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Sen. Susan Collins, R-Maine, speaks with reporters on Capitol Hill in Washington, March 16, 2016. (Photo by J. Scott Applewhite/AP)

Collins points to an underappreciated flaw in the GOP health plan

07/14/17 11:21AM

To make the Senate Republicans' health care bill more palatable to far-right members, Senate Majority Leader Mitch McConnell (R-Ky.) added a provision crafted by Sen. Ted Cruz (R-Texas). For health care advocates, that's not good news.

The basic idea behind Cruz's proposal is to empower insurers to sell plans that ignore the ACA's insurance safeguards alongside plans that include those safeguards. So, consumers could purchase a good plan, with protections for pre-existing conditions and essential health benefits, or a bare-bones plan, that wouldn't meet any of the existing standards under the Affordable Care Act.

As health care experts have repeatedly explained, this would create an unsustainable two-tiered system, with older and sicker patients buying real coverage, and younger and healthier consumers buying cheaper insurance. This, naturally, would lead to vastly higher premiums for people who need coverage the most.

The GOP approach would try to ease the burden by creating a fund to help offset those costs, creating what would, in practice, become high-risk pools. And while that's inherently problematic for all kinds of reasons, as TPM noted, Sen. Susan Collins (R-Maine) raised a separate concern: the money her party's plan sets aside is being used more than once.

[The Cruz] amendment takes money already appropriated in the bill for other needs and says it can be used for these payments to insurers under the Cruz Amendment.

"It seems to me you're using that money over and over again," she said. "It's supposed to relieve the cost of high premiums. It's supposed to solve the problem with deductibles being unaffordable. It's supposed to be available for high-risk or reinsurance pool. It's supposed to be available under the Cruz Amendment to help prevent a huge increase in rates for people with pre-existing conditions."

Matthew Fiedler, a fellow at Brookings Institute's Center for Health Policy, confirmed this double-dipping to TPM.

TPM's report also quoted Tim Jost, a health care law expert and professor at Washington and Lee University, saying the Republican "gives an additional $70 billion to the states and then the Cruz amendment gives it to insurers that offer compliant plans in addition to noncompliant plans."

Putting the same money in multiple pots obviously won't work. How do Senate GOP leaders intend to fix this? So far, they apparently haven't acknowledged that the problem exists.

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The Arizona-Mexico border fence near Naco, Arizona, March 29, 2013.

Trump's case for his border wall gets quite a bit stranger

07/14/17 10:40AM

There are few ideas more closely associated with Donald Trump than his dream of a massive wall along the U.S./Mexico border -- which, he's assured the public, will be financed by Mexico. In a lengthy chat with reporters aboard Air Force One this week, the president made clear that this remains a top priority.

In fact, as the partial transcript shows, it's apparently a subject to which he's given some thought.

"One of the things with the wall is you need transparency. You have to be able to see through it. In other words, if you can't see through that wall -- so it could be a steel wall with openings, but you have to have openings because you have to see what's on the other side of the wall.

"And I'll give you an example. As horrible as it sounds, when they throw the large sacks of drugs over, and if you have people on the other side of the wall, you don't see them -- they hit you on the head with 60 pounds of stuff? It's over. As crazy as that sounds, you need transparency through that wall. But we have some incredible designs."

As best as I can tell, Trump was being quite serious. When the president says he wants "transparency" in this project, he's being literal: he wants people to able to see through the border wall, in order to be able to protect themselves from 60-pound bags of drugs that Mexicans will somehow catapult over Trump's beloved wall.

Perhaps giant signs that read, "Beware of giant bags of drugs falling from the sky" would make the gaps in the steel planks unnecessary.

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Image: Donald Trump, Andrzej Duda

Donald Trump is already a legend in his own mind

07/14/17 10:07AM

About a month ago, at his first full cabinet meeting, Donald Trump spoke very highly of himself. "Never has there been a president, with few exceptions -- case of FDR, he had a major depression to handle -- who has passed more legislation and who has done more things than what we've done," the Republican said.

It was an odd boast for a president who has no meaningful accomplishments and has signed no major bills.

This week, during an interview with Reuters, Trump was a little more specific in explaining why he's so impressed with himself. From the excerpted transcript:

"We have done more in five months than practically any president in history."

"If you look at Iraq and if you look at Syria and you see the progress we've made with ISIS, it's been almost complete."

"The White House is functioning beautifully. The stock market has hit a new high. Job numbers are the best they've been in 16 years. We have a Supreme Court judge already confirmed. Energy is doing levels that we've never done before. Our military is doing well. We're knocking the hell out of ISIS, which Obama wasn't. There's not a thing that we're not doing well in."

Trump hasn't demonstrated any meaningful interest in, or knowledge of, presidential history, so it's possible he actually believes he's already accomplished more "than practically any president in history," but reality points in a very different direction.

Indeed, let's go through Trump's list of purported successes:

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U.S. Senator John McCain (R-AZ) listens during a news conference on the terror attack that killed four Americans in Benghazi Feb. 14, 2013 on Capitol Hill in Washington, DC. (Photo by Alex Wong/Getty)

Don't count on John McCain to follow through on his posturing

07/14/17 09:20AM

Now that the latest iteration of the Senate Republicans' health care plan is available, health care advocates are keeping a close eye on the head-count. Two GOP senators have announced their opposition, but to kill the bill, critics of the far-right bill will need a third.

According to the Washington Post, however, there's already a third. In addition to Sens. Susan Collins (R-Maine) and Rand Paul (R-Ky.), whose opposition is unambiguous, the Post's head-count, as of this morning, showed Sen. John McCain (R-Ariz.) as another "no" vote.

And while I think that's a mistake, I can understand why the newspaper reached such a conclusion. McCain issued a written statement yesterday that sounded a very critical note about his party's bill and the process that created it.

"The revised Senate health care bill released today does not include the measures I have been advocating for on behalf of the people of Arizona. That's why if the Senate takes up this legislation, I intend to file amendments that would address the concerns raised by Arizona Governor Doug Ducey and other leaders across our state about the bill's impact on Arizona's Medicaid system. Arizona has been nationally recognized for running one of the most efficient and cost-effective Medicaid programs in the country.

"This legislation should reward states like Arizona that are responsibly managing their health care services and controlling costs -- not penalize them."

The statement added that if the GOP plan falls short again, McCain wants the Senate to "hold hearings and receive input from senators of both parties, and produce a bill that finally provides Americans with access to affordable and quality health care."

Taken at face value, this certainly sounds like a senator who doesn't like his party's legislation and is fully prepared to vote against it, laying the groundwork for a different approach he prefers more.

There is, however, no reason to accept the statement at face value -- because John McCain has a track record.

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A person man uses a laptop. (Karl-Josef Hildenbrand/dpa/AP)

Are Republicans prepared to help prevent the next Russian attack?

07/14/17 08:42AM

As the Trump-Russia scandal continues to unfold, there are political and policy decisions for U.S. officials to consider, including how best to hold Vladimir Putin's government accountable for the most serious attack on the United States since 9/11. At this point, Donald Trump's White House is prepared to do effectively nothing -- a posture that encourages additional attacks, because it signals to U.S. adversaries that there will be no consequences for their actions.

But let's pull further on that thread. If Trump's complacency and appeasement have the effect of encouraging foreign intervention in American campaigns, what are policymakers prepared to do to help protect the United States going forward? The president has already floated the idea of creating a cyber-security partnership with the people who attacked us -- an idea no sane person could support.

But Team Trump isn't the only game in town. The Washington Post's Greg Sargent had a very interesting scoop yesterday morning.

With President Trump continuing to claim the Russia scandal is a "hoax," this question deserves more attention: What will Trump and Republicans do about the likelihood that Russia will attempt to undermine our elections again next time?

Democrats are now taking new steps to increase the pressure on Republicans to take this prospect a lot more seriously.

The Democratic Congressional Campaign Committee, which oversees House races, has issued a formal request to its Republican counterpart, asking it to join in showing a "united front" and creating a "joint plan" against any Russian efforts to undermine the 2018 elections, I've learned.

It's an approach that makes a lot of sense. U.S. intelligence officials have already said they expect Russia to try again -- Putin's first attack was wildly successful, and he has every incentive to return to the scene of the crime -- and now is the time to prepare a proper American defense against the next foreign intervention.

The DCCC's letter to the National Republican Congressional Committee is based on the idea that partisans are Americans first, and there are steps the parties can take now to help protect the process for everyone.

All Republican officials have to do is agree to a bipartisan partnership before the next attack. As of yesterday, however, that appears unlikely.

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Image: FILES-US-POLITICS-BUDGET

The Republican health care gambit reaches a crossroads

07/14/17 08:00AM

While the details of health care policymaking may be complex, the arithmetic of health care legislating is not. There are 52 Senate Republicans, and to pass the GOP's regressive health care overhaul, the party will need 50 votes (plus Vice President Mike Pence to break the tie).

If two Republican senators break party ranks and oppose the bill, it passes. If three or more do so, it dies.

In June, when Senate Majority Leader Mitch McConnell (R-Ky.) unveiled the original iteration of his blueprint, it was a full day before any GOP senator spoke out against the plan. As Slate's Jim Newell explained, the developments yesterday, with the release of McConnell's amended package, unfolded much faster.

Maine Sen. Susan Collins did not take very long, after seeing the new version of the Republican health care bill in a meeting on Thursday morning, to announce that she would not support it. She listed the many, many problems she still had with the bill, such as the cuts to traditional Medicaid -- which remain just as they were in the first version of the bill. She would also vote no on the motion to proceed, the procedural vote that sets up debate on the bill. She is gone.

Kentucky Sen. Rand Paul also wasted no time after the meeting to declare that he, too, would vote no on the motion to proceed, from the opposite end of the spectrum.... He will not vote to proceed. He is gone.

A funny thing happened, though, after Collins and Paul immediately announced that they would not vote to advance the bill: No one else did.

This left health care advocates with a sense of uncertainty. On the one hand, opponents of the far-right approach were encouraged by the fact that the Republican plan was already struggling, just hours after its unveiling. On the other hand, two "no" votes won't be enough to stop the bill. One more is needed.

What's unclear is whether some GOP senators who balked at the plan in June will find a way out of the box they've put themselves in.

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Thursday's Mini-Report, 7.13.17

07/13/17 05:30PM

Today's edition of quick hits:

* That's quite a bust: "The Department of Justice on Thursday announced charges against more than 400 people in connection with a major crackdown on medical fraud aimed at combating the nation's opioid epidemic."

* Speaking of the DOJ: "A day late, the Justice Department complied this morning with a federal court order and released part of a security clearance form dealing with Attorney General Jeff Sessions' contacts with foreign governments."

* Look for more on this one on tonight's show: "Marc Kasowitz, President Trump's personal attorney on the Russia case, threatened a stranger in a string of profanity-laden emails Wednesday night."

* Candice Jackson: "The Department of Education's civil rights chief apologized for comments she made regarding campus sexual assaults."

* This was a very odd thing to say: "President Donald Trump was overheard complimenting the French first lady, saying she was 'in such good shape,' during a live video in Paris on Thursday."

* I'm glad the clip is getting attention: "Video of Florida's only black state attorney being pulled over by two police officers prompted criticism after it was published to the Orlando Police Department's YouTube page on Wednesday."

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Image: FRANCE-US-POLITICS-DIPLOMACY

Trump's magic words: 'A lot of people don't know that'

07/13/17 04:17PM

The presidential learning curve has been steep at times for Donald Trump, America's first amateur leader. We've all been witness to the president learning things that many of us have known for quite a while.

This awkward process of discovery has, however, produced a phrase of underappreciated beauty: "A lot of people don't know that." These seven words are Trump's way of saying, "I just learned something new, and I'm going to assume others are as ignorant as I am."

Today, for example, Trump held a joint press conference alongside French President Emmanuel Macron, where the U.S. president declared, "France is America's first and oldest ally. A lot of people don't know that." If you watch the brief clip, you'll note that the first sentence was part of the prepared text, but the second sentence was ad libbed.

Trump probably wouldn't admit this out loud, but I'm reasonably sure he said this because he considers this rather obvious historical detail -- already familiar to much of the country -- to be an interesting bit of trivia that only recently came to his attention.

It's reminiscent of remarks Trump delivered in March when he said, in reference to Abraham Lincoln, "Most people don't even know he was a Republican. Right? Does anyone know? A lot of people don't know that."

Referring to the president as "Captain Obvious," the Washington Post's Dana Milbank noted soon after just how frequently Trump reflects on what he assumes others don't know.

That Bill Clinton signed NAFTA: "A lot of people don't know that."

What a value-added tax is: "A lot of people don't know what that means."

That we have a trade deficit with Mexico: "People don't know that."

That Iraq has large oil reserves: "People don't know this about Iraq."

That war is expensive: "People don't realize it is a very, very expensive process."

Whether he thinks "people" are incredibly uninformed, or whether he's simply oblivious himself, will remain a subject of some debate.

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Senate Majority Leader Mitch McConnell speaks to reporters in the U.S. Capitol in Washington, May 17, 2016. (Photo by Kevin Lamarque/Reuters)

McConnell unveils regressive new health care plan

07/13/17 02:57PM

About a month ago, when the Senate Republican leadership unveiled its initial health care proposal, it was widely assumed that the less conservative GOP senators wouldn't like the plan. Party leaders, however, were confident that the so-called "moderates" would succumb to pressure and toe the party line.

"Moderates always cave," one senior GOP aide said at the time.

This was certainly true in the House, where more centrist lawmakers proved to be useless, and it appears that Senate Majority Leader Mitch McConnell (R-Ky.) hopes that it's true in the upper chamber next week. The Huffington Post explained that the new GOP is "basically the same as the old one."

[T]he revised version of the Better Care Reconciliation Act ― which McConnell pulled two weeks ago because too few Republican senators planned to vote for it ― remains a vehicle for massive cuts to Medicaid, less financial assistance for people who buy private health insurance, and the return of skimpy junk insurance policies and discrimination against people with pre-existing conditions. Taxes on the rich would remain, but health care companies would enjoy a major tax cut.

The Senate Republican leadership, in other words, is still counting on the so-called "moderates" to cave. Today's proposal is effectively a dare to the Collins/Murkowski wing of the GOP conference.

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Senate Majority Leader Mitch McConnell of Ky., speaks during a news conference on Capitol Hill in Washington, D.C., Dec. 12, 2016. (Photo by Susan Walsh/AP)

McConnell sells his health plan in the most cynical way possible

07/13/17 12:30PM

As the political fight over health care continues, congressional Republicans are divided along several lines, but one of the more contentious issues is the GOP's deep proposed cuts to Medicaid. In the Senate, several Republicans have pushed back against their leadership, insisting that the plan simply goes too far -- doing too much damage to too many people.

The Washington Post reports today, however, that Senate Majority Leader Mitch McConnell (R-Ky.) has an argument intended to reassure his members concerned about Medicaid's future.

Here's what McConnell has told several hesitant senators (including Portman and Sen. Shelley Moore Capito (R-W.Va.): The bill's deepest Medicaid cuts are far into the future, and they'll never go into effect anyway.

"He's trying to sell the pragmatists like Portman, like Capito on 'the CPI-U will never happen,'" a GOP lobbyist and former Hill staffer told me.

In other words, the current iteration of the Republican health care legislation will include brutal cuts to Medicaid, but the GOP's less conservative senators can vote for it anyway, confident in the idea that, in the future, policymakers will intervene to make sure this policy isn't actually implemented.

Take a moment to consider just how cynical this is. Senators are supposed to vote, on purpose, for legislation they know would do real harm to their constituents, based on assurances from Mitch McConnell that someone, at some point, in some way, will clean up the mess they voted for.

This isn't how responsible legislating in a mature democracy is supposed to work.

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About The Rachel Maddow Show

Launched in 2008, “The Rachel Maddow Show” follows the machinations of policy making in America, from local political activism to international diplomacy. Rachel Maddow looks past the distractions of political theater and stunts and focuses on the legislative proposals and policies that shape American life - as well as the people making and influencing those policies and their ultimate outcome, intended or otherwise.

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