Even with the additional two weeks Senate Majority Leader Mitch McConnell added to the schedule, delaying the start of his chamber's recess, the Senate and the House have their share of several hot button issues -- including health care, Russia, the border wall and sanctions -- to address in the coming days.

The House is expected to wrap up work by Friday. House Speaker Paul Ryan and GOP leaders have said they will only call members back into town if the Senate is able to pass a health care bill and the House needs to take it up. They have vowed to give 72 hours' notice in the event they schedule votes over the recess.

President Donald Trump's family will be in the spotlight as Congress' investigations into Russian interference in the 2016 elections continue to meet with witnesses and hold hearings.

Trump's son-in-law Jared Kushner is scheduled to be interviewed by Senate intelligence committee staffers behind closed doors Monday and speak with the House intelligence committee members Tuesday.

In a joint statement, judiciary committee Chairman Chuck Grassley and top Democrat Dianne Feinstein said, "(W)e will not issue subpoenas for them tonight requiring their presence at Wednesday's hearing but reserve the right to do so in the future."

Sources familiar with the matter say no date has been set for his and Manafort's private interviews with the committee. Both the Senate and House probes continue to push ahead and additional witnesses could appear.

The Senate is expected to vote Tuesday on the procedural motion to bring up the House passed Obamacare repeal legislation, but as of this weekend there continues to be confusion on what exactly senators are going to be asked to vote if that passes.

As it currently stands, Senate leaders do not appear to have the votes to advance their health care plans. After McConnell's strategy on his revised bill fell apart last week, a White House session with Republicans with the President urging a vote forced members back to the negotiating table.

If the GOP is unable to get onto the health care bill, there could be a movement to clear some nominations for executive branch appointments.

If health care remains at an impasse, congressional observers will be on the lookout to see whether McConnell sticks with plan and keeps senators in town for votes on issues other than health care.

For House members, this is the last week in Washington before a five-week summer recess, and they are struggling with two major items they hoped to complete this month -- a broad government funding bill and a budget that sets up a major overhaul of the tax code.

Without agreement on the spending measure, House Republican leaders have instead scheduled a vote on a scaled down security-focused bill, that will include money for the next fiscal year for the military, veterans, energy programs and the border wall that Trump promised he would build during the 2016 campaign. Leaders expect dozens of amendments on a range of issues, and a final vote will likely happen Friday. The measure is expected to pass on a mostly party line vote.

House GOP leaders hoped to approve a budget resolution, which is crucial to their effort to pass major tax reform legislation this year. The leadership's plan was approved by the budget committee last week, but there are no plans for a floor vote yet because of continued splits inside the Republican conference on the size of the mandatory spending cuts.

The House will vote Tuesday on the bill that would include new sanctions against Russia, Iran, and North Korea, according to House Majority Leader Kevin McCarthy's schedule, and the Senate is likely to take it up after that, although Senate leaders haven't yet specified their timing.

"The administration is supportive of being tough on Russia, particularly in putting these sanctions in place," Sanders told ABC's this week.

Trump has not publicly said how he feels about the sanctions package, but did tweet about Russia on Sunday.

House and Senate Democrats will gather Monday for an event in Berryville, Virginia, where they're set to release their economic agenda heading into the 2018 midterm elections.

Their priorities, which they'll campaign on for the next year and a half, consist of three objectives: lower costs for everyday expenses, raise wages and improve job training.

After their devastating presidential election loss last year, Democrats have been soul-searching for a message to help resurrect the party in the Trump era. And the title of the agenda -- "Better Deal: Better Jobs, Better Wages, Better Future" -- invokes memory of the post-depression New Deal launched by President Franklin D. Roosevelt.

CNN's Tom LoBianco, Manu Raju and Jeremy Herb contributed to this report.

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Recess looms over Congress' busy week: Health care, Russia investigations - CNN

As lawmakers in Washington remain divided over the future of health care in the United States, Sen. John Barrasso, R-Wyoming, says there should be a bipartisan approach when it comes to legislation.

"Should have been bipartisan when Obamacare was passed. It should be now as well," Barrasso said Sunday on "Face the Nation."

"For big things that affect the country, it should be done in a bipartisan way," he added.

But while Barrasso is supportive of a bipartisan effort to changing existing health care laws, he said that "with this resistance movement to President Trump and the energy in the Democrat Party," Republicans have been given the impression by top Democrats, like Chuck Schumer of New York and Elizabeth Warren of Massachusetts, that the GOP should "expect no cooperation" in the health care debate.

When pressed if any Republicans had reached out to Democrats in the hopes of creating a bipartisan effort on legislation, Barrasso said he's visited the floor of the Senate with a number of Democrats, but that they have put forth their own contentions to major aspects of the bill.

"They say, 'Well, you know, we do want to work together, but there are a couple things. One is, don't touch the mandate.' Well, the mandate, the individual mandate that says people have to buy a government program, that's the most hated part of Obamacare," said Barrasso.

Meanwhile, Republican Senator Susan Collins of Maine told "Face the Nation" that she would like to see Congress go back into committee and hold hearings on the matter.

Play Video

Senator Susan Collins, R-Maine, discusses the latest on the Russia investigations and the path forward for replacing Obamacare with Face the Nati...

"We could divide this issue into separate bills and take a look at the serious flaws in the Affordable Care Act, the most serious of which right now is the collapse of the insurance market in several counties throughout this country, so that people who have subsidies won't have an insurer that can sell them insurance," Collins said on "Face the Nation."

"That would allow us to hear from expert witnesses, to get input from actuaries and governors and advocacy groups and health care providers, and most important, from members of both sides of the aisle, Republicans as well as Democrats," she added.

Collins was one of three GOP holdouts who along with Sen. Shelley Moore Capito of West Virginia and Sen. Lisa Murkowski of Alaskaeffectively killed the Republican effort to vote on health care. They announced that they would oppose Majority Leader Sen. Mitch McConnell's efforts to move forward with the latest bill.

While it is still unclear what form of the health bill the Senate willconsider in a vote set for Tuesday, Barraasso says there are a variety of ways for the Senate to replace the "failing Obamacare health care plan," adding that for his fellow Republicans who ran on repealing and replacing Obamacare, "This is our chance."

"We are going to vote this week. And I think until the vote is actually on the floor of the Senate, some people may not tell you what they're actually going to do," he said.

Regarding the back-and-forth in Congress, he said, "I was in the Wyoming legislature for five years. That's what legislation is all about. You get a bill on the floor of the House or the Senate. We get a bill, and then you start adding amendments. You bring your best ideas forward. And then people vote up or down."

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Barrasso on health care: "It should be done in a bipartisan way" - CBS News

My colleague Amanda Marcotte and I sat down for Salon Talks with Carrie Lukas, president of the Independent Womens Forum(IWF), to discuss how the unresolved debate over health care policies in the Republican-dominated Congress impact womens health issues.

IWF is a conservative and libertarian organization that createsmessages about how women and families can be empowered by the free market rather than big government. With headlines like, In the Poconos, Another Small Business Falls Victim to Unnecessary Licensing and Who Cares for the Caregivers? and Trump Education Departments Likely Changes in Campus Sexual-Assault Policy Causes Angst Among Activists, IWF writes about health care, women at work, education, women in politics and more.

When it comes to womens health, is there an imbalance in health care costs?

Carrie Lukas: If youre an infertile woman, lets say or a woman who doesnt want to have kids I can imagine saying, You know what, my insurance has gone up the same as a woman whos had five kids. I dont know why everybody should have to be subsidizing maternity expenses.

Should we have to subsidize other peoples health care expenses in the first place?

Amanda Marcotte: Im happy to pay that money [for another womans maternity costs] so that when I get cancer, her higher premiums cover me.

Should we subsidize each others costs when it comes to beliefs? For example, why should a person who doesnt drink for religious reasons pay for substance abuse programs?

Marcotte: If I get hit by a car driven by a drunk driver, and they didnt get alcohol abuse treatment, then yes, that does affect me. Its a community issue we all depend on each others health care.

Link:

WATCH: How would the GOP health care plan affect women? - Salon

Several leading veterans groups are voicing opposition to House legislation scheduled for a vote Monday that would shift $2 billion from some veterans programs to fill a budget shortfall in a choice health care plan that allows veterans to see a private doctor.

The groups, representing 21 million veterans, said the legislation is unacceptable because it would divert tax dollars from Department of Veterans Affairs programs without addressing other critical problems in the VA system.

We oppose legislation that includes funding only for the choice program which provides additional community care options, but makes no investment in VA and uses savings from other veterans benefits or services to pay for the choice program, the groups said.

The statement was signed by AMVETS, Disabled American Veterans, the Iraq and Afghanistan Veterans Association, the Military Officers Association of America, the Military Order of the Purple Heart, the Veterans of Foreign Wars, Vietnam Veterans of America and the Wounded Warrior Project.

The House Committee on Veterans Affairs released the proposal on Friday, and Republican leaders have scheduled a vote by the full House for Monday night. To offset spending, the VA would trim pensions for some veterans who are in nursing homes covered by Medicaid and collect fees for housing loans.

Lawmakers and the VA are trying to find a solution to a funding shortfall in the Veterans Choice program, which allows veterans to seek a private doctor if they live more than 40 miles from the nearest VA medical facility or if they cant get an appointment in the VA system within 30 days. The legislation would extend that program for six months.

The popular program was created as a response to a scandal in 2014 in the VA system over delayed care and veterans who died waiting for appointments. But the choice program is due to run out of money in mid-August, and the VA already has been cutting back on private care options for veterans in the meantime.

The VA has an annual budget of about $167 billion.

The veterans groups opposed to the legislation said Congress should beef up both the choice program and other services for veterans instead of shifting money around within the VA budget.

If new funding is directed only or primarily to private sector choice care without any adequate investment to modernize VA, the viability of the entire system will soon be in danger, the groups said.

Another veterans group that favors providing veterans with more private-sector options, Concerned Veterans for America, has endorsed the legislation.

CVA policy director Dan Caldwell called the House measure a practical solution that will address the problem quickly and in a fiscally responsible manner.

This plan will ensure that the veterans who have been able to successfully use the choice program will not face any lapses in care due to the program running out of money in the coming weeks, Mr. Caldwell said. We urge Congress to reject straw man arguments from defenders of the status quo who are using this moment to advance their anti-choice agenda instead of doing whats best for veterans. There is no reason to tie fixing the Veteran Choice Program to other unnecessary spending increases, especially considering that a VA appropriations bill, with a nearly $2 billion dollar budget, is already in the works.

Still another group, the Paralyzed Veterans of America, chose not to take a position on the legislation. It said tradeoffs in VA budgeting are nothing new.

Paralyzed Veterans main concern is that using these offsets to pay for VA health care comes at the expense of expanding nonhealth care benefits, such as disability compensation, said executive director Sherman Gillums Jr. However, we are not prepared to simply oppose offsets because we believe VA is open to strengthening health care for our most catastrophically disabled veterans, which matters above all else.

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Vets balk at Hill proposal to offer 'choice' health care - Washington Times

For decades, US health reform has failed to address root causes.

Republican proposals such as the Better Care Reconciliation Act of 2017 and Democratic efforts such as the Affordable Care Act have focused on financing reform, re-jiggering the rules by which insurance products are designed, offered, and priced.

Little, if anything, has been done to address the underlying prices of health care goods and services.

Daily Emails and Alerts - Get the best of Newsweek delivered to your inbox

As a result, regardless of the Senate bills fate, it seems the US has committed itself to an inexorable march toward ever-more health care spending. It is essential that the American people recognize what we are foregoing by our choice to let health care spending grow unchecked.

As most readers now know, roughly 18 percent of the USs gross domestic product (GDP), $3.23 trillion annually, is spent on health care. Many industrialized countries achieve consistently superior health outcomes by spending only 12 percent of their GDP on health care.

What if, hypothetically speaking, the US were to follow suit? No one could accuse the US of skimping as 12 percent of the GDP is approximately $7,180 to be spent per capita, topping nearly every industrialized country even after adjusting for purchasing power parity.

Madison Tolchin visits Paula Glass, an advanced registered nurse practitioner, for a health checkup at a Planned Parenthood clinic on April 14, 2017 in Wellington, Florida. Joe Raedle/Getty

At 18 percent of the economy absorbed by health care, we have little room for other health-promoting investments. Our work suggests that directing these resources towards social service delivery could be a strategic way to bolster health system performance and improve outcomes.

Countries and states that allocate more of their total spending to social services in comparison to health services tend to achieve better health.

An impressive 2012 paper titled A Health Dividend for America by Jeffrey McCullogh and colleagues at UCLA lend some shocking figures to this debate.

For $57.8 billion annually less than half of one percent of our current health care spend a host of social investments, all health-producing in themselves, could be made.

Head Start could be doubled in size to include an additional 900,000 children and universal pre-school education could be possible for all pre-k students who are not already enrolled in Head Start (cost: $12.8 billion).

Federal grants could be available to every small town in US so that the public library system could be expanded to reach 30.7 million additional beneficiaries over the next 10 years (cost: $6.9 billion).

Career training could be provided for one quarter of all unemployed people (cost: $18 billion). Job Corps could be doubled to serve an additional 45,000 people (cost: $1.7 billion) and nutritional assistance could be expanded to all 50 million food-insecure individuals in the US (cost: $18.4 billion).

These investments would leave a hundred billion more dollars available to be directed towards debt reduction, tax breaks, or other causes receiving bipartisan support for still less than half a percent of US GDP.

The investments enumerated above generate valuable social ends in their own right. In many cases particularly where spending is directed towards schooling, jobs, housing, and nutrition available evidence suggests that policymakers may expect substantial spillovers in the form of improved health and reduced health care utilization.

Food such as SNAP may provide a particularly illustrative example.

New research released this month by Dr. Seth Berkowitz and colleagues at the Harvard Medical School finds that food insecurity was associated with significantly greater emergency department visits, inpatient hospitalizations, and days hospitalized.

On average, people who were food insecure cost an additional $1,863 in health care expenditures per year, amounting to an excess $77.5 billion annually nationwide. Although not all of this gap could be closed through food supports, some savings could reasonably be expected.

We recognize that extracting health care dollars from our current system is a political challenge if not impossibility. Nevertheless, the public should be aware of the opportunity costs associated with health care spending.

The ongoing outpouring of public support for Medicaid is noble, and efforts to extend financial protection for health care expenses to all should continue; however, more honest discussions about the tradeoffs inherent in health care financing are warranted.

To date, our relentless focus on changing the rules of health care financing has ignored underlying price concerns and overlooked the crowding out of other worthy social investments. Until the public faces up to these uncomfortable truths, the nation is unlikely to make sustainable progress on health reform.

Elizabeth Howe Bradley is president of Vassar College and was the Founder and former Faculty Director of the Yale Global Health Leadership Institute. She has written or co-authored three books including The American Healthcare Paradox: Why Spending More Is Getting Us Less.

Lauren A Taylor is a doctoral student at Harvard Business School and co-author of The American Health Care Paradox.

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Cheaper, Better Health Care Is In Our Grasp. Why Don't We Grab It? - Newsweek

Senate Republicans will try to advance a stalled healthcare reform bill next week while the House takes up the first group of fiscal 2018 spending bills, funding for a southern border wall and a measure to roll back an Obama-era banking rule.

Senate Majority Leader Mitch McConnell, R-Ky., hopes to hold a vote next week on the Better Care Reconciliation Act, the Republican-authored proposal to repeal and replace Obamacare. Because several moderate and conservative GOP holdouts are refusing to sign on to the bill, McConnell is threatening a politically unattractive alternative: a vote on simply repealing Obamacare, which most of the GOP supported in 2015 when a veto was assured from former President Barack Obama. Several Republican lawmakers are unsure about a plain repeal now.

"We are going to vote on whether to proceed to the bill," Majority Whip John Cornyn, R-Texas, told reporters Thursday. "I know people are fixated on what bill to proceed on, but every senator can offer amendments to change the bill, so it really is irrelevant. This is strictly about whether we are going to start the debate. People can offer amendments so we can finish at some point."

The House, which passed its own healthcare bill and is waiting for the Senate to act, will deal with fiscal 2018 appropriations legislation.

Next week is scheduled to be the final House legislative session before a planned five-week recess, but Majority Leader Kevin McCarthy said he would call lawmakers back to Washington to consider a Senate-passed healthcare bill if one passed in the upper chamber. The Senate is scheduled to be in session until Aug. 11.

In the meantime, House lawmakers will vote on the Make America Secure"appropriations act, a measure that combines the fiscal 2018 spending bills for defense, energy and water, the legislative branch, military construction and veterans affairs.

It's a bill that Democrats are vowing to oppose despite the inclusion of a 2.4 percent pay increase for military personnel and a boost in funding for the U.S. Capitol Police.

Republicans plan to use a procedural maneuver to attach an additional $1.6 billion for President Trump's desired southern border wall, which he repeatedly promised during his 2016 campaign.

"Yes, we are taking action," McCarthy said last week. "Just as we said we would do."

Democrats do not support the wall funding. They also accuse the GOP of bringing up spending bills that will never become law because Democratic approval will be needed to get through the Senate.

"Instead of wasting floor time on a smoke-and-mirrors appropriations package that will do nothing to improve our security, the majority should immediately begin working with Democrats on a new budget agreement," said Rep. Nita Lowey, D-N.Y., the top Democrat on the House Appropriations Committee.

The House also plans to revive a procedure it has used more than a dozen times this year to reverse executive branch regulations. Republican leaders plan to vote on the repeal of a banking regulation under the Congressional Review Act, which allows Congress to undo certain executive branch actions with simple majorities in both chambers.

The targeted regulation was imposed in July by the Consumer Financial Protection Bureau, which is led by Obama appointee Richard Cordray. The regulation ends mandatory arbitration for consumers in legal fights with the banks, making it easier for individuals to sue.

The House vote aims to undo the new rule. Republicans say the regulation will force financial institutions to pay for costly class-action suits that benefit only trial lawyers, not consumers, who they say can collect more in arbitration than in court.

Democrats plan to oppose the bill.

"House Republicans are continuing their assault on the financial security of the American people by trying to deny consumers their right to go to court when wronged by a financial institution," said Minority Leader Nancy Pelosi, D-Calif.

Another key fight next week will be on whether to revoke the current authorization for the use of military force by the president. The House spending bill initially included a provision revoking that authority, which would have required Congress to take politically treacherous vote on a new war powers act.

However, Republican leaders used a procedural maneuver to strip it out of the bill and hid the move in the rule governing debate on the spending bill. The move angered Democrats who are likely to raise the issue during debate next week.

"The Republican Congress is subverting the legislative process and abdicating its solemn constitutional responsibility to debate and authorize the Trump administration's use of force," Pelosi said.

Instead of voting to eliminate the war powers authority, Republicans will instead hold a hearing in the House Foreign Affairs Committee on Tuesday on terrorism that will examine "grave threats and authorities that empower our men and women in uniform to carry out important missions that help keep us safe."

Originally posted here:

Next week: Healthcare, border wall and a fight over war powers - Washington Examiner

On Friday, Senate Democrats released a list of provisions in the Republican health-care bill that the Senate parliamentarian holds can pass via a simple, filibuster-proof majority vote. Among those provisions that didnt meet her scrutiny are the bills plans to defund Planned Parenthood, restrict tax-credit funding for insurance plans that provide abortions, and a six-month lockout period from purchasing insurance for people who dont maintain continuous coverage.

If this preliminary guidance holds, the Better Care Reconciliation Actwhich is already in dire straitsseems likely to fail.

The GOP Escalates Its Battle With the CBO

The final assessment of the parliamentarian, Elizabeth MacDonough, is a critical step in the GOPs strategy for passing their bill to repeal and replace Obamacare. Republicans have opted to pass their health-care legislation via the special reconciliation process, under which they can cut debate short in the Senate and thus eliminate indefinite filibusters, which Democrats would certainly use in order to block any attempt to repeal Obamacare. But bills have to follow a certain procedurecalled the Byrd Rulein order to pass by reconciliation.

Broadly, the Byrd rule states that reconciliation legislation can only include changes to laws that directly affect the federal budget, and can be scored by the Congressional Budget Office. So for example, Republicans could repeal Obamacare premium tax credits via reconciliation by making the credit $0 for everyone, but couldnt in theory use the same bill to eliminate the requirement for insurers that take premium tax credits to also take people with pre-existing conditions.

In practice, the parliamentarian reviews every provision of a reconciliation bill and outlines which ones pass muster under the Byrd rule by her own judgment. In this instance, according to the Democratic outline, MacDonoughs office ruled that abortion restrictions on the premium tax credit and the small business tax credit, and the language defunding Planned Parenthood, violate the Byrd Rule. Additionally, other provisions on the chopping block include the BCRAs six-month continuous-coverage lockout, and its sunset of minimum requirements for alternative private-administered Medicaid plans.

Still under review are the BCRAs provisions that allow states to waive certain essential health benefits for exchange plans, increase the age-rating scheme for older adults, and allow Medicaid funding to go to states in lump sum block grants.

Notably, all of these provisions that have either been challenged by the parliamentarians office or still await a final determination are those that were included in the BCRA to gain the support of hard-core conservatives, who, like their counterpart moderate faction have often criticized the bill and could harpoon any legislative action. Its hard to see how a bill that retains Planned Parenthood funding and the use of premium tax-credits for plans that cover abortion would proceed to debate through conservative objections.

There is hope among the backers of the bill that the parliamentarians guidance would allow them to rewrite the key provisions in a way that would allow them to pass the Byrd rule. But the clock is ticking, and substantive rewrites might have to pass CBO review again, and the CBO has been a thorn in Republicans side over the past few weeks.

Some Republicans are hinting at more radical steps to get past MacDonoughs review. Senator Ted Cruz of Texas has been floating the idea of simply ignoring the parliamentarians review for months now. The presiding officer of the SenateVice President Mike Pencetechnically makes the final call on parliamentary procedures, and could overrule the parliamentarians objections, although this would be a highly controversial break of Senate norms that hasnt been attempted for over 40 years.

But this seems to be the era of flouting norms, as evidenced by the increasing willingness of Senate Republicans to challenge the CBO scoring process, and perhaps even consider the filibuster nuclear option. Its hard to rule anything out at this stage.

Link:

The GOP Health-Care Bill's Byrd Rule Dilemma - The Atlantic

Demonstrators protesting the Senate GOPhealthcare legislation were escorted out of Sen. Cory GardnerCory GardnerProtesters interrupt Senate Republicans speech over healthcare Interior recommends preserving Colorado site's monument status Overnight Energy: Exxon sues feds over M fine | Deputy Interior pick advances | Oil concerns hold up Russia sanctions push MOREs (R-Co.) speech addressing healthcare at a conservative conference on Friday.

Video shows police escorting protesters, who were chanting save our liberty, no cuts to Medicaid during Gardners speech, out of the room.

Here's video of the moment when people interrupted Sen. Gardner and when the police showed up to escort them out. pic.twitter.com/eLaKChOxty

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The protesters were from a disability advocate group known as Atlantis ADAPT, according to The Denver Post.

Denvers NBC affiliate KUSA reported two protesters were escorted out.

No arrests were made, according to Denver police.

The latest healthcare protests come after Gardner was subpoenaed to appear in court for cases of five protesters who were arrested at his Denver office.

Gardner is one of many Senate Republicans facing heat for the conferences ObamaCare repeal and replace legislation.

Major portions of the bill require 60 votes, according to the Senate parliamentarian, meaning they most likely will not survive on the Senate floor.

- This post was updated at 10:56 a.m.

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Protesters interrupt Senate Republican's speech over healthcare - The Hill

CHEYENNE, Wyo. (AP) - Members of Wyomings all-Republican congressional delegation disagree whether they should vote to repeal the Affordable Care Act without a replacement law lined up.

Sens. Mike Enzi and John Barrasso say they might support a bill that would repeal President Barack Obamas signature health care reform legislation with no replacement law in sight. Both have been closely involved in writing a Senate repeal-and-replace bill.

But Rep. Liz Cheney says a replacement law is important. Its really important we dont pull the rug out from people, Cheney told the Casper Star-Tribune.

Neither approach appears likely to pass when the Senate votes on Tuesday.

Some Republican senators say repealing the law without a replacement would be too hard on those covered under the act. Others wont consider repealing the law only to see it replaced by a similar one.

The Congressional Budget Office estimates the latest bill put forward by Senate Majority Leader Mitch McConnell would lead to an additional 22 million additional uninsured people by 2026 and drive up premiums for many older Americans.

The repeal-only bill would leave an additional 32 million additional people uninsured over a decade and double average premiums.

Despite disagreeing with Barrasso and Enzi, Cheney praised their work on health care reform.

Wyoming couldnt have two better people in the position theyre in to make sure we get something that works for Wyoming, Cheney said.

___

Information from: Casper (Wyo.) Star-Tribune, http://www.trib.com

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Wyoming delegation differs over best health care approach - Washington Times

The program also isn't working for doctors. The reimbursement rate is roughly half that of private insurance, according to research by the Kaiser Family Foundation. Participation requires reams of paperwork, approvals, and delays in reimbursements. Patients, as a result, increasingly cannot find a doctor to treat them. Over half of doctors no longer accept new Medicaid patients, according to the Department of Health and Human Services, and stories of patients trying dozens of times in vain to get an appointment are not uncommon.

Expanding charity care can relieve some of the Medicaid burden. Perhaps even more importantly, such an uncontroversial reform could achieve the bipartisan support necessary to become law.

Charity health care, where doctors volunteer a certain number of hours a week and donations cover variable costs, has a long history in the United States. There are currently over 1,200 charitable clinics nationwide, largely operating outside and parallel to the Medicaid system.

One major advantage of charity care is that doctors can have their medical insurance costs covered by the federal government under the Federal Tort Claims Act when working in a charity clinic that meets federal government requirements. This allows them to provide good care, but not excessive or defensive medicine, worried that their good deed may go punished.

Charity care could be expanded further if state governments, which have the most to gain from its implementation, cover the private practice liability insurance costs of any physician who volunteers a certain number of hours per week in a free clinic.

Such a trade would be a bargain for both doctors and state governments. The average primary doctors would save roughly $12,000 in annual malpractice insurance premium costs. Specialists would save even more. In return, by keeping Medicaid, uninsured, and undocumented patients out of expensive and overburdened emergency rooms, the state would save hundreds of thousands of dollars per doctor. As an added bonus, defensible and costly malpractice lawsuits would likely be reduced because of the bigger burden associated with suing the government instead of the individual physician.

Dr. Alieta Eck, who runs the Zarephath Health Center, a charity clinic in Somerset, New Jersey, shows how this model can work in practice. By relying on donated physician time and cutting out the burdensome Medicaid bureaucracy, the cost to provide care comes to $15 per patient visit (covered by donations). This is compared to the roughly $1,000 it would ultimately cost the taxpayer if the patient ended up at the ER.

She's spearheaded a New Jersey bill, S239, that calls on the state to provide liability coverage for the private practices of physicians who donate at least four hours per week in a charity clinic. Similar proposals are alive in several states across the country.

While trial lawyers may object, opposing charity care expansion is a dim prospect for even the most hardened partisan legislator. Such small yet beneficial reforms are now the best hope to improve American health care.

Commentary by Joel L. Strom a Beverly Hills dentist and a fellow at the Unruh Institute of Politics at the University of Southern California.

For more insight from CNBC contributors, follow @CNBCopinion on Twitter.

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Here's a health-care fix that's small but powerful - CNBC

WISE, Va. The sick and the disabled pour out of these mountains every summer for their one shot at free health care, but this year was supposed to hold hope for a better solution.

Donald Trump won the White House in part on a promise to fix the nations costly and inefficient health-care system. Instead, Republicans in Congress are paralyzed and threatening to dismantle the imperfect framework of Obamacare.

[Trumps promise to very quickly repeal and replace Obamacare runs into reality]

No relief is in sight for someone like Larry McKnight, who sat in a horse stall at the Wise County Fairgrounds having his shoulder examined. He was among more than a thousand people attending the areas 18th annual Remote Area Medical clinic, where physicians and dentists dispense free care to those who otherwise have none.

I really think that they dont have any clue whats going on, McKnight said of political leaders in Washington. You watch the news and its two sides pitted against each other, which in turn just makes them pitted against us, the normal person.

About 1,100 such people descended on the fairgrounds Friday, with more expected Saturday and Sunday. Medical personnel from across the state were there with makeshift examination rooms in tents and sheds. Sheets hung from clothespins for privacy; giant fans pulled hot air through buildings intended for livestock shows.

These events are staged nationwide, but the Wise clinic is among the biggest, drawing people from throughout Appalachia and casting Washingtons sterile political debates into the starkest human terms.

A third of the patients who registered Friday were unemployed. Those who couldnt afford a room slept in their cars or camped in the fields around the fairgrounds. They lined up in the dead of night to get a spot inside the event.

It is the place of last resort for people who cant afford insurance even under Obamacare or who dont qualify for Medicaid in a state where the legislature has resisted expansion.

At 37, with a long graying ponytail, McKnight had never been sick until about eight months ago. So he hadnt worried too much about not being able to afford insurance on his roughly $18,000 a year in pay as an auto mechanic. But now he was getting a referral to the University of Virginia hospital to check for the source of his pain, which he had vowed to withstand without resorting to opioid medication.

The normal person doesnt care about a lot of the things that they care about [in Washington]. Most people want to work, they want insurance and they want to be able to take care of their family without assistance, he said.

The only way to do that, he said, is to have everybody the healthy and the sick paying into a centralized health insurance plan. I really think the only thing that would truly help this country is if it were single-payer, McKnight said.

Around here, thats not politics, its just life. Many of these people voted for Trump not only for his vow to fix health care, but also for his promise to bring back the coal industry. Theyre still waiting for results, with varying degrees of patience.

[Trumps promise to bring back coal jobs wont be met, experts say]

Patricia McConnell was having trouble speaking around the bloody gauze in her mouth. She had just had four teeth pulled. The unemployed former manager of a McDonalds had driven eight hours from her home in Glen Burnie, Md., to attend the clinic.

My teeth were hurting, she said. McConnell, 63 and disabled, said she had health insurance through Medicaid but no dental coverage.

So this was her dental plan: Shed save for six months to afford a motel room and gas, then wait in line in the morning heat to see a volunteer dentist.

McConnell has been watching the health-care debate in Washington and wondering if it will ever amount to anything that actually helps people like her. I dont know what theyre trying to do, she said, struggling to get the words out around the gauze.

She voted for Trump, she said, and still feels that hes working hard to help. But his anger and his tweets seem to aggravate Congress, and no one is working together, she said.

They need to set all that aside and work to pass health care for everyone, she said. Lets get this done.

Others had a hard time mustering the faith that anyone cared.

Theyre trying to kill us poor people, is what theyre trying to do, said Robert Horne, 55, a disabled former construction worker seeking dental care. Horne said he voted for Hillary Clinton last fall because of her pledge to maintain the Affordable Care Act.

That didnt work out, either.

Virginia Gov. Terry McAuliffe (D), who flew out to the clinic Friday morning, had invited Senate Majority Leader Mitch McConnell to join him but said that the Republican leader politely declined. McAuliffe, who visits the clinic every year, spent nearly two hours touring it twice as long as scheduled and took every opportunity to proclaim that hes been trying for three years to get the state legislature to agree to expand Medicaid under Obamacare.

The Republican-controlled General Assembly has resisted, unlike the legislatures in nearby states, which McAuliffe kept reminding the patients and doctors who crowded around him on the hot fairgrounds.

All of our neighbors in Kentucky and West Virginia and Maryland they did it! he said to a Christian counseling group that had set up shop under an awning. But in Virginia, he said, legislators turned down millions in federal dollars that would be available under Medicaid expansion.

[If Obamacare is here to stay, its time to expand Medicaid, McAuliffe says]

We need it, called out Tonya Hall, operations director for a hospice-care facility. Let them come and visit some in southwest Virginia. Let them see the poverty. Let them see how we live. Let them come.

This isnt about politics, McAuliffe said.

Right! Hall agreed. Its about people.

Its about peoples lives, McAuliffe said to a round of Amens from the group.

Hall, 42, said she had voted for Trump but that she was disappointed he hadnt been able to do anything to improve the health-care system. If Obamacare cant be fixed, she said, then I say we scrap it and start over. You can see the need, she added, gesturing at the masses of people waiting for their turn with a medical professional.

Beyond her, a long line stretched into the triage tent, where people were sorted and their vital signs measured. Allen Sexton, 37, was there to have all his teeth removed, years after a car accident had left them a scrambled mess.

In a metal shed nearby, vision specialists sat in darkness, performing eye exams in pools of light. One man said that his glasses had broken a year ago and that he couldnt see at a distance or up close, but hed been driving anyway.

There was another tent for orthopedic care. Another for basic checkups. Each one was full, with more people waiting outside on metal folding chairs or standing in lines.

Politicians prowled the fairgrounds. Several area legislators attended while Attorney General Mark Herring (D), running for reelection, walked with McAuliffe and Sen. Tim Kaine (D) helped register patients.

Stan Brock, the English philanthropist who founded the RAM clinic program more than 30 years ago, said there was one more visitor hed like to see at the clinic.

Its absolutely imperative that the president of the United States come and visit one of these events, he said. I believe if he did, he would take some immediate action.

Continue reading here:

Thousands flock to free medical clinic, as Washington dithers on health care - Washington Post

Everyones heart goes out to Sen. John McCain battling brain cancer. We pray he survives it as he did his years as a North Vietnamese prisoner of war, which left one arm compromised from severe torture.

Columnist Lynn Sweet surmised his sobering confrontation withhis mortality this week mightmove him to vote in favor ofthe DREAM Act enabling undocumented children to stayhere, having grown up asAmericans.

SEND LETTERS TO:letters@suntimes.com. Please include your neighborhood or hometown and a phone number for verificationpurposes.

From there, its only a short leap to realize McCain received immediate first-rate medicalcare no questions asked, thanksto the platinum insurance coverage he and other senatorsand Congress people enjoy asa fringe benefit: no deductibles; no disqualifying preexisting conditions; no agecutoffs. Bulletproof. Its single-payer coverage like everyone receives in Europe,where health outcomes arebetter at half the cost.

Why deride such coverageas socialism for the rest ofus but not for our federallegislators? Word games. Pure and simple. All that is neededis to re-shuffle the deck andstart fresh, with open minds,seeing as stake-holders notonly the usual players likeBig Pharma, for-profit insurers, etc., but also thepeople.

As long as theres hopeMcCains condition mightdispose him to vote yes onimmigration reform sincewere all pulling for him whynot also hope he speaks in favor of reforming the U.S.health care system for thebetter?

Ted Z. Manuel, Hyde Park

Senate health care bill vote is irresponsible

Tuesday the Senate will be called to vote on a health care plan that will change the lives of at least 32 million people. As of Friday they still didnt know whats in the bill theyre voting on. This bill could be a total repeal of Obamacare, but delayed for two years. It could be a limited replacement. Nobody knows. Whatever side of the health care issue you take, this is irresponsible.

For the last six months, veterans, the elderly and the disabled among others have been on tender hooks about what insurance they would have, or if theyd have insurance at all. In some options that could go on for another two years.

All of the options the Senate leadership are considering would destabilize the insurance market. The ripple effect would spread to everyone who has health insurance whether theyre on the exchange or not. Businesses unsure of next years expenses might be slow with expansion or raises, ultimately slowing the economy.

Our president and our congressional leaders indicate a take our plan or no plan, doesnt matter to us attitude. That doesnt sound like making sure the vast majority of Americans have adequate health care is their priority.

Im asking you to call your senators. Ask them to vote no on any health care bill until they have a fully considered and debated plan that voters have time to review.

Wendy LaFauce, Belvidere

Excerpt from:

LETTERS: The imbalance in health care between legislators and citizens - Chicago Sun-Times

To the editor: You cant repair what is broken. The U.S. spends about twice as much per person on healthcare than other advanced nations and with poorer results. (The U.S. spends more on healthcare than any other country but not with better health outcomes, July 18)

We need to start over. Study successful healthcare systems such as those in France, Switzerland and Singapore. These hybrids mix government coverage and subsidies with consumer choice; they are not purely socialistic, a term we seem to fear.

Create a bipartisan task force and get input from physicians and consumer groups too. If it works in other nations, we can create a U.S. version to work here.

But it will never happen if ego and rigid ideologies declare one side must lose and the other must win. Courageous men and women on both sides of the aisle can do this.

Eileen McDargh Elvins, Dana Point

..

To the editor: This article cites troubling statistics that add up to an embarrassing report on the adequacy of our healthcare system in terms of outcomes.

However, there are certainly many other factors affecting longevity (such as obesity and drug addiction) that are at epidemic levels in the U.S. and should also be factored into the analysis.

Please fill in your full name, mailing address, city of residence, phone number and e-mail address below. Submissions that do not include this information cannot be published. This information is seen only by the letters editors and is not used for any commercial purpose. We generally do not publish...

Please fill in your full name, mailing address, city of residence, phone number and e-mail address below. Submissions that do not include this information cannot be published. This information is seen only by the letters editors and is not used for any commercial purpose. We generally do not publish...

James Maddox, Los Angeles

..

To the editor: This article overlooks the elephant in the room: private insurance companies that consume about 20% of every healthcare dollar.

Two additional reasons for our higher costs that are not mentioned are our failure to reduce drug prices through bulk purchasing and the low ratio of primary care providers to specialists. Primary care physicians decrease costs by coordinating care and providing preventive treatment.

If the government became our insurer, we could cover everyone at a lower cost and have better health outcomes. Thus, if Congress wants to replace Obamacare, it should develop a single-payer system, something that polls now show Americans increasingly support.

Nancy Greep, MD, Los Angeles

Follow the Opinion section on Twitter @latimesopinion and Facebook

Sights, sounds, and the people that made the first day of 2017's Comic-Con a sight to behold.

Sights, sounds, and the people that made the first day of 2017's Comic-Con a sight to behold.

Democrats Debbie Wasserman Schultz and Tim Canova are preparing already for their August 2018 congressional primary rematch by raising and spending campaign money.

Democrats Debbie Wasserman Schultz and Tim Canova are preparing already for their August 2018 congressional primary rematch by raising and spending campaign money.

See the rest here:

What kind of healthcare works in other countries? The US should take a look. - Los Angeles Times

ByLizzie O'Leary and Eliza Mills

July 21, 2017 | 1:56 PM

It's been an uncertain time for health insurance providers. The back and forth debate in Congress over potential plans to repeal and replace the Affordable Care Act has been an ongoing source of stress for consumers and insurers. The complexities seem never-ending and tensions are running high, even within the Republican party.

Medicaid has become a major point of contention, as Republican senators who have expanded Medicaid in their states want to defend their constituents against future cuts.

Sen. Ted Cruz's proposed Consumer Freedom Option amendment, which would allow insurance companies to sell bare-bones policies provided they also sell comprehensive plans, has prompted criticism from insurers. CEOs from the advocacy group American Health Insurance Plans and insurance providers in the Blue Cross Blue Shield Association wrote a letter coming out against the amendment. Under the proposal, people could opt out of maternity or mental health coverage, for example, which could raise the cost of insuring maternity care or mental health to about the actual cost of service.

Craig Hasday, president of Frenkel Benefits, an insurance brokerage and benefits consulting company, joined Marketplace Weekend's Lizzie O'Leary to discuss the ways that the health care debate affects insurance providers and how that affects consumers. The following is an edited transcript of their conversation.

Lizzie O'Leary: What do health insurance markets look like in the U.S. right now?

Craig Hasday: There's a lot of different components of the markets. I mean the vast number of people that have health coverage in the United States are covered by Medicare and Medicaid or by employer provided coverage and within that employer marketplace there's two segments there's the small group marketplace and the large group marketplace. And the large group marketplace is largely self-insured. So when you look at coverage most Americans are actually through the employer covered by self-insured employers and there are no insurance companies.

O'Leary: What does that mean self-insured employers?

Hasday: So insurance means someone's taking risks. Someone is taking a premium and they're paying claims as they're presented. With self-insurance, the employer takes the place of the insurance company: they're taking risks. There might be stop-loss insurance, which is insurance to protect against catastrophic claims, but they're actually paying the claims and making the claims adjudication decisions.

O'Leary: So when you think about where we are right now you work with a lot of companies what do companies come to you guys and say "this is what we want for our employees"?

Hasday:I would say that, largely, employers want to provide the best benefits possible within their budgets. And the budgets vary widely by industry, by profitability of a company, but most employers are good stewards of insurance. Not all, I mean some you know try to get away with as little as they can. It's actually interesting, as the Affordable Care Act went into play there was a lot of consternation among large employers, but really large employers by and large figured out how to navigate around the Affordable Care Act and really not much changed. And you know one of the interesting discussions was regarding the repeal. And I was asked what would happen if there was repeal, what would happen and large employers, and quite frankly, very little. The large employers have largely planned around ACA. The rules would roll back to what they were, and they would eliminate some fees and taxes which they would not have to pay. But really the markets wouldn't really be disrupted for large employers, and for Medicare if there was repeal. The big issue with repeal is Medicaid. And that's a wildcard because so many people have come to rely upon Medicaid benefits.

O'Leary:So what happens if there is just a strict repeal vote? You know these kind of votes that we saw repeatedly in the House? What happens then?

Hasday: Well it doesn't look like that's going to happen at this point. But if there was a repeal it would roll back to the pre-ACA rules. The biggest issues in the rollback of the Affordable Care Act are people with subsidies, and that's going to have an enormous impact. People have subsidies who are paying very little for coverage. They're going to lose those subsidies and all but the very sickest are just simply not going to be able to afford coverage, it's just unaffordable. And we're going to create a situation where the insurance companies are not going to be willing to play. The variable that I think is going to come into play are the states because insurance provided by insurance companies is regulated by state law. As far as Medicaid goes, there are so many people in the country that have become so reliant upon Medicaid benefits, I just don't see that states that have expanded Medicaid are going to be able to roll it back without revolt.

O'Leary:And that certainly seems to be the case with the senators from those states who said absolutely not.

Hasday: Very clearly. The senators in states that expanded Medicaid understand the political realities of pulling back the Medicaid expansion, and they're going to have to find a way to fund it. Increase taxes, something, but I don't I don't think there could be a full rollback of Medicaid in the states that have opted to expand.

O'Leary: If you could make tweaks to the ACA, what would you do?

Hasday: I would definitely expand the coverage tiers, the premium tiers, from three to five. So right now under the Affordable Care Act, the difference in premium between the ones that pay the lowest cost are the ones that pay the highest cost is a maximum of three times. There's only three rate bands.. What it allows is the difference in costs between the youngest and the oldest citizens to be a wider spread of rates. Right now within the Affordable Care Act, we have a vast number of younger, healthier people who are opting out of the system. Part of the reason they're opting out is because they are subsidizing older Americans. If there were more rating tiers then the older people would pay costs which are more equal to the amount of benefits that they would consume. So increasing the rating tiers I think is important. I would unquestionably increase substantially individual penalty to not participate in coverage because one of the other problems with the Affordable Care Act is people would access the system when they needed benefits and then opt out. And that free-riding cost the insurance companies quite a bit.

O'Leary: You study this stuff very closely, look into the future a little bit. Do we have any sense of what's going to happen in the next year?

Hasday: I don't think the future is a year. I think we're looking at more like the five to 10 year time horizon. I think that we're going to be jockeying with chipping away at the Affordable Care Act.I think that even if the Republicans aren't successful in repealing or replacing the Affordable Care Act through the legislative process the Republicans are going to be able to substantially impact things. For example by not enforcing the individual mandate, which by the way is pretty weak anyway. I think that for the next few years we're just going to be stumbling through trying to keep equilibrium in the system. I'm a little worried, because you know one of the things that all of this political posturing does is create uncertainties, and insurance companies are very nervous about uncertainties. I mean they they're concerned about where that's going to lead, because the legislatures, federal and state, have the ability to take what's out there and mandate that insurance companies do certain things or apply political pressure to continue to offer coverage, or continue to offer some types of coverage. Insurance companies are very nervous, and if you've been watching the stock prices of insurance companies they've been moving quite a bit with almost every change in the Republican debate. I think the insurance companies are kind of trying to lay low, because they're not exactly sure what direction the health care in this country is going. I think that what they're trying to do is control the controllable.

Read the original post:

What does the uncertainty around health care mean for insurers? - Marketplace.org

By Ricardo Alonso-zaldivar and Laurie Kellman, The Associated Press

WASHINGTON Americans were never too thrilled with Obamacare and they definitely disapprove of Republican alternatives in Congress, so what does the public want to do on health care?

A new poll suggests the country may be shifting left on this core issue, with 62 percent saying its the federal governments responsibility to make sure that all Americans have health care coverage, while 37 percent say it is not.

The survey findings from the Associated Press-NORC Center for Public Affairs Research indicate a change in public attitudes over the past few months, as concerns mounted about GOP legislation estimated to leave tens of millions without coverage.

Nobody should be without insurance, said Louise Prieto of Fort Lee, New Jersey, a retiree covered by Medicare. She said shes most concerned about seniors, children and people with pre-existing medical conditions.

As recently as March, the AP-NORC poll had found Americans more ambivalent about the federal governments role, with a slim 52 percent majority saying health coverage is a federal responsibility, and 47 percent saying it is not.

The survey didnt specify how the government might make sure that people have coverage, but a true guarantee entails something like the Medicare for all plan that was a rallying cry for Vermont Sen. Bernie Sanders presidential campaign last year. And that would involve hard-to-swallow tax increases.

There is a significant increase in people who support universal coverage, said Robert Blendon of the Harvard T.H. Chan School of Public Health, who tracks opinion trends on health care. The impact of the debate over dropping coverage looks like it has moved (more) people to feel that the government is responsible for making sure that people have coverage.

Currently the U.S. has a hybrid system of paying for medical care, with employers, federal and state governments, and individuals sharing responsibility. Government at all levels pays close to half the annual $3 trillion cost, and federal tax breaks support employer-provided coverage.

Employers cover more than 170 million workers, dependents, and retirees. Medicare, the federal governments flagship health care program, covers about 56 million retirees and disabled people. Medicaid, a federal-state Medicaid partnership, covers more than 70 million low-income people, from newborns, to severely disabled people, to many elderly nursing home residents. About 28 million people remain without coverage although former President Barack Obamas health care law has brought the uninsured rate to a historic low of about 9 percent.

The latest AP-NORC poll found a familiar partisan split: more than 8 in 10 Democrats said health care is a federal responsibility, compared with 3 in 10 Republicans. Political independents were more closely divided, with 54 percent saying coverage is a federal responsibility and 44 percent saying it is not.

In the poll, Americans didnt find much to like about the Republican legislation offered in Congress. Overall, only 17 percent thought they and their families would be better off; 37 percent thought they would be worse off.

On specifics, 73 percent opposed giving states the option to let insurers charge some people higher premiums because of their medical history. And 57 percent opposed allowing states to reduce the types of benefits that federal law now requires insurers to cover. Similarly, 64 percent opposed allowing states to permit some health plans to omit coverage for mental health and drug addiction treatment. There was also solid opposition to Medicaid cuts (62 percent) and overwhelming disapproval (78 percent) for allowing insurers to raise premiums for older adults beyond what is currently permitted.

Republicans have argued that allowing states to loosen such insurance rules, particularly for people who let their coverage lapse, would result in lower premiums all around. The poll also found that Americans disapprove of various strategies that the Obama law and the GOP bills rely on to nudge healthy people to buy coverage, from the current tax penalties for those who dont have insurance, to waiting periods and premium penalties proposed by Republicans.

The poll was conducted as the GOP repeal and replace plan floundered in the Senate during the past week. With the seven-year Republican campaign against the Affordable Care Act now verging on collapse, a strong majority said lawmakers should try to negotiate on health care.

In the poll, 8 in 10 said Republicans should approach Democrats with an offer to negotiate if the current GOP overhaul effort fails, rather than sticking with their own repeal and replace campaign of the past seven years. And nearly 9 in 10 said Democrats should take Republicans up on such an offer.

A foundation for common ground seems to be this: Nearly everyone wants changes to the Obama law, while hardly anyone wants to see it abolished without a substitute in place.

Among Democrats, only 22 percent actually want the ACA kept just as it is; 64 percent want it kept but with changes. Among Republicans, 27 percent want immediate repeal, while 54 percent favor repealing the law when a replacement is ready.

The AP-NORC poll of 1,019 adults was conducted July 13-17 using a sample drawn from NORCs probability-based AmeriSpeak panel, which is designed to be representative of the U.S. population. The margin of sampling error for all respondents is plus or minus 4.1 percentage points.

___

Associated Press polling editor Emily Swanson contributed to this report.

Read more:

Poll: Shift to political left seen on health care - The Denver Post

Senate Majority Leader Mitch McConnell, R-Ky. (center), speaks to members of the media with Senate Majority Whip John Cornyn, R-Texas, (left) and Sen. John Thune, R-S.D., outside the West Wing of the White House after a lunch meeting with President Trump on Wednesday. Alex Wong/Getty Images hide caption

Senate Majority Leader Mitch McConnell, R-Ky. (center), speaks to members of the media with Senate Majority Whip John Cornyn, R-Texas, (left) and Sen. John Thune, R-S.D., outside the West Wing of the White House after a lunch meeting with President Trump on Wednesday.

The Republican scramble to repeal and replace the Affordable Care Act has yielded yet another version of a health care overhaul bill, along with yet another score from the Congressional Budget Office the second analysis from the nonpartisan agency in two days.

The CBO released its Thursday analysis hours after Senate Republicans posted a new draft, but the updated budget report had a familiar ring to it. The agency found that, like a prior Senate version, the latest bill would increase the number of uninsured Americans by 22 million by 2026. Not only that, but as with all other things health care-related these days, it is likely to change in the near future.

Aside from increasing the number of uninsured compared to Obamacare, Thursday's version would also lower premiums and reduce the deficit. The latest draft would reduce the deficits to greater degrees than the older draft: $420 billion, compared to $321 billion in the previously scored version. It would also reduce average premiums in the Obamacare exchanges by 25 percent in 2026, as opposed to the last version's 20 percent.

The provisions in the latest version of the Senate bill are much like the version scored at the end of June: It would end the individual and employer mandates, it would roll back the Affordable Care Act's Medicaid expansion and cut spending to that program by hundreds of millions of dollars, and roll back some taxes. However, this bill would not roll back Obamacare investment income taxes and payroll taxes that hit higher-income Americans.

Notably, Thursday's bill does not have a provision known as the Cruz amendment, pushed by Sen. Ted Cruz of Texas. That amendment, included in a version of the bill released on July 13, said that as long as an insurer offers an Obamacare-compliant plan, it can also offer noncompliant, less-comprehensive plans.

Two large health insurance industry groups, America's Health Insurance Plans and the Blue Cross Blue Shield Association, called the provision "simply unworkable in any form" and said that it would mean prices go up and millions of people who buy on the individual market will lose insurance.

That's because it could lead to a bifurcated market, in which sick people gravitate to the more comprehensive plans and healthy people choose the skimpier coverage. That could create expensive insurance in the sicker pool, meaning some people would get priced out of that pool, which could drive prices even higher. And that would mean more government spending on premium subsidies, as the Kaiser Family Foundation's Larry Levitt noted on Thursday (meaning the CBO's latest deficit-reduction estimate could see a sizable change with a Cruz amendment).

That amendment could still be added to this bill later, and it would likely change these latest headline numbers potentially in a big way. A Senate Republican aide told Bloomberg news that the bill didn't include the Cruz amendment because the CBO isn't scoring it yet.

In a call on Thursday, CBO staff said they would evaluate the Cruz amendment, but had no information on when that estimate might be available.

The latest analysis comes just a day after the CBO estimated that a repeal-only bill without an immediate plan for what would replace the current health law would increase the uninsured population by 32 million by 2026.

That repeal-only bill is one option Senate Majority Leader Mitch McConnell has placed on the table as a possibility for senators to consider next week.

To proceed on any health plan, McConnell must get 50 senators to vote "yes" on a "motion to proceed" (Vice President Pence would provide the 51st vote needed). That would allow senators to begin debating whatever health care legislation they present.

Read more here:

Newest Senate Health Care Overhaul Would Increase Uninsured By 22 Million, CBO Says - NPR

Senate Republican leaders are desperately searching for the 50 votes they need to open a debate on ObamaCare repeal-and-replace legislation after a Wednesday scolding at the White House from President Trump.

Leaders have reopened negotiations on their previous bill, reversing course from their plans to move to a vote on a straight repeal of ObamaCare.

But its not clear if they will have any more luck this time in corralling enough centrist and conservative Republicans to move the bill forward.

Senate Majority Leader Mitch McConnellMitch McConnellOvernight Regulation: Trump administration reveals first regulatory agenda | GOP lawmakers introduce measures to repeal arbitration rule | Exxon gets M fine for sanctions violation Overnight Healthcare: CBO predicts 22M would lose coverage under Senate ObamaCare replacement OPINION | GOP healthcare attack is a vendetta against President Obama MORE (R-Ky.) needs to win 50 votes to proceed and has faced opposition from conservatives, who believe the previous bill kept too much of ObamaCare, and centrists, who think it would leave too many people without affordable insurance.

GOP leaders havent closed the door on bringing a straight repeal of ObamaCare, with a two-year delay, to the floor.

But Trump, who has given mixed messages on whether he wants to just repeal or simultaneously repeal and replace ObamaCare, on Wednesday told Republican senators at a White House lunch that repealing ObamaCare without a replacement was not an option.

We can repeal it, but we should repeal it and replace, and we shouldnt leave town until this is complete, until this bill is on my desk, Trump said.

McConnell appears to believe that if he can get the Senate to agree to open debate on an ObamaCare measure, hell have an opportunity to clear legislation by grinding away at his members. As the pressure intensifies, he clearly hopes that opposition will fall away.

But he first must get past the motion to proceed.

Next week, well be voting on the motion to proceed, and I have every expectation that well be able to get on the bill, McConnell told reporters Wednesday at the White House.

McConnell has failed three times so far to win the support that he needs.

A mix of conservative and centrist senators said they would oppose a procedural motion to begin work on an initial repeal-and-replace bill.

That led to a new round of negotiations and a second repeal-and-replace measure largely similar to the first bill.

On Monday, it became clear that the new bill also lacked the support to advance in the Senate.

McConnell then signaled hed abandon repeal-and-replace, saying the Senate would seek to advance legislation repealing ObamaCare with no guarantee on any replacement.

Centrists then came out against that plan, too.

After the Trump meeting, GOP leaders changed course and signaled a third effort to win support for a repeal-and-replace bill.

Senate Majority Whip John CornynJohn CornynOvernight Healthcare: CBO predicts 22M would lose coverage under Senate ObamaCare replacement Rand Paul opens door to backing healthcare bill on key hurdle Cornyn: Knowing health plan ahead of vote is 'luxury we don't have' MORE (R-Texas) told reporters after the lunch that while the repeal-only bill might come to the floor, he preferred to negotiate a version of the repeal-and-replace bill, known as the Better Care Reconciliation Act (BCRA).

If we can get an agreement here, my preference would be to start with the BCRA, agree to language and I think were getting closer, he said.

Senators were expected to meetWednesdayevening in Sen. John BarrassoJohn BarrassoGOP reverses course on healthcare McCain diagnosis looms over GOP healthcare talks Source: Senate leaders to offer 0 billion to win over moderates MOREs (R-Wyo.) office with Vice President Pence, Health and Human Services Secretary Tom Price and Seema Verma, administrator for the Centers for Medicare and Medicaid Services, to discuss the bill. At press time it was not clear which senators would attend the meeting.

There are going to be some meetingstonightup here with people who still have outstanding issues, and I think the question will be, yeah, can we find a way to get to yes? said Sen. John ThuneJohn ThuneCornyn: Knowing health plan ahead of vote is 'luxury we don't have' Sen. Thune: McCain a hero' to millions GOP signals infrastructure bill must wait MORE (S.D.), the Senates No. 3 Republican.

Leaders face the same problem that has bedeviled them since the beginning. If the bill is moved to the right, moderate senators are lost. If the bill moves to the center, conservative senators defect.

The bills treatment of Medicaid is a major sticking point for moderates.

The latest attempt to win over members is being called a Medicaid wraparound.

This would allow states to take money allocated to them through Medicaid and use the money to cover healthcare expenses for people who no longer qualify for Medicaid because the programs expansion ended.

The idea is to make up for the reduction of federal funding for ObamaCares Medicaid expansion, which would be curtailed by the Senate bill. Under the previous bill, states are given federal tax credits to help people who would no longer quality for Medicaid, but senators have expressed fears that this will not be a big enough pool particularly considering the nations opioid epidemic.

But the plan would actually involve taking more money away from Medicaid, which would already see its federal funding reduced under the Senate bill.

Verma discussed the proposal at the White House lunch.

She explained very briefly, very, very briefly some of the parameters of what theyre calling this wraparound for Medicaid, said Sen. Lisa Murkowksi (R-Alaska), one of the moderates who has threatened to vote against a motion to proceed to the bill.

Despite all the problems theyve had with their ObamaCare effort, a number of Senate Republicans said they believe they are close to getting enough votes on a repeal-and-replace bill.

McConnells move to bring a repeal-only bill to the floor brought it to a head, and he offered one way forward, Sen. Mike Rounds (R-S.D.) toldThe Hill after the lunch at the White House. A lot of us went back in and talked with leadership and said, Look, were close enough on this, we put a lot of work into this, we dont want to go that route.

They are also facing increasing pressure from groups warning of political repercussions if they fail.

The conservative group FreedomWorks said they will hand out traitor awards to Republicans who oppose a healthcare procedural vote next week.

And the conservative Club for Growth said it will track the motion to proceed leading to a vote on a repeal-only bill as a key vote, warning that voting against it would be tantamount to supporting ObamaCare.

Alex Bolton contributed.

Excerpt from:

GOP reverses course on healthcare - The Hill

Donald Trump's push to replace the Affordable Care Act was effectively halted after the Republican-held Senate was unable to moveits version of a more conservative health care bill to a vote.

A full repeal of his predecessors landmark achievement, without any sort of replacement to current lawwhich the president said would be sufficient enough in the wake of the GOPs failurealso appears unlikely to happen, as multiple Republican senators have come out in opposition to the idea.

Related:Here's how Donald Trump could actually be impeached

Daily Emails and Alerts - Get the best of Newsweek delivered to your inbox

Both events would have stripped millions of Americans from their access to quality and affordable health care, but for Trump, having insurance or not shouldnt be much of a concern: The president has long said his family possesses great genes. In fact, they might just be some of the best in the nation.

Trump invited The New York Times to the White House for an exclusive interview Wednesday, discussing his first six months in office and all of the controversies that have followed. His 5-year-old granddaughter Arabella Kushner provided a singular moment of levity throughout the lengthy conversation, showing off her knowledge of the Chinese language while telling the president she loved him in Mandarin.

"Shes unbelievable, huh?"Trump said. "Good, smart genes."

Trump's healthas well as Hillary Clinton'sbecame a contentious talking point along the 2016 campaign trail, as the real estate mogul's doctor released bizarre statements claiming he was in "extraordinary"health, despite his weight, love for Diet Coke and tendency to eat fast food like KFC.

His strength and physical stamina are extraordinary,Manhattan gastroenterologist Harold Bornstein wrote about Trump in August 2016. Mr. Trump has had a complete medical examination that showed only positive results. Actually, his blood pressure and lab results were astonishingly excellent.

That statement, which was analyzed by the medical community and critiqued for not providing any real, tangible evidence of Trump's health, followed years of similarly strange comments on the presidents genes, as well as his mental and physical health, from Trump himself.

"I consider my health, stamina and strength one of my greatest assets,"Trump tweeted in December 2015. "The world has watched me for many years and can so testifygreat genes!"

The president has also fielded several questions via Twitter from users asking about his energy and family, repeatedly pointing to his genes as the basis for his success. "Youre up at 5am and youre awake at 1am. How do you have so much energy? Seriously!?"

"Good genes!"Trump replied.

He also seemed to apparently miss a thinly veiled dig in June 2013, when @YoungBasedGod_g wrote to him, "@realDonaldTrump your dad gives good brain?? Damn."

"Its called genes!" Trump tweeted back.

"Dr. John Trump, uncle, for many years at M.I.T.,"he also wrote in May 2013. "Good genes, I get it!"

Trumps apparent obsession with his own genes could be due to his familys alleged belief in the theory of eugenics, the presidents biographer Michael DAntonio said in 2016.

"The [Trump] family subscribes to a racehorse theory of human development,"DAntonio said in his PBS documentary, The Choice."They believe that there are superior people and that if you put together the genes of a superior woman and a superior man, you get a superior offspring."

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Trump Doesn't Have to Worry About Health CareHis Genes Are Incredible - Newsweek

The Senate GOP's effort to overhaul the health-care system collapsed this week when multiple Republican senators came out against both the revamped bill and the idea of repealing Obamacare and letting the markets "fail" before replacing it. (Jenny Starrs/The Washington Post)

The inability of a Republican Congress and a Republican president to repeal Obamacare, or even just dial it back, is yet the latest demonstration that Republicans simply arent ready to govern.

The facile explanation for this is the unresolved division, within the party, between its radical Tea Party populist wing and its more moderate, business-friendly establishment wing. But the bigger issue is that the partys elected politicians are unwilling to make the trade-offs that are the essence of what governing is about.

On health care, for example, they promised to lower premiums but refused to embrace any of the three approaches that could accomplish that: increase co-payments and deductibles; squeeze the incomes of doctors, hospitals and drug companies; or finance more of the countrys health care through higher taxes.

[Is it inequality of income we care about or inequality of opportunity?]

They wanted to give everyone the freedom not to buy any health insurance but also the freedom to show up at hospital emergency rooms and demand free care, or to buy insurance the moment they got sick.

Republicans vowed to eliminate all the Obamacare taxes but not the healthy insurance subsidies for working families that those taxes were meant to pay for.

They wanted to allow insurance companies to lower premiums for the young and healthy while denying that the inevitable consequence would be higher premiums for the old and the sick.

They wanted to shift more of the responsibility to the states for providing health care to the poor without shifting additional resources to go with it.

They wanted to give more power to state insurance commissioners to regulate policies while also offering insurers the freedom to ignore state regulation by selling across state lines.

[The Republicans Obamacare repeal is one big lie]

Republicans wanted to give every American a new tax credit to help them pay for health care or health insurance while refusing to curtail the current subsidy, the tax exclusion for employer-provided health benefits.

They promise to solve the opioid crisis while eliminating the requirement that insurance policies cover substance abuse treatment.

This same inability to make trade-offs has also prevented action on a host of other Republican priorities.

They want to increase investment in infrastructure but dont want to raise taxes or user fees to pay for it.

Republicans want to cut corporate tax rates nearly in half but cant identify even a single corporate tax loophole they would close to prevent the deficit from ballooning out of control.

They are hellbent on dramatically increasing defense spending but wont vote to authorize current operations in Iraq and Afghanistan.

They think they can deport every undocumented immigrant without raising labor costs for businesses and prices for consumers.

They complain about the slow pace of getting the presidents appointments confirmed but refuse to give up their three-day workweeks and four months of politicking and fund-raising.

Republicans complain of a lack of bipartisan cooperation from Democrats while insisting on drafting all important legislation at meetings and luncheons of the Republican caucus.

Since gaining control of Congress and the White House in January, Republicans have been on a frantic and futile search for the political and economic free lunch. It would be overly charitable to say that, when it comes to governance, they are rusty and out of practice. In fact, they have now exposed themselves to be rank amateurs and incompetents who dont have a clue about getting important things done.

As a group, they have demonstrated a breathtaking lack of policy knowledge and sophistication, a stubborn disregard for intellectual honesty, lousy political instincts and a broken moral compass. Their leaders have forgotten what it means to lead, if they ever knew, while their backbenchers dont have a clue of what it takes to be constructive followers. If there were a bankruptcy code for politics, its safe to say the Republicans would be in Chapter 11.

This complete abdication of governing responsibility was confirmed Tuesday when the partys nominal leader, President Trump, announced to the country, I think we are probably in that position where we will just let Obamare fail. I can tell you the Republicans are not going to own it.

Even Sen. Shelly Caputo, the reliably party-line toting Republican from West Virginia, was moved to distance herself from that cynical win-at-any-cost strategy. I did not come to Washington to hurt people, she said.

Its almost an embarrassment being an American citizen traveling around the world listening to the stupid s we have to deal with in this country, Jamie Dimon, the chairman of JPMorgan Chase, said in an unguarded moment last week. Dimon was quick to add, reflexively, that it wasnt a Republican or a Democratic issue, but he knows better than that. Republicans were handed a golden opportunity to govern and they have blown it. This one is on them.

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The GOP cannot fix itself let alone American health care - Washington Post

Chris Kennedy touted health care coverage as a vital part of the American dream this week yet newly filed campaign expenditures show the Democratic gubernatorial candidate hasnt paid health insurance costs for his own campaign employees.

The Democrats campaign officials says they offered coverage, but no one took them up on it.

That puts Kennedy at odds with at least four other gubernatorial campaigns.

Democrats J.B. Pritzker, state Sen. Daniel Biss and Ald. Ameya Pawar, and Republican Gov. Bruce Rauner, all listed health insurance payments on campaign disclosure reports due on Monday.

But Kennedys health insurance payments are missing.

Its something youd expect to see, said Sarah Brune, executive director for the Illinois Campaign for Political Reform.

Kennedy campaign spokeswoman Hanah Jubeh on Thursday said there were no health insurance payments because many on staff are young and are still covered under their parents insurance, while others opted out. She said staff members that have been recently hired will get health insurance, and it will be reflected on the next required filing. Jubeh, spokesman Mark Bergman and campaign manager Brendan OSullivan were already covered through other employers and opted out of coverage through the campaign, she said.

Recently weve had some new staffers who have expressed an interest and were in the process of actually executing on that, Jubeh said. Itll be on the next report.

On Wednesday at a candidate forum in Little Village, Kennedy touted the importance of health care and its connection to the American dream.

I believe that the American dream, therefore, is a civil right. If it is a civil right, then healthcare has to be part of it, Kennedy said to applause. Because if it is not, every family, every individual is just one bad diagnosis away from bankruptcy, from losing everything that theyve made in this country. We need to make sure that the American dream is the dream for all Americans. And to do that, we need to make sure that everybody in America is covered by healthcare.

Kennedys campaign filing this week showed he took in $703,767.10 in campaign contributions but spent $652,523.79. The quarterly report filed with the Illinois State of Elections offered a deeper glance into Kennedys campaign spending, since many items were missing from his previous report.

In the April filing, Kennedy didnt list some traditional campaign expenditures, includingpayments forwell-known consultants, rented office space, campaign T-shirts and stickers and travel expenses.

The latest filing shows Kennedy spent $16,755 on rent, with monthly payments of $5,273. Kennedys campaign headquarters are in the Merchandise Mart the building he once managed.

He spent $122,600 on payroll for at least 11 staffers. The first report didnt list salaries for key staffers such as OSullivan and finance director Emma Pieper.

Kennedy spent more than $100,000 on consultants, $90,000 on digital consulting and more than $110,000 on research. Consultant pay was also missing from the first report.

The first report also failed to mention how much Kennedy spent on expenses such as campaign stickers and T-shirts, some of which were evident in the Chicago St. Patricks Day Parade Kennedy attended in March. The latest filing shows he spent $2,646 for a printing company, and another $4,968.90 for a print and digital company.

Kennedy, the son of the late Robert F. Kennedy, announced his candidacy via a video sent to supporters on Feb. 8. While this is Kennedys first campaign, he has been touted as a candidate for Congress, U.S. Senate and governor since the turn of the 21stcentury.

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Kennedy hasn't paid for staff health carebut touts coverage for all - Chicago Sun-Times