Trump Sets Off A Virtual Healthcare Bomb That Will Kill Real People
And the rest of your politics news in a rush and a push.
Trump Sets Off A (Virtual) Bomb In A (Virtual) Marketplace That Will Kill (Real) People
Or as Vox’s Sarah Kliff more elegantly puts it: “Trump’s acting like Obamacare is just politics. It’s people’s lives.” Or as Steve Bannon less elegantly puts it: “Gonna blow that thing up, gonna blow those exchanges up, right?”
While both those things are true, the portrayals of Trump’s latest moves to rip apart Obamacare as impetuous and anarchic are overblown. The President is acting out of spite yes, but not blindly.
We believe Trump is employing a specific and deliberate strategy. It’s extremely high risk, but if he’s successful, could pay off big. (Also to pull it off, he truly has to not care if he comes across as reckless and thoughtless and kills people–which is why his being in charge of North Korea also worries us. But that’s a story for another day).
Here’s how we think it goes:
• Trump’s bold move to get what he wants on health care (that is, for Obamacare to explode), despite public outcry and widespread unpopularity is calculated to portray him as tough, and the kind of guy who will get what he says done. In fact, Congress’ failure to pass Obamacare repeal 3 times could turn out to be a blessing for him: because his move also paints Republican leadership as weak, making the President look like the only person in Washington who’s willing to move with force.
• What about the little problem that the very people who are counting on him most for support are the ones his policies are going to hurt the most? That’s where the risk lies. But he’s counting on not losing them, because a lot voted for him because they wanted him to “shake things up”. And he is.
• After that, it becomes real simple: he can count on 100% of those people to get out and vote for him 100% of the time.
What Happened To That Bipartisan Effort To Stabilize Obamacare?
Answer: they’re still talking.
The Senate HELP Committee (“H” stands for Health) continues to work on an agreement to shore up Obamacare, led by Committee Chairman Lamar Alexander and ranking Democrat Patty Murray. Murray continues to say they’re very close, but has said that for a very long time.
The problem (maybe) is the central focus of their effort was to guarantee those cost-sharing payments to insurers, taking the uncertainty of the President’s game-playing out of the market. Now that the President’s moved, the context is a little different.
We’re not sure if Trump’s move puts more pressure on Democrats or Republicans to move this deal ahead:
• Democrats because they’re in crisis mode now to retain this critical piece of coverage. Might they be willing to give in to Republicans on some other issues (like allowing states to have more leeway in opting out of some of the mandatory Obamacare features?) Or will this add pressure internally to fight, be obstructionist, and shut down the government if necessary (which could work to Trump’s benefit, since whomever shuts down the government always ends up looking bad, even if they have a legit reason).
• Republicans because everybody in Congress has to run next year (Trump doesn’t) and unless the public really believes Trump’s lie that this is all about Obamacare imploding and not anything he did, the pressure is going to be on Republicans to justify why they let so many of their constituents’ benefits get taken away without a fight. Then again, there are a lot of Republicans who oppose the payments, so they might not even be able to pass a short term deal.
One other key question resulting from Trump’s quake to the political landscape: was the President’s goal just to force Congress’ hand? Many reports suggest that’s a real possibility: The Hill quotes Trump as saying “I will say that the Democrats should come to me; I would even go to them.” But we think Trump’s not likely to give in as easily right now as he might have even a couple of weeks ago, right after the health care bill he so vigorously supported failed and he was looking for any kind of “win”. So Congress may need way more than enough votes.
Lets Clear A Few Things Up
There was a lot of confusion over the weekend about exactly what (and who) is at stake in both Trump’s health care and Iran moves, so let’s clarify a few key points:
• Even though cutting off cost sharing subsidies directly relates to low-income people, it’s people with higher incomes who will bear the biggest costs: because they don’t qualify for subsidies under Obamacare. So if prices go up 20% due to the end to cost-sharing payments, they’re footing the whole bill. Lower income people could still be hurt if insurers pull out, leaving some markets bare of coverage. The Kaiser Family Foundation has a Twitter Moments presentation that’s pretty good.
• Obamacare rolls will absolutely suffer a blow because Trump’s move comes so close to the start of open enrollment for 2018. Trump just added a layer of uncertainty to an already confusing process, and has shortened the enrollment period and cut funds way back to help people sign up. So this will almost certainly lead to fewer people signing up next year, especially healthy people (sick people, who absolutely need insurance, will be more resolute about buying it).
• Iran deal only sounds confusing, because it’s so meaninglessly convoluted: Trump, who does have the power in this case to completely pull out of the deal, has instead just declined to recertify it. That means it’s on Congress to reimpose unilateral sanctions on Iran, which they probably won’t do. So for now, we’re still in the deal. Pretty much all Trump accomplishes is going on the record that he hates it, and doesn’t consider Iran in compliance with anything, as he shapes his Mid-East policy.
U.S. Flexes Muscle On Korean Peninsula This Week, Will North Korea Respond As It Often Does, With A Missile Launch?
The U.S. has sent an unusually hefty military group to participate in joint exercises with South Korean troops, including an aircraft carrier and nuclear sub. In addition, the U.S. military will show off a bunch of bombers and fighters at an airshow in South Korea this week. North Korea has not launched a missile in nearly a month, but has taken the opportunity of joint exercises to do so in the past.
Here’s Why Deregulation Isn’t Always The Answer
The Washington Post and 60 Minutes put out a joint story over the weekend about a major, successful campaign led by the DEA to limit illegal opioid distribution that was completely undermined by pharmaceutical lobbyists and members of Congress (including one whom Trump has tapped to be his “Drug Czar”).
The DEA’s original efforts cut off questionably large or unusual shipments of opioids from drug wholesalers, or fined the wholesalers if they did them anyway.
What jumped out at us is the statement of a retired DEA official who said of major pharmaceutical distributors: “All we were looking for is a good-faith effort by these companies to do the right thing, and there was no good-faith effort. Greed always trumped compliance.”
Then Who’s Mark Antony?
Steve Bannon in a speech this weekend likened Mitch McConnell to Julius Caesar (hardly) and mused about what apparently loyal crony would turn “Brutus” on the Senate Majority Leader and purge him from power (after his many failings, the biggest, apparently: not being blindly loyal to Trump).
We’re more interested in who’d be the next Mark Antony.
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