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Senator Susan Collins, Republican of Maine, said, Minor changes and tweaks will not be sufficient to win my support for the bill.

Changes are coming, but none that are likely to radically alter the estimate by the Congressional Budget Office that 22 million fewer people would have health insurance in 2026 under the Senate health care bill than under the Affordable Care Act. A new estimate is expected from the budget office early next week.

The revised bill is expected to include a $45 billion fund to help combat the opioid epidemic, as well as a provision allowing consumers to use health savings accounts to pay for premiums.

Senate Republicans are also likely to keep a pair of taxes imposed by the Affordable Care Act on people with high incomes. The law increased the payroll tax rate for many high-income taxpayers and imposed a tax on their investment income. Both taxes would be eliminated by the repeal bill passed by the House in May and by the original version of Mr. McConnells bill.

Keeping those taxes would undercut a major argument against the bill by Democrats, who have branded it as a tax cut for the rich disguised as a health bill.

But the largest changes to the health care system are likely to remain in the bill. About two-thirds of the increase in the projected number of uninsured Americans would result from deep cuts in expected Medicaid spending, the budget office said. The bill would impose caps on Medicaid spending and would roll back the expansion of the program under the Affordable Care Act.

The Senate measure will be considered under special procedures that limit debate to 20 hours, preclude a Democratic filibuster and allow passage with a simple majority vote. It is unclear whether Mr. McConnell would start the debate next week if he lacks firm commitments from enough senators to ensure passage.

Delaying the vote again might not help.

Anybody who thinks that its going to get easier by waiting, said Senator John Kennedy, Republican of Louisiana, thats a testament to the power of human denial as far as Im concerned.

At least 10 Republican senators, led by David Perdue of Georgia, had urged the majority leader to work into the month of August, so lawmakers could show some results to their constituents.

Mr. McConnell said delaying the recess would provide time to work on other matters after the Senate deals with health care next week. But the Senate Democratic leader, Chuck Schumer of New York, suggested a different motivation for Mr. McConnells announcement.

Theyre struggling with health care, Mr. Schumer said. They dont want to go home and face their constituents.

The problem is not the timing, he added. Its the substance.

Senate Republicans are still skirmishing over a proposal by Senator Ted Cruz, Republican of Texas, that would allow insurers to sell stripped-down insurance policies if they also offered at least one plan that complied with federal insurance standards under the Affordable Care Act. Under this proposal, insurers could, for example, omit coverage of certain services like maternity care or mental health care.

Mr. Cruz says his proposal would give consumers new, lower-priced insurance options. On Tuesday, he called it the necessary ingredient to getting the votes to repeal the health law.

I believe we can get there, he said. It remains challenging. More work remains to be done. But there is a path forward, and that path revolves around lowering premiums.

But Mr. Cruzs proposal underscored the problem that Mr. McConnell faces: Making a change to please some Republican senators could alienate others. With Democrats united in opposition, he can afford only two Republican no votes.

Ms. Collins, a former state insurance regulator in Maine who is already dissatisfied with the Senate bill, warned about the potential negative consequences of the Cruz amendment. Critics of his proposal say it would create two insurance markets: an inexpensive one for the young and healthy, and another, far more expensive one for sick and older Americans that could price those with pre-existing medical conditions out of the market.

If it is as described, Ms. Collins said, I believe it would further destabilize the individual markets, undermine the protections for people with pre-existing conditions and cause premiums to increase for people with pre-existing conditions.

I certainly dont think that that is the answer, she added.

Also on Tuesday, the Trump administration approved a waiver sought by the state of Alaska for an innovative program to help stabilize the individual insurance market.

The state, which has exceptionally high health care costs and insurance premiums, has established a reinsurance program to help pay claims for consumers with certain very high-cost medical conditions like metastatic cancer, H.I.V. and AIDS.

The House and Senate bills would provide tens of billions of dollars for such programs, intended to help keep premiums down and encourage more insurers to participate in the market.

Emily Cochrane and Emmarie Huetteman contributed reporting.

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GOP Senators Vow to Unveil Health Bill Thursday, Despite Deep Divisions - New York Times

Kim Chandler, Associated Press

Photo: J. Scott Applewhite, AP

Republican firebrand seeks runoff spot in Ala. Senate race

DAPHNE, Ala. (AP) As U.S. Rep. Mo Brooks told it to young Republicans at a seafood restaurant on the marshy banks of Mobile Bay, the Washington "swamp critters" are trying to have their way in Alabama's Senate race.

Piggybacking on President Donald Trump's promise to "drain the swamp" a jab at establishment politicians he told them: "Well, in this race the swamp is fighting back, and I'm not their favorite candidate. I'm not getting those bazillions of dollars."

The 63-year-old member of the conservative House Freedom Caucus is running to fill Attorney General Jeff Sessions' former Senate seat and is jockeying for a spot in an anticipated runoff after the Aug. 15 primary. Brooks said a recent poll showed him trailing incumbent Luther Strange, who was appointed to finish Sessions' term, and former Alabama Chief Justice Roy Moore, who appeals to evangelicals who supported his losing battles over the public display of the Ten Commandments and gay marriage.

Kevin Spriggs met Brooks a few years ago on a trade association lobbying trip and considers him and Moore the most "anti-establishment" candidates. Brooks was hostile to the pleas for "government goodies," Spriggs said.

"I was actually shocked. To me it was impressive," said Spriggs, who owns gas stations and motels in southern Alabama.

But it's Strange that Brooks has found himself sparring with over who more closely aligns with Trump. Brooks has been in office four terms, but Strange has the backing of a super political action committee tied to Senate Majority Leader Mitch McConnell. Brooks' first campaign ad leaned heavily on Trump's promises: He pledged to read the Bible on the Senate floor to filibuster spending bills until funding is secured for the president's proposed wall on the U.S.-Mexico border.

It's a clear attempt to bat away attacks from Strange, who has pointed to Brooks' previous criticism of Trump. Brooks, who was Ted Cruz's state campaign chairman, called Trump a "serial adulterer." Mailers sent by Strange's campaign used a quote from Brooks about American's facing "tough votes in November" ahead to suggest he had difficulty choosing between Trump and Democrat Hillary Clinton after Trump became the GOP nominee.

Brooks has had solid conservative backing for years. Heritage Action, an arm on the hardline conservative Heritage Foundation, gives Brooks a 94 percent rating. Brooks has also picked up endorsements from well-known conservative commentators such as Sean Hannity and Laura Ingraham.

He defended his past criticisms of Trump saying he did all he "could honorably do" for the Texas senator but supported Trump after he "steamrolled us."

Now, he believes those attack ads are a sign of momentum for his campaign, that his opponents are worried. He still has work to do to build name recognition outside his home base in the northern part of the state.

"The biggest handicap is I don't have the millions upon millions upon millions of dollars that the special interest groups have bestowed upon the favorite candidate," Brooks said.

The last fundraising reports filed in April show Brooks had a little over $1 million, money left over from House races. By comparison, the Senate Leadership Fund in May said it reserved a $2.6 million television ad buy on behalf of Strange.

Brooks made the rounds on cable TV news last month because he was part of the Republican congressional baseball team sprayed with bullets outside Washington, critically injuring House Majority Whip Steve Scalise of Louisiana. Police later told Brooks he was on a list of six names carried by the gunman.

While at the southern Alabama gathering, Brooks quipped to the Baldwin County Young Republicans that the shooting could have been deadlier had the gunman not shot his rifle from the hip: "Fortunately, this guy was a liberal and didn't know how to use a gun."

Continued here:
Republican firebrand seeks runoff spot in Ala. Senate race - SFGate

The Republican Party is in chaos.

Healthcare reform is dying in the backrooms of the Senate. Tax reform efforts are divided between a White House that wants rate cuts at all costs, and others who want reduced rates alongside eliminated loopholes. And the president's son, Donald Trump Jr., is now implicated in conspiracy with a foreign power.

How did we come to this?

How, just six months after Republicans took control of the presidency and Congress, is chaos now triumphant?

Well, for a start, it's down to leadership. President Trump has led as if he's the chief executive of a unitary organization rather than the chief executive of a vast bureaucracy.

Power in Trump Tower rests with one man and a staff who are paid to obey. Conversely, power in Washington rests with 535 representatives of the American people, all of who must face unique electorates.

That's why in Congress, Speaker of the House Paul Ryan and Senate Majority Leader Mitch McConnell have been unable to draw their divided caucuses together. There are too many separate interests at play. And Trump simply does not inspire members of Congress to go out on a limb for him. For all his other failings, in 2010, Obama was able to inspire Democrats to get Obamacare passed.

In part, of course, there is a method in the present madness. At least on the part of the Founding Fathers!

As James Madison noted in Federalist No. 47, "The accumulation of all powers, legislative, executive, and judiciary, in the same hands, whether of one, a few, or many, and whether hereditary, self-appointed, or elective, may justly be pronounced the very definition of tyranny."

The balancing of powers that defines the U.S. system of government is designed to prevent the authoritarian impulses of power. Absent that checking influence, we would see the power of the people transferred to the power of the legislative whips.

In the U.K. for example, whips in Parliament have far greater power to extract votes than in Congress. It's not because the British whips have more power per se, it's because members of Parliament have the chance of joining the executive branch: the ministers who make up the British government. But if they don't play ball, they won't get the jobs they crave. It's a patronage system.

We're lucky to have a more democratic approach to government.

Still, leadership matters. And it's not at all clear that the present chaos was inevitable. Imagine what might have been had Republicans worked in a coordinated fashion to prepare for Obamacare's repeal and replacement. To be sure, some Senators might have changed their minds prior to voting but agreement would have been established far before January 3.

Or consider what might have been possible had Trump decided to listen to members of Congress rather than tweet at them. Or send Bannon to threaten them.

Republicans have a little more than a year to get their acts in gear. If they do, and manage to pass legislation of substance (whether on healthcare, taxes, infrastructure, entitlements, or immigration), they may yet retain control of Congress.

One benefit to the GOP here is the dysfunction of the Democratic Party. If Republicans faced a serious opposition, hope would be looking a lot less possible.

Nevertheless, Americans are clear: we like winners. If Republicans don't start putting legislative points on the board, they'll be losing come next November. And to start winning, they must first end the chaos.

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The Republican Party is a party in chaos - Washington Examiner

The moment state Rep. Steve Andersson, R-Geneva, picked up the Tribune last Friday and saw the now-famous photo running from edge to edge across the front page, he figured he'll be seeing it again. And again. And again.

The image, captured by Justin L. Fowler of The State Journal-Register and reprinted by media outlets all over the state, shows Andersson shaking hands with Democratic House Speaker Michael Madigan. Madigan is simultaneously clasping Andersson's right elbow with his left hand, one of those lightly intimate gestures that suggests more than an obligatory greeting.

The lawmakers were on the floor of the House of Representatives in Springfield. Andersson had just voted, along with nine other Republicans, to join 62 Democrats in overriding Republican Gov. Bruce Rauner's veto of a budget bill that included increases in the state's personal and corporate income tax rates.

Andersson said he'd stopped on his way off the floor to chat with Rep. David Harris of Arlington Heights, another Republican defector, also in the photo, when Harris suggested he turn around. There was the speaker, his hand outstretched.

To further set the stage: Andersson, 52, began serving as a Republican precinct committeeman when he was a college undergraduate, and has been loyal to the party ever since. His voting record in the General Assembly has earned him an 86 percent lifetime approval rating from the American Conservative Union and he seldom agrees with Madigan politically.

Madigan, 75, is the archvillain in every Republican narrative about the state's dreadful finances. The party portrays him as the corrupt insider and cruel despot who for decades has hoodwinked leaders from both parties into agreeing to let him run Illinois into the ground for his own dark purposes.

For a Republican to be seen, much less photographed, having a chummy moment with Madigan is highly risky. Think of the all the grief that New Jersey's Republican Gov. Chris Christie took for embracing President Barack Obama when Obama came to survey storm damage in Jersey in 2011. Then double it.

Andersson didn't hesitate. "When someone offers his hand to me, I'm going to shake it," he said. "I'm not the kind of person to turn away."

They had a very brief conversation Andersson estimates it lasted 10 seconds in which they expressed mutual gratitude for the passage of the first full-year budget since 2014. Madigan's spokesman Steve Brown confirmed the outlines of Andersson's account.

Andersson, who moved up from the Geneva Library District Board to the General Assembly in 2015, was unopposed in both the primary and general elections when he ran for a second term last year. In January his colleagues elevated him to the position of House GOP floor leader.

But Monday, House GOP leader Jim Durkin asked for and received Andersson's resignation from that position. And Andersson said he fully expects to receive a primary challenge from the right in 2018, one that prominently features the photo of him shaking hands with Madigan on mailers and billboards and in web ads.

"They'll play it as evidence that I sold out," said Andersson. "But I didn't. It was the hardest vote I've ever taken, but I took it to protect my district and save my state."

Andersson said that earlier in the budget standoff between Rauner and Democrats, most constituents he heard from in his far west suburban district encouraged him to stand firmly with Rauner, who was refusing to negotiate a new taxing and spending plan until the Democrats agreed to pro-business legislative changes.

But as the stalemate dragged on and the increasingly disastrous effects of operating without a budget became clear, Andersson said sentiment shifted. At a mid-June town hall meeting he heard no support for a radical, spending-cuts-only budget or for continuing to operate without a budget, he said, and grudging acknowledgment, even from "superconservatives in the room," that bringing tax rates back nearly to where they were in 2014 was necessary to prevent a full-on meltdown of state finances.

"They told me they want me to keep fighting for reform, but they want a budget now," he said.

The House and Senate passed a budget bill that included many elements of the so-called Capitol Compromise, a Republican plan with tax rates Rauner had agreed to and spending cuts at least as deep as Rauner had proposed. But Rauner vetoed the plan because, he said, it didn't contain enough "reform."

Andersson announced he would join most Democrats in the vote to override. And my theory that Rauner secretly wanted the budget deal enacted so the state would stay afloat and he could also blame Madigan for the tax increases is supported by Andersson's report that Rauner's only effort to get him to support the veto was a brief and bland voicemail message delivered the morning of last Thursday's override.

He's taken considerable heat for both his vote and the photo taken in its immediate aftermath it was pouring in through social media and on his office and personal phone lines. He was called a traitor, a devil, a fool, a dupe and many names he would not repeat. He received a death threat serious enough that he referred it to the Illinois State Police.

But he has no regrets.

"I voted for what I believe are Republican values," he said. "We don't stiff our vendors. We provide our businesses with stability and predictability. We don't let our state collapse."

I asked how he thought history will judge him.

"History will forget me," he said. "But I did the right thing."

ericzorn@gmail.com

Twitter @EricZorn

Continued here:
Rep. Andersson sticks up for 'Republican values' by bucking GOP governor - Chicago Tribune

The delay on passing a health care bill is one reason Republican lawmakers from both houses of Congress are asking to stay at work this summer. In less than 15 legislative days, lawmakers are scheduled to leave town for the entire month of August.

In their home districts, they will likely face angry constituents frustrated Congress has so far not passed any major pieces of legislation, especially health care.

The congressional August recess goes back to a time before air conditioning when spending time in Washington during the summer was painful. But some lawmakers are starting worry about the heat they'll get when they head home for August if they haven't fulfilled some major promises, reports CBS News correspondent Nancy Cordes.

The calls for a congressional scheduling change are getting louder. Georgia Sen. David Perdue is one of many Republicans pushing to do away with the annual five-week break.

"I can tell you what: if you did a vote out there in the real world, they would vote for us to stay here and get their work done," Perdue told CBS News.

In a letter to Majority Leader Mitch McConnell, Perdue and nine colleagues point out there are only 31 working days until the end of the fiscal year and lots of work to do, including passing a health care bill, tax reform, funding the government and handling the debt limit.

"The gridlock is not understood by people back home, nor is it going to be tolerated," Perdue said.

Perdue is not the only Republican speaking out.

"We should be locked on the House floor until we get some things done," Wisconsin Rep. Mike Gallagher said.

"I'm ready to work through August," Louisiana Sen. John Kennedy said.

"We cannot be taking a vacation or a break in August if we haven't done the people's work," Alabama Sen. Luther Strange said on Fox News.

Maine's Republican Sen. Susan Collins has served in Congress for more than two decades.

"Why does Congress go home so often and for such a long period of time?" Cordes asked her.

"We learn so much when we do go home. It gives us the chance to spend extended periods of time with our constituents," Collins responded.

Congress is actually on track to spend more days in session this year than the 20-year average, as Republican leaders try to make the most of their control of Congress and the White House.

"Look, if time were the only consideration, absolutely staying through August would make sense," congressional scholar Norm Ornstein said. But he said so far, Republicans don't have much to show for the extra workdays.

"They don't have a consensus of the votes and they refuse to try and broaden that base to find consensus by bringing in Democrats," Ornstein said.

Any changes to the congressional calendar would need approval by leadership of both sides, and Democrats aren't eager to give Republicans more time to try to enact their agenda.

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Republican lawmakers' calls for doing away with August recess grow louder - CBS News