Apr 7, 2017

The new state of Trumpcare: Desperation

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Here's the big problem Republicans are facing on Trumpcare: They're facing so much pressure to pass a bill — any bill — that the changes have stopped being about improving the policies, or steering toward a broader, coherent vision of conservative health care reform. It's all about chasing votes now, and the more they try, the more the changes leave health care experts scratching their heads.

The latest as we head into the congressional recess:

  • Republicans have added a $15 billion "Federal Invisible Risk Sharing Program" to the bill to help insurers that attract a lot of expensive patients.
  • It's basically a rebranding of the reinsurance program Obamacare used to help insurers in its first years, though if you say that to the Republican sponsors, they will punch you in the face. There are some subtle differences. Tim Jost has a great deep dive into the new proposal at the Health Affairs blog.
  • The goal is to cover sick people without separating them into a high-risk pool, and to bring down premiums — which it could do, Jost writes, if it were funded with a lot more money.
  • Freedom Caucus chairman Mark Meadows said the provision "doesn't complete the task, but it's a good step in the right direction," Roll Call reports. But the group still wants to get rid of the pre-existing condition regulations, and it's not clear how much the new provision will do to lock up their support.
  • Why are we hearing about this right before the recess? Because the White House leaned on House Speaker Paul Ryan hard to show some progress, not just let everyone leave for two weeks, per Politico.
  • So Ryan put on a big show at his weekly press conference yesterday, loading up the stage with 30-plus Republicans as a backdrop to show unity on Obamacare repeal. "We have made real progress this week," he practically shouted.
  • The Rules Committee held an "emergency" meeting to approve the amendment — right before the recess, for a bill that wasn't about to come up for a vote. It's something I don't remember seeing in more than 20 years of covering Congress.

What the experts are saying: Conservative health care analyst Avik Roy says the risk-sharing fund shows "considerable progress" in improving the bill — though he says it needs more work on regulatory reform and aid to the low-income elderly. But Chris Jacobs, another conservative analyst, wonders why the fund wasn't tied to the state waivers the GOP also wants: "I could be missing something, but I don't see a coherent policy vision."

What's next: GOP leaders are under intense White House pressure to bring everyone back from recess to vote on the bill, but they won't do it unless there are signs that they're actually picking up votes. Ryan spokeswoman AshLee Strong: "Should a path toward 216 votes emerge, the speaker wouldn't hesitate to bring members back to fulfill our promise to repeal and replace Obamacare."

Bottom line: It's not likely right now — but don't make any travel plans you can't change.

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Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 3 p.m. ET: 6,804,044 — Total deaths: 362,678 — Total recoveries — 2,788,806Map.
  2. U.S.: Total confirmed cases as of 3 p.m. ET: 1,909,077 — Total deaths: 109,497 — Total recoveries: 491,706 — Total tested: 19,231,444Map.
  3. Public health: Some people are drinking and inhaling cleaning products in attempt to fight coronavirus, CDC says Fauci: "Very concerned" about spread of virus amid George Floyd protests — Cities offer free testing for protesters.
  4. Tech: The pandemic is accelerating next-generation disease diagnostics — Robotics looks to copy software-as-a-service model as use of robots accelerates.
  5. Business: Sports, film production in California to resume June 12 after 3-month hiatus.
  6. Education: Students and teachers flunked remote learning.

In photos: George Floyd's North Carolina memorial service

The remains of George Floyd are brought into Cape Fear Conference B Church. Photo: Ed Clemente/POOL/AFP via Getty Images

Hundreds gathered in Raeford, North Carolina to honor George Floyd, whose death in Minneapolis nearly two weeks ago has sparked nationwide protests against police brutality.

The state of play: This is the second memorial for Floyd. A number of his family members remain in Raeford, including his sister. He was born in Fayetteville, North Carolina, The News and Observer reports.

George Floyd updates

A protester holds a placard reading "Covid kills People, Racism kills Communities" as they attend a demonstration in Manchester, northern England, on June 6, to show solidarity with the Black Lives Matter movement in the wake of the killing of George Floyd. Photo: Paul Ellis/Contributor.

Thousands are gathering for a day of protests in Washington, D.C., almost two weeks after George Floyd's killing. Protesters in Australia and Europe staged anti-racism demonstrations on Saturday as well.

What's happening: A memorial service for Floyd is taking place in Raeford, North Carolina — near where he was born. Gov. Roy Cooper ordered all flags to fly at half-staff to honor Floyd until sunset. Thousands of demonstrators have gathered in Philadelphia and Chicago.