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The Call-In: Answering Your Questions About The Republican Health Care Plan NPR On this week's edition, we answer your questions about the Republican health care proposal. Facebook; Twitter. Google+. Email. Get The Stories That Grabbed Us This Week. Delivered to your inbox every Sunday, these are the NPR stories that keep us ...

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The Call-In: Answering Your Questions About The Republican Health Care Plan - NPR

The 9th Circuit the largest and most important of the 13 federal court circuits in the country, encompassing 11 Western states and territories and covering nearly 20% of the U.S. population is under siege. Four Republican congressmen have introduced bills to break up the circuit in various ways. All four bills have a chance of passing. None of them makes any sense.

The arguments for splitting the U.S. Courts for the 9th Circuit are perennial: Its too big, too slow and, most of all, too liberal. But none of these complaints is sound. Moreover, breaking up the court would add considerable costs while potentially lowering the quality of judging.

Most of the justifications offered for splitting the 9th Circuit have to do with its size, and it does indeed hear a lot of cases more than 55,000 civil and criminal cases in its district courts in 2015 alone, along with 12,000 appeals in its appellate court.

Big doesnt always mean bad, however. The 9th Circuit may do a lot, but its pretty efficient. The circuit has pioneered mediation units and screening panels to help solve cases early, and it disposes of nearly half its appeals that way. It methodically allocates resources, assigning extra judges to areas faced with a shortage. The appellate court broadcasts arguments on the Web, allowing citizens to watch proceedings without traveling to a courthouse. The 9th Circuit doesnt handle cases any more slowly than other circuits if you account for the number of cases assigned to each judge.

Another common rationale for carving up the circuit is its supposedly high reversal rate in the Supreme Court, which last year hit 79%. That sounds high until you realize the Supreme Court on average reverses lower-court decisions 70% of the time. (The 6th Circuit, comprising just four Midwestern states, had a reversal rate of 81%.) The 9th Circuit also encompasses some of the most experimental states in the country, including Arizona, which frequently passes innovative immigration laws; Oregon, with its expansive individual-rights laws on assisted suicide and marijuana; and, of course, California. If anything, its surprising the Supreme Court doesnt reverse decisions from the 9th Circuit more often.

The real cause behind the efforts to split the circuit is that its appellate court is perceived as too liberal. The 9th Circuit Court of Appeals, based in San Francisco, has been a conservative bugaboo since the 1970s, when President Carter and a Democratic supermajority in Congress doubled the number of judges on the court and appointed some of the most liberal jurists in American history. Right-wing radio hosts and politicians love beating up on the nutty 9th.

But in reality, the courts liberalism has declined dramatically. Judges appointed to the court by Presidents Clinton and Obama have been steadily more centrist, while Republican appointees have remained conservative.

Meanwhile, the real-world costs of splitting the 9th Circuit are extremely high. So high that every prior effort to split the circuit there have been seven or eight attempts since the early 1990s has failed. Division would double the bureaucracy and infrastructure to the tune of some $200 million up front and $35 million a year for taxpayers. Businesses could face twice the litigation and compliance costs depending on where they operate, and they might have to wrangle with different interpretations of federal law throughout the West. This is one reason why Congress has modified circuit borders only twice, in the 1920s and the 1980s, in response to requests from judges. By contrast, the 9th Circuits judges have historically voted to remain cohesive.

If lightening the caseload is the reason to break up the circuit, there is simply no good way to achieve that goal. California cases make up nearly two-thirds of the circuits work, and drawing a line in the middle of a state with different federal law on either side would wreak havoc. Each of the pending congressional proposals to split the circuit would siphon only 20% to 30% of its current cases, a figure so small that one of the new circuits would be back up to the 9th Circuits current numbers within a decade or so. Not to mention that putting California in its own circuit, or with just a few other states, would probably create one that is even more liberal.

Additionally, the quality of appellate judging might suffer from a smaller circuit. When the same judges sit together over and over, they become very familiar, which can foster discord or, worse, an over-willingness to defer to one another. Indeed, Congress would do well to consider merging some of the smaller circuits, rather than breaking up a bigger one.

On the 9th Circuit, the Court of Appeals assigns its three-judge appellate panels randomly from its scores of active, senior and visiting judges. The circuits geographic spread means a case arising out of California might be heard by judges from Idaho, Hawaii or Washington, allowing for a great variety of perspectives to inform the courts judgment. The judges sit in different frequencies and in different months. Their relationships are professional rather than personal, in part because of their number and distance.

Shifting the circuits borders around wont change the overall number of cases per judge or the way its judges decide legal questions, either. There are liberal judges from Montana and Arizona, and there are conservative judges from California and Oregon. If Congress really wants to speed up the 9th Circuit and influence the way it decides precedent-setting cases, it should create more judgeships. Compared with the other circuits, the 9th is understaffed; it should have at least five more appellate judgeships and 21 more district judgeships.

Adding judges might be particularly alluring to Republicans because it would allow them to make use of the gift former Senate Democratic leader Harry Reid now regrets giving them the ability to appoint federal judges without the risk of a filibuster.

The last time a party controlled the White House and had filibuster-proof power to appoint federal judges was in the 1970s, when Carter gave the 9th Circuit its hyper-liberal reputation. If congressional Republicans took this route, they could shift the courts political leanings without creating problems for litigants and businesses along the West Coast.

There is one final advantage to keeping the 9th Circuit intact: Republicans would retain their favorite culprit. After all, what would they do without the nutty 9th to blame?

Ben Feuer is the chairman of the California Appellate Law Group.

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The Republican case for breaking up the notoriously liberal 9th Circuit makes no sense - Los Angeles Times

By Susan Cornwell | WASHINGTON

WASHINGTON Deeply divided Republicans squeezed their U.S. healthcare overhaul, backed by President Donald Trump, through a key House of Representatives panel on Thursday despite defections by three conservatives who consider it too similar to the Obamacare law it is intended to replace.

Trump's first major legislative initiative still faces an uphill battle in the full House and later the Senate despite ongoing efforts by the White House and Republican leaders to satisfy conservative opponents.

The Budget Committee vote was 19 to 17, with Republican Representatives David Brat, Gary Palmer and Mark Sanford - all members of the conservative House Freedom Caucus - joining the panel's Democrats in voting against it. The committee brought provisions approved last week by two other panels into a single bill, helping pave the way for a later vote on the House floor.

Republicans, who control Congress and the White House, could not afford to lose more than three from their ranks on the committee for it to pass.

"I don't think we are anywhere near passage," Brat said after the vote, noting that Republican conservatives as well as moderates had problems with the bill.

The 2010 Affordable Care Act, the signature legislative achievement of former President Barack Obama, enabled about 20 million previously uninsured Americans to obtain medical coverage. About half of those were through the law's expansion of eligibility and increased funding for the Medicaid government health insurance program for the poor.

The close vote illustrated the problems Republican leaders may encounter in corralling enough votes in their party to win passage on the House floor amid unified Democratic opposition. The measure now goes to the Rules Committee before reaching the House floor.

The Congressional Budget Office, a nonpartisan congressional agency, forecast on Monday that the legislation would increase the number of Americans without health insurance by 24 million by 2026, while cutting $337 billion from federal budget deficits over the same period. The bill faces opposition from leading healthcare providers, including doctors and hospitals.

"We are on track and on schedule," House Speaker Paul Ryan, who unveiled the legislation last week and is its chief champion in the House, said after the committee's vote. He added that while the main parts of the bill "are going to stay exactly as they are," Republicans were making unspecified "improvements and refinements."

Ryan told a news conference that Trump was "deeply involved" and "helping bridge gaps" among Republican lawmakers to get a consensus plan.

'CONSTITUENCY OF ONE'

Conservatives were unmoved. "There's no natural constituency for this bill," said Republican Representative Raul Labrador, another Freedom Caucus member.

"The Left is really mad about it. The Right is really mad about it. The middle is really mad about it. And so far it just seems to be a constituency of one, which is Washington insiders, people that are just trying to get something passed so they can get to the next issue."

Trump administration officials and House Republican leaders have said they hope to get the bill to the House floor by the end of the month so it can go to the Senate before lawmakers' mid-April recess.

Conservatives want a quicker end to the Obamacare Medicaid expansion, which the bill has set for 2020, and want to add work requirements for some Medicaid recipients. They also call the age-based tax credits to help people buy insurance on the open market an unwise new entitlement.

The White House said it was discussing changes with House Republican leaders. Trump told a Fox News interviewer on Wednesday that much of the bill would still be negotiated, especially as it moves from the House to the Senate.

Conservative advocacy groups praised the Republicans who voted "no." Club for Growth President David McIntosh said it makes no sense for Ryan and Budget Committee chair Diane Black to force Republicans "to walk the plank and vote for a bad bill that they've already admitted needs to be changed."

Black asked fellow Republicans who had doubts not to "cut off the discussion" by voting no.

After approving the legislation, the panel adopted four non-binding Republican recommendations for changes before it moves to the House floor, including one by the conservative Palmer on adding work requirements for able-bodied, childless Medicaid recipients.

The other recommendations called for no longer encouraging people to sign up for insurance through Medicaid, giving states more flexibility in designing Medicaid programs, and changing the bill's tax credits to help lower-income people more.

Democrats have called the Republicans' plan a blow to the elderly and the poor while giving tax cuts to the rich.

Representative John Yarmuth, the committee's top Democrat, said the legislation was "not a healthcare bill; it is an ideological document." He said the bill imagined a "fantasy land where young people don't get sick, and apparently they don't grow old either, because they don't have to worry about being priced out of the market."

(Additional reporting by Susan Heavey, Doina Chiacu, David Morgan and Yasmeen Abutaleb; Writing by Will Dunham; Editing by Dan Grebler)

WASHINGTON The Republican head of a congressional panel investigating accusations of Russia's interference in the 2016 U.S. election said on Sunday a leak involving former Trump aide Michael Flynn was a crime and that the panel was probing whether other names were leaked.

BEIJING With warm words from Chinese President Xi Jinping on Sunday, U.S. Secretary of State Rex Tillerson ended his first trip to Asia since taking office with an agreement to work together with China on North Korea and putting aside trickier issues.

WASHINGTON U.S. House Republicans are working on changes to their healthcare overhaul bill that would implement a work requirement for the Medicaid program for the poor, as well as boost tax credits for older, lower income people, U.S. House Speaker Paul Ryan said on Sunday.

Originally posted here:
Republicans split, conservatives angry as healthcare overhaul inches ahead - Reuters

March 18, 2017 10:00 PM By PatLoeb

(Photo by Joe Raedle/Getty Images)

PHILADELPHIA (CBS) Last weeks report from the Congressional Budget Office on the Republican health insurance plan set off alarm bells for health care advocates, because it said 24 million Americans would lose their coverage.

An analysis of the report shows what the impact would be locally.

Marc Stier of the Pennsylvania Budget and Policy Center says the CBO report confirms his earlier estimate that more than one million Pennsylvanians will lose insurance under the republican plan, but theres a slight shift in who loses.

He says more people may be able to stay on Medicaid, but more workers may lose job benefits.

It looks like in Pennsylvania we may lose 280,000 to 300,000 people who get insurance through their employer because of different incentives the law creates, Stier said.

There are other winners and losers. Young people may see lower premiums, but people over 40 will pay more.

Stier says a 60-year-old in Philadelphia will pay about $7,000 more, for a worse plan.

Rather than covering 70% or 80% of the cost of health care, theyll cover 50-60%, Stier explained.

Stier sees little good news for the region.

Pat Loeb's radio experience has the makings of a country song:she lived a lot of places, went down a lot of roads, but they all led her home -- to Philadelphia and to KYW Newsradio, where she started her career some 30 years ago. Born and rais...

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Local Impact Of Republican Healthcare Plan - CBS Philly

Arch conservatives have come to define the House Republican brand this decade, pushing the Treasury to the edge of default in 2011, shutting down the government in 2013 and supporting the most right-wing contenders in last years presidential primary.

Now, however, Speaker Paul D. Ryan (R-Wis.) is dealing with a different rebellious flank within the House Republican Conference as he pushes a massive health-care bill toward the floor next week. Larger in number but softer in tone than their conservative counterparts, moderate Republicans are shaping up to be at least as big a hurdle to achieving the long-held goal of repealing the 2010 Affordable Care Act and replacing it with a more market-oriented series of policies.

These Republicans are getting their share of meetings with Ryan and his leadership team, voicing their concerns about the impact specific pieces of the bill would have in their districts. They are making clear that any negative fallout from these policy moves would place their seats in jeopardy in next years midterm elections, a fate that Ryan understands would open the door to losing the House majority.

And, of course, these moderates are making their case in a much quieter fashion than members of the House Freedom Caucus, a group of roughly 30 conservatives who have used their high-profile media appearances to gain several audiences with President Trump to question Ryans direction in the health-care fight.

We have our own way of evaluating things and making our points heard, and its not necessarily through the press, the way that they do it, Rep. Ryan Costello (R-Pa.), a second-term lawmaker from the Philadelphias western suburbs, said Thursday.

This is new math for Ryan. In his first year on the job, he mostly faced the same battles that his predecessor, John A. Boehner, had in his five years as speaker: The right wing always caused the most trouble.

Eventually those rabble-rousers from the Freedom Caucus helped push Boehner (R-Ohio) out the door by threatening to oppose his hold on the speakers gavel, and they had enough votes to likely block him.

[GOP health-care plan: Key House panel calls for work requirements, additional cuts in Medicaid]

For sure, conservatives far outnumber moderates in the increasingly right-tilting caucus that Ryan oversees. But the vast majority of those conservatives are amenable to Ryans policy provisions, leaving 30 or so members of the Freedom Caucus as the biggest troublemakers.

Meanwhile, according to an analysis by the FiveThirtyEight blog, there are roughly 60 Republicans who are either members of the mainstream Tuesday Group or sit in districts that leaned toward Hillary Clinton in the presidential election.

The speaker can afford just 21 defections from his ranks and still pass the bill by the slimmest of margins, so Ryan convened a meeting Thursday with three representatives each from the ideological caucuses, including the Freedom Caucus, the more traditionally conservative Republican Study Group and the moderates in the Tuesday Group.

In the fight over Ryans health bill, the American Health Care Act, Republican strategists suggest the members of the far-right corner of the conference do not have enough votes to sink the legislation on their own.

Theres also a particularly strong belief among House GOP leaders that if Trump puts his full force behind the legislation, these Freedom Caucus members will buckle.

Take Rep. Mark Meadows (R-N.C.), the caucus chairman, who is currently leaning against the legislation. Trump won Meadowss district in western North Carolina by nearly 30 percentage points, a much bigger margin than Republican Mitt Romney won there in 2012.

Thats not the case with almost three dozen Republicans who come from districts that Clinton won or that Trump won by less than 4 percentage points.

These Republicans saw the Congressional Budget Office estimate of 24million more uninsured from Ryans legislation and gasped. They know their constituents might be frustrated with Obamacare, but they tend to be more diverse and from the suburban professional ranks, unwilling to throw people off insurance with no substitute.

We just need to make sure that we are helping the people who are most in need, Rep. Carlos Curbelo (R-Fla.) said.

Curbelo won a second term from his South Florida district in a rout even though Trump lost there by 16 percentage points.

But 2018 will be a very different race. Like the vast majority of Republicans in tough districts, Curbelo has never run with a Republican holding the presidency.

Rep. Darrell Issa (R-Calif.), a longtime reliable ally of leadership, also wont commit to supporting the health legislation despite a meeting Wednesday with Ryan. He barely survived his 2016 election after his suburban Southern California district swung sharply to Clinton.

Many of these wavering Republicans come from states that adopted the expanded Medicaid rolls the ACA allowed, a provision that would be phased out under the current Ryan proposal.

Thats one of the great concerns for Rep. Daniel Donovan (R-N.Y.), whose district in Staten Island and Brooklyn actually supported Trump by a wide margin. His meetings with local health industry officials have been brutal.

Theyre all against the current form of the bill, theyre all concerned, Donovan said.

He wants to prevent his Freedom Caucus counterparts from speeding up the phaseout of the Medicaid expansion.

Our health-care system is broken, it needs to be repaired, but I think we have to help those people that were harmed by the Affordable Care Act without harming the people that were helped by it, Donovan said Thursday.

The underlying theme of the Tuesday Group Republicans is to make their voices heard quietly, in the speakers office or on the House floor, to try keep the bill from going too far to the right. You sort of want to keep your powder dry until youre able to look at everything and sift through it, Costello said.

Ultimately, however, the test for these Republicans will be how they respond if Ryan and Trump appease the conservatives.

Rep. Charlie Dent (R-Pa.), chairman of the Tuesday Group, delivered a warning that his moderates might be willing to topple the entire legislation if it means a bad deal for their districts.

He wouldnt commit to how many were in those ranks, but for the first time these moderates have leverage, if they choose to use it.

Enough to make a difference, Dent said.

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The sleeping giants of the Obamacare debate: Republican moderates in the House - Washington Post