Nel's New Day

July 17, 2017

Waiting for McCain: Senate Struggles

Senators were so desperate to avoid their constituents that they decided to stay in Washington, D.C. for two weeks of their summer recess, departing August 11 soon after DDT’s 200th day. Majority Leader Mitch McConnell (R-KY) had planned to pass the health Trumpcare bill at the end of this week because he wanted major legislation by the end of Dictator Donald Trump’s (DDT) 200th day. That might make up for almost nothing done during DDT’s first 100 days. McConnell’s little train went off the rails, however.

First, McConnell had two definite defections from either end of the political spectra. Sen. Susan Collins (R-ME) opposed the second bill that McConnell’s staffers wrote because it was more punitive than the first one. Sen. Rand Paul (R-KY) said he wouldn’t vote for the bill because it gave people too much health care. The second senate bill came from Sen. Ted Cruz (R-TX) who wants people to save money by buying substandard insurance plans. These would provide almost no care with prohibitively high deductibles, but the premiums might be lower.

Even big guns in the health insurance industry pointed out flaws in the new Trumpcare bill. In a letter to McConnell and Sen. Chuck Schumer (D-NY), Blue Cross/Blue Shield and the insurance industry lobby group America’s Health Insurance Plans (AHIP) called the most recent Trumpcare plan “unworkable in any form.” They wrote that the plan “would undermine protections for those with pre-existing medical conditions, increase premiums and lead to widespread terminations of coverage for people currently enrolled in the individual market.” The letter also asserted that a “single risk pool” would establish “two systems of insurance for healthy and sick people.” The bill has two pools—one for regular policyholders and another for the very sick. According to the letter’s authors, “millions of more individuals will become uninsured” with the proposed “risk pool.”

The second serious hitch for McConnell was Sen. John McCain’s (R-AZ) surgery in Arizona to remove a blood clot above his eye. McConnell delayed a vote to take healthcare from millions until McCain was back from his surgery paid for by the taxpayers. The first expectations were a week of recovery, but surgeons who performed the craniotomy are now less optimistic. He might not be able to vote on Trumpcare for several weeks. McCain’s blood clot was discovered during a routine physical, the kind of preventative care provided by the Affordable Care Act that Republicans hope to take from people if McCain gets back to Washington. The ACA Medicaid expansions in 30 states and D.C. increased preventative services for 5.4 percent more low-income childless adults in the past year.

If only Collins and Paul had defected, the remaining 50 GOP senators could have passed Trumpcare with VP Mike Pence casting the tie vote. But Sen. Ron Johnson (R-WI) indicated that he might join Collins and Paul because of  his irritation about McConnell’s assurances to moderate Republicans. The majority leader said, “The bill’s deepest Medicaid cuts are far into the future, and they’ll never go into effect anyway. McConnell finally pulled the vote on Trumpcare after Sens. Jerry Moran (R-KS) and Mike Lee (R-UT) dropped their support to even proceed to a vote. Moran stated:

“We should not put our stamp of approval on bad policy. Furthermore, if we leave the federal government in control of everyday healthcare decisions, it is more likely that our healthcare system will devolve into a single-payer system, which would require a massive federal spending increase.”

The senate debacle occurred after DDT hosted GOP senators for dinner at the White House. Sen. Lamar Alexander (R-TN), health committee chair, one of the invitees, was also one of those who wasn’t committed to voting in favor of the bill. A media whip count found only eleven GOP senators, mostly elected leaders and chairs of committees negotiating the bill, who fully supported Trumpcare. With Moran and Lee pairing up to deny Trumpcare, no GOP senator is in danger of being the third “no” in a vote.

Like the House, the Senate figured that if people didn’t like the first bill for healthcare, they would create a worse one. In addition to Cruz’s idea of ending federal subsidies and regulations, it still allows insurers to reject people with pre-existing conditions, reinstitutes lifetime coverage caps, and eliminates coverage of essential benefits such as maternity care. McConnell’s bill retains 80 percent of taxes that earlier versions would repeal, but reduction in Medicaid still offsets these taxes. The $100 billion tax break for people who open health care savings accounts gives to the wealthy, the only people who have enough money to establish these accounts. The bill also gives $70 billion to insurers as protection against the bill’s turbulence, but that action didn’t satisfy the health insurance industry. In its opposition to the bill, AHIP issued a press release entitled, “Policies that increase uncertainty or threaten instability should be avoided.”

As bad as the Trumpcare bill is, the process may be even worse. Senate staffers wrote a health bill that even GOP members of the health care committee couldn’t see, and the GOP leaders said they were proud to be part of a “transparent and open” process. They declared that the Democrats were far more secretive about passing the bill. The Affordable Care Act had over 100 hearings; Trumpcare has none, despite suggestions for having hearings now that the vote has been delayed. Trumpcare is the least popular bill in 30 years and growing less popular every day. Twice as many people support “Obamacare” as “Trumpcare”—50 percent to 28 percent. Sixty-one percent of people disapprove of the Senate plan, and almost two-thirds in the survey oppose major reductions to federal funding for Medicaid. Seventy-one percent want Republicans in Congress to work with Democrats to improve, but not repeal, the ACA.

In another mystery surrounding Trumpcare, the mandatory score from the Congressional Budget Office (CBO) has been delayed from its expected release today. The report for the first bill revealed that Trumpcare would increase average premiums by 20 percent in 2018 and 10 percent the next year before going down in ten years. The CBO may be preparing a comparison with the two different senate bills, but Republicans are concerned about what the most recent bill may reveal.

Passing Trumpcare and DDT’s budget could create an epidemic of “super gonorrhea” caused by the overuse of antibiotics. Eliminating the Antibiotic Resistance Solutions Initiative (ARSI) to try to improve detection and containment of resistant infections across the nation could also limit modern medical advances in surgery and chemotherapy from the threat of infection. Nineteen of the leaders in the G20 are planning to coordinate a fight against this problem.

REUTERS/Kevin Lamarque

In another Senate story that keeps dripping, a D.C. judge overturned the conviction of a protester at the confirmation hearing of AG Jeff Sessions. Desiree Fairooz, 61, laughed when Sen. Richard Shelby (R-AL) claimed Sessions had a “clear and well-documented” record of “treating all Americans equally under the law.” The government had argued that her laugh was sufficient for a guilty verdict. The real disruption occurred when a rookie officer took her out of the room. A new trial has been set for Sept. 1.

In Senate confirmation hearings for FBI director last week, Christopher Wray said all the right things and impressed Democrats. Here is his background.

  • Defense of white collar defendants, including a major Swiss bank accused of laundering money for terrorists and helping Iran obtain nuclear weapons.
  • Lawyer for Russian companies Gazprom and Rosneft.
  • Deletion from his bio about representation of unnamed American “energy company executive in a criminal investigation by Russian authorities.”
  • Overseer of a deal with Chiquita, while he was in the Criminal Division, that exonerated executives of the company supporting terrorism in Colombia.
  • Support for Bush-era rules interrogating (torturing?) so-called “non-combatants.”
  • “Less-than-truthful” answers about the murder of a CIA-held detainee.
  • Defense attorney and “chief custodian of missing cell phones” for Gov. Chris Christie (NJ) during an investigation into the closure of the George Washington Bridge.
  • Extreme enthusiasm for the PATRIOT Act in opposition to civil liberties groups, indicating his using extensive surveillance for protesters.

E.J. Dionne gave an excellent rationale for not confirming Wray:

“There is good reason to feel uneasy about having anyone appointed by Trump lead the FBI at this moment. It is obvious to all except the willfully blind that we now have a president who observes none of the norms, rules or expectations of his office and will pressure anyone at any time if doing so serves his personal interests. We also know beyond doubt that this team will lie, and lie, and lie again whenever the matter of Russia’s exertions to elect Trump and defeat Hillary Clinton arises.”

But Wray said the right things to senators, and VP Mike Pence avows (falsely) that Trumpcare “secures Medicaid for the neediest in our society.” Our culture is dominated by “fake” claims.

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