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The Congressional Budget Office weighed in Tuesday with another of its long-awaited analyses of aspects of repealing or tinkering with the Affordable Care Act. This time the topic is the ACAs cost-sharing reduction subsidies, which reduce deductibles and co-pays for the lowest-income buyers of health coverage on the exchanges.

The CBOs findings are timely because the so-called CSRs are the subsidies that President Trump continually threatens to withhold, as a tool for forcing Obamacare to implode. And, as expected, the CBO finds that canceling the subsidies would be a disaster but for Republicans favoring that approach, not Democrats.

Its conclusion is especially germane to the question of what congressional Democrats should trade in return for a GOP agreement to keep the CSRs funded. Earlier this month, healthcare analyst Avik Roy argued that Republicans should demand lots of concessions, including repeal of the individual mandate and enactment of premium-lowering regulatory reforms. Roy didnt specify these, but Republicans have talked about paring down the ACAs list of essential health benefits, such as maternity, hospitalization and prescription coverage, which are mandated to be offered by any qualified health plan.

The CBOs analysis, however, suggests that Democrats should take Michael Corleones approach from The Godfather, Part II. His line to a corrupt senator overplaying his hand was: My offer is this: nothing.

Obamacare supporters havent fully internalized this reality. The Democratic National Committee responded to the CBO report by quoting the agency as finding that if cost-sharing reduction subsidies were ended, millions of Americans would face skyrocketing premium increases of 20% by 2018 and 25% by 2020. Actually, the CBO didnt say that. The premium increases it cited were gross increases, not factoring in premium subsidies, which would reduce the actual impact in many cases to zero.

Health insurance expert David Anderson of Duke got it exactly right: Democrats have no reason to trade CSR funding for policies that they dont prefer, he observed. Inaction gives them an incredible policy victory. Conservatives are the ones who need to make concessions to fully fund CSR.

The fallout from CSR cancellation already is visible in early rate requests filed by insurers in several states. California insurers are seeking an increase averaging about 12.5% for next year but almost double that if the CSRs are ended. Those rates are pre-subsidy, and Covered California, which manages the states insurance exchange, said that the average buyer could avert all or most of the increases through the subsidy and smart shopping.

The CBO says its analysis is based on the assumption that CSRs would be paid through the end of this year, but not thereafter. If the scenario changes say the payments are cut off in midyear, after insurers already have set their annual premiums and signed up customers, the results could be more dire. In that event, however, Republicans would probably be blamed for the resulting market carnage, since it would be associated directly with GOP action.

Before we get into the counterintuitive details, a quick primer.

Cost-sharing reductions are offered to buyers in the individual market with incomes between 100% and 250% of the federal poverty limit. For a family of four, the eligible income range is $24,600 to $61,500. These subsidies are in addition to the ACAs premium subsidies, which cover those with incomes up to 400% of the poverty level, or $98,400 for a family of four. Unlike the premium assistance, which technically is paid to the policyholder, the CSRs are advanced to the insurers based on the co-pays and deductibles they would otherwise charge. About half of all buyers of ACA plans are eligible for the CSR assistance, and about 90% receive premium subsidies.

The subsidies this year are expected to come to $7 billion, to be paid to insurers covering 7 million customers. The subsidies are authorized under the healthcare act, but House Republicans filed a lawsuit in 2014 asserting that because the money hadnt been specifically appropriated, paying the money is illegal. They won the first round in U.S. District Court last year, but the judge stayed her ruling pending an appeals court decision.

Since his inauguration, Trump has dithered over whether to pay out the subsidies and continue fighting for them in court. On occasion, hes threatened to kill the payments as a bargaining chip to force Democrats to negotiate an Obamacare repeal. Periodically, the plaintiff and government lawyers have to return to the appeals court to ask for a three-month hold in the case; the next scheduled appearance is Aug. 20. Recently, 17 states and the District of Columbia won the right to step in to defend the CSR payments if the Trump administration tries to withdraw from the case.

The CBO found that canceling the CSR subsidies might drive some insurers out of the individual market because of uncertainty about the effects of the policy on average healthcare costs for people purchasing plans. Those facing higher deductibles and co-pays might be less inclined to buy coverage. Regions with about 5% of the U.S. population might end up with no insurers in the individual market next year, the agency said. But by 2020, enough insurers would return to the market that almost no one would be left without insurance availability.

Democrats should follow Michael Corleone's lead, and in return for continuing the cost-sharing subsidies offer Republicans "nothing."

Democrats should follow Michael Corleone's lead, and in return for continuing the cost-sharing subsidies offer Republicans "nothing."

Insurers would, however, raise premiums to compensate for the loss of subsidies for deductibles and co-pays. Its likely that insurers would load these higher premiums onto silver plans, the only plans that provide CSR subsidies. That would drive up gross premiums for silver plans by 20% next year, compared to their expected level without a policy change.

But because premium subsidies are tied to buyers incomes and rise as premiums rise, the subsidies would also increase in fact, more Americans would be eligible. The CBO reckoned that many silver-plan buyers receiving subsidies would pay net premiums similar to what they would pay if the CSR payments were continued. Some buying skimpier, bronze plans, would receive sufficient subsidies to cover premiums and some of their deductibles and co-pays too. The average subsidy would be greater, and more people would receive subsidies in most years.

The federal government, however, would take a hit. Over 10 years, the CBO said, canceling the CSR payments would increase the federal deficit by $194 billion. So much for the fiscally responsible Republican Party.

The picture could be materially different if Trump follows through on his threat to cancel CSRs immediately. Any decision to terminate CSRs after insurers had begun charging premiums based on continued CSR funding, the CBO said, would cause them significant financial losses. Some would leave the marketplace immediately, leaving their enrollees without coverage in the middle of the year and causing a spike in the ranks of the uninsured.

Is Trump prepared to explain the consequences to the public? Its doubtful. Many congressional Republicans know that for Trump to cancel the CSRs in midstream would hand them a poisoned chalice. Sen. Lamar Alexander (R-Tenn.), chair of the Senate Health, Education, Labor and Pensions Committee, told Roy he favors an affirmation by Trump of the CSRs at least through September, followed by congressional extension of the CSRs for one year. That would provide sufficient stability, Alexander said, to persuade the insurers to lower their rates.

Keep up to date with Michael Hiltzik. Follow @hiltzikm on Twitter, see his Facebook page, or email michael.hiltzik@latimes.com.

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CBO confirms canceling Obamacare's cost-sharing subsidies would be a disaster for Republicans - Los Angeles Times

BIRMINGHAM, Ala. Voters headed to the polls on Tuesday to choose a permanent Senate successor to Attorney General Jeff Sessions, with both Republicans and Democrats locked in competitive primaries that may have to be resolved in a Sept. 26 runoff.

On the Republican side, a bitter and expensive campaign seemed to favor Sen. Luther Strange (R-Ala.), who was appointed to replace Sessions in February by a governor who later resigned in disgrace. Despite millions of dollars in ads, and tweets and robo-calls from a supportive President Trump, public polling had Strange in a dogfight with Rep. Mo Brooks (R-Ala.) and former state Supreme Court justice Roy Moore. In a Tuesday morning tweet, Trump reiterated that Strange will be great if sent back to the Senate.

I predict that President Trumps endorsement will be incredibly important because people want his agenda passed, Strange told Fox News before heading out to vote. I couldnt be more honored.

But in the final hours of campaigning, both Moore and Brooks attacked Strange as a pawn of Senate Majority Leader Mitch McConnell (R-Ky.), whose Senate Leadership Fund and One Nation super PACs have spent more than $2.4 million to bail out the incumbent. At one of his final stops, at a sporting goods store in his north Alabama congressional district, Brooks lit into Strange as a dishonest and unethical candidate who had been captured by the political establishment.

[Past coverage: Alabama Gov. Bentley taps state AG Luther Strange to fill Senate seat vacated by Sessions]

In this neck of the woods, Luther Strange is getting the living daylights stomped out of him, Brooks said, as a supporter waved a campaign-provided banner reading DITCH MITCH. Were going to beat Luther Strange here two-to-one, or three-to-one, not just because they know me, but because they know that Luther Strange and Mitch McConnell have been lying to the state of the Alabama. And we dont like people who are dishonest with us.

Brooks, a flinty member of the House Freedom Caucus who frequently bucks his party leadership, had been the main focus of the SLFs attacks. The most damaging spots have played back year-old footage of Brooks, then a supporter of Sen. Ted Cruzs (R-Tex.) presidential bid, criticizing Trump; evidence, according to the SLF, that Brooks was on the same side as liberal Democrats.

The SLF only recently turned its guns on Moore, who gained national attention 20 years ago for fighting to display the Ten Commandments in his courtroom. In 2003, he was suspended from the court for refusing to remove a monument of the commandments; in 2016, after an improbable comeback, he was suspended again for refusing applications for same-sex marriage licenses.

[Alabama Supreme Court Chief Justice Roy Moore suspended for defiance over same-sex marriage]

Tellingly, the attack ads against him skirt those controversies to portray Moore as a rip-off artist who added to his six-figure salary by starting a lucrative think tank. At his final campaign stop, speaking to the gun rights organization Bama Carry at a Chinese buffet restaurant in Birmingham, Moore referred to the attack ads as forces coming in from the north to buy your vote, and predicted that his grass roots support would carry the day.

The organization is better than Ive ever had before, said Moore. Money? Well, thats always less. Im being outspent ten-to-one.

The multiple David-and-Goliath stories have rallied some Alabama conservatives, who blame McConnell for Congress languid 2017 pace. In their final TV spots, Brooks displays an Aug. 10 tweet in which Trump blamed McConnell for the failure of the Affordable Care Act repeal push; Moores spot says flatly that McConnells Republicans lied about repealing ObamaCare.

In an interview at one of his final spots, Strange acknowledged that the narrow failure of the skinny repeal bill had depressed voters, even though hed cast his vote with McConnell and the president.

Theyre frustrated, I share their frustration, he said.

Public polling has suggested that the frustration will leave Strange well short of the 50 percent support needed to avoid a runoff. In five polls, conducted by news stations and Republican groups, Strange has never risen higher than 35 percent. The final poll, conducted by the Republican-friendly Trafalgar Group last week, found Moore at 38 percent, Strange at 24 percent, and Brooks at 17 percent. Five other Republicans, led by State Sen. Trip Pittman, came in at single-digit support.

Democrats, who have not won a Senate election here since 1992, see a rare opportunity if the Republicans nominate Moore, or if Strange wins but is dogged by scandal. The oddly-timed special election may depress voter turnout, with a general election not coming until Dec. 12.

But Democrats may have a runoff of their own. Doug Jones, a former U.S. attorney who prosecuted two conspirators in a 1963 bombing of a black church, has the support of party leaders, as well as national surrogates like Rep. John Lewis (D-Ga.) and former Vice President Joe Biden. According to Jones, Biden had been urging him to make a statewide run for more than a decade.

Theres a real opportunity right now, because everything thats been proposed by the Republicans right now would be devastating for this state, Jones said in an interview at his Birmingham campaign office. Moving the election to December broke this wide open its allowed us to focus on one race, with an energized base, plus a group of independents and people who usually vote Republican, who say we need change, we need checks and balances.

The depleted state of Alabamas Democratic Party might complicate Joness bid. He jumped into the race in May, and has raised less than $200,000, which has helped fund radio ads, lawn signs, and a robo-call from Biden. But public polls, which his campaign disputes, have found him well short of 50 percent and running behind an African American military veteran, with little political experience, who happens to be named Robert Kennedy Jr. A poll from Birminghams WBRC TV station put Kennedy at 49 percent, knocking on the door of an outright primary victory.

The Kennedy campaign has given Democrats a queasy deja vu. As the party has collapsed in the deep South, several establishment-backed white candidates have run prudent primary campaigns, and lost to obscure black candidates who did little electioneering but had familiar-seeming names or appeared at the top of the ballot. In 2015, a truck driver named Robert Gray spent $50 to win the Democratic gubernatorial nomination in Mississippi. In 2010, more infamously, a troubled veteran named Alvin Greene won the partys nomination in a U.S. Senate race, defeating a judge and former state legislator.

Kennedy, unlike those candidates, has held public events, bought campaign ads, and worked in politics as a campaign volunteer and Capitol Hill staffer. In an interview, he said hed shaken hundreds of voters hands, and dispelled concerns that he was some sort of Republican plant.

Alabama voters can be completely comfortable knowing that we dont owe anybody anything, said Kennedy. My name might have gotten us some media attention, but our message is what got us to 49 percent in that poll.

Jones was confident of victory, or at least of making a runoff in which voters would be paying more attention to their candidates. Alabama Republicans, who during the Obama years drove Democrats to near-extinction, were operating as if the winner of their primary and runoff would glide toward victory. At his final rallies, Brooks said that voters really had a choice of whether to let the swamp choose who went to Washington, or whether to send a conservative disrupter to replace Jeff Sessions.

If its a Roy Moore and Mo Brooks runoff, there will be hell to pay in Washington, D.C., said Brooks at one rally, as the DITCH MITCH banner waved from the audience.

Read more at PowerPost

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Alabama Republican candidates court Trump voters in today's Senate primary - Washington Post

SALT LAKE CITY (AP) Three GOP candidates hoping to replace former Rep. Jason Chaffetz in Congress faced off Tuesday in a primary election after weeks trying to burnish their conservative credentials and fend off attack ads from deep-pocketed outside groups.

Chaffetz abruptly stepped down from his seat in June after making a name for himself as the Republican who relentlessly investigated Hillary Clinton and her emails while he was chairman of the House Oversight Committee.

His departure opened up a congressional seat in a district where Republicans outnumber Democrats five-to-one, offering voters and donors a choice between three candidates emblematic of the divisions roiling the GOP under President Donald Trump.

Moderate Utah Republicans have backed a popular mayor, John Curtis, who was once a Democrat and said he had strong moral concerns that kept him from voting for Trump.

Those further to the right have split their support behind Chris Herrod, a former state lawmaker known for strict immigration positions, and Tanner Ainge, a business consultant, first-time candidate and son of Boston Celtics president Danny Ainge.

Out-of-state organizations and political action committees have spent about $900,000 in Utah's race on top of about $600,000 in campaign contributions collected by the three Republicans running for Utah's 3rd Congressional District.

Outside spending of that magnitude is generally only seen in heavily Republican Utah when Democrats and Republicans face off in an occasional close race.

Early voter turnout was about 22 percent, and that number was expected to rise with polls open on Tuesday, said elections director Mark Thomas. Total turnout in the last primary, where Chaffetz was a popular incumbent, was about 33 percent.

Herrod, 51, and Ainge, 33, both voted for Trump, but all three candidates say they support the president's agenda including plans to build a wall along the U.S.-Mexican border, revamp the tax code and repeal the Affordable Care Act.

Curtis, the target of most of the out-of-state attack ads, has faced suspicion and criticism from some Republicans for his 2000 run as a Democrat for the state Legislature and his time leading a county Democratic party. The 57-year-old identifies today as a conservative Republican and points out that Ronald Reagan, Trump and Chaffetz were all Democrats at one point.

For Ada Wilson, a 59-year-old Republican homemaker from Orem, Curtis' stint across the aisle is one of the reasons she's voting for him. Wilson said it shows Curtis can work in a bipartisan way to get things done.

"I think he acknowledges that being Republican with an 'R' by your name does not automatically make you a keeper of all the answers," she said.

David Nelson, a pharmaceutical representative from Salem, Utah, said he thinks Curtis' Democratic past shows he's not a conservative. Nelson said it's OK that Ainge hasn't held public office, and he's voting for the younger candidate because of his "business-minded" outlook.

"I think that you don't have to have all the experience in the world to go to Washington and work for the people," he said. "You just have to be in tune with the pulse of the people."

Martin Wilkins, a 39-year-old UPS worker from Orem, said Ainge seems like a nice guy but is too young and inexperienced.

"In the political world, he's just a kid and no one is going to listen to him," Wilkins said. "If you go into college and a kindergarten student starts trying to order people around, no one is going to listen."

Wilkins said he voted for Herrod because seems like the kind of person who tells it straight, whether it's popular or not.

The winner coming out of Tuesday's race will face a well-funded Democratic opponent who initially jumped in to challenge Chaffetz earlier this year. Kathryn Allen socked away more than half a million dollars after she called out Chaffetz early this year for his comments suggesting people should spend money on health care instead of iPhones.

Chaffetz made a surprise announcement that he was resigning at the end of June, citing a desire to spend more time with family after eight years in Congress. He's since taken a role as a Fox News commentator and announced he will be one of six visiting fellows at Harvard University this fall.

His announcement made what would have been a quiet municipal Election Day in which counties were conducting their first mail-in voting into a more complicated affair, and there have been problems with unaffiliated voters receiving ballots that should have gone only to Republicans.

Election officials have explained that unaffiliated voters can vote in the primary if they come to the polls and register as Republicans on Election Day. Unaffiliated votes for Republican candidates won't be counted.

Several third-party candidates are also running in November, including Jim Bennett, the son of the late former U.S. Sen. Bob Bennett, a longtime Republican who lost re-election in 2010, the first of several GOP candidates ousted in tea-party fueled wave. Jim Bennett is running as the first candidate of a new centrist party, the United Utah Party.

Associated Press writer Brady McCombs contributed to this report.

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3 Republicans face off in Utah primary for vacant House seat - STLtoday.com

"Mr. President - we must call evil by its name," tweeted Sen. Cory Gardner of Colorado. "These were white supremacists and this was domestic terrorism."

But, a look back at the two-plus years since Trump burst onto the political scene suggests a disturbing pattern -- which goes like this:

1. Trump says or does something controversial or just plain wrong.

2. Republican elected leaders condemn him for it.

3. Trump never apologizes or acknowledges any sort of remorse or wrongdoing.

4. Republican elected officials carry on in support of Trump and his agenda.

I plucked out nine of the most high-profile instances in which Republican condemnation of Trump turned to acceptance. These are in no order other than that in which I recalled them.

"Who wrote that? Did Hillary's scriptwriters write it?" Trump said in an interview with ABC News' George Stephanopoulos right after the Democratic convention. Trump also responded directly to the attack from Khan that the Republican nominee had never known true sacrifice: "I think I've made a lot of sacrifices," Trump said. "I work very, very hard."

At a campaign rally in May 2016 in San Diego, Trump took out after Gonzalo Curiel, the judge in a lawsuit against Trump University.

"Everybody says it, but I have a judge who is a hater of Donald Trump, a hater," Trump said. "He's a hater. His name is Gonzalo Curiel."

Trump went on to insinuate that Curiel's Mexican heritage -- though the judge was born in Indiana -- meant that he couldn't offer a fair ruling because of Trump's position on building a wall on the US' southern border.

In February 2016, Trump was asked -- again, by Tapper -- about David Duke, a prominent white supremacist who had endorsed him days earlier.

During the campaign, Trump claimed that he remembered Muslims celebrating on New Jersey rooftops on September 11, 2001. Kovaleski was a reporter for The Washington Post at the time, had investigated those reports and found nothing to them.

Trump, unhappy with the the way the one-time Fox News anchor moderated a Republican primary debate, took after Megyn Kelly. "You could see there was blood coming out of her eyes," Trump told CNN's Don Lemon on Friday night. "Blood coming out of her wherever."

He later insisted his reference had nothing to do with Kelly's menstrual cycle. Former Arkansas Gov. Mike Huckabee, at the time a Trump primary challenger, said he "would certainly never say anything about a person like that, and I hope [Trump] apologizes because I think that he should."

In his announcement speech in June 2015, Trump said Mexico was sending bad people to the US. "They're sending people that have lots of problems, and they're bringing those problems with us," Trump said. "They're bringing drugs. They're bringing crime. They're rapists."

Bush said of the comment: "He's doing this to inflame and incite and to draw attention, which seems to be the organizing principle of his campaign."

And yet, through it all, Trump is still in the White House and still, broadly speaking, enjoys the backing of the vast majority of Republican elected officials. Remember that when considering all of the condemnation being issued of Trump's latest major mistake.

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9 times Republicans denounced Trump but came back to him - CNN International

By Robert Bradley | August 15, 2017, 11:10 EDT

Printed from: http://newbostonpost.com/2017/08/15/republicans-need-to-build-their-coalition-not-destroy-it/

One might think that Republicans would understand that political power in America is all about building coalitions. The Republican Party was founded in 1854 by creating a coalition of anti-slavery Northerners and the remnants of the Whig party. Abolitionists, merchants, and the emerging urban middle class combined to create a party which ran the U.S. government most of the time from 1861 until 1913. Moralists and economic pragmatists joined together to win political power and use it effectively. The coalition split in 1912, when Republican Teddy Roosevelt ran against Republican President William Taft, thereby handing the presidency to Woodrow Wilson.

Fast forward one hundred years. Republicans today are in as much disarray as in 1912. How did they get here?

Republicans were largely out of power between FDRs landslide victory in 1932 and 1980, because Democrats had built their own powerful coalition of Northern liberals from large cities and Southern conservatives. But then Republicans figured out how to build another coalition. It started with the conservatives like William F. Buckley Jr. making common cause with Barry Goldwaters losing campaign in 1964, survived Richard Nixons zigzagging and disastrous ending, and came to fruition in the person of Ronald Reagan.

The coalition was made up of economic conservatives and libertarians, patriots who believed America needed a strong foreign policy and military to defeat the evil empire, and social conservatives who focused on strong families, the sanctity of life, and traditional standards of right and wrong.

What were the demographics of this coalition which held together (with a few miscues) from 1981 through 2008? Men, married women, the white working class (Reagan Democrats), and the middle class outside the coastal states. In fact, the coalition was so broad that President Reagan won 49 states in 1984; Mondale won only his home state of Minnesota.

To win, Republicans need voters who care about three crucial groups of issues, which do not necessarily overlap: a strong economy with robust GDP growth and job creation (smaller government and less regulation); a foreign policy and effective military which projects American power to aid our friends and confound our enemies; and traditional moral values dealing with marriage, intact families, and life, which are vital to healthy communities.

In short, economic conservatives, patriots, and social conservatives! When these three groups of voters split or fall out, Republicans lose. And to exercise power effectively and hold it at the polls, Republicans within these three groups need to compromise and work together.

This is not rocket science. What is wrong with Republicans in Washington now? Are they so anti-Trump that they want to see their party fail? Are they more interested in grandstanding for the folks back home than accomplishing Republican goals? Are they narcissists like John McCain whose DNA leads him to feel fulfilled only when acting in opposition (to the enemy or his own party)? (Imagine voting against your own party in the health care debate in the Senate only to receive accolades and hugs from your Democratic opponents.) Are some senators more attached to the Freedom Caucus than their own party? Are key senators so focused on standing for the Presidency in the 2020 elections that they refuse to work within an effective coalition?

Democrats in Washington enforce strict party discipline. It is extremely rare to see a Democratic legislator vote against his or her own party. There are serious consequences for doing so. Not so in the Republican Party! Republicans need to utilize the three-line whip system which is used in the U.K. parliamentary system. A three-line whip is a strict instruction from party leaders that those elected to office in their party must attend and vote with the party. A breach of the three-line whip directive has serious consequences, including preferences in committee assignments and even withdrawal of party support and funds in the next election.

The Republican Party in Washington is pathetic. It is a joke except that squandering this great opportunity to unwind the eight-year debacle of the Obama administration is more tragic than comic. Republicans need to strengthen the coalition which has given them both houses of Congress and the White House not fritter it away! The current Republican coalition can maintain power and use it effectively for a long time, if only Republicans in Washington can learn the precious virtue of unity.

Robert H. Bradley is Chairman of Bradley, Foster & Sargent Inc., a $3.25 billion wealth management firm that has offices in Hartford, Connecticut, and Wellesley, Massachusetts. This column represents his personal views and does not represent the views of the firm.Read other articles by himhere.

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Republicans Need To Build Their Coalition, Not Destroy It - NewBostonPost (blog)