Senate GOP: Our Replacement’s Got to Help Out Seniors Who Don’t Qualify for Medicaid

March 15, 2017

It's the Ides of March. Watch your backs.

Senate GOP: Our Replacement's Got to Help Out Seniors Who Don't Qualify for Medicaid

The work in progress… remains a work in progress.

Nervous Senate Republicans on Tuesday suggested changes to the [Republican replacement for Obamacare]…

They told Trump administration officials — including the health secretary, Tom Price — that they wanted to see lower insurance costs for poorer, older Americans and an increase in funding for states with high populations of hard-to-insure people.

They said those changes would greatly improve the chances of Senate approval even though they might further alienate conservatives.

Senator John Thune of South Dakota, a member of the Republican leadership, said Senate Republicans could take steps to make the bill "more helpful to people on the lower end."

…Senator Bill Cassidy, Republican of Louisiana, noted that Americans over 60 who earn a little too much to qualify for Medicaid would "have a hard time affording insurance" under the House plan, since insurance premiums would rise far higher than the modest tax credits on offer. "That's not good," he said.

The House bill includes large transition grants to the states that can be used to help cover people with pre-existing medical conditions, subsidize insurance purchases beyond the bill's tax credits, or other interventions; some Senate Republicans would seek to make those bigger as well. Mr. Thune wants to revise the tax credits so that they would be focused more on lower-income people.

The final House vote is supposed to come next week. If they're still tossing out significant changes to the bill (that would presumably alter the CBO scoring)… how intractable is that deadline?

Mad-Doh!

Last night, Rachel Maddow breathlessly declared on Twitter, "we've got Trump's tax returns!"

What she meant, we later learned, was that someone had mailed a few pages from Trump's 2005 return to David Cay Johnston. And after a good 17 minutes of Maddow pounding the table about Trump's threat to democracy and all we hold dear, and his sinister Russian connections, and how Trump probably made too much profit on a home sale to a Russian oligarch, and how the whole thing was like a "choose your own adventure" book, and how the other returns probably showed "inexplicable dumps of foreign money into the president's coffers that cannot be explained"…

(This sinister conspiracy theory requires us to believe that years and years ago, powerful Russian interests thought it was not merely plausible that Trump would be president someday, but it was such a likely prospect that it was worth investing large sums of money into the idea.)

After the commercial break, we learned Trump paid $31 million in taxes under the Alternative Minimum Tax provision of the tax code, which he would like to eliminate. There's Rachel Maddow's big scoop: Trump would like to change the tax system so he pays a lot less.

If wanting to change the tax code so that you pay a lot less in taxes is a scandal, almost all of us are guilty. (Hey, did Maddow ever get around to giving her fellow MSNBC hosts any grief for their unpaid taxes?)

David French:

Maddow began her show excoriating Trump for not releasing his tax returns (on that point, we agree; he should release his returns) but then departed from that basic point to launch into a series of truly wild speculations of foreign influence that included (I'm not making this up) conspiratorial references to private plane parking and yacht docking. Honestly, the musings came so fast and furious that I gave up jotting down notes and just soaked it all in. It made me wonder if Maddow and company truly believe that Trump is a full-blown criminal, and media review of the tax returns is somehow the key to bringing down his entire empire.

If you subscribe to the theory that Trump's tax returns include all kinds of evidence of nefarious criminal activity… what has the Internal Revenue Service been doing all these years? They had time to target all of those small-time Tea Party groups seeking tax-exempt status, but they ignored the criminal mastermind who lives in a giant golden tower in the middle of Manhattan?

The new conventional wisdom this morning is that Trump or someone close to him mailed them to get the media on a wild goose chase, or to fool them into breathlessly touting a tax return that shows Trump obeying all appropriate tax laws and paying quite a bit of tax.

"Almost as if somebody selected the single year and the precise 2 pages that would do Trump least harm- and found a way to release only those," says David Frum. "The Trump camp released one positive tax return to distract from Russia hearings and the Trumpcare meltdown. That's painfully obvious," declares Joe Scarborough.

This is all entirely possible, but think about what had to happen here. Trump (or more likely, some associate with his blessing) anonymously mails copies of the pages to David Cay Johnston. He doesn't know for certain that Johnston will go to Maddow. Johnston's an experienced reporter, and could have looked at the tax return (from twelve years ago!) and concluded he had a story, but not a particularly shocking or scandalous one. It's Trump's "luck" that Maddow chose the treat the tax return with the wildest hype since Geraldo Rivera opened up Al Capone's vault.

Best to Kill Off Bad Ideas Like 'Calexit' As Quickly As Possible

An angle I didn't get into in yesterday's piece about secession chic among liberals and the "Calexit" campaign: The state's extreme dependence upon water sources from beyond the state lines. About 65 percent of the water for Southern California comes from the Colorado River. Los Angeles, San Diego, all the agricultural production in that region… if you think there are tensions about water usage now, think about what it will be like when authorities and consumers in Arizona and Nevada control the water flow to a different country, a group of ex-Americans who chose to secede.

In an irate liberal response to the liberal suggestions of secession, Hamilton Nolan writes, "Donald Trump was just elected president. It is no longer safe to assume that wild, half-joking political ideas will not be realized." 

Nolan's a passionate lefty, but everyone across the spectrum can applaud his excoriation of the "I'm taking my bat and ball and going home" attitude after the election:

The impulse to bandy about the threat of secession is not rooted in concern for the vulnerable. It is a tantrum by rich people who are angry that their political power temporarily does not match their economic power. Think about how shallow a self-proclaimed liberal's commitment to social justice has to be for them to say that the proper response to the ascent of a quasi-fascist amoral strongman is to cede him the majority of the nation's territory and stop helping to support social programs for everyone not lucky enough to live in a coastal state. Ah, what brave commitment to justice for all! If 51% of your state voted for the bad man, we will condemn the other 49% to misery. That's what good liberals are all about! We all remember how Abraham Lincoln became an American hero by telling the Confederacy: If you are uneducated enough to think that slavery is good, go be your own country. With time your slaves will certainly come to realize that blue states are preferable!

The other point that California fans forget is that most of the industries that it boasts about the most could transfer to other locations if the tax and regulatory environment became bad enough. More than half the country's television pilots were made in New York, Vancouver, and Atlanta. Silicon Valley is the country's biggest tech cluster, but it has plenty of others – Seattle, New York, Austin, northern Virginia, North Carolina's research triangle, Boston. Farms, mines, fisheries, and scenic views are hard to move. A company isn't.

ADDENDA: The updated agenda for the National Review Ideas Summit is out. Early Friday morning, I'll be interviewing Kellyanne Conway. First rule of NR Ideas Summit: You can sit on the chair or couch any way you like.

 
 
 
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