the national interest

Here Are the 4 Different Ways Democrats Can Save Obamacare

Democratic leaders in Congress defending Obamacare. Photo: Zach Gibson/AFP/Getty Images

The Republican campaign to discredit the Affordable Care Act is a catastrophic success. Republicans have denounced the law for shortcomings that their own plans would all exacerbate, and have taken advantage of widespread confusion about what the law does and whom it benefits — a posture that works only as long as Republicans can avoid responsibility for the status quo. Democrats have the chance to defend and safeguard Obamacare’s successes if they leverage this Republican vulnerability. In fact, they have four chances.

The next phase of the fight over American health care will be confusing. It will unfold over numerous votes and many months (or, more likely, years). But every strategy involves using the GOP’s political weakness against it with the goal of getting the best possible outcome for the people helped by Obamacare.

1. Defeat repeal and delay. Republicans have a two-step plan. First, they will vote to defund Obamacare through a budget-reconciliation bill that can’t be filibustered. Then their replacement plan will be voted on later.

The repeal vote is the easiest step in the Republican plan, but it’s still not very easy. Republicans will repeal the law and delay the effects of the repeal for a long period (the most current reporting suggests three years). A vote to repeal Obamacare without clarity about its replacement will threaten massive chaos in the health-care market. Not only will millions of Americans lose their access to medical care but, even worse (from a Republican perspective), doctors, hospitals, and insurers will face the risk of massive losses. Several Republicans have threatened to oppose a bill that repeals Obamacare without simultaneously replacing it, and the party can only afford to lose two votes.

Last week, Senate Republicans started bleeding votes, as some half-dozen of their members indicated deep reservations about repeal-and-delay. GOP leaders yanked them back into line on a procedural vote by promising that the deadline for the real repeal vote could be extended. But there remains a real chance the repeal strategy could collapse at step one.

2. Negotiate for minimal changes. Republicans hope that defunding Obamacare on a delay will pressure Democrats into giving them cover for the kinds of unpopular changes Republicans want to make to the system — which means letting insurers sell skimpy plans, with lower subsidies, creating sky-high premiums and deductibles that leave medical coverage far less affordable to people who are either poor or sick. The expiration of the phase-out will be a cliff. Trump has said that he thinks he can force at least eight Democrats, which is the number his party needs to write a new health-care bill, to support his plan by convincing voters to blame them if Obamacare ends.

But this is preposterous. Voters always hold the governing party accountable for bad outcomes. Remember, many of the people who would lose their care voted for Trump and expect him to protect or even strengthen their insurance. Assuming repeal-and-delay passes, Democrats should treat it as if the Republican government has set off a time bomb that would blow up its majority.

Of course, expiration of Obamacare without any plan to replace it would create a humanitarian catastrophe as well. So if Republicans want to agree to some package of small fixes that preserves the law’s main accomplishments, Democrats might take such a deal. Then, basically, Obamacare will have been rebranded as Trumpcare. A handful of hard-core anti-government ideologues on the right would howl. But, given that vanishingly few Republicans have any idea what Obamacare does, they could easily be convinced that Trumpcare is amazing, even if it is 95 percent the same as Obamacare.

3. Push for extension. Assuming steps one and two fail, and no deal can be struck, at some point, the deadline for Obamacare extension will approach, perhaps at the end of 2019. Republicans will not want to head into the 2020 elections having presided over a catastrophic failure, with news coverage of suffering, death, and failing hospitals and insurers. Trump would have broken his promise to replace Obamacare with a terrific alternative that takes care of everybody. Lobbyists for insurers, doctors, and hospitals will exert overwhelming pressure to simply extend Obamacare’s deadline, which could be done by the same majority vote that “repealed” the law. The extensions would continue until Trump leaves office.

4. Repeal the repeal. If all the above steps fail, there is one final recourse. Assume Obamacare is repealed and no replacement emerges. (Or perhaps the “replacement” is a handful of hoary Republican measures, like Health Savings Accounts, that do little or nothing to cover people who can’t afford insurance.) Either way, Democrats will have a clear path forward to undoing whatever Republicans do to their system. The disaster of repeal-without-replace could easily be broad enough to power the kind of anti-incumbent wave that produced the last Democratic majority, in 2006 and 2008. Possibly, Democrats will have to wait longer than until 2020 to regain their control of government.

But the legislative dynamic will have changed for good. It’s important to recall that the filibuster is the reason health-care reform was out of reach for decades. Democrats could have passed health-care reform under Bill Clinton, or possibly earlier, if not for the Senate’s 60-vote requirement. They finally overcame that threshold in 2009 by mustering 60 Senate votes. Republicans might defund their bill with 50 votes, but they won’t have 60 votes to eliminate the insurance regulations it created. That means Democrats can pass reform again with only 50 Senate votes. That opportunity will come. And if Trump’s government screws up badly enough, it will probably arrive sooner rather than later.

4 Different Ways Democrats Can Save Obamacare
the national interest

Here Are the 4 Different Ways Democrats Can Save Obamacare

Democratic leaders in Congress defending Obamacare. Photo: Zach Gibson/AFP/Getty Images

The Republican campaign to discredit the Affordable Care Act is a catastrophic success. Republicans have denounced the law for shortcomings that their own plans would all exacerbate, and have taken advantage of widespread confusion about what the law does and whom it benefits — a posture that works only as long as Republicans can avoid responsibility for the status quo. Democrats have the chance to defend and safeguard Obamacare’s successes if they leverage this Republican vulnerability. In fact, they have four chances.

The next phase of the fight over American health care will be confusing. It will unfold over numerous votes and many months (or, more likely, years). But every strategy involves using the GOP’s political weakness against it with the goal of getting the best possible outcome for the people helped by Obamacare.

1. Defeat repeal and delay. Republicans have a two-step plan. First, they will vote to defund Obamacare through a budget-reconciliation bill that can’t be filibustered. Then their replacement plan will be voted on later.

The repeal vote is the easiest step in the Republican plan, but it’s still not very easy. Republicans will repeal the law and delay the effects of the repeal for a long period (the most current reporting suggests three years). A vote to repeal Obamacare without clarity about its replacement will threaten massive chaos in the health-care market. Not only will millions of Americans lose their access to medical care but, even worse (from a Republican perspective), doctors, hospitals, and insurers will face the risk of massive losses. Several Republicans have threatened to oppose a bill that repeals Obamacare without simultaneously replacing it, and the party can only afford to lose two votes.

Last week, Senate Republicans started bleeding votes, as some half-dozen of their members indicated deep reservations about repeal-and-delay. GOP leaders yanked them back into line on a procedural vote by promising that the deadline for the real repeal vote could be extended. But there remains a real chance the repeal strategy could collapse at step one.

2. Negotiate for minimal changes. Republicans hope that defunding Obamacare on a delay will pressure Democrats into giving them cover for the kinds of unpopular changes Republicans want to make to the system — which means letting insurers sell skimpy plans, with lower subsidies, creating sky-high premiums and deductibles that leave medical coverage far less affordable to people who are either poor or sick. The expiration of the phase-out will be a cliff. Trump has said that he thinks he can force at least eight Democrats, which is the number his party needs to write a new health-care bill, to support his plan by convincing voters to blame them if Obamacare ends.

But this is preposterous. Voters always hold the governing party accountable for bad outcomes. Remember, many of the people who would lose their care voted for Trump and expect him to protect or even strengthen their insurance. Assuming repeal-and-delay passes, Democrats should treat it as if the Republican government has set off a time bomb that would blow up its majority.

Of course, expiration of Obamacare without any plan to replace it would create a humanitarian catastrophe as well. So if Republicans want to agree to some package of small fixes that preserves the law’s main accomplishments, Democrats might take such a deal. Then, basically, Obamacare will have been rebranded as Trumpcare. A handful of hard-core anti-government ideologues on the right would howl. But, given that vanishingly few Republicans have any idea what Obamacare does, they could easily be convinced that Trumpcare is amazing, even if it is 95 percent the same as Obamacare.

3. Push for extension. Assuming steps one and two fail, and no deal can be struck, at some point, the deadline for Obamacare extension will approach, perhaps at the end of 2019. Republicans will not want to head into the 2020 elections having presided over a catastrophic failure, with news coverage of suffering, death, and failing hospitals and insurers. Trump would have broken his promise to replace Obamacare with a terrific alternative that takes care of everybody. Lobbyists for insurers, doctors, and hospitals will exert overwhelming pressure to simply extend Obamacare’s deadline, which could be done by the same majority vote that “repealed” the law. The extensions would continue until Trump leaves office.

4. Repeal the repeal. If all the above steps fail, there is one final recourse. Assume Obamacare is repealed and no replacement emerges. (Or perhaps the “replacement” is a handful of hoary Republican measures, like Health Savings Accounts, that do little or nothing to cover people who can’t afford insurance.) Either way, Democrats will have a clear path forward to undoing whatever Republicans do to their system. The disaster of repeal-without-replace could easily be broad enough to power the kind of anti-incumbent wave that produced the last Democratic majority, in 2006 and 2008. Possibly, Democrats will have to wait longer than until 2020 to regain their control of government.

But the legislative dynamic will have changed for good. It’s important to recall that the filibuster is the reason health-care reform was out of reach for decades. Democrats could have passed health-care reform under Bill Clinton, or possibly earlier, if not for the Senate’s 60-vote requirement. They finally overcame that threshold in 2009 by mustering 60 Senate votes. Republicans might defund their bill with 50 votes, but they won’t have 60 votes to eliminate the insurance regulations it created. That means Democrats can pass reform again with only 50 Senate votes. That opportunity will come. And if Trump’s government screws up badly enough, it will probably arrive sooner rather than later.

4 Different Ways Democrats Can Save Obamacare
THE FEED

Biden’s got a boot

Photo: @ABC/Twitter

Add Giuliani to your pardon bingo card

Rudolph W. Giuliani, President Trump’s lawyer who has led the most extensive efforts to damage his client’s political rivals and undermine the election results, discussed with the president as recently as last week the possibility of receiving a pre-emptive pardon before Mr. Trump leaves office, according to two people told of the discussion.


It was not clear who raised the topic. The men have also talked previously about a pardon for Mr. Giuliani, according to the people. Mr. Trump has not indicated what he will do, one of the people said.


Mr. Giuliani’s potential criminal exposure is unclear. He was under investigation as recently as last summer by federal prosecutors in Manhattan for his business dealings in Ukraine and his role in ousting the American ambassador there, a plot that was at the heart of the impeachment of Mr. Trump.

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Scientists at the U.S. Centers for Disease Control and Prevention found evidence of infection in 106 of 7,389 blood donations collected by the American Red Cross from residents in nine states across the U.S., according to the study published online in the journal Clinical Infectious Diseases.


The scientists based their study on blood samples that the American Red Cross collected between Dec. 13 and Jan. 17 and later sent to the CDC for testing to see if any had antibodies to the new coronavirus, which is named SARS-CoV-2.


… In analyzing the blood samples, the CDC scientists found antibodies in 39 samples from California, Oregon and Washington state collected between December 13 and December 16.


The findings suggest there were isolated cases of coronavirus infection on the U.S. West Coast in mid-December, the scientists wrote.


They also found 67 samples with antibodies in Massachusetts, Michigan, Wisconsin or Iowa, and Connecticut or Rhode Island collected between Dec. 30 and Jan. 17.

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Trump is going to have one more COVID outbreak for the road

The White House began the annual holiday party season on Monday afternoon, officials said, kicking off a spate of indoor holiday parties that commemorate various religious traditions over the season.


While many public health professionals have asked Americans not to congregate in large group settings and avoid travel over the holidays because of the coronavirus pandemic that has killed more than 266,000 Americans and infected 13 million more, the White House is expected to throw more than a dozen indoor parties, including a large congressional ball on Dec. 10, officials say.


The parties will be paid for by the Republican Party, a person with knowledge of the planning said, and will cost millions of dollars.

The president and the first lady are determined to have a final holiday season in the White House, officials said, and concerns about spiking cases and deaths across the country have not stopped the events. Many of the administration’s supporters have taken a skeptical view of the restrictions over the virus and are choosing to attend, officials said.


Two people familiar with the planning said events are going to be scaled down in size this year from previous events — and the crowds will be smaller for each individual one — but will still be largely indoors. Mask-wearing and distancing will be encouraged, aides said, but was not included on two formal invites reviewed by The Washington Post.

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Federal and state officials agree that the nation’s 21 million health care workers should be first in line. But there is no consensus about how to balance the needs of other high-risk groups, including the 53 million adults aged 65 or older, 87 million essential workers and more than 100 million people with medical conditions that increase their vulnerability to the virus.


The Trump administration has told states that they have ultimate authority for determining who gets vaccinated first. It has also decided to allocate scarce early doses based on states’ total populations, forcing hard choices in states with a greater proportion of residents at high risk — including Black, Indigenous and Latino communities that have suffered disproportionate rates of hospitalization and death from Covid-19.

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* ARIZONA CERTIFIES 2020 U.S. PRESIDENTIAL ELECTION FOR DEMOCRAT BIDEN@Reuters
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A big subtweet of the president here

Georgia Secretary of State: “There are those who are exploiting the emotions of many Trump supporters with fantastic claims, half truths and misinformation, and frankly they are misleading the president as well. “
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An estimated 28,637 cuts were reported in the industry by late October, Variety, citing data from Challenger, Gray & Christmas, reported, nearly as many as the record 28,803 reported in the media sector in 2008. By comparison, the sector saw just over 10,000 job losses in 2019 and 15,474 in 2018.


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President-elect Joe Biden and Vice President-elect Kamala Harris are set to receive their first presidential daily briefing on Monday. 


The briefing is a collection of high-level intelligence information and other materials pertinent to issues of national security prepared for the president by senior officials and advisers. 


A president-elect typically begins receiving the briefings in the weeks before he is inaugurated to ensure a smooth transition process and protect the nation’s interests at home and abroad. The White House reportedly signed off of the briefings for Biden last week. 

Moderna will become the second company, following Pfizer, to ask the FDA for emergency use authorization for a COVID-19 vaccine

Pharmaceutical company Moderna intends to apply Monday to the US Food and Drug Administration for authorization of its Covid-19 vaccine.


The company will ask the FDA to review an expanded data set showing the vaccine is 94.1% effective at preventing Covid-19 and 100% effective at preventing severe cases of the disease.


“This is striking,” said Dr. Paul Offit, a member of the FDA’s vaccine advisory committee. “These are amazing data.”


Moderna’s chief medical officer said he became emotional when he saw the data Saturday night.


“It was the first time I allowed myself to cry,” Dr. Tal Zaks said. “We have a full expectation to change the course of this pandemic.”

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The coddled dear leader

Sequestered in the White House and brooding out of public view after his election defeat, rageful and at times delirious in a torrent of private conversations, Trump was, in the telling of one close adviser, like “Mad King George, muttering, ‘I won. I won. I won.’ ”


However cleareyed Trump’s aides may have been about his loss to President-elect Joe Biden, many of them nonetheless indulged their boss and encouraged him to keep fighting with legal appeals. They were “happy to scratch his itch,” this adviser said. “If he thinks he won, it’s like, ‘Shh . . . we won’t tell him.’ ” …


In the days after the election, as Trump scrambled for an escape hatch from reality, the president largely ignored his campaign staff and the professional lawyers who had guided him through the Russia investigation and the impeachment trial, as well as the army of attorneys who stood ready to file legitimate court challenges.


Instead, Trump empowered loyalists who were willing to tell him what he wanted to hear — that he would have won in a landslide had the election not been rigged and stolen — and then to sacrifice their reputations by waging a campaign in courtrooms and in the media to convince the public of that delusion.