Republicans flirting with the prospectÂ of repealing the individual mandate as part of the tax change are facing some troublingÂ questions. Would the move to strike theÂ most-reviled part of Obamacare alienate GOP moderates? Would scrapping the mandateÂ even obtain the savings Republicans areÂ hoping with regard to? And would such a moveÂ go beyond the boundary in muddying the watersÂ of theÂ already-contentious process of rewriting the nation’s tax program code? Â
For all those reasons, Conservatives have not yet committed toÂ a rollback of the individual mandate — which demands all Americans to purchase health coverage or even pay a penaltyÂ — as part of the taxes rewrite. At least not right now.
It’s lookingÂ unlikely that a repeal from the mandateÂ will get a ride on the Home GOP tax bill — despite the very fact thatÂ Republicans most involved in tax negotiationsÂ insistÂ a final, final decision hasnâtÂ been made.
The topic didnât come up a lot at yesterdayâs House Ways and Means taxes markup, where Republicans and Democrats instead sparred over the effort toÂ eliminateÂ various deductions, the measure’sÂ impact onÂ low-income people and even a provision allowing parents to set up college savings accounts for their unborn children.
And Methods Chairman Kevin Brady (R-Tex. ) –Â who has previously said he or she didn’t want to attempt individual require repeal as part of the tax effort — didn’t include it among many amendments he proposed to the expenses. A Brady spokeswoman directed to thoseÂ previous comments when inquired whether he’s still open to which includes a repeal of the mandate:
From Fox News’s Chad Pergram:
Ways/Means seat Brady intro’s substitute amdt in order to tax bill. What’s interesting is precisely NOT in it. No repeal individuals mandate
â? Chad Pergram (@ChadPergram) November 6, 2017
From Bloomberg’s Sahil Kapur:
Here are the House GOPâs latest adjustments to the tax bill. One item NOT REALLY included: ACA individual mandate repeal. https://t.co/KKzFbNnfB8 pic.twitter.com/ThHmk57mhW
â? Sahil Kapur (@sahilkapur) November 7, 2017
GOP market leaders — most notably, Senate Majority Head McConnell (Ky. ) — are usually deeply wary of mixing controversial health-careÂ elements into theÂ tax debate. But very conservative aren’t giving up, and neither could be the White House.
President Trump has made it clear he desires the mandate gone, whether by means of aÂ vote in Congress or simply by weakening it through an executive purchase. In fact , the president has salready prepped such an order, presumably to utilize if Congress doesnât act.
The order stops short of rescinding the mandate â? only Our elected representatives can do that because itâs inlayed in the Affordable Care Actâs textual content. But it would allow even more people to declare a âhardship exemptionâ that allows people to move uninsured as the result of extraordinary conditions and wasÂ created under the Obama administration, the colleagues Juliet EilperinÂ and Sean Sullivan reported.
From Vox’s Dylan Scott:
Itâs no surprise, but Trump targeting the particular ACAâs individual mandate is a very BFDhttps://t.co/iQmctQMdaD
â? Dylan Scott (@dylanlscott) November 6, 2017
Andy Slavitt, who going the Centers for Medicare plus Medicaid Services under Obama:
3/ Now, a few R Senators are talking about this anonymously to the press. https://t.co/JLmTYPg5s3 through @dcexaminer
â? Andy Slavitt (@ASlavitt) November 6, 2017
4/ Trump has made no secret associated with his goal of dismantling the particular ACA. See all my tweets as to what I call synthetic repeal.
â? Andy Slavitt (@ASlavitt) November 6, 2017
5/ For everybody paying attention, Trump has been dismantling legislation every piece & chance he or she gets.
The mandate however is among the most radical.
â? Andy Slavitt (@ASlavitt) November 6, 2017
Larry Levitt, senior vice president of the Kaiser Family Foundation:
Without the individual mandate, fewer healthful people would get insured and person market premiums would skyrocket. (2/5)
â? Larry Levitt (@larry_levitt) November 6, 2017
Without a person mandate, healthy people could purchase short-term policies that exclude protection for pre-existing conditions. (4/5)
â? Lewis Levitt (@larry_levitt) November 6, 2017
Middle-income people with pre-existing conditions would be hurt most simply by rising premiums if the individual require is repealed. (5/5)
â? Larry Levitt (@larry_levitt) November 6, 2017
Itâs not surprising that Trump and some Conservatives are fixating on theÂ mandate since the single most vulnerable part of the ACAÂ after GOP effortsÂ crashed and burned in order to repeal the whole law. The particular mandate polls poorly, with simply 35 percent of Americans viewing it favorably, according to Kaiser Family Foundation polling. A repeal of the mandate has been part of everyÂ GOP health-care plan in the past seven years.
And remember, the mandate was the centerpiece of the 2012 Supreme Court case that questioned its constitutionality. The court eventually upheld the mandate by judgment the penalty for being uninsuredÂ was the âtaxâ and therefore within the authority from the federal government to administer.
Of program, the main attraction of repealing the particular mandate is that such a moveÂ would provide Republicans some fast cash to assist fund their tax overhaul. Yet here’s a wrinkleÂ –Â the very same Republicans haveÂ actually criticized the official analysis, which concludedÂ repealing the mandate is a money-saver.
This sounds complicated â? yet itâs not. The Congressional Spending budget Office assumed 16 million less people would choose to buy protection without the penalty for remaining uninsured, leading it to score big protection declines under multiple GOP health-care bills this past spring and summer time.
At the time, many very conservative balked thatÂ the CBO was heading way too far in assuming the particular mandate’s effectiveness in incentivizing individuals to buy coverage. Thereâs no way a lot of people would forgo coverage just because the particular mandate was kaput, they contended.
But hereâs the turn side: Fewer people buying protection means fewer people accessing federal government subsidies to help cover the costs. And that translates to less government investing. The CBO estimated that repealing the mandate would save the us government $416 billion over a decade, which makes it a valuable pay-for as Republicans look for to fund their tax bill.
Thus, the mandate now servesÂ as a huge possible funding mechanismÂ for the GOP precisely because the CBO might have overestimated itsÂ effectiveness. If the CBO reduced its confidence in the mandate, that could mean fewer people estimated never to buyÂ coverage and lessÂ government savings, eventually.
Here’s the bottom line. Â Including the mandate repeal in tax change would help Republicans in 2 big ways: keeping part of their particular most hyped political promise to eliminate Obamacare (in part, anyway). And it also would also serve as a valuable method of offsetting the exorbitant costs associated with tax cuts.
In some other words, maybe Republicans canÂ have their particular Obamacare cake and eat this, too. But such a dessert may simply not be in the offing to get a bunch of other complex reasons. Stay tuned for more.
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Hereâs what we should know about the mass shooting in a church in Sutherland Springs, Tex. that left 26 people deceased and 20 injured. The massacre came amid a âdomestic situationâ involving the alleged gunman, 26-year-old Devin Tanker Kelley, and his family, some of who attended the First Baptist Church. Within suggesting a motive behind the particular attack, officials pointed to their issues with his relatives, Â reportÂ Eva Ruth Moravec and Mark Berman, notingÂ the gunman sent âthreatening textsâ to their mother in-law, who was not on church when he opened open fire Sunday morning.
Kelley, who had been discharged from the Air Force with regard to bad conduct after being found guilty for assaulting his then-wife plus stepson and serving 12 weeks in confinement, Â should not have had the opportunity to buy a gun. Â The Air Drive âfailed to follow policies for alerting federal law enforcement,â about the gunmanâs past, Â our colleague Alex HortonÂ reports. âenabling the former service member… to obtain firearms before the shooting rampage.â
Speaking in Seoul yesterday, President Trump insisted that tougher gun laws and regulations would not have prevented the bulk shooting. Instead he spoke of the man, Stephen Willeford, who snapped up his own gun and exchanged open fire withÂ the gunman outside the church. Trump called WillefordÂ a âbrave manâ and stated âif he had not had a gun, instead of having 26 dead, you would have had hundreds more deadâ¦ Itâs not going to help,â David NakamuraÂ reports. Â ReadÂ Sen. Philip Murphyâs (D-Conn. ) plea hereÂ for his colleagues to âthink about whether the political support of the gun industry is worth the blood that flows endlessly onto the floors of American churches, elementary schools, movie theaters, and city streets.â
Hereâs what we knowÂ about the lives lostÂ in Texas. A state officialÂ said MondayÂ the sufferers ranged in age from 18 months to 77 years. As well as the New York TimesÂ wroteÂ about the Holcombes, that lost eight members of their prolonged family in the shooting.
â? Is actually Day Seven of the ACA’sÂ fifth open up enrollment season. Â Monday’s The Health 202 about the hefty premiums many unsubsidized consumers are encounteringÂ appeared to strike the chord with many readers, who had written me to share their stories. OverÂ the rest of the sign-up period, we’re going try to feature a daily letterÂ in it, so please send me your own story. Â (paige. cunningham@washpost. com). Â We do a lot of high-level analysis upon these pages, but it’s also important to think about the individual experiences — good and bad — of readers like you.
Here’s today’s letter:
âWe make just enough not to qualify for a subsidy. We currently pay about $1, 100/month for health insurance for the 2 of us. Today we found out that will next year, the lowest plan on offer is usually $3, 472/month with a $14, 000 deductible (a $2, 000 hike). As the premiums are about 50% of our pre-tax income and we do not require expensive care, there is no way we are able to afford it…. America used to be a professional country. Now we are faced with exactly the same situation as in a banana republic… If the media only talk about the poor who will continue getting assist until the GOP can slash that will, it is no help. Right now, the unemployed of the self-employed or self-insured requirements highlighting. They are the ones being consigned to the trash. “Â Â Â â? Andrew Foss, Albemarle County, Veterans administration.
AHH, OOF plus OUCH
AHH: An administration official has confirmedÂ there’s been a spike in sign-upsÂ on Healthcare. gov in the first 7 days it’s been open. Â More people have registered in the first few days of registration compared with the same period in prior years, Juliet EilperinÂ writes.
“More than 200, 000 Americans decided on a plan on Nov. 1, the day open up enrollment began, according to one management official. Thatâs more than double the amount of consumers who signed up on the 1st day of enrollment last year. Greater than 1 million people visited HeathCare. gov, the official federal website, the state said, which amounts to approximately a 33 percent increase in visitors compared with 2016. “
The numbers are worth noting as Obamacare advocates worried the word wouldn’t move out that it was open enrollment season provided the GOP Congress’s efforts to remove the ACA, and moves with the Trump administration to slash financing for marketing. Â Experts had expected a significant drop in enrollment amounts, Â as weÂ noted last week. A Standard & Poor’s analysis forecast up to an one 6 million drop overall. Â
“But on opening day, several state exchange officials said that enrollment had exceeded their projections, ” Juliet adds.
Thoughts from Viceâs Alexandra Jaffe:
‘@PeterSullivan4 reports on the surge in OCare signups within 1st daysâmay indicate GOP attempts to undermine law backfired https://t.co/LsYhRej4mA
â? Alexandra Jaffe (@ajjaffe) November 6, 2017
The Daily Beast’s Mike Stein:
People seem to be freaking out that insurance policy wonât be available for them fairly quickly and are rushing to get it today https://t.co/2JiXtHbGme
â? Sam Stein (@samstein) November 6, 2017
Liz Allen, previous deputy communications director under Obama:
Good information here. ACA so far surviving regardless of Trump’s attempts to sabotage. Tip to #GetCovered by Dec. 15. https://t.co/6wbpq8UD9L
â? Liz Allen (@LizMarieAllen) November 6, 2017
From the head ofÂ communications forÂ Oscar Health, a participant in certain of the marketplaces:
So much for sabotage. Two times as many Americans signed up for Obamacare intentions of the first day of Open Enrollment: https://t.co/gZdPaVlZ63
â? Khan Shoieb (@KShoieb) November 6, 2017
Some used the news in order to urge even more people to sign up. Through liberal group MoveOn. org:
Enrollment is open up for the ACA – and signups are setting records. Sign up on https://t.co/NWnUeccD1r thru Dec 15. https://t.co/MKdXptWIaQ
â? MoveOn. org (@MoveOn) November 7, 2017
OOF: Today, Maine voters will decide whether — or not — to accept the ACA’sÂ Medicaid expansion. If they do, the state will be the first to expand the program viaÂ ballot initiative, but the 33rdÂ state overall to simply accept expansion of the insurance program with regard to low-income Americans. About 70, 000 Mainers would be able to join the particular state’s Medicaid program, which presently covers about 265, 000 individuals. Â The question is on theÂ ballot because Maine Gov. Paul LePage (R)Â vetoed Medicaid expansion five instances, the Press Herald writes.
OUCH: Violent mass shootings may be contagious, catching on and multiplying as an epidemic, The Atlanticâs Derek ThompsonÂ writes. Â Three of the five worst bulk shootings in modern U. H. history have occurred in the last 2 yrs and two of them were within the last 37 days.
Derek cites research from Arizona State University or college in 2015 that found âsignificant evidence that mass killings including firearms are incented by comparable events in the immediate past. inch Lead author Sherry Towers informed The Atlantic thatÂ television, radio, as well as other media exposure might be the meansÂ through which one mass shooting infects the following perpetrator.
“Like an industrial, each eventâs extraordinary coverage provides accidental advertising for depravity, â? Derek writes. âGiven the contagion research, one can imagine a menacing feedback loop that might explain the particular recent spate of murderous sprees. If more victims indicate more media coverage, and more protection means more inspiration, it means that historically violent mass shootings may be the most contagious. â? **************************)
Of course, it’s not like the media are likely to stop covering mass shootings (or should stop covering them), Derek acknowledges. But he suggests thatÂ journalists should cover such events “with an awareness that even noble protection can advertise. “
HEALTH ON THE HILL
–Why wouldÂ one medical professionalÂ attack another? The details growing about the altercation between Sen. Seite Paul and his next-door neighbor — which left the Kentucky Conservative with serious injuries — are usually confusing.
Hereâs what we understand four days after Paul had been attackedÂ at his home in Bowling Green. Paul was mowing their lawn when his neighbor, outdated anesthesiologist Rene Boucher, tackled your pet, according to the New York Times. Paul, who had been wearing sound-muting earmuffs, did not discover or hear Boucher coming. He or she suffered five broken ribs plus bruises to his lungs because of the attack. AÂ lawyer for Boucher called the incident a âvery regrettable dispute between two neighbors over a matter that most people would regard as trivial.â
âWe sincerely hope that Senator Paul is doing well and that these two gentlemen can get back to being neighbors as quickly as possible,â Boucherâs lawyer, Matthew Baker, additional.
–Three Kentucky Republicans informed the Times that the incident resulted over the landscaping dispute. “Competing details of the origins of the drama reported stray yard clippings, newly grown saplings and unraked leaves, inch the Timesâs Nicholas Fandos, Noah Weiland and Jonathan Martin compose. But a friend, Robert Porter, who visited Paul over the weekend informed the Times he was not aware of landscaping design drama between the neighbors and that John is âstill unsure why he was attackedâ¦ I donât know if he knows why he was attacked.â
Boucher was billed with fourth-degree assault and launched on Saturday on $7, 500 bond, but our colleagues Wesley Lowery and Ed OâKeefe survey that given the extent associated with Paulâs injuries, police and prosecutors may considering upgrading the fees.
âÂ? *************************)Youâll soon be able to get your medicine delivered almost immediatelyÂ from CVS Wellness. The companyÂ announced yesterday that it willÂ offer next-day delivery from all the 9, 700 stores beginning in 2018. Same-day prescription delivery will also start in major markets, our friend Carolyn Y. Johnson reports, Â including in Miami, Boston, Philadelphia, Bay area and the District. And if you live within Manhattan, you’ll be able to get free delivery inside hoursÂ for prescription medications as well as certain otc products starting Dec. 4.
How much will this most cost? Unclear. A company spokeswoman told Katie Thomas of theTimesÂ that delivery fees outside of Manhattan CVS locations will vary and haven’tÂ been introduced.
Monday’sÂ announcement reflects a sort of preemptive strike by CVSÂ as it hedges Amazon. comâs possible expansion in to the sale of prescription drugs, Katie writes. Â AlthoughÂ Amazon (whose owner, Jeff Bezos, furthermore owns The Post) has notÂ formally announcedÂ plans to sell pharmaceuticals, the online store giant… has made several moves, which includes acquiring state-level permits to be a low cost pharmacy distributor and hiring medication industry leaders. The potential move simply by Amazon has also partly drivenÂ CVS in order to enter into talks with AetnaÂ over any acquisition, something The Health 202 described last month.
A couple of more reads from The Post and round the Internet:
DON’T SKIP THIS: Â The Post and Reside Nation will bring the âCan He Do That?â podcasting to a live audience at theÂ Warner Theatre. Â In this live taping, political reporters Bob Woodward, David Fahrenthold and Karen Tumulty will join host Allison Michaels to examine the past year in President Trumpâs White House and the biggest occasions that made people wonderÂ âCan He Do That?âÂ Tickets can be bought now atÂ Live Nation. Attendees will likely receive a free 30-day digital membership to The Washington Post.
MORE POST PROGRAMMING: Â The Washington PostÂ hostsÂ Secretary of Veterans Affairs David Shulkin for a discussion that will include their departmentâs efforts to curb the particular veteransâ? suicide rate, address post-traumatic stress disorder and other health concerns onÂ Thursday.
- The Hill serves an event on the opioid epidemic showcasing Sen. Jeanne Shaheen (D-N. L. ) and FDA commissioner Scott Gottlieb.
- Kaiser Health News holds anÂ eventÂ on progress care planning onÂ Wednesday.
Axios hosts anÂ eventÂ on a new period in cancer innovation with previous Vice President Joe Biden plus former first lady Jill Biden onÂ Wednesday.
The House Education and the Workforce Subcommittee on Early Childhood, Elementary, plus Secondary Education and Higher Education plus Workforce Development hold a jointÂ hearingÂ on opioids onÂ Wednesday.
- The House Energy and Commerce Subcommittee on Health holds aÂ hearingÂ on MACRA and alternative payment models onÂ Wednesday.
The American Business Institute holds anÂ eventÂ on the opioid crisis with Rep. Greg Walden (R-Ore. ) onÂ Nov. Â 13.
STAT holds anÂ eventÂ on the FDA onÂ Nov. Â 13.
These are the nine talking factors that are repeated after every bulk shooting:
What you need to know regarding semi-automatic rifles like the AR-15:
Stephen Colbert responds to the bulk shooting in Texas:
Seth Meyers requires a closer look at the Russia investigation which is escalating as President Trump moves in Asia:
Watch Elton John’s shock performance of âCircle of Lifeâ at the 20th anniv