Conservative Party? Conservatives remain the largest ideological group in America, with the most recent Battleground Poll, taken after the 2016 election, showing that 52% of those who picked any ideological choice – conservative, moderate, or liberal – chose conservative. Virtually all other polls show conservatives significantly outnumbering liberals nationally.

The CNN exit poll revealed some shocking consequences of Trump not being perceived by conservative voters as a conservative. Hillary won 48.3% of the popular vote, and 5.6% of that represented conservatives who voted for her over Trump. If Trump had won every conservative vote, then he would have gotten 51.5% of the popular vote, and Hillary would have gotten 42.7%.

Trump did get some liberal votes, but if Hillary had gotten all the liberal votes and Trump none, Trump would have gotten 48.9% of the popular vote to Hillary's 45.3%. Nationally, the failure of Republican candidates to garner all conservative votes costs much more than Democrats' failure to garner all liberal votes.

State by state the situation looks worse. Gallup reported this year that in 44 states, conservatives outnumber liberals; in two states, the two groups are tied; and in only four states, liberals outnumber conservatives. Moreover, in 33 states, the conservative advantage is at least ten percentage points, and these states have 325 electoral votes, 66 Senate seats, and 275 House seats – far more than Republicans have won in modern times.

It sure looks as though a National Conservative Party could do much better in winning elections than the Republican Party. How should the campaign for such a party be organized? Why not have a national convention this summer in which a very specific, brief, and clear platform is adopted that included exactly what this party would do if in power and directly blaming both major political parties for creating the mess we are in today?

Communicate this platform directly to voters by as many media outlets as possible, giving voters during this season of great discontent, in which no one trusts Washington and no one trusts Congress, a genuine alternative in the 2018 midterm elections. Begin to build a grassroots network and a national database.

The next step would be to push states to adopt the Louisiana System, in which anyone can run in the first election for political office, but the top two vote-getters face each other if no candidate wins a majority. Republican Party candidates would soon be pushed into extinction in most states. Electoral votes, of course, would need to be chosen this way, too.

If this party won substantial numbers of seats in the next Congress, its members should reject compromise and move to change the structure of Congress so that all the wicked little machinations used to hide what is really happening are purged and so that the people can actually see what is going on without the mystical musings of Capitol punditry.

Would this work? It is hard to see how it could not be better than having the two Siamese twins – Washington Party A and Washington Party B – has been for America.

© 2011 AmericanThinker

How Berkeley Birthed the Right

Pat Buchanan 

In December 1964, a Silver Age of American liberalism, to rival the Golden Age of FDR and the New Deal, seemed to be upon us.

Barry Goldwater had been crushed in a 44-state landslide and the GOP reduced to half the size of the Democratic Party, with but 140 seats in the House and 32 in the Senate.

The Supreme Court of Chief Justice Earl Warren, the most liberal in history, was on a roll, and LBJ was virtually unopposed as he went about ramming his Great Society through Congress.

The left had it all. But then they blew it, beginning at Berkeley.

Protests, sit-ins, the holding of cops hostage in patrol cars -- went on for weeks to force the University of California, Berkeley, to grant "free speech," and then "filthy speech" rights everywhere on campus.

Students postured as revolutionaries at the barricades, and the Academic Senate, consisting of all tenured faculty, voted 824-115 to support all Free Speech Movement demands, while cravenly declining to vote to condemn the tactics used.

Middle America saw the students differently -- as overprivileged children engaged in a tantrum at the most prestigious school in the finest university system in the freest nation on earth.

Here is how their leader Mario Savio described the prison-like conditions his fellow students had to endure on the Berkeley campus in 1964:

"There is a time when the operation of the machine becomes so odious, makes you so sick at heart, that you can't take part; you can't even passively take part, and you've got to put your bodies upon the gears and upon the wheels, upon the levers, upon all the apparatus, and you've got to make it stop. And you've got to indicate to the people who run it, to the people who own it, that unless you're free, the machine will be prevented from working at all!"

To borrow from Oscar Wilde, it takes a heart of stone to read Mario's wailing -- without laughing.

As I wondered in an editorial in the St. Louis Globe-Democrat that week, "If there is so much restriction of speech on the campus, how it is that a few yards from Sproul Hall there is a Young Socialist League poster complaining of 'American Aggression in the Congo' and calling on students to support 'the Congolese rebels.'"

Yet Berkeley proved a godsend to a dispirited right.

In 1966, Ronald Reagan would beat Berkeley like a drum in his run for governor, calling the campus, "a haven for communist sympathizers, protesters and sex deviants."

Reagan relished entertaining his populist following by mocking San Francisco Democrats. "A hippie," said the Gipper, "looks like Tarzan, walks like Jane and smells like Cheetah."

More seriously, the radicalism, intolerance, arrogance and fanaticism of the far left in the '60s and '70s helped to revive the Republican Party and bring it victories in five of the next six presidential elections.

In 1964, neither Nixon nor Reagan appeared to have a bright future. But after Berkeley, both captured the presidency twice. And both benefited mightily from denouncing rioting students, even as liberalism suffered from its perceived association with them.

Which brings us to Berkeley today.

Last week, columnist and best-selling author Ann Coulter was forced to cancel her speech at Berkeley. Her security could not be guaranteed by the university.

In February, a speech of Breitbart editor Milo Yiannopoulos also was canceled out of safety concerns after campus protesters hurled smoke bombs, broke windows and started a bonfire. The decision was made two hours before the event, as a crowd of 1,500 had gathered outside the venue.

The recent attacks on Charles Murray at Middlebury College and Heather Mac Donald at Claremont McKenna call to mind an event from three decades before Berkeley '64.

On Dec. 5, 1930, German moviegoers flocked to Berlin's Mozart Hall to see the Hollywood film, "All Quiet on the Western Front." Some 150 Brownshirts, led by Joseph Goebbels, entered the theater, tossed stink bombs from the balcony, threw sneezing powder in the air and released mice. Theaters pulled that classic anti-war movie.

That same sense of moral certitude that cannot abide dissent to its dogmatic truths is on display in America today, as it was in Germany in the early 1930s. We are on a familiar slippery slope.

First come the marches and demonstrations. Then the assertion of the right to civil disobedience, to break the law for a higher cause by blocking streets and highways. Then comes the confronting of cops, the smashing of windows, the fistfights, the throwing of stones - as in Portland on May Day.

And, now, the shouting down of campus speakers.

The rage and resentment of the left at its rejection in 2016 are palpable. Sometimes this fever passes peacefully, as in the "Cooling of America" in the 1970s. And sometimes it doesn't.

But to have crowds of left and right coming out to confront one another violently, in a country whose citizens possess 300 million guns, is probably not a good idea.