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Trump Has No Idea What’s In His Health Care Bill

Mother Jones

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I’m going to go out and throw some frisbees around. In the meantime, enjoy John Dickerson’s interview with Donald Trump about his health care bill:

JOHN DICKERSON: So but in the bill, as it was analyzed, there were two problems. One, and you talked about this with Congressman Robert Aderholt, who brought you the example of the 64-year-old who under Obamacare the premiums–

PRESIDENT DONALD TRUMP: But that was a long time ago, John.

JOHN DICKERSON: But has that been fixed?

PRESIDENT DONALD TRUMP: Totally fixed.

JOHN DICKERSON: How?

PRESIDENT DONALD TRUMP: How? We’ve made many changes to the bill. You know, this bill is–

JOHN DICKERSON: What kind though?

PRESIDENT DONALD TRUMP: –very much different than it was three weeks ago.

JOHN DICKERSON: Help us explain because there are people–

PRESIDENT DONALD TRUMP: The bill–

JOHN DICKERSON: –out there wondering what kind of changes.

PRESIDENT DONALD TRUMP: Let me explain. Let me explain it to you.

JOHN DICKERSON: Okay.

PRESIDENT DONALD TRUMP: This bill is much different than it was a little while ago, okay? This bill has evolved. And we didn’t have a failure on the bill. You know, it was reported like a failure. Now, the one thing I wouldn’t have done again is put a timeline. That’s why on the second iteration, I didn’t put a timeline.

But we have now pre-existing conditions in the bill. We have — we’ve set up a pool for the pre-existing conditions so that the premiums can be allowed to fall. We’re taking across all of the borders or the lines so that insurance companies can compete–

JOHN DICKERSON: But that’s not in–

PRESIDENT DONALD TRUMP: –nationwide.

JOHN DICKERSON: –this bill. The borders are not in–

PRESIDENT DONALD TRUMP: Of course, it’s in.

Needless to say, it’s not in. It might be in a future bill, but it’s not in the current bill. On the bright side, I’m impressed that Trump even knows about the high-risk pool, even if he doesn’t quite know what it’s called.

We also learned that Trump’s response to North Korea’s missile test is that he’s not happy. What does that mean? “I would not be happy. If he does a nuclear test, I will not be happy.”

Roger that.

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Trump Has No Idea What’s In His Health Care Bill

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4 Ways Trump’s Tax Plan Will Make the Trumps Even Richer

Mother Jones

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President Donald Trump revealed an outline of his big tax reform plan on Wednesday. It’s light on specifics and even lighter on details about how the administration might pay for what it describes as the “biggest tax cut” in US history. But one thing is perfectly clear: Trump and his family could save billions of dollars. Here are four ways Trump’s tax proposals would help people named Trump.

1. Eliminating the Estate Tax

The estate tax, which applies to wealth that deceased people pass on to their heirs, only affects the richest of the richest—roughly 0.2 percent of Americans. Individuals worth at least $5.45 million (or married couples worth at least $10.9 million) will owe estate taxes after their deaths. Currently, assets in excess of this $5.45 million exemption are taxed at 40 percent. President Donald Trump claims to be worth $10 billion, so his heirs could save billions if the estate tax disappears.

2. Eliminating the Alternative Minimum Tax

The alternative minimum tax requires certain taxpayers to calculate how much tax they owe twice—once using the regular income tax rules and again under AMT rules. Originally, the AMT was structured to prevent wealthy people from abusing the system by avoiding paying their fair share of taxes. We don’t know much about Trump’s taxes, but his 2005 returns, which were obtained by MSNBC, indicate the he earned $153 million that year. Without the AMT, Trump apparently would have paid just $7 million in taxes, according to the New York Times—a tax rate less than 5 percent. But the AMT forced him to pony up an additional $31 million that year, raising his tax rate to about 25 percent. Asked at a Wednesday press briefing how eliminating the AMT would impact Trump’s tax liability, Secretary of the Treasury Steven Mnuchin dodged the question and abruptly ended the briefing.

3. Slashing Tax Rates for Pass-Through Corporations

Many businesses are structured as pass-through companies, meaning that rather than filing taxes as corporations, they “pay taxes through the personal income tax code,” as the Times explains. Trump wants to cut the rate for pass-throughs (as well as for corporations) to just 15 percent, which will certainly enrich anyone named Trump. Since the Trump Organization is a collection of pass-throughs, the organization itself isn’t subject to income tax. Instead, the owners are taxed individually. So Trump and his children would only have to pay 15 percent on their earnings from the family organization in taxes, much lower than the current top rate of 39.6 percent.

4. Lowering the Individual Income Tax Rate

Trump wants to eliminate several tax brackets and lower the top individual tax rate from 39.6 percent to 35 percent. Under the new plan, there will be three tax brackets: 10 percent, 25 percent, and 35 percent. That could be a huge giveaway to the Trumps and other wealthy Americans who make millions of dollars each year.

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4 Ways Trump’s Tax Plan Will Make the Trumps Even Richer

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Trump Plans to Cram His Entire Legislative Agenda Into Days 96-99

Mother Jones

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Did Mack Sennett ever make “The Keystone Cops Go to Washington”? No? No matter. That’s what it feels like right now.

Let’s see if I can do justice to our current legislative follies. For starters, it appears that we’re going to get health care, tax reform, and infrastructure all in one week. Why? I guess so that President Trump can say he got going on all of them in his first hundred days. Which totally doesn’t matter and Trump couldn’t care less about it. But he released a truly comical list of all his accomplishments anyway. Not that he cares. But anyway. Let’s move on.

Health care: The House Freedom Caucus has allegedly agreed to an amendment to the previous House bill—the one that crashed and burned last month thanks to the HFC’s opposition—that now makes it acceptable. They haven’t actually said so in public yet, but maybe tomorrow they will. Maybe. Basically, it allows states to opt out of the essential coverage requirements of Obamacare. Except for Capitol Hill, that is. Members of Congress will continue to get every last thing on the list. And there’s no change to pre-existing conditions except for one teensy little thing: insurance companies can charge you more if you have a pre-existing condition. How much more? The sky’s the limit, apparently. Does $10 million sound good? In practice, of course, this means that they don’t have to offer coverage to anyone with a pre-existing condition.

Tax reform: It turns out the Treasury Department really was taken by surprise on this, so Wednesday’s announcement will be little more than the same stuff Trump released on the campaign trail. Corporate taxes get cut by nearly two-thirds, to 15 percent. Ditto for “pass through” corporations like, oh, just to pull an example out of the air, The Trump Organization. There will be no offsetting spending cuts. There will be no border tax. There will be nothing much for the non-rich except a modest change to the standard deduction. There will, of course, be no details about which deductions and loopholes, if any, Trump plans to plug. It will be a gigantic deficit buster. And just for good measure, it’s probably literally unpassable under the Senate’s rules.

Infrastructure: In a laughable attempt to get Democratic support for his tax bill, Trump plans to add infrastructure spending and a child tax credit to it. The problem is that Trump’s infrastructure plan is little more than a giveaway to big construction companies, and his child tax credit—designed by Ivanka!—is little more than a giveaway to the well off. In other words, instead of one thing Democrats hate, the bill now has three things Democrats hate. I’m just spitballing here, but I’m not sure this is how you make deals.

This is lunacy. The barely revised health care bill probably won’t pass the House, let alone the Senate. Tax reform is just a PowerPoint presentation, not an actual plan. Plus it’s such an unbelievable giveaway to the rich that even Republicans will have a hard time swallowing it. And the infrastructure stuff is DOA. It will almost certainly be opposed by both Republicans and Democrats.

This is like watching kids make mud pies. I guess that’s OK, since this is all terrible stuff that I hope never sees the light of day. Still, I guess I prefer even my political opponents to show a little bit of respect for the legislative process.

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Trump Plans to Cram His Entire Legislative Agenda Into Days 96-99

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Rabbi Jack Moline’s Resistance Reading

Mother Jones

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We asked a range of authors, artists, and poets to name books that bring solace or understanding in this age of rancor. Two dozen or so responded. Here are picks from the Rabbi Jack Moline, president of the Interfaith Alliance.

Latest book: Growing Up Jewish
Reading recommendations: I can’t avoid including the Book of Psalms. Aside from the fact that it is the only book in the Jewish Bible that is of undisputed human authorship, it is a collection of essential yearnings and gratitudes that give me a sense that our current troubles, existential and political both, are neither new nor permanent. In addition, the melodies to which so many of the psalms have been set are inseparable from the words. And how can I not also hear Leonard Cohen in every “hallelujah.”

Rainer Maria Rilke’s Book of Hours probably makes me sound like a poetry buff, which, alas, I am not. But Rilke’s extraordinary talent for combining deep spiritual sensitivity with intuition about the human condition can rescue me from almost any funk. I feel the same way about Israeli poet Dan Pagis.

I remember reading Margaret Atwood‘s The Handmaid’s Tale when it first came out. I can remember where I was sitting as I read each chapter. The early chapters that almost breezily describe how quickly an inclusive society can collapse into a corrupt theocracy and, most impressively to me, the epilogue in which future academics look back with disdain and incredulity on the dark age of female servitude still inspire me never to give up resisting injustice and never to give up hope that the moral arc of the universe…well, you know. These two features, by the way, are what make this book a better choice right now than Philip Roth’s The Plot Against America.
_______
So far in this series: Kwame Alexander, Margaret Atwood, W. Kamau Bell, Jeff Chang, T Cooper, Dave Eggers, Reza Farazmand, Piper Kerman, Bill McKibben, Rabbi Jack Moline, Karen Russell, Tracy K. Smith. (New posts daily.)

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Rabbi Jack Moline’s Resistance Reading

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So How Are Millennial Men Doing?

Mother Jones

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James Pethokoukis has a pair of posts up today that reignite a longstanding question: What’s the right way to measure inflation? And what does that mean about earnings and income mobility over time?

These are both complicated questions, but we can start with a very simple chart. If we want to compare, say, 30-year-old men to their fathers, and their fathers to their fathers, we can do it pretty easily. The Census Bureau collects data on median cash earnings (i.e., not counting health care, employment perks, or government benefits) and then all we have to do is adjust for inflation. But which measure of inflation?

The CPI story is grim: In the previous generation, young men earned about 8 percent more than their fathers. That’s not great, but it’s better than nothing. However, in this generation, millennial men earn 10 percent less than their fathers.

The PCE story is different. In the previous generation, young men earned 22 percent more than their fathers. That’s pretty good. In the current generation, millennial men earn about the same amount as their fathers. Stagnation like that is bad news, but at least millennials aren’t literally losing ground.

So which should we believe? There are arguments for both, and it’s a political hot potato too since inflation measures show up in all sorts of benefit calculations. It would be nice if the economic community could thrash out agreement on an overall best measure, and then make it available as a standard series going back 70 years, but if it turns out that the new measure leads to (for example) lower cost-of-living adjustments for Social Security benefits, you can expect a massive pushback. Republicans have shown a particularly aggressive form of this kind of political hackery in the past, approving of new inflation measures that would decrease benefits, but opposing the same measures if they meant that people might pay higher taxes.

All that conceded, we really should be able to agree on a good, general-purpose inflation measure. We can still have lots of different measures for specialized purposes, but the headline inflation rate should be something that, say, 90 percent of economists can agree about. (There will always be a few outliers.)

In a way, though, this doesn’t matter too much for the question of how millennial men are doing. On one measure, their market earnings have dropped from 124 percent of per-capita GDP to 72 percent. On the other measure they’ve dropped from 108 percent to 72 percent. That’s pretty grim either way.

For more on this, Pethokoukis points us, first, to a new study by Bruce Sacerdote, which suggests that consumption has increased substantially over the past several decades, once you adjust for inflation bias and include the growth of government benefits. On a less happy note, he also points us to a study by Scott Winship about income mobility. Winship concludes that although there’s still a fair amount of income mobility within the broad middle class, there’s very little at either end. Poor kids stay poor, and rich kids stay rich.

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So How Are Millennial Men Doing?

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Friday Is D-Day For the Republican Health Care Bill

Mother Jones

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From Politico:

President Donald Trump is demanding a vote Friday in the House on the Republican plan to repeal and replace Obamacare, White House Budget Director Mick Mulvaney said. If the bill fails, Trump is prepared to move on and leave Obamacare in place, Mulvaney said.

This makes sense on a whole bunch of levels:

As a threat against conservatives: Vote for the bill or else Obamacare stays around forever and it’s your fault.

As a boredom minimizer: I doubt very much Trump himself cares one way or the other about health care, and he’s probably tired of all boring technical talk that surrounds it (EHBs, continuous coverage, age bands, etc. etc.). He also instinctively understands that the whole thing is a shit show that’s making him more and more unpopular.

As politics: The current debacle has shown that there’s just no sweet spot acceptable to both moderate and conservative Republicans. Why keep beating yourself up over it?

As revenge against liberals: Trump has said that 2017 is the year Obamacare unravels. He will now do everything he can to make that come true, and there’s a fair amount he can do.

As substance: It frees up time for taxes and trade, things Trump is more interested in.

Besides, I don’t think Trump wants to stay in Washington over the weekend. The Mar-a-Lago golf course beckons. So let’s just put this baby to bed one way or the other, OK?

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Friday Is D-Day For the Republican Health Care Bill

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Republicans Now Considering How to Make a Bad Health Care Plan Into a Complete Wreck

Mother Jones

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Our acronym for the day is EHB, which stands for Essential Health Benefits. These are things which every health care plan is required to cover, and Obamacare spells out ten of them:

  1. Doctor visits
  2. Emergency room visits
  3. Hospital visits
  4. Prescription drugs
  5. Pediatric care
  6. Lab services
  7. Preventive care
  8. Maternity care
  9. Mental health care
  10. Rehabilitation services

The Republican health care bill is still having trouble getting enough votes to pass, so Paul Ryan is thinking about placating conservatives by repealing all of these EHBs. This means that a health insurer could literally sell you a policy that didn’t cover doctor visits, hospital visits, ER visits, your children’s health care, or prescription drugs—and still be perfectly legal. Here’s a rough estimate of how much we spend nationally on each of these categories of EHB:

There are many problems with repealing Obamacare’s minimum required benefits, but I’d like to list just three:

Oh come on. This is ridiculous.

Even if the current version of AHCA doesn’t cause a death spiral, it sure would if EHBs got repealed. Insurers would assume that anyone who asks for a policy that covers one of these (former) EHBs is pretty sure they’re going to need it. Naturally they’d price their policies accordingly: Worthless policies would get really cheap, but comprehensive policies would get astronomically expensive. Virtually no one would be able to afford them.

There’s a good chance that repealing the EHBs would not only produce crappier insurance policies, but would also cost the government more money. Think about it. Every year AHCA provides you a tax credit for health insurance. You might as well use it, right? So insurers would all compete to offer policies that cover almost nothing but cost exactly $2,000 or $3,000 or $4,000. Everybody would sign up for one, because it’s free so they might as well. So instead of, say, 10 million people using the tax credits, 30 million would. These policies wouldn’t do squat, but Uncle Sam has to pay for them anyway—and now he’s got to pay for three times as many of them.

This is all pretty straightforward stuff, and it’s hard to believe that Ryan would go down this catastrophic road. Enough’s enough. If I had to guess—and we might well know the answer before I wake up on Thursday—I’d say that Ryan tries to buy off the conservatives by taking maternity benefits off the EHB list and leaving everything else alone. After all, it’s maternity care that really seems to be a burr in the ass of the Freedom Caucus folks.

Why? Because they’re knuckle-draggers. It’s hard to put it any other way. They figure that being pregnant is solely a woman’s responsibility and there’s no reason men should have to help pay for it. Really. I’m not joking. What can you even say to people so terminally dimwitted?

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Republicans Now Considering How to Make a Bad Health Care Plan Into a Complete Wreck

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GOP Health Care Bill Is Worse Than Just Repealing Obamacare Completely

Mother Jones

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Over at The Upshot, Margot Sanger-Katz catches something that any of us might have noticed if we’d had keen enough eyes. The CBO famously projected that the Republican health care bill would result in 24 million people losing health insurance:

But one piece of context has gone little noticed: The Republican bill would actually result in more people being uninsured than if Obamacare were simply repealed. Getting rid of the major coverage provisions and regulations of Obamacare would cost 23 million Americans their health insurance, according to another recent C.B.O. report. In other words, 1 million more Americans would have health insurance with a clean repeal than with the Republican replacement plan, according to C.B.O. estimates.

Here’s what the CBO said in its January report. If only the individual mandate, the subsidies, and the Medicaid expansion are repealed, 32 million people will lose insurance by 2026. If, in addition, community rating, minimum coverage requirements, and the preexisting conditions ban are repealed—in other words, if essentially all of Obamacare is repealed and nothing put in its place—23 million people will lose insurance by 2026.

As it happens, the current Republican bill is similar to Option 1, which means the GOP is making progress. Under their old bill 32 million people would be kicked off the insurance rolls, while the new bill only kicks off 24 million. However, they could do even better by just repealing everything, full stop.

Now, it so happens that they can’t do that. Democrats can filibuster all the additional stuff in Option 2. Nevertheless, Sanger-Katz is right: it’s pretty remarkable that the Republican bill actually does more damage than repealing Obamacare and simply doing nothing at all. Not just any party can pull off something like that.

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GOP Health Care Bill Is Worse Than Just Repealing Obamacare Completely

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Here’s Why CBO Projects 10% Lower Premiums Under the Republican Health Care Bill

Mother Jones

One of the surprising things about the CBO score of AHCA, the Republican health care bill, is their conclusion that premiums will fall starting in 2020. By 2026, average premiums will be 10 percent lower than they would be under Obamacare. But why? Here’s CBO:

First, the mix of people enrolled in coverage obtained in the nongroup market is anticipated to be younger, on average, than the mix under current law. Second, premiums, on average, are estimated to fall because of the elimination of actuarial value requirements, which would result in plans that cover a lower share of health care costs, on average.

….By 2026, CBO and JCT project, premiums in the nongroup market would be 20 percent to 25 percent lower for a 21-year-old and 8 percent to 10 percent lower for a 40-year-old—but 20 percent to 25 percent higher for a 64-year-old.

Hmmm. Let’s translate this into English. First, CBO assumes that premiums will go up for old people, forcing many of them to drop out of the market. Since old people have expensive premiums, fewer old people means the average for the remaining pool will be lower.1 Second, AHCA policies will cover far less of your medical expenses, so naturally they’ll be cheaper.

The chart below shows how this “reduces” average premiums. If you use CBO’s projections and do a little arithmetic assuming a modestly younger pool, you get the average premium estimate for the overall pool shown on the left. AHCA is cheaper than Obamacare.

But the current age breakdown in the Obamacare insurance pool is 28 percent young, 38 percent middle-aged, and 26 percent old. What if you assume that stays the same? You get the premium estimates in the middle.

Finally, what if you assume that AHCA paid for 87 percent of your medical bills, just like Obamacare? Then you get the premium estimate on the right.

In other words, if you compare apples to apples, AHCA produces far higher overall premiums than Obamacare.2

Note that CBO didn’t do anything wrong here. They simply did their projections based on a (correct) assumption that AHCA would be too expensive for many old people and would produce crappier policies that had higher deductibles and paid far less of your medical bills. The “average” premium is lower, but obviously not in a way that helps anybody in real life.3

1Think about it this way. If a high school sends all its A students to a magnet school across town, the school’s average GPA will go down. This is despite the fact that nobody’s grades have actually changed.

2This is a fairly extreme example because the actuarial value changes a lot (87 percent vs. 65 percent) for the cheaper policies preferred by low-income folks. CBO has a second example that uses a middle-class worker, and it produces similar but less dramatic results.

3Hardly anybody, that is. If you’re young and don’t get any medical care, then the lower premiums really do help you.

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Here’s Why CBO Projects 10% Lower Premiums Under the Republican Health Care Bill

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Trump Plans to Slash the Most Effective Social Program in History

Mother Jones

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Reuters tells us what to expect from President Trump’s budget:

Under the proposal, which was sent to the EPA this week, grants to states for lead cleanup would be cut 30 percent to $9.8 million, according to the source, who read the document to Reuters.

What an idiot. This is hardly the biggest issue in his budget, and I’ll grant that the current allocation for lead cleanup is so pitiful that a 30 percent cut hardly matters. On principle, though, it’s obvious that Mick Mulvaney’s crew just saw a line item in their spreadsheet and slashed it without knowing anything about it. Nice work, folks. You get a gold star.

By coincidence, the Washington Post ran a piece yesterday that’s all about lead—though the reporter didn’t realize it:

In dozens of one-on-one meetings every week, a lawyer retained by the city of Philadelphia summons parents whose children have just been jailed, pulls out his calculator and hands them more bad news: a bill for their kids’ incarceration….He is one agent of a deeply entrenched social policy that took root across the country in the 1970s and ’80s. The guiding principle was simple: States, counties and cities believed that parents were shedding responsibility for their delinquent children and expecting the government to pick up the tab.

.…”It was a very different time, when too many parents frequently wanted to essentially ‘dump’ their adolescent children on juvenile courts when they found them unruly, ungovernable, uncontrollable,” Linda O’Neal, executive director of the Tennessee Commission on Children and Youth, said of the era decades ago when the laws were implemented.

Regardless of what you think about this policy, there’s a reason it “took root” in the ’70s and ’80s: Kids of that era spent their early childhoods surrounded by lead fumes from automobiles, so they contracted lead poisoning in massive numbers. By the time they were teenagers they really were “unruly, ungovernable, uncontrollable,” and parents didn’t know what to do.

As it turns out, there was nothing they could do. The damage was done. But nobody knew that, so we put in place pointless laws based on the premise that if only they worked harder, parents could keep their kids under control. In reality, the only policy that ended up working came from Trump’s hated Environmental Protection Agency, which banned leaded gasoline and put an end to our national epidemic of lead poisoning.

But the old laws are still around, even though they don’t work, while the EPA’s lead cleanup program is being slashed, even though it does work. Welcome to America.

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Trump Plans to Slash the Most Effective Social Program in History

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