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Senate leaders are rewriting their health care plan in an effort to vote on it next week, Republican Whip John Cornyn (R-Tex.) said Monday, even as some GOP senators expressed deep pessimism about the prospect of reaching a final agreement.

The push for a revised bill comes as Senate Democrats are working to enlist the help of Republican governors to scuttle the current health-care proposal. Some rank-and-file Republicans have suggested their party should negotiate with the minority.

Cornyn said that he expects GOP leaders to unveil a new version of the legislation this week, and then well vote on it next week.

At their normal weekly policy lunch Tuesday, Republican senators are expected to hear how their concerns have been addressed, and leaders can measure whether their tweaks are likely to move the needle at all, according to a GOP aide familiar with the talks.

A spokesman for Senate Majority Leader Mitch McConnell (R-Ky.) declined to say when he will release the new version of the bill.

(Jenny Starrs/The Washington Post)

While the prospect of a compromise between the two parties on overhauling the Affordable Care Act may prove daunting given the ideological divide between Republicans and Democrats on health care, the ongoing conversations among a handful of senators suggests some lawmakers are seeking a new path forward should the current bill collapse.

Sen. Thomas R. Carper (D-Del.) said in an interview that he called a couple dozen Republican and Democratic senators and governors over the recess to say this is a good time for us to hit the pause button in the Senate, and step back and have some good heart-to-heart conversations about how to revise the 2010 law known as Obamacare.

Carper, who said he had been encouraged by what he had heard from his colleagues, said the fact that the National Governors Association was holding its summer meeting in Providence, R.I., later this week could give governors a chance to weigh in on the current debate.

The governors can play a critical role in helping us get to where we need to be, Carper said.

However, even as Carper and some of his Democratic colleagues have reached out to Republicans, the White House is pushing back forcefully against the idea of such collaborations. In an interview with radio host Rush Limbaugh on Monday, Vice President Pence questioned those in his party who suggest we ought to reach out and do a bipartisan bill. That description could include McConnell himself, who has said he would have to reach out to Democrats to shore up the insurance markets if Republicans fail to pass their own bill.

Pence continued: The president has made it very clear: We believe that if they cant pass this carefully crafted repeal and replace bill [where] we do those two things simultaneously, we ought to just repeal only and have enough time built into that legislation to craft replacement legislation in a way thats orderly and allows states to adjust to different changes to Medicaid in a maybe three-year or four-year window.

Pences endorsement of an outright repeal of the ACA, along with an amendment Sen. Ted Cruz (R-Tex.) has crafted that would allow insurers to sell minimalist health plans on the ACA insurance market, could further fracture an already divided GOP.

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Senate Republicans plan to introduce a new health bill this week, vote next week - Washington Post

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In dramatic shift, most Republicans now say colleges have negative impact Inside Higher Ed Republicans have soured on higher education, with more than half now saying that colleges have a negative impact on the United States. An annual survey by the Pew Research Center on Americans' views of national institutions, released this week, found a ... The Majority Of Republicans Think Colleges Are Bad For The US, Poll ShowsHuffPost Sharp Partisan Divisions in Views of National InstitutionsPew Research Center for the People and the Press Majority of Republicans Say Colleges Are Bad for America (Yes, Really)Newsweek Nieman Journalism Lab at Harvard -Atlanta Journal Constitution -The Hill all 44 news articles »

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In dramatic shift, most Republicans now say colleges have negative impact - Inside Higher Ed

Although hes been thwarted so far on his legislative agenda before Congress, most notably on health care,President Donald Trump has a bigopportunity to reshape another branch of government outside his control: the federal judiciary. He has already moved swiftly to fill an unusual, inherited vacancy on the Supreme Court, and nowhis aides areworking theirway through a large number of openings on the lower federal courts. Some of his first picks are up for a Senate committee vote this month.

Justice Neil Gorsuch, with only a few months on the high court under his belt,alreadyembodiesthekind of influence Trump seeks to have on the third branch. Gorsuch, who replacedthe late Antonin Scalia, reestablished the 5-4 advantage conservatives long enjoyed when it came to most hot-button social issues. Gorsuch has cast consistently conservative votes on such topics as Trumps travel ban,gun rights, and the separation of church and state. And he doesnt even turn50 until August.

Its actually quite rare for anew president to find a Supreme Court vacancy already waiting.Trump, of course, encountered his good fortunecourtesy of Senate Majority Leader Mitch McConnells unprecedented 10-month refusal to consider President Barack Obamas nominee, U.S. Circuit Judge Merrick Garland. The last time a new presidenthad an inherited vacancywas back in 1881, when the beneficiary was President James Garfield.

But thiscongressional pocket veto of Garland, a 64-year-old moderate and chief of the influential U.S. Court of Appeals in Washington, was simply the most public manifestation of a longer-term strategy. After gaining control of the Senate in 2015, Republicans made it their mission to slow-walkObamas nominations for the lower courts. This effort contributed to the relatively large backlogof 107 vacancies ontrial and intermediate-appellate courts that Trump inherited. Thats more than what awaited four of Trumps five immediate predecessors, according to the public-affairs website Ballotpedia.Only President Bill Clinton had more initial vacancies, with 111. By contrast, Obama found only 54 lower-court vacancies when he took office, while President George W. Bush had84.Trumps starting batch of 107represents12percent of all890 federal judicial positions.

Those vacancies, and the ones to come as more judges retire (the number hasalready jumpedto 136 in the six months since inauguration) offer Trump the chance to sculptthe courts to his liking. During the campaign, hesaid he would appoint judges very much in the mold of Justice Scalia, a forceful conservative who unexpectedly died in February 2016. Perhaps more than some of his liberal detractors gave him credit for, Trump, 71, understood the importance of the judiciary to Republicans who were reluctant to support him. If you really like Donald Trump, thats great, but if you dont, you have to vote for me anyway, he said at a rally in Iowa last July. You know why? Supreme Court judges, Supreme Court judges.

As a candidate, Trump relied on suggestions from two establishment conservative groups,the Heritage Foundation and the Federalist Society, to assemble a list of 21 potential high court picks. Gorsuchwas on their list. Now Trump ispulling from the same compilationfor his lower-court choices. One example is Allison Eid, whom Trump has nominatedfor the vacancy created by Gorsuchsdeparturefromthe U.S. Court of Appeals for the Tenth Circuit in Denver. A member of the Colorado Supreme Court, Eid previously served as the states solicitor general and as a law clerk to the U.S. Supreme Courts right-wing elder, Justice Clarence Thomas.

Conservatives applauded Eidsselectionin June, as well as those of 10 other lawyers, judgesand scholars. Its a fantastic list, Carrie Severino, chief counsel of the right-leaning Judicial Crisis Network, said in apost on the National Reviews Bench Memos blog. Many of the nominees are well known in the conservative legal movement. Trump so far has nominated 15 people to the lower courts, including StephanosBibas, a law professor at the University of Pennsylvania who clerked for the Supreme Courts swing vote, Anthony Kennedy, and has argued several cases before the justices. Bibasis up for a seat on the U.S. Court of Appeals for the Third Circuit in Philadelphia. Professor Amy Coney Barrett of the University of Notre Dame, who previouslyclerked for Scalia, was nominated for a seat on the the Seventh Circuit in Chicago.

Administration officials know what they are looking for, saidJonathan Adler, a conservative constitutional law professor at Case Western Reserve University in Cleveland. Most of the appellate court nominees are current or former academics. That shows a desire for judges who will have an intellectual influence on the courts theyre placed on. Noah Feldman, a liberal professor at Harvard Law School and Bloomberg View columnist, volunteered that these are better picks than one might have expectedmaybe better than one could have hoped. Feldman attributed the quality of these early nominees to the administrations having outsourced judicial selection to elite conservative lawyers.

UnderSenate rules, confirmingjudicial nominations requires only a simple majority. That means Republicans need sway all but one of their 52-member caucus to push through a nominee, and even with just 50, they can count on Vice President Mike Pence as a tie-breaker. It used to be that a Supreme Court nominee required 60 votes, but to guarantee Gorsuchs ascension to what many Democrats bitterly considered Garlands seat, McConnell exercised the so-called nuclear option, and changed the rule.

In the end, Gorsuchreceived three Democratic votes and wasconfirmed54-45. The only other Trump nominee the Senate has voted on so far, AmulThapar, a former federal trial judge, took a seat on the Sixth Circuit in Cincinnati after being confirmed 52-44.

Despite Feldmans muted assessment of Trumps initial nominees, liberal activistssound glum. The whole situation is worrisome, saidNan Aron, president of the Alliance for Justice in Washington. Were seeing nominees, including Gorsuch, who are going to turn back the clock on hard-fought rights and liberties. The prospect of a Trump-shaped federal judiciary is all the more critical now, Aronadded, because the courts are the only institution that are providing a check against the administrations more extreme policies. As an example, she pointed to theban on travel from six majority-Muslim countries, which several lower courts blocked beforethe Supreme Court last month largely reinstated itand agreed to hear arguments on its lawfulnesscome fall.

The narrow Senate majority currently held by Republicans doesnt ensureconfirmation of every Trump nominee, however. Two White House choices that have infuriated Democratsandcould make moderate Republicans queasyare John Bush and Damien Schiff. Both men, who are scheduled for a votebeforethe Senate Judiciary Committee as soon as next week, have come under fire for hard-right views theyveexpressed asprolific bloggers.

Bush, 52, a Kentucky lawyer nominated to an appellate judgeship on the Sixth Circuit, posted(PDF) pseudonymously in 2008 that slavery and abortion have been the two greatest tragedies in our country and added that they stemmed from similar reasoning and activist justices at the Supreme Court, first in the DredScott decision [of 1857], and later in Roe. By that reasoning, justices such as AnthonyKennedywho have voted to uphold Roe v. Wade, the 1973 abortion-rights landmark, ought tobe condemned along with 19th century proponents of slavery. Questioned during a June 14 Judiciary Committee hearing, Bush said that in retrospect he regrets the post equating abortion and slavery and wouldnt allow his personal views tocolor his work as a judge.

Schiff, an attorney with the conservative Pacific Legal Foundation, is a nominee for a spot on the U.S. Court of Federal Claims, a specialized body that hears certain lawsuits against the government. In one 2007post, Schiffassailed Justice Kennedy, a conservative who sometimes sides with the Supreme Courtsliberal bloc. He called the 80-year-old justicea judicial prostitute prone to selling his vote, as it were, to four other justices in exchange for the high that comes from aggrandizement of power and influence, and the blandishments of the fawning media and legal academy. At the June 14 hearing, Schiff, 37, apologized for his harsh language and said his point wasnt to impugn or malign any person but to attack a certain style of judging that is frequently applauded in the media.

As it happens, rumorshave swirled lately in Washington that Kennedy, soon to turn 81, is considering retirement. His potential departurewould give Trump another important vacancy to fill. Given Kennedys critical role in several 5-4 victories for the liberal wing, it may be the most important of all.

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One of the Biggest Reasons Republicans Stick by Trump - Bloomberg

Politicians call the Medicaid program that provides health care for the poor "broken." Academic studies have reported on its limited health benefitsor the longer appointment wait times that people with Medicaid face.

But as Republicans feverishly work to revise ahealth-care bill that would trigger deep cuts to the program over time, a massive new survey reveals that people enrolled in Medicaid rate their health care pretty high.

On a scale of 0 ("the worst health care possible") to 10 ("the best health care possible"), more than 270,000people covered by Medicaid in 46 states rated their health care at an average of 7.9, according to an analysis in the journal JAMA Internal Medicine. That's just slightly worse than how Medicare enrollees rated their health care and not far behind how privately insured patients feel about their coverage.

"The future of Medicaid is just the hottest topic in the health policy world. But its been, for a long time, a lot of rhetoric," said Michael Barnett, assistant professor of health policyandmanagement at the Harvard T. H. Chan School of Public Health. Missing from the debate, Barnett said, is what people covered by the program feel.

"If theyre satisfied, its really an argument: Does reducing those benefits, having fewer peopleon Medicaid, really improve populationhealth?" Barnett said.

Under a Senate Republican health-care bill, spending for Medicaid would be cut 35 percent by 2036, according to the Congressional Budget Office. For millions of children and families on the program, that could mean losing important health services. (Jorge Ribas/The Washington Post)

[Martin Shkrelis trial shows just how angry people are about drug prices]

The survey took place from December 2014 to July 2015 and included a sample of people who were enrolled in Medicaid as of fall of 2013. That means it did not capture people who received coverage as a result of the Medicaid expansion of the Affordable Care Act.

The survey can't show how the health law changed Medicaid, but it provides a snapshot across a broad swath of enrollees including the elderly, disabled people and adults. Nearly half of the people rated their Medicaid coverage a 9 or 10, while less than 10 percent gave it a score less than 5. Older adults rated the care a bit higher than others, but their scores were strikingly consistent overall.

The vast majority of people 84 percent reported being able to get the care they needed over the last six months.

A common critique of Medicaid has been that theprogramcosts the federal government a lot of money but doesn't provide much access to health care because people struggle to get appointments or find many physicians decline to accept their coverage.

Various barriers to care have been documented, but the survey found that only 3 percent of enrollees reported not being able to get care because of waiting times or doctors not accepting their coverage.

Another issuethat policymakers worry about is whether people have a "usual source of care," meaning a primary care doctor or another kind of clinic where they can seek care in non-emergency situations.

The goal is to have people manage chronic diseases such as diabetes and prevent illness altogether, instead of waiting until they are acutely sick and must relyon the emergency room. Only 2 percent of respondents said they lacked a usual source of care because they couldn't find a physician who took their insurance.

Read more:

Louisiana considers radical step to counter high drug prices: Federal intervention

Why the Senate health-care bill is even harsher than it looks, in one chart

Lawmakers make bipartisan push to understand the soaring price of a lifesaving drug

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Republicans say Medicaid is 'broken.' Here's how the people it covers feel. - Washington Post

Housekeepers and baristas are often stiffed.

July 10, 2017, 12:01 AM EDT

Hoping to get a good tip? Seek out the table with the most conservative men from New England. A new survey finds men, Republicans, and residents of the northeast are the best tippers.

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Women tip a median of 16 percent, whileDemocrats and southerners leave a median15 percent at a restaurant, according to a new survey of more than 1,000 American adults conducted by Princeton Survey Research Associates International on behalf of CreditCards.com. That's compared with the median 20 percent that men, Republicans, and northeasterners leave. Those who pay with plastic leave a median 20 percent, compared with 15 percent for those who pay in cash.

Though roughlyhalf ofpeople tip between 16 percent and 20 percent, about a fifth of restaurant goers polled admitted to stiffing the wait staff at least occasionally.

I was definitely surprised by how many people tip over 15 percent, but I was also surprised by how many people never tip at all at a restaurant, Matt Schulz, CreditCards.coms senior industry analyst, said in a statement. Im guessing they don't get very good service on their next visit.

Tipping isn't customary worldwide, but it's a critical source of incomefor nearly all American service workers.The federal minimum wage for tipped employees is just $2.13. Such workers rely on the collective whim of their customers for the remainder of their earnings. (A handful of states have a higher minimum wage for such employees, includingAlaska, California, and Oregon.)

There's a discriminatory nature to tipping, advocates of alternative payment options argue. "The typical full-time, year-round female server is paid just 68 percent of what her male counterpart is paid ($17,000 vs. $25,000 annually)," a February 2012 report from the Restaurant OpportunitiesCenters Unitedfound. "The gender pay gap is even larger for women of color. Black femaleservers, for example, are paid only 60 percent of what all male servers are paid."

The report found that, among more complex gender and economic reasons,these servers were paid less because women, particularly women of color, more frequently worked at fast-food and family-style establishments, rather than infine dining, where tips are higher.

There's been a recent trend against tipping, with some restaurants factoring the service charge into the cost of their products. Famed restaurateur Danny Meyernixed tipping at his restaurants entirely. The majority of restaurants, however, still have tipping policies.

Issues with tipping extend beyond the restaurant industry. The survey found that 31 percent of those surveyed never tip their housekeeper when staying at a hotel and 30 percent never tip their barista at a coffee shop. Hair stylists and barbers fared slightly better: Only 12 percent of those polled stiffed these workers. Women were more likely than men to tip in all three of thesescenarios.

The bottom line? Tip your service workers.

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Men and Republicans Are the Best Tippers - Bloomberg - Bloomberg