The CBO Score on Trumpcare: Legislative Evil

The CBO came out with the score of Trumpcare.




From Mayhew at Balloon Juice:

What does this mean?

1) Keep on calling. Targets are Murkowski, Cassidy, Portman, Capito-Moore, Cotton, Cruz, Lee, Johnson. Adjust your asks per your Senator. What might work for Murkowski won’t work for Cruz and vice versa.

2) Time for some analysis. The ideal situation for any Republican Senator is it either passes without Vice President Pence’s vote so that no single Republican Senator can be blamed as the decisive vote or it fails miserably so there is protection in numbers from primary challenges. Everything else is an intermediate outcome. Given Heller and Collins statements, I don’t think the first preferred option is available. I am betting and speculating that the internal dynamics of the Republican caucus will push the bill to a bare majority if there are 48 Yes votes as it is introduced on the floor. Again, no one wants to be the decisive vote.

So the objective of everyone is to determine the size of the swing factions in the Republican caucus and see which way Senators who are ideologically/pragmatically/politically close to the Senator in question are leaning. The isolated buffalo gets taken down by wolves while a herd of deer working together offers protection to everyone. Everyone is trying to figure out where their herd is and not get too far in front. Signalling and raised eyebrows will matter.

3) Fundamentally we are probably at the equivalent place as Thursday afternoon in March as the House was considering their bill. There was rumbling that the votes weren’t there as both sides of the caucus were pulling apart. That was probably true at that point. But seven weeks later, they pulled something that was even worse and cobbled together a bare majority.

So keep on calling!




If you can, visit their local office.

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44 Responses to The CBO Score on Trumpcare: Legislative Evil

  1. Keep making those calls, folks! Don’t let up! We have to fight until we kill this bill. #Trumpcare

    (202) 224-3121

  2. rikyrah says:

    Trump’s ignorance about health care carries real consequences
    06/28/17 08:00 AM—UPDATED 06/28/17 08:08 AM
    By Steve Benen

    A few months ago, when the House was trying to pass its far-right health care plan, Donald Trump thought some presidential pressure could help seal the deal. The president’s ignorance about the basics of the debate, however, kept getting in the way.

    Politico reported in March that when the president tried to lean on the far-right House Freedom Caucus, its members found Trump charming, but it became clear “that no serious changes were going to be made” during the conversations, because “the president didn’t have sufficient command of the policy details to negotiate.”

    Trump has had ample time to get up to speed in recent months, but by all appearances, he doesn’t feel like it. The president hosted a meeting yesterday with Senate Republicans – after GOP leaders scrapped a scheduled vote on the party’s far-right plan – and some came away with the impression that Trump still doesn’t know what he’s talking about. The New York Times reports today:

    A senator who supports the bill left the meeting at the White House with a sense that the president did not have a grasp of some basic elements of the Senate plan – and seemed especially confused when a moderate Republican complained that opponents of the bill would cast it as a massive tax break for the wealthy, according to an aide who received a detailed readout of the exchange.

    Mr. Trump said he planned to tackle tax reform later, ignoring the repeal’s tax implications, the staff member added.

    This isn’t a point-and-laugh-at-the-amateur-president moment. There are practical consequences to Trump’s ignorance.

  3. rikyrah says:

    McConnell On the Ropes. For Now.
    Published JUNE 27, 2017 9:02 AM

    I wanted to start the morning with a brief update on the latest developments with the Republican Senate’s drive to pass Trumpcare.

    For the last several days I’ve been saying that I thought it was much more likely than not that McConnell would succeed in passing the Trumpcare bill this week, even as I said over the weekend that McConnell was running into more turbulence than I’d expected. Yesterday evening the tide turned. The odds of passing the bill this week now seem stacked against McConnell. This is a critical breakthrough for the opponents of the bill and the 22-24 million people who stand to lose their health care coverage. But so far it’s only a limited and temporary victory if it even happens, which is no sure thing.

    Let’s run through the key developments.

    On Friday you’ll remember Sen. Heller of Nevada came out against the bill. I said this was positioning, not real opposition. I stick to that, though on rereading Heller’s statement I think I understated in my Friday write-up how deep he’d dug himself in. In any case, that at least moved Heller into a contingent opposition to the bill.

    Yesterday, we had the CBO report which posited a total of 22 million people losing their coverage over ten years – one million down from the second House bill and two million down from the first. The headline, though, was that 15 million lose coverage next year. Like 2018, in advance of the mid-term election. As I’ve said, we don’t need these CBO scores to tell us the basic story, which is that the coverage gains achieved by Obamacare are lost by repealing it. (This doesn’t even get to the massive out-year cuts to Medicaid and various loss of protections for additional millions.) But this was a bad headline for McConnell. And it came after a weekend when public protests had pushed three broad groupings of Republicans not into opposition but onto the sidelines, waiting to see who would go first in pledging support.


    All that said, if McConnell can’t get this done and has to bust his deadline, that is as big a victory as the opposition could have expected and it will be a big one. This was never going to be easy or quick. It was barely going to be possible to prevent McConnell from doing this. It’s going to be a long series of pitched battles. Opponents of Trumpcare will need to fight this over and over. But it now seems possible they win this first fight. If they do, it’s a big big deal.

  4. rikyrah says:

    McConnell Gives Up and Delays the Health Care Vote
    by Martin Longman
    June 27, 2017 2:30 PM

    CNN’s Senior Congressional Reporter Manu Raju just made a tweet announcement that I’ve been anticipating for months and months now. Senate Majority Leader Mitch McConnell can’t get the votes from his own caucus to repeal Obamacare.

    MCCONNELL tells senators: He will delay the health care vote until after the recess to solicit more support from GOP senators

    — Manu Raju (@mkraju) June 27, 2017

    I’ve written piece after piece about how Trump miscalculated when he made the decision (if it really was a “decision” at all) to try to govern with zero Democratic votes. In a last ditch effort to win over wavering members of his caucus, Mitch McConnell finally said something approximating the truth:

    Mitch McConnell is delivering an urgent warning to staffers, Republican senators and even the president himself: If Obamacare repeal fails this week, the GOP will lose all leverage and be forced to work with Chuck Schumer.

    Working with Chuck Schumer should have been Trump’s starting point because he promised to protect Medicare and Medicaid. He promised not to leave people dying on the streets. He promised people would get excellent and even more affordable access to health care. If he wanted those things, the last people to rely on would be ideological conservatives.

    Trump was too stupid to understand this up front, so he went along with a plan that not only would break some of his more important campaign promises, but which is polling just above the Ebola virus. Maybe Trump doesn’t realize it, but one major reason he won over so many Obama Democrats is because he distinguished himself from ordinary Republicans like Paul Ryan who have built their entire careers around destroying the safety net.

  5. eliihass says:

    Sabotage the ACA, then keep telling your dumb alt-right supporters that it’s dead..

  6. rikyrah says:

    Tax cuts in the Republican health care plan are the ‘central’ issue
    06/27/17 12:58 PM—UPDATED 06/27/17 01:09 PM
    By Steve Benen


    But it wouldn’t satisfy any of the Republicans’ ideological goals, starting with the GOP’s raison d’etre. The Washington Post’s Matt O’Brien had a good piece yesterday on the central pillar of the party’s health care plan.

    The Senate health-care plan isn’t a health-care plan. It’s a tax cut.

    That’s clear enough from how little thought it puts into actually stabilizing insurance markets versus how much it does into showering the rich with as much money as possible. Indeed, it would go so far as to retroactively cut the capital gains tax – something, remember, that’s supposed to be about incentivizing future investment – in an apparent bid to get people to create jobs six months ago.

    That may sound like a joke, but it’s quite real. The Senate health plan actually includes a provision that cuts taxes with an effective date of Dec. 31, 2016.

    It’s part of the broader plan to cut taxes, primarily on the wealthy, by hundreds of billions of dollars according to yesterday’s report from the Congressional Budget Office.

    I mention this in large part because it appears to be one of the parts of the legislation that the bill’s architects prefer not to talk about. White House Budget Director Mick Mulvaney has insisted the tax cuts in the GOP plan are “not central” to the policy debate. Why not? Because he says so.

    In early March, House Speaker Paul Ryan (R-Wis.) was asked about the tax breaks in the Republican legislation, and the Republican leader replied, “I’m not that concerned about it.” Of course, whether or not the House Speaker is “concerned” is of no real consequence.

    To be sure, none of this is surprising, but it makes an indefensible piece of legislation almost comically malevolent. The Republican blueprint would impose tangible harm on millions of families, and it would do so while handing massive tax breaks to the wealthy and the health care industry.

  7. Keep making those calls, folks! It’s working. We have to fight until we kill this bill.

  8. rikyrah says:

    Republican rhetoric on the uninsured descends into incoherence
    06/27/17 11:05 AM—UPDATED 06/27/17 11:24 AM
    By Steve Benen
    Republicans have plenty of criticisms for the Affordable Care Act, and some of their points are more credible than others, but of all the arguments GOP officials are pushing aggressively, I think we’ve identified the worst.

    Yesterday afternoon, for example, Donald Trump’s White House published a curious tweet:

    FACT: when #Obamacare was signed, CBO estimated that 23M would be covered in 2017. They were off by 100%. Only 10.3M people are covered.

    I realize the White House’s communications office is struggling right now – the communications director recently quit after a few months on the job, and no one wants to replace him – but someone over there probably should’ve read this before publishing it. If the Congressional Budget Office projected that the ACA would cover 23 million Americans, and the CBO was “off by 100%,” that means it would’ve been off by 23 million – because 100% of 23 million is 23 million. According to the White House’s own message, that’s not what happened.


    Yes, in reality, the Congressional Budget Office has found that under the Affordable Care Act, there are still 28 million uninsured Americans. If Team Trump and John Cornyn believe that number is too high, then we’re all on the same page.

    Of course, that number would be much lower if Republican governors had adopted Medicaid expansion through the ACA – in other words, the 28 million figure is partly a failure of GOP governance, not “Obamacare” as a model – but federal officials can’t force those state officials to do the right thing.

    The Congressional Budget Office also found, however, that the Republican alternative to the ACA would make this problem vastly worse, forcing 22 million Americans into the ranks of the uninsured.

  9. Liza says:

    Senate GOP Healthcare Bill Estimated to Kill 28,600 More in U.S. Each Year & Drop 22M from Insurance
    JUNE 27, 2017

  10. rikyrah says:

    With support for the ACA growing, Republicans go after single payer
    06/27/17 09:22 AM—UPDATED 06/27/17 09:46 AM
    By Steve Benen

    For the last several years, Republicans have defined themselves by their hatred for the Affordable Care Act. That, however, is quickly becoming a greater challenge: “Obamacare” is not only a successful policy, it’s also the most popular it’s ever been. Public support for the ACA is quite a bit stronger than public support for Donald Trump, congressional Republicans, or their regressive health care alternative.

    And that’s led some Republicans to shift their posture a bit. Unable to win a debate over the Affordable Care Act, GOP officials have turned their attention toward a single-payer system.

    Last week, for example, Sen. John Thune (R-S.D.) said, “If we don’t get this done and we end up with Democratic majorities in ‘18, we’ll have single payer. That’s what we’ll be dealing with.” Sen. Pat Roberts (R-Kan.) added that Congress has to pass an unpopular far-right bill, no matter what, because the alternative is single payer, “and that’s socialized medicine.”

    At yesterday’s untelevised White House briefing, Press Secretary Sean Spicer seemed quite animated on the subject.

    “But make no mistake about it that Obamacare is dying. And the reality, as I mentioned last week, is that, when you look at the majority of House Democrats, they support a single-payer, $32 trillion bill backed by Bernie Sanders. That’s what the alternative is.

    “It’s not a question of Obamacare versus the American Health Care Act. It’s a question between we need to accept that Obamacare is dead, we need to understand that the reality is that what the choice is is between putting in a system that is affordable and accessible, or a single-payer $32 trillion healthcare plan that the majority of House Democrats support.”

    It’s a shame that White House officials struggle this badly to keep up with the basics of the debate. We know, for example, that the Affordable Care Act is neither “dying” nor “dead.” It may make Trump World feel better to believe this, but for those who still take reality seriously, the claim just isn’t true.

    It’s also a shame that Republicans no longer see the fight against the ACA as one they can win, so they find it necessary to change the subject.

  11. rikyrah says:

    As their health plan falters, Republican leaders reach a crossroads
    06/27/17 08:00 AM—UPDATED 06/27/17 08:59 AM
    By Steve Benen


    To pass the regressive bill, Senate Republican leaders can lose no more than two of their own members. At least for now, the tally appears to be well above two – and the number of GOP opponents is growing, not shrinking.

    And that leaves Senate Majority Leader Mitch McConnell (R-Ky.) with a limited number of options.

    1. McConnell can hold the vote anyway. I don’t doubt that McConnell wants to pass this monstrosity, but the GOP leader isn’t delusional. If he counts heads, realizes he doesn’t have the votes, and doesn’t expect to get then, McConnell has the option of bringing his bill to the floor, watching it die, and then moving on to something else.

    2. McConnell can punt. This week has been designated the make-or-break week for the Senate Republicans’ health plan, but that’s because of a self-imposed deadline. There’s no reason McConnell can’t do exactly what the GOP-led House did: pull the bill temporarily, allow for some behind-the-scenes negotiations to continue for weeks (or months), and revisit the issue at some point down the road. There’s literally nothing – substantive, procedural, etc. – that says the vote has to be this week.

    3. McConnell can start throwing money around. The CBO found that the Republican plan reduces the deficit by over $300 billion in the coming years. That effectively gives Senate GOP leaders a pot of money to play with, allocating it in such a way to curry favor with his skeptical members. Indeed, McConnell could even start applying the available money to take some of the rougher edges off his far-right proposal.

  12. rikyrah says:

    CBO: Insurance markets will *collapse* in some areas. What CBO is describing here is a classic death spiral:

    Topher Spiro (@TopherSpiro) June 26, 2017

  13. rikyrah says:

    1/ ICYMI: the waiver provision of the Senate bill is pretty crazy, as I explain at @voxdotcom.
    — Nicholas Bagley (@nicholas_bagley) June 26, 2017

  14. rikyrah says:

    Indefensible: Senate bill would allow governors to spend their state’s (reduced) Obamacare funding on whatever they want for whatever reason
    — Jon Favreau (@jonfavs) June 26, 2017

  15. rikyrah says:

    Healthcare THREAD:
    — bardgal (@bardgal) June 27, 2017

  16. rikyrah says:

    All the cable networks on Monday night led with the 22 million uninsured, because it’s the biggest number and because it’s the “out-year” projection, which is what these reports always emphasize. But politically, the far more important number is 15 million. The CBO projects that the Senate bill would create 15 million more uninsured in 2018. That’s next year. An election year.

    That is to say that 68 percent of those expected to lose their coverage are going to lose it in the bill’s first year. The Republicans are gonna throw 15 million Americans off the insurance rolls in an election year? That’s a lot of people. Divided by 435, it’s around 34,000 people per congressional district, but of course the distribution won’t be even, and there will be many districts—toss-up districts—where 60,000 or 80,000 people will stand to lose their coverage. And states where half a million will lose coverage. How’d you like to be a Republican incumbent House member or senator defending that next fall?

  17. rikyrah says:

    I’m unfamiliar with the economic theory that says tax cuts for billionaires trickle down to working people in the form of health insurance.
    — Jason Kander (@JasonKander) June 26, 2017

  18. rikyrah says:

    GOP meeting in a full caucus lunch today for a gut check on Senate health bill.
    — igorvolsky (@igorvolsky) June 27, 2017

  19. rikyrah says:

    If our calls stop, Trumpcare will rise like death-thirsty monster it is.
    Call 202-224-3121
    Especially if you’re in 1 of these key states.
    — LOLGOP (@LOLGOP) June 27, 2017

  20. rikyrah says:

    One reason Republicans are so eager to undo Obamacare? Many view it as their last chance to wipe out its tax hikes.
    — Sahil Kapur (@sahilkapur) June 27, 2017

  21. rikyrah says:

    I honestly haven’t heard 1 decent argument in favor of Trumpcare.
    We need to get millionaires their tax breaks now isn’t even an argument.
    — LOLGOP (@LOLGOP) June 27, 2017

  22. rikyrah says:

    Here’s a truth bomb from @NBCFirstRead
    — Bradd Jaffy (@BraddJaffy) June 27, 2017

  23. rikyrah says:

    Watch this.#ProtectOurCare #SaveACA #Resist
    — Scott Dworkin (@funder) June 27, 2017

  24. rikyrah says:

    Remember: The health care bill isn’t over until the bill is dead. If we raise our voices together, we can win this fight — (202) 224-3121.
    — Kamala Harris (@KamalaHarris) June 26, 2017

  25. rikyrah says:

    Problem isn’t just 22m uninsured. It’s the vision of a system where average insurance has a $6000 deductible & bad chronic illness coverage.
    — Atul Gawande (@Atul_Gawande) June 27, 2017

  26. rikyrah says:

    Another example of how nothing’s real UNTIL IT ACTUALLY HAPPENS TO A REPUBLICAN..

    WHY can’t they just friggin’ have EMPATHY?

    Fmr. Republican congressman @DavidJollyFL was once anti-Obamacare… until he found himself unemployed with a pre-existing condition. WATCH:

    — The Last Word (@TheLastWord) June 27, 2017

  27. rikyrah says:

    From Mayhew at Balloon Juice:

    A scheme in a no MLR world
    by David Anderson
    at 7:51 am on June 27, 2017.

    Part of the Senate bill invites states to file waivers that basically would allow a state to do whatever it wanted. One of the elements of the ACA that can be waived is the requirement that insurers spend at least 80% of the premium dollars on claims. That is known as the Medical Loss Ratio. It is an invitation to loot in single insurer states.

    The #ACA req’d that insurance companies use your premiums for actual healthcare cov. #TrumpCare repeals it #CBOScore

    — Khary Penebaker (@kharyp) June 26, 2017

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