Operation Sketchbook: (The Trump/Nixon Tapes Part 7)

trump courtroom sketch

[What follows is a transcript of President Donald Trump speaking into the Oval Office recording device originally used by President Richard Nixon. This series of recordings encompass the president’s communication to his inner circle.]

To: The Trump Circle of Trust (TCT)

cc: Attorney General Jeff Sessions, Majority Leader Mitch McConell

As all of you should know by now, I don’t watch CNN anymore. I think I made that clear to the AP when they were here this week. Where is it? Here: (sound of second tape recorder button clicking)

TRUMP: OK. The one thing I’ve learned to do that I never thought I had the ability to do. I don’t watch CNN anymore.

AP: You just said you did.

TRUMP: No. No, I, if I’m passing it, what did I just say (inaudible)?

AP: You just said —

TRUMP: Where? Where?

AP: Two minutes ago.

TRUMP: No, they treat me so badly. No, I just said that. No, I, what’d I say, I stopped watching them. But I don’t watch CNN anymore. I don’t watch MSNBC. I don’t watch it.

(recording ends)

So I was passing by CNN and noticed Sean was looking less fat. I was thinking that maybe we could put him back on camera, but then Steve pointed out that it was just a drawing by a CNN sketch artist. It was such a beautiful drawing I couldn’t get over it. So I got my own courtroom sketch artist. I like how honest he is about my hairline and number of chins. I’m thinking we just use this guy from now on: Operation Sketchbook. We can get him to draw me standing behind the podium and we’ll blow it up and stand it up there. The dishonest media can shout questions at it then go write their fake news.

Speaking of “fake news,” what about my big reveal on the Comey tapes? Pretty fantastic, right? Sean Hannity loved it. Wait. I’ve got that (button press)

SEAN HANNITY (HOST): I’m sorry, this was one of the most brilliant, strategic, doubt-inducing, mind-messing tweets in the history of mankind, because he basically said to Comey, “Well, if there’s tapes, you’re in trouble with the deep state,” it was also a nice shot at them. 

Ha ha ha. Oh and Fox and Friends thought it was pretty brilliant, too. I mean everybody is saying what a great Tweet it was. (click)

AINSLEY EARHARDT (CO-HOST): Big news today. You said you didn’t tape [former FBI Director] James Comey. Do you want to explain that? Why did you want him to believe you possibly did that? 

PRESIDENT DONALD TRUMP: Well I didn’t tape him. You never know what’s happening when you see that the Obama administration, and perhaps longer than that, was doing all of this unmasking and surveillance. And you read all about it and I’ve been reading about it for the last couple of months about the seriousness and horrible situation with surveillance all over the place. And you’ve been hearing the word “unmasking,” a word you probably never heard before. So you never know what’s out there, but I didn’t tape and I don’t have any tape and I didn’t tape. But, when he found out that there may be tapes out there, whether it’s governmental tapes or anything else, and who knows, I think his story may have changed. I mean, you’ll have to take a look at that because then he has to tell what actually took place at the events. And my story didn’t change. My story was always a straight story. My story was always the truth. But you’ll have to determine for yourself whether or not his story changed. But, I did not tape. 

EARHARDT: That was a smart way to make sure he stayed honest in those hearings. 

TRUMP: Well, it wasn’t very stupid, I can tell you that. He did admit that what I said was right. And if you look further back, before he heard about that, I think maybe he wasn’t admitting that, so, you’ll have to do a little investigative reporting to determine that. But, I don’t think it’ll be that hard.

See? The honesty is really striking, right? Why can’t they get that over at CNN? It’s a disaster over there. What did I ever do to Jake Tapper? I mean who cares, right? I never said I had tapes. I just waited for 41 days to say I didn’t have tapes. I’m busy. I got a lot of things on my plate. Sheila? What’s for lunch? No. I want one of those shark steak sandwiches like Jeff Bridges got in that movie where he was president. Oh, who am I kidding? I’m not going to eat that. Get me a QPC from McDonald’s. Extra ketchup.

Okay. So what was I talking about? Sheila? Sheila? She’s gone already? Man, she moves fast. She’s a go-getter, Sheila. I mean she’s really going and getting, right? That’s the way it works.

You know, the more I look at that sketch of me, the more I like it this Operation Sketchbook. We should all just not appear on camera anymore. Jared gets the idea. He’s off solving the Middle East thing and nobody even knows what he sounds like because he can keep his mouth shut. Jared, you’ll have to tell me how you managed to talk a journalist from the AP into deleting photos of you from his camera. That must have been some talk.

Whoever is covering Jared’s muffin basket duty while he’s bringing an end to a centuries-old conflict this weekend should send Jared a muffin basket. Wait. Never mind. He’s done.

Will somebody bring me something else to sign? What is taking so long with that health care bill? Are the Democrats being obstructionists again? Just pass something so I can sign it and tell everybody how great your “mean son of a bitch” bill is.  Mitch, you fixed all that right? You told me to leave it to you and I said “Happy to do it” because one less thing for me to do, right? But you fixed it, right? I’m sure it’s okay. Here’s an idea! Must credit Trump!

Send it over, I’ll sign it before you vote on it. What about that, huh? Is that a great idea or what? I sign the bill before you bring it to a vote and you can say, “Look, it’s a done deal. The president has already signed it, so you need to get on the right side of this thing or you’re going to be left behind.” I think that would be beautiful. Can you imagine the look on Chuck Schumer’s face? [laughter]

But seriously, send me some legislation to sign. It is the best part of this job, showing off for the cameras and . . . hmmm. That’s . . . that’s tough . . . Guys, I’m not sure Operation Sketchbook is going to work out. Let me think about it. I’ll let you know something in two weeks.

I’ve been hitting the Russia thing pretty hard on Twitter. You know, I had no idea when I took this job that so many people would turn on you so quickly. I was just saying to Nixon’s ghost the other night. Nixon’s ghost is a good friend of mine, let me tell you. He’s the one who told me to tweet about the Comey tapes. “Keeps everybody honest,” he said. Ole Honest Nixon, they used to call him. Good times.

Anyway, I was telling Nixon’s ghost, “Look, it is nobody’s business who I call or when I call them or what we talk about when I call. Don’t give me “Presidential Records Act” this or “You can’t block people on Twitter” that.” The president deserves a little privacy to yell at his lawyers. Nixon’s ghost agreed with me, except for the Twitter part. He died in 1994. He doesn’t know what Twitter is. But I believe 90 percent of the ghost presidents living in the White House would agree with me. If not 95 percent.

So I don’t want to read in the paper about me making my morning calls to my lawyers to get all my Russia yelling out early in the day. That’s my “me time.” The dishonest media shouldn’t be writing about that, I don’t care if it is true.

So I’ve pivoted on the Russia thing, now that I’ve figured out how to blame it on Obama. I don’t know if you noticed because it was such a subtle shift in tone:

Now:

Amazing, right? It was such a subtle pivot that no one is going to notice my tacit admission that Putin stuck his thumb on the scale. Well, Sheila noticed, but she’s a real go-getter. I wonder when she’s going to be a come-bringer-er soon? I’m starving here.

So I’m thinking about firing Mueller. I know firing Comey didn’t work out exactly as Jared said it would. But this time I don’t have to be the one firing him. I can order Rosenstein to do it. Or whoever’s next in line if Rosenstein isn’t loyal. Have we fixed that yet? Find me a Bork and let’s get this Saturday Night Massacre on the road!

Mueller can’t investigate me if he’s best friends with Comey! He can’t use lawyers who have donated to Democrats! He can’t keep expanding his investigation to include money laundering and racketeering. I didn’t sign off on that and you guys know me, I’ll sign anything. He’s going after my general, my campaign manager, my consigliere, my Jared and now me? Putin told me I don’t have to put up with it. He said if it were him, he’d be making a pot of polonium tea for Mueller. That’s not really my style. Maybe some polonium Diet Coke? I’ll ask ghost Nixon. He knows how to handle these special prosecutors.

 

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They’re Coming To Take Me Away Ha Ha Ho Ho Hee Hee (The Trump/Nixon Tapes Part 5)

Trump Jackson Screwball[What follows is a transcript of President Donald Trump speaking into the Oval Office recording device originally used by President Richard Nixon. This series of recordings encompasses the president’s communication to his inner circle.]

To: The Trump Circle of Trust (TCT)

cc: Speaker Paul Ryan

I swear. You people are going to put me in the looney bin. Why is everyone talking like I’m crazy? Morning Joe? George Will? The Washington Post? CNBC? NPR? They’re all talking about how I’m losing it. Like I got a screw loose! Can you believe it? I mean, I expect that sort of thing from Keith Olberman, but Terry Gross? What did I ever do to her?

This is completely unfair. So I occasionally have trouble getting the words out. Or I confuse names. Or I repeat simple phrases over and over again. Or I talk about dead people as if they’re still alive. Or I forget how government works. Or I’m afraid of stairs. Or I compliment dictators and strongmen around the world.

Speaking of which, I heard Kim Jong-un’s dad has a hell of a golf swing. Maybe I should invite him out to Mar-a-Lago for 18 holes and we can work this whole nuclear thing out. Sheila? Get me Kim Jong-il on the phone. What? Dead? When? Does Kim-Jong-un know? He’s a smart cookie. I bet he does know. Any word on how his golf game is? If he’s anything like his old man, it’s tremendous.

Someone might have mentioned that Andrew Jackson died 16 years before the Civil War started. Or that the Civil War is one of the most researched questions historians have written about. Am I the only 70-year-old white man who hasn’t watched a thousand documentaries about the Civil War? To see my Twitter mentions, you’d think so. Don’t worry, though. I fixed it.

I genuinely believe Andrew Jackson saw the Civil War coming and was really mad about it. Look at a $20 bill. Doesn’t he seem angry? Someone ask Steve Mnuchin if we can put me on some money. I’m thinking we bring back the $20 gold coin and put my face on one side and me standing at the 14th hole at Trump National on the other. Just make sure it shows the plaque memorializing that “River of Blood” Civil War battle that the fake news people at the failing Golf Digest say never happened.

How about that health care bill, huh? Great job everybody. We twisted arms and prodded those squishy moderates then all of a sudden we got us an Obamacare replacement that does everything I promised it would do. It covers everybody. What was that, Shiela? 27 million? Really? Well, it protects people with pre-existing conditions. What? No? Are you sure? I’m pretty sure I saw Paul say it would protect pre-existing conditions. It will jack up their premiums? But I promised it would lower premiums. I said it would cost a tiny fraction of what Obamacare costs. I remember it clearly because that was a huge applause line. Ugh, am I going to have to read this bill? Shiela? Get someone in here to read this bill for me.

[tape pauses for 8 minutes]

Enough! Enough! Get out! Who knew health care could be so boring? Am I right? Shiela? Tell Paul, I’ll take his word for it. Man, I thought I was going to die listening to that. Good thing I’ve got great health insurance. Whew. I’ll tell ya, that was brutal. I did catch something about Medicaid in there. I assume we’re keeping my promise to not cut Medicaid, right? I really gave ole’ Huckabee the business on Twitter that time he copied me.

Wait, what was that, Shiela? You were mumbling something. Block grants to the states? What’s that? Oh. Well, that doesn’t sound too bad. I mean what’s $880 billion? It’s not like that’s serious money. It’s probably mostly fraud and waste, right? What? What’s a “special-needs kid?” Oh, come on. Really? What about vets? Them too? So who gets the $880 billion? Tax cuts for billionaires? And they voted for that? Wow. Unbelievable. I’m sure everyone else is okay with it, though. What? Well, yeah, I’ll sign it. I promised, didn’t I?

Man, I’m bushed. I hope I don’t say something to undercut our entire argument when I meet with the Australian prime minister tonight. You know how I get when I haven’t had my well-done steak with ketchup.

Okay. Now that we’re finished with repeal and replace can we move on to something else? I am so tired of pretending I care about health care. I need to get out of Washington for a few days. Maybe I’ll go visit Melania in New York. That’s the one place in the country where I know they love me. New York is my town. What’s that, Shiela? Mike Pence has another executive order for me to sign? I sure do sign a lot of these things for someone who used to really hate the idea of presidents signing executive orders.

What’s this one about? Religious Freedom? Is it the one where we let Christians discriminate against gay people or the one where we let churches fundraise for politicians? Both? Ask Mike if he can combine them into one, I don’t want to sign two of them. I’ve only got so much left in in the old tank today and I’m trying to make a tee time at Trump National. Oh, has Ivanka signed off on this? Well, at least no one can get mad about this one, right?

Shiela? Tell Steve Mnuchin that when he’s done with his weekly meeting with Ivanka that I need to see her. I want to give her a hug and tell her it’s going to be okay. Everybody puts fake quotes in their book nowadays. Nobody cares except a bunch of nerds that are going to find something to complain about no matter what you write. Shiela? Get the State Department on the phone. They’re not doing anything important. Maybe they can help goose her book sales a bit.

You know, I’m getting a little sick of the attitudes around here. Maybe some of you need a little refresher course in who is in charge. Shiela? What can I do to punish a bunch of federal employees that requires virtually no effort on my part?

Okay, I’m off the New York. Good job on the . . . uh . . . health care thing . . . and stuff. Just terrific. Really. I’m sure that’s going to be a huge, huge, part of my legacy.

 

Trump and Ryan Celebrate Bullying Their Own Party Into Supporting A Bad Bill That Will Never Become Law

trump-and-paul-ryanThe House voted 217 to 213 to pass the American Health Care Act (AHCA). This cynical divisive act of cowardice served one (and only one) purpose — to give Donald Trump a legislative “victory.” But what did they win, exactly? I can guarantee you that, even as Trump talks about how great this plan is, he has no idea what the bill does. None. He just knows it must be a good plan because it passed.

During the campaign, Trump promised universal coverage at “a tiny fraction of the cost” and “it will be so easy.” It was only after he was elected that he realized how complicated health care is. By most estimates, it counts for a sixth of our economy and House Republicans passed it without knowing what was in it.

I know what you’re thinking. Didn’t Nancy Pelosi, when she was the speaker, say they had to pass Obamacare to find out what was in it? No. That’s one of the enduring myths of Obamacare — a quote, truncated and removed from its context then used as a bludgeon. The Affordable Care Act took 18 months to develop. There were hours and hours of hearings and debates. President Obama toured the country promoting it and taking ownership of it. During that year and a half, we lost Sen. Ted Kennedy and had to endure a special election. Democrats (though they controlled both houses) negotiated away popular provisions such as the public option to garner bipartisan support, incorporating demand after demand from Republicans only to have them vote no anyway. So no, the ACA wasn’t “rammed through” like so many Republicans claim.

The bill that passed the House yesterday was debated for six hours. No amendments were allowed. No hearings were held. There was no score from the Congressional Budget Office letting us know how much it would cost or what the impact would be on the people. The previous version (the one that didn’t make it to a floor vote) was going to kick 27 million people off their health insurance. It was polling at 17 percent. Somehow, I doubt this version will be any better and, when the CBO score comes out in a week or so, we’re likely to find that it is much worse.

Why did they have to rush this? What was the hurry? One reason is that the Trump administration needed some legislative victory to tout. The president just held a 100-day rally in a town he once referred to as a “war zone” and all he could say was that he nominated a Supreme Court justice (which was McConnell more than Trump) and he signed a bunch of executive orders, which were themselves broken campaign promises. The evidence of this assertion is that after voting on the bill, House Republicans got on buses and rode to the White House for a Trump victory celebration. What were they celebrating? Paul Ryan and Donald Trump had bullied their own party into supporting bad legislation? That’s a win?

Trump said Obamacare is “dead” well, “essentially dead.” He described the Republican bill as “something that is very, very, incredibly well-crafted.” I can guarantee you with all certainty that he has no idea what is in that bill. Most of the Republicans who voted for it hadn’t read it.

Now, I can break down for you all the terrible things in this bill, such as how it declares being a woman a pre-existing condition, screws over special-needs kids, cuts Medicaid funds that help the poor to fund a tax cut for the wealthy, and offers states a waiver to allow insurance companies to jack up rates on pre-existing conditions and old people. But what’s the point? This bill will never become law. The Senate is going to start from scratch. That’s the thing that really bothers me about this. The AHCA will be DOA in the Senate. So all the arm twisting and bullying to get the votes they needed in the House was just so Trump could have his Rose Garden photo op:

It was a sea of white men all celebrating killing health care for at least 27 million people and passing a tax cut for people making more than $250,000 a year. They are so proud and happy. But most of them don’t even know what they voted for because what they really voted for was for Paul Ryan to keep his leadership post. Aside from Trump’s photo op, that was the priority here. Because if Ryan failed to pass a bill on this third try, then his speakership was going to be over. In fact, the entire House leadership team would have been kicked out.

Think about that. If you were a rank-and-file member, that conversation had to go something like:

“We need you to support this bill.”

“Can I read it?”

“We don’t have draft language yet.”

“What about a CBO score?”

“Nope.”

“Is it popular with the public?”

“Polling nationally at about 17 percent.”

“This bill sounds awful.”

“Don’t worry. You and your staff will get an exemption from whatever is in it.”

“Why should I vote for it?”

“If it fails again, the entire House leadership will be fired and you might have to take one of the posts.”

“Oh hell no!”

The American Medical Association, the American Nurses Association, the American Hospitals Association, the AARP, insurance companies, and editorial boards across the country all oppose this bill. Perhaps the president has succeeded in uniting this country afterall.

Next week (or maybe the week after) the CBO is going to tell everyone exactly what the Republicans passed yesterday. Your congressman needs to hear from you. One of the easiest ways to make that happen is to use ResistBot to send faxes and letters to your representatives for free (though they would appreciate donations). I use it three or four times a week to let my congressman, Dr. Phil Roe, know that his district isn’t as safe as he believes. If we can’t make these people feel uneasy about something as egregious as this dumpster fire of a bill, then we’ve lost already. Next year will be the midterms and every member of congress needs to be held accountable for what they did yesterday. I’ll do my part. I’m counting on you to do yours.

None Dare Call It TrumpCare?

In all fairness, President Donald Trump had very little to do with the ACA replacement bill making it’s way speedily through the House of Representatives right now. No one wants to put their names on it, (including Trump) so the Republicans call it the American Health Care Act. I’m hard pressed to think of a way you could have written a worse bill to replace Obamacare (We’re keeping all the fees and penalties, cutting your subsidies and coverage, defunding Planned Parenthood, and gutting Medicare). But let’s take a look at what we’re being fed.

First of all, though this claims to be a healthcare bill, it’s a budget bill. The House presented it as a budget bill so they could get it through the Senate with a simple majority. This also means you can’t have any real non-budget-related policy changes in the bill. That’s why we’re not seeing anything in that doesn’t have to do with how the government spends money.

There’s nothing about such Trump promises as selling insurance across state lines, transparency in pricing, or repealing the McCarren Ferguson Act. That would make the bill subject to the filibuster.

Obamacare took a year to pass — there were public hearings, debates, speeches, countless hours of TV coverage, a special election in Massachusetts when Sen. Ted Kennedy died, and an entire summer of Tea Party Town Hall meetings. The president moved off his positions to help bridge the gap with Republicans who had plenty of demands, but no interest in voting for it even when those demands were met. The result was an imperfect legislation-by-committee that nonetheless provided insurance coverage for millions of Americans who could not get it before.

It passed seven years ago. Republicans have been promising to repeal and replace it all this time including voting to repeal it more than 60 times. So it is unconscionable that they didn’t have a replacement ready to go on day one. But now that they have a replacement, they don’t want to debate it. It passed through the first committee at 4:30 a.m. without any markups. That’s unheard of — unless you’re trying to ram it through. Speaker Ryan wants to pass the bill next week and Sen. McConnell promised to have a vote in the Senate by April.

Neither of them can tell you how much the bill will cost or how many people will lose insurance because the Congressional Budget Office hasn’t scored the bill yet. And while Ryan argued that it was a sham to vote on Obamacare without a CBO score, now Republicans are attacking the CBO (which is an office filled with non-partisan number wonks).

Personal Mandate

Healthy people pay for insurance they don’t use to offset the costs of sick people. That’s how insurance works. That’s how it’s always worked. So Speaker Ryan’s contention only makes sense if your goal isn’t to provide health care. The goal is a tax cut for the rich.

Why do we have a personal mandate anyway? If you make a law that says insurance companies can’t turn away sick people, then you have to also make it a law that everyone has to have insurance. Otherwise, no one buys insurance until they get sick.

Under Obamacare, If you don’t have health insurance, you pay a fine. This drives healthy people into the marketplace:

“I have to buy insurance or I have to pay the IRS a penalty. I’m going to buy health insurance.”

Trumpcare flips this on its side. There is no penalty for not buying health insurance. But if you have a gap in coverage, you have to pay a 30 percent surcharge on your premiums for a year:

“I didn’t buy health insurance while I was looking for a job out of school, now I don’t want to buy it because I have to pay a 30 percent penalty. I’ll put that off until I get sick and have no choice.”

This alone makes this bill worthy of the name “Trumpcare” because it solves a problem that nobody thought was a problem. Seriously, during the entire year of debate over Obamacare, did anyone ever suggest that the issue with the penalties for not having coverage was who got to keep the money? The entire SCOTUS case over Obamacare was about whether the penalty was a fee or a tax. This bill doesn’t eliminate the penalty. It just changes who gets paid. How is that an improvement for anyone except insurance companies?

Premium Subsidies

If you have a personal mandate, you have to subsidize those who can’t afford it. Obamacare based subsidies on income as well as other factors. If you couldn’t afford your coverage you could receive subsidies to help pay for your health insurance. That’s the way it was supposed to work, anyway. But there was a donut hole in the law that left some people in a bind if they made too much money for a subsidy but still couldn’t afford coverage.

The expansion of Medicaid was designed to cover those people. Originally, the Medicaid expansion was mandated for every state. But several states sued and the courts said the fed couldn’t require states to expand Medicaid or build state insurance exchanges. The result was that states that expanded Medicaid saw a dramatic drop in uninsured. Those that refused, saw a lot of angry poor people.

The bill bases these subsidies on age. The older you are, the more money you get. This makes no sense because poverty affects young and old alike. And instead of increasing the subsidy with need, you get a flat rate.

Trumpcare doesn’t make sense as a health care bill. It doesn’t make sense as a budget bill. It only makes sense as a tax cut for the wealthy.

Goodbye, Medicaid

Medicaid under Obamacare was expanded. Medicaid under Trumpcare gets gutted. Speaker Ryan bragged that the bill does something that’s never been done before — it defederalizes an entitlement program, capping both spending and rate of growth. What he means by that is that rather than administering Medicaid. The fed will give block grants to states to run their own version of Medicaid. Capping spending and rate of growth is Ryanspeak for cutting funding and letting that states make up the difference in costs. I don’t know about your state, but Tennessee can’t afford it.

The bill calls for the savings from these Medicaid cuts go toward tax cuts for upper brackets. What this does is shift the money designated for poor people to rich people. In fact, according to the Center for Budget and Policy Priorities, this bill will transfer $370 billion from the poor to the top one percent of earners over ten years.

By the way, healthcare for the poor (according to Speaker Ryan) is an entitlement. But the tax breaks for the rich aren’t. Sounds like “Trumpcare” to me.

Compare and Contrast

Republicans want to compare the two plans using odd benchmarks like how many pages it took to print the bills.

Image: US-POLITICS-SPICER-BRIEFING

Incidentally, despite being so many fewer pages than the ACA, the Trumpcare bill has six pages dedicated to how to deal with a poor person who wins the lottery. It devotes a not-insignificant amount of space to allowing insurance companies to write off huge salaries for CEOs. I don’t recall that being part of the Tea Party chants. I don’t remember Trump campaigning on giving insurance companies a big tax cut. This only makes sense if the bill is a tax cut for the rich and not a healthcare bill.

When it comes to more important and relevant benchmarks, the Republicans don’t want to hear it. Literally. How much will Trumpcare cost? We don’t know. The Congressional Budget Office hasn’t scored it yet and the GOP doesn’t want to wait on them. How many people will be left uninsured? Speaker Ryan can’t say.

The House is trying to rush through a vote and the Senate has already indicated that they’ll vote on it by April. That’s crazy. The only reason to do that is to hide the cost. They don’t want to know. Trumpcare.

They don’t care because the purpose of the bill is not to ensure healthcare for all Americans but to ensure profits for all insurance companies. If this bill makes it to Trump’s desk and he signs it, it won’t be while surrounded by old people, children, or the sick. He will be flanked by insurance executives in suits all tenting their fingers and licking their chops.

The ironic thing to me is that the people who will be hurt worst by this bill (those who stand to lose at least $5,000 in subsidies) voted for Trump by 59 percent. Is there a better name than “Trumpcare?”

Coverage

Let’s get something out of the way about insurance coverage. Republicans in the House don’t understand how it works. Later in the exchange in the video above, a House Republican yells that what he wants is for people to buy their insurance ala carte — picking the coverage they want to pay for. But insurance isn’t sold that way. It’s never been sold that way and Republicans don’t have the power to change the way an industry does business (not with a “budget” bill).

Think of it like your cable bill. You want HBO, but you don’t want CSPAN. You watch “Game of Thrones” but have no interest in watching our government’s dysfunction first hand.

You buy a package. The package includes CSPAN and HBO. You don’t get a break on your bill for not watching CSPAN. You don’t get to pick and choose which channels are part of the package. CSPAN isn’t for everyone, but it is important and so everyone gets access.

The same goes for things like prenatal coverage. I know a couple who owns a successful business, have no children, and no plans to adopt. Their health insurance covers prenatal care. This couple won’t use it. But their package will help subsidize the Duggers’ 21st kid instead. We can’t mandate the number of children people can have. So we spread the cost around. That’s how it works.

Republicans like to frame this debate as about access to healthcare, rather than affordability of healthcare. They seem to believe the problem is not enough patient choice, rather than not enough patient money. Along those lines, Trump and his surrogates have made some crazy promises about coverage that this bill cannot keep.

We’re going to have insurance for everybody. There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us. You can expect to have great health care. It will be in a much-simplified form. Much less expensive and much better.” — President-elect Trump, January 15, 2017.

“I firmly believe that nobody will be worse off financially in the process that we’re going through. They’ll have choices that they can select the kind of coverage that they want for themselves and for their family, not the government forces them to buy.” — HHS Secretary Tom Price, March 12, 2017.

S&P Global says between 6-10 million will lose coverage. Brookings says at least 15 million will lose coverage. The Congressional Budget Office (which released a report while I was writing this) estimates 24 million will lose coverage.

So How’s It Going?

The AARP is out.

The Heritage Foundation is out.

The House Freedom Caucus is out.

Breitbart is out.

Sen. “Tehran Tom” Cotton is out.

Sen. Rand Paul is out.

The American Medical Association is out.

The American Nurses Association is out.

The American Hospital Association is out.

Freedomworks is out.

Americans for Prosperity is out.

That’s some heavy hitters from the industry and from conservative politics. Well, if liberals don’t like it and conservatives don’t like it, who does support it?

Trump, Ryan, and The US Chamber of Commerce.

There is every indication that this bill won’t pass in its current form. Speaker Ryan said not passing it could stall the Republican’s agenda. Trump said if the bill fails, his plan B is to let Obamacare fail (because, you know, “death spiral”) and blame the Democrats.

The bottom line is that this bill is a travesty that fixes none of the problems Obamacare has and creates a whole new set of issues. To fix the problems with Obamacare, you’ll have to spend more money. Republicans are not interested in spending money to fix it. They’re not interested in providing healthcare to poor people. They just want to transfer more wealth to the upper earners.

I can’t think of a better name for that than “Trumpcare.”

 

EDIT: Here’s the CBO report.

 

This way lies madness: Tennessee, the Affordable Care Act and the Nullifiers

The Affordable Care Act is the law that created both the federal health insurance exchanges and the state health insurance exchanges. It also created mandates for some business owners and people to buy health insurance. It isn’t socialized medicine (where the government owns the hospitals) and it isn’t single-payer health care (where the government pays private companies to provide health care). The exchanges are a hybrid where healthy people who might not feel like they need health insurance are required to buy it to support the costs of older, less-healthy people who really need health insurance to keep from being bankrupted by medical bills. It is the result of a compromise reached after months of negotiations. It is imperfect, but it is the law.

The result of the ACA is insurance companies can no longer discriminate against people who have “pre-existing conditions.” They can no longer charge women more money for the same care. They can no longer kick you out of your plan when you become ill. There are no more lifetime caps to benefits. Your children can remain on your health care plan until they’re 25. But you have to buy insurance or pay a fee for not buying it. The ACA set up government subsidies for people who can’t afford insurance and produced a web site, healthcare.gov, for people to shop for plans if their state chose not to set up a state-based exchange.

The ACA also provides money to states to expand medicare coverage for the poor, uninsured residents. The federal government offered to pay 100 percent of the costs of the expansion for the first three years and then reduce the subsidy thereafter. Some states with the largest populations of poor, uninsured residents (*cough* Texas *cough*) refused the expansion.

My home state, Tennessee, refused to accept the federal expansion and did not set up a state-based exchange. So Tennessee residents had to shop on healthcare.gov. So far about 36,000 of us did.

The ACA isn’t health insurance. It is a marketplace where people can compare insurance plans available and make an informed decision. They can also find out if they qualify for subsidies to help defray the costs. But when you’re done, what you have is a health insurance plan sold by a private company to an individual or family. The plans are the same as the ones sold out in the world by agents and brokers. The ACA doesn’t reform health care. It reforms health insurance, establishing minimum standards of coverage, encouraging people to buy plans and helping those who can’t afford them.

Enter State Senator Mae Beavers and State Representative Mark Pody. These two have cooked up a bill to make it illegal to use healthcare.gov to buy insurance. Specifically, the bill states:

…no powers, assets, employees, agents or contractors of the state or its local government subdivisions, including higher education institutions, can be used to implement or administer the federal health care program; bans Obamacare healthcare exchanges in the state; prohibits local governments in Tennessee from participating in or purchasing insurance from an ObamaCare health insurance exchange;
provides that any health insurance contracts purchased in violation shall be void in a court of law in Tennessee; and empowers the General Assembly to enact sanctions, fines and penalties for violation of the proposed law and gives the state’s Attorney General the right to file a lawsuit against violators;

So, even though my insurance (which is employer-based) is identical to your insurance (which you purchased through healthcare.gov) mine is fine and legal, but yours is null and void. Plus, you could be sued by the state for buying it and state-sponsored hospitals can by sued by the state for honoring it. As Betsy Phillips points out in the Nashville Scene, the University of Tennessee Medical Center would, under this law, have a nightmare responsibility to not only verify that patients have insurance, but where they bought it.

Why? Because reasons, that’s why. Beavers and Pody claim that Tennesseans don’t want the ACA and that the federal government cannot force state agencies to comply with federal laws. They believe, based on Printz v. US that the state can nullify federal law. And oooooh do right wingers love the idea of nullification. Beavers’ Facebook page (find your own link) is full of people commenting in all caps “NULLIFY!!!!”

Quick review: Printz v. US was a Supreme Court case in which state law enforcement officers sued the government over the Brady Law, which established the federal criminal background check requirement for gun purchases from licensed dealers. Specifically, before the instant check system was implemented, there were interim regulations requiring gun sellers to fill out of a form on the buyer and submit it to law enforcement who was compelled to run a background check within five days. The court ruled that the federal government cannot commandeer state law enforcement to enforce federal law.

Beavers and Pody believe this decision can be applied to the ACA so that the feds cannot require that the state implement Obamacare. But here’s the thing: Printz v. US does establish a precedent that the fed can’t commandeer the state’s assets to enforce federal law, but it doesn’t allow for nullification of the law. Nor does it allow the state to block federal officials from enforcing federal law in the state. Nullification allows states to ignore unconstitutional laws, but the ACA has been upheld by the Supreme Court as constitutional.

See, if states could just ignore any federal laws they wanted to, we’d still have segregated schools in the South and Chicago and Washington, D.C. would still have a ban on guns. In 1960, the Supreme Court found in Bush v. Orleans School Board that the concept of nullification was  an “illegal defiance of constitutional authority.” So you can scream in all caps on Facebook “NULLIFICATION” all you want, but the courts are going to smack you down.

When Beavers and Pody announced the bill, they were asked some basic questions:

Have they talked with the governor’s office about this? No. Not yet.
Have they talked to state officials who implement TennCare — the state’s Medicaid program for the uninsured poor (which uses healthcare.gov to help people find insurance plans and subsidies)? No. But they’ll probably come to us.
How will this affect the 36,000 or so Tennesseans who have already purchased insurance through the federal exchange? It isn’t clear.

Well, shouldn’t it be clear before you go and make them criminals after the fact? What about the people who go along with you and decide not to buy health insurance? When the federal government imposes a fine, will the state be there to pay it? Or defend against it? The ACA allows that fine to be taken from federal tax refunds. How will this law affect them?

My gut tells me that Beavers and Pody don’t believe this bill will ever become law. They introduced it as a way to fend off primary challengers from the right. But it begs the question if my insurance is the same as your insurance, why does it matter where either of us bought it?

It isn’t pro-life, it is pro-forced birth.

As an avid new media fan, I took to Twitter to follow the drama in the Texas state house regarding the draconian abortion restrictions being debated there. It was inspiring to see all those women and men engaging the legislature during what became known as “The People’s Filibuster.” The gallery in Texas was crammed full of protesters in the burnt orange of the University of Texas.

I read updates as Sen. Wendy Davis stood and talked for more than 11 hours about why this was bad law. She was amazing and most likely launched a campaign to gain statewide office. She and the Democrats ran out the clock and the special legislative session ended without the Senate passing the bill.

The next day, Gov. Perry called for another special session. He had no choice, because there were other bills that needed attention, including a highway funding bill and a bill to reform the juvenile justice system in the state. Nevertheless, the state senate took up the abortion bill as the first order of business: SB1.

This time around, supporters showed up in blue shirts to cheer on the Republicans who sat around and voted down amendment after amendment, waiting until the time for the vote so they could go home. Impassioned pleas for sanity? Nope. Testimony from medical professionals? Ignored. Testimony from people affected by this bill? Why bother?

The omnibus abortion restrictions bill is a wish list for pro-forced birthers: It outlaws abortions after 20 weeks (supposedly the point where the fetus can feel pain). It creates a series of new regulations for health care clinics that provide abortion services, including making them adhere to the rules for an ambulatory surgical center, requiring doctors have admitting privileges at hospitals within 30 miles of the clinic, requiring all patients seeking an abortion to have an ultrasound at least 24 hours before the procedure, requiring doctors performing the procedure to amplify the fetal heartbeat for the patient, requiring patients who want non-surgical abortions (i.e. taking RU486) to travel to a surgical center and take the pill in front of a doctor.

Similar laws, passed in other states, have been struck down by courts, but Texans have their fingers crossed, I guess, that somehow, they’re special enough to get around that pesky Constitution.

What struck me was the difference in debate style between the two sides: Democrats offered testimony by medical professionals saying the restrictions were unnecessary and would have little or no affect on the care provided patients. The law would just shut down more than 80 percent of health care clinics in the state that provide abortion services. The Republicans cited the Bible, Jesus, the fear of God and debunked claims about the safety of the procedure.

It was daft. The author of the bill, Rep. Jodie Laubenberg refused any and all amendments, including exceptions for victims of rape and incest or considerations for the health and life of the mother. During the first special session, she claimed that the rape kits used by hospitals to collect forensic evidence would clean the woman out, so there was no need for an exception for rape victims. During the second special session, she claimed that the bill wasn’t about reducing abortions and it wouldn’t close any clinics because nothing in the bill specifically said a clinic has to close.

It was an astounding case of brain myopia. Each Republican claimed the bill was about providing a safe environment for the mother to have her abortion. They didn’t intend to restrict abortion at all, just make it safer. But if that were the case, why didn’t a single one of the state’s healthcare organizations endorse the bill?

Dr. Peter Carmel, president of the American Medical Association said the bill was a “needless, dangerous interference in the practice of medicine by politicians.”

But let’s get back to Rep. Laubenberg for a second. After spending hours and hours claiming the bill wasn’t designed to eliminate abortion or close clinics, she ended the evening’s debate by saying she wanted to limit abortions. She said there had been 70,000 abortions in Texas. Now let’s set the way-back machine to 2007, when Rep. Laubenberg was debating a health care bill in Texas, specifically a bill to provide health insurance to children (CHIP).

Laubenberg proposed an amendment to prevent pregnant women from seeking prenatal care under the program until three months into the pregnancy. When challenged by Democrats as to why these supposedly unborn babies didn’t deserve health care, Laubenberg replied “They’re not born yet.”

Look at what the bill requires:

1) All abortions must be performed in an ambulatory surgical center (ASC). Republicans say this requirement would make the procedure safer for women. In reality, surgical abortion is about as safe a procedure as there is in medicine. It is done with a local anesthetic without actually opening up the patient. It is considerably safer than carrying a child to term. On July 8, an offical from the Department of Social and Health Services testified “I wouldn’t be able to say abortion procedures would be safer if performed at an ambulatory surgical center.” Most abortions aren’t actually surgical procedures at all and the bill doesn’t specify that only surgical abortions must be performed at ASCs. In the first trimester, most patients are given medications to take home with instructions on how to take the pills. This law specifies that the patient must go to an ASC no matter what type of procedure she requires.

An interesting note about ASCs that came up during the debate: Abortion clinics are inspected by the state every year, but ASCs are only inspected every three years (and fertilizer plants are only inspected once every 30 years, evidently).

Another interesting note is that Gov. Perry’s sister is a big advocate for ASCs and most likely will make a bunch of money on abortions if the law passes.

2) No abortion after 20 weeks. If this seems familiar, it is because lots of Republican-controlled state legislators rolled out this bill in the last few years. The idea is that fetuses can feel pain at 20 weeks. This isn’t actually supported by medical evidence. In fact, embryologist say that the neural pathways necessary to feel pain haven’t developed by then. Last March, a federal court struck down Idaho’s fetal pain law (enacted in 2010). So far, 11 states have fetal pain laws working their way through the courts.

3) Doctors performing abortions must have admitting privileges at a hospital within 30 miles of the abortion clinic. Now, think about that for a minute. Suppose something goes wrong during a surgical abortion. The patient is rushed to a hospital emergency room and is treated regardless of whether the doctor has privileges or not. In fact, even if the doctor has privileges, it is unlikely he or she will be the one to treat the patient at the hospital. So why does it matter? (I mean other than to interfere in a woman’s right to reproductive choice.)

4) All patients seeking an abortion are required to have an ultrasound. The doctor must amplify the fetal heartbeat and show the image to the patient. Patients must wait 24 hours after an ultrasound before having an abortion. Now, if a doctor believes an ultrasound is necessary, then he or she can order one, but forcing a patient to have (and pay for) a procedure that is medically unnecessary belies an attitude that a lot of old, fat men in these sacred halls of power possess: Women don’t really understand what they’re doing and need to be helped along. This law is often proposed as a way of ensuring that women have all the “necessary information” to make a good choice and have time to wrap their pretty little heads around their decisions. It infantilizes women and it is insulting. The 24 hour waiting period just creates another barrier for poor women who must take extra time off work, pay for a hotel room or make two trips.

5) A doctor must be present for every procedure. We live in a world where we can use our phones to watch live streaming video from Mars. Telemedicine has been around for years. Doctors in nearly every other field of medicine use it without problems. Certainly doctors should be present for any surgical procedures, but if the patient is simply seeking a “medical” abortion (as opposed to a surgical abortion) then there is really no reason for a doctor to be in the room to watch the patient take a pill.

As an aside: our second child was born at a birthing center with a nurse practitioner/midwife and a doula. Carrying a baby to term is way more complicated and dangerous than a medical abortion, but we weren’t required to see a doctor at all during the 72 hours of labor.

So let’s stop pretending that this bill was about anything other than throwing up boundaries between a woman and her right to reproductive choice. I’d also point out that Texas’ fascination with the life of a fetus ends with birth. In the last few years they have cut funds for education, family planning, health insurance for children and nutrition programs. The legislature doesn’t care about children, only forcing women to give birth. More than 96 percent of Texas school districts teach abstinence-only sex education. Texas leads the nation in teen births and is fourth in teen pregnancy. Studies and surveys show that teenagers who are only taught abstinence are just as likely to have sex as other students, but were much more likely to have an unwanted pregnancy as a result. The entirety of Texas law in this area seems to be institutionalized punishment for women who have sex.

In a recent interview with the Texas Tribune, Gov. Perry was asked why, given the statistics, does Texas still favor abstinence-only education? He replied “Abstinence works… it is the best form to teach our children.” Gov. Perry turned down $4.4 million in federal dollars aimed at expanding sex ed in the state to include information on birth control and STIs. You know, to help reduce unwanted pregnancy and, by extension, abortions.

It’s seriously like Texas is one big episode of “My Big Fat Gypsy Wedding.” If you’ve ever seen the show, you’ll understand what I mean. The teenaged girls get married to teenaged boys. The mothers refuse to talk about sex with their daughters beforehand and the teenaged boys are suspicious of any gypsy girl who knows too much about sex before the wedding. The boys, on the other hand, are encouraged to have sex with non-gypsy girls so they’re all ready for the wedding night and it is all legitimized under a cloak of “tradition” when in reality it is a form of child abuse.

So what happens next? Well, for one thing, Rick Santorum is headed to Texas in case some of us weren’t aware of his views on abortion. The House will have a third reading of the bill (HB2) this week, then the Senate will pass it. It will be challenged in the courts and will be struck down. Perry has already announced he won’t run for another term. That’s probably a good idea since he’s lost the votes of a lot of women this month. Demographics are catching up with Texas and the fat, old men who believe they know better than a woman about what’s good for her will continue to demonstrate their ignorance and stupidity (I saw two people on Twitter post the same quote from a Texas rep: “An abortion is one of the most violent, terrible acts one man can do to another”) and eventually they’ll die off.

Can’t happen soon enough for the women of Texas.

I will say this for Texas, though. The reason I can get so worked up about it is because it was done in the light of day. Sure, it had to be done in a special session with different rules so the Republicans could ram it through, but by and large, it was done out in the open.

In North Carolina, Republicans took a bill to ban Sharia Law in the state (don’t get me started) and brought it to the floor with additional anti-abortion measures added, making this the most ironic bill to come out this year. It was a bill designed to ban Islamic law which is often used to subordinate women and it became a Christian bill designed to subordinate women. It is full of measures requiring abortion clinics to widen hallways and entrance awnings. You know, in the name of “safety.” Should the bill pass, all but one clinic in North Carolina would be forced to close.

In Ohio, Republicans added anti-abortion measures to the state budget, dumping the entire thing in Gov. Kasich’s lap. Kasich, who has the line-item veto, could have excised them, but instead he signed off. This new budget requires every woman seeking an abortion to have a trans-vaginal ultrasound (the state budget now requires a woman to be vaginally probed against her or her doctor’s will. When this came up in Virginia, opponents called it “State-sponsored rape“)

The budget also defunds Planned Parenthood, threatens jail terms and fines for any rape counselors receiving state funds to offer information about abortion to rape victims, provides funding for “crisis pregnancy centers” which are criticized for giving false and misleading information to pregnant women and requires doctors performing abortions to read from a script to the patient (even if he or she doesn’t believe the information in the script is necessary or acurate).

And, in case you still think this is about the safety of woman, the state budget forbids public hospitals from admitting women who have complications as a result of abortion procedures. None of this was debated. It was simply added to the must-pass state budget.

I’ll finish this screed with this: Right after the Texas House passed the bill on the second reading, Twitter lit up with people on both sides. I read a bunch of Tweets and I knew better, but one struck me and I decided to engage:

Hobby Lobby and the “Abortion Mandate.”

hobby-lobbyStand back, kids, because I’m about to whip a little science on you.

Recently, I read this hand-wringing account of what’s happening to the poor owners of Hobby Lobby. Although it is never a good idea when it comes to these articles, I read down into the comments. I did this to see if there was any disagreement among the readers about the nature of this “tragedy.”

But I’m getting ahead of myself. Here are the facts as I understand them:

The Green family, owners of Hobby Lobby, are reportedly devout, evangelical Christians. Shopping at Hobby Lobby makes this point very clear. But the Greens have always said they want their business to be run on Christian principles.

When the Affordable Care Act (ACA) passed, among the new regulations was a mandate that contraceptives be provided without a co-pay for employees. There were exceptions carved out for religious institutions and delays for religiously affiliated institutions, but if you’re just a regular company looking to make a profit (even if you adhere to biblical principles in your decision-making) you are required to provide contraceptive coverage in your health care plan.

The Greens didn’t like this and sued the federal government for emergency injunctive relief until this was all settled in the courts. The Supreme Court denied their request, so Hobby Lobby employees can get their contraceptives without a co-pay.

Or they would, except that the Greens have said they will defy the court order and pay the fines, which can total as much as $1.3 million per day.

That’s where the hand-wringing comes in.

The Greens claim that their religious freedom has been infringed upon because they are being forced to pay for abortions, which they believe is murder. The commenters mostly agreed except for a few who pointed out that an employer’s religious beliefs shouldn’t outweigh those of the employees’.

But I believe that’s the wrong argument (even though it is a valid one).

The argument should be over whether the contraception mandate is actually an abortion mandate. All through this article, the author refers to the “Obamacare abortion mandate.” The author claims this has nothing to do with contraceptives and that no one is trying to outlaw contraceptives (*cough* Santorum *cough*). They see it as unconscionable that a devout Christian can be forced to pay for his employee’s abortions.

To that point I can only say “Look at the science.”

When the Greens (and the author) talk about the abortion mandate, they are referring to “Plan B” or “emergency contraception” or “the morning after pill.” They and their ilk refer to these drugs as “abortifacients,” meaning they induce abortions.

But abortifacients aren’t a part of the contraceptive mandate. If you look at the HHS regulation, it says that insurance should cover “contraceptives” approved by the FDA. This list includes Plan B and emergency contraceptives, but neither of these drugs are abortifacients.

They simply aren’t. You may not like that fact. It may not jibe with what your minister or elected official tells you, but facts are facts.

If you are pregnant and you take either Plan B or emergency contraceptives, then the drugs have no affect. None. They don’t induce abortions in pregnant women. They can’t. They don’t work like that. They are classified as contraceptives because they prevent conception. Just because you happen to take them after sex doesn’t mean they are abortifacients and believing otherwise belies an ignorance of how one actually gets pregnant.

No one was making that point in the comments section and I wasn’t about to stick my hand in that particular hornet nest.

So, I say let Hobby Lobby pay all the fines it wants to. If it drives the company out of business, then they’ll serve as a cautionary tale for other business owners who want to impose their religious beliefs on their employees, based on bad science.

You can always buy your glue gun refills at Michaels, right?