Third time’s a harm

The Huffington Post has the outline of yet another Republican healthcare deal:

he deal, brokered between House Freedom Caucus chairman Mark Meadows (R-N.C.) and Tuesday Group co-chairman Tom MacArthur (R-N.J.), would allow states to get waivers eliminating the so-called community rating provision ― the rule that prohibits insurers from charging higher premiums to people with pre-existing conditions. In order to obtain the waiver, states would have to participate in a federal high-risk pool or establish their own, and satisfy some other conditions.

In exchange for that conservative concession, the amendment would reinstate the Essential Health Benefits that were already taken out of the bill ― though, again, states could waive those provisions as well if they were able to show that doing so would lower premiums, increase the number of people insured, or “advance another benefit to the public interest in the state.”

What does this mean?
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Cleveland Murder Suspect Update

Pennsylvania State Police are reporting that Steve Stephens, wanted by the Cleveland Police Department for the murder, streamed live via Facebook, of 74 year old Robert Godwin, has killed himself after being spotted by law enforcement near Erie, Pennsylvania.

Here is the latest statement from Cleveland Police Chief Williams regarding the case.



Healthcare and KS-04

A loss can contain very useful information. Kansas-04 is such a loss.

There are half a dozen tactical decision making fights going on Twitter that I’ll avoid for a moment. What does this mean for healthcare?

Anything that has to get out of the House needs to have all of the House Freedom Caucus on board plus most of the Tuesday Morning group or all of the Tuesday Morning Group and a third of the House Freedom Caucus. The House Freedom Caucus policy demands are clear; revert the American healthcare system to 2009 as quickly as possible. The Tuesday Morning group’s demands are a bit more nebulous as they don’t want to be blamed for anything bad and they want large upper income tax cuts.

The AHCA went down because the House Freedom Caucus defected en masse and the Tuesday Morning Group was fleeing very quickly as it was obvious that the bill was going to inflict a lot of very obvious and blamable pain. Rep. Justin Amash (R-MI) thinks that there would have been at least fifty Republican votes against the bill.

Since then, the bill has become even more incoherent on a policy basis while moving in the direction of the House Freedom Caucus’s demands.

So what does this recent history lesson mean?

The AHCA, if it was to pass the House, needs the entire House Freedom Caucus and no more than twenty four total defections from the least conservative Republicans. The original danger zone for Republicans were the twenty three Republican reps who sit in seats where Hillary Clinton won. This matters. We can assume that Republicans who now sit in seats that Trump barely won are on edge. The margin of passage of the AHCA or anything that looks like it was always hyper narrow. It is even narrower.

And by the way:



So now what?

So now what?

That is a hell of a question but I think the right way to start probing towards some of boundaries of the possibility space is to ask what happened.

As I see it, the winning coalition that blocked the bill was a combination of unanimous Democratic opposition plus state level Republicans who actually have to balance a state budget and deal with real issues plus Republicans in districts that make them inherently vulnerable during a mid-term swing against the incumbent party plus the reactionaries of the House Freedom Caucus. We were also aided by the ineptitude of the wank “wonk” Paul Ryan and his coterie of enablers.

We told our stories. We mobilized. We stiffened the spine of Democrats whose spines probably did not need much stiffening. We put the fear of god into vulnerable Republicans. We scared the people who have to balance a state budget. We had on our side almost all of the interest groups that had bought into the ACA — doctors, insurers, hospitals, big drug makers and everyone else that gave a bit to get a bit. The only people who were not aghast at the AHCA were high income tax cut fanatics and policy illiterate decision makers.

We had a huge and unusual coalition pushing back against a bum’s rush. Most of this coalition was assembled in 2009 and 2010 to push the ACA through. And it was re-activated days after the election as everyone recovered from their shock, dismay and hangovers. Any time something changed, wonks were ripping through the documenation and making fast, rough and directionally right analysis with maps, figures, graphs and other hooks to allow advocates to tell personal, powerful stories that landed. And we kept on iterating powerful and emotionally connecting truth on every iteration of the bill.

We won. And our win helps our community:

Does it mean I finally can breathe again? That my health care won’t be pulled in a matter of weeks or months, on the eve of my starting biologic therapy for my Crohn’s?

This is why we fight. We’re not going to win every time. But we have to fight for conceding defeat and defeatism without making an effort means throwing ArchTeryx and others to the dogs. We’re not going to win every time, but we need to fight for both the chance to win as we did this week and to be able to look at our friends, our countrymen and ourselves with honesty as we say that we are doing everything that we can. We will need that for immigration. We will need that for global warming. We need that for our LBG and especially T allies. We might not win every time, but we can mitigate some damage, impose some delay, inflict some cost, and build effective coalitions for future action and progress every time that we hold to our values and our ideals.

So what does this mean for policy? The fear is that the ACA is here, but that the Trump Administration will sabotage it. This is a real fear, and it is one that the coalition that won this week will need to be engaged on to protect the implementation of the ACA.

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Whats going to happen today?

The short answer is mass chaos.

The longer answer is we will seeing some non-controversial bills come up under suspension rules this morning.  Around 10:00 AM, the Rules Committee will vote on the most recent set of changes that were placed in the bill overnight.     Those changes (stripping or punting EHB mainly) are probably going to cost a quarter of a trillion dollars and could lead to millions more not getting coverage but they are not waiting for a CBO score.  Once a special accelerated rule is voted on, the actual voting starts.

My opinion is that we are in good shape if there is an immediate blocking coalition of 23 Republican No votes in the first six or seven minutes.  At that point, the internal logic of the Republican caucus makes voting Yes and seeing the bill Fail become a no reward position so we could see a cascade towards No.  If we don’t see that, I would not be optimistic.

My gut feeling is that AHCA either passes by less than three votes or fails by more than fifteen. I can’t see the incentive structure for a narrow failure as the House leadership will hold the vote open for hours to arm twist a couple of hold-outs.

So call the House one last time.

Update 1:

 

He is from New Jersey, part of leadership and as of this morning he was in the New York Times Undecided/Unclear column. So him moving to a clear No is intriguing.



Good news

Right now the whip counts are going in the right direction. New York Times is up to 31 Republican No’s. I am reluctant to have too much faith in that number as a good number are House Freedom Caucus who can be bought off by making the bill atrocious through provisions that will get stripped in reconciliation. But every minute that they have to spend defending this monstrosity of a bill is a win for liberals, progressives, Democrats and people who either currently need or may at any point need the protections of the ACA.

I don’t know if we’re going to win, but we’re doing a whole lot better today than I thought we would have been on November 10, 2016.

If you have a chance, call Congress.

If you have a solid No, thank them. Their interns will appreciate it.
If you have a lean No, remind them they really don’t want to throw pregnant women off of coverage nor grandparents out of nursing homes.
If they are a solid Yes, remind them that this bill has 17% support in the general public and under 40% support in Republican circles and that 2018 is not that far away.

Update 1

Feedback works people. Let Congress know that their jobs are at stake because our lives or the lives of our friends are at stake.



Call Congress

There is a chance that we can win tomorrow.

Let’s work to increase that chance. Call Congress. If you are represented by a Democrat or a Republican who is on the 100% No list as maintained by the New York Times , thank them, or their interns.

If you are represented by an Undecided or Concerned Republican, encourage them to vote No.

If you are represented by a highly probable yes Republican, tell them to have fun losing in November of 2018.

There is no guarantee that we can win tomorrow. There might be a seven hour vote as arms get twisted and bribes concessions are offered to flip votes. But I would rather try and fail then resign myself to learned helplessness. So call.

Here is the House Rep finder:

Update 1 For the waverers, they will vote to be on the winning side. If there are twenty three or more quick GOP NO votes, we will see a cascade of No Votes as there is no upside to be a Yes and Fail. If there is only 10-20 GOP NO votes in the first 12 minutes, we’re in for a long afternoon of arm twisting.