Late Night Comedians On Republicans & Internet Privacy

Yesterday, the House of Representatives voted to get rid of internet privacy rules. Members cast their vote, then immediately ran home to delete their browser histories. –Conan O’Brien

I guarantee you there is not one person, not one voter of any political stripe anywhere in America who asked for this. No one in America stood up in a town hall and said, ‘Sir, I demand you let somebody else make money off my shameful desires. Maybe blackmail me someday.’ –Stephen Colbert

Aren’t we passed this point now? Our phones are already spying on all of us. Today I just looked at a bowl of fruit and two minutes later my Facebook page was covered with ads for Banana Republic–James Corden

This bill has been passed by the House and the Senate and will now go to Trump for signing. And Trump says he is going to sign it, because remember, privacy only matters when we are talking about his tax returns. –James Corden

Another Prediction That Trump Could Cost Republicans Control Of The House

The failure of Donald Trump to repeal and replace Obamacare, as he repeatedly claimed he would do as soon as he took office, has led to a further deterioration in public perceptions of Trump’s job performance, and risks hurting the entire Republican Party. I have previously looked at predictions that a low approval rating for Trump could cost Republicans control of the House. National Journal has another prediction that Dems Could Take House in 2018:

Demo­crats now have a real­ist­ic shot at re­tak­ing the House in 2018. Each of the past three midterm elec­tions have swung wildly against the party in power—re­flect­ive of the long­stand­ing dis­sat­is­fac­tion of voters to­wards polit­ic­al lead­er­ship, no mat­ter who’s in charge. Trump’s job ap­prov­al rat­ing is hov­er­ing around 40 per­cent, a tox­ic level for the dozens of Re­pub­lic­ans run­ning for reelec­tion in swing dis­tricts. Re­pub­lic­ans would be fool­ish to as­sume that Pres­id­ent Obama’s co­ali­tion of mil­len­ni­als and non­white voters—many of whom stayed home in past midterm elec­tions—re­mains dis­en­gaged giv­en their aver­sion to Trump.

Polit­ic­ally speak­ing, the health care bill couldn’t have been more dam­aging for Re­pub­lic­ans. In a dis­cip­lined Con­gress, safe-seat Re­pub­lic­ans would be more will­ing to take risky votes so those in com­pet­it­ive seats could main­tain some in­de­pend­ence from the party. But this time, hard-line con­ser­vat­ives in the Free­dom Caucus de­clared their un­stint­ing op­pos­i­tion early on, for­cing some vul­ner­able Re­pub­lic­ans to go on re­cord in sup­port of the un­pop­u­lar le­gis­la­tion—which didn’t even come to a vote. Adding in­sult to in­jury, Trump bragged on Twit­ter that the health care ex­changes would col­lapse as a res­ult of his in­ac­tion—the worst pos­sible mes­sage to send to any­one who viewed Trump as a can-do ex­ec­ut­ive…

There are already signs that Trump’s sag­ging ap­prov­al rat­ing is rais­ing the pos­sib­il­ity of a stun­ning up­set in an up­com­ing con­gres­sion­al elec­tion in sub­urb­an At­lanta. The race, to fill the va­cant seat held by Health and Hu­man Ser­vices Sec­ret­ary Tom Price, couldn’t be more rel­ev­ant to the health care de­bate. One pub­lic poll shows the Demo­crat­ic front-run­ner, Jon Os­soff, nar­rowly lead­ing sev­er­al of his GOP op­pon­ents in a run­off—this in a con­ser­vat­ive dis­trict that has elec­ted Re­pub­lic­ans to Con­gress for over four dec­ades. Fear­ing an em­bar­rass­ing de­feat, the party’s lead­ing House su­per PAC is spend­ing over $2 mil­lion on at­tack ads con­nect­ing Os­soff with Nancy Pelosi.

Of the 36 at-risk House Re­pub­lic­ans, ac­cord­ing to The Cook Polit­ic­al Re­port’s rat­ings, 28 rep­res­ent urb­an or sub­urb­an dis­tricts where Trump isn’t par­tic­u­larly pop­u­lar. In last year’s elec­tion, most of these GOP rep­res­ent­at­ives sig­ni­fic­antly out­per­formed Trump as voters dis­tin­guished between the pres­id­en­tial nom­in­ee and the re­cord of their own mem­ber of Con­gress. But with Trump as pres­id­ent, that dis­tinc­tion is harder to make…

Demo­crats need to net 24 seats to win back the House ma­jor­ity, which sounds a lot more im­pos­ing than it ac­tu­ally is. As polit­ic­al ana­lyst Nath­an Gonzales noted in a re­cent column, the pres­id­ent’s party has lost House seats in 18 of the last 20 midterms, with an av­er­age loss of 33 seats in those 18 los­ing cycles. Two of the most im­port­ant big-pic­ture factors—pres­id­en­tial ap­prov­al and par­tis­an en­thu­si­asm—are now point­ing against the GOP.

Un­der nor­mal cir­cum­stances, Re­pub­lic­ans would ex­per­i­ence some early gov­ern­ing suc­cesses and rally be­hind their pres­id­ent. With Trump, Re­pub­lic­ans have come up empty-handed so far. We’re more than a year away from the next big elec­tions, but there are already signs that a Cat­egory 5 hur­ricane is build­ing.

The Republicans risk further losses following their defeat on health care. Trump continues to lose credibility, and is losing in his attacks on the press. Many sources, including The Wall Street Journal, have discussed the difficulties they will have on rewriting the tax code. Trump’s executive order to reverse Barack Obama’s efforts to fight climate change could also turn out to harm Republicans. The New York Times, in an editorial describing the harm which Trump’s actions will do, concluded in noting the possible public opinion backlash:

And then there is public opinion. It punished the Republicans severely in 1994 when Newt Gingrich and his allies tried to roll back environmental laws. It punished them again in 2008 after eight years of denialism and prevarication on climate change under George W. Bush and his fossil fuel acolyte, Dick Cheney. There is time enough before Mr. Trump’s ignorance translates into actual policy for the public to make its opposition to this anti-science agenda felt again.

It is possible that the Democrats might benefit from Trump’s unpopularity regardless of what they do, but it must also be kept in mind that the Democrats did lose to Trump in 2016 despite all the blunders from Trump during his campaign. That might be written off as the consequence of the Democrats fielding a weak candidate against him, but it also must be kept in mind how the Democrats also  lost badly in 2010 and 2014 when they ran as a Republican-lite party. The Democrats need to have the courage to stand for something, giving voters a positive reason to vote for them rather than counting on dislike of Republicans to be enough.

Republicans Out Of Step With Majority On Transgender Bathroom Laws

Texas is considering following North Carolina in passing conservative legislation regarding transgender bathroom use, but Republicans remain out of step with the majority of the country in caring about which bathroom people use. Reuters reports:

Fifty-three percent of the Americans surveyed oppose laws requiring transgender people to use bathrooms that correspond to their sex at birth, according to the national poll by the Public Religion Research Institute.

The survey showed that 39 percent of respondents favored such laws, and almost one in 10 of the 2,031 adults surveyed in February by telephone had no opinion.

The issue of transgender bathroom rights has become the latest flashpoint in the long U.S. battle over lesbian, gay, bisexual and transgender rights.

Significant partisan divisions remain, the survey found. While 65 percent of Democrats and 57 percent of independents oppose laws limiting transgender bathroom rights, 59 percent of Republicans support the laws, according to the poll. Thirty-six percent of Republicans oppose them.

“This is a case where it really is Republicans kind of pulling away and being more of an outlier to the rest of the country,” said Robert P. Jones, chief executive of the Washington-based group.

Public opinion also has gone heavily against conservative Republicans on same sex marriage with  63 percent in support, increased from 52 percent in a 2013 poll. Even a majority of Republicans under the age of 50 support legal same-sex marriage.

The Republican Health Care Plan Screws Many To Help Very Few

It looks like Republicans think that America has been demanding a new health care plan which will greatly reduce the number of people who are insured, increase costs for poor and older Americans, destabilize the individual insurance market, and cut taxes for the wealthy. While waiting for the CBO scoring, the Brookings Institute has made their calculations as to how terrible the Republican health care bill is, predicting that at least 15 million people will lose health care coverage:

There is significant uncertainty about exactly how CBO will model these provisions and how it will expect the various provisions to interact with one another. Nonetheless, we conclude that CBO’s analysis will likely estimate that at least 15 million people will lose coverage under the American Health Care Act (AHCA) by the end of the ten-year scoring window. Estimates could be higher, but it’s is unlikely they will be significantly lower.

 

Many will suffer from the cuts to Medicaid. Many of those who purchase private coverage on the exchanges will suffer because of how the subsidies are restructured, based on age as opposed to income and the actual costs of insurance. The Kaiser Family Foundation has posted projections regarding this.

Medical organizations and those representing the elderly including AARP, the American Medical Association and the American Hospital Association have objected to the Republican plan. AARP issued a statement opposing the “House plan that would make changes to our current health care system, such as shortening the life of Medicare, hiking costs for those who can least afford higher insurance premiums, risking seniors’ ability to live independently, and giving tax breaks to big drug companies and health insurance companies.”

The less affluent voters who backed Trump will be hurt by the changes. Of course some people do benefit. “Nearly everyone in the Top 1%, who earn more than $774,000 a year, would enjoy a hefty tax cut, averaging $33,000, according to the non-partisan Tax Policy Center. Those in the Top 0.1% would get an average tax cut of about $197,000.” Insurance companies also benefit:

Obamacare allowed insurance companies to deduct only $500,000 of their executives’ pay as a business expense. The GOP bill would repeal that limitation, starting in 2018.

Top insurers pay their leaders millions in compensation every year so this provision could mean a nice tax savings for the companies.

One excuse given by Republicans for repealing Obamacare is the increased cost of premiums. However, most people receive health care coverage through either government programs or employer programs, which have not had major increases in premiums. The individual market had frequent jumps in premiums, and that has continued, except under Obamacare most people receive subsidies to help cover this. As a consequence, only about three percent of the country is actually facing the increases in premiums which Republicans are using to justify their plan. In return, we receive more comprehensive coverage which cannot be denied based upon medical problems.

As one of the three percent who purchases health insurance without qualifying for subsidies, I certainly do not see the Republicans as doing me any favors. My premiums will be higher under the Republican plan than they are now, and the even bigger problem is that the plan may “threaten the stability of the individual market” per the Brookings report, possibly making it impossible to obtain coverage.

 

Discussing Obamacare Replacement With A Republican Congressman

House Republicans have finally released their plan to replace Obamacare. I have a lot of concerns about the plan, such as whether the tax credits will be sufficient for low income families to afford health insurance, and their attack on Planned Parenthood.

I am going to wait until I have a chance to look at the details of the plan to discuss it in depth, but for other reasons I have found it a good day to blog about health care. Hours prior to the release of the plan, I met with my conservative Republican Congressman, Bill Huizenga, along with a few colleagues, to discuss health care. I figured it would be futile to change the mindset of a conservative Republican, but when I received the invitation I also thought I should make the attempt to try to explain how health care really works. After all, there is zero chance of changing anyone’s mind if no attempt is made to persuade them. I was also appreciative that he was willing to meet with a group which strongly disagreed with him on the issue, while many Republicans around the country are reportedly hiding from their constituents.

The first time I spoke today I made a point of explaining how I am self-employed and have purchased health care on the individual market for my entire life. Therefore I could definitely state that high premiums and high out of pocket expenses, often cited as a failing of the Affordable Care Act by Republican, have always been a characteristic of the individual market–and are not something created by Obamacare.

Discussion got bogged down for quite a while over philosophical issues, especially when someone referred to health care as a right. Congressman Huizenga disagreed. While I managed to get out most of what I wanted to say today, in a conversation with multiple people present, sometimes the topic changed before I got a chance to speak. I didn’t get a chance until after the meeting while speaking to a colleague that I can understand a Republican’s position in not seeing health care as a Constitutional right in the same way as civil liberties specifically expressed in the First Amendment. After all, the Founding Fathers would have never conceived of health care being as expansive, and expensive, as it is now. However, regardless of whether you want to call it a right, access to affordable health care is both highly desirable, and something which is expected in a modern, advanced, industrialized society such as the United States. We should do it regardless of whether you want to label it a right.

The limited nature of assured coverage in the United States, compared to the rest of the world, was an underlying thought in many of our comments. It did come up that 1) the sick can show up to the Emergency Room and will not be turned away and 2) a significant portion of the Medicare population consists of the disabled. In typical Republican dodging of the issue, the Congressman at one point tried to claim that this does provide some form of basic health care as people can go to the Emergency Room. I pointed out that it is one thing to receive coverage in the Emergency Room, but this does not mean that people will receive necessary follow up medical care, especially for the types of chronic medical conditions I typically treat, such as diabetes, heart failure, and emphysema. Initial stabilization in an Emergency Room is both costly and not adequate health care. Plus an Emergency Room physician present pointed out that being seen does not mean patients do not receive large bills, which could be well beyond their ability to pay.

Congressman Huizenga responded that the disabled can receive coverage on Medicare, but I pointed out that people with chronic medical problems are not necessarily disabled, especially if they receive adequate medical treatment. Someone with diabetes, for example, can live and work for many years with the condition. However, without adequate care, twenty years down the road they are far more likely to develop problems such as heart attacks, strokes, and renal failure.

The Congressman’s philosophy on limited government (which, like most Republicans, is terribly selective, ignoring everything from infringements on reproductive rights to today’s revised anti-Muslim travel ban), also influenced his responses. Before his arrival I had discussed with others how market solutions have not worked well, with insurance companies having developed a business strategy based upon collecting premiums and then finding ways to deny care. Congressman Huizenga brought up irrelevant matters such as restrictions on choice present in Canada and other countries which Americans might not tolerate. The typical Republican scare stories. My response was simply that we do not have to adopt the restrictions which he mentioned, regardless of what other countries have done. One point I did not manage to get in was that in the United States, private insurance plans are often far more restrictive on the choices which patients and physicians can make than the government Medicare program is.

The physicians present generally saw Obamacare as an improvement over the previous system, but not going far enough, with Medicare for All being seen as a preferable solution. As a couple of us discussed afterwards, this is a far easier sell for physicians, who see first hand the amount of time and money wasted in having to deal with multiple different insurance companies, with  multiple different sets of rules. Plus this has the huge advantage of taking the astronomical profits received by the insurance industry, and using that money to actually provide health care. (Medicare for All was promoted by Bernie Sanders in the 2016 nomination battle, leading to politically-based opposition from Hillary Clinton.)

If Medicare for All is too hard a sell immediately, I, and others, suggested phasing it in. I also mentioned ideas such as the public option and the Medicare buy-in which were considered when the ACA was being written, but died when the two most conservative Senators voting with the Democrats (Joe Lieberman and Ben Nelson) opposed the ideas. Either would help with the high costs on the individual market.

The  higher cost for caring for older individuals, with some of that cost spread to the premiums of younger purchasers, is a major problem in health care coverage.  I doubt insurance companies even want to cover their older customers, who are responsible for the bulk of their costs. Either outright lower the Medicare age (even if gradually, such as initially to 50 or 55, and ultimately to around 40) or allow a Medicare buy-in.

After the Congressman left, his Legislative Director remained for a brief time and suggested that Americans would not go for expanding a government program such as Medicare. While a typical Republican thought, it does not hold up. I pointed out that we all do wind up on a government program, with most people going on Medicare at age 65. Not only are Americans failing to rebel at the though of going on Medicare at age 65, many look forward to the opportunity. Remember all those tea party protests with signs like “Keep Government Out Of My Medicare.”

My parting comment to Congressman Huizenga before he left was that Republicans must move beyond their anti-Obama rhetoric and actually address the problem. I related how for the past eight years I have often heard patients blame Obama for anything wrong with the health care system, even if it was over matters not even related to the Affordable Care Act. However, in early January, before Donald Trump even took office, I started to hear patients blame Trump for their healthcare problems. Republicans now “own” healthcare and must deliver.

I have my doubts as to whether the plan released today does deliver, but I do want to take a look at the details beyond what is in the initial news stories I have read.

Opposition To Trump Could Cost Republicans Control Of Congress

I have said many times that the party winning the 2016 presidential election would very likely suffer for it, considering how flawed and unpopular both candidates were. If Hillary Clinton had won, most likely we would see Democrats lose further seats in Congress and the state legislatures in 2018 and 2020. Opposition to Donald Trump should help the Democrats, especially with Hillary Clinton not on the ballot. The elections will largely be a referendum on Donald Trump. Will Jordan recently showed that historically a president with an approval rating as low as Trump’s typically  loses thirty-nine House seats, with the Democrats needing twenty-four votes to retake the House. Larry Sabato had similar findings:

History is on the Democrats’ side: The president’s party has lost ground in the House in 36 of 39 midterms since the Civil War. The average loss is 33 seats, a shift in seats that would flip the House next year. Unpopular presidents can galvanize the opposition — and Democrats already seem highly engaged in battling Trump — and President Trump’s approval rating is already underwater in some polls, meaning he hasn’t had much of a honeymoon. Of course, there’s plenty of time for that to change, both positively and negatively for the president.

While it is far too early to be certain that Trump’s approval rating will remain at its currently low levels, there is considerable cause for concern among Republican House members. This is exacerbated by the complaints many are seeing from their constituents. CNN has reported on the anger at Republican town halls and  The Washington Post reports that Swarming crowds and hostile questions are the new normal at GOP town halls:

Republicans in deep-red congressional districts spent the week navigating massive crowds and hostile questions at their town hall meetings — an early indication of how progressive opposition movements are mobilizing against the agenda of the GOP and President Trump.

Angry constituents swarmed events held by Reps. Jason Chaffetz (Utah), Diane Black (Tenn.), Justin Amash (Mich.) and Tom McClintock (Calif.). They filled the rooms that had been reserved for them; in Utah and Tennessee, scores of activists were locked out. Voters pressed members of Congress on their plans to repeal the Affordable Care Act, on the still-controversial confirmation of Education Secretary Betsy DeVos and even on a low-profile vote to disband an election commission created after 2000.

House Republicans had watched footage earlier this week of McClintock’s raucous town hall in northern California and his police-assisted exit — a warning of what might come. And with Congress scheduled for a week-long recess and a raft of additional town halls starting Feb. 18, the warning may have been warranted…

Remembering how voter anger and heated town halls helped end Democratic control of Congress in 2010, Republicans have begun taking security precautions. Some have avoided in-person town halls, holding forums on Facebook or by telephone instead. Many were briefed on security recommendations for public events and their district offices at a closed-door meeting led by Rep. Dave Reichert (R-Wash.), a former county sheriff.

If the Democrats are to retake Congress, it will depend on Trump’s popularity remaining low. Pollsters such as Mark Blumenthal are looking at both whether it is likely to remain low, and how low it can go:

One striking characteristic of Trump’s initial job rating is the relative intensity of disapproval. In our most recent full week of tracking, for example, far more Americans strongly disapprove of the way Trump is handling his job (41 percent) than strongly approve (29 percent). That gap means that Trump’s overall 46 percent approval rating includes 17 percent who only “somewhat approve” of his performance…

One of the themes of new administration, as the NBC News Politics team recently noted, is how “Trump picks fights with, well, almost anyone.” Those stories help reinforce the perception of his toughness and outspokenness.

The downside of these “sprays of attack,” as CNN’s Jake Tapper called them, are the “sprays of falsehoods coming from the White House” that accompany them. These controversies help further reinforce negative perceptions about Trump’s honesty forged during the campaign.

A second theme has been the flurry of initial executive actions that helped drive the sense, especially among Republicans, that Trump can get things done. But note that relative softness in perceptions of effectiveness among Trump’s least committed supporters. As the NBC Politics team points out, executive actions aside, the Trump team has made little progress so far on his “big ticket agenda items (Obamacare repeal and replace, tax relief, paying for that border wall).”

Again, it is very early in the Trump presidency and the long term trends in his approval rating will be influenced by the direction of economy and by war, peace and scandal, or the lack thereof. However, if the initial flurry of executive action gives way to gridlock and legislative stagnation, perceptions of Trump’s ability to “get things done” may atrophy, and with it, his overall approval rating.

We don’t know where Trump’s approval rating will be in 2018 and 2020. There are many factors beyond the actual actions of the president, and if the country is doing well despite Trump’s actions, the Republicans will benefit. However, the first three weeks of Trump’s presidency give Republicans a lot to worry about.

Trump Screws Up Obamacare So He Can Falsely Call It A Failure

The White House has pulled ads to promote signing up for coverage under Obamacare, including ads already paid for. If the goal is to provide more affordable coverage, this is counterproductive. Younger, healthier people tend to put off signing up, and are among the last to enroll each year. Having more healthy people sign up for coverage leads to lower insurance premiums.

Of course if the goal is to call Obamacare a failure, then this was a smart move by Trump. The higher premiums are, the easier it is to criticize the plan.

What Donald Trump might not even understand is that the Affordable Care Act did not bring about insurance with high premiums, along with high deductibles and copays. Insurance on the individual market has always been like this for those of use who purchase our own insurance, as opposed to receiving insurance through employers or government plans. The difference is that, prior to Obamacare, people could purchase expensive, high deductible plans and then lose their coverage if they got sick. If they already had preexisting medical conditions, they would often be denied coverage, or have the reasons they need health care coverage be excluded from the plan. These problems no longer exist under the Affordable Care Act.

Republicans are meeting to discuss health care, with a goal of introducing legislation by late March for an alternative program. While President Trump and Republican Congressional leaders are talking about a quick repeal of Obamacare, The Washington Post reports that, behind closed doors, many Republicans are expressing concerns:

Republican lawmakers aired sharp concerns about their party’s quick push to repeal the Affordable Care Act inside a closed-door meeting Thursday, according to a recording of the session obtained by The Washington Post.

The recording reveals a GOP that appears to be filled with doubts about how to make good on a long-standing promise to get rid of Obamacare without explicit guidance from President Trump or his administration.

Senators and House members expressed a range of concerns about the task ahead: how to prepare a replacement plan that can be ready to launch at the time of repeal; how to avoid deep damage to the health insurance market; how to keep premiums affordable for middle-class families; even how to avoid the political consequences of defunding Planned Parenthood, the women’s health-care organization, as many Republicans hope to do with the repeal of the ACA.

In a survey conducted by The New England Journal of Medicine, most primary care physicians preferred making improvements to the Affordable Care Act and opposed repeal. Improvements supported by physicians included creating a public option similar to Medicare to compete with private plans, providing tax credits to people eligible for Medicaid to purchase private plans, and increasing the use of health savings accounts. There was less support for some good ideas such as expanding Medicare coverage to those 55 to 64 years of age. There was also less support for two of the ideas promoted by Republicans, shifting even more costs to consumers and reducing regulations on insurance companies by allowing them to sell insurance over state lines. (From or dealings with insurance companies, doctors know that they cannot be trusted, and regulation is needed.) From the report:

We found that in response to the question, “What would you like to see the federal policy makers do with the Affordable Care Act?,” 15.1% of PCPs indicated that they wanted the ACA to be repealed in its entirety. Responses varied according to the physicians’ self-reported political party affiliation; no Democrats wanted to see the ACA repealed, whereas 32.4% of Republicans did. Among physicians who reported voting for Trump, only 37.9% wanted the ACA repealed in its entirety. PCPs were less likely than the general public to want the law repealed. A Kaiser Family Foundation poll conducted after the election that used a question and response options similar to those in our survey showed that 26% of the general public wants the law repealed in its entirety

When asked about aspects of the ACA as it currently exists, the physicians we surveyed almost universally supported the insurance-market regulations that prohibit insurance companies from denying coverage or charging higher prices on the basis of preexisting conditions (95.1% stated that the prohibition was “very important” or “somewhat important” for improving the health of the U.S. population). There was also strong support for other key provisions of the law, including allowing young adults to remain on their parents’ insurance plan until 26 years of age (87.6%), providing tax credits to small businesses (90.8%) and tax subsidies to individuals (75.2%), and expanding Medicaid (72.9%). A lower proportion — just under half — favored the tax penalty for individuals who do not purchase insurance (49.5%)…

Although only 15% of PCPs want the ACA repealed, nearly three quarters (73.8%) favor making changes to the law. Physicians responded most favorably to policy proposals that might increase choice for consumers, such as creating a public option resembling Medicare to compete with private plans, providing tax credits to allow people who are eligible for Medicaid to purchase private health insurance, and increasing the use of health savings accounts. PCP Survey Responses Regarding Potential Health Reform.). Physicians responded most negatively to policies that would shift more costs to consumers through high-deductible health plans. Less than half were in favor of proposals to decrease insurance-market regulations (by allowing insurance companies to sell across state lines), require states to expand Medicaid, or expand Medicare to adults 55 to 64 years of age.

Republican Attempts To End Obamacare May Have Died

As I’ve discussed previously, Republican plans to repeal Obamacare are not going well for them. Donald Trump is still talking about immediate repeal, while having no idea what is actually going on. Repeal might not be possible as more Senators, in addition to those mentioned in the previous post, are jumping ship.  Jonathan Chait writes that their plans to destroy Obamacare may have died, reporting that additional Republican Senators are now pushing to include a replacement plan with legislation to repeal Obamacare.

Over in the House, Paul Ryan is also talking vaguely about including portions of a new plan in the repeal legislation.

Including a replacement plan could very well kill off any Republican plans to repeal Obamacare. From a public relations stand point, they will have difficulty obtaining public support for a health plan which does not include popular components of the Affordable Care Act. Politico confirmed this in a new poll:

Voters want — and expect — President-elect Donald Trump and the GOP-controlled Congress to repeal the 2010 health care law, according to a new POLITICO/Morning Consult poll released Tuesday, but they are skeptical of repeal without a plan to replace Obamacare and some of its most popular elements…

Testing eight separate elements of the law, more voters want to keep each of the eight provisions than want to repeal them, in some cases by overwhelming margins.

Nearly two-thirds of voters, 66 percent, favor keeping a provision that prohibits insurance companies from denying coverage to patients with pre-existing conditions. Sixty-three percent of voters want to keep the requirement that insurance companies allow policyholders to keep their children on their plans until age 26. Fifty-six percent think subsidies for low-income Americans to buy insurance should stay, and the same percentage wants to keep federal funding for states to expand their Medicaid programs.

A 55-percent majority also wants to keep the requirement that businesses and companies with more than 50 full-time employees offer health insurance to those employees, while only 27 percent want that provision repealed. Many Republicans say that requirement has led businesses to slash jobs and hours to avoid hitting that threshold.

And 53 percent of voters want to keep requiring insurance companies to cover prescription birth control, while just three-in-10 want that requirement repealed. (The Supreme Court ruled in 2014 that employers may exclude contraceptive coverage for their employees if it violates the employers’ religious beliefs.)

Pluralities of voters also want to keep two other provisions of the law, though by narrower margins: 46 percent want to keep the elimination of lifetime and annual limits on health reimbursement to individuals, while 32 percent want that repealed. And 33 percent of voters want to repeal the long-derided medical-device tax, compared to 37 percent who want to keep it.

The most-popular elements of the law are also well-regarded by Republicans. Sixty-three percent of Republicans want Trump and Congress to keep the prohibition on denying coverage to those with pre-existing conditions, and 56 percent want to retain requiring insurance companies to allow the children of policyholders to stay on their plans until age 26.

In other words, as has been the case all along, the public opposes Obamacare by name but supports its components when asked.

Besides the public relations issues, the repeal of Obamacare might be dead due to Senate rules. The Senate can repeal Obamacare as part of a budget resolution with a simple majority, but a bill which repeals Obamacare and establishes a replacement program can be blocked with a filibuster if it lacks sixty votes. If Republicans cannot get a simple majority for repeal now, they could wind up with a choice of continuing Obamacare or only replacing it with a plan which can obtain bipartisan support. Such a plan will very likely be much like Obamacare, even if under a different name.

Republicans Might Lack Votes In Senate To Repeal Obamacare

As I discussed earlier in the week, it was far easier for Republicans to vote to repeal Obamacare when it would be blocked by a filibuster or veto. Republicans might not have the votes in the Senate for repeal. The plan was to repeal the Affordable Care Act through budget reconciliation, where only a simple majority is necessary, with promises to replace it with something else in the future. The absurdity of that is obvious to pretty much everyone who is not a Republican.

The Republicans might not be able to achieve even a simple majority to repeal Obamacare. Now four Republicans, Rand Paul, Bob Corker, Tom Cotton, and Susan Collins are now showing skepticism towards the plan. Susan Collins also opposes the plans to defund Planned Parenthood.

Bloomberg reports that it is unclear how this will play out:

Only one of the senators — Rand Paul of Kentucky — has so far said he plans to vote against the procedural gambit that sets up Obamacare repeal, citing unrelated budget concerns. Paul and three others are concerned that Republicans haven’t said yet how they would replace the health insurance scheme after repeal, with one of them also opposing the plan to defund Planned Parenthood as part of the repeal.

The skeptics could end up yielding to pressure from their colleagues to support the plan when it reaches the Senate floor, but Republicans can only afford to lose two senators. If they lose a third, the effort would stall, and they’d be forced to return to the drawing board. Such a delay would be an embarrassing setback for Republicans, given the intense pressure from conservatives and the Trump team to speed this through.

One problem faced by the Affordable Care Act is that, with lack of Republican cooperation, it was rarely possible to pass further legislation to make adjustments, which a program this massive would normally receive. The ideal situation would be if Republicans fail to defund Obamacare and are forced to take ownership of health care policy, leading them to work in a bipartisan manner with Democrats to pass an improved plan. Unfortunately we cannot count on the Republicans acting in such a reasonable manner.

GOP Convention Day One: Plagiarism, Horrors, Nude Protests, Stephen Colbert & Jon Stewart

The first day of the convention did not go well for Republicans between having to put down an attempted anti-Trump revolt, poor scheduling, and Melania Trump’s speech plagiarizing even more blatantly from Michelle Obama than Hillary Clinton has taken ideas from Bernie Sanders. It is quite clear from the video above that portions were too similar to be coincidence. I wonder if whoever wrote this speech had studied at Trump University.

Melania also appeared to Rickroll the audience.

Actually the plagiarism might be a good thing. I see the Trump campaign as being more about ego than ideology. The more ideas they steal from the Obamas, the better.

While this probably won’t affect many votes, it is just another example of how Trump does not seem prepared to run a major presidential election campaign (or be president). Other mistakes included having Melania speak before 11 pm eastern time, leading to many people leaving the convention hall, and probably turning off their television, before the final speakers of the evening.

Giuliani Speech

Melania was preceded by speakers including Rudy Giuliani. Giuliani was terrifying to listen to, and it was even worse in the original German. Maybe they knew what they were doing here. After this, Donald Trump will look sane. While Giuliani looked rabid, Donald Trump made his entrance (to introduce Melania) with his version of an imitation of God:

Trump Convention Entrance

Besides Rudy Guiliani, it was a big night for war mongers, making it feel like Hillary Clinton should have been the keynote speaker. Of course she was mentioned frequently. While the Republicans did a poor job of raising her real faults, they did exploit the suffering of the mother of one of those killed at Benghazi, while remaining loose with the facts.

Other Republicans were on-message for interviews. For example see Steve King explain in the video above how whites are the master race. The Republican world view explained briefly.

GOP Nude Protest 1

There were protests outside, including one hundred naked women greeting Donald Trump:

For Cathy Scott, a Republican, being here is a message directly aimed at her party’s presumptive nominee.

“Donald Trump has said so many outrageous, hateful, inflammatory things,” Scott says. “He underestimated his female, Republican vote. I feel like he shot himself in the foot a little bit. I don’t think he knows there’s a black, single, 35-year-old mom, like me, who is listening to what he’s saying. I don’t think he knows I’m in his political party—and that’s unfortunate.”

GOP Nude Protest 2

Monica Giorgio, a 19-year-old nursing student who came straight from the night shift still wearing her teal scrubs, adds: “Because of his negative views on women. I think this is a great way to contrast that.”

“For me, it’s less about Trump and more about creating positive energy around the RNC and to create light where there maybe isn’t as much,” says Sabrina Paskewitz, 23, a student who’s done nude modeling.

Stephen Colbert turned to Jon Stewart to try to figure out how Donald Trump could be the Republican nominee.

Colbert revived a segment from his previous show, The Word, to explain Trumpiness.

Colbert also took his Hungry for Power Games character to the site of the GOP convention.