We’ve been living high on the hog these last few years: getting mammograms and colonoscopies whenever we need them, vaccinating ourselves against cancer-causing viruses for free, preventing unwanted babies from showing up in our wombs without having to spend our rent money to do so. But those days might be over soon,…
Sometimes you have a really bad idea, but you need friends to help you pull it off. Maybe it’s something that will benefit you but not them; or maybe you’ve all talked yourself into believing that this obviously stupid idea has some kind of upside.
Late-night host Jimmy Kimmel delivered a tearful monologue last night about his newborn son who was born with a heart defect and had life-saving surgery at just three days old. And today, Republicans are trying to get the votes to pass a health care law that will make it next to impossible for people like Kimmel’s…
After first helping to sink the original Republican healthcare bill, known as the American Health Care Act (AHCA), the group of ultra-conservative House members decided to lodge its support behind the bill following a few changes. Lawmakers managed to appease the group after tacking on the MacArthur-Meadows amendment, which essentially lets states opt out of certain Obamacare rules.
Under the new amendment, states can choose to offer high-risk pools and decide whether or not they want insurers to cover some services like maternity care, preventative visits, or mental health benefits, the Associated Press reports. States would have to apply for federal waivers if they wanted to skip out on some of the existing Obamacare provisions. Although the amendment offers states a bit more flexibility, Freedom Caucus members admit that, for them, it still doesn't go far enough.
"While the revised version still does not fully repeal Obamacare, we are prepared to support it to keep our promise to the American people to lower healthcare costs," the group said in a statement. "We look forward to working with our Senate colleagues to improve the bill. Our work will continue until we fully repeal Obamacare."
The Freedom Caucus boasts roughly three dozen members, giving the bill a boost toward the 216 House votes it needs to move to the Senate. However, the new amendment isn't likely to garner a ton of support from moderate Republicans, many of whom are still against the AHCA and concerned with how it could allow states to weaken protections for people with preexisting conditions.
"The amendment doesn't address the things that I had concerns about—the things I think are detrimental to the people I represent," Representative Dan Donovan, a centrist from New York, told Politico.
Last month, Obamacare repeal was so unpopular it couldn’t get a vote in the House of Representatives. Today, a new version of that bill is back on the table, and this time it has support from some of the most conservative members of the House. Here’s what’s in the new bill and how it would affect your health care.
After weeks of drafting, hiding, debating, and tweaking a bill that would repeal and replace the Affordable Care Act, House Republicans scrapped it just minutes before a scheduled vote on Tuesday. ACA repeal, which the Republican Party has been promising voters since the bill was signed into law by Barack Obama seven years ago, is suddenly in doubt.
The Republican-backed American Health Care Act (dubbed "Trumpcare" by some) faced resistance from legislators on both sides of the aisle—Democrats objected to a bill that would cause millions of people to lose health insurance, and some conservative Republicans were upset it didn't strip enough provisions of the ACA. Despite President Donald Trump and House Speaker Paul Ryan's best efforts to ram the AHCA through Congress, it was clear by Friday afternoon that they couldn't get enough Republicans onboard. Ryan reportedly went to the White House to tell Trump the votes weren't there, and hours later the speaker officially announced the bill would be pulled.
The loss is a big-league embarrassment for Trump, who threw his full support and a handful of tweets behind his first major legislative effort. He told Republicans that he wanted to move on from healthcare if they couldn't manage to pass the AHCA today. Congressional Republicans, meanwhile, were willing to admit that this was a failure.
"You can't pretend and say this is a win for us," Republican representative Mark Walker said, according to the New York Times.
"Moving from an opposition party to a governing party comes with growing pains. We're feeling those growing pains today," added Ryan. "This is a disappointing day for us. Doing big things is hard," he added. "All of us, all of us—myself included—will need to time to reflect on how we got to this moment."
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Everything you need to know about the world this morning, curated by VICE.
Trump Threatens to Leave Obamacare in Place if Health Bill Fails
President Trump has reportedly issued a threat to Republican lawmakers ahead of Friday's expected vote on the American Health Care Act, telling them to back the bill or else he will move on. Republican leaders amended the bill Thursday evening to remove an obligation under the Affordable Care Act that insurers provide "essential benefits," including mental health treatment and maternity care.—The Washington Post
Senate Votes to Get Rid of Online Privacy Rules
The US Senate voted to repeal rules that require internet-service providers disclose what information they're collecting and how they're using it on consumers. The bill was expected to pass in the House as well, after which it would go to President Trump for his signature.—NPR News
Nunes Eventually Apologized to Intelligence Committee, Members Say
Republican Devin Nunes has apologized to fellow Intelligence Committee members for failing to brief them on evidence US agencies might have surveilled Trump's team during the presidential transition before telling the White House and the public. Representative Jackie Speier said Nunes apologized and pledged to share the information with the committee without saying when he would do so.—CNN
Chicago Sees Nation's Biggest Population Drop
The Chicago area is the least hot metropolitan enclave in the US, according to the latest census data. The city and its surrounding suburbs lost more than 19,500 people in just one year. The Dallas and Houston metropolitan areas saw the biggest influx of new people, welcoming more than 100,000 residents each.—AP
Mubarak Released After Six Year Imprisonment
Former Egyptian president Hosni Mubarak has been freed after six years spent in prison. Mubarak was released from a military hospital in Cairo and returned to his home in Heliopolis, according to his lawyer, after receiving a life sentence in 2012 for collusion in the killing of Egyptian protesters. The country's top appeals court acquitted him earlier this month.—BBC News
UN Condemns South Sudan for Neglecting Famine
António Guterres, the UN secretary general, has condemned South Sudanese president Salva Kiir and his government for failing to help 100,000 people enduring a famine. Guterres said there was a "refusal by the leadership to even acknowledge the crisis." The UN has estimated that 7.5 million people in South Sudan need humanitarian aid.—Al Jazeera
Hundreds of Migrants Feared Dead in Mediterranean Crossing
Roughly 250 migrants who attempted to cross the Mediterranean are thought to have drowned after two dinghies capsized off the coast of Libya. The charity Proactiva Open Arms said it had recovered five dead bodies near the dinghies. A spokeswoman for the charity said the vessels were typically packed with between 120 to 140 people each.—TIME
Former Russian MP Shot Dead in Ukraine
Former Russian member of parliament Denis Voronenkov, an outspoken critic of Vladimir Putin, has been killed outside a hotel in Kiev, Ukraine. After exchanging fire with Voronenkov's bodyguard, the killer later died in a hospital. Ukrainian president Petro Poroshenko immediately blamed Moscow and labeled the shooting an act of "state terrorism."—The Guardian
Gorillaz Finally Announce New Album, 'Humanz'
Gorillaz has released details on its long-awaited new 14-track album, due out April 28. It will feature Vince Staples, Danny Brown, and De La Soul, among a host of other high-profile artists.—Noisey
Twitter Mulls Paid Premium Subscription Service
Twitter is considering introducing a premium service that could involve charging interested users a subscription fee. The company said it was surveying "the interest in a new, more enhanced version of Tweetdeck" for professionals.—The Verge
Father John Misty Microdosing LSD for Depression
Father John Misty has revealed he regularly takes diluted doses of LSD as a way to combat anxiety and depression. "I've had therapists tell me that I really need to be on it," he said. "It's just kind of like being a stoner. I'm not on a psychedelic journey all the time."—Rolling Stone
Future and Migos Feature on New Mike WiLL Made-It Album
New Mike WiLL Made-It dropped a new album overnight that features a score of big-name artists: Rihanna, Kendrick Lamar, Migos, Future, Pharrell Williams, and Lil Wayne, among others. The 17-track album is entitled Ransom 2.—Billboard
Subway Accused of Exploiting 'Sandwich Artists'
An online job ad attempting to entice people to work for Subway as an "apprentice sandwich artist" has been removed after a flurry of criticism. The UK government ad offered just under $150 a week for the junior position, less than minimum wage.—Munchies
For the past couple days Donald Trump and his allies have been attempting to twist the arms of Republicans in Congress to vote for the American Health Care Act (AHCA), a piece of legislation that would water down the Obama-era Affordable Care Act (ACA).
The AHCA is widely hated—Democrats dislike it because it would weaken the ACA, and many conservatives don't think it goes far enough to repeal the current law. So Trump has been using a combination of charm and threats to sell the AHCA right-wing House members who might not like the bill, but like opposing Trump even less. It's a tough sales pitch even for a master persuader—if 22 Republicans are against the bill it will go down, and as of Wednesday afternoon it looked like it was going down big league thanks to conservative opposition:
That tweet is from a spokesperson for the Freedom Caucus, a group of hardline right-wingers who have achieved an outsized amount of power because the Republican leadership needs their votes to pass anything. (They were behind the push that ousted former Speaker John Boehner.)
If Trump and current Speaker Paul Ryan can't win enough votes in the next day or so—it's nut-cutting time—the AHCA may either be withdrawn to go through more revisions, or it may be defeated on the floor of the House on Thursday, when the vote is scheduled.
Even if the AHCA passes the House it faces a tougher path in the Senate. But if it couldn't even get out of the House, it will be a huge embarrassment for Ryan, who is guiding his first piece of major legislation through the sausage machine of DC. It would also be a sign that Trump—who has put his full support behind the bill—is going to have a harder time bossing around Republican members of Congress than cast members on The Apprentice.
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In the days after Donald Trump's election as president, Americans suffering from chronic health conditions began to worry that they might be left for dead. Republicans had spent the past six years hammering Obamacare, and now that they controlled the White House and both houses of Congress, it seemed like only a short matter of time before they would ax it once and for all. Those fears were soon given voice by increasingly mainstream left-wing favorites like Bernie Sanders, who tweeted about a week before the inauguration that 36,000 people would die annually if Obamacare were repealed.
Of course, all that panic emerged before anyone had concrete information about what, exactly, Republicans were planning to pass in Congress. At the time, there were five competing GOP plans floating around. (A version of the repeal had actually passed in previous years, albeit mostly as a symbolic gesture, since President Obama was never going to sign a death certificate for his signature domestic achievement.) Republican leaders were finally in a position to kill their least favorite law ever but strangely decided to hide the repeal legislation in a basement, where no one could find it. Once it did see the light of day, the non-partisan Congressional Budget Office (CBO) had a chance to score the American Health Care Act (AHCA), the official Republican plan. But the CBO analyzed the law almost entirely for its effect on the budget, rather than life and death.
Although every think tank that works on health policy has taken a crack at guessing how many people could end up without health insurance if Obamacare went away, the CBO report gave us a go-to number of 24 million over the course of the next decade. That figure includes several broad categories of people who probably would have insurance ten years from now under current law but are much less likely to have it if the AHCA passes. They include people who would receive less generous subsidies to purchase insurance through insurance exchanges, people whose employers will no longer be incentivized to provide plans, lower-income individuals who benefitted from a more generous Medicaid program, and risk takers who probably won't buy a plan once the law stops requiring it.
David Himmelstein is a physician who teaches at the City University of New York and Harvard Medical School and has spent decades studying the connection between healthcare and mortality. He told me that while it's impossible to reach a single definitive figure before a new law like this is finalized, we can get pretty damn close.
His method comes from tweaking data in an authoritative 2012 study in the New England Journal of Medicine (NEJM) that focused on those who benefitted from expanded Medicaid programs in New York, Arizona, and Maine. By applying the percentage change in that report to the average adult death rate, he came up with the estimate that for every 455 people who gained healthcare coverage, one person's life was saved.
"That's probably not a bad rough estimate for the population that would lose coverage with the replacement of the ACA because there'd be a lot of young people who'd lose Medicaid and also a fair number of older people who wouldn't be able to afford the coverage through the exchanges," he told me. "It's not an unreasonable assumption."
Meanwhile, Benjamin Daniel Sommers, a Harvard-based health economist who co-authored the NEJM report Himmelstein used for his calculation, suggested a different approach. He published a paper two years ago in the Annals of Internal Medicine on how death rates changed in Massachusetts after the state implemented healthcare reform in a program not too different from what Obamacare does nationally. Sommers says that data is more applicable to this hypothetical since it speaks to both public and private health insurance.
Although he hedges that—obviously—it's a messy extrapolation. But Sommers gave me a number from that paper to make a back-of-the-envelope calculation anyway. In Massachusetts, at least, one life was saved for every 830 people covered by the statewide expansion, according to his research.
Two more things to note here: Death from Obamacare repeal might be concentrated in states carried by President Trump in the election, and some liberal state governments might try to plug the coverage gap as best as they can. But it's unlikely that Democrats in any given state will be able to quickly pass something similar to what's already in place in Massachusetts––a plan Matthew Fiedler at the Brookings Institute calls "the exception that proves the rule" when it comes to the tricky politics of healthcare.
He says that much of "Romneycare"—as the state's health law was dubbed, after the Republican governor who signed it—was financed through a Medicaid waiver given by the federal government, and that it now relies heavily on Obamacare funding streams to keep plugging along. Places like New York and California have (relatively) high tax rates already, so it may not be viable for them to raise state income taxes to foot the bill for such a costly program. Perhaps more likely, if Medicaid expansion is clawed back by the feds, some states will fight back with lawsuits.
But assuming the CBO score is on point, Himmelstein's death estimate is 52,747 and Sommers's is 28,915—which is to say these are the experts' estimates for the number of deaths that would likely be avoided if Obamacare remained in effect. These are wildly different numbers, obviously, and it should be noted that there may be a difference in death rates when it comes to gaining insurance versus versus losing it. Still, two of the most prominent experts on the relationship between health insurance and morality stand by these figures, rough though they may be.
"Neither of these data points are identical to the current circumstances, so both extrapolations are somewhat imprecise," says Sommers. "That said, I think it's a fair statement from our studies that tens of thousands of lives could be at stake with the ACA repeal debate and the proposed replacement."
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