North Korean leader Kim called Trump a what? A ‘dotard’

Associated Press

North Korean leader Kim called Trump a what? A ‘dotard’

Hyung-Jin Kim, Associated Press,              September 22, 2017

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SEOUL, South Korea (AP) — Famous for using bombastic, derogatory and often-awkward English slams against enemies, North Korean state media sent people scrambling for dictionaries Friday with a dispatch that quotes leader Kim Jong Un calling President Donald Trump “the mentally deranged U.S. dotard.”

The what?

Dotard means a person in a feeble or childish state due to old age. It’s a translation of a Korean word, “neukdari,” which is a derogatory reference to an old person.

It was used in an unusual direct statement from Kim that the Korean Central News Agency transmitted verbatim in response to Trump’s speech at the U.N. this week, in which he mocked Kim as a “Rocket Man” on a “suicide mission,” and said that if the U.S. is “forced to defend itself or its allies, we will have no choice but to totally destroy North Korea.”

Past KCNA reports have used the Korean word against South Korean conservatives, but they rarely translate it as dotard.

Sometimes, it is translated into the neutral “old people” or omitted, depending on the context or the importance of the statement. KCNA last used the word in February to describe supporters of ousted South Korean President Park Geun-hye, whom it also called “neukdari” and a “prostitute.” Before that, KCNA called Park’s conservative predecessor, Lee Myung-bak, “the traitor like a dotard.”

So why did KCNA use the word again?

It may have simply resorted to a Korean-English dictionary. Putting “neukdari” into a popular online Korean-English dictionary in South Korea returns two English equivalents: an “aged (old) person” and a “dotard.”

There has been a widening linguistic divide between the rival Koreas, but “neukdari” has the same meaning in North Korea as in the South, according to a South Korean organization involved in a now-stalled project to produce a joint dictionary.

The Korean version of Friday’s dispatch places “michigwangi,” which means a mad or crazy person, before “neukdari,” so a more accurate translation might have been a “crazy old man” or an “old lunatic.”

In the past, KCNA has occasionally not published English versions of crude insults directed at U.S. leaders or officials in an apparent effort to differentiate its statements for domestic audiences and outsiders.

KCNA called President Barack Obama a “monkey” in 2014, but attributed the remarks to a factory worker and did not issue an English version. Later the same year, an unidentified North Korean defense commission spokesman called U.S. Secretary of State John Kerry a wolf with a “hideous lantern jaw,” but again only in Korean.

After Trump threatened North Korea with “fire and fury” in August, Gen. Kim Rak Gyom, commander of the North’s strategic rocket forces, was quoted in a KCNA Korean dispatch as saying Trump showed his “senility” again. But the KCNA English dispatch omitted that word.

This story has been corrected to fix KCNA’s last usage of “dotard.”

GOP’s know-nothing approach to health care is symptom of a bigger disease

The Seattle Times

GOP’s know-nothing approach to health care is symptom of a bigger disease

https://static.seattletimes.com/wp-content/uploads/2017/09/f99877cc-a009-11e7-a65e-0f6bb27f8072-960x640.jpgRep. Cathy McMorris Rodgers, R-Wash., listens during a news conference at the Republican congressional retreat in Philadelphia on Jan. 25. (Matt Rourke/AP)

Republicans’ odd and repeated failures to come up with a health-care reform plan, despite controlling all branches of government, might be because the anti-government party doesn’t want to govern.

Danny Westneat , Seattle Times staff columnist        September 22, 2017

A few years back, our state’s highest-ranking GOP official, Rep. Cathy McMorris Rodgers of Spokane, went on a fact-finding mission. It sums up why Republicans still are struggling to do anything constructive about health care.

McMorris Rodgers, who is in the leadership of the U.S. House, asked the public to “please share your story with me so that I can better understand the challenges you’re facing” regarding health insurance and the Affordable Care Act.

More than 10,000 people responded (10,659 to be exact). As I wrote at the time, most of the stories were positive. (“I was recently diagnosed with Fibromuscular Dysplasia and thanks to Obamacare, I know I won’t be dropped by my insurance carrier.”) But also, that same week, the state released data showing McMorris Rodgers’ own district had some of the higher Obamacare sign-up rates in the nation.

She ignored all of it — the stories she had solicited and the inconvenient data she hadn’t — when she called for the total repeal of the health law the next day.

I’m recalling all of this now because fast forward 2 ½ years, and the Republicans’ obsession with this issue has become almost pathological. They’re still at it — still pushing repeal, still with no viable plan of their own, and still not listening to the opinions of the public or myriad experts and medical-interest groups.

The first problem with what McMorris Rodgers did is that it was phony. She was trolling the internet for talking points to support her already adopted position.

But the larger problem — the one that continues to hang the party today — is that she wasn’t remotely interested in the real story.

That real story is mixed. It’s complicated. It’s true, Obamacare hasn’t worked well for many people who don’t qualify for a subsidy. But at the same time it has directly helped hundreds of thousands of people in this state, and brought the uninsured rate here to historic lows. You can’t put all that on a bumper sticker.

Yet the GOP, heedless of these complexities, keeps rolling out one half-baked repeal attempt after another. How half-baked? Well Friday, when GOP Sen. John McCain announced he couldn’t support the latest “Graham-Cassidy” repeal bill, he noted in passing that senators of his own party still don’t know “how much it will cost, how it will affect insurance premiums, or how many people will be helped or hurt by it.”

So he’s saying they basically know nothing. They’ve been at it seven years. They know so little they are being schooled nightly about the contents of their own bill by a late-night TV comedian, Jimmy Kimmel.

Now, health-care reform is dense, and the trade-offs can be crippling (as the Democrats discovered). But understanding the basics isn’t that hard. There’s something else going on here, something elemental and disturbing.

The GOP just doesn’t seem interested in the substance of this issue, beyond checking off a campaign promise (a wildly implausible promise, at that, of spending billions less on health care yet somehow making it better for everyone). How else to explain why they keep coming up with simplistic proposals that everyone in the industry opposes and that cut coverage for millions of people?

The latest bill’s central premise is proof of this disinterest. It punts the federal role in health care to the states, giving them block grants. That’s fine as far as it goes, but it’s another way of saying: “We have no clue. You figure it out.”

Or as the state Medicaid directors put it in an unusual opposition letter this week: The GOP plan “constitutes the largest intergovernmental transfer of financial risk from the federal government to the states in our country’s history.”

Yikes. Maybe health care is special kryptonite for Republicans. Maybe they’ll craft better policy if they ever move on to something else. But maybe this is a group that is so anti-government in its DNA, it has no idea how to govern.

Or worse, like McMorris Rodgers with her fake survey, they don’t want to know.

Danny Westneat’s column appears Wednesday and Sunday. Reach him at 206-464-2086 or dwestneat@seattletimes.com

Repeal and Go Fuck Yourself’ Is in Full Effect

Esquire

Repeal and Go Fuck Yourself’ Is in Full Effect

The Graham-Cassidy bill is earning the nickname.

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By Jack Holmes        September 21, 2017

Lindsey Graham has really good healthcare that he definitely won’t lose, even if the moral catastrophe he’s calling a “reform” bill passes the Senate. Graham has cosponsored an Obamacare Repeal and Replace Plan with the impressively mendacious Bill Cassidy and two other Republican heartthrobs. It is somehow worse than the previous plans.

The bill would usher a number of shocking cruelties into law, not least the possibility that as many as 32 million Americans could lose health coverage. That’s 10 percent of the population. We don’t know for sure because Republicans are trying to force the bill through the Senate before its effects can be assessed by the nonpartisan Congressional Budget Office. The bill is full of fun surprises, like the loophole it creates allowing insurers to deny people coverage for a series of basic medical treatments, including:

  • Pregnancy and maternity care
  • Prescription drugs
  • Mental health services
  • Reproductive health services, including birth control
  • Substance abuse treatment

These were among the 10 “Essential Benefits” that the Affordable Care Act mandated insurance companies had to provide to people who bought their insurance policies. That approach was based on the idea that people’s medical needs might include emergency room visits or prescription drugs, and that insurance companies shouldn’t be able to deny them coverage for things they might actually use. This concept is apparently unacceptable to Republicans—or at least to the donors paying their campaign bills. We can assume Republicans will just wish the millions of Americans suffering in the opioid epidemic the best of luck.

https://hips.hearstapps.com/hmg-prod.s3.amazonaws.com/images/lindseygraham-1505942744.jpg?crop=1xw:1xh;center,top&resize=768:*Graham makes his case for the bill.                Getty

Graham-Cassidy opens a very intentional loophole where states can apply for waivers to change the definition within their borders of what constitutes an Essential Benefit. If, say, Mississippi successfully applies to strike pregnancy from the list of Essential Benefits, then insurance companies in Mississippi can refuse to cover some or all procedures involved in pregnancy, or jack up rates on patients who use those services. It would essentially end these protections in states where insurance companies have sufficient influence over state officials.

A host of red states opted out of Obamacare Medicaid expansion after a Supreme Court decision allowed them to. It was free money from the federal government to start, with a relatively small uptick in state contributions down the line. However, it would also have been a win for Barack Obama.

Luckily, the revenge can extend further: Graham-Cassidy is the first Republican plan that would actively punish (primarily Democratically-controlled) states for expanding Medicaid under Obamacare by redistributing some of their funds to red states that refused to expand coverage. This would, according to Graham, “create parity,” even though there could have been parity if Republican governors had simply accepted free money from the federal government to get more of their citizens insured. This could have less than ideal impact for Republicans in future elections, as the states that stand to have their funding shipped off to Texas, Alabama, et al. include Michigan, Ohio, Pennsylvania, and Florida.

The same waiver mechanism could be applied to preexisting conditions. States could apply for waivers to get certain illnesses and medical conditions exempted from pre-existing condition classification. Insurers could then deny coverage to people with those conditions, or jack up their rates. The preexisting conditions provision in Obamacare is based on the concept that people who are already sick may need healthcare, and in America, to get healthcare you need insurance. No need to concern yourself with that any longer.

Let’s give the insurance companies the benefit of the doubt—never a wise decision—and assume they wouldn’t cancel coverage for certain pre-existing conditions, and instead just raise rates on patients who have them. Since Republicans would rather not see a CBO score, we must turn to an outside source: the left-leaning Center for American Progress. As with previous Republican bills, the Center ran estimates on hypothetical premium increases for a 40-year-old with a number of different conditions. Here’s what they found:

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4-grand extra for asthma? It’s a bargain! Just ignore that extra $72,000 if you happen to have brain cancer.

That same waiver mechanism could also be used to circumvent the ACA’s ban on annual and lifetime coverage caps. Soon we could return to the days when an insurance company could arbitrarily cap the amount they’ll pay for your medical care in a year or in your life, regardless of the fact that you did not choose to get, say, a chronic illness like multiple sclerosis. It’s for cases like these that the various Republican bills were so aptly nicknamed “Repeal and Go Fuck Yourself” by the folks at Pod Save America.

Another type of cap the bill fully supports is a cap on Medicaid spending. Graham-Cassidy would end the Obamacare Medicaid expansion program, which currently covers 15 million people, and would pull all childless adults off the program. Instead, the bill will give states a capped block grant for both Medicaid and to substitute for the subsidies provided to people so they can buy plans in Obamacare exchanges. These will be capped at a lower growth rate than scheduled under the current system, and the grants will simply end in 2026, at which point states can either replace federal dollars or roll back coverage. Again, RAGFY.

These Republican bills are aptly nicknamed “Repeal and Go Fuck Yourself.”

One estimate from the left-leaning Commonwealth Fund on Wednesday projected 15 to 18 million would lose insurance by next year, with 32 million off the rolls by 2026. Because Graham-Cassidy will, like the earlier bills, repeal the individual mandate, premiums could spike as much as 15 to 20 percent. Even if these constitute the worst-case scenario, the mediocre case wouldn’t be pretty. It would leave fewer Americans insured, and the ones still on the rolls could be paying more for patchy coverage that might not even have their back when their baby is born.

Actual doctors are almost unanimous in their opposition to this bill. As The Atlantic tells us, it’s very rare for physicians to agree as strongly on anything as they do on the belief that the Graham-Cassidy bill is absolute trash. The bill’s detractors include:

  • The American Medical Association
  • The American Psychiatric Association
  • The American Public Health Association
  • The National Institute for Reproductive Health
  • The American Academy of Pediatrics
  • The Association of American Medical Colleges
  • The American College of Obstetricians and Gynecologists
  • The Federation of American Hospitals

This is not a comprehensive list. Some of these groups were critical of the Affordable Care Act, but only in regard to certain problems that have emerged with the law. They are all united in forceful opposition to the central goals of the Graham-Cassidy trainwreck.

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So why is Lindsey Graham, a Senate veteran normally known for shoveling money towards defense contractors, putting his neck out on this bill? Why are any of his colleagues giving it a moment’s consideration? It’s hard to say for sure. Certainly, Republicans are desperate to complete the final act of their grand, seven-year-long piece of performance art known as Repeal and Replace Obamacare. Having run on that magic incantation for four straight election cycles, they feel they must deliver for The Base—particularly the members eager to strike Barack Obama’s name from every history book for some reason.

But the real reason this bill has a chance is money. It is not merely the fact that the bill’s savage cuts to health coverage for some of the most vulnerable among us—the youngest, the oldest, the sickest, the poorest—open up billions of dollars of budget savings, which Republicans then plan to use in their grand attempt at tax reform. It’s that the real owners of the party, the donors and the fat cats, have demanded it. At least, that’s the intel The Guardian dug up at a Koch Brothers megadonor conference in June. The “piggy bank” holding a cascade of cash, much of it set to be filtered through dark money operations into Republican campaign coffers and the Super PACs that abet them, are closed until the rich guys get their tax cut.

If reports Thursday morning are anything to go on, Graham doesn’t actually know much in terms of details about his own bill. It’s not as much what he knows as who he knows, however. Not only is Graham very well acquainted with the donors demanding this thing, he’s also BFFs with John McCain, whose dramatic deciding vote spelled death for the previous Senate Republican healthcare bill and etched a truly delicious expression on the face of Mitch McConnell. Perhaps Graham has been enlisted to get his old friend on board. Better get to boarding, Lindsey.

Years of Living Dangerously

EcoWatch

Years of Living Dangerously

The Trump administration says its not the time to talk about climate change.

The Donald J. Trump Administration says it's not time to talk climate change.Read more: http://bit.ly/2hdHJldvia Years of Living Dangerously #YEARSproject #ClimateFacts

Posted by EcoWatch on Thursday, September 21, 2017

#YEARSproject

The bait and switch at the heart of the new Obamacare repeal bill

Vox

The bait and switch at the heart of the new Obamacare repeal bill

Graham-Cassidy is being sold as giving states flexibility. But it hugely cuts health care spending.

by Andrew Prokop       September 20, 2017

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As Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA) try to wrangle Senate votes for their Obamacare repeal bill before September 30, they’re relying on one argument most of all: Their bill, they say, will give much more flexibility to individual states to figure out how to make health care work.

Cassidy and Graham like to emphasize that their bill would roll back Obamacare’s spending and regulations and would instead simply send states money in a block grant. States, they say, would be free to figure out how to use that block grant money however they see fit — they’d be able to experiment with their own approaches. Even moderate Republicans are likely tempted by an argument like that.

Here’s the catch: The bill doesn’t just move around Obamacare’s spending. It severely cuts federal spending on health care overall — both for Obamacare and for traditional Medicaid. And since covering people costs money, the result will inevitably be that millions of people will lose coverage.

The Graham-Cassidy bill is essentially a Trojan horse for these dramatic cuts on health spending that Republican leaders have been pushing all along. Three features of the bill in particular make this clear:

1) The bill dramatically cuts and restructures traditional Medicaid. Like previous Obamacare repeal bills Republicans have put forward, Graham-Cassidy goes far beyond just rolling back Obamacare, to instead restructure the finances of the Medicaid program as a whole.

It does this by converting Medicaid to a “per capita cap” system, in which the federal government would no longer commit to open-ended funding to help states afford enrollees’ health bills. Instead of matching the money states spend on Medicaid enrollees, the federal government would provide a set amount of money to states to spend on recipients.

Using numbers from previous Congressional Budget Office scores, the Center on Budget and Policy Priorities estimates that this proposal would cut about $175 billion from traditional Medicaid between 2020 and 2026. Experts argue that per capita caps also give states incentives to kick more expensive patients off Medicaid or roll back coverage.

2) In turning Obamacare’s spending into a block grant, Cassidy and Graham aren’t just redistributing it — they’re reducing it: In theory, it would be possible to restructure Obamacare’s existing spending into block grants for states — and even to distribute it differently among states — without cutting spending overall.

But that’s not what Graham-Cassidy does. Per CBPP’s analysis, the way the bill’s block grant formula is designed, it would dole out “$239 billion less between 2020 and 2026 than projected federal spending for the Medicaid expansion and marketplace subsidies under current law.”

Cassidy has tried to dismiss the CBPP numbers as coming from a liberal think tank. But since the CBO hasn’t released its analysis yet — and won’t have time to before Senate Republicans’ September 30 deadline — these are the outside numbers we have to work with.

3) The new block grant ends entirely after 2026, and there is nothing to replace it afterward. Yes, the vaunted block grants that Graham and Cassidy say will give states such flexibility have a built-in expiration date. They have claimed that this is because of the Senate’s budget reconciliation rules, though it’s not clear how or whether that’s true.

The practical effect, though, would be to set up a major fight several years down the road about whether these block grants should be continued at all, or whether they should be reduced even further. And since the default outcome if no action is taken is for the block grants to vanish, conservatives who want even deeper spending cuts will have the advantage in this showdown.

We can see the CBPP’s estimated impact of these three provisions together in the below chart:

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Center on Budget and Policy Priorities

From 2020 to 2026, there will be cuts from the transformation of Obamacare funding into a smaller block grant (in dark red) and the restructuring of traditional Medicaid (in pale red). Then in 2027, the block grants disappear entirely, meaning enormous cuts unless Congress manages to agree on a deal to continue them.

So the argument about giving states “flexibility” leaves out a whole lot. Less money would be available to states overall in those newly flexible block grants, and on top of that, traditional Medicaid would be cut — which clearly points toward millions losing coverage overall. And that’s even before the whole system is set to fall off a cliff in 2027.

With all this in mind, Graham-Cassidy looks a whole lot like all the previous GOP Obamacare repeal bills this year. At its core, it’s basically another way to cut hundreds of billions in federal health spending and toss millions off coverage.

North Korea’s Kim Jong Un Ripped Teen Sex Slaves From Schools and Forced Citizens to Watch Executions, Defector Says

Newsweek

North Korea’s Kim Jong Un Ripped Teen Sex Slaves From Schools and Forced Citizens to Watch Executions, Defector Says

Greg Price, Newsweek           September 21, 2017

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North Korea’s Kim Jong Un Ripped Teen Sex Slaves From Schools and Forced Citizens to Watch Executions, Defector Says

Kim Jong Un’s depravity and abuses of power have no bounds, extending even to North Korea’s upper echelon. The North’s authoritarian regime snatches teenagers out of school to be his sex slaves, forces members of the country’s upper class to watch executions and Kim is perfectly content to eat expensive lunches while his people subsist on grass, a defector told the Daily Mirror this week.

In order to protect the defector, The Mirror did not publish her real name nor the names of her family members, but refers to her as Hee Yeon Lim and states she’s a 26 year old whose father was a senior officer in Kim’s regime. Hee spoke to the British news outlet in a secret location in Seoul, South Korea days after Kim and his regime conducted its sixth nuclear test this month.

Hee claimed supreme leader Kim forces those in the walled-off country’s “upper-class elite” to watch executions, and said she was witness to a mass execution of 11 musicians who were put to death by an anti-aircraft gun shortly after Kim took over for his late father Kim Jong Il in 2011. The musicians were killed over allegedly making a pornographic video, and Hee said 10,000 people witnessed their execution.

Though she was considered privileged compared to millions of the North’s other citizens, Hee was standing 200 feet away from the kill site.

“We were ordered to leave our classes by security men and made to travel to the Military Academy in Pyongyang,” Hee told The Mirror. “There is a sports ground there, a kind of stadium.

“The musicians were brought out, tied up, hooded and apparently gagged, so they could not make a noise, not beg for mercy or even scream,” she said. “What I saw that day made me sick in my stomach. They were lashed to the end of anti-aircraft guns.”

The musicians’ bodies “disappeared” and then tanks ran over their remains “repeatedly,” Hee said.

Over the years, and well before Kim Jong Un came to power around 2011, defectors have managed to escape the North’s violent regime and tell their stories.

Earlier this month, 30-year-old Hak Min recounted the brainwashing tactics used to strike fear into citizens to USA Today. He’s now in Seoul running an iPhone repair shop after defecting in 2013, and instead of Kim’s picture hanging in his shop, he’s put up one of Apple founder Steve Jobs, whose biography has inspired him.

“When they brainwash students in North Korea they say: ‘We can read your words, actions and thoughts,’” Hak said. “If you have bad thoughts about the Kim family they will know. But in the book, Jobs said: Do not let others’ thoughts rule over you. Do what you want. Be yourself.”

Defectors have provided significant information about Kim’s regime and helped shed light on the human rights atrocities occurring in the North, but their numbers slipped recently. This week, South Korea reported a recent 12.7 percent decrease in the number of defectors leaving the North to the South between January and August of this year, with 780 fleeing compared to 1,417 throughout 2016.

Livid Jimmy Kimmel turns up the heat on Sen. Cassidy for a second night

HuffPost

Livid Jimmy Kimmel turns up the heat on Sen. Cassidy for a second night

HuffPost      September 21, 2017

For the second night in a row Wednesday, late-night talk show host Jimmy Kimmel raged against a Senate bill meant to repeal Obamacare. It followed an impassioned critique of Sen. Bill Cassidy (R-La.) that captured media headlines just a day before.

Kimmel used the opening monologue of his Tuesday “Jimmy Kimmel Live” show to slam Cassidy and Sen. Lindsey Graham (R-S.C.), co-sponsors of a measure that would end the Affordable Care Act. The new bill, which Republican leaders are trying to ram through the Senate before the end of the month, would leave states with substantially less money to spend on health care, all but forcing them to cut programs so that literally millions of people would end up without insurance coverage. The bill would also allow states to waive rules that guarantee coverage to people with pre-existing conditions.

Kimmel accused Cassidy of lying to him during the senator’s appearance on his show in May, when the lawmaker pledged that no family would be denied medical care because they couldn’t afford it. “This guy, Bill Cassidy, just lied to my face,” the host said.

Following Tuesday’s monologue, Cassidy responded by saying he was “sorry” Kimmel didn’t understand the legislation and made wildly misleading claims about the contents of the bill. The host fired back just hours later.

“Could it be, Sen. Cassidy, that the problem is that I do understand and you got caught with your G-O-Penis out. Is that possible?” Kimmel said.

The host also took aim at Fox News’ Brian Kilmeade, who lambasted Kimmel on Wednesday as one of the Hollywood elite “pushing their politics on the rest of the country.”

“This is a guy, Brian Kilmeade, who, whenever I see him, kisses my ass like a little boy meeting Batman,” Kimmel said. “Oh, he’s such a fan. … He follows me on Twitter. He asked me to write a blurb for his book, which I did. I don’t get anything out of this, Brian, you phony little creep. Oh, I’ll pound you when I see you.”

He also lobbed hits at New Jersey Gov. Chris Christie, President Donald Trump and threw a light jab at Graham, although he said he’d hold off because “he’s one of the few Republicans who stands up” to the president.

Once again, Kimmel ended the segment by urging viewers to call their elected officials, pointing to a story in The New York Times that found Sen. Susan Collins (R-Maine) hadn’t received an increased number of calls over the new bill after his Tuesday segment.

“This is why things like this keep happening, because we don’t do anything about them,” Kimmel said. “So please stop texting for five seconds and make a phone call. Especially call these senators … It really does make a difference.”

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Jimmy Kimmel Calls Out the Incredible Hypocrisy of the Cassidy-Graham Healthcare Bill

Esquire

Jimmy Kimmel Calls Out the Incredible Hypocrisy of the Cassidy-Graham Healthcare Bill

Senator Bill Cassidy went on Jimmy Kimmel’s show back in May after Kimmel offered an emotional plea to lawmakers to make sure kids like his own son, who was born with a congenital heart defect, would be protected under the Republican repeal-and-replace plan for Obamacare. Cassidy himself made up “the Jimmy Kimmel test” and agreed to make sure any plan passed it before he’d vote for it. Fast forward to September, and Cassidy has cosponsored a bill that flagrantly fails the test. Cassidy seems to have embraced the thoroughly Trumpian strategy of simply acting like something you did or said never happened.

Kimmel described The Old Cassidy’s demands for a healthcare bill thusly:

  1. Coverage for all
  2. No discrimination based on preexisting conditions
  3. Lower premiums for middle-class families
  4. No lifetime caps

The New Cassidy, however, just wrote a bill with Lindsey Graham  that does none of those things. Back in May, Cassidy agreed that the monstrosities creeping through the Republican House and Senate were too cruel. He then promptly turned around and crafted a bill that may well be crueler. It’s hard to know for sure because Republicans appear poised to try to force the bill through before it can be legitimately debated in the Senate, and before its effects can be scored by the nonpartisan Congressional Budget Office.

But the most astounding thing is that Cassidy thinks he can do this. The Louisiana senator constructed an entire publicity tour around creating a more humane Republican health plan. He went on every TV show that would have him, trumpeting specific demands that would make that a reality. And now he is behaving as if none of that ever happened, even though we all saw him. It was on TV. It’s almost as if he is learning a thing or two from our fearless leader: If President Deals can claim 1.5 million people came to his increasingly expensive inauguration, a measly Republican senator can get away with this. The era of post-truth politics can get you The Bowling Green Massacre and The River of Blood, but it can also get you a shamefully bad healthcare plan.

If you would like to let your senators know you oppose Cassidy’s new brainchild, you can reach them at: (202) 224-3121

This New Healthcare Bill Wrecks Lives in Exchange for, What, Exactly?

Esquire

This New Healthcare Bill Wrecks Lives in Exchange for, What, Exactly?

A few thoughts, and questions, about the Cassidy-Graham plan.

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By Charles P. Pierce     September 19, 2017

Let us stipulate right at the beginning that, if you put the menu for Chinese takeout in front of the president* and wrote “Obamacare Repeal” across the top, he’d sign it. So let’s take him out of the whole equation. The tragedy is that, once you do that, you are left with the inescapable conclusion that, on the matter of the Affordable Care Act, the Republican Party is little more than a cult centered around human suffering.

The latest evidence comes to us as The Cassidy-Graham Plan, named for its co-sponsors, Bill Cassidy, Republican of Louisiana, and our old pal, Lindsey Graham of South Carolina. The difference between this proposal and the rest of the Walking Dead plans that have wandered through Congress this year is that this one is at least nominally detailed. And that’s the problem, and the cruelty, of it.

As Sarah Kliff explains at Vox, this plan comes closer to absolute de facto repeal of the ACA as any of the other plans did.

The proposal would eliminate the health care law’s subsidies for private insurance and end the Medicaid expansion. States could allow for waivers that let insurers charge sick patients higher premiums and stop covering certain benefits required under the Affordable Care Act, like maternity care or prescription drugs. The health insurance marketplaces would no longer exist as they are envisioned to continue under other Republican proposals. The federal government would convert some (but not all) of that spending into a lump-sum payment to states. States could choose to spend this money on providing insurance — or they could use it to fund high-risk pools, or do other activities to pay the bills of patients with high medical needs. States wouldn’t get this money for free: They’d be required to kick in a small percentage themselves. The plan hasn’t been scored by the Congressional Budget Office yet, but analysts who have studied Cassidy-Graham estimate it would cut deeply into federal funding for the health law programs, likely resulting in millions losing coverage. Cassidy-Graham would arguably be more disruptive, not less, to the current health care system than the plans that came before it. It would let money currently spent on health insurance go toward other programs, providing no guarantee that the Affordable Care Act programs individuals rely on today would continue into the future.

The individual details of this plan have been exposed as scams, time and time again. (For a party that doesn’t want “government” controlling healthcare, these people seem remarkably enthusiastic of handing it over to governors like Scott Walker and Sam Brownback.) It’s demonstrably worse for people than the plan that famously was sunk by a single vote. And yet it’s just as close to passing right now as that one was. Maybe closer. It’s likely going to be voted on without a score from the Congressional Budget Office, which likely would be as grotesque as the CBO scores its predecessors rang up. It likely once again will garner no Democratic votes. (Joe Manchin on Tuesday said he was against it.) But it is the fundamental anti-politics of the thing that clearly shows that the entire Republican Party is lashed to the side of the whale at this point. The party opposes any attempt to reform the healthcare system in this country—and, certainly, any attempt to improve the ACA—in a fashion that is damned near evangelical in its blind and reckless fervor.

Consider: Dean Heller, Republican of Nevada, voted for the previous bill and likely will vote for this one, despite the fact that his state’s Republican governor, Brian Sandoval, is practically screaming at him not to do so.

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Consider: John McCain, who cast a crucial vote the last time around, has been all over the lot this time around, probably because he’s Damon and Graham is Pythias. This time, McCain has tried to hide behind Arizona Governor Doug Ducey and nobody has any idea what he’s finally going to do.

Consider: state governors in general seem to be reluctant to embrace the freedom that comes with this latest bag of rocks, at least if you listen to its sponsors. From USA Today:

“Among the list of governors was Alaska’s Bill Walker, an independent, who had been lobbied by the Trump administration to support the bill because Alaska GOP Sen. Lisa Murkowski is undecided and is a critical vote to get the legislation through. “As you continue to consider changes to the American health care system, we ask you not to consider the Graham-Cassidy-Heller-Johnson amendment and renew support for bipartisan efforts to make health care more available and affordable for all Americans,” the 10 governors urged in a letter addressed to Majority Leader Mitch McConnell, R-Ky., and Minority Leader Chuck Schumer, D-N.Y.”

It’s still anyone’s guess if this dog’s breakfast even will get to a floor vote in the Senate. But the insistence on trying marks the Republican congressional majorities pretty lousy. They know the country doesn’t want this. They know that an effective majority of their members don’t want it. They know that governors of their own party don’t want it. And they know that the president* of their own party has moved on to threatening nuclear annihilation, among other hobbies. Why this fanatical pursuit of this one legislative goal? It can’t all be about money; none of the senators in question seems to be in danger of a serious primary challenge or of having the golden spigot turned off.

The only conclusion would seem to be that there is something in their political makeup that believes that the people who benefit from the ACA, and the people who would benefit if it were repaired and not destroyed, are unworthy of those benefits and that it is not the proper function of government to question this fundamental truth. (This, at least, is what Rand Paul is honest enough to say out loud.)

They will wreck lives to prove a point that isn’t even true to begin with, and on which they are such monumental hypocrites that even the elite political press is beginning to notice. (Much as has been the case with immigration, the people seeking to “hand power back to the states” are more willing to take power away from the states if the states dare do on their own that which the senators are trying desperately to head off nationally.) Listen to Lindsey Graham go all mad-preacher about the subject on Monday, Per the Washington Examiner:

“This is Bernie Sanders’ worst nightmare,” Graham said in an interview on Breitbart News Saturday on SiriusXM, speaking about his healthcare proposal. “It’s either this or we’re going to Obamacare and Berniecare. Now, Berniecare is full-blown single-payer socialism. It is his dream and that’s where Democrats are going.”

Don’t tease me, bro.

Update (6:04 p.m.): OK, so it’s a little bit about money. (Koch network ‘piggy banks’ closed until Republicans pass health and tax reform, The Guardian)

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GOP senators are rushing to pass Graham-Cassidy. We asked 9 to explain what it does.

Vox

GOP senators are rushing to pass Graham-Cassidy. We asked 9 to explain what it does.

by Jeff Stein        September 20, 2017

https://cdn.vox-cdn.com/thumbor/2v3JBmxpvd46i6wLcMj1ZVBrpsY=/0x0:3000x2000/1520x1013/filters:focal(1172x941:1652x1421)/cdn.vox-cdn.com/uploads/chorus_image/image/56759205/187000950.0.jpg“You have to have a car to get into, and this is the only car there is,” Sen. Pat Roberts (R-KS) said. Photo by Chip Somodevilla/Getty Images

Republican senators are struggling to articulate why they are rushing to pass their last-ditch effort to repeal and replace Obamacare over the next 10 days before running into their September 30 deadline.

In interviews with Vox on Tuesday, nine Republican senators primarily argued that their “Hail Mary” bill — spearheaded by Sens. Lindsey Graham (SC) and Bill Cassidy (LA) — would return federal power to the states, giving them greater flexibility to improve their health systems locally. “The heart of the legislation takes the policymaking role of Washington and sends it to the states,” Texas Sen. Ted Cruz said.

Far less clear is exactly how Graham-Cassidy would pull off this feat without resulting in millions of Americans losing their insurance — and the number of millions is still unknown, since any vote would likely have to come before the Congressional Budget Office completes its analysis of the bill. The GOP senators insisted that the tens of billions in cuts to federal health spending proposed in the bill would not result in coverage losses because, they said, the states would have more flexibility.

“They can do it with less money,” said Sen. Jim Inhofe (R-OK), who was unable to explain how or why.

Other Republican senators, meanwhile, fell back on political explanations for a bill that experts warn could result in millions losing their insurance. “If we do nothing, it has a tremendous impact on the 2018 elections,” said Sen. Pat Roberts (R-KS). “And whether or not Republicans still maintain control and we have the gavel.”

And then some members of the upper chamber acknowledged that the spending changes might have a big impact, but argued their home states would not be negatively impacted. “Four of our states are getting a disproportionate amount of money from health care now,” Sen. Richard Shelby (R-AL) said. The bill, he added, “wouldn’t cut Alabama.” (Numbers from the Center on Budget and Policy Priorities suggest Alabama would receive more than $1 billion in additional funding under the bill, but most states would see big cuts.)

The stakes of the Republican rush to repeal and replace Obamacare could hardly be higher. The GOP has less than two weeks to pass a repeal-and-replace plan before their budget reconciliation instructions expire, and the insurance of tens of millions of Americans hangs in the balance.

Vox conducted the interviews with nine Republican senators throughout the Capitol and Russell Senate Office Building on Tuesday.

Transcripts of those conversations follow.

Sen. Pat Roberts (R-KS): “If we do nothing, it has a tremendous impact on the 2018 elections”

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Jeff Stein

Senator, I wanted to ask you for a policy-based explanation for why you’re moving forward with the Graham-Cassidy proposal. What problems will this solve in the health care system?

Pat Roberts

That — that is the last stage out of Dodge City.

Jeff Stein

I’m just trying to explain to our readers what the policy —

Pat Roberts

What readers? Who do you represent?

Jeff Stein

It’s a website called Vox.

Pat Roberts

… [Graham-Cassidy] is the last stage out of Dodge City. I’m from Dodge City. So it’s the last stage out to do anything. Restoring decision-making back to the states is always a good idea, but this is not the best possible bill — this is the best bill possible under the circumstances.

If we do nothing, I think it has a tremendous impact on the 2018 elections. And whether or not Republicans still maintain control and we have the gavel.

Jeff Stein

But why does this bill make things better for Americans? How does it help?

Pat Roberts

Pardon me?

Jeff Stein

Why does this make things better? What is this doing?

Pat Roberts

Look, we’re in the back seat of a convertible being driven by Thelma and Louise, and we’re headed toward the canyon. That’s a movie that you’ve probably never seen —

Jeff Stein

I do know Thelma & Louise, sir.

Pat Roberts

So we have to get out of the car, and you have to have a car to get into, and this is the only car there is.

Sen. Jim Inhofe (R-OK): “Efficiencies” from federal-state transfer “can very well make up the difference”

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Jeff Stein

What’s the policy explanation for the Graham-Cassidy bill? What substantive problems does this solve?

Jim Inhofe

Well, first of all, as a general rule the states do things better than the federal government does [things]. And that is essentially what the bill is. We actually had a bill that passed, except at the last minute — as you know — we had one deciding vote against it that was unforeseen. And I think what we’re looking at right now is essentially the same thing.

It’s a stronger position for the states to be in, and generally, Republicans agree with that.

Jeff Stein

I understand what you’re saying with the states having the ability to make these decisions, but the bill doesn’t just “give states more freedom” — it also cuts federal funding to the states. So it’s not just about giving the states more control; it’s also about cutting federal expenditures, right?

Jim Inhofe

Well, yes, but that doesn’t mean it’s going to be — I think the efficiencies that come with transferring the funding to the states can very well make up the difference between what the federal thing would be.

A philosophical difference — you know?

Jeff Stein

No, what do you mean?

Jim Inhofe

I mean it’s more efficient when it’s done from the states, and so they can do it with less money.

Jeff Stein

Are you confident, and how do you know those savings will be close to enough to protect everyone?

Jim Inhofe

Well, nothing protects everyone.

Sen. Ted Cruz (R-TX): “It lets states innovate and adopt creative solutions”

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Jeff Stein

I’m looking for a broad policy explanation for what Graham-Cassidy will do — how does it improve the American health care system?

Ted Cruz

Well, the details of it are still being negotiated, but the heart of the legislation takes the policymaking role of Washington and sends it to the states. It lets states innovate and adopt creative solutions to local problems, which vary state by state.

Jeff Stein

But it’s not just devolving power from the federal government to the state. It also involves a 16 percent cut in federal spending [upfront] and a 34 percent cut over the next 10 years.

If you’re saying, “Let’s just devolve power to the states,” why also cut federal spending so dramatically?

Ted Cruz

My central focus from the beginning has been on lowering health insurance premiums.

The biggest reason so many millions of people are hurting under Obamacare is that it has made premiums skyrocket. And what I think is critical for Obamacare repeal is that we expand consumer freedom so that you, the consumer, can be in charge of what health insurance you want to buy, and we lower premiums so that health insurance is more affordable.

Jeff Stein

Why not wait until the CBO says what you’re saying about premiums? Why not confirm with them? Over the first few votes, the CBO suggested that premiums would go up and that tens of millions of people would lose health insurance.

Ted Cruz

CBO’s analysis throughout this process has been ridiculously slow, unreliable, and based on policy assumptions that are demonstrably false.

Jeff Stein

You really believe that cutting federal spending by 34 percent will not result in any other people losing their insurance?

Ted Cruz

What federal spending is cut?

Jeff Stein

Well, the Medicaid expansion would be sunset, for one, is my understanding.

Ted Cruz

The decrease in future rates of growth is not a cut. And it is only in the bizarre world of Washington that billions more money is characterized in the press as a cut rather than an increase, which is in fact what it is.

Sen. John Kennedy (R-LA): “Read the bill and you’ll understand”

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Jeff Stein

What are the policy explanations for the bill?

John Kennedy

I think it’s an improvement over Obamacare, but I have sent four amendments to Lindsey [Graham] and Bill [Cassidy] that I think will strengthen the bill. The one I feel most strongly about is that I want the Medicaid work requirement — I don’t want it to be optional; I want it to be a requirement. Just like we did with welfare reform.

And number two, I want to get us to give guardrails to the states to say, “You cannot use these moneys to set up a state-run single-payer system.” I don’t believe in it. I think it’s a mistake.

I’ve lived under a single-payer system, and I think the bill would be stronger with that prohibition. [That’s an apparent reference to England, where Kennedy received a law degree in the 1970s and which has the National Health Service.]

[Guardian reporter] Lauren Gambino

Do you think that kind of goes against the idea of states’ rights and being able to use this money [as the states want to]?

John Kennedy

No, no. We have plenty of federal rules that apply to every state, but we still agree with states’ rights.

Jeff Stein

What are the main policy explanations for getting behind this bill? What does this bill do right, policy-wise?

John Kennedy

I think it’s an improvement over Obamacare.

Jeff Stein

Why?

John Kennedy

My position has always been that, number one, I think Obamacare has been a failure.

Number two: First chance I get to vote for repeal it, I’ll do it.

And number three: If it’s replacement, if replacement is better than Obamacare, I will vote for it.

Jeff Stein

What are the policies that make you think that?

John Kennedy

I think it spends scarce resources in a more rational manner. It will control costs. I like the idea that it encourages states to innovate.

Jeff Stein

How does it do that? Any of those things?

John Kennedy

Well, you need to read the bill.

Jeff Stein

Well, you’re voting for it, right? So what is the explanation for how it does those things?

John Kennedy

I am. Because it gives states added flexibility. Read the bill and you’ll understand.

Sen. Richard Shelby (R-AL): “It wouldn’t cut Alabama, though”

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Jeff Stein

In broad strokes, what do you think this bill is going to accomplish?

Richard Shelby

This is what a lot of us ran on — we’ve been advocating it for years. Let the states run it. They know more about it. They run the Medicaid program. They run our highway programs. We send 80 percent of money to various transit and highway stations — there, where the rubber hits the road.

Jeff Stein

But it’s not just that it devolves power to the states — it also involves a 16 percent cut in federal health spending.

Richard Shelby

But I’ll tell you what: Our states — our 50 states — are very flexible, very innovative. Much more so than we are here. I think it will work, and it will be a big step toward federalism.

Jeff Stein

The bill would cut federal funding to states by 34 percent over the next —

Richard Shelby

But it wouldn’t cut Alabama, though.

Jeff Stein

Well, do you think the other states should deal with —

Richard Shelby

Well, you see some of our states, four of our states, are getting a disproportionate amount of money from health care now. You know which ones.

Sen. Johnny Isakson (R-GA): “I don’t know what the numbers are going to end up looking like”

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Jeff Stein

What is the policy explanation for the Graham-Cassidy health care bill?

Johnny Isakson

Policy explanation? I’m not into policy, so I don’t really know. I’m into facts.

Jeff Stein

[In a follow-up interview hours later on Tuesday] You were joking earlier, but what is the health policy in the Graham-Cassidy proposal that you like?

Johnny Isakson

More state innovation. More input from the states.

Jeff Stein

What does that mean, exactly?

Johnny Isakson

The governors — I’m from a state that didn’t expand Medicaid, and the way we were going in health care looked like those states would actually be hurt worse than other states.

By going to block grants, back to the states, the control of money stays with the states, and you have less [un]predictability and external deviation in terms of funding.

Jeff Stein

So just a follow-up on that. It’s one thing to say the bill gives the states power — that’s one thing.

But it doesn’t just do that. It also cuts the money they have — some estimates say around 16 percent of federal funding.

Johnny Isakson

I’m not going to confirm that statement one way or another. I don’t know what the numbers are going to end up looking like.

Jeff Stein

Right, but if it does cut federal spending overall, would you support it?

Johnny Isakson

You know, those are dangerous questions. I’m waiting until I see the totality of the legislation to say whether I support the whole thing or not, anyway.

I’m not a no, but I’m not a yes either — and I’m waiting for my governor to respond to me with their input as well. It’s really key what they’re doing.

Sen. John Barrasso (R-WY): “The governors who decided to expand [Medicaid] knew that they were going to lose federal funding”

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Jeff Stein

I want to ask, in a big-picture way: What is the policy explanation for how this bill makes people’s lives better?

John Barrasso

It gets the money out of Washington, lets people at home make the decision, and gets state legislatures involved, and governors involved. It moves money out of Washington. It’s away from socialism.

Jeff Stein

CBPP says it will also reduce federal health spending on Medicaid and the exchanges by about [20] percent.

John Barrasso

I’d love to reduce federal spending on health insurance.

Jeff Stein

Right, but so it’s not just about moving power to the states — it’s also about cutting funding.

John Barrasso

It’s about moving power to the states, where money can be spent much more effectively.

Jeff Stein

How does it do that?

John Barrasso

Well, you have to read the formula and read the bill, and it will tell you how it moves money to the states and how much they get and how much they don’t get. …

Jeff Stein

There’s a concern from Republican governors who have come out and said, “This is too dramatic a cut in spending; we won’t have enough money to insure everyone.”

John Barrasso

You have to interview them on that.

Jeff Stein

Do you think they’re wrong?

John Barrasso

Well, it depends on if they’re states that expanded Medicaid or not. …

Jeff Stein

In the Medicaid expansion states, they still have a lot of people who rely on Medicaid expansion for health insurance.

John Barrasso

I opposed Medicaid expansion. I think the Supreme Court got it wrong [when it ruled in 2012 that Congress did have the constitutional authority to implement most of Obamacare].

The governors who decided to expand [Medicaid] knew that they were going to lose federal funding over time, and they’re objecting to that — but they knew it. You could say, “Some of them didn’t understand it, and so-and-so wasn’t there, and he wasn’t governor yet,” but they understood that this would be part of the process. So if they used the money poorly —

And my concern with Medicaid is that the people who Medicaid was designed for originally have been cut out of the process, because they’re still on the waiting list to get on Medicaid. I don’t know how much you understand about Medicaid, but this whole expansion of Medicaid went for healthy, working-age individuals — it did not go for the people who [Medicaid] was designed for, which was low-income women, children, and the disabled.

Sen. Luther Strange (R-AL): “I like the idea of sending money back to the states and letting the states experiment”

https://cdn.vox-cdn.com/thumbor/3MqZyllE8ILLtC_mUFOFDdNTbhc=/1200x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/9282683/673467338.jpgLuther Strange. Photo by Win McNamee/Getty Images

Jeff Stein

I had a quick question on the Graham-Cassidy bill — could you explain what the policy purpose of the bill is? What is this bill going to achieve, policy-wise?

Luther Strange

Honestly, I have a meeting to talk about that shortly — so let me get back to you on that shortly. I have to talk to my staff.

Jeff Stein

[In a follow-up conversation with Strange about eight hours later]

So what do you think?

Luther Strange

We’re still looking at the details on how it affects Alabama, so we haven’t taken a position on it yet.

I like the idea of sending money back to the states and letting each state experiment with what’s best for their citizens. But I haven’t seen enough detail to know how it affects Alabama to have taken a position on it.

Jeff Stein

Do you worry about the billions in cuts in federal health care expenditures?

Luther Strange

That’s the kind of detail I haven’t seen on how it would affect our state.

Jeff Stein

Anything in particular you’ll be looking for?

Luther Strange

How it affects the state of Alabama, and how we are treated as a non-expansion state.

Jeff Stein

Will you be looking for protections for those with pre-existing conditions? What else matters?

Luther Strange

All of the above.

Sen. Chuck Grassley (R-IA): “This is the last attempt to do what we promised in the election”

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Jeff Stein

I was hoping you could explain, in broad detail, what the point of Graham-Cassidy is.

Chuck Grassley

Let me give you a political answer, and then I’ll give you a substance answer.

The political answer is that Republicans have promised for seven years that we were going to correct all the things that were wrong with Obamacare, and we failed the first eight months. This is the last attempt to do what we promised in the election.

The substance answer is that Obamacare starts with the principle that all knowledge about health care, and all decisions on health care, ought to rest in Washington, DC. The complete opposite of that is Graham-Cassidy, that Washington doesn’t know best and we’ll let each of the 50 states [decide what’s best].