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.S. Senate Minority Leader Mitch McConnell (R-KY)(R) watches as John Cornyn (R-TX) speaks to the press on Capitol Hill in Washington, November 14, 2012. Republicans in the U.S. Senate voted Cornyn as the new minority whip on Wednesday.   REUTERS/Jason...

Republican rhetoric on the uninsured descends into incoherence

06/27/17 11:05AM

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.

Worse, by claiming that "only" 10.3 million Americans have gained coverage through the ACA, Trump World has cut the actual number roughly in half (though it is a nice change of pace for Republicans to acknowledge that the ACA has brought coverage to millions, even if the White House's numbers are all wrong). The figure only includes consumers who've bought insurance through exchange marketplaces, and ignores others who've gained coverage through the law.

But the underlying point of the tweet is that coverage levels matter. If you want to evaluate a health care blueprint, the argument goes, then take seriously how many Americans are insured under that system.

Senate Majority Whip John Cornyn (R-Texas), in a message apparently intended to serve as criticism of the ACA, added yesterday, "28 million uninsured under Obamacare." The White House has been pushing this data point, too.

It's baffling to see Republicans push this argument because it makes their own side look so much worse.

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The White House's international credibility collapses in Trump era

06/27/17 10:03AM

During Barack Obama's presidency, Republicans chose a strange line of attack. As regular readers know, Obama's GOP detractors seemed absolutely convinced that the Democratic president had done real damage to the United States' international standing. The opposite was true, but GOP officials nevertheless argued, with unnerving vigor, that America had forfeited the admiration of the world -- and it was Obama's fault.

During the Republican presidential primaries, for example, Jeb Bush insisted that during the Obama era, “We have lost the trust and confidence of our friends.” Around the same time, Scott Walker and Donald Trump had a chat about “how poorly” the United States is now “perceived throughout the world.” Mitt Romney added, “It is hard to name even a single country that has more respect and admiration for America today than when President Obama took office."

All of this was bizarre and sharply at odds with the evidence. But perhaps more importantly, it's also terribly inconvenient for the GOP now that those same criticisms actually apply to a Republican president.

Although he has only been in office a few months, Donald Trump's presidency has had a major impact on how the world sees the United States. Trump and many of his key policies are broadly unpopular around the globe, and ratings for the U.S. have declined steeply in many nations.

According to a new Pew Research Center survey spanning 37 nations, a median of just 22% has confidence in Trump to do the right thing when it comes to international affairs. This stands in contrast to the final years of Barack Obama's presidency, when a median of 64% expressed confidence in Trump's predecessor to direct America's role in the world.

The sharp decline in how much global public trusts the U.S. president on the world stage is especially pronounced among some of America's closest allies in Europe and Asia, as well as neighboring Mexico and Canada. Across the 37 nations polled, Trump gets higher marks than Obama in only two countries: Russia and Israel.

The Pew Research Center's report included several helpful charts to help illustrate the data, but I made the above image to help drive the point home.

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Image: White House Press Secretary Sean Spicer Holds Daily Press Briefing

With support for the ACA growing, Republicans go after single payer

06/27/17 09:22AM

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.

But perhaps most important is the fact that Republicans, whether they realize it or not, may be inviting the one policy they hate the most.

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The sun rises near the White House on Nov. 8, 2016 in Washington, DC. (Photo by Zach Gibson/Getty)

White House's Syria threat raises awkward questions about credibility

06/27/17 08:40AM

Just before 10 p.m. (ET) last night, White House Press Secretary Sean Spicer issued a rather striking statement about developments in Syria, which raised the prospect of further U.S. military intervention. The entire statement, which Rachel highlighted at the end of last night's show, read as follows:

"The United States has identified potential preparations for another chemical weapons attack by the Assad regime that would likely result in the mass murder of civilians, including innocent children. The activities are similar to preparations the regime made before its April 4, 2017 chemical weapons attack.

"As we have previously stated, the United States is in Syria to eliminate the Islamic State of Iraq and Syria. If, however, Mr. Assad conducts another mass murder attack using chemical weapons, he and his military will pay a heavy price."

Taken at face value, this suggests the Trump administration received intelligence pointing to a possible chemical-weapons attack, being considered by Syria's Assad government, and the statement was intended to serve as a warning.

The trouble is, it's become increasingly difficult to take what Team Trump says at face value. BuzzFeed reported last night, for example, that several Pentagon sources didn't know what the White House was referring to, and one U.S. Central Command official said he/she had "no idea" what Spicer's statement was about. The same report said statements like these are usually "coordinated across the national security agencies and departments before they are released," but this one was not.

NBC News had a similar report, citing defense, military, and intelligence officials who were "caught off guard by the White House statement." One responded, "I don't know what the [White House] statement is."

Often these kinds of statements are accompanied by some kind of press briefing, in which supporting information is presented to reporters, but there was no such effort last night.

At least so far this morning, Donald Trump published a variety of tweets, nearly all of which promoted Fox News, and none of which referenced his White House's warning to Syria about chemical weapons.

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Senate Majority Leader Mitch McConnell (R-KY) listens to a question during a press conference following the weekly policy meeting at the U.S. Capitol Dec. 1, 2015 in Washington, DC. (Photo by Win McNamee/Getty)

As their health plan falters, Republican leaders reach a crossroads

06/27/17 08:00AM

The Congressional Budget Office's report on the Senate Republicans' health care plan was simply brutal. The GOP blueprint, Congress' non-partisan scorekeepers found, would take coverage from 22 million Americans, increase consumer costs, and make insurance worse.

Sen. John McCain (R-Ariz.), asked about the CBO's findings, told reporters on Capitol Hill late yesterday, "Well, obviously that's not good news."

The question now becomes what Senate Republicans intend to do about it. Sen. Dean Heller (R-Nev.) announced his opposition to the GOP legislation on Friday, and as of last night, as others joined him, GOP opposition appeared to reach a critical mass.

Sen. Susan Collins, R-Maine, announced via Twitter that the CBO report reaffirmed her fears about deep cuts to Medicaid in the Better Care Reconciliation Act and said she would vote against the "motion to proceed," a procedural vote that allows the Senate to bring up a piece of legislation to be debated and eventually voted on. [...]

Sen. Rand Paul, R-Ky., also said he wouldn't vote for the motion to proceed, a vote expected to take place either Tuesday or Wednesday of this week.... Sen. Ron Johnson, R-Wis., is a third senator who said that he could vote against the procedural motion this week, saying he "would highly doubt" that he would support it.

Asked whether she would vote for her party's plan, Sen. Lisa Murkowski (R-Alaska) added last night that she's not in a position where she could "vote in the affirmative"

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.

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Monday's Mini-Report, 6.26.17

06/26/17 05:30PM

Today's edition of quick hits:

* The right call: "The U.S. Supreme Court ruled Monday that Arkansas authorities must list the names of both same-sex parents on their child's birth certificate."

* The wrong call: "The U.S. Supreme Court reduced the wall of separation between church and state Monday in one of the most important rulings on religious rights in decades. The decision could doom provisions in 39 states that prohibit spending tax dollars to support churches. The states defended the limits as necessary to keep the government from meddling in religious affairs."

* This will be interesting: "The U.S. Supreme Court agreed Monday to hear an appeal from a Colorado bakery that refused to make wedding cakes for same-sex couples."

* Moscow has pushed back against this report, for what it's worth: "Ending one the most turbulent tenures of a Washington-based ambassador in recent memory, the Kremlin has decided to recall Ambassador to the United States Sergey Kislyak, three individuals familiar with the decision told BuzzFeed News."

* Look for more on this on tonight's show: "One month before Election Day, Jared Kushner's real estate company finalized a $285 million loan as part of a refinancing package for its property near Times Square in Manhattan."

* Read this whole story out of St. Louis: "An off-duty officer was wounded by 'friendly fire' as police looked for suspects after a stolen vehicle fled police and crashed late Wednesday."

* This relationship isn't working: "The White House is becoming increasingly frustrated with Secretary of State Rex Tillerson and a close-knit circle of aides over the slow pace of hiring and a chokehold on information and access to Tillerson, according to senior Trump administration officials and others familiar with the rift."

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The dome of the U.S. Capitol Building is reflected in a puddle on a rainy morning in Washington.

CBO: Senate Republican plan would take coverage from 22 million

06/26/17 05:05PM

During the debate over the House Republican plan, Sen. Susan Collins (R-Maine) made clear she was unimpressed with the GOP proposal. Any bill resulting "in 23 million people losing coverage is not a bill that I can support," the Maine Republican said in March.

OK, how about 22 million?

The Senate health care bill would insure 22 million fewer people after a decade than current law, according to an analysis by the non-partisan Congressional Budget Office.

It would save $321 billion in the same period overall by spending $1 trillion less on health care and using the savings to repeal the Affordable Care Act's taxes, which primarily affect wealthy individuals and medical companies.

The CBO's full report is online here. Note that the impact imposed on the nation would be felt almost immediately -- there would be 15 million more uninsured Americans next year, which happens to be an election year, according to the non-partisan office's estimate -- before getting worse in the years that follow.

Complicating matters, the CBO score added, "By 2026, among people under age 65, enrollment in Medicaid would fall by about 16 percent and an estimated 49 million people would be uninsured, compared with 28 million who would lack insurance that year under current law."

I should concede that this report is quite a bit worse than I thought it'd be. Senate Republican leaders worked fairly closely with CBO officials while writing their secret legislation, getting periodic updates. Indeed, it's one of the reasons the CBO score, which would ordinarily take two weeks, was turned around so quickly.

With this in mind, I figured Senate Majority Leader Mitch McConnell's (R-Ky.) office would carefully game the system, and tweak his blueprint in such a way that the numbers would look less awful. But if that was the plan, it failed spectacularly: the CBO's findings are, or at least should be, a punch to the gut of proponents of Senate Republicans' legislation.

Donald Trump has gone out of his way lately to say he wants to see a health care bill "with heart." By any sensible standard, it's now painfully obvious that the GOP legislation fails this simple test.

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Image: U.S. President Donald Trump signs a revised executive order for a U.S. travel ban on Monday, leaving Iraq off the list of targeted countries at the Pentagon in Washington, U.S.

Supreme Court opens the door to Trump's troubled Muslim ban

06/26/17 12:00PM

Donald Trump's Muslim ban has struggled badly in the face of multiple legal challenges, and has already run into trouble in two separate appellate courts. But the Republican White House has some allies at the U.S. Supreme Court, who appear to be approaching the controversy from a different perspective.

The U.S. Supreme Court agreed Monday to reinstate much of President Donald Trump's travel ban before hearing the case this fall, dealing a partial victory to the administration in one of the most divisive policy battles of his presidency.

The Supreme Court said the ban cannot be enforced for people from six nations -- Iran, Sudan, Syria, Libya, Somalia and Yemen -- who have relatives in the U.S. and want to travel to America.

However, the ban can be enforced for refugees and those who do not have that personal relationship.

Note, this wasn't a ruling on the constitutionality of the administration's policy on the merits. Rather, the Supreme Court agreed this morning to hear the White House's appeal, and in the interim, the justices said parts of Trump's policy can be implemented. That's a break from the status quo: previous courts that have heard challenges to the policy did not allow the administration's ban to go into effect.

Justices Clarence Thomas, Samuel Alito, and Neil Gorsuch -- by most measures, the high court's three most conservative members -- said they wanted to go further, allowing all of Trump's policy to go into effect immediately.

Oral arguments in this case will be heard in the fall, but in the meantime, this policy will get a little tricky.

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Empty hospital emergency room. (Stock photo by  DreamPictures/Getty Images)

The poor would be crushed by GOP health plan, but they're not alone

06/26/17 11:30AM

One of the core cruelties to the Republican health care plan is the burdens it would impose on low-income families. As many have noted many times in recent days, at the heart of the GOP legislation is the belief that the poor should pay more for worse coverage in order to finance tax breaks that would disproportionately benefit the wealthy.

For those concerned with economic and social justice, such circumstances are obviously obscene. It's also true, however, that few groups in America have less political capital than the poor.

For health care advocates, trying to find the most compelling arguments to sway Republican lawmakers, pointing to the impact on the low-income communities may not do the trick. Many on the right, after all, agree with Ben Carson's recent assessment that poverty is really just "a state of mind."

So what's more persuasive? Maybe by focusing on the impact on nursing homes?

Under federal law, state Medicaid programs are required to cover nursing home care. But state officials decide how much to pay facilities, and states under budgetary pressure could decrease the amount they are willing to pay or restrict eligibility for coverage.

"The states are going to make it harder to qualify medically for needing nursing home care," predicted Toby S. Edelman, a senior policy attorney at the Center for Medicare Advocacy.

Or how about the impact on hospitals?

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