Mar 21, 2017

Trumpcare gets a makeover, but not an extreme one

Greg Ruben / Axios

So after all of that talk about big changes to the House Obamacare replacement bill, Republican leaders skipped some of the biggest ones they could have made. They did give some concessions to conservatives and moderates in the manager's amendment they released last night, but they also did a lot of punting. That means we will still have lots of drama between now and Thursday night.

The biggest actual changes the House GOP is making:

  • States can now choose Medicaid per capita caps or block grants.
  • There will be an optional Medicaid work requirement (with extra federal funds for states that do it).
  • There will be a more generous Medicaid inflation adjustment for the costs of elderly and disabled.
  • Obamacare taxes get repealed a year earlier.

The punty change:

  • A reserve fund to beef up the tax credit, especially for the low-income elderly, but no actual change to the tax credit. That's up to the Senate.

What they left out:

  • It doesn't end the Medicaid expansion earlier, as conservatives wanted. Rep. Joe Barton could still bring that to the Rules Committee on Wednesday.
  • It doesn't try to repeal Obamacare's insurance regulations. GOP leaders say that can't be done in a budget "reconciliation" bill, but conservatives want them to try.

It may not be good enough for the Freedom Caucus. Chairman Mark Meadows told Jonathan Swan that "our leadership is going to put forth a bill that does not address any of the concerns in a meaningful way and will dare us to vote against it." He says the group won't take a formal position against it, so that frees up some group members to vote for it.

But not Rep. Justin Amash, who tweeted: "They haven't changed the bill's general framework. They don't have the votes to pass it. They have seriously miscalculated." Get ready for suspense!

For the radar: The Club for Growth is launching a $500,000 TV and digital ad buy to urge House Republicans to vote against the bill. (Mainly ones who are already opposed or leaning against it.)

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Bernie's juggernaut

Sen. Bernie Sanders speaks in San Antonio last night with his wife, Jane. Photo: Eric Gay/AP

Sen. Bernie Sanders won so big in the Nevada caucuses that Democrats are hard-pressed to sketch a way he's not their nominee.

Driving the news: With 60% of precincts counted (slow, but better than Iowa!), Sanders is running away with 46% of delegates — crushing Joe Biden's 20%, Pete Buttigieg's 15%, Sen. Elizabeth Warren's 10% and Sen. Amy Klobuchar's 5%.

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Buttigieg campaign claims Nevada caucuses were "plagued with errors"

Photo: Win McNamee/Getty Images

Pete Buttigieg's campaign wrote a letter on Sunday asking the Nevada State Democratic Party to release early vote and in-person vote totals by precinct and address certain caucus errors identified by campaigns, The Nevada Independent reports.

The big picture: The campaign alleges that the process of integrating early votes on caucus day was “plagued with errors and inconsistencies,” and says it received more than 200 incident reports from precincts around the state.

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Coronavirus threat grows, threatening some drug supplies

Data: The Center for Systems Science and Engineering at Johns Hopkins, the CDC, and China's Health Ministry. Note: China numbers are for the mainland only and U.S. numbers include repatriated citizens.

As the novel coronavirus continues spreading globally and China grapples with a limited production capability, there's a growing risk to about 150 prescription drugs in the U.S., sources tell Axios.

The big picture: The coronavirus has spread to more countries, with both South Korea and Italy stepping up emergency measures amid rising case numbers on Sunday. COVID-19 has killed at least 2,467 people and infected almost 79,000 others, mostly in mainland China.

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