Tuesday, March 7, 2017

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House Republicans release long-awaited ObamaCare replacement bill

The politics of the ObamaCare overhaul
House Republicans on Monday evening released the text of their long-awaited ObamaCare replacement bill, proposing to eliminate the various taxes and penalties tied to the original legislation while still preserving certain patient protections.  
Aiming to deliver on their signature campaign promise after several election cycles trying to reclaim control of Washington, majority Republicans unveiled what they call the American Health Care Act. The sweeping legislation would repeal ObamaCare’s taxes along with the so-called individual and employer mandates – which imposed fines for not buying and offering insurance, respectively.
It also would repeal the Affordable Care Act’s subsidies, replacing them with tax credits for consumers.
CLICK TO READ THE TEXT OF THE OBAMACARE REPLACEMENT BILL.
The bill would continue Obama's expansion of Medicaid to additional low-earning Americans until 2020. After that, states adding Medicaid recipients would no longer receive the additional federal funds the statute has provided.

More significantly, Republicans would overhaul the federal-state Medicaid program, changing its open-ended federal financing to a limit based on enrollment and costs in each state.
“We begin by repealing the awful taxes, the mandate penalties and the subsidies in ObamaCare,” House Ways and Means Committee Chairman Kevin Brady, R-Texas, told Fox News’ “Special Report with Bret Baier” in an exclusive interview.
Asked about some conservatives’ concerns that GOP leaders are merely pushing ‘ObamaCare Lite,’ Brady countered, “It is ObamaCare gone.”
House Energy and Commerce Committee Chairman Greg Walden, R-Ore., told Fox News they also “are not pulling the rug out from under people.” Rather, he said Republicans want to restore power to the states and control costs in Medicaid and elsewhere.
“It’ll amount to the biggest entitlement reform, probably in at least the last 20 years,” he said.
The release of the bill touches off what is likely to be a contentious debate, not just with Democrats but within the Republican Party.
The White House signaled its approval of the plan, with spokesman Sean Spicer saying, "Today marks an important step toward restoring healthcare choices and affordability back to the American people."
House Minority Leader Nancy Pelosi, D-Calif., said the bill "hands billionaires a massive new tax break while shifting huge costs and burdens onto working families across America."
Senate Minority Leader Charles Schumer, D-N.Y., said the proposal "would cut and cap Medicaid, defund Planned Parenthood, and force Americans, particularly older Americans, to pay more out of pocket for their medical care all so insurance companies can pad their bottom line."
The first test for GOP leaders, who have been under heavy pressure ever since President Trump took office to release a bill, will be whether the text satisfies the influential conservative wing  – which has the numbers to torpedo the legislation. But it is a balancing act, as moderate Republican lawmakers, as well as governors of both parties, also have warned against going too far in rolling back consumer protections and benefits.
House Speaker Paul Ryan, R-Wis., said the bill would "drive down costs, encourage competition, and give every American access to quality, affordable health insurance." He added, "This unified Republican government will deliver relief and peace of mind to the millions of Americans suffering under Obamacare."
However, Sen. Rand Paul, R-Ky., said the bill "looks like ObamaCare Lite to me ... It's going to have to be better."
Rank-and-file Republicans were watching to see if the legislation brings down the cost of healthcare.
"If it doesn't, we haven't changed anything," one House Republican told Fox News.
While subsidies would be repealed in the new bill, they would be replaced by monthly tax credits. The credits, worth between $2,000 and $14,000 a year, could be used by low-and-middle-income families who don’t get work- or government-sponsored insurance to buy state-certified plans.
The credits would be based on age and family size, unlike the income-based version under ObamaCare. Conservatives have objected that that feature creates a new entitlement program the government cannot afford.
"I can’t believe many conservative groups are going to like this," one GOP lawmaker told Fox.
Republicans said they'd not yet received official cost estimates on the overall bill from the nonpartisan Congressional Budget Office. That office's projections on the bill's price tag and the number of people the measure would cover could be key in winning over recalcitrant Republicans, or making them even harder to win over.
It's unclear how many people might lose coverage under the new plan.
The legislation, meanwhile, would preserve protections for those with pre-existing conditions by prohibiting insurers from denying coverage or charging them more. It also would continue to allow young adults to stay on their parents’ plans up to age 26.
Further, the plan would call for a “transition” away from the current Medicaid expansion, which was used under the original law to cover millions more people. Republicans also say they’d give states $100 billion to design their own programs, while upping the amount of money families can contribute to so-called Health Savings Accounts.
A series of tax increases on higher-earning people, the insurance industry and others used to finance the Obama overhaul's coverage expansion would be repealed as of 2018.

In a last-minute change to satisfy conservative lawmakers, business and unions, Republicans dropped a plan pushed by Ryan to impose a first-ever tax on the most generous employer-provided health plans.
Fox News is told the plan is to go to both the Energy and Commerce and Ways and Means committees on Wednesday for "mark-up" sessions where they will craft a final version of the bill. The legislation would tentatively go before the House Budget Committee next week.
The hope is that the bill would hit the House floor the week after that -- and the Senate before the Easter recess.
Senate Finance Committee Chairman Orrin Hatch, R-Utah, wouldn't rule out changes in the measure by his chamber, where significant numbers of moderate Republicans have expressed concerns that the measure could leave too many voters without coverage.

"The House has the right to come up with what it wants to and present it to the Senate by passing it. And we have a right to look it over and see if we like it or don't," Hatch told reporters.

Underscoring those worries, four GOP senators released a letter to Senate Majority Leader Mitch McConnell, R-Ky., shortly before the bill was unveiled.

They complained that an earlier, similar draft of the measure "does not provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states." Signing the letter were Sens. Rob Portman of Ohio, Shelley Moore Capito of West Virginia, Cory Gardner of Colorado and Lisa Murkowski of Alaska.

GOP lawmakers get behind Trump immigration order reboot amid new legal threats


Republican lawmakers largely endorsed President Trump’s revised immigration executive order on Monday and suggested it addressed concerns they had about the original measure, even as a coalition of Democratic attorneys general and civil rights groups prepared for a new round of legal action.
House Speaker Paul Ryan, who had voiced reservations about the original travel ban rollout, said the new version advances “our shared goal” of protecting the United States.
Another Republican critical of the original version, South Carolina Sen. Lindsey Graham, said he believes the revised order will “pass legal muster.”
“I congratulate the administration for modifying the original order to ensure that it is prospective in application, protective of those with valid visas and legal status, and exempts Iraqis, as five thousand Americans are currently fighting alongside them against ISIL,” Graham said in a statement.
Trump’s revised executive order, signed Monday, suspends the refugee program and entry to the U.S. for travelers from six mostly Muslim countries, curtailing what was a broadly worded directive in a bid to withstand court scrutiny.
As before, the order will suspend refugee entries for 120 days. But it no longer will suspend Syrian refugee admissions indefinitely.
The new order also will ban travelers from six countries who did not obtain a visa before Jan. 27 from entering the United States for 90 days. The directive no longer includes Iraq, as the original order did, but covers travelers from Iran, Libya, Somalia, Sudan, Syria and Yemen.
Iraq, a key U.S. ally in the fight against terror group ISIS, was removed from the travel ban list after Secretary of State Rex Tillerson said he spoke with the Iraqi government about its vetting process and felt that the screening system was thorough enough to stand on its own.
As Republican lawmakers threw their political weight behind the revised version, Democratic officials in Washington, Virginia and Massachusetts said they were considering their next legal steps.
Washington Attorney General Bob Ferguson, who took the Trump administration to court over the constitutionality of the original order, said Monday he still has legal concerns about the updated language.
At a news conference, he said he and his office will review the policy and will decide on a course of action later this week.
“I do not take lightly suing the president of the United States,” he said.
Massachusetts Attorney General Maura Healey said she’s also considering legal options in response to the reworked travel ban. Healy called the newest language misguided and said it is “a clear attempt to resurrect a discredited order and fulfill a discriminatory and unconstitutional campaign promise.”
Virginia Attorney General Mark Herring, who also led a legal challenge to Trump’s first ban, said the new directive still “sends a horrible message to the world.”
"Our goal has always been to protect the commonwealth of Virginia and our residents who were harmed by President Trump's ill-conceived, poorly-implemented, and un-American ban, particularly green card holders and those at our businesses and colleges with valid work and student visas,” he said. “It is significant that after we won the nation's first preliminary injunction against the ban, President Trump has now revoked his original order and apparently exempted all those persons from his revised order."
Chicago Mayor Rahm Emanuel calling the revision a betrayal of the country’s core values.
“The legal grounds of the first travel ban were questionable at best, and today’s iteration is nothing more than a wolf in sheep’s clothing – different packaging intended to achieve the same result,” Emanuel said in a statement, adding that the order would “slam the door” on refugees fleeing war-torn countries.
Unlike the first rocky rollout of the executive order, Trump privately signed the new directive while Tillerson, Attorney General Jeff Sessions and Homeland Security Secretary John Kelly formally unveiled it. The Trump-free event was in contrast to the first version of the order that the president signed in a high-profile ceremony at the Pentagon’s Hall of Heroes.
Tillerson defended the new order on Monday, saying Trump is using “his rightful authority” to keep people safe with the new directive.
“This order is part of our ongoing efforts to eliminate vulnerabilities that radical Islamic terrorists can and will exploit,” he added.
Kelly said the new executive order “will make America more secure.”
“Unvetted travel isn’t a privilege especially when national security is at stake,” he said.
Among other things, the revised order also makes clear that green card holders are not affected.
“If you have travel documents, if you actually have a visa, if you are a legal permanent resident, you are not covered under this particular executive action,” White House Counselor Kellyanne Conway told Fox News on Monday. “I think people will see six or seven major points about this executive order that do clarify who is covered.”
The Trump administration also plans to cap the number of refugees it accepts to 50,000 a year – down sharply from the 110,000 accepted by the Obama administration.
According to the new executive order, the U.S. Department of Homeland Security will have 20 days to perform a “global, country-by-country review of the identity and security information that each country provides to the U.S. government to support U.S. visa and other immigration benefit determinations.”
Countries will then have 50 days to comply with requests to update or improve the “quality” of the information they provide to U.S. officials.
For countries that don’t comply, the State Department, DHS and intelligence agencies can make additional recommendations on what, if any, restrictions should be imposed.
The new order also details categories of people eligible to enter the United States for business or medical travel purposes.
Almost immediately, there was pushback from Democratic lawmakers and human rights groups.
“A watered down ban is still a ban,” Sen. Charles Schumer, D-N.Y., said. “Despite the administration’s changes, this dangerous executive order makes us less safe, not more, it is mean-spirited, and un-American. It must be repealed.”
Omar Jadwat, director of the ACLU’s Immigrants’ Rights Project, agreed.
“President Trump has recommitted himself to religious discrimination, and he can expect continued disapproval from both the courts and the people,” he said in a statement.
More than two dozen lawsuits were filed in response to the original travel ban. The suit filed in Washington state succeeded in having the order suspended by arguing that it violated constitutional protections against religious discrimination.
The White House was criticized the first time around for its rocky rollout of the travel ban. Trump has expressed frustration both in person and on social media over the stalled ban, at times targeting the courts and federal judges who he claimed put the country at risk by holding up the order.
Last week, Trump told reporters at the White House that “the new order is going to be very much tailored to what I consider to be a very bad decision.”
Despite widespread belief the first order was done in haste, Trump and other White House officials have repeatedly called it a success.

Trump offers Planned Parenthood funds if it halts abortions


President Trump has offered to maintain federal funding for Planned Parenthood if the group stops providing abortions. Its president has spurned the proposal and noted that federal money already is not allowed to be used for abortion.
Trump confirmed there had been discussions after The New York Times inquired about what it described as an informal proposal. In a statement to the newspaper, Trump says "there is an opportunity for organizations to continue the important work they do in support of women's health, while not providing abortion services."
The paper reported that, in private conversations, White House officials mentioned that there could even be an increase in federal funds if Planned Parenthood stopped work related to abortions.
There is reportedly an internal struggle amongst Republicans about how to approach the abortion issue. Trump has, during the primary, mentioned what he sees as some of the positive work Planned Parenthood does.
“Millions and millions of women—cervical cancer, breast cancer—are helped by Planned Parenthood,” he said during a televised debate, according to the report. “I would defund it because I’m pro-life, but millions of women are helped by Planned Parenthood.
In a response to the report of the proposal, Planned Parenthood Federation of America President Cecile Richards says the group "will always stand for women's ability to make decisions about their health and lives, without interference from politicians."
According to their own annual report, Planned Parenthood saw 2.5 million clients in 2015, which is down from 3.1 million in 2006. While that number may seem high, it means that 98 percent of women of reproductive age will never step foot inside a Planned Parenthood in any given year for health care.
Diane Max, a big donor to Planned Parenthood, told The Times that the reported offer is an “absurd play.” Trump, she said, had been “sympathetic to a woman’s right to choose until it was politically unpopular” for him.

THAAD deployment threat stokes US tensions with Beijing, Moscow



The U.S. decision to send equipment needed to set up a controversial missile defense system in South Korea is likely to add to the tensions among Beijing and Moscow, countries that have spoken out in the past about deploying the system.
China said Tuesday that it will take measures against US missile system deployed in S. Korea, says US and Seoul will bear consequences.
"China firmly opposes the deployment of THAAD," Chinese Foreign Ministry spokesman Geng Shuang said. "We will definitely be taking necessary measures to safeguard our own security interest. All consequences entailed from that will be borne by the U.S. and (South Korea). We once again strongly urge the relevant sides to stop the process of deployment and refrain from going further down that wrong path."
Lou Yuan, an outspoken, retired Chinese general, wrote in the Global Times, a state-run paper, that the Chinese military “could conduct a surgical hard-kill operation that would destroy the target, paralyzing it and making it unable to hit back,” The New York Times reported.
He went on, “Since the United States, Japan and South Korea choose not to respect China’s major security concerns, China does not need to be a gentleman on everything."
Washington and Seoul says the Terminal High-Altitude Area Defense system, or THAAD, is not meant to be a threat to China or Russia. The U.S. military said in a statement that THAAD can intercept and destroy short and medium range ballistic missiles during the last part of their flights.
Kim Yong-hyun, a professor of North Korean Studies at Seoul’s Dongguk University, told The Korean Times that it is “apparent that China is trying to draw its two Cold War allies to its side, at least over THAAD-related issues. It will also highlight the alliance between South Korea and the U.S. as well as their ties with Japan as part of tactics against THAAD.”
On Monday, North Korea fired four ballistic missiles in an apparent protest against ongoing U.S.-South Korean military drills that it views as an invasion rehearsal. The missiles flew about 620 miles on average, three of them landing in waters that Japan claims as its exclusive economic zone, according to South Korean and Japanese officials.
But China and Russia see the system’s powerful radars as a security threat.
An official from South Korea's Defense Ministry, who didn't want to be named, citing office rules, said that the equipment that arrived in South Korea included launchers, but didn't confirm how many.
While South Korea's media speculate that the THAAD deployment could be completed by as early as April, the ministry official couldn't confirm those reports. The official said that the plan was to have the system operational as soon as possible.
China's condemnation of South Korean plans to deploy THAAD has triggered protests against South Korean retail giant, Lotte, which agreed to provide one of its golf courses in southern South Korea as the site of THAAD. The South Korean government also raised worries about a reported ban on Chinese tour groups visiting the country.
On Tuesday, China's Global Times, an outspoken nationalist tabloid published by the ruling Communist Party's flagship People's Daily, criticized North Korea over the missiles.
"By firing four missiles at once this time, the military confrontation between Pyongyang, Seoul and Washington escalates a notch," the paper said. "Noticeably, the Chinese public is angry that Pyongyang's nuclear program has provided an excuse for Seoul to deploy THAAD."

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