CBO: 22 Million People Will Lose Insurance under the Senate Bill

The Republicans are definitely making progress with their health care bill. The first House version would have cost 24 million people their insurance, so the House fixed the bill. In the second version, only 23 million will lose their insurance. The Congressional Budget Office has now scored the Senate bill and it is better than even the second House bill. Only 22 million people will lose insurance if it becomes law. Extrapolating from these data, we can project that with 22 more bills, the Republican plan will cover as many people as the ACA does.

This new report does not make life any easier for Senate Majority Leader Mitch McConnell (R-KY). Conservatives in his caucus want to make the bill more restrictive, which will cause even more people to lose insurance. But Senate Republican moderates want to cover more people, and this report is going to make it much harder for them to sign on to the bill, even as amended yesterday (see below). The real stumbling block is Medicaid, which conservatives hate with a passion since it gives (poor) people free medical care that everyone else has to pay for. Moderates think everyone should get medical care when they need it. It is a difficult divide to bridge. The approach currently being used is a traditional Senate technique known as "kicking the can down the road." It would phase out Medicaid expansion, but do it over 3, 5, 7, or some other number of years, so there isn't a big blowback in 2018. The danger, of course, is that some future Democratic Congress could halt the phase out. (V)

The CBO report makes it much more difficult for the bill to pass this week before the Senate takes off for hot dogs and fireworks, although there might be some fireworks in the Senate this week. McConnell is afraid that if senators go home and start talking to constituents, when they come back they will be even in less of a mood to pass the bill than they are now. That could mean the end of it. He really doesn't want to take that risk. Cornyn seemed to say that the Republicans really mean it when he announced yesterday that the vote will be this week. (V)

Senate Leadership Revises the Health-Care Bill

Senate Republican Whip John Cornyn (R-TX) yesterday admitted what everybody knows, namely, that the votes for the Senate health-care bill aren't there. At this point, the bill is being tweaked to satisfy various senators and interest groups. A new version was released yesterday that is designed to encourage people to have continuous health coverage. In the original bill, people could drop off insurance and later when they got sick, buy insurance. The insurance companies weren't too keen on that. Monday's bill says that anyone without insurance can buy it at any time, but it doesn't go into effect for 6 months.

Maybe the insurance companies will now be happy, but the doctors aren't. The American Medical Association announced its opposition yesterday because it violates a basic AMA principle: First, do no harm. More tweaks are likely in the next couple of days.

Graham to Colleagues: Trump Won't Have Your Back

Sen. Lindsey Graham (R-SC) is undecided about the Senate's health care bill, but says he's leaning towards supporting it (Translation: My vote is available, but it's going to cost you, Mitch). Regardless of where he ends up, however, Graham has a warning for his fellow senators: "If you're counting on the president to have your back, you need to watch it. If you're looking for political cover from the White House, I'm not sure they're going to give it to you."

Graham is simply acknowledging what everyone now knows: Donald Trump cares about exactly one person in Washington (well, maybe two or three). Beyond his immediate family—and, apparently, Michael Flynn—the President will not hesitate to throw anyone, even members of his own party, under the bus. And he will not spend any of his (rapidly diminishing) political capital on anyone but himself. Certainly, Trump is not the first resident of 1600 Pennsylvania Avenue to think of himself first, second, and third, but it is unprecedented that he has so little use for the other members of his party. What The Donald does not seem to realize is that friends in Congress can actually be useful once in a while, and it's good to play nice with them for that reason, even if you don't mean it. It's really quite astounding that someone who spent 50 years as a high-flying businessman, and who sort of wrote "The Art of the Deal," cannot transfer a few lessons about wheeling and dealing to his political career. (Z)

Pelosi: 'Hundreds of Thousands' Will Die if Health Care Bill Becomes Law

House Minority Leader Nancy Pelosi (D-CA) appears to have reached the same conclusion that Hillary Clinton did: Democrats should be talking about those who will die if the Obamacare replacement becomes law. Appearing on CBS This Morning, Pelosi said, "We do know that many more people—millions, hundreds of thousands—of people will die if this bill passes. These bills systemically, structurally, they are very, very harmful to the American people."

Pelosi knows well that a loss of insurance means less access to medical care. And less access to medical care means a higher likelihood of death (at least it does today, now that doctors wash their hands and no longer bleed their patients). However, the Minority Leader tripped over her tongue a little bit, as she tried to guess exactly how many lives would be lost. But now, guessing is no longer necessary, as a pair of academics and public health experts released a report on Monday that puts things on a more precise basis. According to their calculations, 29,000 more Americans would die each year if the Republicans' plans are put into effect. More than a quarter of a million people over the next decade, and that's before we talk about the people who will not die, but will become sick (or sicker), or handicapped, or will otherwise have a lesser quality of life. All of this primarily so that the ultra-rich can have a tax break. The 2018 campaign ads practically write themselves. (Z)

Supreme Court Will Take the Muslim Travel Ban Case in October (Unless it Doesn't)

The Supreme Court issued a somewhat complicated ruling on Donald Trump's Muslim travel ban v2.0 yesterday. None of it is straightforward. To start with, the Court said it will consider the case on its merits in October. However, the ban itself says the government needs 90 days to review its immigration policy. But by the time the oral arguments are heard in October, the 90 days will have passed, making the case moot. Will the Court take up a case in which the government is arguing that it needs 90 days to review its immigration policy after it has had 90 days (starting yesterday) to do so? It might simply rule that the case is moot and no hearing or ruling is needed.

The other part of the ruling is also complicated. The Court refused to allow the government to ban entry of everyone from the six Muslim-majority countries named in the executive order that created the ban. It said that people with a legitimate reason to come to the U.S. could not be barred. That includes people visiting family, students who have been accepted at a school, people who have accepted a job with a U.S. company, people who have been invited to give a lecture to a U.S. audience, etc. It seems mostly to block tourists who have no previous connection to the U.S. But it is hard to imagine that the State Dept. was granting a lot of tourist visas to citizens of places like Yemen and Somalia in the first place. So, there are two main effects of the ruling:

• Donald Trump can claim a win because part of his ban was upheld and there might be oral arguments in October
• Nothing actually changed yesterday

One complication that is sure to arise is the question of what a legitimate reason to come is. Suppose someone from Yemen wants to come and contacts a Yemeni organization in the U.S. asking for an invitation. The organization obliges by writing a letter inviting the person to come visit them to address the group about the situation back home in Yemen. Imagine the situation at JFK Airport when the person hands the letter to the immigration official, who has no idea what the group is, how big it is, whether this person has anything useful to say, and how long ago this was all planned. It is going to lead to chaos at airports and arbitrary decisions that depend largely on the mood the immigration officers were in when they made their decisions.

As expected, Trump called the ruling "a clear victory for our national security," adding that, "Today's ruling allows me to use an important tool to protect our Nation's homeland. I also am particularly gratified that the Supreme Court's decision was 9-0." The Court could have thrown the ban out immediately or refused to review the lower-court decisions, so Trump did get something out of the ruling, but a complete victory it was not. On the other hand, it is increasingly clear that Trump doesn't actually care about any of his own policies. He just wants to tell his base that he got a "win." This decision is a plausible "win," at least until the Court rules on the merits (or doesn't) in the fall. (V)

Supreme Court Will Look at Wedding Cake Case

Another case that the Supreme Court will take up in the fall is one involving a baker who violated a Colorado law when he told a gay couple he wouldn't bake a wedding cake for them. The baker, Jack Phillips, claims that the Constitution's guarantee of religious freedom means that he doesn't have to violate his religious beliefs by baking a cake to celebrate what he considers to be a sin. He says he is not anti-gay and is happy to bake generic cakes for them, just not wedding cakes.

Numerous similar cases are pending in a number of states. In one of them, a Washington florist refused to supply flowers for a same-sex wedding, citing that she had no objection to doing business with gay people, and had previously sold flowers to the gay couple numerous times. She just didn't want to participate in a same-sex wedding. Conservative groups are excited about the case due to the presence of a new Justice, Neil Gorsuch, on the Court. On the other hand, the late Justice Antonin Scalia would almost certainly have supported the religious argument, so in a sense, the case is riskier now than when Scalia was alive. (V)

No White House Ramadan Celebration this Year

Off and on, going as far back as Thomas Jefferson, presidents have held iftar dinners to commemorate the end of Ramadan. It's a useful way to build bridges with American Muslims and with the Muslim nations of the world. In Jefferson's case, for example, he was trying to make nice with the nations of north Africa, who had the nasty habit of attacking and ransacking American merchant ships.

Starting with Bill Clinton's second term, the iftar dinners became an annual tradition. The main purpose, in the context of the 1993 World Trade Center bombing and later the 9/11 attacks, was to make clear that the United States' enemy is terrorism and not Islam. But now, the custom is coming to an end (at least temporarily). This is not too much of a surprise, as Donald Trump hates to do anything that Barack Obama did. Further, his base would not be pleased to see pictures of him fraternizing with Muslims. There's also the problem that many of the Muslims who might have been invited (if not all of them) were at risk of boycotting in protest of the Muslim travel ban. There's nothing worse than giving an iftar dinner and having nobody show up. Of course, just as having the event sent a message to Muslims across the nation and the world, canceling it also sends a message to them. (Z)

Ryan Draws Ironworker Opponent

Speaker Paul Ryan (R-WI) has some powerful advantages every time he stands for re-election: universal name recognition, a massive war chest, friends in high places. One might even say he's invincible, given the circumstances. Of course, they also said that about Eric Cantor.

The point is that Ryan may have a huge advantage, but nobody is unbeatable. And now, this particular Goliath has drawn his David. Challenging the Speaker will be a salt-of-the-earth ironworker named Randy Bryce. He's run for office (unsuccessfully) a few times before, and if his first ad is any indication, he's putting the lessons he learned to good use. The ad is about health care, of course, and features Bryce's mother worrying what will happen if she's no longer able to get the drugs she needs to treat her multiple sclerosis. It's very effective. Bryce is still a longshot, but if someone is going to unseat the Speaker, it's probably a folksy, blue-collar, white guy. If nothing else, 434 other Democratic candidates for the House should be watching the ad and taking copious notes. (Z)

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---The Votemaster and Zenger