washington, dc

The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

Ed Kilgore

May 18: Miller To Write, Trump To Deliver, Speech Lecturing Saudis on Islam

There was so much going on in Washington this week that it was missed by many observers that Donald Trump’s impending overseas trip will include a “major speech” on Islam in–wait for it–Saudi Arabia. And the news just kept getting worse, as I noted at New York:

Trump will be making a speech on Islam in Saudi Arabia, before an audience of representatives of more than 50 Muslim countries.

Yes, that’s right: The president, a man who has espoused openly Islamophobic views and is known for his less-than-subtle thinking and speaking, will go to the birthplace of the religion, as a guest of a regime whose entire legitimacy derives from its role as the guardian of Islam’s Holy Places, and presume to lecture Muslims on their obligation to fight “radical Islam.”

What could possibly go wrong?

Before answering, one should be aware of another fact about this speech: It is reportedly being written by Senior Policy Adviser Stephen Miller, who has a record of Muslim-baiting as long as your arm. He is the close White House ally of former Breitbart executive Stephen Bannon and former Breitbart writer Julia Hahn, two people who appear to believe Muslim refugees are an existential threat to America. Miller did not let his lack of legal training get in the way of drafting the Trump travel-ban order that caused horrific chaos before being stopped by the courts. His own casual words identifying the travel ban with Trump’s call for an unconstitutional “Muslim ban” during the campaign became a central part of the rationale for said judicial intervention.

Perhaps there are wiser advisers looking over Miller’s shoulder and keeping him constantly aware of the extreme sensitivity of Saudi Arabia’s Wahhabi Muslims toward pronouncements on Islam by infidels, even the most well-intentioned, and tutoring him on the intricacies of intra-Muslim affairs, and the constant risk of blundering into deadly insults that would take decades to erase. Maybe Trump will stay close to a cautious shift, and avoid setting back U.S.-Middle Eastern relations decisively. But this is the Trump White House we are talking about, where even the most basic guidelines are often ignored for reasons ranging from understaffing to byzantine rivalries to paranoia.

Trump is already, according to Politico, in danger of blundering into what it calls a “Saudi Game of Thrones” between two princely aspirants to the succession of aging King Salman. Tossing pronouncements on religion into that tinderbox could be a very bad idea.

Isn’t there a domestic-policy issue (supposedly his specialty) Miller should be attending to? Or perhaps a pro-Trump rally where he could be shouting and cavorting and whipping up the crowds like he did during the campaign? Trump should stay a thousand miles away from pontificating on Islam, and Miller a thousand miles beyond that.


Miller to Write, Trump To Deliver, Speech Lecturing Saudis on Islam

There was so much going on in Washington this week that it was missed by many observers that Donald Trump’s impending overseas trip will include a “major speech” on Islam in–wait for it–Saudi Arabia. And the news just kept getting worse, as I noted at New York:

Trump will be making a speech on Islam in Saudi Arabia, before an audience of representatives of more than 50 Muslim countries.

Yes, that’s right: The president, a man who has espoused openly Islamophobic views and is known for his less-than-subtle thinking and speaking, will go to the birthplace of the religion, as a guest of a regime whose entire legitimacy derives from its role as the guardian of Islam’s Holy Places, and presume to lecture Muslims on their obligation to fight “radical Islam.”

What could possibly go wrong?

Before answering, one should be aware of another fact about this speech: It is reportedly being written by Senior Policy Adviser Stephen Miller, who has a record of Muslim-baiting as long as your arm. He is the close White House ally of former Breitbart executive Stephen Bannon and former Breitbart writer Julia Hahn, two people who appear to believe Muslim refugees are an existential threat to America. Miller did not let his lack of legal training get in the way of drafting the Trump travel-ban order that caused horrific chaos before being stopped by the courts. His own casual words identifying the travel ban with Trump’s call for an unconstitutional “Muslim ban” during the campaign became a central part of the rationale for said judicial intervention.

Perhaps there are wiser advisers looking over Miller’s shoulder and keeping him constantly aware of the extreme sensitivity of Saudi Arabia’s Wahhabi Muslims toward pronouncements on Islam by infidels, even the most well-intentioned, and tutoring him on the intricacies of intra-Muslim affairs, and the constant risk of blundering into deadly insults that would take decades to erase. Maybe Trump will stay close to a cautious shift, and avoid setting back U.S.-Middle Eastern relations decisively. But this is the Trump White House we are talking about, where even the most basic guidelines are often ignored for reasons ranging from understaffing to byzantine rivalries to paranoia.

Trump is already, according to Politico, in danger of blundering into what it calls a “Saudi Game of Thrones” between two princely aspirants to the succession of aging King Salman. Tossing pronouncements on religion into that tinderbox could be a very bad idea.

Isn’t there a domestic-policy issue (supposedly his specialty) Miller should be attending to? Or perhaps a pro-Trump rally where he could be shouting and cavorting and whipping up the crowds like he did during the campaign? Trump should stay a thousand miles away from pontificating on Islam, and Miller a thousand miles beyond that.


May 11: Possible Obstruction of Justice Makes Impeachment Talk Inevitable

As the potential implications of the Comey firing, aggravated by the wildly varying accounts of how and why it occurred, begin to sink in, so, too are the remote but tangible chances of really serious consequences, as I discussed at New York:

The timing and manner of Donald Trump’s dismissal of FBI director James Comey raise an inevitable suspicion — not proof, but a suspicion — of presidential obstruction of justice. And the only real remedy for presidential obstruction of justice, if it is stubborn, is impeachment, or at least the threat of impeachment — as we learned during the Nixon administration. Because presidents have the power to gum up every other path to the revelation and reversal of serious patterns of administration misconduct, there’s a pretty low threshold for talk of the “I-word,” once said gumming up appears to be happening.

As Matthew Yglesias notes, the Republicans who control Congress can head off an impeachment crisis by un-gumming the path to justice via some investigative entity beyond Donald Trump’s control. But that will require a break with Trump that most of them do not want to make.

If the situation we are in right now gets worse for the White House, and the rest of 2017 unfolds under the shadow of unresolved allegations about Russian collusion, then serious impeachment talk will become unavoidable. One might assume that the talk would go nowhere, since the president’s party controls the congressional levers that would have to be used to formally begin proceedings. But what could ensue, though, is the realization that Republicans might privately crave impeachment more than Democrats.

Why? Absent normal legal proceedings and without the safety valve of impeachment, the only way for an aroused public to hold Trump accountable is by spanking his political party in the 2018 midterms, an election in which the White House party is almost certain to lose ground even in normal conditions. And after that, if Trump stubbornly resists any independent scrutiny of his past and present behavior, Republicans could have a nightmarish 2020 cycle in which efforts to retire Trump after one term collide with his hard kernel of GOP grassroots support, strongest among people who know little and care less about their hero’s compliance with legal and political traditions for presidential accountability. You could definitely envision a vicious primary fight followed by a difficult general election.

In those circumstances, how many conventional conservative Republicans would resist the temptation to fantasize about a deus ex machina procedure that could remove the troublesome Trump and replace him with the extremely well-known quantity of Mike Pence, perhaps just in time to change the dynamics of 2018 — or certainly 2020 — in the GOP’s favor? Conversely, Democrats might prefer to keep Donald Trump around as long as possible to indelibly stain the GOP with his misdeeds and his alarming demeanor.

This is not to say that political considerations will determine the course of events more than the facts that eventually emerge; if it turns out there is no evidence of collusion in the Russia-Trump investigation, then the president is not going to be hounded out of office for acting as though there was.

But the fact remains that the politics of impeachment or a coerced resignation are hard to predict and impossible to dismiss. In all the talk since Comey’s firing of the parallels with Nixon’s 1973 “Saturday Night Massacre” it has been largely forgotten that Nixon’s brash action was preceded just ten days earlier by the resignation of Vice-President Spiro Agnew, as part of a plea deal over bribery charges. Agnew, in some ways a precursor of Trump in his “politically incorrect” rhetoric, had been what Nixon not-so-jokingly called his “insurance policy” against impeachment. His replacement by the ever-genial Gerald Ford had a definite if hard-to-measure impact on the willingness of Democrats and Republicans alike to send the Tricky One packing.

All in all, Mike Pence resembles Gerald Ford more than Spiro Agnew. Just sayin.’


Possible Obstruction of Justice Makes Impeachment Talk Inevitable

As the potential implications of the Comey firing, aggravated by the wildly varying accounts of how and why it occurred, begin to sink in, so, too are the remote but tangible chances of really serious consequences, as I discussed at New York:

The timing and manner of Donald Trump’s dismissal of FBI director James Comey raise an inevitable suspicion — not proof, but a suspicion — of presidential obstruction of justice. And the only real remedy for presidential obstruction of justice, if it is stubborn, is impeachment, or at least the threat of impeachment — as we learned during the Nixon administration. Because presidents have the power to gum up every other path to the revelation and reversal of serious patterns of administration misconduct, there’s a pretty low threshold for talk of the “I-word,” once said gumming up appears to be happening.

As Matthew Yglesias notes, the Republicans who control Congress can head off an impeachment crisis by un-gumming the path to justice via some investigative entity beyond Donald Trump’s control. But that will require a break with Trump that most of them do not want to make.

If the situation we are in right now gets worse for the White House, and the rest of 2017 unfolds under the shadow of unresolved allegations about Russian collusion, then serious impeachment talk will become unavoidable. One might assume that the talk would go nowhere, since the president’s party controls the congressional levers that would have to be used to formally begin proceedings. But what could ensue, though, is the realization that Republicans might privately crave impeachment more than Democrats.

Why? Absent normal legal proceedings and without the safety valve of impeachment, the only way for an aroused public to hold Trump accountable is by spanking his political party in the 2018 midterms, an election in which the White House party is almost certain to lose ground even in normal conditions. And after that, if Trump stubbornly resists any independent scrutiny of his past and present behavior, Republicans could have a nightmarish 2020 cycle in which efforts to retire Trump after one term collide with his hard kernel of GOP grassroots support, strongest among people who know little and care less about their hero’s compliance with legal and political traditions for presidential accountability. You could definitely envision a vicious primary fight followed by a difficult general election.

In those circumstances, how many conventional conservative Republicans would resist the temptation to fantasize about a deus ex machina procedure that could remove the troublesome Trump and replace him with the extremely well-known quantity of Mike Pence, perhaps just in time to change the dynamics of 2018 — or certainly 2020 — in the GOP’s favor? Conversely, Democrats might prefer to keep Donald Trump around as long as possible to indelibly stain the GOP with his misdeeds and his alarming demeanor.

This is not to say that political considerations will determine the course of events more than the facts that eventually emerge; if it turns out there is no evidence of collusion in the Russia-Trump investigation, then the president is not going to be hounded out of office for acting as though there was.

But the fact remains that the politics of impeachment or a coerced resignation are hard to predict and impossible to dismiss. In all the talk since Comey’s firing of the parallels with Nixon’s 1973 “Saturday Night Massacre” it has been largely forgotten that Nixon’s brash action was preceded just ten days earlier by the resignation of Vice-President Spiro Agnew, as part of a plea deal over bribery charges. Agnew, in some ways a precursor of Trump in his “politically incorrect” rhetoric, had been what Nixon not-so-jokingly called his “insurance policy” against impeachment. His replacement by the ever-genial Gerald Ford had a definite if hard-to-measure impact on the willingness of Democrats and Republicans alike to send the Tricky One packing.

All in all, Mike Pence resembles Gerald Ford more than Spiro Agnew. Just sayin.’


May 10: Trump Fires Comey To Curb Russia Investigation as GOP Stands By

As pols began to choose up sides after Donald Trump’s firing of James Comey, I made this initial assessment of the partisan politics for New York.

The morning after the president’s abrupt firing of FBI director James Comey, an account of what was really going on is beginning to emerge in which the official explanation of steadily mounting, retroactive bipartisan dismay with Comey’s handling of the Clinton email case is but a flimsy pretext. Politico boils down the background story succinctly:

“[Trump] had grown enraged by the Russia investigation, two advisers said, frustrated by his inability to control the mushrooming narrative around Russia. He repeatedly asked aides why the Russia investigation wouldn’t disappear and demanded they speak out for him. He would sometimes scream at television clips about the probe, one adviser said.”

And so he decided to drop the hammer on Comey at the first convenient opportunity. A screwup in Comey’s description of the emails on Anthony Weiner’s laptop that were the subject of the FBI director’s famous October surprise provided the immediate excuse. It seems clear that Team Trump believed Democrats would be thrown into disarray by the clever use of the Clinton emails as the rationale for a firing that was really about something else.

That calculation was clearly wrong, but the fact remains that if Trump’s move was intended to curb the Russia investigation, his enemies have limited means of stopping him.

Yes, the FBI can and probably will formally continue the investigation, but the odds are pretty good that whoever Trump chooses as Comey’s immediate successor will treat it as a very low priority.

The Justice Department can — and given the recusal of the attorney general, Jeff Sessions, on matters related to the Russia-Trump connection, almost certainly should — appoint a special counsel to take over the investigation and clear the air. But why would a White House determined to shut it all down accept that course of action? It’s implausible unless the administration winds up with no other good options.

Congress could create a special committee, or even a congressionally constituted commission, to delve into the various issues involving the Russians. The latter course is what conservative House gadfly Justin Amash talked about doing in the immediate wake of the Comey firing.

But a lot of Republicans would have to go along with that approach, and most significantly in the wall of noise that rose across Washington after the firing was announced, the chairmen of the House and Senate Judiciary Committees — Representative Bob Goodlatte and Senator Chuck Grassley — seemed to be buying the White House/DOJ explanation of the matter. If their posture is that Comey had to go for cumulative sins in the Clinton email case, why would they want to waste taxpayer money on some special investigation of that Russian thingy Democrats insist on talking about? You could see any drive for a congressionally authorized investigation running into some real obstacles. For his part, Senate Majority Leader Mitch McConnell is arguing against any new investigation of Trump and Russia at all, suggesting the Senate Intelligence Committee’s inquiries are sufficient.

Once upon a time, there might have been a wellspring of support for the appointment of an independent prosecutor that would not report to Congress or to the administration. But the law authorizing that institution was allowed quietly to expire in 1999 after its generally conceded abuse in seven separate investigations of the Clinton administration.

As veteran journalist Jeff Greenfield points out, the disarray of Congress is the single most important problem with treating this situation as analogous to Richard Nixon’s “Saturday Night Massacre,” despite the obvious parallels of an angry president trying to dispose of an underling who might be getting too close to securing dangerous information. Nixon was dealing with a Democratic Congress and a much smaller and more uniformly hostile news media; he was quickly forced to replace the fired special counsel Archibald Cox instead of shutting down the Watergate investigation altogether. The 37th president was also laboring under the ultimately fatal existence of massive evidence of wrongdoing documented by his own White House recording system; Cox was fired for trying to secure some of the relevant tapes. If the Trump White House is harboring a “smoking gun” in the Russia case, we don’t know of it at present.

The bottom line is that Trump has a much better chance of getting through this “crisis” than Nixon did when he “massacred” a special counsel and the Justice Department officials defending him. The key thing to watch is whether congressional Republicans decide in large numbers that Trump’s stonewalling over Russia and his generally imperious habits are endangering their grip on the Legislative branch in 2018.


Trump Fires Comey to Curb Russia Investigation As GOP Stands By

As pols began to choose up sides after Donald Trump’s firing of James Comey, I made this initial assessment of the partisan politics for New York.

The morning after the president’s abrupt firing of FBI director James Comey, an account of what was really going on is beginning to emerge in which the official explanation of steadily mounting, retroactive bipartisan dismay with Comey’s handling of the Clinton email case is but a flimsy pretext. Politico boils down the background story succinctly:

“[Trump] had grown enraged by the Russia investigation, two advisers said, frustrated by his inability to control the mushrooming narrative around Russia. He repeatedly asked aides why the Russia investigation wouldn’t disappear and demanded they speak out for him. He would sometimes scream at television clips about the probe, one adviser said.”

And so he decided to drop the hammer on Comey at the first convenient opportunity. A screwup in Comey’s description of the emails on Anthony Weiner’s laptop that were the subject of the FBI director’s famous October surprise provided the immediate excuse. It seems clear that Team Trump believed Democrats would be thrown into disarray by the clever use of the Clinton emails as the rationale for a firing that was really about something else.

That calculation was clearly wrong, but the fact remains that if Trump’s move was intended to curb the Russia investigation, his enemies have limited means of stopping him.

Yes, the FBI can and probably will formally continue the investigation, but the odds are pretty good that whoever Trump chooses as Comey’s immediate successor will treat it as a very low priority.

The Justice Department can — and given the recusal of the attorney general, Jeff Sessions, on matters related to the Russia-Trump connection, almost certainly should — appoint a special counsel to take over the investigation and clear the air. But why would a White House determined to shut it all down accept that course of action? It’s implausible unless the administration winds up with no other good options.

Congress could create a special committee, or even a congressionally constituted commission, to delve into the various issues involving the Russians. The latter course is what conservative House gadfly Justin Amash talked about doing in the immediate wake of the Comey firing.

But a lot of Republicans would have to go along with that approach, and most significantly in the wall of noise that rose across Washington after the firing was announced, the chairmen of the House and Senate Judiciary Committees — Representative Bob Goodlatte and Senator Chuck Grassley — seemed to be buying the White House/DOJ explanation of the matter. If their posture is that Comey had to go for cumulative sins in the Clinton email case, why would they want to waste taxpayer money on some special investigation of that Russian thingy Democrats insist on talking about? You could see any drive for a congressionally authorized investigation running into some real obstacles. For his part, Senate Majority Leader Mitch McConnell is arguing against any new investigation of Trump and Russia at all, suggesting the Senate Intelligence Committee’s inquiries are sufficient.

Once upon a time, there might have been a wellspring of support for the appointment of an independent prosecutor that would not report to Congress or to the administration. But the law authorizing that institution was allowed quietly to expire in 1999 after its generally conceded abuse in seven separate investigations of the Clinton administration.

As veteran journalist Jeff Greenfield points out, the disarray of Congress is the single most important problem with treating this situation as analogous to Richard Nixon’s “Saturday Night Massacre,” despite the obvious parallels of an angry president trying to dispose of an underling who might be getting too close to securing dangerous information. Nixon was dealing with a Democratic Congress and a much smaller and more uniformly hostile news media; he was quickly forced to replace the fired special counsel Archibald Cox instead of shutting down the Watergate investigation altogether. The 37th president was also laboring under the ultimately fatal existence of massive evidence of wrongdoing documented by his own White House recording system; Cox was fired for trying to secure some of the relevant tapes. If the Trump White House is harboring a “smoking gun” in the Russia case, we don’t know of it at present.

The bottom line is that Trump has a much better chance of getting through this “crisis” than Nixon did when he “massacred” a special counsel and the Justice Department officials defending him. The key thing to watch is whether congressional Republicans decide in large numbers that Trump’s stonewalling over Russia and his generally imperious habits are endangering their grip on the Legislative branch in 2018.


May 4: Trumpcare Will Also Do Damage In Blue States That Don’t Seek Exemptions From Obamacare Requirements

After today’s narrow House passage of the American Health Care Act, it really began to bug me that so any people were focused to the exclusion of everything else on the effect of the bill in conservative states that seek waivers from Obamacare regulations. That was, in fact, the key issue that seemed to separate House Republicans. But as I explained at New York, damage from the bill would be severe in blue states, too.

Trumpcare, at least in its current form, will allow states to decide whether to carry on with something resembling the systems in place under Obamacare, or to opt out of various key requirements under current law — including the one protecting people with preexisting conditions. It seems safe to assume that most blue states will not even consider applying for waivers to screw over their own most vulnerable citizens. But at the same time, there are many provisions in the revised American Health Care Act that will affect people everywhere, often not in a good way.

States like New York, California, Illinois, Massachusetts, Pennsylvania, and Virginia — states with Democratic governors and/or legislatures — are not going to seek exemptions from Obamacare requirements affecting the essential benefits health plans must offer, or prohibiting discrimination on the basis of health conditions. And there may be other states that don’t accept the poisoned chalice of health-policy autonomy. One of the House Republicans who seems to be coming around to a vote for Trumpcare, Carlos Curbelo, offered that excuse, even for his own red state of Florida:

“I would highly doubt that any governor, especially the governor of a large state like Florida, would seek a waiver. I just don’t think that any state would want to carry the burden of managing health care more than they already do, through Medicaid.”

Actually, it’s not clear that most of the people priced out of the individual health-care market by preexisting conditions would qualify for Medicaid, particularly in non-expansion states like Florida. But it is true that applying for the waivers that the House Freedom Caucus demanded will at least be controversial in the states that consider it.

For many of Trumpcare’s provisions, however, there’s not really much state flexibility at all. Indeed, blue states — most of which took advantage of Obamacare’s optional expansion of Medicaid — will be most affected by the bill’s abrupt termination of enhanced federal funds for the expanded population. Indeed, of the 24 million Americans the Congressional Budget Office estimated would lose health coverage under the original Trumpcare bill, 14 million would lose Medicaid coverage.

Some of the Obamacare regulations Trumpcare seeks to revoke and/or replace also are not optional, including the expansion of allowable price discrimination based on age and the elimination of the individual purchasing mandate (to be replaced by a surcharge on people who wait to buy insurance until they are sick).

Trumpcare also gets rid of the tax subsidies set up by Obamacare, and creates its own tax-credit system, with arguably very insufficient credit amounts, especially for low-income and older people. None of this can be waived for any states.

And the cost-sharing-reduction subsidies that have been critical in keeping insurers offering coverage under the Obamacare exchanges — the subsidies the administration has been threatening off and on to withhold — would be formally killed as well.

Finally, there are all sorts of little-recognized side effects of Trumpcare — such as the unraveling of benefit requirements for employer-sponsored health insurance — that do not discriminate by geography. And there is one big national provision that could do vast damage to women’s health care, especially in rural areas: the prohibition on any federal funds for Planned Parenthood.

It is worth watching closely the special provisions cooked into this legislation that affect certain states exclusively. The original AHCA (and hence its successors) included a deal to secure votes from upstate New York GOP House members that shifted Medicaid costs from county to state taxpayers. More of that sort of home cooking could be tucked into the legislation later.

We have no way of knowing what the Senate will do to the “state flexibility” provisions that have been so important to Trumpcare’s struggle towards House passage. On the one hand, there may be some “moderate” GOP resistance to how far conservative states will be allowed and encouraged to go in messing with poorer and sicker people who have benefited from Obamacare. On the other hand, some Republican senators—notably Bill Cassidy and Susan Collins—want to go much further in allowing states to go their own way, to the point of letting blue states keep most of Obamacare in place.

For blue-state progressives, this may be a tempting approach insofar as it insulates them from much of the damage wrought by an Obamacare replacement. But they need to ask themselves if they are willing to sell vulnerable red-state people down the river and accept a sort of health-policy apartheid. Republicans may not actually give them a lot of choice, but it’s important for everyone to understand the trade-offs involved in getting this unwieldy beast of a health-care bill to Donald Trump’s desk.


Trumpcare Will Also Do Damage In Blue States That Don’t Seek Exemptions From Obamacare Requirements

After today’s narrow House passage of the American Health Care Act, it really began to bug me that so any people were focused to the exclusion of everything else on the effect of the bill in conservative states that seek waivers from Obamacare regulations. That was, in fact, the key issue that seemed to separate House Republicans. But as I explained at New York, damage from the bill would be severe in blue states, too.

Trumpcare, at least in its current form, will allow states to decide whether to carry on with something resembling the systems in place under Obamacare, or to opt out of various key requirements under current law — including the one protecting people with preexisting conditions. It seems safe to assume that most blue states will not even consider applying for waivers to screw over their own most vulnerable citizens. But at the same time, there are many provisions in the revised American Health Care Act that will affect people everywhere, often not in a good way.

States like New York, California, Illinois, Massachusetts, Pennsylvania, and Virginia — states with Democratic governors and/or legislatures — are not going to seek exemptions from Obamacare requirements affecting the essential benefits health plans must offer, or prohibiting discrimination on the basis of health conditions. And there may be other states that don’t accept the poisoned chalice of health-policy autonomy. One of the House Republicans who seems to be coming around to a vote for Trumpcare, Carlos Curbelo, offered that excuse, even for his own red state of Florida:

“I would highly doubt that any governor, especially the governor of a large state like Florida, would seek a waiver. I just don’t think that any state would want to carry the burden of managing health care more than they already do, through Medicaid.”

Actually, it’s not clear that most of the people priced out of the individual health-care market by preexisting conditions would qualify for Medicaid, particularly in non-expansion states like Florida. But it is true that applying for the waivers that the House Freedom Caucus demanded will at least be controversial in the states that consider it.

For many of Trumpcare’s provisions, however, there’s not really much state flexibility at all. Indeed, blue states — most of which took advantage of Obamacare’s optional expansion of Medicaid — will be most affected by the bill’s abrupt termination of enhanced federal funds for the expanded population. Indeed, of the 24 million Americans the Congressional Budget Office estimated would lose health coverage under the original Trumpcare bill, 14 million would lose Medicaid coverage.

Some of the Obamacare regulations Trumpcare seeks to revoke and/or replace also are not optional, including the expansion of allowable price discrimination based on age and the elimination of the individual purchasing mandate (to be replaced by a surcharge on people who wait to buy insurance until they are sick).

Trumpcare also gets rid of the tax subsidies set up by Obamacare, and creates its own tax-credit system, with arguably very insufficient credit amounts, especially for low-income and older people. None of this can be waived for any states.

And the cost-sharing-reduction subsidies that have been critical in keeping insurers offering coverage under the Obamacare exchanges — the subsidies the administration has been threatening off and on to withhold — would be formally killed as well.

Finally, there are all sorts of little-recognized side effects of Trumpcare — such as the unraveling of benefit requirements for employer-sponsored health insurance — that do not discriminate by geography. And there is one big national provision that could do vast damage to women’s health care, especially in rural areas: the prohibition on any federal funds for Planned Parenthood.

It is worth watching closely the special provisions cooked into this legislation that affect certain states exclusively. The original AHCA (and hence its successors) included a deal to secure votes from upstate New York GOP House members that shifted Medicaid costs from county to state taxpayers. More of that sort of home cooking could be tucked into the legislation later.

We have no way of knowing what the Senate will do to the “state flexibility” provisions that have been so important to Trumpcare’s struggle towards House passage. On the one hand, there may be some “moderate” GOP resistance to how far conservative states will be allowed and encouraged to go in messing with poorer and sicker people who have benefited from Obamacare. On the other hand, some Republican senators—notably Bill Cassidy and Susan Collins—want to go much further in allowing states to go their own way, to the point of letting blue states keep most of Obamacare in place.

For blue-state progressives, this may be a tempting approach insofar as it insulates them from much of the damage wrought by an Obamacare replacement. But they need to ask themselves if they are willing to sell vulnerable red-state people down the river and accept a sort of health-policy apartheid. Republicans may not actually give them a lot of choice, but it’s important for everyone to understand the trade-offs involved in getting this unwieldy beast of a health-care bill to Donald Trump’s desk.


May 3: GOP Congressman Says Sick People Whose States Kill Coverage Should Move

The latest in many a revealing quote from GOP Members of Congress on health care policy came from North Carolina’s Rep. Robert Pittenger. I wrote about it at New York with some real anger.

It is not quite down there in the hall of shame with his Alabama colleague Mo Brooks’s suggestion that sick people often don’t deserve health coverage because they’ve brought it all down on themselves with bad habits. But North Carolina Republican representative Robert Pittenger was similarly cavalier about people with preexisting conditions who might lose affordable coverage if their state chose to waive protections for them under the terms of the revised American Health Care Act that the White House and Republican congressional leaders are trying to get through the House this week.

Quoth Pittenger: “People can go to the state that they want to live in. States have all kinds of different policies and there are disparities among states for many things: driving restrictions, alcohol, whatever,” he continued. “We’re putting choices back in the hands of the states. That’s what Jeffersonian democracy provides for.”

Seems Pittenger thinks the sick should vote with their feet, or their other afflicted parts, to live in a place that doesn’t view their health as a disposable asset.

I do believe we had a civil war over the proposition that states can do any damn thing they want with people, and the proponents of the states’-rights version of “Jeffersonian democracy” lost. It’s true that the victims back then did not always have the option to move elsewhere (there was this thing called the Fugitive Slave Act), but it should be beyond argument now that some rights and privileges of citizenship ought to be national in scope. Maybe health insurance is one of them, and maybe it’s not, but Pittenger’s glib assertion that the theoretical option of flight for poor, sick people makes it okay to discriminate against them is morally and politically obtuse.

This is not Pittenger’s first or worst comment of this nature. Last year, after protests broke out in Charlotte (a city partially represented by Pittenger) when an African-American man (Keith Lamont Scott) was fatally shot by police, here’s what he had to say:

“The grievance in their minds — the animus, the anger — they hate white people, because white people are successful and they’re not,” Pittenger told BBC Newsnight when he was asked about what is driving heated protests in Charlotte.

He later apologized for the nasty racist slur, but perhaps he should have moved to a different state.


Republican Congressman Says Sick People Whose States Kill Coverage Should Move

The latest in many a revealing quote from GOP Members of Congress on health care policy came from North Carolina’s Rep. Robert Pittenger. I wrote about it at New York with some real anger.

It is not quite down there in the hall of shame with his Alabama colleague Mo Brooks’s suggestion that sick people often don’t deserve health coverage because they’ve brought it all down on themselves with bad habits. But North Carolina Republican representative Robert Pittenger was similarly cavalier about people with preexisting conditions who might lose affordable coverage if their state chose to waive protections for them under the terms of the revised American Health Care Act that the White House and Republican congressional leaders are trying to get through the House this week.

Quoth Pittenger: “People can go to the state that they want to live in. States have all kinds of different policies and there are disparities among states for many things: driving restrictions, alcohol, whatever,” he continued. “We’re putting choices back in the hands of the states. That’s what Jeffersonian democracy provides for.”

Seems Pittenger thinks the sick should vote with their feet, or their other afflicted parts, to live in a place that doesn’t view their health as a disposable asset.

I do believe we had a civil war over the proposition that states can do any damn thing they want with people, and the proponents of the states’-rights version of “Jeffersonian democracy” lost. It’s true that the victims back then did not always have the option to move elsewhere (there was this thing called the Fugitive Slave Act), but it should be beyond argument now that some rights and privileges of citizenship ought to be national in scope. Maybe health insurance is one of them, and maybe it’s not, but Pittenger’s glib assertion that the theoretical option of flight for poor, sick people makes it okay to discriminate against them is morally and politically obtuse.

This is not Pittenger’s first or worst comment of this nature. Last year, after protests broke out in Charlotte (a city partially represented by Pittenger) when an African-American man (Keith Lamont Scott) was fatally shot by police, here’s what he had to say:

“The grievance in their minds — the animus, the anger — they hate white people, because white people are successful and they’re not,” Pittenger told BBC Newsnight when he was asked about what is driving heated protests in Charlotte.

He later apologized for the nasty racist slur, but perhaps he should have moved to a different state.