Axios - Politics
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New Trumpcare amendment would require states to define essential health benefits

(Alex Brandon / AP)

A final amendment to the American Health Care Act was introduced Thursday night by the authors of the legislation, a last-minute attempt to win conservatives over by requiring states to define what services insurers must offer enrollees.

Here's what's in the amendment, which will be voted on in the Rules Committee tomorrow before the bill heads to the House floor for a final vote:

  • Beginning in 2018, states will determine essential health benefits. There are currently 10 federal ones under Obamacare, which apply to the individual and small group markets.
  • The repeal of the Medicare payroll tax on high earners would be delayed until 2023.
  • The original bill's Patient and State Stability Fund would get an extra $15 billion to be used for maternity coverage and newborn care, as well as mental health and substance abuse disorder treatment.
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Trump orders tougher Visa screenings

J. Scott Applewhite / AP

President Trump is ordering tougher screenings for Visa applicants as part of his "extreme vetting" policy. Last week Secretary of State Rex Tillerson sent four cables to U.S. embassies and consular officials demanding scrutiny be tightened up, as originally reported by Reuters.

The new rules don't apply to 38 countries who can be admitted using the visa waiver program, including Australia, New Zealand, Japan, South Korea, and most of Europe.

Profiling and delays: This will include "mandatory social media check" if an applicant has been in a territory controlled by ISIS. Such checks are rarely done at present, former officials told Reuters. Consular officials and immigration experts told the NYT this will make it much more common to be denied a Visa to the U.S. and they fear this might lead to profiling based on nationality. It will likely also extend Visa review times.

Context: The cables were issued to complement the travel ban that was upended by a court in Hawaii, but some provisions were remedied to abide by the temporary restraining order. Namely, questions specifically aimed at applicants from the six countries listed in the ban were rescinded.
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Trump's ultimatum: If vote fails, Obamacare stays

AP

Budget Director Mick Mulvaney has just laid down a gauntlet to House Republicans on behalf of President Trump: pass this bill, or Obamacare remains in place.

Members of the conservative Freedom Caucus want more concessions but, according to Mulvaney, Trump will not negotiate further.

The president demanded a vote tomorrow, and now it appears he will get it. He is all but daring Republicans to vote no.

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White House pressures leadership for Friday vote

J. Scott Applewhite / AP

The White House is insisting to House Republican leadership that they vote on the GOP health care bill tomorrow — and it looks like it's going to happen.

President Trump's message to leadership: give me your vote list and tell me which members campaigned since 2010 to repeal Obamacare and then wouldn't vote to do it, said a source privy to the private conversations. The plan now is for the House to vote tomorrow, and the latest changes to the bill — stripping out the law's "essential health benefits" — will be made through a rule to be written overnight.

The GOP leadership's view was that they're still short on the vote count, and they wanted to be assured of 216 votes before putting it on the floor. They think if the bill comes to the floor with less than the required number, the vote will collapse on them. They say simply calling a vote is not going to cause the whip count to go up. Members don't want to vote on something that will fail.

The White House took a different view, according to two sources familiar with the conversations happening at the highest level. Top administration officials believe the vote is close, that it needs to happen tomorrow, and that if they get a deal with Freedom Caucus chairman Mark Meadows it will give them enough momentum to get it done.

Members made "battle" pitches: At a GOP conference meeting tonight, Rep. Tom Cole told his colleagues that "this is not a test for President Trump, he's already leading. This is not a test for our leadership. This is a test for us," according to a source in the room. "If you vote against this because you think it's 'not good enough,' that's not legislating, that's not leading."

And Rep. Brian Mast, an Army veteran, got a standing ovation when he told Republicans that while he's never been in battle with a perfect plan, he's never lost a battle when the troops were unified.

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Here are the AHCA changes demanded by the Freedom Caucus

Alex Brandon / AP

The key changes to the Republican health care bill demanded by the conservative Freedom Caucus:

  • A repeal of ACA's Essential Health Benefits (like emergency or maternity treatment) guaranteed under Obamacare
  • An elimination of the "single risk pool," which prevents insurers from splitting the market into healthy and sick groups
  • An elimination of rating restrictions, which allow insurers to base premiums only on age, area, tobacco use and family vs individual plan
  • A repeal on lifetime or annual limits
  • A reversal of standard documentation mandates, which make it easier to compare insurance plans
  • A reversal on Medical Loss Ratio standards, which force large insurers spend at least 85% of premiums on claims

Why it matters: These changes would appease the Freedom Caucus, but could see moderates abandon the bill.

Featured

Fox News: GOP expects 'smoking gun' proving Obama admin spied on Trump

Jack Gruber / AP

Republicans in Congress are expecting a "smoking gun" showing the Obama administration intentionally spied on Trump associates, and possibly Trump himself, Fox News reports:

The intelligence is said to leave no doubt the Obama administration, in its closing days, was using the cover of legitimate surveillance on foreign targets to spy on President-elect Trump, sources said.

A source told Fox that the surveillance left a "paper trail" indicating there was "no other plausible purpose... than to damage the incoming Trump administration." No, Trump Tower wasn't bugged, as POTUS claimed, but if the report is accurate his transition team was targeted for surveillance.

What's next: Fox says the House Intelligence Committee expects to receive the evidence this week. Trump said he felt "somewhat" vindicated by Devin Nunes' statements yesterday about "incidental" surveillance of Trump's communications. Expect him to be less restrained if this report proves accurate.




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The new reality on Trump and the Freedom Caucus

Evan Vucci / AP

House leadership has been hoping that President Trump would turn the screws on the Freedom Caucus. They'd love nothing more than for Trump to threaten Freedom Caucus members like Mark Meadows with primary challenges. In fact, they were banking on Trump doing that. They thought he could break the Freedom Caucus.

The emerging reality: Trump is doing nothing of the sort. He was joking when he told Meadows in the GOP conference meeting earlier this week that he'd come after him. And in today's White House meeting Trump did not brow-beat the Freedom Caucus members or make a hard sell on a "final offer."

According to three sources in the room for the meeting, Trump didn't demand loyalty tests, and there was lots of laughing, jokes, and stories.

"He is not being heavy handed," said a White House official. "[The House Freedom Caucus] made clear all week they appreciate respect and engagement from the White House but are upset that they feel leadership excludes them."
Featured

Updated Trumpcare estimate: less savings, same number uninsured

Andrew Harnik / AP

The Congressional Budget Office released a new estimate of the impact of the American Health Care Act this afternoon, showing less federal savings than the original bill but roughly the same coverage loss over 10 years. It was updated to include the proposed amendments to the legislation that were released on Monday night, but not any of the additional changes the White House has been discussing with the Freedom Caucus.

The takeaways:

  • The bill would save $150 billion between 2017 and 2026. The original bill would have saved $337 billion.
  • In 2018, 14 million people would lose coverage. This number would increase to 24 million in 2026. This number did not change.
Featured

Pelosi spooked by suspicious Russian deaths

Oleksandr Synytsia / AP

Nancy Pelosi raised questions at her press briefing Thursday about two suspicious incidents this week, which followed at least seven mysterious Russian deaths since November:

"Nikolai Gorokhov, he fell from four stories…he's injured very seriously…and then Denis Voronenkov was killed in the city center of Kiev, he was to testify in the trial of former — pro-Russian — Ukrainian President Yanukovitch."
  1. Gorokhov, a lawyer for a Putin-foe, was reportedly thrown from a window Tuesday in Moscow. However, press outlets with ties to Russian security forces reported Gorkohov fell while trying to move a bathtub into his apartment. Gorokhov was set to testify as a U.S. government witness in a money laundering case in New York.
  2. Voronenkov, a former Russian MP, was shot dead in Kiev today, according to the BBC. Voronenkov was to testify against deposed Ukrainian President Viktor Yanukovych and had ruffled feathers in Russia for calling the Crimean annexation illegal. Kiev police said it was likely a contract killing but the Kremlin rejected the remarks as "absurd."
A note about Gorokhov: He was also poised to challenge Moscow's refusal to investigate organized crime the day after the fall, according to The Daily Beast.
Featured

Trumpcare problems could hit tax reform — and stocks

Evan Vucci / AP

A big part of the "Trump rally" in stocks has been a consensus belief that corporate tax reform of some sort will occur in 2017. Now that belief is being severely tested.

The problem: Trump and Congressional Republicans put healthcare ahead of taxes, because doing the latter without a baseline from the former is mathematically nonsensical. Healthcare, however, is proving far more difficult to get done than the GOP expected, judging by the postponement of Thursday's planned House vote. Every day (or week) that passes without healthcare getting done is another day (or week) that tax reform has to wait, and Congress isn't actually in session all that often. The calendar is tyrannical.

The (bigger) problem: If Republicans can't agree on healthcare reform, it isn't entirely clear that taxes will be much easier. Even within the White House there is a major split over the proposed border adjustment tax, and that doesn't even address Trump's plans for a 15% corporate tax rate that could give deficit hawks a minor aneurysm. The White House calls Trump "the closer," but his struggles in the ninth on healthcare could raise new questions about his ability to deliver on tax promises. And tax reform is the air that a lot of current stock prices are floating upon.