Primer: Senate Health Bill CBO Score—Fatal Blow or Flesh Wound? | News
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Tuesday, June 27, 2017

Primer: Senate Health Bill CBO Score—Fatal Blow or Flesh Wound?

Posted by on Tue, Jun 27, 2017 at 10:08 AM

Hey, y’all. There’s A TON of news today, and, as ever, I’ll move through it as expeditiously as possible. First, though, a teaser: later this afternoon, the INDY is going to drop part one of what will be a three-part series on North Carolina’s pork industry and its effect on the state’s environment and hog farms’ eastern North Carolina neighbors. Reporters Erica Hellerstein and Ken Fine have been working on this project for months. It’s deeply reported and a very (in my estimation) important read. Keep an eye out for it. Anyway, let’s begin.


The New York Times uses the phrase “edging toward collapse.” The Washington Post says that “senators and aides appeared nervous and unsure.” In any event, it seems the Congressional Budget Office’s analysis of the Senate’s health care bill, released late yesterday afternoon, delivered a psychic blow to the Better Care Reconciliation Act’s chances. The CBO found that, within a decade, the bill would leave twenty-two million uninsured compared to current law, including fifteen million who would lose Medicaid. That’s only the slightest of improvements over the House’s bill. What’s more, because the Senate’s bill didn’t include a penalty for not having health insurance, the CBO projected fifteen million people wouldn’t have health insurance next year; premiums and out-of-pocket expenses would skyrocket in the short term.
  • Nut graph, from the Times: “Under the bill, the budget office said, subsidies to help people buy health insurance would be ‘substantially smaller than under current law.’ And deductibles would, in many cases, be higher. Starting in 2020, the budget office said, premiums and deductibles would be so onerous that ‘few low-income people would purchase any plan.’”
POINT: IT’S DEAD: Already at least three senators have said they won’t vote to support a preliminary motion to proceed, which would be enough to kill the thing. That would at minimum seem to imperil Majority Leader Mitch McConnell’s plan to have a vote this week, ahead of the July 4 recess. For a vote Friday, the motion would have to go through tomorrow, then an amendment vote-a-rama and twenty hours of debate. That’s a tight schedule in any event, made all the more difficult if you have to convince one or maybe more members of your caucus to go along with just the first step. And, if the bill seems destined to fail anyway, the Republicans won’t want it to get past that first step: the vote-a-rama will be the Democrats’ chance to force them to vote on all sorts of potentially embarrassing amendments.

COUNTERPOINT: JUST A FLESH WOUND: The upshot, if you’re McConnell, is this: the Senate bill, because it reduces subsidies more dramatically than the House version, also contains more deficit savings—about $200 billion more. That means McConnell has about $200 billion with which to wheel and deal. Think more generous subsidies, or an opioid program, or state-specific funding to buy off wavering senators (akin to the Affordable Care Act’s Cornhusker Kickback). Whatever you think of McConnell, know this: the man knows how to get legislation through.

WHAT’S NEXT: If I knew, I’d tell you. I wouldn’t bet against McConnell, though.


THE GIST: In a partial win for President Trump, the Supreme Court agreed to review whether the president’s temporary ban on people from countries he deems dangerous (read: Muslim) was constitutional. The court also allowed that ban—which was immediately blocked by federal courts—to go into effect, albeit with strict limits that will effectively enable most people seeking to enter the U.S. to do so.
  • Trump declares victory: “As president, I cannot allow people into our country who want to do us harm. I want people who can love the United States and all of its citizens, and who will be hardworking and productive.” On Twitter: “Very grateful for the 9-O decision from the U. S. Supreme Court. We must keep America SAFE!”
  • Nut graph: “But those challenging the travel ban said the court’s opinion would protect the vast majority of people seeking to enter the United States to visit a relative, accept a job, attend a university or deliver a speech. The court said the ban could not be imposed on anyone who had ‘a credible claim of a bona fide relationship with a person or entity in the United States.’”
WHY ARE WE ARGUING ABOUT THIS? If you’ll recall, Trump issued the 90-day travel ban soon after taking office. Refugees were going to be blocked for 120 days. This was needed to address problems with the government’s screening process. That was six months ago. He’s had time to address those problems. So what’s the point? The Supreme Court seems to be wondering the same thing: “The Supreme Court agreed to review both cases in October, noting that the government had not asked it to act faster. The court suggested that the administration could complete its internal reviews over the summer, raising the prospect that the case could be moot by the time it is argued.”

Related: The world doesn’t think much of the U.S. under Trump.


THE GIST: On Monday night, the White House issued a stern statement warning Syria that it will “pay a heavy price” for launching future chemical weapons attacks and announcing that it has evidence that the regime intends to do so.
  • The statement: "The United States has identified potential preparations for another chemical weapons attack by the Assad regime that would likely result in the mass murder of civilians, including innocent children. The activities are similar to preparations the regime made before its April 4, 2017 chemical weapons attack. As we have previously stated, the United States is in Syria to eliminate the Islamic State of Iraq and Syria. If, however, Mr. Assad conducts another mass murder attack using chemical weapons, he and his military will pay a heavy price."
  • Nut graph: “The public warning was seen as highly unusual—reflecting both confidence in the intelligence information suggesting that another attack might be imminent and a willingness to take military action should the warning not be heeded. [A senior administration official] said it was intended to send a strong message that Trump is prepared to action again like he after the April attack, ordering a salvo of Tomahawk missiles from U.S. warships at a Syrian airfield from where the chemical attack was launched. In other words, U.S. retaliation was not a one-off event.”
THIS SEEMS UNUSUAL:Five US defense officials reached by BuzzFeed News said they did not know where the potential chemical attack would come from, including one US Central Command official who had ‘no idea’ about its origin. The officials said they were unaware the White House was planning to release its statement; usually such statements are coordinated across the national security agencies and departments before they are released.”

ALSO UNUSUAL: Within a half-hour of the statement’s release, Trump was back to tweeting about Fox News and the Russian “Witch Hunt.”



THE GIST: At a press conference yesterday morning, Governor Cooper announced that he would veto the General Assembly’s budget, saying it “shortchanges our state at a time when we don’t have to.” He blasted tax cuts tilted toward the wealthy and called for the legislature to enact child care tax credits and better fund education. Almost immediately, Senate leader Phil Berger and House Speaker Tim Moore pledged to override his veto, and they have the votes to do it.

WHAT IT MEANS: Unless and until Democrats win back enough seats to break the GOP’s supermajority in one of the legislative chambers, Cooper isn’t really calling the shots. Blame gerrymandering if you want, but that’s just the way things are. He’s been basically irrelevant in the budget process this year, and the back-and-forth in the media between him and GOP leaders has amounted to little more than political posturing.

Related: The state cap on light-rail funding remains in budget.


THE GIST: Yesterday, the school board was supposed to vote for the second and final time on a revision to the school system’s dress code that would ban the display of the Confederate display and other forms of “indecent, profane, or racially intimidating” clothing or accessories. But then the school board decided, on a 4–3 vote, to kick the matter back to a committee and take it up again in the next policy committee meeting. Those who wanted the flag ban had complained that the policy school board members preliminarily approved two weeks ago left too much discretion to principals to enforce.

WHAT IT MEANS: This thing has dragged on for six months now. Who knows when it will end.

THIS IS WEIRD: The school board has also decided that it’s had enough of this discussion. From now on, the board will limit public comments at monthly regular-business meetings to thirty minutes and prioritize those who are speaking about things on the board’s agenda that evening as opposed to those who are speaking on other topics—such as, for instance, the Confederate flag.
  • Nut graph: “The move comes after months of speakers asking the board to ban the Confederate flag from student clothing and anywhere on school system property. At some meetings, dozens of speakers have spoken for an hour or more, almost all of them in support of a ban. After about 50 people spoke at a February meeting, with only one not speaking about the Confederate flag, the school board looked to change the student dress code policy.”
  • Money quote: “In April, board Chairman Steve Halkiotis had suggested the ban’s supporters were taking too much time of the board meetings.‘I know they were serious,’ Halkiotis said in an interview. ‘I know there were issues they cared about. I didn’t have to hear it a second, third and fourth time. That’s not how government works. That’s not how the school board works.’”



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