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Late-night host Jimmy Kimmel made an emotional plea to lawmakers to fund health-care spending for preexisting conditions on May 1. Kimmel teared up while discussing his newborn son Billy's heart condition on his show. (Amber Ferguson/The Washington Post)

Its easy to assume in the moment that moments from pop culture will bear more resonancein national politics than is warranted. But if a moment were to affect the political conversation, this seems like a good candidate:

ABCs Jimmy Kimmel has, in the past, been willing to engage in politics in a sincere way. But its exceptionally rare for a late-night host to offer the depth of emotion that Kimmel displayed Monday night, a natural function of how deeply the issue affects him. There are few more sympathetic characters in the human imagination than sick children; Kimmels personal story makes this exploration of the idea even more affecting.

That is one side of the debate over health-care reform in the United States; a side that, it seems safe to say, is meant to run at odds with the current plan offered by congressional Republicans. What, by contrast, is the rhetoric clincher on the Republican side, the side thats calling to overhaul the Affordable Care Act? Heres the GOPs explanation of how their legislation, the American Health Care Act, will improve health care.

What were proposing will decrease premiums and expand and enhance health care options so Americans can find a plan thats right for them.

We also make sure Americans can save and spend their health care dollars the way they want and need not the way Washington prescribes.

Its worth reiterating that one way the nonpartisan Congressional Budget Office foresees premiums falling is by pricing out of the market those at higher risk of health issues, like older Americans.

President Trump promised on April 30 that new GOP health-care legislation will preserve coverage for people with preexisting medical conditions but critics say that's at odds with his promise to lower premiums. (Peter Stevenson/The Washington Post)

The Republican website promoting their plan from which thetext above wastaken hasnt been updated since the proposal of anamendment that has revived the partys hopes of passage.

Americans should never be denied coverage or charged more because of a preexisting condition, the site reads. The amendment from Rep. Tom MacArthur (R-N.J.), however, would allow insures to do just that: charge more if theres a lapse in coverage.

Taken by itself, take control away from Washington is a tough sell against my kid would die if I cant afford this.

The wan outreach to the public at large hasnt spurred broad support for the bill; a Quinnipiac University poll found that only 17 percent of Americans backed the proposal and that was before preexisting conditions were put at risk. Support for mandating coverage of preexisting conditions is broad, with even more than half of Trump voters backing a requirement that such conditions be covered. Republican lawmakers have repeatedly been confronted with angry constituents at town hall meetings; before the initial vote on the American Health Care Act was postponed, calls to members of Congress ran 50-to-1 in opposition to the measure.

So whats the motivating argument being offered by Republican leaders to their members in support of their proposal? Arguments about government control are no doubt more effective on Capitol Hill than outside the Beltway, with 57 percent of the country now saying that the government should do more, versus 39 percent who say its doing too much. Arguments about reducing taxes are also resonant, though the effects of that tax reduction will heavily fall on wealthier Americans. An estimated 40 percent of the benefit will go to the 1 percent of America at the top of the income ladder.

In effect, the argument seems to come mostly down to partisanship: Do this because the party said we would. Do this because we want to show that we can govern, now that we have control over Capitol Hill and the White House. Do this because President Trump wants a win.

That last point seems to loom large. The reason the push for reform was renewed when it did was, in no small part, because Trump was nearing his 100-day-in-office mark and he was looking for a success to which he could point. Trumps arm-twisting during the first push on the bill was rarely nuanced, often coming down to you need to do this. It even going so far as to threaten Republican members with primary challenges if they balked.

They balked anyway. Why wouldnt they? Republican voters and Democratic voters are certainly motivated by partisanship at the ballot box, meaning that standing in opposition to the party might hold electoral risks. But whats the alternative? How do you ask someone to stand by a president whos repeatedly expressed indifference about or unfamiliarity with the contents of the bill and who displays loyalty to neither its focus or its proponents?

Why, if youre a Republican member of the House, would you stand behind a president who is both inconsistent and unpopular? He cant be trusted to have your back and, even if he does, its not clear it would do you much good. Trump is popular with Republicans now, but unusually unpopular with both independents and the opposition. If youre in a district thats anywhere close to competitive, youre no doubt very aware of that fact.

Theres an outside chance, floating on the distant horizon, that Trumps unpopularity and disinterest in partisan loyalty might actually break down some of the partisan unanimity thats guided Washington in recent years. A far outside chance, mind you, but Trumps political fumbling may make choices easier for a number of Republicans in the House.

Whats the better bet for a moderate Republican: Buck the party and its leader or go along with a House bill that faces huge hurdles in the Senate?

When next years campaign rolls around, which ad would you like to see run in your district: one with Jimmy Kimmel crying as a narrator explains that you voted to weaken preexisting conditions, or one that shows a frustrated Trump railing against your opposition to the bill he decided to champion?

If youre House Speaker Paul Ryan, how, without simply insisting on partisan loyalty, do you make the case that the former is the cost of doing business?

Continue reading here:
The simplified choice for moderate Republicans: Jimmy Kimmel or Donald Trump - Washington Post

House Republicans can only lose 22 votes and still pass the bill. | AP Photo

But House Republicans and the White House stepped up their efforts to win passage.

By Rachael Bade , Kyle Cheney and John Bresnahan

05/02/17 10:35 AM EDT

Updated 05/02/17 11:01 PM EDT

A sense of gloom settled over House Republicans on Tuesday as support for their Obamacare repeal plan seemed to erode even further and members began reckoning with the unthinkable: They may never be able to repeal Obamacare.

But House GOP leaders and the White House kicked into high gear Tuesday night in a last-ditch effort to save the bill.

Story Continued Below

Speaker Paul Ryan and his team began crafting an amendment aimed at assuaging moderates' concerns about how the bill treats people with pre-existing conditions. The language, multiple sources say, is expected to be released Wednesday.

President Donald Trump, meanwhile, is personally wading in to save the bill, calling members who oppose the legislation to help whip support, two sources told POLITICO. Trump will also huddle with opponents of the bill at the White House Wednesday, the sources said. And insiders are crossing their fingers that he can flip enough to "yes" to push the bill over the finish line.

Discussions of a new amendment followed a disheartening day for House Republicans. Rank-and-file members increasingly acknowledged the difficult path to passage for their long-stalled bill, the American Health Care Act.

Their pessimism stemmed from the defection of a key leadership ally, Rep. Fred Upton. The Michigan Republican, who once authored a slew of Obamacare repeal measures, said the latest GOP proposal failed to protect people with preexisting conditions.

House Freedom Caucus Chairman Mark Meadows (R-N.C.), who helped broker the latest version of the AHCA, said Uptons departure could be a significant blow to the cause.

Obviously thats not a move in the right direction, Meadows said.

Rep. Chris Collins (R-N.Y.) described the recent loss of support as disappointing and said hes worried about the House Republican health care effort. Collins even suggested scrapping the latest version of the plan the result of painstaking negotiations between House conservatives and a top moderate and reverting to an earlier iteration of the bill that had more support from centrists.

"Then leadership can go work on getting the votes, Collins said.

Yet that move would certainly lose conservative votes, and put Speaker Paul Ryan (R-Wis.) and President Donald Trump even further away from their goal. Neither man can afford a loss right now, especially Ryan, who is already under pressure from hardline conservative media outlets over his stewardship of the House.

White House officials and GOP leaders on Tuesday night seemed hopeful that additional "tweaks" to the bill could win new supporters. Trump officials are pushing for a vote on the health care bill before House Republicans break for a one-week recess Thursday.

All day, House leaders struggled to shake the hardening narrative that sicker Americans would suffer under their plan. Ryan argued to lawmakers in a closed-door GOP conference meeting that people with pre-existing conditions would not be harmed by the latest draft. Vice President Mike Pence and Health and Human Services Secretary Tom Price spent the afternoon huddling with lawmakers attempting to tamp down their concerns.

House leaders even began floating the notion of piling billions of additional dollars into a fund meant to cover costs for people with preexisting conditions in an attempt to woo back reluctant moderate Republicans. It is unclear if the changes might win over skeptics like Upton and Long. It's also unclear whether the Freedom Caucus, which currently backs the bill, would approve.

Rep. Phil Roe (R-Tenn.), a member of the whip team, is optimistic the remaining undecideds and some opponents can be brought on board. But he admits the bill might have to be changed.

Its about seeing what they can get comfortable with on preexisting conditions, Roe said. Ive got one more idea Im going to shop with them today, he said, but refused to share details.

Rep. Tom Cole (R-Okla.) said leaders would likely throw every sink in every kitchen they can find to win last-minute support for the bill. But Cole said the most persuasive argument may be the most basic.

If you kill it in the cradle, youre basically ratifying Obamacare, he said.

About 20 GOP lawmakers mostly moderate or centrist Republicans worried about sicker Americans paying more for premiums have now added their names to the no column. At the same time, the list of Republicans who say theyre undecided has grown to at least two-dozen. Even several GOP whips tasked with drumming up support for the bill said Monday night they have not yet made up their minds on whether to support the revised American Health Care Act.

Without any Democratic support, House leaders can only lose 22 votes in their 238-member caucus to pass the bill.

Republicans are planning a Thursday members-only meeting to discuss the repeal effort. While top Republicans insist Ryan's leadership team is close to reaching the 216-vote threshold needed for passage, their job is becoming tougher by the day, as more lawmakers publicize their opposition to the latest version of the bill.

Privately, GOP leaders and the White House appear to have had some individual successes convincing opponents of the measure to come back into the fold. Rep. Paul Gosar said he recently became a supporter after Trump and Pence promised the Senate would vote on an anti-trust bill he authored for the insurance industry.

"I got assurance that my Competitive Health Insurance bill that passed the House 416 to 7 will get a vote on the Senate floor," Gosar said. "It was one of my assurances working with the vice president and the president, the majority leader... Ryan is on board as well."

Publicly, GOP leaders are projecting an upbeat message. House Majority Leader Kevin McCarthy (R-Calif.) said Monday night that I actually feel were in a very good place. Chief Deputy Whip Patrick McHenry (R-N.C.) said I think well pass the bill as he walked into the GOP conference meeting on Tuesday morning.

Leaders are also reminding members that, under the bill, insurance companies could only charge people with pre-existing conditions more if they have a gap in coverage. If they remain on insurance, they cannot be charged more than a healthy person.

"Our bill protects people with pre-existing conditions, and actually provides multiple layers of protections for people with pre-existing conditions in ways that Obamacare doesn't do," argued Majority Whip Steve Scalise in a press conference Tuesday morning.

On Tuesday, Trump, addressing members of the U.S. Air Force Academy at the White House, greeted several lawmakers in the crowd before prodding them to get health care legislation done.

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Hows health care coming folks? he said to an audience that included Reps. Martha McSally (R-Ariz.), Doug Collins (R-Ga.), Rep. Doug Lamborn (R-Colo.), Rep. Ted Poe (R-Texas) and Rep. Don Bacon (R-Neb.). How are we doing? We moving along? I think its time now.

Leadership is operating under a severe time crunch. The House is scheduled to break for a one-week recess starting Thursday, and Republicans fret that they could lose even more momentum during the break. Some are talking about canceling the recess, though GOP leaders have not yet decided how to proceed.

If we dont get a yes vote this week, then what happens realistically? Were taking flack back in the districts for not voting for a repeal, said Rep. Dave Brat (R-Va.). What is the response? The response is: 'Well, if we block this again, then youll get a scenario like the budget vote, where we go out and get Democratic votes to pass the health care bill, and that is a worse outcome!'... If you dont get this policy passed, you end up with a Democratic bill.

Meadows, too, said getting the AHCA done this week would be crucial.

There comes a point in time where you say, either we continue to move forward with this foundational piece of legislation or you come back and regroup and find another piece of legislation that potentially could bring more people together.

The White House, too, senses trouble for their health care push.

One senior White House official said "it's probably a toss-up right now" as to whether the plan passes the House this week, although other administration officials thought they had picked up some votes.

Josh Dawsey and Jennifer Haberkorn contributed to this report.

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More:
House Republicans floundering on Obamacare repeal - Politico

First Read is your briefing from Meet the Press and the NBC Political Unit on the day's most important political stories and why they matter

NBC's Leigh Ann Caldwell and Alex Moe report that Republicans "are growing more confident" that they are close to the votes needed to pass their renewed and revised push to repeal and replace Obamacare. But NBC's whip count underscores that they have no margin for error and that's under the best-case scenario.

According to our count, 20 House Republicans are firmly against the legislation, and they can afford to lose only 22 to hit the magic number of 216 votes for passage (assuming no Democrats back the bill). But that doesn't tell the whole story: The momentum, at least right now, appears to be going in the wrong direction for GOP leaders, per HuffPost's Matt Fuller. "Instead of members who were 'no' coming out in support Monday, the weekend seemed to calcify the most ardent moderate opposition and leave a number of members who are usually reliable cheerleaders of leadership's agenda with lingering questions... Even some GOP deputy whips, members who are normally dispatched to do leadership's bidding and build support for proposals, reported on Monday that they were undecided. David Valadao (R-Calif.), Elise Stefanik (R-N.Y.), Kevin Yoder (R-Kan.), and Erik Paulsen (R-Minn.), who actually lives with Majority Whip Steve Scalise (R-La.) when they're in D.C., all reported Monday that they hadn't made up their minds."

Bottom line: Republicans may be close and certainly closer than they were last month but they need to have almost all of the undecideds break their way. And they can't afford any more defections.

And our undecided list doesn't include Valadao, Stefanik, and Paulsen who were mentioned above as House Republicans who haven't make up their minds.

On "Nightly News" last night, NBC's Peter Alexander noted how President Trump said Monday he'd be "honored" to meet with North Korea's Kim Jong-Un. ("If it would be appropriate for me to meet with him, I would absolutely, I would be honored to do it.") He raised eyebrows in commenting about Andrew Jackson and the Civil War. ("He was really angry that he saw what was happening with regard to the Civil War" -- when Jackson died 16 years before the war began.) And Politico has more on Trump's Monday: "The president floated, and backed away from, a tax on gasoline. Trump said he was 'looking at' breaking up the big banks, sending the stock market sliding. He seemed to praise Philippines strongman President Rodrigo Duterte for his high approval ratings. He promised changes to the Republican health care bill, though he has seemed unsure what was in the legislation, even as his advisers whipped votes for it."

As presidential historian Douglas Brinkley told Politico, "It seems to be among the most bizarre recent 24 hours in American presidential history." Added a senior administration official about all of Trump's different interviews: "They were not helpful to us," the official said. "There was no point to do all of them."

Today, per NBC's Alex Seitz-Wald and one of us, Republicans and Democrats will each face off in separate primaries in the race to replace Rep. Mick Mulvaney in South Carolina's 5th Congressional District. The district voted for Trump by a wide margin in 2016 (57%-39%). Mulvaney won his most recent re-election race by 20 points (59%-39%). Unlike in Georgia's 6th District, where Democrats and Republicans ran together in an 18-person "jungle primary," the two parties in South Carolina are holding separate contests. But in each case, if no candidate tops 50% of the vote in their party's primary, there will be a primary runoff between the top two vote-getters two weeks later on May 16. The general election will be held on June 20. A handful of third-party contenders will also be on the general election ballot then.

Who are the Republicans? It's a crowded race on the GOP side, with seven Republicans on the ballot. The top contenders on the GOP side are considered to be former state Rep. Ralph Norman, state House Speaker Pro Tempore Tommy Pope, and former state GOP chairman Chad Connelly. Another candidate who's been in the news is conservative activist Sheri Few, who received national attention and a rebuke by the pastor of Emanuel AME Church after she released an ad in which she defended the Confederate flag while wielding a military-style rifle.

Meanwhile, three candidates are facing off on the Democratic side. The favorite is tax expert and former Goldman Sachs adviser Archie Parnell; his two opponents are Army vet Alexis Frank and Marine Corps veteran Les Murphy. Parnell is aiming to avoid a runoff by getting over 50%.

At 11:30 am ET, President Trump participates in presenting the Commander-in-Chief trophy to the U.S. Air Force Academy And at 12:30 pm ET, he speaks with Russian President Putin by phone.

Excerpt from:
Republicans Have No Room for Error in Latest Health Care Push ... - NBCNews.com

The topic of the day is pre-existing conditions: namely the fact that the latest version of the Republican health care bill guts Obamacare's guarantee that insurers have to insure all customers at the same price. It's what everyone is talking about.

Wait. Did I say "gut"? National Review editor Rich Lowry disagrees:

The Phrase Pre-Existing Conditions Leads to the Suspension of All Thought

The moderates are abandoning the health-care bill largely because it makes it possible for states to get a waiver from the pre-existing condition regulation in Obamacare. This is being distorted as an abolition of that regulation, with the moderates either contributing to the misunderstanding or being carried along by it. Ramesh ably explained the other day why this isnt true. But apparently all you have to do to win the debate over Obamacare repeal is say pre-existing condition, regardless of whether you have any idea what you are talking about. I dont think anyone wants to go back to the pre-Obamacare status quo on this issue, but....

The Ramesh Ponnuru post that Lowry links to is worth a read, though I think Ponnuru downplays the real effect of the waiver clause. I'm also pretty sure that, actually, lots of people would like to go back to the pre-Obamacare status quo. That's especially true of people who really understand how health insurance works. After all, once you accept that people with pre-existing conditions should be allowed to buy health coverage at the same price as everyone else, you pretty much have to accept both the individual mandate and the federal subsidies in Obamacare. You can call them "continuous coverage" and "tax credits" if you want, but they're the same thing.

But for a moment let's put that all aside, because there's a more fundamental question here. Like it or not, Obamacare does protect people with pre-existing conditions. Insurers have to accept anyone who applies and they have to charge them the same premiums as anyone else. This has no effect on the federal budget, which means it can't be repealed in a reconciliation bill.1 Unless someone kidnaps the Senate parliamentarian's dog and threatens to kill poor Fido unless they get a favorable ruling, any attempt to repeal Obamacare's pre-existing conditions ban will be tossed out of the bill. And keep in mind that Obamacare's ban is absolute. As long as it's around, insurers have to take all comers at the same price no matter what any other legislation says.

So all the limitations regarding pre-existing conditions in the Republican bill are just kabuki. What's the point?

1Oh sure, you can gin up a case where it has some small effect. But that doesn't work. Reconciliation bills are limited to things that directly affect the budget. Incidental effects don't count.

Read more:
Republicans Are Playing Pre-Existing Conditions Kabuki - Mother Jones

One of the most exciting things for conservatives after the election was that they had a quasi-Republican president, and, more importantly, a GOP-controlled Congress. With House Speaker Paul Ryan at the helm the Randian wonk with a powerpoint budget plan the federal government could be a lean, mean, fiscal machine, cutting spending and shrinking the government in no time. But alas, when they had their chance, Congress failed to cut the bloated behemoth that is Planned Parenthood and didn't even slice a comma off the Affordable Care Act. This is, as they like to say, "How we got Trump."

What the GOP promised

Political Twitter is a toddler's playground wrapped in a group therapy session inside an insane asylum but sometimes it's so spot on:

Indeed, Ryan is a stud, but after shenanigans like these please wait while I roll my eyes to California and back. "Pretty is as pretty does" my mama used to say, and Ryan has failed to do as he promised the American people he would. The most fiscally hawkish of them all knows full-well Republicans as a collective group promised to defund Planned Parenthood, repeal all or most of Obamacare, and a litany of other things. We the American people are not so enraptured with Ryan's dapper appearance that we believed all those things, but c'mon now: Those were the basics. And with a Republican majority in Congress, they should be feasible.

What this means

The ACA is a complicated leviathan, but it's politicians who made it that way: You can't be a mechanic for Ford and pretend not to know the basics of how a Chevrolet works. They can tinker with partisan bills and repair what's ailing it. That's literally what they're supposed to do. No one believes this charade that it was too hard everyone thinks Republicans are either liars or wusses. Republicans had years to cobble together ideas, research, policy proposals that could replace parts of, or repeal all of, the ACA. When their moment in the spotlight came, they drove the broken-down Chevrolet to the Ford dealership and said, "We don't know what to do."

Pro-life Americans will have even less sympathy when they discover Republicans didn't bother to defund Planned Parenthood while negotiating their budget. For starters, the House Oversight Committee found two years ago the organization was sufficiently funded without the $500 million it takes in federal taxpayer funds. Second, most pro-lifers disagree with its primary activity (performing abortion) so this should have been a one-two punch: It's immoral, and it's a poor use of taxpayer dollars. Yet it too remains fully-funded. Cecile Richards, Planned Parenthood's CEO, is laughing so hard on her yacht right now, for a moment she's forgotten she spearheads the nation's largest abortion shop.

What Ryan should have done

Of course, Ryan's political excuse is that he won't be able to get votes from the moderate wing of the party to defund Planned Parenthood and repeal Obamacare completely, so they have to negotiate with them, moving the GOP to the Left in the process. What the leadership should do is hold a hard line on these items. Republicans that don't go along with defunding Planned Parenthood, repealing Obamacare, and cutting taxes will find themselves in a primary, challenged by more conservative members of the party. Sure, the Democrats will take the opportunity to pick off some vulnerable moderate seats where a conservative challenger is able to knock off a moderate Republican, but overall it will shift the party to the Right. Then he may find it easier to accomplish some of the things they said they would do.

In the meantime, people will still ask, "How did we get Trump?" It's because politicians never do what they say they would. So the people didn't elect one, for better or for worse.

Nicole Russell is a contributor to the Washington Examiner's Beltway Confidential blog. She is a journalist in Washington, D.C., who previously worked in Republican politics in Minnesota. She was the 2010 recipient of the American Spectator's Young Journalist Award.

If you would like to write an op-ed for the Washington Examiner, please read ourguidelines on submissions here.

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Dear Republicans in Congress: You had one job, and you failed - Washington Examiner