Millions of Americans Could Lose Health Insurance Under Republican Health Care Proposal

Congressional Republicans and the Trump Administration had 24 million reasons to be unhappy on Monday: that’s the number of Americans who would lose their health insurance under the Republican-crafted American Health Care Act by 2026, according to a cost estimate from the Congressional Budget Office.  The major findings of the CBO estimate:

  • The AHCA would reduce federal deficits by $337 billion from 2017-2026.
  • The biggest savings would come from reductions in Medicaid and the elimination of subsidies provided by the Affordable Care Act.
  • The biggest costs would come from repealing changes to the Internal Revenue Code caused by the ACA.
  • In 2018, there would be 14 million more uninsured people than under the current ACA law.
  • This figure will continue to increase by 21 million in 2020 and 24 million in 2026.
  • By 2026, an estimated 52 million people would be without health insurance, compared to 28 million people for current projections under the ACA.
  • The reduction in insurance coverage between 2018-2026 would be in large part from states discontinuing the Medicaid expansion program offered under the ACA.
  • In 2018 and 2019, average premiums for single policyholders would be 15-20 percent higher than under the current law. Average premiums would start to decrease in 2020.
  • By 2026, average premiums for single policy holders would be 10 percent lower than under the current law.
  • However, the savings on premiums (or lack thereof) vary by age:
    • For a 21-year-old: 20-25 percent less
    • For a 40-year-old: 8-10 percent less
    • For a 64-year-old: 20-25 percent higher
  • Medicaid spending would decrease by $880 billion from 2017-2026.
  • By 2026, Medicaid spending would be 25 percent less than what the CBO estimates currently under the ACA.

Republicans – who had previously cited CBO estimates as evidence to attack the ACA – had been preemptively attacking or trying to question the credibility of the agency in the days leading up to the estimate’s release. Gary Cohn, director of the White House National Economic Council, told Fox News, “We will see what the score is, in fact in the past, the CBO score has really been meaningless.” Health and Human Services Secretary Tom Price told reporters, “We disagree strenuously,” with the CBO’s findings.

Not all Republicans were optimistic about the proposed law, even before the CBO estimate was released. Sen. Tom Cotton (R-Ark.) warned House Republicans that they would be risking their majority if they voted for the AHCA, and told them, “Do not walk the plank and vote for a bill that cannot pass the Senate and then have to face the consequences of that vote.”

Opposition to the bill is not limited to Democrats. A variety of organizations ranging from the left, right and center have all publicly come out against the AHCA. They include the AARP, the American Hospital Association, the Federation of American Hospitals, the American Medical Association, the American Nurses Association, Heritage Action, Americans for Prosperity, the Club for Growth, Moveon.org, and the Center for American Progress.

Democrats attacked the AHCA almost immediately after its unveiling last week, because it finally gave them a concrete Republican policy proposal to target after nearly seven years of a vague and undefined “repeal and replace” pledge Republicans offered as an alternative to the ACA.  The CBO estimate will provide them with quantifiable data for campaign ads and talking points to target Republicans running for election or reelection in the 2017 and 2018 cycles.

In a statement, Democratic National Committee Chairman Tom Perez said, “Donald Trump’s ‘insurance for everybody’ pledge was a big fat lie.”

“The CBO, which is headed by a Republican-appointed director, just made it clear that Trump’s health care plan will cause up to 24 million Americans to lose their health insurance. At the same time, the plan slashes Medicaid, drives up the cost of care for older Americans, and defunds life-saving services provided by Planned Parenthood. The only winners here are Trump, and the corporations and rich people who get to pocket new tax breaks.”

“Of course, instead of admitting that the bill would leave millions without health insurance, Republicans are desperately trying to discredit the CBO with more ‘alternative facts.’ The American people are smarter than that.”

Tyler Law, spokesman for the Democratic Congressional Campaign Committee, issued a statement saying, “Every single House Republican owns this catastrophic bill and should be prepared for backlash at the ballot box, particularly given the anticipated loss of coverage for 14 million people as early as next year.”

UPDATE: Politico viewed a White House assessment of the AHCA which estimated 26 million Americans would lose their health insurance by 2026 – two million more than the CBO estimate. The explanation for the document from White House Communications Director Michael Dubke was, “This is OMB trying to project what CBO’s score will be using CBO’s methodology.”

John Kerry Signs Deal For His Memoir

This was announced today in Publisher’s Weekly:

Former Secretary of State John Kerry will publish a memoir with Simon & Schuster. Jonathan Karp, president and publisher of the Simon & Schuster imprint, and Bob Bender, v-p and executive editor, who will edit the book, acquired world publishing rights in all formats from Robert B. Barnett of Williams & Connolly. No publication date has yet been set. The book will also be published by Simon & Schuster’s international companies in Australia, Canada, India, and the United Kingdom, and in audiobook by Simon & Schuster Audio.

Kerry was represented by Bob Barnett, the same Washington uber-lawyer who has negotiated book deals for the Obamas, George W. Bush, Karl Rove, Sarah Palin, and many other national political figures. In addition to his tenure as Obama’s Secretary of State, I assume the book will also cover his 2004 presidential run and his Senate career.

Biden Foundation Launches

Twelve days after leaving office, former vice president Joe Biden announced the launch of the Biden Foundation. According to the foundation’s website, it will “build upon Vice President and Dr. Biden’s lifelong commitment to protect and advance the rights and opportunities of all people through educational programming and public policy analysis.”

The statement from Vice President and Dr. Jill Biden:

Wilmington, DE – My dad used to have an expression: “It’s a lucky person who gets up in the morning, puts both feet on the floor, knows what they’re about to do and thinks it still matters.” Jill and I have been very lucky these past decades.  We look forward to this new chapter where we will continue our work to ensure that everyone—no matter their income level, race, gender, age, or sexuality— is treated with dignity and gets a fair shot at achieving the American Dream. That’s why we are honored that a group of long-time friends and supporters have begun the work of founding the Biden Foundation to build on our lifelong commitment to issues that have always motivated us.

The foundation’s work will focus on foreign policy, cancer research, and ending violence against women, and other issues.

One interesting point on the Biden Foundation website: it will not accept donations from foreign citizens, organizations or countries. This is presumably a response to the fundraising practices of the Clinton Foundation which caused so much controversy during Hillary Clinton’s presidential campaign.

A Preview of the Obama Post-Presidency

According to TMZ, the former president and First Lady are getting on a plane after tomorrow’s inauguration and heading straight to Palm Springs.

The Obamas will remain in Washington D.C. for two more years, until youngest daughter Sasha graduates from high school in 2019, according to the Chicago Tribune. In the meantime, they will be renting a home in the Kalorama neighborhood belonging to former Clinton White House press secretary Joe Lockhart.

President Obama will be leasing office space in the World Wildlife Fund headquarters near Dupont Circle and George Washington University.  He has hired Anita Decker Breckenridge, an aide since he was a state legislator contemplating a U.S. Senate run in 2003, to be his chief of staff. He will be involved in efforts to rebuild the Democratic Party, as well as the National Democratic Redistricting Committee led by his former attorney general Eric Holder. He will also begin fundraising for his foundation and presidential center, which is scheduled to open in Chicago in 2021.

As for the outgoing first lady, the Washington Post has a great story on her possible post-White House plans: after a break, she will hire a small staff and get an office space. Her team will be led by Melissa Winter, her longtime deputy chief of staff since 2007.

Both the President and the First Lady are expected to write their memoirs after leaving office. Literary agents and book publishers told the New York Times the Obamas’ potential book deals could range from $10 to 45 million. One key detail from the NYT: “Under a $1.9 million contract he signed in 2004 with Crown, Mr. Obama is obliged to produce another nonfiction book for the publishing house. But Mr. Barnett has said that book would not be a memoir, and no one interviewed for this story thought Mr. Obama would deliver that book to Crown under the 2004 terms.” This means that President Obama likely has more books in him (at least one more, per his 2004 contract) than just his memoirs.

The Obamas’ popularity abroad could make the foreign rights to any books they write even more valuable. They are both expected to make the rounds on the speaking circuit, which has proven to be a lucrative source of income for former presidents and first ladies.

The other thing to remember is that in addition to their popularity at home (President Obama is leaving office with a 60 percent approval rating, according to a recent CNN poll) and abroad, the Obamas are relatively young compared to other former presidents and first ladies: he’s 55, she’s 53. Considering that both Jimmy Carter and George H.W. Bush are in their early 90s, this means the Obamas will likely have a long post presidency ahead to continue to defend and shape his White House legacy, as well as other endeavors.

Democrats in the Twilight of the Obama Era

Check out this story from the Associated Press looking at the diverging political successes of President Obama and down ballot congressional and state Democrats. This is the dynamic of the past eight years that Democrats are trying to reverse, starting with the election of the next Democratic National Committee chair in February, followed by a series of congressional special elections and state legislative and gubernatorial races later on in 2017.

Obama Foundation Hires White House Political Director as CEO

The Obama Foundation announced the hiring of White House political director David Simas as Chief Executive Officer. According to the foundation’s press release, Simas will join the foundation’s leadership team and help work on the creation of the Obama Presidential Center in Chicago. According to Simas’s biography in the announcement:

A Taunton, Massachusetts native, David Simas received a bachelor’s degree in political science from Stonehill College and a doctor of law degree from Boston College Law School. In 2007, he was appointed Deputy Chief of Staff to Massachusetts Governor Deval Patrick. In 2009, Simas joined the Obama Administration as a Deputy Assistant to the President, working with senior advisors David Axelrod and David Plouffe. He then served as Director of Opinion Research for President Obama’s re-election. Simas most recently served as Assistant to the President and Director of the Office of Political Strategy and Outreach. He lives in Washington with his wife Shauna and two daughters, Payton and Rowan.

Comments from Simas himself, via Twitter:

Obama Says He Will Help Democrats Rebuild After Leaving Office

This comment came up during President Obama’s press conference on Friday. From the White House transcript:

What I’ve said is, is that I can maybe give some counsel and advice to the Democratic Party.  And I think that that the thing we have to spend the most time on — because it’s the thing we have the most control over — is how do we make sure that we are showing up in places where I think Democratic policies are needed, where they are helping, where they are making a difference, but where people feel as if they’re not being heard and where Democrats are characterized as coastal, liberal, latte-sipping, politically-correct, out-of-touch folks.  We have to be in those communities.  And I’ve seen that when we are in those communities, it makes a difference.

That’s how I became President.  I became a U.S. senator not just because I had a strong base in Chicago, but because I was driving around downstate Illinois and going to fish frys and sitting in VFW halls and talking to farmers.  And I didn’t win every one of their votes, but they got a sense of what I was talking about, what I cared about, that I was for working people, that I was for the middle class, that the reason I was interested in strengthening unions, and raising the minimum wage, and rebuilding our infrastructure, and making sure that parents had decent childcare and family leave was because my own family’s history wasn’t that different from theirs, even if I looked a little bit different.  Same thing in Iowa.

And so the question is, how do we rebuild that party as a whole so that there’s not a county in any state — I don’t care how red — that we don’t have a presence and we’re not making the argument.  Because I think we have the better argument.  But that requires a lot of work.  It’s been something that I’ve been able to do successfully in my own campaigns.  It is not something I’ve been able to transfer to candidates in midterms and sort of build a sustaining organization around.  That’s something that I would have liked to have done more of, but it’s kind of hard to do when you’re also dealing with a whole bunch of issues here in the White House.

And that doesn’t mean, though, that it can’t be done.  And I think there are going to be a lot of talented folks out there, a lot of progressives who share my values who are going to be leading the charge in the years to come.

In recent history, the norm has been for the outgoing president to stay quiet (or at the very least, keep a low profile) after leaving office. In addition to the lingering effects of the Monica Lewinsky scandal, Bill Clinton left office under a cloud after a controversial series of presidential pardons at the end of his presidency. George W. Bush’s poll numbers were in the low 30s by the time he left office due to a combination of the Iraq war, Hurricane Katrina, and the collapse of the housing market – all three of which happened during his second term. (Caveat: the Iraq war began in Bush’s first term, but the political and security situation on the ground started going south during his second term).

Obama is in a unique position in that he is in a much better situation than his predecessors. President Obama’s approval ratings are in the high 50s – he will leave office with Reagan-esque poll numbers. He is also popular and respected within the Democratic Party, somebody who can appeal to most of the factions vying for control and direction right now as he prepares to leave office four weeks from now. The fact that he was so successful in both his presidential runs means that he has created a model for others to follow – one that Hillary Clinton was not successful at replicating.

He will probably have some say in the form and shape the party take as the opposition for the next few years, though he will probably allow Democrats running for DNC chairman now and the primaries three years from now to let them sort things out for themselves.  He also has a vested interest in rebuilding the party, because Donald Trump and the congressional Republicans’ agenda will consist in large part on trying to undo or erase much of Obama’s legacy – Obamacare, Dodd-Frank, the Paris climate change agreement, etc. Republicans will complain that Obama should give Trump the same courtesy of silence that George W. Bush gave him, but that argument ignores the fact that Dick Cheney was one of his most blistering critics in the opposition.

Keep an eye out for Obama around sometime next spring, after he has presumably taken a long vacation and settled into life as a private citizen again.