The CBO Bomb

So, what do you think of the bomb the CBO dropped on Trumpcare yesterday? And let us not forget all of Trump’s bigly promises (image from Talking Points Memo) —

Let’s hear it from the horse’s mouth —

So what are we really going to get?

  • The CBO estimates the Trump/Ryan bill would leave 14 million fewer people insured in the first year, 24 million fewer by 2026.
  • The CBO says deductibles and other out-of-pocket costs will be higher.
  • The CBO says premiums for private insurance will go up 15 to 20 percent until after 2020, when they could come down. But premiums will come down because the bill pushes out older, sicker people, leaving only younger and healthier people able to buy insurance.

As a lot of people have already pointed out, this is not a health care bill. It’s a tax cut bill.

What are the odds this monstrosity will pass? Discuss …

What Do You Mean by “Our” Civilization, Wingnut?

Rep. Steve “Calves Like Cantaloupes” King tweeted this recently:

Kind of takes your breath away, doesn’t it?

Slammed because his tweet was rather nakedly racist, King said on CNN,

“I’ve been to Europe and I’ve spoken on this issue and I’ve said the same thing as far as ten years ago to the German people and to any population of people that is a declining population that isn’t willing to have enough babies to reproduce themselves. And I’ve said to them, you can’t rebuild your civilization with somebody else’s babies,” King said on CNN. “You’ve got to keep your birth rate up and that you need to teach your children your values.”

King then lamented that the U.S. has “aborted nearly 60 million babies” since 1973 and claimed that there is an effort to “replace that void with somebody else’s babies.”

“That’s the push to bring in much illegal immigration into America, living in enclaves, refusing to assimilate into the American culture and civilization,” he said. “Some embrace it, yes. But many are two and three generations living in enclaves that are pushing back now in resistance against the assimilation. It’s far worse in Europe than it is today here in the United States, but I want us to be looking at that, promoting the birth rate in America, restoring the rule of law, putting an end to illegal immigration and recognizing that we need to be a country that’s pulled together on similar values.”

Never mind that in the 19th century Americans were saying the same things about the Irish that they’re saying about Syrians now.

The CNN host told King that the congressman has appeared to push for white people to raise their birth rate, prompting the congressman to argue that he has talked about “culture,” not race.

“I did defend western civilization,” King said. “If we have an element of Americans here — and that’s a big element — that reject western civilization, then what have we? This is an effort on the left I think to break down the American civilization and the American culture and turn it into something entirely different.”

“This western civilization is a superior civilization and we want to share it with everybody,” he added.

The Republican-dominated federal government is poised to do away with the National Endowment for the Arts, and this clown is concerned about western civilization because there aren’t enough (white) American babies? That’s rich.

Western civilization is doing just fine, actually. There’s an all-Beethoven program scheduled for the Qatar Philharmonic Orchestra. The National Ballet of China will be performing “Giselle” later this month (and also that perennial favorite, “The Red Detachment of Women”). And check out the schedule for the Royal Opera House Muscat in Syria.

What’s great about western civilization is widely appreciated just about everywhere but in the U.S., it seems. And I don’t think that has anything to do with who’s having babies.

See also Charles Pierce, “This Is the Most Blatantly Racist Statement from a Member of Congress in 50 Years.”

What Democrats Need to Do to Win Again

So here’s another article about the poor Appalachian people who used to work in coal mines and don’t anymore and are dependent on Obamacare and might lose it and voted for Trump. And it’s really, really sad. Here’s just a bit of it:

Heartburn is just the latest problem for Clyde, a patient Keisha sees every three months. Like so many in this corner of Appalachia, he used to have a highly paid job at a coal mine. Company insurance covered all of his medical needs. Then he lost the job and ended up here, holding a cane and suffering not only from heartburn but diabetes, arthritis, diverticulitis, high blood pressure and high cholesterol.

Because of the ACA, Clyde’s visit is covered by Medicaid. Before the law, most West Virginians without children or disabilities could not qualify for Medicaid, no matter how poor they were. The ACA — better known here as Obamacare — expanded the program to cover more people, such as Clyde, who can depend on Keisha to fix his heartburn without having to worry about the cost.

As for the other problems in his life, he has put his hopes in Trump, who came to West Virginia saying he would bring back coal and put miners back to work. When Trump mentioned repealing Obamacare, Clyde wasn’t sure what that might mean for his Medicaid. But if he had a job that provided health insurance, he reasoned, he wouldn’t need Medicaid anyway, so he voted for Trump, along with 74 percent of McDowell County.

And we might judge this man a fool, but in truth he voted for the candidate who promised him something, as opposed to the one who promised him nothing. And assuming he gets most of his politics news from the teevee, nobody warned him what a con man Trump is.

The truth is that Clyde was abandoned by both parties. It might be that the Democrats were working to get him better benefits, but neither party has ever been straight with coal people about why their jobs are not going to come back. Neither party, on a local, state or national level, has hustled to come up with a plan to replace those coal jobs or otherwise come up with a way for the Clydes of America to find self-worth and income.

And it’s not like the end of coal was something that just sneaked up on everybody last week. They’ve had years to figure out what to do about Clyde. Meanwhile, nobody tells him straight-out what’s really going on. They just dangle promises in front of him that nobody intends to keep.

One of the best things I’ve read today is An open letter to America’s coal miners, and to America by Mark Sumners, a former mineworker himself. In other words, he’s someone who knows the business. Here’s a bit:

This is the hard truth. In 2000, coal generated almost 53 percent of all the electricity in the United States. By 2009, that was 45 percent. In 2014 it was 39 percent. One year later, it was 33 percent.

Look at that last number. Coal’s contribution to the electrical picture dropped by 6 percent in a single year. That didn’t happen because of rules on carbon pollution that were never even made. It didn’t happen because of regulations on water pollution that never went into effect.

It happened because fracking for natural gas has made that fuel extremely abundant, and generators of electricity would much, much rather deal with gas than coal. Even when the gas itself is more expensive than coal, gas is easier to transport, easier to store, easier to burn. You don’t need expensive ash-removal on the smokestacks of a gas-powered plant, because gas doesn’t make ash. You don’t need to worry about where to bury ton after ton of clinkers left over when the coal is burned. There are no dams full of slurry to burst.

Better still, from the point of view of the people making electricity, gas generators are cheaper. You can buy them small and add on power gradually. Coal plants are big. They take a huge amount of money up front and don’t start making money for decades after construction.

That’s why there are no new coal plants under construction anywhere in the United States. None.

Forget the songs. Ignore the banners. You don’t sell coal to “America.” You sell it to Duke Energy, and Southern Company, and NRG and a few dozen others. That’s who buys coal. Only they’re buying less. And they’re going to keep buying less, until they’re buying none at all. Donald Trump isn’t going to change that. Short of passing a law that requires power companies to burn coal, which he won’t, there’s nothing that can stop it.

If Congress repealed every environmental law and every safety law that affects coal mining tonight, you know what would happen tomorrow? There would be fewer coal jobs. And fewer still the day after.

In fact, the regulations that Trump is repealing will make that happen faster. The rule that was changed on allowing more coal waste in streams won’t make new coal jobs. It will allow mining companies to replace underground mines with mountaintop removal mines. Those mines use far fewer people. When Trump signed that document and handed you the pen, what he was repealing was coal jobs.

There was a time that mine workers got much of their news about what government was up to from the unions. I assume Clyde doesn’t hear from unions any more, either, but if he did I’m not sure how they are handling the cold, hard fact that coal mining is going the way of the whaling industry.

And I’d also bet that Clyde had no idea what any Democratic running for office anywhere actually proposed. And that isn’t entirely Clyde’s fault.

Of course, a lot of people are being left behind by the economy. I keep reading that this isn’t really the fault of outsourcing jobs to other countries, although that used to be the cause. Maybe it isn’t the real cause these days. But something is a problem.

Someone asked some pollsters recently about what the Democrats have been doing wrong, and they said,

[Hillary Clinton] had a list of policies, but she didn’t have an overall explanation of what her diagnosis of the problem was, or what her solution was. This is what we call the Listerine test, after the eight-word slogan: “Listerine kills the germs that cause bad breath.”

It defines the problem, and gives a solution that sounds like it might work. It’s what advertising calls a “reason to believe.” Hillary didn’t have one. She had a goal statement: “An economy that works for everyone, not just those at the top.”

The very first question of the very first debate came from [moderator] Lester Holt, and it was: “Secretary Clinton, why are you the better choice than your opponent to create the kind of jobs that will put more money in the pockets of American workers?” And her answer listed 14 different policies, but with just a few grace notes to connect them. That was the moment at which I became convinced she wasn’t going to win.

That is not her problem—it is a party problem.

It is a party problem, and it goes deeper than just messaging.

First, they need to figure out what they’re going to do about Clyde. And I don’t mean appealing to his presumed racism or misogyny or anything else. We don’t need to do that, and we shouldn’t do it. I mean they need to figure out how are they going to change the economy so that there’s a place for Clyde in it, somewhere. Because until they figure that out, all the clever slogans in the world aren’t going to help them.

And I don’t know what that solution might be, but I suspect it’s going to take more than a few tweaks to status quo. Be bold, Democrats. Stop negotiating with yourselves. Stop whimpering that Republicans are mean to you. Come up with the plan you’d like to put into place if you had complete control of Congress and the White House, and stick to it.

Then, when you’ve got the plan, sell it. Get everybody on the same page with a simple message that basically says, We can do this. But it’s got to be more than a slogan; people need to know the message means something.

And at this point the Democratic Brand has become so degraded it’s going to take a few election cycles to be credible again to most of the Clydes. But if they don’t do this, they’re going to be keep losing.

See also: Andrew O’Hehir, How the DudeBros ruined everything: A totally clear-headed guide to political reality

With Republicans, It’s Always About Privatization and Tax Cuts

Seriously, the end result of Republican ideology is to privatize all government functions, including the military; expect all these functions to pay for themselves out of profits; and then cut taxes to zero. Well, except maybe for sales taxes and user fees. Anyone reading this who thinks that would be a great idea … must be a wingnut.

Catherine Rampell writes for WaPo,

Let’s abandon the pretense.

Republicans’ “health care” bill is not really about health care. It’s not about improving access to health insurance, or reducing premiums, or making sure you get to keep your doctor if you like your doctor. And it’s certainly not about preventing people from dying in the streets.

Instead, it’s about hundreds of billions of dollars in tax cuts — tax cuts that will quietly pave the way for more, and far larger, tax cuts.

And she makes a good case for it. Why are the Republicans ramming through this mess of legislation that nobody likes as fast as they can? Because they need this to cut more taxes and privatize Medicare, and they know that if people actually have time to look at this monstrosity of a bill, it will never pass. It’s now or never.

The American Health Care Act, which has been opposed by nearly every possible stakeholder of nearly every ideological orientation, is being rushed through Congress with non-extreme vetting. In fact, it passed out of one committee in the middle of the night, overseen by a committee chairman who just a day earlier criticized Obamacare for being “written in the dark of night.” …

… Part of the reason they have rushed the bill through committees is to front-run an (inevitably unflattering) analysis from the nonpartisan Congressional Budget Office.

In the meantime, other experts and government bodies have scrambled to compile their own estimates for the bill’s effects.

The ratings and analytics firm S&P Global has ballparked the number of people who would lose their insurance at 6 million to 10 million; others have offered figures as high as 15 million and 20 million. Meanwhile, a group of health researchers calculated that the bill would increase costs for enrollees on the individual insurance market by, on average, more than $1,500 per year when it would take effect, and by more than $2,400 per year by 2020.

Oh, and the Medicare trust fund would be exhausted by 2024, according to Brookings Institution researchers.

And the point is …

… tax cuts. Specifically, $600 billion of them, predominantly benefiting the rich.

And the connection is …

The presence of expensive tax cuts in a bill purportedly about health-care reform is not a side effect; it’s the entire point. They make it easier for Republicans’ (much bigger) individual and corporate tax cuts to sail through the Senate with minimal Democratic obstruction in a few months’ time.

Why? Under normal circumstances, Democrats would almost certainly filibuster the coming tax overhaul, preventing it from ever getting to a vote. But Republicans can take the filibuster option away by using the “reconciliation” process, which is an option if, and only if, the tax bill doesn’t increase government deficits in the long term, relative to existing law.

How do you keep tax cuts from increasing deficits relative to existing law? One useful tool is to change existing law — that is, to move the goalposts. Cutting taxes in the Obamacare repeal bill today lowers the revenue baseline against which a tax overhaul plan will be judged tomorrow.

Allegra Kirkland writes for TPM:

By repealing a payroll tax on high earners that provided a critical additional revenue stream for the Medicare trust fund, the GOP’s proposed American Health Care Act would speed up the fund’s exhaustion by as many as three to four years, according to estimates from health care policy experts. …

…  Critics say this provision is a prime example of the GOP bill granting tax breaks to the wealthy at the expense of the country’s neediest citizens, and that it paves the way for Medicare privatization. One former Obama administration official argued that by endangering the program’s funding, so-called “entitlement hawks” like House Speaker Paul Ryan (R-WI) will have cover to argue that Medicare as we know it is financially unsustainable—then realize their long-held dream of turning it into a voucher program.

Andy Slavitt, acting administrator for the Centers for Medicare & Medicaid Services during the last two years of the Obama administration, has been ringing this bell loudly since the AHCA was made public Monday night.

“I think it’s a smarter play for them to move Medicare closer to a crisis, try to get this bill done, and then build a case about why this crisis needs to be addressed,” he told TPM in a Thursday phone interview.

The Center for Budget and Policy Priorities figured out how much Trumpcare tax credits would actually provide compared to Obamacare subsidies. In some states — mostly red ones, ironically — people will end up paying thousands of dollars more out of their own pockets every year for insurance. At the same time, the Republican bill is expected to increase the deficit because of the tax cuts. The White House has pre-emptively attacked the CBO, anticipating their bill will get a bad grade.

So … costs more, provides less. Lose/lose! That’s the Republican way!

Stuff to Read, TrumpCare Edition

I’m short on time today and can only provide some links to keep you busy —

Charles Pierce, Paul Ryan Doesn’t Know How Insurance Works

LA Times, The GOP isn’t replacing all of Obamacare — just the parts that work

Jonathan Chait, Watch Paul Ryan’s Adam’s Apple When He’s Asked Why His Health Plan Cuts Taxes for the Rich

Greg Sargent, Trump has a secret backup plan to kill Obamacare. It’s actually brilliant.

Gail Collins, Getting Freedom from Health

Josh Marshall, Why Repeal and Replace Are Going So Badly

If you run into any more good ones, please add them to the comments.

The Republican Health Care Farce

By now you’ve heard this one — House Oversight Committee Chairman Jason Chaffetz (R — Asshole) said this

Jason Chaffetz told CNN’s Alisyn Camerota on “New Day” that he wants low-income Americans to be able to have more access to health coverage.
“But access for lower income Americans doesn’t equal coverage,” Camerota said.
“Well, we’re getting rid of the individual mandate. We’re getting rid of those things that people said that they don’t want,” Chaffetz replied. “Americans have choices, and they’ve got to make a choice. So rather than getting that new iPhone that they just love and want to go spend hundreds of dollars on that, maybe they should invest in their own health care.
“They’ve got to make those decisions themselves,” Chaffetz added.
Camerota asked if health care will “require some sacrifice” for lower-income Americans.
“We have to be able to lower the cost of health care,” he said. “We do think that with more choices, that you will get a better product at a lower price and that will be good for everybody on the entire spectrum of income.”

The problem is this — you can buy a new iPh9ne 7 plus for less than $900; a lot less, if you shop around. In 2016 the total average cost for employer-sponsored health care cost for a family of four was $25,826, a cost usually split between employer and employee. Individual insurance costs are paid entirely by individuals, unless they qualify for a subsidy in the exchanges that the new GOP bill would do away with. And individual insurance usually is more expensive than group insurance.

But let’s go with the $25,826 figure anyway. Our family of four could easily buy 29 or 30 iPhone 7s with that kind of money.

And the larger point is that politicians like Chaffetz (R-Moron) haven’t bothered to even look at the numbers. They know nothing about what health insurance really costs, and why. They have no idea why “choice” under the proposed Republican plan is a joke for anyone but upper-income Americans.

Click for Full Image

Health insurance is expensive because health care is expensive, and the Republican bill does absolutely nothing to address health care costs. Obamacare did, a little bit, on the margins. But the bottom line is that health care is expensive in the U.S. because we have a for-profit system with no meaningful price controls, and prices are being gouged all over the place. And not just by the pharmaceutical industry.

Other countries put limits on what profits can be made on providing drugs and technology and what not; we don’t. The chart above is an old one, and shows how costs were skyrocketing in the U.S. before Obamacare went into effect. Giving people phony “choices” to buy health insurance they can’t afford doesn’t do a dadblamed thing to address the real problem.

What the Republicans are doing doesn’t erase a penny of actual cost. It just pushes more of the cost burden back on the poor so that taxes on the better-off can be cut.

The Holy Free Market (blessed be It) doesn’t care if our average family of four gets health care or not. It has no incentive to give them health care at cost or at a loss. That family can just die already.

Here’s just a bit of what the Republicans want to offer us:

Obamacare’s tax credits are based on income, with those who earn less getting more help. Under Obamacare, people who earn less than 200 percent of the poverty line (about $24,120 for an individual or $49,200 for a family of four) get the most generous help. They would get enough money so that a midlevel plan would cost no more than 6.4 percent of their income. People who earn more than 400 percent of the poverty line ($48,240 for an individual or $98,400 for a family of four) get nothing at all. There is no cap on what they have to pay for insurance.

The Republican plans would be based mostly on age and a bit on income. Everyone who earns less than $75,000 (or $150,000 for a couple filing jointly) would get the same amount of help. Those above the income threshold would have the help slowly phased out in 10 percent increments. The tax credits would be doled out this way:

  • $2,000 for those under 30
  • $2,500 for those between 30 and 40
  • $3,000 for those between 40 and 50
  • $3,500 for those between 50 and 60
  • $4,000 for those over 60

On the surface, the tax credits for the oldest Americans seem the most generous. People in their 60s, for example, get twice as much help as those in their 20s.

But under the Republican plan, insurers would be allowed to charge the oldest Americans five times as much as the youngest Americans. Their financial help would not scale nearly as much as their premiums would.

“You’re both jacking up the prices and giving people less of a subsidy, which is a damaging combination,” says David Certner, legislative policy director for the AARP, which lobbies on behalf of Americans over 55.

I assume our family of four — let’s say they are two 30-something parents with two children — will be enjoying something like $9,000 worth of tax credits to help them pay for their $25,826 of health costs, regardless of whether they are living near the poverty line or not. Wealthier people, however, will be paying much less as a percentage of income. Of course.

So yeah, this sucks. Along with Sarah Kliff’s analysis see Ezra Klein.

Stuff to Read

Republicans released their ACA “repeal and replace” plan, and it’s crap, but we knew that. Tell me how this isn’t going to deprive millions of people of health insurance. I’m sure there will be more analysis tomorrow.

However, some Republicans are objecting. They’re going to be in for a fight to pass this thing in the Senate. I haven’t yet heard if the House Freedom Caucus is on board.

Trump put out his new travel ban today. Paul Waldman writes,

…the terrorism that would be stopped by this new ban is virtually nonexistent. That’s for two reasons. First, experts have noted that there have been no fatal terrorist attacks on U.S. soil perpetrated since 9/11 by anyone from those six countries. Second, as an assessment from Trump’s own DHS has concluded, most foreign-born, U.S.-based violent extremists probably were radicalized years after getting here, rendering screening procedures of limited value in preventing the entry of such potential terror plotters.

See also: Hayden: Trump ‘Forgot That He Was President,’ Could See Wiretapping Proof. If only the rest of us could forget he is president. Seriously, this is ridiculous.

 

Trump Needs His Brakes Fixed

So this happened:

The F.B.I. director, James B. Comey, asked the Justice Department this weekend to publicly reject President Trump’s assertion that President Barack Obama ordered the tapping of Mr. Trump’s phones, senior American officials said on Sunday. Mr. Comey has argued that the highly charged claim is false and must be corrected, they said, but the department has not released any such statement.

Mr. Comey, who made the request on Saturday after Mr. Trump leveled his allegation on Twitter, has been working to get the Justice Department to knock down the claim because it falsely insinuates that the F.B.I. broke the law, the officials said.

A spokesman for the F.B.I. declined to comment. Sarah Isgur Flores, the spokeswoman for the Justice Department, also declined to comment.

Mr. Comey’s request is a remarkable rebuke of a sitting president, putting the nation’s top law enforcement official in the position of questioning Mr. Trump’s truthfulness. The confrontation between the two is the most serious consequence of Mr. Trump’s weekend Twitter outburst, and it underscores the dangers of what the president and his aides have unleashed by accusing the former president of a conspiracy to undermine Mr. Trump’s young administration.

WaPo‘s fact checker ,Glenn Kessler, is a man who surely will want to retire to a quiet, happy place if he survives the Trump Administration. He tried to determine if the White House has any information about wire taps that it didn’t get from media reports, and came up zilch.

There are credible media reports that intelligence agencies — not President Obama — made a FISA request to investigate connections between Russian banks and a server owned by the Trump organization that may or may not have been in Trump Tower. That’s a far cry from Obama tapping Trump’s Trump Tower phones.

A lot of the reporting on right-wing sites is coming from a British reporter named Louise Mensch. Mensch just reported that there is new evidence of collusion between Trump and the Russians, however, so the righties may have to find a new favorite reporter.

Karen Tumulty writes for WaPo,

Donald Trump’s presidency has veered onto a road with no centerlines or guardrails.

The president’s accusation Saturday that his predecessor, Barack Obama, had tapped his phone “during the very sacred election process” escalated on Sunday into the White House’s call for a congressional investigation of that evidence-free claim.

The audacious tactic was a familiar one for Trump, who has little regard for norms and conventions. When he wants to change a subject, he often does it by touching a match to the dry tinder of a sketchy conspiracy theory.

But the stakes have gotten higher, and the consequences more real and serious, as questions mount over Moscow’s reported attempts to interfere with last year’s presidential election.

It’s my understanding that if Trump has knowledge of classified information on the wiretaps, he could have that information declassified. One suspects he does not.

Remember all those illegal voters gave Hillary Clinton the popular vote majority? Yeah, nobody but Trump does, either.

It was kind of amusing for private citizen Trump to continue to make stupid allegations about Barack Obama’s birth certificate, but he’s not a private citizen any more. Some of the senior Republicans need to sit him down and gently explain to him that a president can’t do crap like this.