How Many Americans Will Lose Their Health Insurance? How Deep Will The Government Slash Health Care Funding?

Assessing The Potential Impact Of Last-Ditch Trumpcare Proposal: We Put It Together For You

There’s a lot we don’t know. That’s because the Congressional Budget Office won’t have its complete report on the bill’s impact ready by next week, and the Senate has to vote on it before then so it can pass with only 51 votes (instead of 60).

Republicans are trying to use that to their advantage: in the absence of a robust report (which is really their fault, not the CBO’s), they’re peddling lies and half-truths (see below) to obscure the fact that the Graham/Cassidy “buzzer beater” bill is, as Vox’s Sarah Kliff puts it “the most radical of them all.” Here’s how she distills the bill’s main thrusts:

• “Takes money from states that did a good job getting residents covered under Obamacare and gives it to states that did not.

Eliminates an expansion of the Medicaid program that covers millions of Americans in favor of block grants.

States aren’t required to use the money to get people covered or to help subsidize low- and middle-income earners, as Obamacare does now.”

Two independent consultants put out some eye-opening research. We’ve linked to their individual reports:  [CBPP] [Avalere] Bottom line: the bill would slash health care spending $215 to $239-billion. Hardest hit would be big blue states: California, for instance, would lose $78-billion, New York $45-billion, while Texas would gain $35-billion, Mississippi $6-billion.

There’s another potentially major impact that isn’t really being discussed much yet (so we thought we’d get the ball rolling): with these huge block grants of federal funds flooding into individual states, the #1 job of many state legislatures will suddenly become running a massive health care system, and many Governors will essentially become health plan administrators first and foremost. 50 states, united only in their struggle to keep up with rising health care costs, now the federal government’s washed its hands of it.

Republican Senators were hugely critical last time when the House took a vote without a CBO analysis. But Now they’re poised to do just that. Many also questioned the impact of dramatic cuts to Medicaid, and lack of treatment for opioid addiction. Little talk of that now. Instead, a “magical” belief on the part of those Republicans who questioned Trumpcare earlier that since states will have virtually all the say in how the money is spent, they will be able to focus on problems and issues they feel most strongly about. In other words, the promise of flexibility is apparently enough to get them to go to a vote blindly.

Iowa Senator Chuck Grassley was remarkably candid about the whole deal, telling the Des Moines Register:You know, I could maybe give you 10 reasons why this bill shouldn’t be considered. But Republicans campaigned on this so often that you have a responsibility to carry out what you said in the campaign. That’s pretty much as much of a reason as the substance of the bill.”

Senator Chuck Grassley (R) Iowa

Republicans May Be Inadvertently Legislating A Massive Tax Hike On The Rich

Here’s a twist: Graham/Cassidy could result in rich people (in blue states at least) facing a much higher tax burden. Those states–New York, California, Maryland, etc.–will lose the largest amounts of federal funds. So they will almost certainly have to raise state taxes to make up for shortfalls, especially if they continue to embrace liberal principles. And since, according to the Census Bureau, the wealthiest people in the country live in those same states, it’ll likely fall on them.

Does Graham/Cassidy Cover Pre-Existing Conditions, Or Doesn’t It?


We’re not trying to be flippant here: both are “technically” true (though only one is reality). Federal law will continue to require coverage of pre-existing conditions. However, since the biggest selling point of Graham/Cassidy is states can do pretty much whatever the hell they want, they can waive pretty much any part of the federal law they want. So when President Trump Tweets:

He’s not lying. But what he’s saying is completely untruthful.

Same for when Trump Tweets:

Because while he is a physician, here’s Bill Cassidy lying:

Editorial: Doesn’t Trump Realize This Plan Represents The Opposite Of Everything He Stands For (Except For Blowing Things Up)?

• It doesn’t deregulate anything: it adds thousands and thousands of new regulations, that will differ astronomically state-by-state.

• It doesn’t “deconstruct the administrative state“: it adds massive new bureaucracies to each state, on top of what exists at the federal level now.

• And what about sick people moving across state lines if another state offers better health care? Will we have to build more walls?

Iran, You’re Next

Trump continues to disrupt the United Nations General Assembly, telling reporters he’s decided on what to do about the Iran nuclear agreement, but limiting his comments to “I have decided“. (Apparently he wouldn’t even tell British Prime Minister Theresa May what he’s decided when she asked him right after.)

Secretary of State Rex Tillerson hinted at a favorite Trump approach: always be renegotiating. Tillerson delivered a somewhat convoluted argument that while Iran may in fact be in compliance with the letter of the agreement, it has strayed far from the expectations of the other countries that signed it. You can watch some of that here:

Iran’s President responded by saying a deal’s a deal: if the U.S. wavers on its commitment, Iran will feel freed up to do whatever it wants.

North Korea Trolls The Hell Out Of Trump

North Korea’s Foreign Minister arrived at the United Nations after deliberately missing Trump’s speech, and ahead of his own speech tomorrow.  Ri Yong-ho likened Trump’s threats to “the sound of a dog barking”, adding: “I feel sorry for his aides.” (Remember, this is a guy whose boss has executed political rivals by strapping them to an anti-aircraft gun.)

North Korean Foreign Minister Ri Yong-ho arrives in New York

100% Of Puerto Rico Is Without Power

That’s after the U.S. Territory was brutalized by Hurricane Maria, which came barreling in as a Category 4 with winds in excess of 100 miles an hour. Although the hurricane is pulling away (and strengthening again), at the time of publication of this newsletter, the National Weather Service has not yet lifted a flash flood warning for the entire island. That went into effect late last night.