Mediaboss Marketing

Rand Paul, pragmatic deal-maker? Photo: Bill Clark/CQ-Roll Call,Inc.

Late last week, Donald Trump revived repeal and delay the GOPs short-lived plan to kill Obamacare first, and draft a replacement second. GOP senators Mike Lee, Rand Paul, and Ben Sasse promptly endorsed this way out of their partys health-care quagmire.

Most observers saw these developments as threatening Mitch McConnells fragile hopes of bridging his caucuss divide on health-care policy. Politico declared, Trump further disrupts Obamacare repeal efforts.

But it now looks like the opposite may prove true: The reemergence of the strategy of repealing Obamacare in one bill, and replacing it in another, might just lay the foundation for the Senate GOPs grand bargain over health care. Observe how Rand Paul described his vision for clean repeal on Fox News Sunday:

Lets do clean repeal like we promised, and, I think, you can get 52 Republicans for clean repeal. You can have a simultaneous bill or a concurrent bill that they can call replace, and that I think, perhaps, if its big spending, they could probably get Democrats to go along with big spending. Im not for that, but Im saying, I want repeal to work, and the way you do it is you separate into two bills and you do it concurrently.

In other words, Paul is asking leadership to give conservatives one more chance to register their symbolic opposition to Obamacare, for old times sake and then, immediately pass a big spending bipartisan bill that props up the existing law, with moderate Republican and Democratic votes.

Its hard to imagine a better way for an arch-libertarian who represents Kentucky to have his ideological purity and keep his states rural hospitals running, too.

But Paul wasnt the only one endorsing this sort of scheme.

Id like to say lets do the repeal and then lets try to get 60 out of 100 senators, Sasse told CNN. The Nebraska senator suggested that, unlike Paul, he would favor an extended period of legislative deliberation between Obamacares repeal and its replacement. But, nonetheless, his suggestion that the bill pass with 60 votes is a tacit endorsement of a legislative process that ends with technocratic fixes to the existing law (which Trump could then rebrand as his own).

Its possible that Sasses insistence on 60 votes has less to do with an attraction to bipartisanship than frustration with the limits of reconciliation the legislative process that allows the Senate to pass bills with a simple majority. Right now, Senate conservatives have their hearts set on rolling back Obamacares regulatory protections for people with preexisting conditions. But under the rules of reconciliation, the Senate can only pass measures that have a direct impact on the budget, and its unlikely that regulatory reforms would meet that standard.

Still, whatever Sasses motivation, a modest bill fortifying the private market is the only thing that could get eight Democratic votes.

And, over the weekend, White House Director for Legislative Affairs Marc Short endorsed such a legislative endgame.

If the replacement part is too difficult for Republicans to come together, then lets go back and take care of the first step and repeal, Short told Fox News Sunday. And then at that point, if youve repealed it, you can come back with a replacement effort that could be more bipartisan.

Maine senator Susan Collins has long favored a bipartisan bill. Kansass Jerry Moran expressed a similar sentiment this week.

And on Thursday, even McConnell seemed to signal that a bipartisan bill may be nigh, saying, If my side is unable to agree on an adequate replacement, then some kind of action with regard to private-health-insurance markets must occur.

Republican senators appear to have irreconcilable disagreements about health-care policy. But thats only true to the extent that they actually care about health-care policy. It seems possible that what the conservatives really care about is performing rituals of ideological purity while the moderates just want to avoid throwing hundreds of thousands of their constituents off health insurance for the sake of affirming some lies they sold voters about Obamacare.

If thats the case, then pseudo-repeal and bipartisan replace might be the grand bargain theyve been searching for.

There were no injuries, but the minor derailment caused more even delays at the troubled station.

Doctors said the congressman, who was shot last month, tolerated the procedure well.

The erosion of global power tends to become evident in a crisis.

A vote crucially affected by, say, foreign interference might be an injury without an obvious Constitutional remedy.

Let conservatives vote to fully repeal Obamacare then have moderates and Democrats immediately pass a bill strengthening the law.

The Trump administration wants to make space great again, too.

Seismic air-gun blasts help detect oil reserves. They also kill zooplankton the basis of every ocean food web. Trump is about to lift a ban on them.

Pat Toomey spills a secret: Republicans didnt have a policy plan because they didnt think theyd have the power to enact it.

The Atlantic City casino is having a liquidation sale.

Walter Shaub Jr. has clashed with the White House for months. Now hes leaving the government altogether.

The Education secretary is blocking new rules that would make it easier for students defrauded by for-profit colleges to have their debts forgiven.

White House staff reportedly started looking too late.

Agata Kornhauser-Duda avoided shaking the presidents hand like a pro.

The Trump administration is now openly threatening to use the Justice Department as a tool for punishing critical speech.

Trump lavishes praise on Poland, reaffirms his commitment to NATO, and even brings up Russia to a cheering audience.

Initially praised as brilliant, Cruzs idea of letting insurers offer cheap, skimpy health plans is now looking like a deadly threat to sick people.

Something will have to be done about North Korea, Trump told reporters in Poland.

The president displays his signature alt-arguments on the international stage.

After several decades, the effort to build a U.S. missile shield has had only mixed results.

Original post:
Senate Republicans May Have Found Their Health-Care Compromise - New York Magazine

Robert Farley, FactCheck.org Published 1:23 p.m. ET June 28, 2017 | Updated 5:21 p.m. ET June 28, 2017

A new USA TODAY/Suffolk University poll shows low support among Americans for the GOP healthcare bill. Susan Page, USA TODAY Washington bureau chief, explains the findings. USA TODAY

Sen. Rand Paul speaks to the media about the Senate Republican health care bill on June 22, 2017 in Washington.(Photo: Mark Wilson, Getty Images)

Sen. Rand Paul, who opposes the Republican Senate health care bill, says subsidies are actually greater under the Republican bill than they are under the current Obamacare law. But the nonpartisan Congressional Budget Office says the average subsidy under the bill would be significantly lower than the average subsidy under current law.

In all, CBO estimates the government will save $424 billion over 10 years (compared with current law) due mainly to reductions in government subsidies.

Pauls comment came on ABCs This Weekon June 25, as he argued that the current version of the Senate health care bill, the Better Care Reconciliation Act, looks just like Obamacare and still doesnt fix the fundamental flaw of Obamacare.

Paul, June 25: "But realize that this just one second realize that the Obamacare subsidies in this bill are actually greater under the Republican bill than they are under the current Obamacare law. That is not anywhere close to repeal."

The Affordable Care Act, or Obamacare, subsidizes health insurance in two main ways: tax credits to cover a portion of the premiums for individuals who buy their own insurance, and cost-sharing subsidies paid to insurance companies to reduce out-of-pocket payments required under insurance policies.

Tax credits to help people buy insurance would remain at the same levels as under the ACA until 2020. But over the long-term, the Senate plan would be less generous with tax credits than the ACA.

Under the Senate bill, the premium tax credits would be smaller in most cases than under current law, the CBO says.

The ACA provides tax credits to those earning between 100%and 400% of the federal poverty level. Under the Senate plan, tax credits would go to those earning from 0% to 350% of the poverty level.

Also, the tax credit under the ACA is designed to cap what an individual would have to pay toward premiums, based on the cost of a benchmark plan. The Senate GOP bill would use a less expensive plan as the benchmark and adjust what individuals would pay out-of-pocket for premiums based on age for those earning above 150% of the federal poverty level.

Someone earning between 300% and 350% of the federal poverty level, for example, would pay 6.4 percent of income for an insurance policy if he or she is 29 years old or younger. The required contributions then go up with age: 8.9% for 30- to 39-year-olds; 12.5% for 40- to 49-year-olds; 15.8% for 50- to 59-year-olds; and 16.2% for those over age 59. (Under the ACA, those at the poverty level contribute 2.4% of income in 2020, and those earning 400% of the poverty level would contribute 10.2%, according to projections from the Kaiser Family Foundation.)

As for the cost-sharing subsidies available now under the ACA which can lower out-of-pocket costs for copays and other expenses for those earning between 100% and 250% of the federal poverty level those would be eliminated under the Senate bill in 2020.

According to CBO, while individual cases would vary, the average subsidy per subsidized enrollee under this legislation would be significantly lower than the average subsidy under current law.

CBO, June 26:"According to CBO and [the Joint Committee on Taxations] estimates, the average subsidy per subsidized enrollee under this legislation would be significantly lower than the average subsidy under current law, starting in calendar year 2020. Nevertheless, some people would be eligible for larger subsidies than those under current law, whereas others would be eligible for smaller ones."

In all, CBO estimates the government will save $424 billion over 10 years (compared with current law) due mainly to reductions in tax credits for premium assistance starting in 2020 and from eliminating cost-sharing subsidies. Those savings would be partially offset, CBO says, by an increase in spending of $107 billion for short-term assistance to insurers to address disrupted coverage and access and to provide support for states through the Long-Term State Stability and Innovation Program.

Indeed, the amount of subsidies provided in the Senate bill is less than what was proposed in the Republican health care bill that passed in the House.

CBO, June 26:"The structure of subsidies for coverage in the nongroup market differs in the two versions of the legislation and would have substantially different effects by income and by age. The overall spending on such subsidies under this legislation would be $134 billion lower than under the House-passed legislation."

So why does Paul say that subsidies are actually greater under the Republican bill than they are under the current Obamacare law?

Pauls reasoning hinges on a legal debate over the cost-sharing payments currently being paid to insurers to offset the costs for millions of low-income Americans. The subsidies are critical to the success of the Affordable Care Act, as insurers have threatened to pull out of the ACA marketplaces or dramatically increase rates if the subsidies are cut off.

A lawsuit filed by the Republican-controlled House of Representatives in November 2014 contended that funding for cost-sharing subsidies was never appropriated by Congress, and that government payment of those subsidies violated the Constitution and amounted to unlawful transfer of funds, as TheNew York Times put it.

A federal district court judge last year sided with the House. But the judge stayed her decision to allow the government to appeal. In May, the Trump administration asked for a three-month delay in the appeal case, leaving the issue in limbo.

In theory, President Trump could drop the appeal and stop making the subsidy payments. In fact, he has said he could end them anytime I want. But so far, he hasnt. The payments have continued as the case is under appeal.

So are those subsidy payments part of the Affordable Care Act? Paul argues they are not. And since the Republican bill would specifically sunset those payments at the end of 2019, Pauls argument is that the Republican plan amounts to additional funding beyond what is contained in the Affordable Care Act.

The proposed new bill funds a piece of Obamacare that is currently not funded, the cost sharing subsidies which got blocked by a court, Sergio Gor, a spokesman for Paul told us via email.

Gor further points out that according to CBO, the ACA tax credits will cost $156 billion in 2017, 2018, 2019. We do not make any changes to these credits in the first 3 years.

On this point, Paul is taking a short-term (three-year) view and ignoring the long-term implications of the Senate bill, which would cut tax credits after three years.

Pauls comment suggests subsidies would be more generous under the Senate health care plan than those currently offered by the Affordable Care Act. That assumes that the cost-sharing subsidies, which have been regularly paid, are not a part of the ACA. On the tax credit side, it is a short-term comment that ignores that tax credits will be reduced significantly after the first three years.

Autoplay

Show Thumbnails

Show Captions

More coverage from USA TODAY:

Poll: Only 12% of Americans support the Senate health care plan

Senate leaders delay health care vote, lacking GOP support

Heres why its so hard to write health care legislation that will pass

Health care bill winners (wealthy) and losers (Medicaid recipients), according to the CBO

What's next on health care now that the Senate has punted?

Read or Share this story: https://usat.ly/2tYSZn8

Excerpt from:
Fact check: Rand Paul's subsidies twist - USA TODAY

Rand Paul pushed for the Senate to take up a straight repeal of the massive health care law and simultaneously consider legislation to replace it. | Getty

Sen. Rand Paul on Sunday criticized the current Senate GOP plan to repeal and replace Obamacare, likening legislation pushed by Majority Leader Mitch McConnell to a Christmas tree for its spending.

"Here's the problem. ... I don't think we're getting anywhere with the bill we have. We're at an impasse. Every time you add federal money, more spending, for the big-government Republicans, it offends the conservatives," Paul (R-Ky.) said on "Fox News Sunday." "So right now, this bill, which is not a repeal, has become the kitchen sink."

Story Continued Below

"The bill is just being lit up like a Christmas tree full of billion-dollar ornaments, and it's not repeal," Paul said, referencing proposals used to win over moderate Republican senators, such as $45 billion to combat the opioid epidemic and potentially boosting subsidies or maintaining some of the law's taxes.

Instead, Paul pushed for the Senate to take up a straight repeal of the massive health care law and simultaneously consider legislation to replace it. President Donald Trump last week endorsed the idea that the Senate, failing a replacement, should first repeal the Affordable Care Act.

Paul and Nebraska Republican Sen. Ben Sasse both advocated the idea as the Senate put off a vote on its replacement plan.

Sign up for our must-read newsletter on what's driving the afternoon in Washington.

By signing up you agree to receive email newsletters or alerts from POLITICO. You can unsubscribe at any time.

"Let's do clean repeal like we promised. I think you can get 52 Republicans for clean repeal," Paul said. "You can have a simultaneous bill or a concurrent bill that they can call replace and that, I think, perhaps if its big spending, they could probably get Democrats to go along with big spending."

"I'm not for that, but I'm saying I want repeal to work, and the way you do it is you separate it into two bills and you do it concurrently," he added.

Missing out on the latest scoops? Sign up for POLITICO Playbook and get the latest news, every morning in your inbox.

Read the original here:
Rand Paul: Obamacare bill 'a Christmas tree full of billion-dollar ornaments' - Politico

HuffPost

Rand Paul: Republicans 'Have Insufficient Confidence in What Made America Great' CNSNews.com Paul said he would like to separate the repeal and replace bills, although I think they could still be done concurrently. He doubts moderates would vote for a clean repeal bill without a simultaneous replacement plan. So, what I've suggested is ... White House Says Health Care Vote Is Close; Rand Paul Says Not So MuchHuffPost Rand Paul: 'I don't think we're getting anywhere with the bill we have'The Hill Rand Paul says the GOP health-care bill is 'lit up like a Christmas tree full of billion-dollar ornaments'The Week Magazine Conservative Review -Breitbart News -Newsmax -Congressional Budget Office all 602 news articles »

See original here:
Rand Paul: Republicans 'Have Insufficient Confidence in What Made America Great' - CNSNews.com

The median family income for a family of four in the United States these days is approximately$56,500. Members of the U.S. House of Representatives and the Senate earn$179,000 annually. Each chambers leadership makes even more: $193,400. For this kind of money, taxpayers -- who pay these salaries -- might expect their elected representative to do their jobs.

They dont.

Legislators are paid towell, legislate. Legislating means crafting policy proposals, meeting with constituents, holding legislative hearings, and, ultimately, voting. High school students who come to Washington, D.C., still get copies of that perennial civics favorite,How A Bill Becomes A Law.But that brochure never discloses the reality of the American legislative process and how it differs significantly from that cheerful civics description.

That situation is what prompted Senator Rand Paul, R-Kentucky, to again propose legislation, timed just as Senate Majority Leader Mitch McConnell introduced a new GOP-sponsored health-care-reform bill, mandating that Senators first read legislation before they vote on it. If you are an elected representative, shouldnt there be a presumption that before you decide how to vote, you actually know what youre voting on? Its not acceptable for members just to be told by their partys Whip how they should vote as they enter the chamber.

One of the more revealing comments in this regard was made by then Speaker of the House Nancy Pelosi who was commenting on the proposed Affordable Care Act. She remarkably said that, We have to pass the bill so that you can find out what is in it.

TheRead the Bills Act" was firstproposed in 2006. Senator Paul endorsed it in 2010 and proposedsimilar legislationin June 2012. If enacted, the bill would not only promote greater transparency in government by requiring that bills be posted publicly at least 72 hours before a vote, but it would also most certainly produce legislation that was clearer, more coherent, and much shorter.

The new Senate Republican health care proposal is 142 pages long. CNNs Wolf Blitzer asked Senator John Cornyn, R-Texas, on June 22 whether he had read the new proposal. Senator Cornyn held up the bound text, said that he hadnt yet read it, but announced that given its relative brevity, he planned to read the bill that evening. By contrast, the Obama administrations 2010 Affordable Care Act contained some2,700 pages, roughly the length of Marcel ProustsIn Search of Lost Time,one of the longest novels ever written. How many elected officials read that bill?

Is it really asking too much of our well-paid public servants in Washington to take the time to read and understand legislation before they vote on it? One of the more revealing comments in this regard was made by then Speaker of the House Nancy Pelosi who was commenting on the proposed Affordable Care Act. She remarkablysaid that,We have to pass the bill so that you can find out what is in it.At least she was being candid.

Pelosis remark, however, stands in sharp contrast to what Congress expects from others. For example, the 2003Sarbanes-Oxley Act(intended to protect investors from fraudulent accounting practices)requiresthat chief executives and chief financial officers of publicly traded companies certify with each quarterly-earnings report that they have read their report and that it is accurate. Failure to do so can result in stiff civil penalties and, under certain circumstances, criminal liability. A health-care bill that impacts nearly18percentof the countrys gross domestic product has the potential for creating far more harm than almost any corporate quarterly earnings report imaginable.

So why do so many members of Congress not take the time to read bills before they vote? Its probably not because they are lazy. These men and women are typically Type A, driven individuals. Its probably not because they are stupid or have short attention spans. You dont get to serve in Congress -- at least for very long -- if you are intellectually challenged.

The answer is much simpler: they dont have enough time. And the one reason they dont have enough time is because they spend an inordinate amount of their time dialing for dollars to fund their next reelection campaign. Some members of Congress have confessed to spending more than40 percent of their time raising money. American taxpayers, in effect, are subsidizing nonstop electioneering in a manner that precludes their elected representatives from doing their real jobs.

We need an overhaul of how our Congress works, and we can start by mandating that members certify that they have read legislation before they vote on it. Perhaps a more comprehensive bill, theMaking Congress Work for the American People Act,(withWorkhaving more than one meaning) should be considereda bill that addresses the multiple dysfunctions of our Congress. This legislation could include: (1) banning all fundraising by members whenever Congress is in session, (2) withholding pay from all members if appropriations bills are not completed on time, (3) posting all legislation publicly at least 72 hours before a vote, (4) using technology to track changes in the legislative drafting process to allow more public scrutiny and accountability, (5) extending the Congressional workweek beyond what has now become a routine three days, and (6) having fewer and shorter Congressional recesses.

Something tells me that members of Congress would read every word of this proposed bill. When traditional American pragmatism and common sense merge with todays resurgent populism on the left and the right, it is likely that members of Congress will change their ways and start delivering for the American people andnot just for themselves.

Charles Kolb is CEO of DisruptDC. From 1990-1992, he served as Deputy Assistant to the President for Domestic Policy in the George H.W. Bush White House, and from 1997-2012, he was president of the Committee for Economic Development.

See more here:
Sen. Rand Paul's 'Read the Bills Act' - Is it really too much to ask members of Congress to read legislation before ... - Fox News