The Phony Healthcare ‘Compromise’ Is Coming – Esquire.com

The campaign to make people sick to make rich people wealthier never sleeps. Axios tells us how:

Senate Republicans have asked the Congressional Budget Office to analyze Sen. Ted Cruz's proposal for further health insurance deregulation, and they've asked for one estimate of a health care bill that includes his changes and one that doesn't, according to a GOP aide familiar with the discussions.

Oh, they're very cute, they are. Keep submitting proposals until you get a CBO score you can plausibly use to con the country, the elite political press, and the mind of Susan Collins into thinking you're "moderating" the bill. Even trim the massive tax cut a bit, full in the knowledge you can get that back when it's time to produce a phony "tax reform" plan. Do it over what is essentially a four-day holiday weekend.

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The only variable in the calculation is the number of uninsured that will allow the big con to proceed. 20 million? 19? How many millions of American families will have to suffer so that Paul Ryan's sommelier will be kept properly busy for the next few years? How many millions of the sick and suffering will have to become sicker and suffer more before the TV pundits and op-ed cowhands declare that Mitch McConnell's genius has produced a "compromise"?

If you're going to wind up with a celebration-related injury, I suggest you do it this weekend. Labor Day may be too late.

This 21st Century Modern Presidency Is a Sh*tshow

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The Phony Healthcare 'Compromise' Is Coming - Esquire.com

Single-payer healthcare backers fan out at California Capitol to protest shelving of bill – Los Angeles Times

July 3, 2017, 1:53 p.m.

Supporters of a stalled single-payer healthcare bill returned to the Capitol in Sacramentoon Monday to express their anger that Assembly Speaker Anthony Rendon (D-Paramount) shelved the measure more thana week ago.

Backers of the bill, SB 562, disrupted a separate hearing on the Assemblyfloor by unfurling a banner from the gallerybefore being escorted out. They also attended a hearing of the Assembly Rules Committee, the panel in whichRendonheld back the bill, holding up signs on which they'd written personal healthcare stories. And asmall contingentstaged a "sit-in" near Rendon's office, chanting "SB 562."

Rendoncalled the bill "woefully incomplete" and has shown no appetite to advance the bill, but Pilar Schiavo, an organizer with Healthy California, an advocacy group backing the measure, said supporters plan to keep up the pressure.

"We continue to build. There is incredible grassroots movement around this," Schiavosaid, adding of the enthusiasm around single-payer, "it's too late to put it back in the box."

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Single-payer healthcare backers fan out at California Capitol to protest shelving of bill - Los Angeles Times

Here’s where Republicans’ health care plans stand – CNN

Story highlights

Despite tweets on Friday from President Donald Trump and several high-profile Republican senators, the "repeal, then replace later" option is not really on the table and isn't something that will be pursued by GOP leadership as they try to pull together the 50 votes they need to pass their health care plan. Negotiations are continuing as planned for a proposal that repeals and replaces Obamacare simultaneously.

As CNN reported Friday, there is almost no chance senators will vote on a health care bill the week senators return from recess. Expect the health care negotiations to be a multi-week process.

Senate Majority Leader Mitch McConnell is sending several different proposals and basic outlines to the Congressional Budget Office to help speed up the final scoring process, as CNN reported several times last week. Although the top White House legislative official, Marc Short, said Sunday on Fox News that McConnell sent two bills to CBO for scoring; that's not exactly the case. McConnell actually sent two outlines, plus several other proposals that may make it into a final bill.

The future of the proposal continues to depend on whether there is some compromise resolution on the same issues, including a softer landing for the eventual Medicaid reforms and how to craft some acceptable version of Texas Sen. Ted Cruz's regulations amendment into the final proposal. In his comments Sunday, Short appeared to give the White House endorsement to Cruz's regulations proposal, which if so would be no small thing.

Opioid funding and changes to regulations related to the use of health savings accounts appear to be settled and locked in.

A still looming, very real fight that will be coming when they return: whether to repeal the 3.8% investment tax in Obamacare or not. This is not at all settled, but sources tell CNN this is something that won't be dealt with until Congress returns to Washington.

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Here's where Republicans' health care plans stand - CNN

‘Don’t take away our healthcare’ says Trump country – BBC News


BBC News
'Don't take away our healthcare' says Trump country
BBC News
The Central Appalachian mountain ranges in Kentucky are home to some of the poorest - and most fervent - Trump supporters. But what happens in the next few weeks hundreds of miles away in Washington could shape their future. Dr Van Breeding is ...

and more »

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'Don't take away our healthcare' says Trump country - BBC News

Democrats pressure 2020 senators on health care vote – Politico

Sen. Thom Tillis of North Carolina is one of the first-term GOP senators likely to face a tough battle in 2020. | AP Photo

Few GOP senators are up for reelection in 2018, but polling shows the Republican health care plan unpopular in several key 2020 states.

By Kevin Robillard

07/03/2017 05:21 AM EDT

With few Senate Republicans up for reelection in 2018, Democrats and other groups looking to defeat the GOP's plan to repeal Obamacare are looking to 2020 to pressure politically vulnerable senators.

Save My Care, a progressive group dedicated to defeating repeal attempts, is out with new surveys from the Democratic firm Public Policy Polling showing the GOP proposal, which would cut Medicaid funding and repeal Obamacare's tax increases, is deeply unpopular in Iowa, North Carolina and Colorado three swing states where Republican Senate wins in 2014 helped the GOP gain control of the chamber.

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In Iowa, where Trump won by a wide margin in 2016, 27 percent of voters approve of the bill, and 54 percent disapprove, according to PPP's automated poll in that state. In Colorado, where Clinton won, 26 percent approve and 59 percent disapprove. And in North Carolina, where Trump won by small margin, 33 percent of voters approve and 53 percent disapprove.

All three states have senators who are facing reelection in three years: Sen. Cory Gardner of Colorado, who is also the National Republican Senatorial Committee chairman; Sen. Thom Tillis of North Carolina; and Sen. Joni Ernst of Iowa. Of the three, Ernst is in the strongest position in the Save My Care polling, leading a generic Democratic opponent 48 percent to 41 percent. Tillis is trailing a generic Democrat, 48 percent to 44 percent, and Gardner is trailing 53 percent to 39 percent.

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The polling is designed to show the three senators they may face political peril even if they're not up for reelection in 2018. With narrow margins in the Senate, Democrats are aiming to deter as many Republicans as possible from becoming clear 'yea' votes, starting with Republicans who won seats that were previously held by Democrats during the GOP wave year of 2014.

"There is clear evidence that supporting this health care repeal will do lasting damage to a Senators standing with the voters in their state," strategists with Save My Care wrote in a polling memo. "Voters will reject Senators who support repeal."

The only Republican facing reelection in 2018 in a state won by Democrat Hillary Clinton, Nevada's Dean Heller, has been harshly critical of the GOP proposal. But AARP has run ads attacking the bill in Gardner's Colorado, and in Alaska, the home of Sen. Dan Sullivan. The American Medical Association has also released polling showing the bill is unpopular in Colorado, Alaska and Arkansas.

The Save My Care polls specifically asked whether Congress should continue working to repeal Obamacare or if lawmakers should focus on fixing the law when they return from the Fourth of July recess. In Colorado, voters prefer a fix by 59 percent to 36 percent. In North Carolina, a fix is favored by 53 percent to 40 percent, and in Iowa, the figures are 54 percent to 34 percent.

The polling also shows voters are much less likely to back Republican senators for reelection if they vote for the law, and that large majorities in each state say health care will be one of their top issues during the 2018 midterm elections.

Public Policy Polling conducted the survey of 870 voters in Colorado, 1,102 voters in North Carolina and 784 voters in Iowa on June 30 and July 1. Read the full results for Colorado, North Carolina and Iowa.

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Democrats pressure 2020 senators on health care vote - Politico

5 things for Monday, July 3: Trump tweets, health care, an attack in Iraq – CNN

1. Twitter 2. Senate recess Speaking of health care news, Republicans seem to be repealing and replacing that old "repeal and replace" line. Now, some GOP leaders and even Trump himself are floating a possible "repeal now, replace later" approach. 3. Iraq At least 14 people were killed, among them four children and a captain in the Iraqi police, when a suicide bomber detonated a device in a camp for internally displaced people in the Iraqi province of Anbar on Sunday.ISIS claimed responsibility for the attack and said they were targeting members of the Iraqi military. The attack comes as Iraqi forcespush ISIS elements out of their last major Iraqi stronghold, the northern city of Mosul.The city is expected to be fully liberated soon. 4. Arkansas shooting Twenty-eight people were wounded early Saturday in a shooting at a nightclub in Little Rock, Arkansas. In addition to 25 people who were shot, three people were injured in the ensuing chaos. Police believe the incident may be gang-related and likely happened after "some sort of dispute." To add to the confusion, an underground rapper was arrested shortly after the shooting, and a US Marshal initially said the arrest was connected with Saturday morning's incident. It wasn't. So far, no arrests have been made in connection with the shooting. 5. Bernie Sanders Sen. Bernie Sanders on Sunday denied an allegation that his office might have pressured a Vermont bank to speed up the loan process for a real estate acquisition his wife Jane orchestrated for Burlington College while president of the school.Sanders' latest remarks come amid reports the FBI might belooking into the land deal. A vice chair of Vermont's Republican Party, who was also involved in theTrump campaign, brought the accusations to the table last year and called for a federal investigation of Jill Sanders. BREAKFAST BROWSE

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5 things for Monday, July 3: Trump tweets, health care, an attack in Iraq - CNN

Fight for what really matters on health care reform – Montana Standard

Too often, policy debates in Washington, D.C., devolve into partisan fistfights. Each side becomes so focused on landing a punch that they forget why they climbed into the ring in the first place.

Just a few years ago, one in five Montanans did not have access to health insurance, and people couldnt afford to get sick.

When we passed health care reform, we took a big step forward, and today, more Montanans have access to health care than ever before.

But the current health care system is not perfect, and there are still folks in Montana who are struggling to pay expensive premiums and high deductibles.

I have heard that message from Plentywood to Libby and everywhere in between as I travel the state holding face-to-face town halls, listening sessions and public events. I know that to bring down the cost of health care we need to do something now, but the Senate health care proposal that was unveiled last week is not the answer.

This partisan bill imposes a tax on folks in their 50s and 60s, and rips health care away from 22 million Americans and tens of thousands of Montanans.

It kicks nearly 80,000 Montanans off Medicaid, many of whom now have health insurance for the first time.

It threatens coverage for folks with pre-existing conditions like high-blood pressure and diabetes.

It could bring back the days of lifetime caps when folks paid for health insurance their entire lives, but were booted off when they needed coverage the most.

The bill fails to address the very issue Montanans need us to tackle: the rising cost of health care. And it ignores families who are facing another round of premiums hikes next year.

But it doesnt ignore the wealthiest Americans who will see $541 billion in tax breaks.

If this bill passes, working families will pay more money for less coverage, while millionaires and big corporations walk away with fatter wallets.

While some elected officials continue to prioritize scoring political points, I still remember why I got in the ring to fight for Montana.

I am willing to sit down with Republicans, Democrats, independents, and Libertarians and come up with a solution that keeps whats working in our current health care system and improves where it falls short.

I am optimistic that we can pass a good health care bill that works for every Montanan, but this will only happen if it is done in a bipartisan, transparent way with input from folks of all walks of life.

The final vote on the disastrous Senate health care bill was delayed because thousands of Montanans raised their voices together. Now it is time to throw in the towel on partisan bickering, and start fighting for what really matters.

-- Jon Tester, a farmer from Big Sandy, is Montanas senior U.S. senator.

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Fight for what really matters on health care reform - Montana Standard

33 percent in NC approve of Senate health care bill, Raleigh-based poll finds – News & Observer (blog)


News & Observer (blog)
33 percent in NC approve of Senate health care bill, Raleigh-based poll finds
News & Observer (blog)
When Senate Republicans return to the U.S. Capitol next week, their top priority will be passing their version of a now-stalled health care repeal-and-replace bill. But the Better Care Reconciliation Act is not that popular among North Carolinians ...

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33 percent in NC approve of Senate health care bill, Raleigh-based poll finds - News & Observer (blog)

Trump: If GOP health care bill fails, repeal Obamacare now …

"If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date," tweeted Trump.

Trump's declaration -- which marks a political shift for him and could further imperil delicate negotiations on Capitol Hill -- came shortly after Sen. Ben Sasse, R-Nebraska, urged the President in a letter to repeal Obamacare now and replace later. The current Republican plan in Congress is to do both in one massive piece of legislation, though the Senate's bill has struggled to gain necessary GOP support.

Sasse quickly approved of Trump's tweet.

"Sounds great, Pres. @realDonaldTrump We are agreed. We need to break the logjam," he tweeted.

Trump's message Friday morning also marked a notable return to his efforts to push his agenda rather than distract from it, as he did on Thursday when he viciously and personally attacked MSNBC anchor Mika Brzezinski.

White House deputy press secretary Sarah Huckabee Sanders said Trump "hasn't changed his thinking at all" on health care as she fielded a question on Trump's tweet this morning on the health care reform efforts.

"We're still fully committed to pushing though with the Senate at this point, but we're looking at every possible option of repealing and replacing Obamacare. We are focused on doing that," Sanders said.

Sanders also said she did not know where Trump got the idea for that plan, noting that "people have been talking about this for quite some time."

"I don't know where specifically it may have come from," she said.

But Trump's tweet appears to mark a new public stance for him regarding health care.

"We're going to do it simultaneously," he said. "It'll be just fine. We're not going to have, like, a two-day period, and we're not going to have a two-year period where there's nothing. It will be repealed and replaced."

The President's tweet also could have the effect of further complicating health care negotiations. A GOP official close to leadership and supportive of the current repeal/replace effort told CNN: "Nothing like rolling a hand grenade into ongoing negotiations, eh?"

The concern, the official outlined, is that this now gives conservatives a reason to go back to their corner. While they were hardly at the breakthrough point, there's no question conservatives, particularly Sen. Ted Cruz, had been working in good faith to get to a deal.

Now the concern is conservatives can just say they wanted the 2015 repeal bill all along, and because the President clearly supports that plan, talks on a sweeping replacement plan can be scrapped.

A GOP Senate aide noted Trump's initial opposition to a straight repeal bill.

"We did this dance six months ago," the aide said. "We've litigated repeal, delay, replace. Thoroughly. The President spoke against it. This all might be more helpful if we weren't in the late stages of negotiations."

Appearing on CNN's "New Day" on Friday, Rep. Adam Kinzinger, R-Illinois, also rejected the President's suggestion.

"I think it's repeal and replace," he told CNN's Chris Cuomo. "We can argue whether they like the system we're bringing them in or not, but simply a repeal, even with the sunset the year or two down the road -- the problem (is) we know how Washington works."

He explained: "Sometimes on deadlines we still don't get things done. You can't leave the American people out like this. This is how sequester happened, because we thought we could fix the problem and never did."

Earlier this year, Hill Republican leaders floated the idea of repealing Obamacare and providing a transition period during which Congress would write a new law. But many Republicans opposed that idea, and along with Trump calling for passing both simultaneously, the party shifted tactics.

One reason behind that shift is repealing Obamacare without an immediate replacement plan would likely cause massive destabilization to an insurance market already unnerved by Washington's efforts to address health care. Many insurers are asking for another round of steep rate increases for 2018, and others aren't even willing to return to the exchanges at all.

The Affordable Care Act was troubled even before Trump took office, but the Republicans' quest to dismantle it has made things worse. Trump has caused confusion about whether he'll continue key components of the law. The two at the top of the list: the mandate that everyone have insurance and the cost-sharing subsidies for lower-income Americans.

Meanwhile, the future of the GOP health care efforts remains unclear. Senate Republican leaders scuttled plans for a vote on health care reform earlier this week as GOP leaders criticized the bill, but Trump was optimistic in his outlook Wednesday.

Trump declined to say what the surprise would be, but his optimism contrasted significantly with the nine Republican senators publicly expressing their opposition to the bill the President is championing.

The White House can only afford to lose two of the 52 Republicans in the Senate to pass the legislation.

CNN's Tami Luhby, Phil Mattingly, Lauren Fox, Manu Raju and Dylan Stafford contributed to this report.

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Trump: If GOP health care bill fails, repeal Obamacare now ...

Trump administration remains confident health-care bill will pass – Washington Post

(Bastien Inzaurralde/The Washington Post)

Top Trump administration officials insisted Sunday that the odds of passing health-care legislation when the Senate returns to Washington next week remain high, but others in the GOP charged that the bills problems require more than a quick fix.

Health and Human Services Secretary Tom Price and White House legislative affairs director Marc Short are fighting off a tide of discontent that has been exacerbated in recent days by President Trumps tweet that the Senate could simply repeal the Affordable Care Act and replace it later if it cannot pass the pending measure.

Price and Short both argued in television appearances Sunday that President Trump doesnt actually endorse the staggered approach. They said Trump was working the phones this weekend to urge senators to get on board with the Senate bill.

Still, Trumps comment a sharp departure from his campaign promises is undercutting the efforts of Senate Majority Leader Mitch McConnell (R-Ky.) to collect 50 GOP votes to support the current bill. Conservative Republicans are calling for separate efforts, urging quick action to undo Obamacare to allow more time for the difficult endeavor of structuring its replacement.

Those senators are still divided, however, on whether the replacement must be devised now or sometime in the future.

I want repeal to work, and the way you do it is you separate into two bills and you do it concurrently, said Sen. Rand Paul (R-Ky.), who declared on Fox News Sunday that we are at an impasse with the health-care bill on offer before the Senate.

We should do repeal with a delay, Sen. Ben Sasse (R-Neb.) said on CNN Sunday, saying that he was still willing to give the Senate bill another week before declaring it dead.

In an appearance on Face the Nation, Sen. Mike Lee (R-Utah) also endorsed repealing Obamacare with a delayed implementation that would give lawmakers time to craft a replacement, noting that approach might be easier.

Sometimes when you lump too many things into one piece of legislation, you doom its chances of success, Lee said. That might be where we are.

Lee is also one of the senators pushing a change to current legislation to insist that every state have at least one Obamacare-compliant insurance plan, in exchange for lifting the rules on the others. Short endorsed that change on Sunday, calling it perfectly appropriate, and part of the process of bringing everybody together.

But Republicans from the other side of the party spectrum are also distancing themselves from the Senate bill, as Democrats suggest they are ready for a bipartisan approach.

Last week, Senate Minority Leader Charles E. Schumer (D-N.Y.) asked the president to relaunch the health-care push in a bipartisan fashion, declaring that Democrats are ready to work across the aisle.

Trump surrogates scoffed at that offer Sunday, with Short declaring that Senator Schumer might talk about bipartisanship, but he has no interest in bipartisanship whatsoever.

Sen. Bill Cassidy (R-La.) used a Sunday appearance on NBCs Meet the Press to hawk the health-care proposal he drafted with Sen. Susan Collins (R-Maine), which they say was designed to build bipartisan support. Both have been skeptical of the current Senate bill. But on Sunday, Cassidy said he, too, is skeptical that Democrats are serious about cooperation.

Until a Democrat says they are willing to sign on to the Patient Freedom Act, which allows a blue state to do what theyre doing now, but allows a red state to do something different, Im not sure were ready for bipartisanship, Cassidy said.

Trump administration officials identified three areas that could need last-minute changes to win a more favorable impact score from the Congressional Budget Office and more support from members. Price said the administration and lawmakers are working to ensure that individuals transitioning off Medicaid do not fall through the cracks, that more coverage options are available and that opioid abuse is addressed.

Not all Republicans are convinced that those efforts will help. In an appearance on ABCs This Week, Ohio Gov. John Kasich, a Republican, warned against efforts to try to buy people off with little, last-minute fixes on issues such as opioid abuse programs that he called anemic. Its like spitting in the ocean. Its not enough.

Kasich had harsh words for both Democrats and Republicans, excoriating them for being too consumed with politics to be anything but shortsighted and disingenuous when it comes to fixing the health-care system, and complaining that sometimes my party asks too much.

Right now, theyre not ready, they are not ready to sit down and put the nation first in my opinion, Kasich said of congressional lawmakers. His problems with the bill, he said, cover the whole package.

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Trump administration remains confident health-care bill will pass - Washington Post

President largely sidesteps the bully pulpit in pushing health-care bill – Washington Post

With the Republican push to revamp the Affordable Care Act stalled again, even some allies of President Trump question whether he has effectively used the bully pulpit afforded by his office and are increasingly frustrated by distractions of his own making.

Trump has spoken out repeatedly during his tenure about the shortcomings of Obamacare, which he brands a disaster. But he has made relatively little effort to detail for the public why Republican replacement plans which fare dismally in public opinion polls would improve on the former presidents signature initiative.

The lackluster sales job, combined with recent controversial tweets and public statements targeting the media, has diminished the focus on the presidents leading legislative priority at a key juncture in the Senate, allies and analysts say.

Its a mystery, said Barry Bennett, a Republican operative who advised Trumps campaign last year and remains close to the White House. I dont know what theyre doing.

In recent days, Trump, who heads to Poland and Germany later this week, has seemed largely preoccupied by other things, including a Twitter feud with multiple news outlets. On Sunday, Trump sent around a video showing him body-slamming a CNN avatar, just days after calling an MSNBC host dumb as a rock.

(Bastien Inzaurralde/The Washington Post)

A top Trump lieutenant, Health and Human Services Secretary Tom Price, was pressed Sunday on whether the media attacks are interfering with the presidents push of the unpopular Senate bill.

The fact of the matter is that he can do more than one thing at a time, Price said during an exchange with host Chuck Todd on NBCs Meet the Press that grew testy at times.

Price argued that Trump has been holding multiple meetings within the White House itself, with physicians, with small-business groups, with other folks who have been harmed by Obamacare, with patients, individual stakeholders from across this land who tell him and have told us repeatedly that the current system is collapsing.

Trumps public efforts to dismantle the health-care law, however, contrast sharply with President Barack Obamas efforts to build support in advance of its 2010 passage. Obama gave a joint address to Congress on health care. He fielded questions at town hall meetings around the country. And he even bantered on live television with hostile lawmakers at a Republican retreat.

Not only has Trump been unsuccessful at swinging public opinion toward the legislation, but also he hasnt really tried that much, said George C. Edwards III, a professor of political science at Texas A&M University and author of On Deaf Ears: The Limits of the Bully Pulpit.

He hasnt been out there consistently making a case for the legislation, Edwards said of Trump.

Its not hard to imagine other things Trump could be doing to try to boost support for the GOP plan among the public and, by extension, on Capitol Hill, Bennett said.

Trump could make much better use of Twitter, urging his 33million followers to call their senators and ask them to back the GOP bill, Bennett said.

Trump could have visited several states last week, holding events that highlight the sharp rise in premiums under Obamacare, he said. And Trump could mobilize his supporters to come to Washington and rally outside the Capitol, demanding passage of a bill.

Trumps seeming ambivalence about selling the GOP plan may reflect that he has always been more animated about getting rid of Obamacare than he has been about what should replace it.

To the degree he has discussed what the American health-care system should look like, Trump has talked about insurance for everybody and coverage that would be much less expensive and much better standards that the bills produced by the House and Senate dont come close to achieving, according to analyses.

Trumps public statements about the bills, at times, have risked doing more harm than help, leading to questions about how dedicated he is to the task at hand a view bolstered by Trumps head-scratching comments that he considered the House bill mean and that it would be unfortunate but okay if senators are unable to pass a bill.

Trump further muddied the waters last week by floating the possibility on Twitter that lawmakers could repeal the ACA now and replace it later a view that Price on Sunday emphasized is not the administrations preference.

White House press secretary Sean Spicer said that theres no reason Trump should follow models used by Obama or other past presidents to build public support.

You use the model that works for you, Spicer said, noting that Trump has advanced a health-care bill further in the process at this point in his term than Obama. The ACA did not pass until the second year of Obamas first term.

Weve been more efficient, Spicer said.

Marc Rotterman, a GOP consultant based in North Carolina, said Trump needs to be more repetitive when speaking to the public about why the bill should pass.

When you push a measure, redundancy matters, and these constant tweets against the media distract from the real issue, which is getting health care done, said Rotterman, adding that hed like to see Trump deliver an Oval Office address on the subject.

To bolster support for their initiatives in Washington, presidents often travel to friendly territory outside the Beltway to make their case. Trump has traveled outside of Washington several times lately, but those events have mostly focused on other issues, and when he has mentioned health care, he hasnt dwelled on it.

During Trumps recent travels to Ohio and Wisconsin, he staged secondary events meant to highlight victims of Obamacare.

In a mid-June trip to Milwaukee, for example, Trump invited two local families to join him on Air Force One to talk about their struggles to pay for insurance under the ACA. Afterward, Trump and the families spoke briefly to the news media on the tarmac, with Trump telling reporters, these citizens deserve so much better.

His motorcade then whisked him to a technical college to talk about workforce development and apprenticeships an event that received the majority of local coverage.

At a Trump rally late last month in Cedar Rapids, Iowa, the president could have made an extended argument about the need for moving forward on health care. But Trump didnt discuss the issue in much detail as he pledged to deliver a bill with heart.

He made at least as many headlines for pledging to crack down on the use of welfare by immigrants and to use solar panels to help pay for a promised wall on the U.S.-Mexico border.

Ari Fleischer, the press secretary to former president George W. Bush, said Trump to this point deserves mixed marks for his use of the bully pulpit on health care.

Fleischer credited Trump with having kept his foot on the gas while the House was struggling to pass its version of the bill in early May.

In the Senate, Trump seems to be hindered by his low job-approval ratings, which have undercut his ability to reach out to some conservative Democrats, in particular, Fleischer said.

If Trump were more popular, Fleischer said, a handful of those Democrats would probably be more willing to support the bill, out of fear of incurring the presidents wrath. Instead, theyre now worried about drawing a Democratic primary challenger if they work too closely with Trump.

Since the focus turned to the Senate in recent weeks, Trump has also delegated much of the lobbying to Vice President Pence and senior administration officials, who have more extensive knowledge of the bill and a better sense of how to bring senators on board.

Trump is also faced with the prospect of selling a very unpopular product. A Congressional Budget Office analysis of the Senate plan projected that it would lead to 22million fewer Americans having coverage within a decade.

Only 17percent of adults nationwide approved of the Senate health-care bill, while 55percent disapproved, according to an NPR/PBS NewsHour/Marist poll released Wednesday.

Even among Republicans, support was tepid, with 35percent voicing approval and 21percent saying they disapprove. Other recent polls have had similar numbers.

Meanwhile, even as Trump has repeatedly railed about shortcomings of the ACA, public support for Obamas initiative has increased, polls have found.

In December, as Trump prepared to take office, 43percent of American adults viewed the ACA favorably, while 46percent viewed it unfavorably, according to a Kaiser Health tracking poll.

In the June poll, 51percent viewed the law favorably, compared with 41percent unfavorably. That was the best the ACA had fared since Kaiser started its polling in 2010.

The term bully pulpit was coined by President Theodore Roosevelt, who used the powers of the office to court reporters and deliver major speeches on legislation related to railroad regulation and food inspection.

Frances Lee, a government and politics professor at the University of Maryland, said presidents traditionally have poor records of changing public opinion when pushing unpopular initiatives, as Trump is attempting to do.

Use of the bully pulpit is mainly effective when presidents are pushing Congress to do something the public already favors, she said, citing the wide latitude Bush had with Congress after the Sept.11, 2001, terrorist attacks.

Still, there is no shortage of suggested initiatives Trump could be taking that he has not.

After the House narrowly passed its health-care bill in early May, Aaron Kall, the director of debate at the University of Michigan, penned a piece for the Hill newspaper, urging Trump to give an address to a joint session of Congress to bolster Senate support.

In an interview, Kall said he still thinks that would be helpful to Trump, given the large television audience such an address would command.

If Trump wants legislation to pass at this point, he really needs to adopt some new tactics, said Kall, editor of Mr. Speaker, the President of the United States: Addresses to a Joint Session of Congress.

Kall suggested that Trump also make himself available for television interviews focused on health care with outlets beyond the friendly confines of Fox News.

I think weve underestimated him sometimes, Kall said. With a few days preparation, I think he could withstand an interview on this subject. He has a persuasive story to tell. It just needs to be packaged in the right way.

Others say that Trump would be well-served by putting down his phone.

Asked Sunday whether Trumps tweets made it harder to work on health care, Sen. Bill Cassidy (R-La.) admitted that he gets frustrated when the media and lawmakers focus on what the president says on Twitter.

Our focus cannot be on the tweet, Cassidy said on Meet the Press. Our focus has to be on that kitchen-table family paying $20,000, $30,000 and $40,000 for their premiums, wondering how theyre going to make ends meet.

Jenna Johnson and Ashley Parker contributed to this report.

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President largely sidesteps the bully pulpit in pushing health-care bill - Washington Post

Why We Will Never Control Healthcare Costs – National Review

On one hand bioethicists bemoan the high costs of medical care and promote health care rationing forthe elderly, seriously disabled, and dying.

On the other, they promote expanding publicor insurance funding of health care to ensure that peoples desires are satisfied and to promote social justicemedicine harnessed in the service of hedonism,the ethical theory that pleasure (in the sense of the satisfaction of desires) is the highest good and proper aim of human life.

For example, California requires all group insurance plans to cover fertility treatments for gays and lesbians in the same way they do biologically infertile heterosexual couples. The Obama Administration promulgated a regulation so that Medicare now funds sex change surgeries.

Now this. Advocacy has commenced in the UK to have the socialized NHS fund uterus transplants so that men who identify as women can give birth. From the Daily Mail story:

Transgender women who were born male should be given womb transplants so that they can have children, leading NHS doctors have told The Mail on Sunday. And fertility experts say taxpayers should fund such transplants for those who identify as women, on the basis of equality enshrined in law.

Leading the debate on the controversial procedure is medical ethics lawyer Dr Amel Alghrani, who is pressing for a talks on whether womb transplants for trans-women should be publicly funded. Dr Alghrani, of Liverpool University, also predicts that a successful programme would lead to others demanding wombs including gay and straight men who wanted to experience the joys of carrying a child.

This would be wrong on so many levels, ranging from safety concerns for both patient and potential future baby, the prospect of doctors and hospitals being forced to participate even if it violates their religious or moral beliefsalready beginning to happento the question of whether going to such extremes to satisfy individual yearnings constitutes wise public policy.

But make no mistake: Powerful political and cultural forces will bearepushing us hard in this direction.

This much is sure: If the current trends continue, there is no way we will ever be able to adequately control healthcare costs.

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Why We Will Never Control Healthcare Costs - National Review

Sasse: ‘Repeal with a delay,’ then replace – CNN

"If Leader McConnell can get us across the finish line in a combined repeal and replace, I'd like to see that happen," the Republican freshman senator said in an interview with Jake Tapper on CNN's "State of the Union." "It needs to be a good replace, but if we can do a combined repeal and replace over the next week that's great. If we can't, though, then there's no reason to walk away. We should do repeal with a delay let's be clear, I don't want to see anybody thrown off the coverage they have now. I would want to delay so that we can get straight to work."

Sasse first suggested the option of repealing and then replacing the Affordable Care Act, President Barack Obama's signature health care law, in a letter to President Donald Trump on Thursday an idea that Trump also voiced, but was met by criticism from both Republicans and Democrats who worried that it could harm Americans by leaving them without coverage.

"On July 10, if we don't have agreement on a combined repeal and replace plan, we should immediately vote again on H.R. 3762, the December 2015 ObamaCare repeal legislation that the Congress passed but President Obama vetoed," Sasse wrote in the letter. "We should include a year-long implementation delay to give comfort to Americans currently on ObamaCare that a replacement plan will be enacted before expiration."

Later that day, Trump tweeted, "If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!"

Vermont Sen. Bernie Sanders countered Sasse's argument on Sunday, calling the "repeal and then replace" option "absurd."

"I have a lot of respect for Sen. Sasse, but that idea is an absurd idea," the independent senator said in an interview on "State of the Union."

Republican Rep. Adam Kinzinger of Illinois has also rejected the suggestion of repealing and then later replacing the law, saying it could harm Americans.

"I think it's repeal and replace," Kinzinger told CNN's Chris Cuomo Friday on "New Day." "We can argue whether they like the system we're bringing them in or not, but simply a repeal, even with the sunset the year or two down the road -- the problem (is) we know how Washington works."

Sasse cast doubt on the CBO report Sunday, saying that "(r)egularly, government scorekeepers underestimate cost and they overestimate coverage."

"CBO is filled with lots of well-meaning people, and they're good at certain kinds of analysis, but analyzing macro long-term, highly complex, dynamic social programs, thev're almost never been right," Sasse added.

The current Republican plan in Congress is to do both a repeal and a replacement of the law in one massive piece of legislation, though the Senate's bill has struggled to gain the necessary GOP support.

"I think we need to do both repeal and replace, and I'm a little agnostic as to whether they're paired or separated," Sasse added in his "State of the Union" interview on Sunday, calling for the cancellation of the Senate's August recess so lawmakers can get to work on a replacement plan.

Senate Majority Leader Mitch McConnell said Friday that he will stick to the path of accomplishing both a repeal and a replacement together.

Finding a replacement for the law is "very challenging," but allowing Obamacare to remain in place is not an option, McConnell said, according to a video of his remarks posted on the website of the Courier-Journal newspaper, based in Louisville, Kentucky.

"We think that Leader McConnell and his senators within the Senate are working to try to get this piece of legislation on track," Price said. "Their conversations are ongoing as we speak, so we look forward to hopefully them coming aback after this 4th of July recess and getting the work done."

Go here to read the rest:

Sasse: 'Repeal with a delay,' then replace - CNN

Ohio Gov. Kasich on health care: ‘Sometimes my party asks too much’ – Washington Post

Ohio Gov. John Kasich (R)lecturedcongressional leaders of his party on Sunday for being shortsighted, disingenuous and, ultimately, doomed to be forgotten by history if they persist withtheir approach to health-care legislation.

Sometimes my party asks too much, Kasich said on ABC's This Week, saying he and others would not be fooled by efforts to try to buy people off with little fixes to the Senate billto increase spending to combat opioid addiction or give more financial support to low-income people seeking health coverage.

[Republicans grow increasingly anxious about heading home without a health plan]

This is not the first time that Kasich has criticized the GOP for the health-care legislation it istrying to shepherd through Congress. Last month, he joined with two other Republican governors and four Democratic governors to urge the Senate not to reduce Medicaid coverage which the Senate bill contracts.

But Kasich stressed Sunday that it's not just Medicaid, and the fact that there's not enough money in Medicaid legitimately to treat people that has prompted his oppositionto the bill.

Its the whole thing, he said. It's the entire package, which I believe can and should be fixed.

The sins of the health-care package Kasich has identified go right to the heart of the bill, he said.If the Obamacare exchanges are collapsing, he stressed, you can't also give people three or four thousand dollars a year and think they can buy an insurance policy.

What kind of insurance policy can you buy at three or fourthousand dollars a year? Kasich asked.

[GOP health-care talks center on stark question: Help vulnerable Americans or help the rich?]

He also said that the latest proposal to inject the effort with money to combat opioid abuse $45 billion over 10 years was anemic. It's like spitting in the ocean. It's not enough.

Kasich didn't reserve his harsh words only for the GOP he criticized Democrats, too, and politicians generally as being slaves to their party instead of working to improve the country.

No one will ever remember you if you don't put the country first, Kasich warned members of Congress.

Right now, they dont want to concede anything, he concluded. Right now, theyre not ready, they are not ready to sit down and put the nation first in my opinion.

[Fresh polls find Republicans health-care proposal is still a clunker]

Notably, Kasich did not direct the same sort of criticism atPresident Trump, who he suggested would be open to negotiations with Democrats.

I think hed be fine with it, the governor said, noting that Trump is a real estate businessman and that negotiation is part of their DNA.

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Ohio Gov. Kasich on health care: 'Sometimes my party asks too much' - Washington Post

Polling prescribes bipartisan compromise to move health care forward, argues Peggy Noonan – MarketWatch

Former Ronald Reagan speechwriter Peggy Noonan believes a patriotic bipartisanship is the path forward on health-care policy, and she says the polls back her up. To fellow Republicans worried that compromising with Democrats and leaving much of President Barack Obamas signature health-care law in place would represent abandonment of seven years worth of repeal promises, the Pulitzer Prizewinning Wall Street Journal columnist serves up this metaphor:

The Noonan recipe revolves in roughly equal parts around the Democratic Partys exhibiting humility in accepting that Obamacare [is] in some respects on the verge of collapse; the Republicans climbing down from a position wherein Majority Leader Mitch McConnell broaches with his caucus the notion of bipartisanship only in a manner that sounds threatening; and the adoption of a sort of Realpolitik that permits all parties to see that current health-care law requires improvement but also that polls suggest the American people are not in the mood for tax cuts to the comfortable and [health insurance] coverage limits on the distressed.

She name checks Democrats Joe Manchin, Joe Donnelly amd Heidi Heitkamp and Republicans Shelley Moore Capito, Bill Cassidy and Lindsey Graham as having shown hopeful recent signs of willingness to reach across the aisle. Noonan also takes heart from President Trumps palpable desire for a legislative accomplishment, no matter what the legislation itself prescribes.

Of Trump, Noonan writes:

Read the complete Peggy Noonan column at WSJ.com.

More about health care:

The Obamacare repeal risk no one is talking about: nearly 1 million jobs

Trump says Republicans will get health-care over the line

Nearly one-quarter of Americans are one emergency away from financial disaster

CBO says Senate bill would increase number of uninsured Americans by 22 million

Rand Paul would prefer a Senate health bill that repeals Obamacare

View post:

Polling prescribes bipartisan compromise to move health care forward, argues Peggy Noonan - MarketWatch

As GOP struggles with health care, Democrats forge ties with ‘resistance’ – Washington Post

As Republicans return to their home districts to sell a flailing health-care bill, liberal groups are using the congressional recess to build opposition. They believe tens of thousands of phone calls, emails and in-person pushes will force on-the-fence senators to reject the legislation for good.

The fresh activism is coming with encouragement from Democratic lawmakers who are mired in the minority and have been mostly left to watch as Republicans struggle to reshape the nations laws to their liking. After starting the year on the defensive with their own base, party leaders and House and Senate Democrats are finally taking cues from these groups, believing that tactics honed far outside Washington could help scare Republicans into abandoning long-standing promises to upend the Affordable Care Act.

Ahead of the recess, while Republican senators toiled over details of their health-care overhaul behind closed doors, Sen. Brian Schatz (D-Hawaii) did whats become natural for Democrats lately: He lashed out on Twitter.

CBO confirms this thing is a %#$@ sandwich, he tweeted shortly after the release of the Congressional Budget Offices report that estimated 22 million more Americans would be uninsured under the Senate GOPs plan. He tweeted later that the lefts fight against the legislation is a test of the morality of our country. We have to win this one.

Democrats can see with their eyes where the energy is in American politics right now, said Ben Wikler, the Washington director of MoveOn.org, a liberal group initially launched to oppose the impeachment of President Bill Clinton.

Its to abandon politics as usual and put up a bare-fisted fight. Thats really sinking in.

Schatz won reelection last year with more than 70 percent of the vote and acknowledges he did so by airing really pretty ads and taking advice from expensive consultants. It might have worked for him in Hawaii, but President Trump won the White House and Democrats failed to win back control of the House or Senate.

So now he admits to being a recent convert to the tactics used by Wiklers group and other organizations such as CREDO Mobile; the American Federation of State, County and Municipal Employees; and the fast-growing Indivisible movement. The groups have organized protests or sit-ins at congressional district offices and urged followers to flood Capitol Hill phone lines in opposition to Education Secretary Betsy DeVoss appointment or Trumps travel ban. Neither pressure campaign stopped DeVos or the Trump ban, but Schatz said they signaled to Democratic lawmakers that the groups could quickly mobilize Americans against Trump.

Our playbook needs a refresh. Its predictable and its stale, Schatz said. That refresh is not just new language or a new standard-bearer, but a recognition that for Democrats to win, we need to fight for Democrats and then theyll fight for us.

For Schatz, that has meant firing off quick stream-of-consciousness tweets that have earned him headlines and 30,000 more followers so far this year. Its also meant marching in the streets for the first time in his life, as he did last week with activists who opposed the GOP health-care plan. And it means providing counsel to constituents or activists who still want a little guidance from an elected official.

The senator who once chastised Attorney General Jeff Sessions on Twitter for calling Hawaii an island in the Pacific said his change in tone is a recognition that people dont want to be sold soap.

They dont want a prepackaged product; they want to know that were people and that we respond to outrages in the same way that they do.

Democrats willingness to fight, particularly on health care, has not gone unnoticed by progressive activists who say they deserve credit for drawing in even wary moderates.

Democratic Sens. Joe Manchin III (W.Va.), Heidi Heitkamp (N.D.) and Claire McCaskill (Mo.) who are all up for reelection in states Trump won handily have all been eager to speak out. They joined a protest-turned-photo-op on the Senate steps with Senate Minority Leader Charles E. Schumer (N.Y.) and other Democrats, with each senator holding a portrait of a constituent who had benefited from Medicaid.

The way theyve coalesced around the health-care issue has been better than expected; theyve done so because of how many people were demanding it, said Winnie Wong, the co-founder of People for Bernie Sanders and an Occupy Wall Street veteran.

Schatz was one of only a handful of Democratic lawmakers to actually march in last weeks health-care rally other party leaders just showed up to give speeches. He waited restlessly as Sens. Ron Wyden (D-Ore.), Patty Murray (D-Wash.) and Schumer addressed the crowd.

They have lots of powerful wealthy people on their side, Schumer said of Republicans. Who do we have? You!

Schumer especially has seen his fortunes change with the far left. In February, thousands of protesters marched to Schumers Brooklyn home to demand resistance to Trumps Cabinet nominees; some chanted What the f---, Chuck.

The infighting has largely stopped since then. Schumer has been a regular presence at protests, thanking activists for having Senate Democrats back. Theyve returned the praise. Schumer is both speaking out at every opportunity and keeping the caucus aggressive, said Wikler, whose group helped organize the Capitol protest.

After Schumer spoke, Schatz stepped on stage and called the GOP health-care bill literally an $800 billion cut in Medicaid and literally an $800 billion wealth transfer to people who dont need it.

He offered some advice for the congressional recess: Dont wait for instructions from any organization. Whatever you think you can do in that moment, just do it.

Six months ago, everyone in that building thought that repeal of the Affordable Care Act was a done deal, Wikler said, pointing to the Capitol. Since then, he said, Democrats had learned to take some cues from the resistance.

Weve mobilized hundreds of thousands of people to participate in our democracy, and thats taught us something crucial about the resistance to Trump: its working, said Faiz Shakir, national political director for the American Civil Liberties Union.

In many ways, Schatz is an ideological counterweight to conservative foot soldiers such as Sens. Mike Lee (R-Utah), James Lankford (R-Okla.) or Joni Ernst (R-Iowa), other senators in their 40s with no obvious White House dreams who could find themselves in the Senate for decades to come. While many of his Democratic colleagues ponder a run for president, Schatz said he intends to stay in the Senate.

Somebody has to not run for president, Schatz quipped.

Schatz came to the Senate in late 2012 as the appointed successor of the late Sen. Daniel Inouye (D-Hawaii), who died after 49 years in the Senate just as Congress was in the throes of the fiscal cliff fight. The day after Christmas, Schatz flew to Washington aboard Air Force One with President Obama, who cut his annual Hawaiian vacation short to avert a financial disaster.

As Schatz prepared to travel from Washington to Honolulu on Thursday, a trip he makes nearly every weekend to see his wife and two young children, he admitted that despite doling out advice on how progressives should pressure Republicans during the upcoming recess, he hadnt determined what he will do. Schumer and House Minority Leader Nancy Pelosi (D-Calif.) have urged Democrats to hold news conferences, host rallies with progressive groups and submit op-eds to newspapers. Schatz said thats not good enough.

You cant fill a calendar and think thats a plan, he explained, meaning that he will avoid a strategy that dictates, Im going to use Facebook on Tuesday and use Twitter on Wednesday, and then Im going to send an op-ed in and hold a news conference on Friday.

Its a pretty chaotic environment out there, he said. We need to be a little more flexible.

Read more at PowerPost

Originally posted here:

As GOP struggles with health care, Democrats forge ties with 'resistance' - Washington Post

Manchin: Dems want to work with Trump on health care – POLITICO – Politico

Sen. Joe Manchin's comments echo those of Senate Minority Leader Chuck Schumer. | AP Photo

Sen. Joe Manchin on Sunday said members of his party are willing to work with Republicans and President Donald Trump to find a bipartisan solution on health care.

Manchin, a moderate Democrat from West Virginia who has been seen as a potential partner on parts of Trump's agenda, made the comments in an interview on "Fox News Sunday."

Story Continued Below

"I want him to know there are Democrats that want to work with him," Manchin said. "But right now, they can't even repeal it. They can't get 50 votes to repeal it because somebody's getting hurt more than what they're willing to sign on to."

"Look at some of us. Work with us Democrats who are willing to meet you in the middle, who have always been willing to meet you in the middle," Manchin said.

Manchin's comments echo those of Senate Minority Leader Chuck Schumer (D-N.Y.), who called for Trump to meet with Democrats to discuss how to fix problems in the health care system as a vote on the Senate GOP plan to replace Obamacare was delayed.

But Trump said at a recent rally he didn't think Democrats would vote for any health care bill, regardless of its merits. And earlier on Fox, White House legislative affairs director Marc Short called Schumer's calls to work on health care "disingenuous," citing Democrats' resistance to Trump's agenda so far, as well as resistance to confirmation of the president's nominees.

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Manchin also clarified during the interview that he has never supported the GOP's plan of repealing or replacing the law, but instead said the Affordable Care Act needs "repair."

"I think it needs repair," Manchin said. "I've thought from Day One. .. the private markets aren't working, and then on top of that we can do better through efficiencies."

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Manchin: Dems want to work with Trump on health care - POLITICO - Politico

Senate asks for CBO score on Cruz’s healthcare proposal – The Hill

Senate Republicans are asking the Congressional Budget Office to analyze a healthcare billthat includes changes proposed by Sen. Ted CruzTed CruzSenate asks for CBO score on Cruzs healthcare proposal The party of Lincoln has no soul the GOP and its toxic healthcare bill GOP scrambles to win centrist votes on ObamaCare repeal MORE (R-Texas), Axios reported Saturday.

They are also asking the independent scorekeeper to come out with an estimate on a healthcare bill without the proposed changes, in an effort to better understand the potential effects of Cruz's plan.

Cruz, who has said that he cannot vote for the Senate Republicans' healthcare bill in its current form, proposed an amendment to the measure this week that would allow health insurers to sell plans that do not meet the standards required by the Affordable Care Act.

Under that provision, insurance companies would still be required to sell at least one plan that meets the ACA's standards.

The plan could win support by some conservatives in the Senate, like Sens. Rand PaulRand PaulSenate asks for CBO score on Cruzs healthcare proposal Sunday shows preview: Trump clashes with media as health push delayed Surprise war vote points to shift in GOP MORE (R-Kent.) and Mike LeeMike LeeSenate asks for CBO score on Cruzs healthcare proposal Sunday shows preview: Trump clashes with media as health push delayed The party of Lincoln has no soul the GOP and its toxic healthcare bill MORE (R-Utah), who say the current Better Care Reconciliation Act (BCRA) does not do enough to repeal ObamaCare or lower insurance premiums.

By requiring insurers to offer at least one plan in each market that meets ObamaCare's regulatory standards, Cruz's plan could appease moderate Republicans, who have called for the Senate bill to maintain the ACA's rule prohibiting insurers from denying coverage to people with preexisting conditions.

The CBO released its assessment of the BCRA on Monday, estimating thatthe measure would trim the federal deficit by $321 billion, but would also increase the number of uninsured people by 22 million over the next decade.

Updated at 8:50 p.m.

Follow this link:

Senate asks for CBO score on Cruz's healthcare proposal - The Hill

Health care cuts: Rural hospitals ‘hanging on by their fingernails … – CNN

Raju pleaded with the hospital's owner to keep it open a few more days.

Ultimately, the hospital closed that Friday, leaving the rural town without a hospital for miles. Raju, who had been the hospital's chief of staff, is now the only doctor left in the town a two-hour drive south of Atlanta.

"I was very devastated when the hospital was closed," Raju said. "I was so attached to it. I practiced there for 33 years."

Raju knew that Richland's Stewart-Webster Hospital was "financially strained." Even for those patients covered by Medicaid, low reimbursement rates did not make a big enough dent. But Raju did not turn away any patients, even if they couldn't pay, he said.

Rural hospitals take a financial hit when they provide care to uninsured patients who can't afford it, said Elehwany. By insuring poorer patients, the Affordable Care Act hoped to remedy that. Despite its positive impacts, she said, it wasn't the magic bullet rural communities had hoped for.

"We strongly support the goals of the ACA," Elehwany said. "Everybody admits there's a few problems with the ACA, and unfortunately ... they seem to be magnified in rural America."

Sen. Shelley Moore Capito, a Republican from West Virginia, came out against the Senate health care bill this week for these reasons.

The Senate bill could cut revenues to rural providers by $1.3 billion each year, according to the Chartis Center and its partner iVantage Health Analytics. Roughly 34,000 jobs are also at risk, according to the analysis.

Raju, who sees 20 to 25 patients a day in his office, is not optimistic that hospital doors will reopen in Richland.

"I'm very doubtful it's going to happen, but we're not going to give up. We'll keep trying," he said.

That leaves his patients in what is known as a "medical desert." A long drive to the nearest hospital -- 45 minutes or more -- could be the difference between life and death, he said.

"Time is essential," he said. "We're going to lose some patients on the way because they cannot get the care in a reasonable amount of time."

But that doesn't deter Raju, who has been a staple in Richland for nearly four decades.

"I grew up in a rural area in India, and I always liked the small town," he said. "I've been here too long. I just can't go."

Continue reading here:

Health care cuts: Rural hospitals 'hanging on by their fingernails ... - CNN

McConnell: Senate will stick with working on health care bill – USA TODAY

USA Today Network Morgan Watkins, The (Louisville) Courier-Journal Published 10:36 p.m. ET June 30, 2017 | Updated 10:40 p.m. ET June 30, 2017

Sen. Mitch McConnell slams the Democrats' efforts to preserve Obamacare during the Hardin County GOP's Lincoln Day Dinner. Sam Upshaw Jr./Courier-Journal/USA TODAY Network

Majority Leader Mitch McConnell speaks during a fundraising event at the State Theater in Elizabethtown, Ky on Friday evening. June 30, 2017(Photo: Alton Strupp/CJ)

LOUISVILLE Although his conservative comrades in the Senate are still butting heads over a controversial health care bill, Sen. Mitch McConnell of Kentucky was optimistic about the potential for compromise Friday evening.

President Trump tweeted Friday that congressional Republicans should consider repealing the Affordable Care Act popularly known as Obamacare first and then work on a replacement. Kentucky's other Republican senator, Rand Paul, has expressed support for that idea.

But McConnell told reporters Friday that he and his colleagues in the Senate will stick to working on their current health care bill, which would repeal and replace the ACA simultaneously.

Speaking to a friendly crowd in Elizabethtown during a fundraiser for the Republican Party of Hardin County, McConnell compared his current predicament to holding a Rubiks cube.

Read more:

For Sen. Rob Portman, 'maybe' is the sweet spot

Senate health care bill negotiations: These are the big issues on the table

Poll: Only 12% of Americans support the Senate health care plan

The Senate majority leader said hes trying to figure out how to twist the dials to get enough votes to pass this proposal, which is expected to slash hundreds of billions of dollars from Medicaid over time and reduce some of the taxes paid by wealthy Americans.

Rolling back the ACA was a signature issue for Republicans during last year's election, and some conservative lawmakers have suggested shortening or eliminating Congresss recess in August so theyll have more time to work on that as well as other priorities.

McConnell didnt offer a definitive opinion about that idea Friday evening. Instead, he said, Well see what we need to do.

During his speech to a roomful of Hardin County Republicans on Friday, McConnell said he is confident that comprehensive tax reform another key goal for the GOP will happen.

Despite the deep divisions between Republicans and Democrats, McConnell said he sees infrastructure as an area where their interests may intersect. But Democrats aren't interested in comprehensive tax reform, he said. Instead, they'd prefer "raising taxes on people who are productive."

Sen. Mitch McConnell said wrestling with an Obamacare repeal is like working with a Rubik's Cube during the Hardin County GOP's Lincoln Day Dinner. Sam Upshaw Jr./Courier-Journal/USA TODAY Network

America is a land of second opportunities, he said. There are only two ways to fail in this country: Give up or die.

Do we want it to be a country in which risk-taking is applauded and failure is possible? Yes, he said. Failure has to be possible or you cant have success.

As McConnell spoke at the Historic State Theater in Elizabethtown on Friday evening, a small but passionate group of people concerned about the future of health care in America gathered across the street.

Approximately 85 people stoodtogether, chanting and waving anti-McConnell signs as passers-by occasionally honked their horns in solidarity or yelled "Trump" as they drove by.

Abbey Sorrells, 22,of Elizabethtown, who works at a rape crisis center, said she came to the rally with some friends who are part of a group called the Heartland Progressive Alliance.

Healthcare not Wealthcare, read the sign she carried.

I just feel like the health care bills really for the 1%, she said.

Audrey Morrison, 68, of Louisville drove down to Elizabethtown to join her daughter, who interns for Planned Parenthood.

I hope that we persist, she said, because the Republican plan to repeal and replace the Affordable Care Act isnt a done deal yet.

Morrison said she didnt expectthe rally to change McConnells mind.

I think hes been bought and sold. I dont think anythings going to make a difference to him, she said.

However, she still hopes Kentucky voters, whove repeatedly elected McConnell to the Senate for the past 30 years, will finally turn against him and call for change.

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