The Basically Just One Topic Edition
I know the last two weeks' TWIPNs have been short and late. Once again, the week just got away from me. But really, who needs the additional heartache anyway, right? (Wow, this hits way too close to home.)
TRUMPCARE'S DEATH RATTLE REQUIRES IMMEDIATE ATTENTION: After late July’s unbelievable win for the Forces of Good against those seeking to strip millions of health care access, I had thought we were basically done with trying to repeal Obamacare. That feeling was reinforced earlier this month, when Trump tweeted his apparent view that the GOP should move on to tax cuts and forget about Obamacare. In short, I got complacent. But in the last 48 hours, a new repeal effort seems to be gaining speed -- and we must mobilize, once again, to kill this final, last-ditch effort. The new bill, called Graham-Cassidy, is just as bad (if not worse) than the earlier repeal bills. The bill “essentially turns control of the health-care markets over to the states. Rather than funding Medicaid and subsidies directly, that money would be put into a block grant that a state could use to develop any health-care system it wants. It also allows states to opt out of many ACA regulations. . . . Medicaid expansion and subsidy funding would be cut sharply compared to current spending, going to zero in a decade.” The bill eliminates the individual and employer mandate; eliminates all current subsidies, allowing states to continue them or not as they see fit; permits insurers to refuse to cover certain medical treatments (ie, effectively permits discrimination based on health status); allows insurers to charge older customers far more; would fund Medicaid on a per capita basis (just like the original Trumpcare/senate bill), rather than ACA’s open-ended funding; and allows states to cut or redefine what constitute “essential health benefits” that must be covered (permitting the sale of junk insurance and creating a backdoor to annual and lifetime caps).
So the bill is substantively terrible. Now for the politics: The GOP has exactly two weeks (until the end of September) to pass this with a 51-vote margin, when the current budget resolution expires. After that, they’d have to pass a new budget resolution or get 60 votes -- both unlikely events. But the bill has similar (and potentially graver) political challenges as the old repeal bills because of the slashes to Medicaid and the concomitant loss of coverage for millions of Americans. In addition, as Vox points out, the bill “will have clear state-by-state winners and losers in a way that other bills did not. This is because its block-grant formula redistributes the Obamacare funding from states that expanded Medicaid to states that did not.” For example, Alaska, Arizona, and West Virginia -- to name just three states with crucial GOP senators -- would likely lose hundreds of millions of dollars, though Cassidy is trying to change the numbers to get these senators on board. McConnell has pledged a vote if 50 of his 52 members support the bill. What’s scary to me is that 49 Republicans have already come out and voted for a similarly cruel and ridiculous bill, so they face little downside to voting again. And this time, McCain is less likely to be the saving figure, given his Best Bud status with Graham. So that could get them to 50 right there. Andy Slavitt reports that the bill’s funding is being shifted around to move money from blue states to red states, especially Arizona (to get McCain).
MoveOn’s Ben Wikler explains more about the actual process ahead of us. Here are the highlights. First, the GOP conference meets tomorrow (so that’s a good time to CALL). Then they go home for a recess on Wednesday through Monday, which means you should look for (or plan your own) protests and JOIN THEM. The Senate can only vote if the CBO gives a score to the bill, but the GOP is now asking the CBO to score only the cost and not the coverage (ie, how many people lose access); Dems will fight against this. If the bill is going to come to a vote, there are exactly three days for a possible vote: September 27-29 (the 30th is Yom Kippur). Wikler also notes that McCain has said that he won’t vote without hearings, so Sen. Johnson has scheduled a show-hearing (wrong committee, no real warning). And then the bill will come for a vote with ZERO hours of debate (Wilker explains how that works here -- the bottom line is that Graham-Cassidy will be simply an amendment on the AHCA, the original House bill that the Senate took up months ago and used up all debate on).
Folks, we need CALL CALL CALL. I know it’s hard to mobilize on this right now when there is so much going on that merits our attention and concern (and our hiding under the covers with our fingers in our ears), but we have TWO WEEKS to kill this bill. If you live in Colorado, Ohio, Arizona, West Virginia, Nevada or Alaska, CALL YOUR SENATOR. If you live in any other state represented by a Republican, CALL YOUR SENATOR. We have beaten this effort many times in the past few months; we need to do it one more time in the next two weeks. Let’s do this.
THIS COULD BE THE WAY FORWARD FOR DEMS: I want to highlight this article by Brian Beutler, in which he argues that the policy agenda that will move the Dems back to majority status should be tackling the concentrate of corporate power (ie, antitrust reform). It sounds dry. But it is in many ways the defining issue of our time. (Josh Barro made a similar though less-well-thought-out point in June.)
Buetler outlines how the Consumer Finance Protection Board, Elizabeth Warren’s brainchild, was born and has thrived over the last few years, and advocates for a similar effort to address monopolies. First, we must move away from evaluating mergers only on the “consumer welfare” metric (i.e., will consumers pay more) and instead focus on many other important factors, like whether upstream competition is blocked, whether workers will have the ability to move between jobs, whether private user data will be protected, etc. As Roosevelt Institute’s Marshall Steinbaum says, “What we need is, rather than a consumer-welfare standard, a competitive marketplace standard.” “But the critical piece, according to Steinbaum, Khan, and others, will be whether Democrats advocate a reversal of the government’s basic presumption that mergers are permissible, and instead require companies to show that their mergers will benefit the economy across these metrics before a merger can be approved.” Lefty scholars are now drafting antitrust white papers and bills for the Democrats to introduce and discuss. “By the time Democrats set about selecting their next presidential nominee, a seriousness about antitrust reform—not empty platitudes, but detailed commitments—will be a litmus test.” Of course, this could force the Dems into direct conflict with their biggest donors, including the tech giants. Read the article to learn more about this issue and the politics surrounding it. I think it needs to be a central component of how the Democratic party moves forward. We need this issue to give people a reason to vote FOR Dems, and not just against the GOP. (Josh Barro has an interesting column about how the anti-monopoly drive will probably fail against Big Tech because the monopolistic tendencies of firms like Google and Facebook are popular. He advises focusing on pharma, hospitals, and telecom companies.)
Endorsements:
- At the risk of stepping into a possible minefield, I highly, highly recommend this Emily Yoffe article about the disturbing problems with campus adjudications of sexual assault, problems that were in large part caused by well-intentioned Obama-era reforms. We need to take sexual assault seriously. And we also need to avoid a mob mentality that confirms guilty without process and that gets swept up in its own momentum and bureaucracy. This article is a convincing argument that current rules are deeply damaging -- and that the current administration’s determination to rethink those rules is sorely needed. (If you think Yoffe gets it wrong, I’d love to hear from you.)
- This interview Hillary Clinton gave to Pod Save America. Her thoughts on Bernie’s freedom to propose wild new programs, while she felt obligated to defend and build on Obama’s record, were really interesting and something I had not thought of before. She also comes off as warm, intelligent, and pissed as hell. It’s nice.
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