THE MORNING PLUM:
As the political world absorbs the implications of the House GOP vote to repeal and replace Obamacare, it is being widely suggested that the move could put GOP control of the House in jeopardy. There is a long way to go until Election Day 2018, and all kinds of things can change, but there are two indicators right now that this may be shaping up as a legitimate worry for Republicans.
First, there’s the energy evident among Democrats, which Republicans themselves are reportedly worried about. Second, there’s the relentless lying and dissembling from Republicans about what the House actually voted for.
On the first one: I am told that the Democratic Congressional Campaign Committee is on track to announce sometime this month that it raised $20 million online this year — which would already outpace the entire online haul of the last off-year of 2015. DCCC spokeswoman Meredith Kelly tells me that this online fundraising got a major boost in the 48 hours just after the GOP health-care vote last week, which brought in some $675,000.
While it’s true that in the aggregate, the NRCC — the GOP’s House campaign arm — outraised the DCCC overall in the first quarter of 2017, that includes all forms of fundraising. But online fundraising in particular is a useful measure of grass-roots energy; the new numbers show that Democrats are vastly outpacing previous online efforts; and the health-care debate, which figures in many Democratic fundraising appeals, is a key reason. GOP strategists involved in the Georgia House special election cite Democratic enthusiasm as a worrying sign.
On the second one: Republicans have fanned across the talk shows to defend the bill, but what they have really revealed is that they can’t defend it without spewing all sorts of lies and distortions about what’s actually in it. A rundown:
- On ABC’s “This Week,” Paul Ryan insisted that under the GOP bill, “you cannot be denied coverage if you have a preexisting condition.” That’s pure misdirection: By allowing states to scrap the ban on jacked-up premiums for people with preexisting conditions, it could lead to soaring costs for many, pushing untold numbers of them off of coverage, and the high-risk pools that are supposed to pick up the slack would be woefully underfunded. Ryan also repeatedly said the bill would give everyone “access” to “affordable” care. That’s an empty, dishonest talking point, given that the bill would lead to 24 million fewer covered, in part through its huge cuts in spending on the poor, to finance a huge tax cut for the rich.
- On CNN, Jake Tapper pressed Health and Human Services Secretary Tom Price about Trump’s support for the GOP bill, which cuts more than $800 billion over 10 years from Medicaid while phasing out the expansion of it. Price claimed that under the proposal, Medicaid spending would “go up every single year.” But as Glenn Kessler shows, this is complete nonsense. Not only does the bill cut Medicaid’s spending in raw dollars; its funding growth formula, which is fixed by a per-capita grant to states, very well could fail to keep pace with the actual growing health-care expenses of patients, forcing states to try to make up the shortfall or slash coverage.
- Also on CNN, Rep. Tom Reed (R-N.Y.), who voted for the bill, dodged and weaved in a telling fashion. CNN’s Chris Cuomo pressed him on why Republicans don’t simply “own” the fact that the bill’s huge tax cuts for the rich will result in many fewer people covered and defend it on the merits. In response, Reed segued into talking points about how high taxes are crushing his state — sidestepping the little detail that the GOP bill’s tax cuts are targeted toward the very affluent and very rich — and insisted that Republicans were devoted to finding “innovative” ways to cover those who might be left uninsured, while suggesting the bill could be fixed later.
The bottom line is that Republicans are broadly sidestepping any defense of what their bill actually does. For years, most Republicans argued that the ACA’s individual mandate is snuffing out freedom. Others protested the law’s redistributive features — its taxes on the rich to expand coverage to those with lower incomes; the mandate’s effort to ensure that the young and healthy help subsidize coverage for the sick. It is obviously possible to harbor those objections in a principled fashion.
But it is hard to find a Republican who will forthrightly defend the actual projected consequences of the bill’s manner of undoing all of those things. Untold numbers of people with preexisting conditions will be more vulnerable to losing coverage, financial ruin and, in certain cases, possibly death. Millions of lower-income people will lose coverage. Instead of arguing that these things are worth the trade-off of doing away with the mandate and the high-end taxes, Republicans who support the bill continue to deny that those things will happen at all, in the face of all evidence and expert analysis to the contrary.
It’s hard to say how much all this will matter for the 2018 elections. As Ross Douthat points out, the Senate version could end up restoring much of the funding that the House GOP bill slashes, making it look less like a naked plutocratic exercise in gutting coverage for poor people to put money back in the pockets of the rich, softening it politically. Still, now that the Senate is taking up health care, we will be debating this for months to come, and that might make the realities of the bill House Republicans did vote for harder for them to escape.
* NEW AD CAMPAIGN BLASTS REPUBLICANS ON HEALTH CARE: Save My Care, an advocacy organization defending the Affordable Care Act, today is launching a new, six-figure ad campaign blasting 24 House Republicans who voted for the GOP repeal bill.
Here is the version of the spot targeting Rep. Martha McSally (R-Ariz.): It slams her for voting to raise premiums, to cut health coverage for millions and to strip away protections for people with preexisting conditions. Last line: “Congresswoman McSally: How could you do this to us?”
* VULNERABLE REPUBLICANS MAY FACE ANGRY CONSTITUENTS: NBC News’s Alex Seitz-Wald talks to voters in the Miami suburban district of GOP Rep. Carlos Curbelo, who voted for the bill and may be one of the most vulnerable of all House Republicans. Summary:
Almost two dozen interviews with voters … reveal a mix of opinions on his vote … But the voters with the most passionate responses were generally those who opposed the Republican plan and their representative’s support for it.
As one opponent put it: “I have never canvassed before, but I will f—ing crawl door to door to make sure you lose.” That level of energy is what Republicans need to worry about.
* KASICH SLAMS GOP HEALTH BILL: On CNN’s “State of the Union,” Ohio Gov. John Kasich (R) suggested that the GOP health bill would kick untold numbers off Medicaid and asserted that he would not seek the GOP bill’s state waiver for the ban for insurers on jacking up premiums for preexisting conditions. He said its “high-risk pools” are “not funded” and are “ridiculous.”
This is another sign that GOP governors who represent Medicaid expansion states are going to be very critical of any GOP bill that guts it. It also shows that the GOP bill, by giving them the option of trying to relax regulations for insurers, would put them in a very tough political spot.
* REPUBLICANS FEAR LOSS IN GEORGIA: McClatchy reports that Republicans are now seriously pondering the possibility that Democrat Jon Ossoff could beat Karen Handel in the special election for a House seat in the Atlanta suburbs:
[A loss] would harden the narrative that Republicans face a daunting task in maintaining control of Congress in 2018. It would also underscore the challenges facing Republicans running in districts Donald Trump either lost or, as is the case in Georgia, barely won … interviews with a half-dozen Republican operatives and strategists familiar with the race reveal a recognition that Democrats have enthusiasm on their side.
But keep in mind that this is still a Republican district: Tom Price, who is now HHS secretary, won it by more than 20 points in 2016.
* TRUMP SHAKEUP OF EPA CONTINUES: The Post’s Juliet Eilperin reports that EPA chief Scott Pruitt has decided to replace half of the officials on a review board that judges the agency’s scientific research. This is part of a broader shift:
Pruitt is planning a much broader overhaul of how the agency conducts its scientific analysis, said a senior administration official who spoke on the condition of anonymity to discuss internal deliberations … The agency may consider industry scientific experts for some of the board positions, Freire said, as long as these appointments do not pose a conflict of interest.
A climate skeptic leads the EPA and may replace key scientific review positions with industry experts. What could go wrong?
* MACRON WON — BUT WARNING SIGNS PERSIST: E.J. Dionne Jr. writes that Emmanuel Macron’s defeat of Marine Le Pen represented an important reassertion of pluralist liberal democracy in the face of the nationalist threat, but it’s not all reassuring:
Macron ran as a confident and unflinching advocate of pluralism and openness, and he will become, instantly, a major global voice for those values. But he will have to govern a deeply torn nation in a surly mood. Le Pen’s share of the vote … was still a major breakthrough for what had once been a pariah party long dismissed as a neofascist movement rooted in unsavory aspects of French history. Like Trump, Le Pen rallied voters in once prosperous but now ailing industrial towns.
Meanwhile, Nate Silver notes an interesting trend: This represented the latest example of the nationalist candidate under-performing the public opinion surveys.
* GOP BILL IS ‘AN ACT OF DELIBERATE BETRAYAL’: Paul Krugman runs through all the promises the GOP health bill would break (by leading to higher premiums; widespread loss of coverage; and gutted protections for the sick) and concludes:
This isn’t one of those cases where people try to do what they said they would, but fall short in the execution. This is an act of deliberate betrayal: Everything about Trumpcare is specifically designed to do exactly the opposite of what Trump, Paul Ryan and other Republicans said it would.
After all, if your goal is to gut coverage for millions of poor people while giving the rich an enormous tax cut, you can’t really say that out loud.