We're beginning to get the sense the American Health Care Act is on life support. The numbers from the Congressional Budget Office on Monday afternoon hit like a bomb on Capitol Hill. Congress' nonpartisan financial watchdog predicts that, if enacted, the bill would cause 14 million people to lose their health insurance next year and a total of 24 million more to be uninsured by 2026 than would be uninsured under the current law. That would more than reverse all the health coverage gains achieved by Barack Obama's Affordable Care Act. Losses in coverage would primarily come from people choosing not to buy insurance without the individual mandate, while longer-term losses would come from changes to Medicaid. Given the estimated insurance losses next year, it seems that charging people a 30% penalty on their premium after a lapse in coverage, instead of having a mandate, would not be a large enough incentive to purchase insurance.
The CBO analysis says that under the House bill, premiums on the individual market would drop roughly 10% by 2026, after an initial bump, and younger Americans could see substantial declines in cost. The plan would also save the federal government $337 billion over the next decade, primarily via cuts to Medicaid and subsidies for exchanges. But this analysis of the bill signals it will not keep President Donald Trump's campaign promise that his health care plan would give all Americans coverage. Many Americans, especially the poor and elderly, would see massive increases in premiums — by up to 750%.
The numbers led top Republicans to dismiss or ignore the CBO analysis. Health and Human Services Secretary Tom Price said those in the White House "disagree strenuously" with the report. (A leaked White House analysis of the bill leaked to says 26 million people would lose insurance under the GOP plan, 2 million more than what the CBO predicted.) House Speaker Paul Ryan said he was pleased the analysis showed the bill would cut costs, but didn't mention the declines in coverage.
If the bill can pass the House, several Senate Republicans have already suggested they will require major revisions for it to even have a chance of passing the upper chamber. For their part, Democrats continued to be hypercritical of the bill. Following the CBO report, Vermont Sen. Bernie Sanders called the GOP plan "disgusting and immoral."
With the prospect of 14 million people losing health coverage next year alone, Republicans must decide if the political consequences of passing the AHCA are worth the gains. The GOP has long promised to "repeal and replace" Obama's ACA, and has stressed that this is only the first of three steps in their health insurance reform plan. (Though at least one Republican has said the other two much-discussed steps are a red herring.) Now we will find out how important changing this law really is to the GOP.
The Planned Parenthood effect: The current House bill cuts funding for Planned Parenthood, which provides reproductive health care for millions of Americans annually. The CBO predicts cutting funds will result in "several thousand" additional births each year. (Mic)
Breitbart throws a curve ball: The same day the CBO analysis was released, Breitbart unveiled a recording of Paul Ryan that apparently features the House speaker criticizing Trump after the release of the now infamous Access Hollywood tape. "I am not going to defend Donald Trump — not now, not in the future," Ryan says on the recording. The speaker reportedly said this on a conference call with House Republicans in October.
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Will the AHCA survive?
• Today: The Congressional Budget Office says the Republican health care plan would cause 14 million people to lose their health insurance next year, and up to 24 million by 2026.
• More: The analysis shows the American Health Care Act would save the federal government money and cut premiums for some people. But a loss of subsidies and cuts to Medicaid will remove insurance access from millions of others.
• Even more: The wiretapping story drags on.
• Trump's agenda today: Meeting with the deputy crown prince of Saudi Arabia. Speaking with the CEO of Anthem, a top health insurance company. Speaking with House Speaker Paul Ryan and Majority Leader Kevin McCarthy.
The wiretap saga slows down to a simmer
There were two developments Monday that signaled the wiretapping drama has likely reached its conclusion. Press Secretary Sean Spicer backed off the specific wiretap allegation, using air quotes to suggest the president was referring to surveillance more broadly. Facing a Congressional deadline to provide proof substantiating the president's allegation, the Justice Department of Justice asked for more time to find such evidence. Yesterday, we reviewed why Trump and his administration have no interest in perpetuating the wiretap story.
Cuts to American diplomacy
The White House is expected to announce the president's final budget on Thursday and with it, potentially major cuts to United States support for the United Nations. American contributions to the U.N. could decrease by half, according to Foreign Policy. Overall, initial reports of a 37% cut to the State Department have been scaled back, Politico reports. Trump's budget will be a major step toward Steve Bannon's vision of the "deconstruction of the administrative state." The budget is expected to dramatically scale back federal agencies and especially take aim at cutting regulations.
A looming government shutdown?
Senate Democrats, led by Minority Leader Chuck Schumer, sent Majority Leader Mitch McConnell a letter on Monday signaling they may shut down the government if Republicans try to fund the construction of Trump's border wall. Democrats wrote that any spending bills that include funds to build a wall between the U.S. and Mexico will be blocked — even if that means closing the government. The last time the federal government shuttered was in 2013, when Republicans repeatedly introduced bills to defund the ACA. The impasse between the political parties led to two weeks of federal government closure.
News and insight you cannot miss:
• Remember Judge Neil Gorsuch? Democrats are having a hard time finding anything about the judge that they can oppose. The conservative justice appears to be headed for confirmation with at least 60 votes in the Senate. (Politico)
• Rep. Steve King (R-Iowa) was rebuked by the chairman of the Iowa Republican Party for his weekend tweet that drew outrage for suggesting immigrants should not have children in the U.S. (Twitter)
• The National Policy Institute, a white supremacist organization led by alt-right celebrity Richard Spencer, lost its tax-exempt status. After Spencer took over, the group stopped filing tax returns with the IRS. (Mic)
• Rep. Jason Chaffetz (R-Utah) is using the fact Rosie O'Donnell donated to his opponent in fundraising pleas. The anti-Trump TV star told Mic's Celeste Katz she's not having it. (Mic)
• British Parliament has taken the first concrete step toward Brexit. (CNN)