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Though they failed to mobilize Congress to repeal the Affordable Care Act last month, Paul Ryan (R-Wis.) (right), Kevin McCarthy (R-Calif.) and the White House could still undercut the insurance exchanges, reduce Medicaid benefits and let states limit coverage of birth control or prenatal visits. Chip Somodevilla/Getty Images hide caption

Though they failed to mobilize Congress to repeal the Affordable Care Act last month, Paul Ryan (R-Wis.) (right), Kevin McCarthy (R-Calif.) and the White House could still undercut the insurance exchanges, reduce Medicaid benefits and let states limit coverage of birth control or prenatal visits.

The Affordable Care Act's worst enemies are now in charge of the vast range of health coverage the law created. They're also discussing changes that could affect a wider net of employment-based policies and Medicare coverage for seniors.

Although Republicans failed last month in their first attempt to repeal and replace the ACA, President Donald Trump vows the effort will continue. And even if Congress does nothing, Trump has suggested he might sit by and "let Obamacare explode."

Health insurance for the 20 million who benefited from the ACA's expanded coverage is especially at risk. But they're not the only ones potentially affected. Here's how what's going on in Washington might touch you.

A 3-year-old lawsuit threatens many health plans

A suit by the Republican-led House challenges some of the subsidies that support private plans sold to individuals and families through the ACA's online insurance marketplaces (also called exchanges). The lawsuit has already gained one court victory. By many accounts, it would wreck the market if successful, leaving up to 12 million people without coverage.

"It's the single-biggest problem facing the exchanges," said Rachel Sachs, a health law professor at Washington University in St. Louis. "That would make insurers not only exit tomorrow but also not want to offer plans in 2018."

The litigation involves lesser-known ACA subsidies that reduce out-of-pocket costs such as co-payments and deductibles for lower-income consumers. These are different from the law's income-linked tax credits, which help pay for premiums.

Filed in 2014, when Barack Obama was president, the lawsuit could backfire by politically harming the Republicans now in charge. House leaders requested and were granted a delay of the litigation for now, and said they won't drop the lawsuit but will continue the subsidies while it gets considered. The administration has not said how it plans to handle the lawsuit.

Policy confusion undermines coverage

Even if Congress doesn't repeal the ACA, the continuing battle is making insurance companies think twice about offering marketplace policies for next year. The less clarity insurance carriers have about subsidies and whether the administration will promote 2018 enrollment, the likelier they are to bail or jack up premiums on the policies they offer, to cover themselves.

Preserving the subsidies, which limit out-of-pocket costs for lower-income consumers, "is essential," said Kevin Lewis, CEO of Community Health Options, a nonprofit Maine insurer.

"Markets don't like uncertainty," Lewis said. "The 'sword of Damocles' hanging over our collective heads is unsettling, to say the least."

Democrats say Republicans are sabotaging Obamacare

Shortly after taking power, Trump officials yanked advertising designed to maximize enrollment in marketplace plans just before a Jan. 31 deadline. It was partly restored after an outcry.

Then the administration said it would scrap an Obama-era plan of rejecting tax returns from individuals who decline to say whether they had health insurance. Scrapping that plan weakens the requirement that everyone have health coverage.

Trump aide Kellyanne Conway suggested in January the administration might entirely stop enforcing that requirement it's the part of the law most hated by many Republicans. If officials persist with that message, health plans might attract even fewer of the young and healthy members whose insurance premiums are needed to support the ill. That would cause more hikes in premiums and exits by insurers.

"More mischief can be done," said Dr. Peter Kongstvedt, a health industry consultant and senior faculty member at George Mason University. "It is absolutely possible that some markets will end up with no carriers unless a combination of state and federal government act to preserve the market" with taxpayer money.

Trump officials will move to roll back ACA coverage even if Congress doesn't repeal

Tom Price, secretary of the Department of Health and Human Services, has signaled his intent to reverse parts of the ACA through regulation even if Congress doesn't repeal the law.

For example, Price couldn't unilaterally eliminate coverage for birth control or maternity care, both of which many Republicans object to on moral grounds or because of cost. But birth control might no longer be free as a preventive benefit. Maybe the administration would let states limit the number of prenatal visits in maternity coverage. Perhaps more employers could gain religious exemption from providing birth control.

Medicaid coverage for people with low incomes could shrink

Obamacare's coverage expansion included government Medicaid coverage for folks with lower incomes. Thirty-one states and the District of Columbia expanded Medicaid to most adults who have incomes below about $16,000 for singles and $28,000 for a family of three (although eligibility varies).

Republicans want to reduce the growth of Medicaid spending and give more control over the program to states. Discussions about a Medicaid overhaul have focused on replacing ACA provisions with less-generous federal grants to states.

But even if the ACA survives, it's likely the administration will give states more say in who gets Medicaid coverage and how much. Many Republicans favor having work requirements for Medicaid recipients and raising out-of-pocket payments for patients.

Under the failed House replacement bill, the American Health Care Act, 9 million people in those states would have lost Medicaid coverage in 2020, according to estimates from the nonpartisan Congressional Budget Office.

At the same time, however, Republican support for the ACA's Medicaid expansion is growing, which might mean overall cutbacks would be less severe or Medicaid coverage could increase among the 19 states that didn't expand the program under the ACA.

Some Republicans want to overhaul Medicare for seniors

House Speaker Paul Ryan wants to restrain Medicare growth by giving members fixed, "premium support" payments to buy plans; he'd also like to raise the age of eligibility for Medicare. Both those ideas could lead to less coverage or greater out-of-pocket expense.

But those proposals weren't part of the Republicans' replacement bill. Changing Medicare likely would trigger loud objections from AARP and other powerful lobbies. And Trump doesn't seem inclined to back a change.

"I don't think ... Trump wants to meddle with Medicare or Social Security," White House chief of staff Reince Priebus told the press in January.

Job-based coverage could become less generous

Although ditching Obamacare would end the requirement for large employers to offer health insurance, most companies would keep their plans as a way to attract workers, analysts say.

But that coverage could become less generous. The ACA limits the annual out-of-pocket costs for members of employer-based plans, and also prohibits caps on annual and lifetime benefits. The ACA also prohibits waiting periods for covering a new worker's preexisting illness.

Any replacement law signed by Trump might not include those protections.

Kaiser Health News, is an editorially independent part of the Kaiser Family Foundation. You can follow Jay Hancock on Twitter: @jayhancock1.

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Republicans Now Control Obamacare. Will Your Coverage Change? - NPR

ATLANTA Republicans are becoming increasingly concerned about their ability to hang on to former Republican congressman Tom Prices seat here in a wealthy, suburban district where restive Democratic energy has been surging since Novembers election.

Democratic hopes rest on Jon Ossoff, a 30-year-old former congressional staffer and preternaturally on-message candidate. He has raised a whopping $8.3 million for the special election to replace Price in Georgias 6th Congressional District more than anyone has ever collected to win this seat, which has not been represented by a Democrat for nearly four decades.

Ossoff is a first-time candidate who is leading the field of five Democrats and 11 Republicans in the April 18 special election. If he does not receive more than 50percent of the vote in that race, the top two vote-getters will move on to a runoff on June 20.

The progressive and anti-Trump groups founded through the nonprofit Indivisible project after Novembers election are plunging in to help him, and the liberal blog Daily Kos is channeling donors Ossoffs way. Most of Ossoffs money, $7.7 million, came though the progressive donation hub ActBlue. Republicans have tried to toxify him by raising the specter of meddling out-of-state liberals only 6 percent of the money is from Georgia but Ossoff points to his volunteers.

The atmosphere in Georgia is electric right now, Ossoff said in a short interview at his parents home. Thousands of folks, many of whom have never been engaged in politics before, working together to make the statement that we think the country can only become stronger and more prosperous and more secure if we stick to our core values.

(Jenny Starrs/The Washington Post)

Republicans, however, are fighting back, unwilling to easily cede a district that Trump won by 1.5percentage points in 2016 albeit down from the 23.3-point margin enjoyed by 2012 GOP nominee Mitt Romney.

Outside groups and the national Republican Party are spending millions on television ads that paint the Democrats as the hope of window-smashing anarchists who want Ossoff in Congress. Georgia Republican Party mailers darkly warn about Ossoffs work for the Qatar-funded Al Jazeera TV network. (The mailers print the networks Arabic name on a black background, resembling the flag of ISIS.) The National Rifle Association warns, in drawling radio ads, that Democrats want to steal this election and your freedom.

Asked about the attacks Friday, Ossoff paused, then rattled off adjectives.

Predictable, cynical, partisan, negative politics, with a whiff of desperation, he said.

Ossoffs lead might also be artificially inflated. The number of Republicans running here means that the GOP vote is split, and no contender is likely to win the more than 50 percent of the vote needed to avoid a runoff. Its possible that Republicans will unite around whoever emerges from their field.

It is also possible that the progressive energy kicked up because of Trumps presidency could see its first real victory here in Georgia in the campaign to flip the 6th. The race will test Democrats strength in the kind of districts they need to win if they hope to retake the House in 2018 mainly suburban areas that have become more demographically diverse.

[Should House Democrats write off rural congressional districts?]

Five special elections are underway in congressional districts where Trump pulled Republicans out of Congress to join his administration. All came from safely red districts or states; in three of them, small donors and political groups are churning up competitive races. On Friday, Republicans announced new spending in Kansass much more Republican 4th District, which votes Tuesday Sen. Ted Cruz announced that he would fly from Texas to campaign there.

But the Georgia race has attracted more money and volunteers. No open House district swung harder away from Republicans in 2016. The district is diverse, rich and highly educated, a microcosm of the rising American electorate that Democrats hoped to ride to victory last year.

Ossoff paints himself as a pragmatist, willing to work with both sides of the aisle. But he has also taken on Trump, running a campaign ad that shows him tweeting that he will stand up to Donald Trump because anyone can send a tweet.

Sitting silently on a desk in a suit with a blue tie, the only sound is of the Democrat typing on his smartphone. His words run across the screen as though they were being posted to Twitter. He should act like a president, the ad ends.

Republicans and their allied groups are fighting the money and the messenger.

The National Republican Congressional Committee is running ads invoking House Minority Leader Nancy Pelosi (D-Calif.). The Congressional Leadership Fund super PAC, closely allied with House GOP leaders, debuted a widely panned ad that used old footage of Ossoff in a Han Solo costume to portray him as immature.

Since then, the super PAC has attacked Ossoff for contracting with Al Jazeera on a documentary film about the Islamic State and tied him to the anarchists who disrupted Trumps inauguration. In a memo to donors, the CLF credits its ads with giving Ossoff a net negative favorable rating with 60 percent of voters viewing him as liberal and with keeping him far from the 50 percent threshold needed to avoid a runoff.

The only thing hes ever accomplished in his life is having the fortune to be born to rich parents who will spend millions of dollars on him, said Corry Bliss, the CLFs executive director, who plans to spend at least $2.2 million in Georgia. You could go down to Georgia, give anyone $8 million, and theyd get 40 percent of the vote.

In the first 10 days of early voting, 17,871 ballots have been cast and self-identified Democrats have outnumbered Republicans by a 19-point margin. On Friday, however, the Democratic margin was just five points. By Sunday, the CLF was up with its third commercial branding Ossoff a rubber stamp for Pelosi, ending with the plea vote Republican.

People arent very happy about it, but were also like: Hey, theyre feeling threatened, said Amy Nosek, 42, of the districts Indivisible Georgia chapter. Theyre fighting back, because were fighting.

The reasons for that confidence were on display at this weeks candidate debate, held at the Atlanta Press Club. Ossoff had ready (and sometimes wooden) answers to questions about his resume. He responded with flawless Hill-speak to ads accusing him of inflating his experience working for Rep. Hank Johnson (D-Ga.): For two annual fiscal authorizations for the Department of Defense, I contributed language to the National Defense Authorization Act.

Meanwhile, Ossoffs rivals had their arms full defending the Republican record in the Trump era. Karen Handel, a near-miss candidate in two statewide races currently polling highest to make the runoffs second spot repeatedly rejected the House GOPs health-care proposal and the negotiations to strip essential health benefits from the current system.

Thats not Tom Prices plan, said Handel. Not every single time do we have a mandate that is horrible. Moments later, longtime tea party activist and candidate Amy Kremer said that she, too, opposed the bill; Ossoff deflected one of her attacks by praising her bipartisanship for criticizing both parties.

The people in that district are educated, and theyre tired of the mudslinging they saw in the presidential campaign, so it doesnt work like it used to, Johnson said. Theyre looking at issues. They were promised a bill of goods that was not delivered.

Republicans hope that in a runoff, with Ossoff facing just one Republican, he wont be able to zoom around the partisan differences. But every Ossoff event, or interview, offers more evidence of how he is already effectively smoothing away those rifts. On Friday night, speaking to a house party of about 50, the Democrat fielded questions on health care, infrastructure and partisanship itself.

The only test to policy that Ill supply is, is it in the interest of this community? Ossoff said. If it is, Ill support it. If its not, I wont. Ill work with anyone who wants to help us here and help the country, and Ill stand up to anyone who doesnt, regardless of party.

On Friday, Ossoffs style helped him evade the sort of issue that can swerve a campaign off-course Trumps missile strikes on Syria. Ossoffs ads portray the president as reckless and in need of congressional checks.

Congress has an important role to play in ensuring the conduct of U.S. foreign policy is the interest of the American people, but so too does the commander in chief have significant discretion to act where appropriate, Ossoff said.

Georgia Democrats have longmemories about moderate-looking candidates getting whipsawed by international events. In 2002, then-Sen. Max Cleland, a Democrat who lost his legs and one arm in Vietnam, was defeated after an ad shamed him for votes against the Department of Homeland Security and illustrated it with images of Osama bin Laden. The new ads, from both the CLF and the Georgia Republican Party, also try to blur a strength Ossoffs documentary company that reported on the Islamic State into a question-raising weakness.

Its disgusting, and its eerily reminiscent of what they did against me in 2002, Cleland said. But people are sick and tired of that kind of stuff.

Read more at PowerPost

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Republicans begin to fret about holding on to Tom Price's Georgia seat - Washington Post

Montana Republicans are demanding the state spend $750,000 it didnt budget to avoid what the GOP sees as a potential political catastrophe: high voter turnout in an upcoming special election.

The state didnt plan for spending on federal elections in 2017, and for good reason. Neither senator is running until 2018, and its lone House member, Ryan Zinke, seemed entrenched unless Senate Majority Leader Mitch McConnell taps him to challenge Democratic Sen. Jon Tester.

President Donald Trump, however, named Zinke interior secretary, setting the stage for a May 25 special election to fill the House seat. The race has received national attention, particularly from Democrats, who hope anti-Trump sentiment and increased Democratic Party activism since Novembers election will boost their candidate Rob Quist to a surprise victory.

State lawmakers concluded that the special election would cost an unbudgeted $750,000, so they set about figuring a way to do it more cheaply.

A Republican lawmaker proposed a one-time mail ballot system. At the time, nobody in their right mind thought the election would be seriously contested Democrats havent won a House seat in Montana since 1994, after all and the state Senate approved the cost-saving measure.

But then something strange happened: The election got real. And Republicans who often boast of fiscal conservatism had a change of heart.

The GOP-controlled state House effectively killed the mail-in ballot bill on March 31, after the state GOP chair, state Rep. Jeff Essmann, wrote a letter to party members warning that a mail system would favor Democrats and hurt the GOPs chances of holding onto the seat.

Unless we have protections for ballot security in mail ballots, I think people should have the option to vote the way they want to, Essmann told The Associated Press last month.

Democratic Gov. Steve Bullock revived debate over the matter on Friday, after he used his veto power to amend an unrelated piece of legislation to allow counties to conduct mail-in voting. Republicans, however, are seeking to delay those changes from being debated to prevent the bill from being brought to the floor, according to the Bozeman Daily Chronicle.

Bullocks last-minute move to force a vote on mail-in balloting in the legislature may be too late, however. Election officials face a Monday deadline to present their plans to the secretary of states office, and some counties are already planning to print ballots and arrange polling sites.

Quist will face Republican Greg Gianforte in the May 25 special election.

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Montana Republicans Spending Taxpayer Money To Avoid A Defeat - Huffington Post

Axios caught up with Lampkin for some frank talk on her findings and the state of diversity in Silicon Valley.

There's this perception that all tech companies are equally bad at actual results on diversity but your scores show a wide range. Is it a misperception?

Yes, definite misperception. Unfortunately, I think the media has played a role in creating this reality because once we pull back the layers, with companies like Slack for example, we're surprised to find how homogenous their leadership team still remains. What I'm hoping to do is show the real differentiation because many companies are just hiring a chief diversity officer, giving money to non-profits, but still aren't putting underrepresented people in positions of real power/influence.

Who is doing more than talking about diversity?

I'd say that top 35 companies on the BlendScore list are doing a pretty good job, but there is definitely still room for improvement. I've created the algorithm such that attaining a score of 100 doesn't take extreme measures (much like the Human Rights Campaign's Corporate Equality Index). Most of these companies have zero underrepresented minorities on their board or executive teams.diversity for them is often White, occasionally Asian, cis-gender straight women which is why I put photos up there too.

What is actually working?

CXO's and Board Members that genuinely give a f**k! Hiring and rewarding talented people equally is more important than driverless cars, AI, and virtual reality and it has to be regarded as suchwhy? Because there are talented people who can solve these problems that aren't even able to get in the game or get there and aren't treated well. Investment in education/STEM pipeline and human resource management that is comparable to R&D will work.

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Trumpcare ads to whack Republicans on recess - Axios

How does one describe President Donald Trump? If youre a left-leaning journalist or a member of the media, you look for stories that highlight the faults in our President. You do not outright call our President names, but instead criticize his policies and decisions. You describe a situation and allow audiences to place their own labels on our President.

Overall public opinion of President Trump has taken a negative turn, evident from his approval rating reaching new lows. As our new government kicks into gear, it has created a gold mine for programs like The Late Show and Saturday Night Live.

Political satire is not new in our culture, but has steadily increased during the 20th and 21st centuries. While the majority of our population enjoyably digests this, our UW College Republicans find that the media has overstepped its boundaries.

At their last meeting, the majority of members expressed concern and disgust with todays political satire. It was surprising to discover that members have reached a point where they stop consuming political satire because of how upsetting it is.

To them, the mockery of our President feels as though they are being mocked. One said, When President Trump is called stupid, I feel stupid. Others maintained that a line needs to be defined between berating Trump and berating supporters.

These students seem to feel that they are personally responsible for getting Trump elected and are now being punished for it. This is slightly ironic since now all of America knows how the Electoral College works because of the popular vote fiasco.

Despite that, I can sympathize with this: People want others to support the politicians they voted for. We want others to like what we like. Its a fundamental concept that can be applied from our choices in music to our choices in politicians. Its easy to feel personally attacked when those politicians are constantly made fun of.

Why is it that these College Republicans are so concerned with immediate political satire? Many individuals expressed that if President Trump is being mocked, they want other politicians to be mocked as well.

Much of the media does criticize our President, but is it because the media has a vendetta toward Trump? Trump is not the first president to be targeted, nor will he be the last. Presidents like George W. Bush and Barack Obama received a wide variety of criticisms, with topics ranging from actual crises to Obamas birthplace.

The College Republicans maintained that previous mockery was funny, but it has now progressed to coming off as rude and harsh. However, political satire has not evolved in its type of content from these past two presidential administrations, and there have largely been the same jokes and same type of mockery with Trump as there was with Obama.

The only variable that has changed is the amount of political satire we are exposed to. There are more late night shows and more political skits than ever. It seems that the College Republicans are okay with previous mockery because they didnt personally vote for those presidents being mocked.

So whats wrong with todays media according to the College Republicans? Its far too left-winged. But if were going to criticize the medias political orientation, we should take into account the viewers and the current majority political party.

Newspapers today are struggling to remain relevant. To stay afloat, they try to reel in readers with the most controversial and interesting news. In the 2014 film Nightcrawler, the news station focuses primarily on stories of urban violence in affluent communities in order to increase viewership. Current media is guilty of the same thing; they know viewers would rather hear about Trumps latest verbal mishap than an international crisis in Germany.

To say the media is left-winged doesnt really capture the big picture. Media only seems to be liberal now because it is negatively approaching a current Republican administration. A few years ago, the media appeared conservative because it took the same negative approach toward the Obama administration.

There may never be complete peace between our government and our media, but that may not be so terrible. The critical lens that the media takes demands the most of politicians and allows President Trump to know where he stands with the majority of the American population.

Reach columnist Christine McManigal at opinion@dailyuw.com. Twitter: @clmcman

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Redefining Republicans: Has today's political satire gone too far? - Dailyuw