DiscoverVox's The WeedsLegends of the secret health care bill

Legends of the secret health care bill

Update: 2017-06-14


Sarah, Ezra, and Matt take the deepest look they can at Senate Republicans' secret health care bill, plus a quick look at Jeff Sessions’s non-answers on Russia and new research on the long-term impact of lead exposure.Links!White paper of the week from the Brookings Institution: New evidence that lead exposure increases crimeCaitlin Owens in Axios on the Senate GOP not releasing their healthcare billDylan Scott on what it would look like it Senate Republicans voted to repeal ObamacareDavid Leonhardt's New York Times piece on the half-hearted opposition to the GOP’s health care planJeff Stein's piece on the left's game plan for beating the GOP health bill9 legal experts weigh on whether or not Sessions can discuss his conversations with the presidentKevin Drum on lead's connection to violent crime and lower IQs in Mother Jones

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weeds minds of many great courses plus Santa today at The Great courses plus that time slash weeds Showtime and decode the weeds at checkout on Showtime that com to receive a special extended thirty day free trial offer expires June internet ever so that the weeds in the Box Media podcast Network come into play CS at week at Ezra Klein's hair clip but me we wanted to acknowledge at the top while recording this just is as news has been breaking of that shooting at a Congressional softball game in Alexandria Virginia It's obviously a big deal at work sort of horrifying event but also as of now we don't really know anything about it if we were to discuss it on the show it would just be idle speculation which I don't think it's really appropriate so check up box and come on the internet if you're interested in real coverage and we're going to move on with that with our regular plan and resin to the first I get home so it you that the big news of the week is sort of odd policy story because the Senate is making progress toward an Obamacare repeal bell but the bill is secret and it's been I think challenge again for journalists to give the attention to this issue that it really merits because the story isn't having that kind of like marker points of the legislative news story that we're accustomed to like there's no committee hearings there's no public debate there's no unveiling of the text and so a lot of the kind of normal news coverage isn't isn't happening but Sarah's like what what do we know what's going on yet so it's it's definitely different and much harder to cover when there's not like an actual they're there and I think senators one hundred percent recognize this there was a kid but Owens is a great health care board for at sea oats knew she'd talk to some Senate aides who said they are not planning to release the draft of this belly yes and why is that we're not stupid which is an amazingly blunt recognition of why this works in their favors I've covered you know the original AC a debate as it was covered that too I cover due to the Republican repeal or the House repeal plan just a month or two ago and now the Senate one in dual ear looks super different experiences I knew you remember as are with the original easy a debate like so many hearings I like almost like an Ikea is like another like a CA hearing a lot of fanfare around early the release of the bill was like a big deal like the Democrats one attention they wanted reporters to write about it with HCA of the house you saw him there was a release of and you know I went to was like six pm on the capital they gathered all the health care reporters that there's room I'm in the basement of one of the staff buildings had AIDS there we asked them questions and there was like an embargo sad that we could release the bell and this one it seems like there isn't going to be a draft that they want to move as quickly as possible because you and this is here from Cave in's of wearing black CEOs did you know we're not stupid we just want to like get the bailout get the CBO score have the vote and like go to our July Fourth recess is the timeline is being charted in the Senate and he knew it I understand if a political strategy point but it kind of begs the question of like why are you doing this like what is the goal of this effort that is happening my colleague Dylan sky and I'm here Fox's Bones was this time of the hill he and co authors this newsletter box care with me and he had this line inbox care that is really jumped out of me yesterday where he said at this point McConnell doesn't seem to care much about the actual policy cares about getting to the votes and this just seems like a very obvious to see a very very bad way to make policy that could have some very negative impacts on a lot of people embracing the Senate moved toward the Delta looks more and more like the hostel everyday and in Medicaid expansion less generous tax credits you at some points this will catch up with Republicans not to look at some point the bill becomes public and they vote on it and the bill becomes law but it catches up to a point when millions of people have been hurt by the consequences of passing a bill like this Oh and this is a remarkable political process in a lot of ways but one that I just think is foundational and can be under noticed it is often the case that political majorities pass laws that are somewhat unpopular despite the majority's best efforts and I think he can look at the affordable care act like this I keep thinking about the Blair House today when when Brock Obama invited Republican leadership and Democratic leadership to the Blair House for forget how long a multi hour today standing allies made over it and the foundation the premise of that political decision was that Kirk was not popular in its success was in danger of that was nearly as hot as the American health care activists but Democrats believe Obama believed it would be popular if only they had the opportunity to make the case to the public may believe that what they had was a popular bill that had been stored in the public sphere distorted in ad campaigns distorted by coverage of conflict in the media and if only Obama can argue this out and just let people listen they bind to it that it's not the Republican Party's you on this they believe as far as I can tell they have a politically indefensible bill and they do have a politically indefensible bell I mean the absolute core of the legislation true in the house film as far as you can tell from the Senate bill is to move hundreds of billions of dollars from subsidizing health insurance for the port of cutting taxes for the rich like everything else is a sideshow to what that basic change in priority and redirection of money and that is not what people want is not a popular idea and it is not something Republicans believe that if they could just get enough airtime and say no but you don't understand what we're doing is going to take health care from pour people and make a capital gains tax cut out of it that the problem is the media's not correctly reporting that wonderful party set so the theory is don't have a publicly debate don't try to make the bill more popular the latest Quinnipiac poll said that the Republican help tell which obviously is not exactly the Senate bill but this is just last week is pulling twenty percent approval which is incredibly incredibly low and their ideas get passed as quickly as possible and move on hopefully never talk about it ever can know what's going to happen when a bill like it's implemented who notes that really is the theory and theory because Republicans know that what is happening to the bill is not that it's been distorted what's happening to the bill is not the public is juz noe its nt was happening the bells that their health care parties or incredibly unpopular and they will only become worse those people understand what they are yeah I mean it's interesting how To me how fast this has boomerang back because he really did seem I'm we've discussed there's a live show but he really did seem a couple months ago way that they were a number of Senate Republicans who really wanted the bill to be in some way substantively different from the House's legislation in a way that would do a lot more to it to take care people and you know Senator that Cassidy spoke with you Sarah quite a bit Emmy did some interviews he did that event at the box conversations and the whole premise of those discussions at least it seemed to me was that the House bill really just like took a lot of money out of giving people health care and he feels like he was not on board for that idea that he wanted to do because it was like two different things that the four look at me before look at alot of things but it like put a lot more money into health insurance also wrote a ton of rules about how that money would be used and how this will be regulated so he would be perfectly possible to say OK holding this pool of resources fixed we have some other theory about how it should be divided up and the House bill is really saying no we're going to like take hundreds of billions of dollars out of the healthcare system use them for tax cuts that necessarily leaves you with way worse health care and four while it just it seemed like a bunch of Senate Republicans were on board for that idea that they thought it was a viable that their stakeholders back home in like it and then switch flat as far as like and how and why they continue to haggle of the details they're basically all seem to now be on board for the fundamental premise that what's wrong with healthcare in America is that rich people are over taxed yeah I think I mean that's like the geeky you know in the Health wonk world is like so what you can talk about this just like this question of like to fix America's health care do we need to take money out of subsidizing poor people and do a giant tax cut I think Bill Cassidy who you mentioned and Susan Collins the senator from Maine are the two over the age of six senators to watch in the space because they co authored as a bell that it essentially spends a month of money as a CA doesn't cover the taxes but just kind of changes who's getting what money to kind of promote like a more conservative vision of health care and that's like one path you could go right say like we just think the organization of this thing is wrong but the overwhelming desire is to get rid of the taxes I think they're a lot I think Estee and Collins are small minority in the Senate Republicans in wanting to keep those taxes in place and keep the money flowing towards health care and I think it's been really like the notable things to me that it happened over the past week pieces idea as are brought up the House debate of like healthcare hot potatoe I feel like I'm watching the exact same thing play out in the Senate right now where nobody really wants to be like the man or woman standing in the way overkill the passing scene seem like some more moderate senators say like Yeah I can get behind ending Medicaid expansion you know we're on a seven year time line verses three to see like on the conservative side some of the really strong anti abortion voices are saying well we can take out the anti abortion things you know if that's like the last thing in the night you get to be polite as in Collins' I haven't seen Senator Cassidy talk yet about you know if he'd support a bill that gets rid of the ACH taxes but you know it's hard to be like the guys standing in the way of the state dime Republic and repeal plan one other dynamic that's interesting to watch our college outside of Macy's on this today is how how the Left mobilize is in a situation like this where there isn't like a hearing or a town hall or like theirs and they are to mobilize against sand and how how they make sure that people are like really active on the issue I think it's a it's his struggle at this point just for the gorilla is tired of them right now people Google trends like people searching for information on this and like there's a spike in March around the house boat and there's like no changed out like you know there is he also suffered in a street yesterday with the four covers of the major newspapers like no stories about the health care debate even though that does seem to be moving pretty quickly through the Santa and I think this is Daisy liberal groups alt caught off guard with the last vote on in May it is kind of snuck up on them a little bit and it's really hard to think they're very worried about a similar situation playing out in the Senate this is one of these ways what the policy process does the pulse of us like this anyway is it forces political movements to articulate and show their bottom lines right when you're just talking just talking about what might be good health care bill people of all sorts of positions right of Kathy Collins and you have a better way and you have whatever the Tom Price bill is called you a wide bend it back in the day and then you get to this point where the movement has to create a coalition to pass something and you know we're what the real bottom line for the Republicans and it's not increase coverage and it's not um you know whatever it is not here for McCall and Cassidy are saying that they're the principals encoded in their legislation will bottom line from that maven a preference for them but not a bottom line it is get rid of Obamacare and get the money spent on subsidies in to tax cuts for wealthy people I want to keep coming back to that because I think there there's a lot of smoke screen happenings a lot of diversions lot of hay this waiver or that insurance regulation but that is fundamentally what is happening here and it's first I think it's a little bit disturbing just as a political movement or philosophy it's very funny The Donald Trump apparently the meeting with Senate Republicans called the House health bill which it previously called incredibly well crafted I think now the reporting he caught a cold blooded mean and also the bill a son of a bitch which is kind of footwear they cut a piece of legislation and said Yeah Republican contests and think about it like this bill is a means of the fatherless I was always intended to say that there's a sort of weird thing happening where they all seem to know that what they're offering up his parable is really about Mitch McConnell as you say has constructed an entire and very unusual and extremely hypocritical process for this bill of which the central Tenet is don't let anybody see don't have anybody talk about it do not have time for people to discuss it do not allow people to really offer benefits on it as they do not allow this to become of public debate and it's really really happy when one of the other dynamics is crates of the tax cuts is one thing that surprised me is like how muted response that from health care interests because like I kind of expected like hospitals have a lot to lose if I you know if millions of people whose health insurance but I think there's also a lot of people at the top of these lobbies who stand to gain from having some pretty significant tax cuts are not to be like to identify like being like too much of a conspiracy there is there did David Leonardo nice piece in The Times yesterday on this topic kind of running through UAE health care leaders know they think they expect a work of the Republican Congress or the next two years and they they also stand to benefit and sms specific ways from like a bell like this passe and they've been weighty way quieter than I would've ever expects to send some specific reporting on this weekend it's always hard to know it isn't somebody starts right when you when you report people you get you get up an answer built for witches alike oh well that's great but it's something that I've been hearing from them is that they are frustrated in some ways they're frustrated by the critique of them which is the point is a bit this that Democrats have had this view it in for how they pass their health care bill that Republicans are very in Hock to the healthcare industry and that wherever the insurers aren't farm is and so on that's Republicans will be and use of these industry players like they don't listen to us there are Republican Party's very illogical party it's not as transactional the Democratic Party it's a little bit less into the horse trading they're not even really horse trading with each other and so they're just not listening now could there be I wonder what are you can find that it could be a more aggressive mobilization right could the insurers American Medical Association and the doctors and hospitals and so on be like flooding Congress with people they probably could be spending more and I absolutely could but they have been mostly spice been quite clear and usually clear actually an unusually strident in their denunciations of it my mistake or not they don't care the Republicans don't care what we think without being stopped by this there they don't care even what their own think tanks appear to think the interesting events basically pulls the look at the U S Chamber of Commerce Way which is you know of big business lobby and one thing you will see that they do is sometimes they agree with Democrats on policy issues right like in twenty eleven Republicans took the view that the American government should default on all of its obligations and destroy the entire global economy as of the Chamber of Commerce was very clear public statements they thought destroying the entire world financial system was a bad idea but then like they also agree with Republicans that some things like wealthy businessmen should pay lower taxes and if you call them up the likes of wealthy businessmen pay lower taxes and again that they should but not only that like in the twenty fourteen midterms they will pump millions of dollars into attack ads against Democratic candidates and critically the ads won't be like Here's a rich businessman saying twirling his mustache thing I wish I'd paid lower taxes it'll be like if Senator So and so took a vote in favor of gun control they will do ads targeting gun owners about how this piece of shit wants to take the wage political campaigns right because people understand that like in politics the way you do politics is you identify your enemy is that you identify your enemy's weak points the new attack on the points and the health insurance industry is not doing the right like they are NOT say we will become bitter about Senator Cory Gardner and we will put our backs into making Senator Cory Gardner lose the election unless he stops this bell but they're saying we don't like this bill we want more money to go out and thus good for them you know they say all Republicans OK we think that like there's a reason Republicans don't care what they think like Republicans care a lot with the NRA thinks I mean he and so you know I think that the flipside of this is that you see year after year time after time this kind of pious hope from Democrats that like the white nights of corporate America are going to ride to the rescue and defend like the party of reasonable ness and it doesn't it doesn't happen right there was some absurd Larry Summers out that last week about how like corporate America needs to stand up to the Trump administration like to stand up to the administration because like they like tax cuts and they like deregulation and it is what it is I think an interesting question is going to be you know if Mitch McConnell is like stealth bill goes through you know what happens next I mean it seems like this cuts off at the U's like all of the tactical and strategic arguments for moderation on the part of Democrats yet I think we as a client is ready if he is the fact that I've added a run to making this point how this makes a lot easier for Democrats to go aggressively but you would think I like the insurance industry figure in a really interesting spiders they've been like really denounce the bell like you know I don't think that's actually they they've been like a little kind of moderate and you gotta think of like what the future looks likely to lead you wage war against the US and they like have the Harry and Louise ads in ages like really like spend all this time lobbying and advertising like making it clear that America's Health Insurance companies oppose the American Health Care Act and they kill it so use it to the king of your insurance industry they are they're left with this like a see a zombie that they're supporting that he knew is inserted looks like in the marketplaces are really difficult place to navigate it is a place were more people have health insurance but I don't know that lake like they are staring down to like challenging alternatives either way adn that I can see the hospitals make less sense to me like hospitals like less people with insurance like necessarily a bad thing for come for hospitals that bill insurance companies for the insurance industry it's like the kind of think through what are they defending like How much do they like living in a world where the Trump administration is implementing a law that they want to appeal so there is for all these players short term and long term interest and I think a lot of them have mistaken what the long term interest is or have overly discounted at and this goes to that to the piece you edited and unmentioned here so I think it sort of what is happening in the broader politics of health care let's say Republicans pass some version of the American Health Care Act which now looks like a totally possible of possibility they will have they can pass right to control the House and to listen to the control was nobody can stop them from passing the bill but they kept protected a bill that you are not willing to even argue about before it passes is not a bill that you can protect one comes in takes away insurance for tens of millions of people and for the entire system into chaos Republicans will create in Democrats the same kind of driving force that repeal and replace created and Republicans Democrats naturally care more about health care center public and so once Republicans take away these coverage gains this will become like the raisin d'etre of the Democratic Party with a lot more institutional and policy support behind it so then eventually Democrats who among other things have won the popular vote and six of seven presidential elections are going to take back power and they're going to do something on health care and what will happen here there have long been the sort of democratic incremental lists who believe maybe like single payer maybe they don't even like Medicare for all maybe they don't but they don't believe you can get it done for all kinds of reasons they thought something to be more stable and more possible to pass with Republican support they thought that it was importing get the health industry on board because they could exercise a lot of force and destroying anything that happened that was one of the big lessons of nineteen ninety four where I think the Harry Louise ads get more credit than they really deserve killing a bill that but it's part of the Democratic mythology around that failed effort and so there are these moderate Democrats of which Obama was one Obama said to us in our interview if I could do from the beginning I would do single payer but not starting from the beginning you know they decide to create these public private hybrid programs hoping get Republican support hoping to get insurance industry support and so what Republicans have taught them now you'll not get Republican support for one of these hybrid public private programs it doesn't matter how much you want it doesn't matter what you bargain away to get this matter whether you based on Mitt Romney's plan like Republicans are going to Haiti as much as if it were true single pair so that argument is off the table in the health industry is proving to be completely useless ally so the idea that it's really important to have them onboard Republicans are disapproving that because of all this going to have from here on out the presumption that you do major health reform with fifty one votes the reconciliation seed something that can fit through that which expanded government programs does re regulating private insurance markets doesn't have the smoking ruins of Obamacare which were already pretty hard to defend because Democrats have defended the decisions of private insurance actors right Anna decides to increase premium somewhere now Democrats are on the hook for why there's an app based premium increase and so what's going to happen when Democrats come back and I think what's going to happen in a party is already moving left is they're going to go all the way for single payer where you wipe out everybody employer based insurance but the something like Medicare buy in highly subsidized by taxing rich people and the ensure the health industry is going to come to them and say Hey that's a terrible idea and I think Democrats and liberals going to say sorry you know you've had your chance Republicans might scream and yell that they're going to scream and yell anyway and there might be the Democratic incremental is to say why don't we go revisit Obamacare and then be completely discredited their political argument totally destroyed so one thing that I really think is true here is that Republicans passed this bill they're creating unsustainable political equilibrium their idea of what to do in health care system is not popular and that's why cannot be defended it's been proving reasonably expect Ford to defend Obama has coverage gains for Democrats which is why the Republican bill is so unpopular I do not think it's going to be easy to defend fewer people insured in the future Democrats have a lot of energy on this end is going to be really no capital laughed in the wing of the party that has been trying to find compromise isn't trying to find middle ground solutions and so yeah I do think that cause I believe is completely Mitch McConnell would be for Senate Republicans said Obama has left in place he thinks it'll become single pair I think it's just the opposite if they destroy Obamacare I think there can get again maybe not full single payer but something like Medicare buy in within ten ish years have went if one thought I have on that's a one way I could see that not happening is that we don't really know what like healthcare likes scorched earth campaign looks like and right now am thinking another reason health insurance may not be going super hard against this is like the end of the day their sole role for health insurance companies under HCA the individual market as a case small I think it's about seven percent of the overall insurance market like you can toy around with the insurance markets and that you hold insurance companies will generally be fine I'd be curious to seize its own kind of like the argument you're making is that even in this really you don't have to worry about that as much as we thought I think there's some truth to that but I could see an effort by Democrats to do like Medicare buy Medicaid buy in getting a much more aggressive response from industry and you know like like going for like the ads unlike the lobbying unlike the huge response that we haven't seen in HCA because they would see something like that threatening their existence in the way at that ad the Republican Bell dozens and I don't know how that plays out like how much that kind of campaign against it like really amped up how much that would matter to like stopping a Medicare buy and I think it matters uses a two level so it is like the intra party and is the inter party argument and agree with you that like these industry that suddenly powerless like well find that is actually quite powerful when it when he gives a damn were they good as raise the dialogue between Democrats white like there's been a fight going on for years between you know single payer advocates and Democratic incremental s in which the incremental isn't always had transformation is an incremental if yes then I'm trying to popularize it I always have the overwhelming upper hand right and then like Bernie Sanders can unexpectedly like like punch really really hard although you know Clinton had a bunch of other weaknesses and stuff but you know he showed it was still like the grassroots love out there for this and then Republicans are coming along with the bill that completely discredit its moderate democratic stance I don't think it eliminates the worry is that moderate Democrats have about actually taking on industry but it discredit the idea that there's an alternative to taking the industry right in Bernie's average York Times op ed that a lot of I think we're decisions about British politics like it just has this thing in the end where it's like I'm going to be really simplistic and say like Democrats have decided they on the side of my good things are terrible company and that's basically what's happening here right leg if you can make a deal with the terrible company is that winds up helping poor people get health care in a way that's bipartisan sustainable them like he's right you have to Peck and if you have to Peck is what is right in the tobacco industry fought like a long and hard but they were eventually defeated and that was just no
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Legends of the secret health care bill