Clearest Picture Yet Of Fallout From Graham/Cassidy Health Care Bill
New projections by the widely respected Kaiser Family Foundation paint a stark landscape. Kaiser focuses on the punitive aspect of the bill: punishing states that are doing a good job covering people under Obamacare; rewarding states that are not. According to the chart below, the mostly blue states that expanded Medicaid, will lose $180-billion dollars, while the mostly red states that didn’t, will gain $73-million dollars .
That amounts to a 35% decline in federal funds for New York, 32% for Oregon. Meanwhile, Texas gains 75%, Mississippi 148%. Kaiser points out however, that because Graham/Cassidy also institutes a cap on “traditional” Medicaid, even the states that make out like bandits under new the block grant system, would still lose funds for traditional Medicaid.
Kaiser’s overall numbers are a bit more conservative than other private assessments we’ve told you about in the past few days: showing overall federal health care spending slashed by $160-billion.
Absent a formal report from the Congressional Budget Office, which won’t be ready before the bill is voted on, these private assessments are all we have to go on.
50 States, 50 Plans, 2 Meager Years To Get It Together
The Kaiser report also trumpets something we’ve mentioned isn’t being sufficiently covered, that: “every state would be expected to create new health insurance coverage programs from scratch.” Margot Sanger-Katz also now discusses that in the New York Times. We feel that’ll turn out to be the most difficult (and unnecessary) part of implementing Graham/Cassidy if it passes. Medicaid administrators agree, pointing out there is no money in the bill to help states transition, even though they face the largest transfer of risk from the federal government to the states in the nation’s history.
John Cornyn, Man Of Many Faces
When the Majority Whip said two weeks ago: “we’re going to have to do it bipartisan”, and pretty much everybody swallowed it hook, line and sinker (headline in Politico “Senate GOP accepting defeat on Obamacare“), we suggested it might a fake out: a little reverse psychology. (After all, that’s his job). Cornyn now: bipartisan health care is “not going anywhere”.
Could Graham/Cassidy Still Run Into A Brick Wall?
That’s a long-shot possibility that would come in the form of a ruling by the Senate Parliamentarian. For technical reasons, the part of the bill giving states the right to waive pretty much any regulation they want, might be declared not eligible to pass by 51 votes. Vox’s Dylan Scott explains it well. Seems a little like grasping at straws to us…
What’s Up With John McCain? Rand Paul? Lisa Murkowski? Others? Some Predictions:
• McCain: In our opinion, a lot of space is being wasted speculating about where John McCain comes down on this bill. To us, it’s simple: he’ll likely vote for it. We think the Arizona Senator’s bluster about how he wants “the regular order”, and his fond remembrances of how bills used to be passed after amendments and debate are just his way of saying he’s reluctant to do what he’s about to do. Not that McCain is wrong: fast-tracking as much as possible and passing stuff willy-nilly just because you have a window sets a dangerous precedent, and one the President wants as the rule going forward, not the exception.
• Rand Paul: His voice has been the loudest and most eloquent in opposing Graham/Cassidy among Republicans and Democrats alike. (In his case because he says it doesn’t go far enough). But will he have the guts to cast the single deciding “no” vote if that’s what it comes down to? Don’t be so sure about that… Remember, Paul was also vehemently opposed to earlier attempts to repeal Obamacare, until he wasn’t. And even though he seems more dug in this time, we think he’s a definite “no” only if the bill isn’t going to pass anyway.
• Lisa Murkowski: Last time, Republicans stacked piles of money in front of her and she didn’t budge. They are again. This time the code words are “low density state“. In fact, using the sparseness of its population as an excuse, Republican leadership looks ready to propose Alaska keep its full complement of Obamacare funding. In exchange for Murkowski’s vote, of course. (Which begs the question: if the new bill is so great, why does Republican leadership view an offer of letting Alaska keep Obamacare as the most persuasive perk?)
Although it wasn’t widely reported, after Murkowski’s earlier “no” vote, the Trump Administration halted all federal grants to Alaska. This went on for several weeks. Just a warning…
• The Upshot: If McCain’s a “lean yes” and Paul’s “maybe not, if I’m the last man standing“, then even if Murkowski and Susan Collins end up as “no” votes, some “mystery” Republican might have to step forward for the bill to fail. Who? Keeping our eyes wide open, and so should you. If anyone over the weekend hints at moving in that direction, they’ll need our encouragement and support.
Facebook Will Cooperate With Congress
After resisting for several weeks, (which founder Mark Zuckerberg seems to attribute to his being on parental leave), Facebook says it will turn over more than 3,000 political ads it sold and ran and subsequently discovered were linked to Russia. Zuckerberg saying: “I don’t want anyone to use our tools to undermine democracy.”
Trump this morning Tweeting this too is a “hoax” and mainstream media’s coverage of Hillary is what really ought to be investigated.
“Rocket Man” vs. “Deranged Dotard”: North Korea Threatens To Test Nuclear Bomb In The Pacific
In a rebuttal to Trump’s “totally destroy Rocket Man” rhetoric at the United Nations this week, Kim Jong-un promises to “tame the mentally deranged U. S. dotard with fire”. Like Trump, he likes to keep up the suspense, so he doesn’t specify further. Here’s the full text of Kim’s statement. (BTW, this is not a translation: North Korea does its news releases in English).
But North Korea’s Foreign Minister Ri Yong-ho, who showed up at the UN after Trump’s speech, was willing to take it a step further: saying his country’s leader might be referring to exploding a hydrogen bomb somewhere in the Pacific. Ri was scheduled to give a speech at the UN today, but cancelled it.
Meanwhile, Trump signed an executive order stiffening unilateral sanctions against North Korea. That move seems largely symbolic. And he shot a rather mild Tweet Kim Jong-un’s way. Less symbolic might be China’s Central Bank ordering financial institutions to wind down services to North Korean clients.
Trump “Wins” The U.N.! (According To Him)
Trump really seemed to enjoy himself immensely hanging out at the UN this week. And this morning, he Retweeted data showing himself #1 on the list of “most Tweeted about world leaders.”
Frankly, we’d forgotten it was a pageant or publicity contest…