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Trump's mystery tweet: "add more dollars" to health care

President Trump is back on Twitter, and tonight he tweeted about an intriguing idea that's disconnected from pretty much all of the current Republican health care plans: he wants to "add more dollars" to health care.

What the House health care bill does: It would cut overall health care spending by $1.1 trillion over 10 years, including $834 billion in Medicaid savings, according to the latest Congressional Budget Office estimate.

What his budget does: It would cut Medicaid by an additional $610 billion.

Why it matters: It's not clear whether Trump's tweet is an actual policy proposal or just a stray thought that we'll never hear again (a White House spokesman said they have nothing to add). Either way, it's not helpful to Republicans who are have already gone on record supporting an Affordable Care Act repeal plan that cuts spending.

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Trump jolts Europe

Andrew Medichini / AP

After spending time with President Trump at the G7, German Chancellor Angela Merkel has concluded that the United States can no longer be relied upon as a security blanket for Europe. Merkel's comments foreshadow a transformation of the U.S.-European alliances that have underwritten post-WWII stability.

What's behind this: Trump publicly lectured NATO allies that they must stop shirking their financial commitments and begin paying for their own defense rather than relying on the U.S. While the White House publicly rejects this interpretation, Trump's unmistakable message to Europe on his first foreign trip was that the days of unquestioning protection from the U.S. are over.

Merkel's comments, per the AFP:

  • Europe "must take its fate into its own hands" faced with a western alliance divided by Brexit and Donald Trump's presidency, Merkel told a crowd Sunday at an election rally in Munich, southern Germany.
  • While Germany and Europe would strive to remain on good terms with America and Britain, "we have to fight for our own destiny", Merkel went on. Special emphasis was needed on warm relations between Berlin and newly-elected French President Emmanuel Macron, she said.
  • "We Europeans truly have to take our fate into our own hands."
  • "The times in which we could completely depend on others are on the way out. I've experienced that in the last few days."

Side note: As the NYT's Maggie Haberman points out, the place where Merkel's comments will be best received is Russia. Putin is constantly looking for ways to sow discord between European countries and the United States. (Though, it's also worth noting that if NATO countries respond to Trump's pressure by meeting their defense spending commitments, this is bad news for Putin.)

What's next: Trump unsettled Merkel by making the U.S. the only G7 nation to refusing to reaffirm the Paris Accord on climate change. We scooped yesterday that Trump has told confidants he's planning to exit the Paris deal. With Trump there's always the caveat that he could change his mind...But based on my conversations over the past 24 hours, I expect EPA Administrator Scott Pruitt will present a detailed withdrawal plan to Trump and Trump will act on it.

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Dems to tie Russia to Iran on sanctions

Sergie Karpukhin / AP

A well-placed Senate Democratic aide emails this tip: "Expect many Senate Dems to push for the Senate to not do Iran sanctions without Russian sanctions."

What this means: Democratic leaders will exploit the ties between Iran and Russia — and the administration's weak position with regard to anything concerning Russia — to demand that no new sanctions are imposed on Iran without additional sanctions to Russia.

Our thought bubble: Democrats who support the Iran nuke deal, like former Secretary of State John Kerry, are worried about a bill that passed through the Senate Foreign Relations Committee last week. The bill imposes new sanctions on Iran over its ballistic missile tests and other destabilizing behavior. These additional sanctions don't relate to the nuclear deal, but some Democrats are anxious that imposing these sanctions could unravel the Iran deal.

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Hardliners turn on Gary Cohn over coal

Evan Vucci / AP

Almost three days have passed since Gary Cohn expressed skepticism about the future of the U.S. coal industry, but expect conservative hardliners to keep weaponizing Cohn's comments.

The offending comments, made by the President's top economic advisor Thursday aboard Air Force One: "Coal doesn't even make that much sense anymore as a feedstock. Natural gas ... is such a cleaner fuel ... If you think about how solar and how much wind power we've created in the United States, we can be a manufacturing powerhouse and still be environmentally friendly."

  • Breitbart News, the right-wing website formerly run by Trump's chief strategist Steve Bannon, ran an immediate hit piece accusing Cohn of launching a "war on coal." The website followed by interviewing Joe Manchin — "a Democratic U.S. Senator from the heart of coal country in West Virginia" — who attacked Cohn from the right.
  • Myron Ebell, who ran Trump's EPA transition team and wrote the agency's action plan, isn't happy about Cohn's comments and emails me: "NEC Chairman Gary Cohn does not represent the people who voted for Donald J. Trump ... I hope that what President Trump learned is that the other G7 leaders are marching in lockstep in the wrong direction and that it is up to him to lead the world towards energy abundance and prosperity."
  • Thomas Pyle, who headed Trump's energy transition team, emailed me this in response to Cohn's comments: "The wind and solar industry has been built on the backs of American taxpayers and yet still produce a tiny fraction of the energy we consume in the U.S., significantly less than coal. President Trump is a successful businessman who understands the severe impacts that the policies of politicians past have had on working class families in the American Rust Belt. He hardly needs to evolve on this subject."
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Merkel suggests Europe can no longer rely on U.S.

Domenico Stinellis / AP

German chancellor Angela Merkel issued a call for unity within the E.U. at a campaign event Sunday, stating that she learned over "the past few days" that "the times in which we can fully count on others are somewhat over."
Merkel's comments came after President Trump scolded NATO members over defense spending and was at odds with the rest of the G7 over climate change.
"We Europeans must really take our destiny into our own hands."
Why it matters: These are extraordinary words from Merkel, revealing fractures within the transatlantic alliance — long underpinned by close cooperation between the U.S., U.K., France and Germany — after the seismic events of Trump's election and Brexit. Times have changed — just a few months ago, Merkel was Barack Obama's closest foreign partner.
Symbolism alert: It was no accident that France's Emmanuel Macron embraced Merkel before shaking hands with Trump at the NATO summit last week. European alliances are being strengthened, and the U.S. is increasingly on the outside looking in.

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Report: Top Trump advisers think Kushner should 'step back'

Alex Brandon / AP

Jonathan Karl reports on ABC's "This Week" that people "very close to the president" think the Russia investigation's current focus on Jared Kushner means it's time for the president's son-in-law to "take a step back":
"Even if he is ultimately completed cleared, he is at the center of this investigation right now, and you hear people close to the president, quietly saying, is it too much and is it time for Jared to take a step back, maybe even take a leave of absence from the White House."
Why it matters: Some in the White House have long resented Kushner's influence, and now see an opportunity to sideline him. And Kushner allies have been noting that he and Ivanka have made no long-term commitments to the administration. But it's still far from clear that his spot in Trump's inner circle is at risk.
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'Raging Bull' Trump shifts back into 2016 campaign mode

Chris O'Meara / AP

On Day 129 (and the beginning of the 19th full week), the next phase of Trump's presidency is becoming clear.

Facing political and legal jeopardy, he follows his instincts and runs the government even more like a campaign, with renewed stature for "street fighter" aides and an elevated obsession with his base.

Returning last night from a nine-day overseas trip where Russia headlines wrestled with beauty shots from the world stage, here's a snapshot of the emerging "Raging Bull" Trump:

  • Axios' Jonathan Swan and Amy Harder scooped last night that Trump has privately told multiple people, including EPA Administrator Scott Pruitt, that he plans to leave the Paris agreement on climate change. Trump has told different things to different people, and said yesterday in a TV-teaser-style tweet that he'll make up his mind this week. But his willingness to entertain such a drastic step, right up against his own deadline, was a brushback to Europe and a reminder to moderates in the West Wing, most notably Ivanka Trump and Jared Kushner, that they're advisers, not puppeteers.
  • The President is likely to spend more time in his happy place: massive rallies with supporters. The Washington Post reports (lead story: "Trump may retool his staff") that among the ideas from White House officials, in an effort to revive his stalled legislative agenda and overhaul communications, are proposing "more travel and campaign-style rallies nationwide so that Trump can speak directly to his supporters."
  • We're told that big changes are imminent for the press and communications operations, with a diminished role for the on-camera daily briefing that has proved so entertaining for daytime cable viewers, and such a gift to network correspondents who get to run daily cameos of themselves badgering Sean Spicer.
  • A classic line in the Post story: "'Go to the mattresses,' a line from the film 'The Godfather' about turning to tough mercenaries during troubled times, has circulated among Trump's friends."
  • All three members of the triumvirate who ran the fall campaign saw their power wane, but now are ascendant. White House Chief Strategist Steve Bannon has restored clout as the West Wing draws up org charts for a war room to field Russia incoming. Kellyanne Conway, White House counselor, had been isolated by West Wing enemies but has been empowered to court outside support for Trump. And conservative firebrand Dave Bossie, banished after the campaign, may come into the White House in a political or war-room role.
  • Corey Lewandowski, who ran afoul of the family as Trump's first campaign manager, is once again talking regularly to Trump. Corey is unlikely to come back inside, but a Trump confidant laughed at the press speculation about Corey returning: "Corey's already back."
  • The biggest talker of all inside Trumpland: Sam Nunberg, on the outs with the Trump inner circle since he was fired from the campaign in 2015, is among the members of Trump's outside chorus who are "being courted to play more active roles," The Post said.

The takeaway: One of the most plugged-in West Wing advisers points to this essential dynamic: "Jivanka has influence where it does not conflict with the base."

Coming attractions... N.Y. Times reports in an above-the-fold mash-up, "President Faces Growing Crisis On Russia Ties": "White House aides were trying to assemble a powerhouse outside legal team that they hoped would include seasoned Washington lawyers of the stature of Paul D. Clement, Theodore Olson or Brendan Sullivan, and they planned to introduce some of them to Mr. Trump as soon as this weekend."

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DHS Sec. Kelly: high-level classified leaks are 'borderline treason'

Susan Walsh / AP

Homeland Security Secretary Kelly said on Meet the Press Sunday that high-level classified leaks, like those over the Manchester attack in the U.K., are "borderline treason."
"I don't know where the leak came from. But I... immediately called my counterpart in the UK.... She immediately brought this topic up. And, if it came from the United States, it's totally unacceptable. And I don't know why people do these kind of things, but it's borderline, if not over the line, of treason."
He added: "I believe when you leak the kind of information that seems to be routinely leaked — high, high level of classification — I think it's darn close to treason."
On reports that Jared Kushner wanted to open a secret backchannel with Russia:
  • "I don't see any big issue here relative to Jared.... I think any time you can open lines of communication with any one, whether they're good friends or not so good friends, is a smart thing to do."
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Trump's trip sent clear signals about his foreign policy

Domenico Stinellis / AP

President Trump has just returned from his first overseas trip as POTUS, and it was a busy one. From the red carpet greeting in Saudi Arabia to the awkwardness with NATO allies like France's Emmanuel Macron, it revealed quite a bit about the state of his foreign policy.

Peace in the Middle East: Instead of criticizing the Saudi regime or encouraging a more democratic way of governing, Trump was decidedly diplomatic: "We are not here to lecture — we are not here to tell other people how to live, what to do, who to be, or how to worship. Instead, we are here to offer partnership — based on shared interests and values — to pursue a better future for us all," he said in his Riyadh speech.

Why it matters: Trump previously took a hard stance against Saudi Arabia, claiming secret documents would reveal they were behind the 9/11 attacks and criticizing Hillary Clinton for taking money from "people that kill women and treat women horribly." Saudi investment in U.S. arms and cooperation on terrorism seem to have led to a change of heart, and he was more comfortable with King Salman and other Arab leaders like Egypt's el-Sisi than with the likes of Angela Merkel later in the trip.

Pay up or shut up: During meetings with some of America's NATO partners, Trump had one thing on his mind: money. "NATO members must finally contribute their fair share and meet their financial obligations, for 23 of the 28 member nations are still not paying what they should be paying and what they're supposed to be paying for their defense," Trump said. He also made the allies nervous by failing to affirm the Article V commitment to mutual defense.

Why it matters: Whether awkwardly shaking hands with Macron or pushing Montenegro's leader out of the way so he could be front and center in a photograph, Trump didn't play nicely with his fellow NATO partners. It's a vital alliance, and one with which Trump has decidedly cooler relations than many of his predecessors.

Climate change: German Chancellor Angela Merkel left the G7 Summit disappointed in the leaders' conversation about climate change. Trump was clearly the odd man out, as it was "six against one," Merkel said — highlighting that Trump was the only G7 leader who didn't explicitly support the Paris climate treaty.

Sounds familiar: Trump has a bunch of important people asking him for something and he holds the decision-making power, a position the president knows and likes well.

What's next: Trump tweeted Saturday morning that he's going to make a final decision on the Paris deal this coming week. If he follows through on what he's told close confidants — that he's withdrawing from the deal — that indicates pressure from other nations, which started before his G-7 trip and reached a climax while he was there, was not convincing enough considering the lens the administration was viewing the decision: What's best for America, according to White House economic adviser Gary Cohn.

Sound smarter: This decision isn't about the environment. The decision rests upon ensuring the deal doesn't hurt U.S. companies. Former President Obama's pledge was to cut U.S. greenhouse gas emissions between 26% and 28% by 2025 based on 2005 levels. No matter what you think about whether that pledge would actually hurt U.S. companies (a lot of independent experts don't think it would), ratcheting it down would provide a concrete change Trump could point to show how he got what he wanted for America.

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The Goldwater Rule and diagnosing Trump

Lazaro Gamio / Axios


The debate on the "Goldwater Rule" resurfaced last week at the American Psychiatric Association's annual meeting: In the age of Trump, should psychiatrists be allowed to give their professional diagnosis of a public figure?

Background

The Goldwater Rule is an ethics guideline for members of the APA.

  • It was established in 1964 after Fact magazine published a survey from thousands of psychiatrists saying Barry Goldwater was psychologically unfit to be president — Goldwater later sued the magazine.
  • APA members are banned from giving professional opinions to the public about a public figure without consent and a direct examination.

The case for the rule:

In a piece soon to be published in the Journal of the American Academy of Psychiatry and the Law, former APA President Paul Applebaum raises what he notes as even more substantial concerns, "including the risk of harm to living persons and discouraging persons in need of treatment from seeking psychiatric attention."
And in March, the APA reaffirmed their support of the rule.
  • Diagnosis without consent violates principles of psychiatric evaluations.
  • Professional opinion without a direct examination compromises both the integrity of the psychiatrist and the profession.
  • They have the potential to stigmatize those with mental illness.

The case against it:

Nassir Ghaemi, Professor of Psychiatry at Tufts, was part of the APA symposium, and told Axios about his views:
  • Psychiatrists already diagnose patients without consent and use behavior and history from third parties as the basis — like patients taken to emergency rooms and patients who can't be trusted to understand their own symptoms, he said.
  • "That we shouldn't talk about psychiatric issues actually discriminates against psychiatric issues."
  • He views diagnosis as often beneficial and notes that some illnesses are associated with positive character traits for a leader, like creativity and realism.
  • Presidents subject themselves to a medical evaluation with the exception of metal health, which he believes further discriminates against psychiatric issues.