DiscoverVox's The WeedsDon't Call It a State of the Union

Don't Call It a State of the Union

Update: 2017-03-01


Sarah, Ezra, and Matt try to discuss Donald Trump's address to a joint session of congress through the lens of actual policy.

Following script is auto-generated by Speech to Text Technology:

we sponsor many great courses plus get your first full month free by going to the great courses plus that complex weeds sponsored by Hewlett sleep but Helix leap that complex weeds fifty dollars off your first order and see how good he said a calm right now is to promote weeds for free month of amazing the following podcast contains explicit language piece of pop and I think it's uh I think it's time for more aid to assert the Hello and welcome to another episode of the weeds boxes policy podcast apparently network I met you guys his term by Sara Clifton Ezra Klein so nice to not be able to see you all it's great it's great to be here behind the walls and microphone that I don't think cameras her thing and overlapped sort of format today's the morning after Donald Trump's for some reason you don't call it a state the union in the first during If you why that is anyone going now it's Matt something up yet because it's big news so my tradition you don't give a state OF THE Union I'm your first year because you haven't been presidency can update people on the state of the Union Some president a few presidents ago said he liked wanted to do a speech in that same time of year and said it was going to be his budget message and subsequent presidents have also enjoyed the opportunity to do the speech but it turns out is really fucking hard to actually get your budget together by late February the first time I do not remember which would be a good weaves fact and I so I don't sometime we seem to be dropping the pretense he has not gotten this budget thing together which is honestly fine it's hard it would be better to do it well this is like that instead of the budget speech speech speech showing that he got a speech together he gave a speech to put it on to tell the park later about that like speech response in the media because it's interesting and I think a little bit curious but first I think we're going to just play it straight unlike talk about what Trump said in the speech policy is that Donald Trump administration as explained by Donald Trump health care seems like it had seemed to me more substantive than the other sections of the speech yeah I I think I was a bit of an outlier here but I actually consider this like the most substantive health care plan doesn't put forward by the company's vision to date like that does not say much like there was no plan before this but it's like it's a lot more substantive than anything we saw from his campaign like any really just lays out some core principles of where the administration is that that hadn't been done before before the speech that being said I don't think it gives like a ton more guidance what the executive wants it doesn't say like ok Paul Ryan that here's how to move forward but it basically says like Trump is on board with with where congressional leaders are or that he's like in the same ballpark so he does a five point plan and I think the three point three first ones were the most important one so his first birdie said protecting people with preexisting conditions making sure they have access to health insurance what this sounds alot like is that something we've seen from congressional Republicans idea that everyone should be able to buy insurance or car this be a priest in condition but you might let some people be charged more if they don't maintain continuous coverage I think is really notable his word choice he didn't say insurers can't discriminate against people with pre existing conditions he said people with existing conditions of access health insurance I think there's a significant word choice and wording that would've been different and you wanted to spend a moment how that's working the bills and you can correct me if I'm wrong but the sort of pre Obamacare status quo and ensure a casino but isn't that the price villager can do is charge two hundred and fifty percent of the normal price yes so busy the idea is that Republicans need some way to encourage sick people or to encourage healthy people to buy health insurance Obamacare as the individual mandate ever hits the individual mandate Republicans come with this idea called continuous coverage where as long you maintain continuous coverage you from jobs individual market to medicate whatever as long as you are always covered insurers cannot charge you more because of preexisting condition however view a break in coverage really the leaked draft says If you've more than a sixty three day break in coverage trust is something about getting past two months I don't really understand at the view was sixty three day break in coverage insurance companies can charge you one hundred and thirty percent of the standard premium if they liked it when they could do that for an entire year before you can get back to the normal rate on your red as are the price winners hundred and fifty they've gone down a little bit which I think is interesting but basically that's the idea they're kind of combining the pre existing protections with the individual mandate into this continuous coverage provision has signed a standard the standard rate is the stand is the listed price for any insurance plan yes no underwriting know ask questions about how the are those kind of part one Part two it was interesting argument most controversial part the health care plan is where he and or city of a tax credit he said that people should get a tax credit to help purchase insurance and this is something is actually dividing Republicans right now we see like a pretty sharp blinding drawn between someone like Paul Ryan news kind of more moderate at least on this issue the Freedom Caucus someone like Mark Meadows R who does not want any sort of tax credit so I think Republicans generally agreed the tax cuts should not be as generous as the Affordable Care Act they disagree on whether there should be any tax credit also is notable to me that Trump said the guests to tax credits it seems like he is choosing a side on the debate isn't the only thing he really did there that I thought I guess Medicaid I love that he was about was notable that he kind of came down on the side of tax credits in the third part is I plan plan and that was notable was a little plank on Medicaid where he said I'm your governor said flexibility was frolicking on to block grants and is that I believe the exact phrasing but is something like no one should be left behind which seemed sort of like a nod to keeping Medicaid expansion but it felt a little bit in tension with like the nod to block grants a bit earlier but if he was a mention of like we are cognizant of this very large Medicaid population we are cognizant of the meeting we have junk is a sadder day like we understand the population matters and I think you have this all together and turn over us or because you wrote about this yesterday and really shows like the baseline of American health policy shift day I would erode as Ray without the AC eighty really to have a Republican president come into office in his first major speeches thing he suggests is a health care plan with tax credits protections are pre existing conditions and no one being left behind and Medicaid but that is much more liberal than where Republicans would have been before the health care law this is this speech showed an Obamacare world Republicans just living and the couple thing something or saying you're so into reactions to it I think it's interesting that both you and I have come down on the side of what he said on health care is pretty consequential there's also been a reaction which I don't think is wrong some healthcare was bake and both these things are simultaneously true so what I think is really important about what he did on health care is if you rewind the clock just really a month a month and half back there it was almost no there was no agreement and no clear signal from the White House even what the path would be forward with the repeal and delay their band conflicting statements of the White House conflicting statements out of Congress would they have health care plan that had totally wiped out Medicaid in the House Freedom Caucus they say that if you do not completely reverse the Medicaid expansion they will oppose a bill that is also currently the position so now Trump is on the left or the House Freedom Caucus significantly tax credits as you know our big open question here I will not something that I did not catch on the first run around but it is worth noting a secondary find in tax credits are whether they're refundable or not right now in the leaked GOP draft they're refundable I think if you listen to the rhetoric of Trump they would not be able to survive what he is said and make these credits non refundable given the coverage does that are from Grandpa Lowe's today about how well he didn't they're fun of all I have the same I think these are refundable I think the thing which was basically saying that he is more or less on board for what the House GOP is looking at and where it's going to go from here which I think in order to get to the Senate will have to be a lot more liberal as you actually got these leaked documents that the plan as currently structured reply create thirty to fifty percent individual market coverage drop which are not going to be able to do not knock in what they said but the other thing all the different is even one sec the other thing though that I do think is fascinating is this really to me showed just how much Obamacare is setting the terms that it has really changed them forever so you now have a debate on healthcare which a couple of years ago there have always been Republican health care ideas floating around and in fact a bomb because based on a lot of them like Mitt Romney's ideas Massachusetts but the Republican Party has never in any serious way prioritized a coverage expansion or any kind of significant expansion of health care coverage outside of maybe the Medicare Part D expansion under George W Bus and what you're seeing now is a sort of a new reality for Republicans and which the argument is not over whether it should be the government's job to be funding health insurance for able bodied healthy and young people but how it should be doing that and Republicans arguing that that should be done to age based credits that are more universal than what Obamacare has been also a lot less generous and that the health care that goes by I should be also a lot less comprehensive should cover fewer things should be more catastrophic but theirs but that is he different vision of coverage it is not a vision that is this not have coverage included in it and similarly I am very struck and it's I met Eunice language last night that the Medicaid expansion has put down deeper roots in Republican states then certainly I expected but the degree to which now is agreed upon that even going to try some stuff to do long term costs of Medicaid and per capita block reading and I think a lot might be coming there in a lot that I will not like the degree to which the Medicaid expansion is now taking something that more or less has to be protected those people have to be protected is is striking so yeah we to the legacy of Obamacare at this point in addition to being status quo an existing law is that the Republican Party elected new president the first in the president feel like he has to do is Wade into this health care debate and it move the Republican Party along with Paul Ryan to a place for their converging in a way they happened before on a vision of how to do an expanded coverage system where as before with they're probably happy to do is have some plans floated around early not do anything and to prioritize things like tax cuts and tax reform over giving people who can't afford health insurance health insurance at a little bit of skepticism here one of the mean things a president presidential speeches can only do so much but one of the things they can do is try to align your own partisans behind the president's way of thinking why is the president's chance to explain to his own fans how he is thinking about things and how He wants you to think about things so when Barak Obama did his healthcare speech and everything was September two thousand and nine he didn't like magically conjure up mass popular support for his idea but he said okay the problem is that we have too many Americans who are uninsured another problem is that we need to shore up and protect the insurance plan that the insured majority has a third problem is that we need to bend the health care cost curve and then he started talking about some of his ideas about how to do those different things and whether you liked all of his ideas or not the ideas were all ideas that supported the vision that he had laid out and so we all communicated to Democratic partisans at home here's what is going on here it communicated to Obama as allies or may be wavering in Congress this charismatic young man who just won the White House feels this is a defensible political agenda I may want to get behind him and it left you know you're Mary Landrieu Senator Blanche Lincoln's a new Ben Nelson's were like outside the Obama number A still feeling like I'm nervous about it what Trump did in this speech to me I think far and away the most important thing to deny health care which he maintained the false pretense that the Republican Party's diagnosis of the Affordable Care Act is that has fallen short in providing Americans with a generous health insurance coverage they have said that that is their complaint with it but they are lying lying is gray and sometimes dumb has gotten really really far by lying but if you are Bill Cassidy or Susan Collins or Dean Heller or any of the other Republicans who is worrying Shelly Markham Pluto what you have been worrying about since election day is what is going to happen to me when it is exposed that we are lying to get those people on board you need to give them some kind of reassurance that you can get away with this sleight of hand standing up in front of an audience and continuing to lie doesn't do that right like the reason repeal until a already fell apart is that a critical mass of senators has realized that Paul Ryan's pitch on health care is a lie and they are nervous about going to war on the basis of that lie Trump is just doubling down on it right he's saying we're going to give everyone better coverage is going to be cheaper coverage and he's not going to do that the ideas he endorsed will not accomplish those goals it's not that like I don't think they will accomplish those goals Work Center on Budget and Policy priorities and the goal comes as was Paul Ryan doesn't think they will accomplish those goals and if you just interviewed him five years ago like he would say it right he would say that America has become a cushy hammock in which poor people are taken care of too much and what we need to do is put all of our energy behind reducing pore people's standard of living like that is the driving force of his philosophy the whole legislative framework supports that is slightly less extreme version of it is still aimed at making sure that if you have a low income in the United States of America you receive worse rather than better health insurance which is fine that is a fine idea is like very Indian vision where you know school lunch may give people food but it doesn't nourish their soul is I believe a Paul Ryan idea like that's great but it gives people food the forecast gives people health insurance what Paul Ryan wants to do is for people that less health insurance down from one up there is he said he wants people have more health insurance so they can keep spinning their wheels on this but like either they get fifty one votes for the proposition that we will tell people your insurance is going to get better but then we make it worse or else they can't and they're just like in this holding pattern seems to me and this beach and not move at all and that it was like a mild slap down of these like Looney Toon Freedom Caucus people but that's not like it all the problem movies if Obama gave a speech with the entire audience of the speech was Dennis Kucinich and I don't think that makes any sense you know so I am sleepy to do with this freedom of speech I think is seeing movement in the Republican Party and that I don't know it's for my philosophy of its term by politics is like a lot of it is political but I know I've been following these Republican plan is basically since the election A and one things that really struck me in this leaked draft that came out on Friday is these plans are getting less punitive to poor people like me go sick they're definitely worse if your pour on the Affordable Care Act is clothed with the proposed proposition of the most generous of these mines of Cassidy Collins right is that more people will get worse insurance on your definition of worst insurance so again I magically learn in terms of the Paul Ryan Donald Trump Nouveau bullshit view in which the problem with the Affordable Care Act is that the deductibles are too high and you don't have enough choice of doctors nobody is putting on the table a proposal that will make deductibles lower and will give people more choice of doctors there doing the opposite learning is great I think if you listen to the weeds you probably like to learn the public to listen to things you probably enjoy modern digital communications devices and that's why I'm a huge fan of great courses plus with my subscriptions soon fasting video lectures by award winning experts and their sponsoring the show they to discover that requires us to offer listeners a full month of free video courses to sign up using a special URL The Great courses plus dot com site we've met so many topics as formal logic which is the best kind of logic and family photography Russian history at over eight thousand the lectures more added all the time stream and want I've been watching a economic history the world have loved history courses I was in college they were very sort of political history focused and this is a different lens and I'm looking at the economy looking at this are of little economic shifts new technologies are developed new trade patterns emerge it really alters how we live and that is is what drives history a certain viewpoint it's fascinating to check our listeners get the first month free you just sign up for their special URL The Great courses plus dot com slash weeds get free monthly journal of the Senate today The Great courses plus complex weaves its The Great courses plus com slash weeks one of the things I talked alot about Obamacare been running these focus groups at the research firm the past few days and I have become a more sympathetic to a lot of people we did one the people who are uninsured right now people who are just not able to afford the premiums are mostly Clinton voters in one of the things there are actual affordability issues that the Affordable Care Act or a significant number of people who can't afford health insurance and you know we've talked to them about I think they're number one choice words the more subsidies to get a generous plan but their number to trace would be at least some kind of coverage they could afford them I think I've become talking to Obama can roll these more sympathetic than I was earlier to allowing skin care plans signed the health insurance market because you do have some people were just locks out right now by the benefit package I know this is like but don't Trump say that his plan so I I think this is actually a place where Donald Trump is in the past whose love language that when exactly the direction you're talking about last night did not last night he used the very sort of weasel easy but very specific we're going to make sure everybody has access to health care we're going to make everybody a health care by making health care cheaper if you read that it sort of like which usually can't do with Trump because he usually doesn't know how to do this but here are some he was like Tom Price who had a hand in a speech he said and was pretty clear that we are going of takedown Insurance regulation so that your going to be able to get cheaper plans the the the time has come to give Americans the freedom to purchase health insurance across state lines will create a truly competitive market place that will bring cost way down and provide far better care so important it is true that with my want glasses on I understand that what he means by that is we're de regulating the insurance industry so people can get worse so I think hers says is that they will provide not just slightly better care not equivalent care far better keep your is no so if you are somebody so I actually do not very much want to be in the position of defending the speech but I'll so I also think that you are you're not giving credence to what are actually some of the legitimate reasons of stuff is powerful the affordable care is often not great for you if you are thirty three and you make forty seven thousand dollars a year and they're coming up with an idea that will give you a larger subsidy because they traded its age based you will get potentially cheaper plan because he trading will fall and so for some people they're going to be winners and they're also going to be loses and also I don't think this will pass which is where I'd like to take it next but I actually agree with you in the broad case they are not resolving contradictions that they cannot get where they're going but they're also coming up with a vision of healthcare and says read about the salon she's going about it I think correctly that what they're saying is that they would like to more advantage younger healthier folks who want more catastrophic care who won on cheaper plan to want to be able to buy a plan that California would allow itself to Koda would get once in the speech the the make health insurance to everyone is to lower the costs of health insurance and that is what we are going to do the I'm not sure that we are really disagreeing sharply on this I don't think anybody argues he made a stirring case for an alternative vision of healthcare but he laid out was a different vision of health care what he did to signal I mean right now piecing the House Republicans I'm in a back what you're doing I got was a signal that had not existed before like there's no I don't think it is is reasonable now this doesn't just need fifty one votes and sixty I don't see where this goes from here because if you do not see what can pass the House that is not too conservative they can even get fifty one in the Senate much less get the sixties because this is a vision of health care based on differently regulating the insurance market and you can't do that a reconciliation yeah I I if this was and is a weird thing to like hold both ideas and I had that like I'm really convinced they're going to do this and I see no possible to have to do is doing this but that's kind of where I'm at right now you know the planet because of rain last night as are the This plan is is getting liberal as they have these townhomes as they hear from people who talk about losing their health insurance is a hero like their old fart constituents who I really like their generous subsidies day you seen the new draft of the plan kind of reacting to that news in the backlash on the conservative side saying this is all we want we want to make a batch like original Paul Ryan likes to go back to class subsidies are no subsidies and I certainly don't see any Democrats getting on board that there's no discussion of getting some centrist Democrats on board because why would they possibly I cannot see maybe you guys can but I cannot take a political rationale of year like a moderate Democrat to really get on board with us like why why do this I was in the one moment I think things can actually change in the nearest future it is that insurance plans are going to have to do in spring I think it's April or May are going after like say Yes I want to sell Obamacare no I don't and one of things ought not shock me if it happen is if we just saw like a mass Exodus to the marketplaces and that like basically forces the Democrats plan to enter the spine different ways by both parties the Democrats as they were looking class the market Republicans say Obama cares collapsing in any case one eclipsing health insurance Marquette and that will be the mechanism that forces change because you can blame everyone but at that point Obamacare has become unsustainable rates are skyrocketing some people can't get insurance to the marketplace that seems like to me the most plausible catalyst for moving this forward but that sounds to me like it's going to actually harden Democrats' hearts right leg room you know not having been president for a month having already received his rave reviews oh his presidential now when insurance marketplaces start collapsing as it is a total chump got a big problem with your collapsing insurance marketplaces here's our bill for public option here's ability increase subsidies here's this year's that here's the other thing then you still going to have Freedom Caucus people who are like knowing I can do you know you're just like you did the latter it's Trump is not taking this seriously but what if you like millions of people in a situation where they just can't get the tax credits and there's no health dangers of falling that's terrible I couldn't demagogue or the illegal your problem no Democrats are going to put forward in good faith what they believe would make health insurance in America better like the ideas drawn from Hillary Clinton's campaign ideas that were left on on that timetable I mean and maybe you know there's what this forty eight Democrats in the Senate so you might find for five or six who think that the best solution is to move health care policy to the right but most of them think you should move policy to laugh I think the question I agree that this is going to be the big question and I think the issues or stabilization plan because if you go back to Brock Obama version of this address on the eight years ago now he comes out in the first thing he says is I'm not the first president to do this but I want to be the last obviously he was not the best but the thing that usually happens when presidents try to reform the healthcare system is it just fail I think Obama has sort of put our heads alike well they get it done somehow re likely grind it out and you finally pass it and it happens on Christmas Day I think it's just a really significant chance that it's incredibly difficult to get something out of the house and they just can't afford in the Senate also and then there's this collapsing market problem and they have to come up with some kind of patch but I don't know that I think Democrats would work with them on a patch I don't think they would work with them they would have to just come up with something that is so different from the Ryan plan that I just don't see how you get support among House Republicans for it I have trouble getting out the politics of the stake if you're a Democrat from a state like but thats am of Earl state that that doesn't have a carrier marketplace said Like your choices are between like supporting some Ryan seal a vision mechanisms are saying y'know I'm built like I'm going to stick to that I know it when you pick which one should Democrats do have like a desire to make they see a work in like if they felt like it was actually stabilizing they would get behind something seen the above position as today has had to do this and very small levels there's been two years where they had one county one years in Mississippi last year's Arizona insurance company want to sell and the bees or the like had to have these negotiations with insurers in like kind of begged them to get in the market and they did give them a nice proposition of like monopoly in particular market but doing that on a massive scale and doing that when you hit the Affordable Care Act that I don't know that there is a key infrastructure or stabilization makers and mechanisms are like desires to do that on a massive scale that's why I don't think Democrats will patch leaks so far every time something goes wrong you know in a marketplace in their right to Trump administration does not take responsibility and say we're doing XYZ to make it better and said they and Paul Ryan both that press releases to put a face book means to Twitter videos bragging about how this shows that they are correct right that like this Affordable Care Act is not working out so we need to take everyone's help and turns away and it is driving me serious and I think that I am not the only one after months of this if they keep deliberately trying to make it worse in order to advance their larger goal of making things even worse the idea that they're going to get some kind of bailout from Democrats like it strikes me at So you think will happen on the other end of that ABC you've set of Senate Democrats will put forward a bill that also won't pass any of this issue of Arizona has no carrier us play so well either the administration will change course and start trying to do a good job of running the United States of America in which case I think they absolutely have the ability to like make the phone calls and get people that can come or else like the people will lose their health insurance and a CA will come down to new regulations on employer sponsored market and a large Medicaid expansion and well you know fight things out in subsequent elections but like I don't think I think it's a less stable equilibrium than you do but I think deleting it is like to talk about immigration to Iran because before the speech began a bunch of I think it is
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Don't Call It a State of the Union