Tag Archives: Republicans

The “Skinny” Repeal of the ACA Is Back

Republicans in the Senate want to cut taxes so much for rich people and corporations that the federal deficit would go way up. That means they need to reduce government spending or find new revenue to offset the cuts. Their latest idea is to bring back the “skinny” repeal of the Affordable Care Act. The repeal would be “skinny”, because the only thing being repealed would be the “individual mandate”, the requirement that people have health insurance or pay a fine.

But why would getting rid of the individual mandate help offset tax cuts? The reason is that millions of low-income people would no longer buy health insurance, so the government would no longer need to give money to help them afford it. Right now, the government spends millions of dollars on health insurance subsidies for people who couldn’t otherwise get it. If those people don’t have health insurance anymore, the subsidies won’t be paid.

Unfortunately, there are serious problems with this approach. From The Washington Post:

Repealing the mandate would undermine … key parts of the Affordable Care Act. The health care law banned insurance companies from discriminating against people with pre-existing health conditions. But in order to prevent people from waiting to buy insurance until they got sick, the law … imposed financial penalties [the individual mandate] for individuals who did not maintain health insurance coverage.

Health experts say eliminating the mandate would destabilize the individual insurances markets set up by the Affordable Care Act, as they would be full of people with high health care costs but have far fewer of the healthy people that insurance companies bank on. In response, insurance companies would likely either massively raise premiums or pull out of the marketplaces entirely.

A powerful group of stakeholders, including the major health insurance and hospital insurance lobbies and two influential doctors’ groups, wrote a letter to leaders from both parties arguing that they should retain the individual mandate.

“There will be serious consequences if Congress simply repeals the mandate while leaving the insurance reforms in place: millions more will be uninsured or face higher premiums, challenging their ability to access the care they need,” the groups wrote.

The Congressional Budget Office (CBO), among others, analyzed “skinny” repeal earlier this year. Their conclusions led three Republican senators to vote against it on the night of July 27th (it was in all the papers). Maybe the same three will defeat it again if it’s part of the Republican tax bill, but there might be more pressure on them to accept it this time.

Meanwhile, Republicans in the House of Representatives have their own version of the tax legislation. Today, the CBO had something to say on that. From Yahoo Finance:

If the House GOP tax plan passes, it is projected to cut revenue significantly, likely increasing the deficit by $1.456 trillion from 2018 to 2027, according to the Joint Committee on Taxation and Congressional Budget Office.

… the CBO explained that without any more money to offset the fall in revenue, the Office of Management and Budget (OMB) would be required to issue a “sequestration order” to reduce spending in 2018 by $136 billion.

The effects of this sequestration order would trigger automatic cuts to various programs, including Medicare. According to the CBO, this could be as much as 4% for Medicare, which amounts to $25 billion in 2018. Furthermore, all non-exempt programs would be eliminated, which include some farming subsidies, border security, and student loan help.

So, in order to give the wealthy and corporations an enormous tax cut, Republicans will either raise insurance premiums for millions of average Americans or apply major spending cuts to programs like Medicare (or do both). This is in addition to increasing taxes on millions of people who itemize their deductions because they have big medical bills or live in states or cities with high taxes. All of this will happen while they increase the deficit by $1,456,000,000,000, give or take several billion. 

On the plus side, the president, his family, the billionaires in the Cabinet and lots of other plutocrats, including many CEO’s, will have a lot more money in their very deep pockets, a few dollars of which will trickle down to the rest of us. Inequality will increase, people will die too soon, but that’s all right, because I’ve got mine, Jack!

This, That and the Other Thing

There are few places as forlorn as a resort town on a chilly, cloudy, damp, out of season weekday afternoon. Thus, Virginia Beach, Virginia, last week:

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But let’s move on.

Paul Waldman writes about “The GOP’s Baffling Decision to Raise Taxes on Millions of Americans” at The Week.

If there’s one thing we thought we could count on in this crazy world, it’s that Republicans will never, ever, ever support a tax increase. It wasn’t always this way — Ronald Reagan, who to hear some people tell it practically walked the Earth without sin, actually raised taxes multiple times — but today there may be no more foundational belief to the GOP than the principle that taxes must come down, everywhere and always.

Nevertheless, “the GOP is right now rallying around a bill that will raise taxes on tens of millions of Americans.” It certainly is strange. One part of the explanation, however, is that Republicans aren’t very good at this governing thing. Another part is that they’re so eager to cut taxes for rich people and corporations, they’re willing to antagonize millions of voters and lie about what they’re doing.

As a partial antidote to the above, consider reading all about “The Relentless Honesty of Ludwig Wittgenstein”. Ian Ground presents an excellent overview of Wittgenstein’s philosophy, both early and late, at The Times Literary Supplement.

The Nonsense, the Abyss & a Call to Action

I’ve been slowly writing a post about whether to avoid the news. I might never finish it. The news keeps intruding.

We are finding out what it’s like to live in a country ruled by its worst people (that’s called a “kakistocracy”). There are too many problems and offenses to monitor or understand.

Regarding just two of them, Paul Waldman of The Washington Post does a great job with “GOP spin about the new ‘Steele Dossier’ story is disingenuous nonsense” and “The GOP strategy on the Russia scandal: ‘No puppet. You’re the puppet.’” Read these two articles and you’ll be totally inoculated against the toxic bullshit soon to rain down on us from the Republican “Let’s Invent a Clinton Scandal” machine and the relatively respectable journalists who should know better by now.

The other thing I wanted to share today is Andrew Sullivan’s insightful summary of the current situation in New York Magazine: “This Is What the Trump Abyss Looks Like”. If reading it gets too depressing, you can jump to the last paragraph, where he issues a call to action:

The past week was another watershed, it seems to me, in the rising power of Donald Trump. Flake is quitting; Corker is retiring; McCain is mortal…. A new slew of Bannonite candidates is emerging from under various rocks and crannies to take their places. The Trump propaganda machine was given a chance to turn the Russia story into a Clinton scandal – lowering even further the possibility of impeachment – and gleefully took it. The FBI is the next target for a barrage of hostile propaganda, since it might expose the Supreme Leader. Mueller is being daily savaged in the right wing press. Outside Washington, Trump’s targets are faltering. [A] Gold Star widow is attacked; Obamacare is at risk of being sabotaged to death; the EPA is castrated….

The Congress is paralyzed, reduced entirely to staffing the judiciary with the far right; it can pass no significant legislation and reach no compromise on anything without Trump undermining it. The bureaucracy is shell-shocked and demoralized; the State Department is a wasteland; the press has sunk even further into public disdain. The police are increasingly seen either as incapable of error or morally suspect. The essential civilian control of the military has been weakened, with an embittered general’s honor now deployed as a way to play political defense in front of the press corps. “My generals”, as the president calls them, as if they swear loyalty to him and not to the Constitution. The Republican candidate for the Senate from Alabama, Roy Moore, believes that there should be a religious test for public office. As Ben Sasse blurted out yesterday: “It feels like this party I’m a member of has gone post-Constitutional.”

The discourse has been coarsened to sub-tabloid levels; the courts’ authority has been weakened by their own over-reach and Trump’s refusal to follow core Constitutional norms. The neutral institutions that might be capable of bringing the president to heel, such as the FBI, are now being trashed by their ultimate boss. The possibility of a shared truth, about which we can have differing opinions, has evaporated in a blizzard of web-fueled distraction and misdirection, aided and abetted by a president for whom reality is whatever he wants it to be at any given moment, and always susceptible to change. It turns out that Mark Zuckerberg’s real achievement will be the collapse of a rational public dialogue….

Almost all our liberal democratic norms and institutions are much weaker today than they were a year ago. Trump has not assaulted the Constitution directly. He has not refused a court order, so far. But he has obstructed justice in his firing of James Comey, and abused the spirit of the pardon power by using it for a public official who violated citizens’ Constitutional rights, before he was even sentenced. In the most worrying case so far, he has refused to enforce the sanctions against Russia that were passed by a veto-proof margin by the Congress. I fear this is because his psyche cannot actually follow the instructions of anyone but himself. This is also why, after failing to repeal, replace or amend Obamacare, he has not faithfully executed the law, but actively sabotaged it. If he does not have his way, he will either sulk and refuse to do his constitutional duty, or he will simply smash whatever institution or law that obstructs his will. At some point, we may come to a more profound test of his ability to operate as just one of three equal branches of government. I think he’ll fail it.

Yes, the forms of the Constitution remain largely intact after nine months. But the norms that make the Constitution work are crumbling. The structure looks the same, but Trump has relentlessly attacked their foundations….

And we know something after a year of this. It will go on. This is not a function of strategy or what we might ordinarily describe as will. It is because this president is so psychologically disordered he cannot behave in any other way. His emotions control his mind; his narcissism overwhelms even basic self-interest, let alone the interest of the country as a whole. He cannot unite the country, even if, somewhere in his fathomless vanity, he wants to. And he cannot stop this manic defense of ego because if he did, his very self would collapse. This is why he lies and why he cannot admit a single one of them. He is psychologically incapable of accepting that he could be wrong and someone else could be right. His impulse – which he cannot control – is simply to assault the person who points out the error, or blame someone else for it….And do not underestimate the stamina of the psychologically unwell. They will exhaust you long before they will ever exhaust themselves.

But by far the most important development in all this, the single essential rampart, is how, through all this, Trump has tightened his grip on 35 percent of the country. He has done this when he has succeeded but also critically when he has failed, because he has brilliantly turned his incapacity to be president into an asset with his base. No wall? Congress’ fault. Obamacare in place? The GOP’s fault. No tax cut? Ditto. The only way forward? A deeper and deeper trust in him. Only he can fix the Congress by purging it. Only he can fix the Courts through nominees who will never stand up to him.

And this base support is unshakable. It is not susceptible to reason. No scandal, however great, will dislodge it – because he has invaded his followers’ minds and psyches as profoundly as he has the rest of ours. He is fused with them more deeply now, a single raging id, a force that helps us understand better how civilized countries can descend so quickly into barbarism. In a country led by a swirling void, all sorts of inhibitions slowly slip away. Nativism, racism, nationalism: these are very potent catalysts of human darkness. Usually it is the president who takes responsibility when these demons appear to emerge, and attempts to refute, or discredit or calm them. But this one amps them up….

He is the total master of an enormous mob that, so far, has completely overcome the elites. He achieves this mastery through incendiary oratory, hourly provocations, and relentless propaganda. His rallies are events of mass hysteria and rage. His propaganda machines – Fox News, Limbaugh, Breitbart, Drudge – rarely crack. And there is no one in our political life capable of matching this power. Name one, if you can. And when you look at the Democratic field of 2020, no one seems up to it at all. Among the few responsible Republicans left, what we see is either utter cowardice in the face of an enraged base, or the kind of courage that manifests itself too late to make a difference, which is to say no real courage at all….

What could change this? Maybe a recession – although Trump would probably blame that on the Fed or some other target. Maybe a catastrophe, such as a nuclear conflict in Korea. Maybe, such a massive and impregnable revelation from the Mueller investigation it shakes even the base out of its trance. But the only reliable and sane solution is a massive mobilization of the anti-Trump majority at the polls next year. The huge Democratic fundraising advantage is encouraging; as are the new grass roots organizations that are going in strength. Maybe an unexpected leader from the left or center might emerge. Maybe a strong Democratic message that can somehow keep its minority edge and simultaneously re-engage the white Obama-Trump voters in the Midwest. The key is to sustain a sense of the urgency of the moment, a resolute refusal to accept this descent into an illiberal authoritarianism, and a decision to put all our differences aside for a year in order to mobilize a turnout next year that eclipses Obama’s. We have to turn the mid-terms into a presidential election. Sane Republicans need to vote for the Democrat. Leftists have to put aside their divisive identity politics. Liberals need to coalesce around a simple strategy – not impeaching but checking Trump decisively.

We have close to 60 percent of the country with us. We have to mobilize every single one. Or the abyss will open wider.

What Republican Senators Are Thinking

Cracks may be developing in Congress’s support for the president. Fred Kaplan of Slate writes about the silence of Republican senators regarding recent statements by fellow Republicans to the effect that the president needs round-the-clock supervision and isn’t playing with a full deck:

It is a hair-raising fact that though few Republicans have seconded [Senator Corker’s] or [Secretary of State Tillerson’s] appraisals of Trump, still fewer have spoken out in their president’s defense. The day after Corker’s interview in the Times, CNN staffers phoned all 52 Republican senators to see if any of them would come on Wolf Blitzer’s show to discuss politics that day. Not one assented.

They chose not to protest that one of the party’s leaders in the Senate likened Trump to a patient in an “adult day care center.” They don’t seem to mind that the nation’s top diplomat called Trump a “fucking moron.” And no one has as yet rebutted the latest report on Trump’s appalling cluelessness about nuclear weapons. The Republicans don’t deny any of these indictments, yet they do nothing about them; they do nothing to address the clear and present danger.

Elsewhere, Robert Reich, an economist who was the Secretary of Labor in the Clinton administration and now teaches at Berkeley, posted this on Facebook. I can’t vouch for its accuracy, of course, but it does give one hope:

This morning I phoned my old friend, a Republican former member of Congress.

RR: So what’s up? Is Corker alone, or are others also ready to call it quits with Trump?

He: All I know is they’re simmering over there.

RR: [Senators] Flake and McCain have come pretty close.

He: Yeah. Others are thinking about doing what Bob did. Sounding the alarm. They think Trump’s nuts. Unfit. Dangerous.

RR: Well, they already knew that, didn’t they?

He: But now it’s personal. It started with the Sessions stuff. [Attorney General Sessions] was as loyal as they come. Trump’s crapping on him was like kicking your puppy. And then, you know, him beating up on [Majority Leader McConnell] for the Obamacare fiasco. And going after Flake and the others.

RR: So they’re pissed off?

He: Not just that. I mean, they have thick hides. The personal stuff got them to notice all the other things. The wild stuff, like those threats to North Korea. Tillerson would leave tomorrow if he wasn’t so worried Trump would go nuclear, literally.

RR: You think Trump is really thinking nuclear war?

He: Who knows what’s in his head? But I can tell you this. He’s not listening to anyone. Not a soul. He’s got the nuclear codes and, well, it scares the hell out of me. It’s starting to scare all of them. That’s really why [Corker] spoke up.

RR: So what could they do? I mean, even if the whole Republican leadership was willing to say publicly he’s unfit to serve, what then?

He: Bingo! The emperor has no clothes. It’s a signal to everyone they can bail. Have to bail to save their skins. I mean, Trump could be the end of the whole goddam Republican party.

RR: If he starts a nuclear war, that could be the end of everything.

He: Yeah, right. So when they start bailing on him, the stage is set.

RR: For what?

He: Impeachment. 25th amendment.

RR: You think Republicans would go that far?

He: Not yet. Here’s the thing. They really want to get this tax bill through. That’s all they have going for them. They don’t want to face voters in ’18 or ’20 without something to show for it. They’re just praying Trump doesn’t do something really, really stupid before the tax bill.

RR: Like a nuclear war?

He: Look, all I can tell you is many of the people I talk with are getting freaked out. It’s not as if there’s any careful strategizing going on. Not like, well, do we balance the tax bill against nuclear war? No, no. They’re worried as hell. They’re also worried about Trump crazies, all the ignoramuses he’s stirred up. I mean, Roy Moore? How many more of them do you need to destroy the party?

RR: So what’s gonna happen?

He: You got me. I’m just glad I’m not there anymore. Trump’s not just a moron. He’s a despicable human being. And he’s getting crazier. Paranoid. Unhinged. Everyone knows it. I mean, we’re in shit up to our eyeballs with this guy.

Will Congressional Republicans stick with this monster to the bitter end? If only they were brave enough and clever enough to get rid of him and put Vice President Pence in the Oval Office. They have to be looking for an excuse to dump Trump, since their lives would be so much easier with President Mike Pence. Before Pence became governor of Indiana, he served in Congress for 12 years. He’s a standard right-wing religious fanatic they could work with!

Whither the Grand Old Party?

Jennifer Rubin writes a blog for The Washington Post called Right Turn. It’s advertised as “Rubin’s take from a conservative perspective”. But in recent months she’s been churning out articles with titles like today’s “Americans as a Whole Haven’t Lost Their Minds, But the GOP Has”. That makes perfect sense, of course, because the Grand Old Party is no longer “conservative” in the traditional sense. It’s become the party of radical reactionaries and know-nothings.

Citing an opinion poll that contains bad news for the Republicans, she writes:

Voters say 47 – 38 percent, including 44 – 32 percent among independent voters, that they would like to see Democrats win control of the U.S. House of Representatives in the 2018 Congressional elections.

Americans, it turns out:

  • Are not bamboozled by his NFL and flag histrionics;
  • Do not think it’s all the media’s fault;
  • Know he is not making America great (stressed and anxious maybe, but not great);
  • Have figured out he’s botching most policy matters — and is a bad person to boot; and
  • Don’t buy into his race-baiting act.

Americans are neither brain-dead nor moral vagrants. In voting for him many probably hated Hillary Clinton more, engaged in wishful thinking about Trump and/or figured incorrectly a rich guy and his friends must know how to do things. But they do not like him now, and that speaks very well of the American people.

The bad news is Republicans overwhelmingly like him, his policies, his distractions, his character, his racial appeals, etc. Among Republicans 79 percent approve of his performance, 79 percent think he is honest (!), 85 percent think he cares about ordinary Americans, 62 percent think he is level-headed (!!) and perhaps worst of all, 78 percent think he shares their values.

Now, it’s possible that having voted for him these Republicans don’t want to admit he is, as LeBron James eloquently put it, a bum. But it’s also possible that a declining share of voters identify as Republicans but that those who do, by and large, live in a Fox News-created political universe in which Trump is just the best. They refuse to see Trump as a bigot or an incompetent narcissist. They believe what he tells them about immigrants, the world and the “liberal elites.”

The question that many #NeverTrump Republicans or now former Republicans face is whether that GOP base has become so divorced from their own world view that they cannot consider themselves Republicans any longer. To be a Republican these days is to be at the very least an apologist for Trump and at the worst a cultist. Maybe these Trump fans were always there in the party, but now they are the dominant voice…. [Note: Crazy right-wingers, now known as “Trump fans”, have indeed always been there.]

It doesn’t seem possible that logic or experience will change the minds of the 75 percent to 80 percent of the GOP who remain in Trump’s quarter…

Rubin concludes that “distressed Republicans and ex-Republicans” have three options, because “the GOP that was, is no longer”:

(1) “Recruit new non-Trumpkins to the GOP (but which Americans would want to join?!) to out-vote Trump’s base” 

(2) “Start a new center-right party (with an invitation out to moderate Democrats)” 

(3) “Set up shop across the aisle as [conservative] Democrats”.

Option (1) is clearly a non-starter, so it’s not worth thinking about. Option (2) could happen if a conservative billionaire or two gave up on the Republican Party and made a serious, highly-publicized effort to recruit candidates and get them on ballots nationwide, although finding a significant number of Republican politicians with the courage to suddenly leave their party sounds highly unlikely.

That leaves option (3). Rubin thinks this would depend on “the direction the Democrats take (will it be the party of Sen. Bernie Sanders or the party of Truman/JFK/Bill Clinton — policy-wise, that is)”. If the Democratic Party moves further to the left, it will make it more difficult for Republicans and ex-Republicans to switch. On the other hand, if conservatives move to the Democratic Party in serious numbers, the party won’t move to the left. It will stay where it is or move to the right. 

In the meantime, Democrats continue to do well in special elections at the state level. Maybe some Republican voters are already switching:

Democrats on Tuesday flipped two seats in special state elections in Florida and New Hampshire.

Earlier this month, Democrats flipped State House seats in New Hampshire and Oklahoma, replacing Republicans in two districts ahead of the 2018 midterm elections….

Since Trump’s election, Democrats have flipped eight GOP-held seats at the state level, and Republicans have yet to flip a seat in 27 special elections.

These results suggest that the Democrats may make even more significant progress in statewide legislative races in Virginia and New Jersey in November, less than six weeks from now.

The Grand Old Party Today

Once again, the bastards failed to repeal the Affordable Care Act. A few Republican senators refused to go along with the herd. No doubt they’ll keep trying to kill it, no matter how many people suffer as a result.  

Until this latest repeal effort took precedence, Sen. Alexander, a Republican, and Sen. Murray, a Democrat, were working on a bipartisan set of improvements to the ACA. They were making progress, but the Republican leadership ordered Sen. Alexander to end the discussions. When the repeal effort quickly fizzled, the Democratic leadership called for Alexander and Murray to resume their work. Here’s what the Republican leader, Senator McConnell, said:

Senate Ds have 2 thoughts on how to fix #Obamacare 1. Do nothing 2. A fully gov-run system that would take away even more of their decisions 4:45 PM – 25 Sep 2017

McConnell stopped Alexander and Murray from working together on a set of mutually agreeable fixes to the ACA. Then he claimed the Democrats weren’t willing to work with the Republicans. He knew this was totally false, but said it anyway.

Now the Republicans have pivoted to what they’re calling “tax reform”. As usual, the changes they have in mind are skewed to benefit the rich:

The tax plan that the Trump administration outlined on Wednesday is a potentially huge windfall for the wealthiest Americans. It would not directly benefit the bottom third of the population. As for the middle class, the benefits appear to be modest.

The administration and its congressional allies are proposing to sharply reduce taxation of business income, primarily benefiting the small share of the population that owns the vast majority of corporate equity….

The plan would also benefit Mr. Trump and other affluent Americans by eliminating the estate tax, which affects just a few thousand uber-wealthy families each year, and the alternative minimum tax, a safety net designed to prevent tax avoidance [by people with high incomes].

The precise impact on Mr. Trump cannot be ascertained because the president refuses to release his tax returns, but the few snippets of returns that have become public show one thing clearly: The alternative minimum tax has been unkind to Mr. Trump. In 2005, it forced him to pay $31 million in additional taxes. [The New York Times]

In addition, the Republicans want to cut taxes for “pass-through” businesses from as high as 39% down to 25%. The Trump Organization just happens to be a pass-through business.

So there are at least three big changes that would almost certainly benefit the president and his family, assuming any of them pay income tax. Yet last night he had the nerve to deny it:

President Trump unveiled his long-awaited tax plan Wednesday during a speech in Indiana. He asserted without qualification that the proposal — still only roughly outlined — would be good for middle-class Americans and not the wealthy.

“Our framework includes our explicit commitment that tax reform will protect low-income and middle-income households,” Trump said. “Not the wealthy and well-connected. They can call me all they want; I’m doing the right thing.”

He then added: “And it’s not good for me, believe me.” [The Washington Post]

Meanwhile, our fellow citizens in Puerto Rico and the U.S. Virgin Islands are in a horrible situation, having been subjected to two major hurricanes, but the Republicans who control the government aren’t responding to the crisis as urgently as they did when Texas and Florida suffered similar but less serious problems. And the Midwest and Northeast have been experiencing an unprecedented heatwave — “Late-September heat wave leaves climate experts stunned. ‘Never been a heat wave of this duration and magnitude this late in the season’ reports NOAA” [ThinkProgress] — while the Republicans deny that global warming is real and are running yet another religious fanatic (who doesn’t believe in evolution and thinks homosexuality should be a crime) for a seat in the U.S. Senate.

Years ago, Republicans weren’t as bad as they are now. Back then, I wondered whether they were mostly selfish or mostly ignorant. Those are still factors, but what’s still known as the Grand Old Party has deteriorated to the point where mere selfishness and ignorance aren’t enough to explain its awfulness. The fundamental problem is that Republicans are immoral. They don’t observe norms of human behavior that the modern world requires: caring about the lives of strangers; intellectual honesty; respect for scientific inquiry; the willingness to cooperate for the common good; long-term thinking; promoting equality of opportunity.

There is no excuse for being a Republican today. The Grand Old Party has become evil and deserves to die.

The Bastards Are At It Again

It’s been 51 days since Republican Senator John McCain cast the dramatic “No” vote that sunk the bill that would have sunk the Affordable Care Act. Most of us assumed that was the end of the story. Even Sen. McConnell, the evil Majority Leader, said it was time for the Republicans to “move on”.

But we were wrong. They’re making one more attempt to repeal the Affordable Care Act. They have until September 30th, because the Senate rules say that’s the last day they can pass a bill with only 50 senators, plus the Vice President, voting “Yes”.

Sarah Kliff of Vox calls the latest bill, released by Sens. Bill Cassidy and Lindsey Graham on Wednesday, “the most radical” repeal effort yet:

Work on Cassidy-Graham began in the midst of the chaotic Obamacare repeal effort in July….

The senators are selling this idea as a compromise plan and say it is a way to return power to states, giving local governments more control over how they spend federal dollars….

But the plan does much more than that. The proposal would eliminate the health care law’s subsidies for private insurance and end the Medicaid expansion. States could allow for waivers that let insurers charge sick patients higher premiums and stop covering certain benefits required under the Affordable Care Act, like maternity care or prescription drugs. The health insurance marketplaces would no longer exist as they are envisioned to continue under other Republican proposals.

The federal government would convert some (but not all) of that spending into a lump-sum payment to states. States could choose to spend this money on providing insurance — or they could use it to fund high-risk pools, or do other activities to pay the bills of patients with high medical needs….

The plan hasn’t been scored by the Congressional Budget Office yet, but analysts who have studied Cassidy-Graham estimate it would cut deeply into federal funding for the health law programs, likely resulting in millions losing coverage.

Cassidy-Graham would arguably be more disruptive, not less, to the current health care system than the plans that came before it. It would let money currently spent on health insurance go toward other programs, providing no guarantee that the Affordable Care Act programs individuals rely on today would continue into the future.

Jonathan Cohn of the Huffington Post quotes Aviva Aron-Dine of the Center on Budget and Policy Priorities:

“This bill is far more radical [than previous repeal bills] in that it envisions going back to the pre-ACA world, where the federal government wasn’t in the business of helping low-income adults or moderate-income people without employer coverage get health insurance at all… Compared to pre-ACA, there would be some extra state grant money floating around ― but it would have virtually no requirements attached to it at all and, since the funding wouldn’t adjust based on enrollment or costs, it would be hard for even well-intentioned states to use it to create an individual entitlement to coverage or help.”

Cohn continues:

Oh, and the bill would repeal the Affordable Care Act’s individual mandate, and do so right away ― destabilizing insurance markets and causing premiums to rise right away, according to official projections….

It’s difficult to say where this is all going. After all, the idea that repeal could get another look now, despite its unpopularity, in the form of a proposal that in some respects is more radical than its predecessors, is difficult to fathom. And yet here we are, fathoming it.

So it looks like we need to speak up again. Republican senators need to hear from their angry constituents again. Facebook and Twitter need to heat up again. Activists need to get arrested again, because this is a matter of life and death for many of our fellow citizens and nobody knows if three Republicans will still vote “No”. McCain, who provided the crucial third “No” in July, has changed his tune from day to day (he’s 81 and has a brain tumor). People are saying he might vote “Yes” this time because he and Sen. Graham are very good friends. 

In November 1932, the German government was in disarray. Hitler was demanding to be made chancellor. He had many supporters, but others feared he would immediately institute a murderous dictatorship if given the chance:

Yet it was entirely unclear who would succeed [Franz von Papen] as chancellor or whether a way out of the political crisis could be found. The only thing that was clear, [a German count named Harry Kessler] noted … was the absolute impenetrability and uncertainty of the situation: “Everything more or less depends on chance and the good or bad moods of four or five individuals”.

Hitler became chancellor two months later.