The Senate Republican Health Care Screw Job

How does one put this delicately? Mitch McConnell and his gang that couldn’t shoot straight are trying to fuck us in the ass. Okay, maybe that’s not delicate, but there is no way to over-emphasize the degree to which this Senate Republican health care initiative is a screw job, the same as what was passed in the House. Their version is called the “Better Care Reconciliation Act,” and in some ways it’s worse than what was passed in the House.

So  how did we get here? Let’s review:

  • The Clinton administration initially tried in its first term to pass a universal health care bill, and famously appointed his wife Hillary to lead the project. The effort failed after it ran into unplaccable opposition from the health insurance industry and their very effective “Harry and Louise” ad campaign.
  • Shortly after (and in response to) the ill-fated Clinton Health Care Initiative, the Heritage Foundation conceived of the idea of the “individual mandate.”
    This is well known among health care experts and has never been disputed.[1]
  • Republican Governor Mitt Romney incorporated the “individual mandate” into the Commonwealth’s first in the nation universal health care bill, enacted in 2006 as Chapter 58.
  • When working on the Affordable Care Act (aka “Obamacare”) President Obama and his team used some of the same ideas, as well as some of the same architects, in crafting the federal act.
  • Although Obama assiduously sought out Republican input and participation, the Republicans steadfastly refused to participate in the crafting of the Affordable Care Act. At the time, Mitch McConnell, recently installed as Senate Majority Leader, let it be known that his #1 priority was to see that Obama was not re-elected.[2]
  • Since then, the Republican engaged in a six year campaign to demonize the Affordable Care Act so that Obama would not get credit for being the President to finally enact universal health legislation in the United States.
  • Along the way the Republicans voted to repeal the Affordable Care Act somewhere around 60 times, knowing that the President would veto the repeal.
  • Now that they have control of the Presidency, the House and the Senate, the Republicans have pushed forward with repealing and replacing the affordable care act because it has been so central to all of their campaigns.
  • Several months ago, after an initial false start, the Republicans managed to pass the “American Health Care Act,” which even President Trump conceded was “mean.” The non-partisan Congressional Budget Office estimated that among other things, it would likely throw 14 million American off the health care rolls in 2018, 21 million by 2020, and 24 million by 2026.[3]
  • Since arriving in the Senate, Mitch McConnell and a group of 12 additional male Senators have been working in secret on a Senate version of the plan. They have had no committee hearings, circulated no drafts of the bill, and excluded even the rest of their Republican colleagues, all because they know that if their plan looks anything like the House plan, it would run into virulent opposition.
  • This is the plan that McConnell has finally released today, and which he wants the Senate to vote on next week. Even though the plan is not a budget, McConnell and friends have structured in such a way that they can use the budget reconciliation process in the Senate to avoid what would otherwise be a certain Democratic filibuster.[4]

What I really want to say to the Republican Congress is, Members, Obama is out of office now. You can stop obsessing about his legacy. You can stop trying to destroy the Affordable Care Act to score political points.

But with our Republican friends, it’s always politics first. Always.

McConnell has violated every rule relative to the normal historic operating procedure of the Senate. This immense Überhypocrite, who has had the temerity to complain about how the Democrats ran the Senate when they were last in power, wants to pass a bill that would literally screw millions of Americans out of health care. He knows it. The Gang that can’t shoot straight knows it. His Republican colleagues know it.

They don’t care.

No sane person has ever argued that the Affordable Care Act is a perfect bill. We all know that it’s not perfect, and it definitely needs some adjustment. Democrats practically begged Republicans to work with them on adjusting it while Obama was still in office, but the Republican response was their 60 efforts at repeal.

The Affordable Care Act is not “in a death spiral” as Republicans have repeatedly claimed. What is in a bit of chaos these days is the health insurance market, and the cause for that chaos is the Republicans continued attempts to completely repeal the Affordable Care Act.

I have some history with the efforts to enact universal health insurance in Massachusetts, and I’ve written extensively about the Affordable Care Act. Anybody who is interested in the details can read about them here. In any case, the enactment of the Affordable Care Act – whatever flaws it may contain – was at least a sincere best effort at finding a way to bring Universal Health to the American people in a way that would not generate total opposition from the health insurance industry (in a way that a single-payer solution would).

But this, this American Health Care Act, that the Republicans are promoting: this is just a cynical attempt to score political points at the expense of the American people, and which more than anything would hurt the people who largely supported Donald Trump.


[1] See “Assuring Affordable Health Care for All Americans” by Stuart M. Butler (1989).

[2] In this he clearly failed, but it set a pattern for the depth of his hypocrisy. One might reasonably think that the #1 priority of the Senate Majority Leader should be the proper governance of this country, and doing whatever possible to “make it great again,” but McConnell was at least honest enough to disclose his obsession with obstructing Obama.

[3] While an in-depth examination of the American Health Care Bill is well beyond the scope of this post, there are plenty of articles that have demonstrated in great detail what a disaster this bill would be for the American people.

[4] The budget reconciliation process is a complex set of rules that are designed to insure that budgets can pass in the Senate and not be waylaid by opposition filibusters. Budgets often have special rules because Congress must pass a budget in order to keep the government functioning. An in-depth examination of the reconciliation process and why it is inappropriate for this bill is also beyond the scope of this post.

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We have a President with the emotional maturity of a Five year old.

As most of you know already, last week Donald Trump fired James Comey, and his administration fabricated this lengthy alibi involving Deputy Attorney General Rod Rosenstein (technically Comey’s boss) and his negative assessment of how Comey handled the Hillary Clinton probe, and then the Donald went and undercut his entire administration by announcing to Lester Holt that he had fired Comey because he was a “showboat” and because he wouldn’t proclaim his loyalty to the President and because he wouldn’t wrap up the Russia investigation. And then he followed that up with a tweet threatening James Comey if he had any tapes of their conversation, which brought up a whole new set of questions, like is the White House taping people’s conversations again (as Richard Nixon and some of his predecessors had done) or did the President engage in obstruction of justice?

But never mind all that.

The two most fascinating stories for me, coming out of the White House this week were:

  1. That in a dinner with reporters from Time Magazine, the Donald had two scoops of ice cream on his chocolate pie, whereas the rest of the diners only had one.
  2. That in an interview with the Economist magazine, the President claimed to have invented the phrase ‘Prime the Pump.’

To which one can only say, really?!

Our President, my friends, has the emotional maturity of a five year old.

He needs to distinguish himself by getting two scoops of ice cream. He apparently needs to believe of himself that he invented phrases which have been in common usage since the Great Depression. And he has such an ego that he needs everyone to know that he made the decision to fire Comey, because that’s what he does, even though it may lead to an obstruction of justice investigation for him. (Prior to this week, I doubt the Donald even knew what obstruction of justice was.)

This is a guy who genuinely thought that Democrats would celebrate his firing of Comey since most of us already blamed Comey for creating the conditions that led to Hillary Clinton’s loss. Which he did.

We’ve moved from a guy (Obama) who was in the White House for eight years without creating any kind of a scandal to an emotional toddler who had a scandal brewing on the day he was inaugurated.

That’s our alternative reality now, my friends.

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What to make of Trump’s firing of FBI Director James Comey?

What to make of the firing of James Comey yesterday by Donald Trump? It  certainly had echoes of the Saturday Night Massacre under the Nixon Administration.

The official explanation from Trump’s administration is that Comey mishandled the investigation into Hillary Clinton’s emails. Well, no argument here.

Of course, it didn’t help that Comey lied in his testimony to a Joint Senate committee just last week. As reported by NPR,

Comey said that Clinton aide Huma Abedin had forwarded “hundreds and thousands” of Clinton’s emails, “some of which contained classified information,” to her husband, former Rep. Anthony Weiner, to print out. The discovery of those emails while Weiner was being investigated for possible lewd contact with a minor online is what triggered the reopening of the Clinton investigation just before Election Day. However, after ProPublica reported Comey’s testimony had been inaccurate and that there had been only a “small number” of emails forwarded, Comey had to clarify those comments in a letter to the Senate Judiciary Committee released Tuesday at nearly the same time news of his firing began to break in the media.

Jesus, Comey, you couldn’t even get that correct?

No one doubts that Comey is a certified asshole. But he was Trump’s certified asshole. He’s also a bit of a wild card, apparently, and seemed to get uncomfortably close to things the Trump administration did not want disclosed on their ties to Russia during the Presidential campaign. As further reported by NPR,

“The first question the administration has to answer is, why now?” said Senate Democratic Leader Chuck Schumer, D-N.Y. “If the administration had objections to the way Director Comey handled the Clinton investigation, they had those objections the minute the president got into office. But they didn’t fire him then. Why did it happen today?”

Yeah, good question Chuck. What are the chances that Trump’s Justice Department will appoint a special prosecutor? You already know the answer to that one.

Just a reminder:

  • Hillary Clinton’s email server = eight independent investigations.
  • Trump campaign’s ties to Russia = one botched House investigation and one lonely Senate investigation.

Oh yeah. Anybody remember the term “false equivalence?”

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Here we go again with the Republicans on Health Care

Here we go again on health care. Today the Republicans will try again to engross a ‘repeal and replace’ of the Affordable Care Act (aka Obamacare).  Not because there is anything seriously wrong with Obamacare. Certainly nothing that couldn’t be fixed with a little cooperation. No, they want so desperately to repeal and replace because – after having demonized Obamacare since the day it was enacted – because they said that they would.

Many of you probably saw the emotional opening monologue that Jimmy Kimmel gave after he came back to his show shortly after his son was born, needing open heart surgery almost immediately because of the heart defect he was born with.

Kimmel is not a political comedian, but he actually made an appeal around ‘pre-existing conditions,’ noting that one shouldn’t have to be rich (as he is) in order to have the possibility of saving your child.

Shocking!

At least shocking if you’re a conservative Republican, apparently. Oh my God!, he made an argument for covering pre-existing conditions!

Of course, pre-existing conditions are already covered under Obamacare. That’s one of its most popular provisions, if not the most popular provision.

The only way that Republicans can get the support of their Tea Party wing is by fucking with the requirement of coverage of pre-existing conditions.[1] They want to allow states to opt out of the requirement, as well as opting out of many other requirements. In order not to lose the moderate wing of their party, the Republicans have added a $8 billion sweetener to high risk pools which may (or may not) get funded in future fiscal years.

The measure faces a “wall of opposition from health care providers, patient advocates and retirees.” It’s almost certain to die in the Senate[2]. But who cares? The Republicans just want to be able to say to their constituents that they ‘voted to repeal and replace’ before their members have to go back to town hall meetings.

Although I don’t know. If they do vote to screw the protections around pre-existing conditions, they might really get to hear a handful at their town hall meetings.


[1] Republicans have in the past try to fudge the issue by requiring insurance companies to cover pre-existing conditions but allowing them to charge however much they want in order to cover them. For anybody but the super-wealthy, that effectively means no coverage, of course.

[2] Remarkably enough, the Senate will almost certainly not abolish the filibuster for legislation – they’ve already abolished it for judicial appointments – so Republicans would need to swing about eight Democrats for any health care legislation they want to pass.

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WTF, Government shut-down avoided for one week?

Some of you may have noticed that on Friday the United Congress voted to avoid a government shut-down by passing a resolution that keeps the Government funded for one more week, so that they can do it again this week.[1]

Which prompted me to think: what the fuck?

In recent years we’ve had essentially two government shut-down fights, that in each case involved a Democratic President (Bill Clinton, Barack Obama) and a Republican Congress. In both cases it was a Republican Congress throwing down ultimatums (and having a temper tantrum), and in both cases it hurt the Republican party more politically than it did the Democrats.

Now, however, the Republicans own the whole government, and yet they’re still trying to blame the Democrats. President Trump – and yes, I follow him on Twitter because in a certain way I have to[2] – has been tweeting about how “bad” or “sad” (doesn’t he know any other adjectives?) the Democrats are because they’re threatening to shut down the government (which they’re not). So, let’s review the history of government shut-downs.[3]

  • In 1995-96 the Newt Gingrich-led Congress was in a budget fight with then-President Clinton. The government was actually shut down twice, from November 14 through November 19, 1995, and from December 16, 1995, to January 6, 1996, for a total of 27 days. In many ways this was a mano-a-mano between Bill Clinton and Newt Gingrich – although technically a dispute over Medicare Part B may have been the actual sticking point – and highlighted by a report that Gingrich initiated the shutdown because Clinton made him exit from the back of Air Force One to Yitzhak Rabin‘s funeral in Israel.
  • More recently, in 2013, the Republican Congress shut down the government for 16 days from September 30 through October 17, 2013. This fight was primarily over the wishes of the Republican Congress to defund the Affordable Care Act (“Obamacare”).

In both cases, it was the Republican-led Congress trying to get a Democratic President to capitulate. This time the Republicans own all of the branches of the federal government, and they can still barely avoid a government shut-down. Republicans are annoyed that the Democrats don’t want to rubber stamp all of their budget proposals, to which I say so what? When does the opposition party rubber-stamp the majority party’s budget proposals? The answer is never.

So, what’s going on here? It seems that this fight is mostly about the Republican party’s own fractiousness, where their (barely remaining) moderate wing cannot come to agreement with the radical right Tea Party wing (especially on, health care) and with the Trump administration on their “fairyland” tax proposals.

For those people who are trying to sell you on the notion that the Democrats are to blame here, don’t you buy into it. The Democrats have made no ultimatums, they are not in the majority in either the House or the Senate. It’s the Trump administration and their Republican Congress that can’t get their act together this time around.


[1] In what has to be described a minor miracle, the Republicans and Democrats were actually able to compromise on a budget deal yesterday which will keep the government running through the end of September.

[2] These days I’m mostly using Twitter to send sarcastic tweets to Trump, and occasionally Paul Ryan or Mitch McConnell, in response to the latest propaganda nonsense that they’ve been trying to get past the American people. I’d love for one of my tweets to go viral, but unfortunately, I’m not nearly clever enough.

[3] I’m focusing here on government shut-downs in recent history. There have been other government shut-downs, but most of them involved just a few days, and most of them did not require the government to furlough employees.

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Trump’s first 100 Days

One of the very few things I agree with Donald Trump on is the notion that the “first 100 days” standard is essentially a meaningless standard. As National Public Radio pointed out in a recent story, the first 100 day standard goes back to Franklin Delano Roosevelt, and although he accomplished a remarkable number of things in his first 100 days – abated by historical circumstances related to the Great Depression – even his accomplishments have been somewhat exaggerated.

https://www.npr.org/player/embed/525810758/526077830

The idea of measuring an American president by the accomplishments of his first 100 days in office goes back to 1933 and President Franklin Delano Roosevelt’s dash to staunch a banking crisis and pull America out of the Great Depression.

In a July 24, 1933, fireside chat, he assessed the early months of his administration.

“I think that we all wanted the opportunity of a little quiet thought to examine and assimilate in a mental picture the crowding events of the hundred days which had been devoted to the starting of the wheels of the New Deal,” Roosevelt said.

He had signed a record 15 major pieces of legislation in those first 100 days. But it’s not as simple as the legend would make it seem.

So what has Trump achieved in his first 100 days? The short answer is nothing on the legislative front, and a bunch of stuff (of uncertain efficacy and questionable legality) on the executive front.

On the Legislative front

In brief, on the legislative front, Trump promised on the campaign trail to enact all of the legislation set forth below in his first 100 days. He has accomplished none of these, with the repeal and replacement of Obamacare heading that list. To be fair, the Trump administration does require some cooperation from the Congress, and they haven’t gotten much. That’s because the Republicans in Congress have no idea how to govern and are themselves hopelessly divided between the Tea Party, traditional pro-business and (barely alive) moderate factions. On the legislative side the Trump administration has not:

  • Repealed and replaced the Affordable care (That attempt was a clusterfuck of gigantic proportions)
  • Enacted middle class tax relief or provided for tax simplification. (The did propose a 1 page outline of a tax plan which would have been a gigantic give-away to corporations and the rich.)
  • Enacted the End Illegal Immigration Act. (This act would fund the Mexican border wall, and establish a 2-year mandatory minimum federal prison sentence for illegally re-entering the U.S. after a previous deportation, among other things.)
  • Enacted the End the Offshoring (This act would have established tariffs to discourage companies from laying off their workers while relocating in other countries and shipping their products back to the U.S. tax-free.)
  • Enacted the American Energy & Infrastructure Act. (This act would have leveraged public-private partnerships to spur $1 trillion in infrastructure investment over 10 years.)
  • Enacted the School Choice and Education Opportunity Act. (This act would have given parents the right to send their kid to the public, private, charter, magnet, religious or home school of their choice.)
  • Enacted the Affordable Childcare and Eldercare (This act would allow Americans to deduct childcare and elder care from their taxes and incentivizes employers to provide on-site childcare services, among other things.)
  • Enacted the Restoring Community Safety Act. (This act would increase funding for programs that train and assist local police, increase resources for federal law enforcement agencies and federal prosecutors, and create a Task Force On Violent Crime).
  • Enacted the Restoring National Security Act. (This act would expand the military by eliminating the defense sequester and expanding military investment.)

Now I’m not personally disappointed that so much of this legislation seems to be nowhere in sight, as I disagree with almost all of it. But for Trump supporters, this should be a major disappointment. Of course, their cognitive dissonance will not allow them to see that.

On the Executive font

Trump has fared better on the executive front, although (as we know) a number of his executive orders have been found to be unconstitutional. Some of what Trump has accomplished include:

  • He did impose a short hiring freeze on all federal employees (to reduce federal workforce through attrition) but lifted it in April. Military positions had been excluded all along.
  • He did issue an executive order requiring that for every new federal regulation, two existing regulations must be eliminated.
  • He did sign an executive order which, among other things, required new executive branch employees to pledge that they would not lobby the particular agency they worked at within five years of the end of their employment there.[1] That order also imposed a lifetime ban on White House officials lobbying on behalf of a foreign government.
  • He did withdraw the United States from the proposed Pacific trade agreement, fulfilling one of his longtime campaign pledges.
  • He did fulfill part of his campaign promise to lift the restrictions on the production of $50 trillion dollars’ worth of American energy reserves, including shale, oil, natural gas and clean coal. Trump got things started with an executive order last month that eliminated smaller restrictions on coal and greenhouse gas emissions.
  • He did sign memorandums that cleared the way for construction of the Keystone XL and Dakota Access pipelines.
  • He did issue two executive orders banning visitors from seven Muslim-majority countries from traveling to the United States. Both of those orders were overturned as being unconstitutional.
  • He did issue an order withholding funding from sanctuary cities. That order has also been held unconstitutional.
  • He also got Judge Neil Gorsuch confirmed to the Supreme Court, although in order to do so the Senate had to blow up their own rules around the Filibuster, a decision that may well yet come to haunt them (and especially the Republican party).

Some of what he has not accomplished on the executive front include:

  • He has not proposed a Constitutional Amendment to impose term limits on all members of Congress, as he had promised to do.
  • He promised a complete ban on foreign lobbyists raising money for American elections, a promise on which he has not kept.
  • He promised to renegotiate NAFTA or withdraw from the deal under Article 2205, a promise which he has not kept.
  • He promised to begin removing the more than 2 million criminal illegal immigrants from the country and cancel visas to foreign countries that won’t take them back, a promise which has not kept.
  • He is far behind in staffing his administration, as he has made a mere 50 nominations to fill the top 553 positions of the executive branch.

It’s not that Trump has not been active as President, his every-weekend excursions to Mar-a-Lago notwithstanding. It’s just that he has been very ineffective.

To which I say, Thank God!

But his partisans may not be so kind. His delusional core will stay with him, of course, but many of the swing voters who were willing to “give him a chance” are going to want to see some real progress on issues pretty soon. And Trump is not going to be able to talk his way out of that lack of delivery forever.


[1] However, this order does not apply to Congress, and on the campaign trail he had also promised that Congressional employees would be subject to a similar ban.

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The Trump Tax ‘Plan’: here we go again

Yesterday the Trump administration announced its new tax ‘plan’ in order to beat the ‘100 day’ deadline[1], by all appearances.

Trump has – and I know this will come as a shock to those of you keeping score – been on both sides of that issue. On the campaign trail he promised to do more in 100 days than any President before him, and if you ask him now, he will claim that his administration has done more than any President before him. On the other hand, just days ago he called the 100 day deadline meaningless and arbitrary, in implicit acknowledgement that his administration has accomplished almost nothing in its first 100 days, the blizzard of (mostly meaningless) executive orders notwithstanding.[2]

That may be the most truthful thing he has said during his entire reign as President.

But back to the tax ‘plan,’ if one can call it that. It was really just a double-spaced one-page outline of a tax plan, not an actual plan.[3] Calling it a ‘plan’ is being extremely charitable. Even so, let’s look at what is supposedly in it.

For individuals the tax plan would apparently

  • Reduce personal income tax rates and reduce the number of brackets from seven to three: 10%, 25%, and 35%.
  • Repeal the estate (or ‘death’) tax altogether
  • Repeal the Alternative Minimum Tax (designed to ensure that high earners can’t bring their tax bill down to zero by invoking all manner of deductions and loopholes).
  • Repeal the surcharge on capital gains.
  • Eliminate certain unspecified loopholes (but apparently including the popular deduction for state and local taxes).
  • Double the standard deduction.
  • Increased child-care tax credits.

For businesses the tax plan would apparently

  • Cut business income tax rates from 35% to 15%.
  • Cut rates for ‘pass-through’ companies.[4]
  • Tax foreign-held profits.
  • Introduce a territorial tax system. [5]

Loyal readers of the blog may be surprised to hear me say this, but not every one of these ideas is bad. For example, bringing down the corporate tax rate – which conservatives are very fond of reminding everyone is the ‘highest in the world’ – isn’t a bad idea as long as it’s married to closing a large number of corporate loopholes. Because currently the ‘effective’ (i.e. actual) tax rate that many clever companies (like Apple, for example) is closer to zero.

Taxing foreign-held profits is another very reasonable idea.

Simplifying the number of personal rates and eliminating some deductions isn’t such a bad idea either.

But the basic problem with this tax plan is how much it would add to the federal deficit. Trump’s economists are assuming that the tax plan would generate 4.5% of annual sustained growth, which assumption more sober economists have dubbed as residing in ‘fairyland.’ Those are the kind of numbers even China hasn’t been able to sustain.

The last time we had ‘trickle down’ economics was, of course, during the Reagan administration. David Stockman, the Budget Director at the time (and chief architect of ‘trickle down’) proposal has long ago rebuked it, and admitted that it doesn’t work.  At all. The federal deficit grew like a baby cow on steroids during Reagan’s years in office.

So, here we go again.

Once Trump puts some meat on those bones, it’s going to smell just like the Republican replacement to the Affordable Care Act. In other words, not so good.[6]


[1] There is no real 100 day deadline. It’s a marker that was first set up when Franklin Delano Roosevelt, coming into office to combat the Great Depression, enacted a remarkable number of measures in his first 100 days, setting a high water mark which successor Presidents have been trying to match ever since.

[2] He did get Neil Gorsuch appointed to the Supreme Court, but needed the Senate to blow up its filibuster rule in order to get there. It was mostly an ‘accomplishment’ (if you will) by the Senate.

[3] This is the same approach that the Republicans used when releasing their alternative to the Affordable Care Act. Once they put meat on those bones, things suddenly went downhill in a hurry.

[4] Small partnerships, independent contractors, and some larger firms don’t pay corporate taxes. Instead they treat their business income more like a salary and include it with their individual income tax filings.

[5] While this aspect of the plan is particularly vague, the basic idea is to somehow stop taxing companies’ overseas earnings and focus just on their domestic operations.

[6] Since Trump has not released his own tax returns, it’s hard to know how these proposals would effect him personally, and his business as a whole. But since Trump’s business is closely held (so a private person can’t buy stock in the Trump organization), it is likely that income from the Trump organization would be treated as ‘pass through’ income, and he and his people would be entitled to report at the lower personal rates than the corporate rates.

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