McCain unloads on Trump for failing to sanction Russia

Posted By: Andrew Romans October 11, 2017

Sens John McCain (R-AZ) and Ben Cardin (D-MD) just publicly condemned the Trump administration for failing to meet a legally-mandated deadline to impose sanctions against Russia for their interference in the 2016 election.

“The delay calls into question the Trump administration’s commitment to the sanctions bill which was signed into law more than two months ago, following months of public debate and negotiations in Congress. They’ve had plenty of time to get their act together,” the pair said in a joint statement on Wednesday.

The bipartisan bill was passed months ago, and had set an October 1st deadline by which Trump was required to identify which Russian targets should be punished as part of Russia’s defense and intelligence sectors. Those named would be met with sanctions.

The bill was passed as a way to force Trump to punish Russia for tampering with the election. The administration has not done so thus far.

Trump, for his part, has yet to weigh in on whether Russia interfered at all. An ongoing, much-publicized investigation is also being conducted into connections between Trump’s campaign and Russian operatives, which Trump has said is “fake news.”

“In addition to the administration’s lack of responsiveness on this deadline, there does not appear to be a significant diplomatic effort to engage our allies in Europe and lead an effort to increase pressure on Moscow,” McCain and Cardin continued. “Congressional intent was clear, reflected in the overwhelming bipartisan majority in favor of the legislation.”

McCain and Cardin attempted to remind Trump of his upcoming deadline in another letter on Sept. 29th, the same day Trump later issued a memorandum delegating the bulk of the task to Secretary of State Rex Tillerson. Despite this, the Trump administration has yet to name any names as the bill demands.

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Ohio Issue 2’s yes, no sides debate 1 month before voters decide

A public forum in Columbus Wednesday night attempted to cut through that rhetoric of Issue 2, known as the Ohio Drug Price Relief Act
By Jason Aubry Published: September 22, 2017, 2:56 pm Updated: October 11, 2017, 11:47 pm

COLUMBUS, Ohio (WKBN) – Trying to untangle the complicated and controversial topic of Ohio’s Issue 2 on the November ballot is no easy task, especially when the rhetoric from both sides is so deeply entrenched.

Under what is also known as the Ohio Drug Price Relief Act, the state would not be allowed to enter into a purchase agreement for prescription drugs unless the net cost is the same or lower than the lowest price paid for the same drug by the U.S. Department of Veterans Affairs. The law would also require state payment of attorney fees and expenses for defense of the law.

Proponents of the act say its goal is to control prescription drug spending.

For months, Dale Butland and Matt Borges have gone head-to-head on TV and radio, discussing why Ohioans should vote for or against the measure. Their talking points have not changed much over the past few months.

Meanwhile, TV ads that some call deceptive continue to confuse the public’s understanding of what Issue 2 proposes to do. You have probably watched commercials for and against the issue for several weeks.

A public forum in Columbus Wednesday night attempted to cut through that rhetoric. Butland and Borges were invited to, once again, explain to voters in simple terms how the issue works and what it will do for them.

As we have come to expect from politically-charged issues, they used spins and pivots liberally.

New information did find its way into the discussion, however. Sprinkled throughout was talk of a fiscal analysis released Tuesday from the Governor’s Office of Budget and Management that ultimately found there to be “insufficient information to estimate savings.”

Read more: Fiscal analysis of Issue 2

Proponents of Issue 2 have continually claimed that passing the measure would save Ohioans $400 million. During the forum, Borges even referenced some passages from the study that sounded as if they supported this position, such as:

However, theoretically, if all the issues identified in this analysis were worked through to successfully implement Issue 2, it is likely there would be some state savings.”
As well as:

The other state entities and programs with prescription drug spending — OSU Medical Center, higher education institutions, state employee health benefits, workers’ compensation, institutional facilities, and CMH — are similar to one another in the amount of discounts and rebates they receive, which is far less than Medicaid. Thus, they generally appear to pay more than the VA pays for prescription drugs. So theoretically, if suppliers agreed to provide drugs currently purchased by the state and the VA at the lower VA prices without any manufacturer response or implementation impediments, there could be savings in the millions of dollars.”
However, he never clarified that such language carried with it significant caveats that made those savings unlikely.

Meanwhile, those opposing Issue 2 continued to field questions about where their funding comes from — predominantly, major pharmaceutical companies.

It is clear the “Vote Yes” campaign is taking an approach that focuses on the voter’s opinion of pharmaceutical companies, using negative terms in describing them.

The “Vote No” campaign wants voters to trust local opinions of medical professionals and newspapers, while painting a major financial backer of the “Vote Yes” campaign as an outsider trying to influence their vote.

In the end, both sides were able to get their messages out to the viewers. Which message stuck, and if it clarified this convoluted issue, remains to be seen.

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Trump Plans To Sign Order That Would Undermine Obamacare Insurance Rules

It could create a parallel insurance system for healthy people.

By Jonathan Cohn

President Donald Trump on Thursday plans to sign an order that could rattle the Affordable Care Act’s private insurance markets by allowing a proliferation of cheaper, less comprehensive plans that would undermine rules about who and what insurers must cover.
The changes represent a step toward repeal of Obamacare, something Trump and Republicans have unsuccessfully attempted to do through legislation. And the ultimate impact on small businesses and people who buy private coverage on their own ― the two groups Thursday’s order would affect directly ― is likely to resemble some of the effects that experts predicted GOP repeal bills would have if they become law.
The new, less regulated insurance plans could provide an attractive alternative to consumers who don’t expect to have large medical bills and who are frustrated with the high premiums they pay for policies today. At the same time, comprehensive coverage could become harder and eventually even impossible to find, especially for people with pre-existing conditions.
For the moment, it’s difficult to say just how far-reaching the order’s effects will be or when all of the changes would take place.
As first reported by The Hill and The Wall Street Journal, and as described to HuffPost by two sources familiar with the administration’s thinking, the order will call for writing new regulations. Some of those could test the boundaries of executive authority, prompting legal challenges that could drag on in the courts for years.
But some parts of the order are likely to take effect more quickly. Perhaps the most consequential of those is a decision to end a rule that limited short-term insurance plans to no more than three months.
Many insurers, including at least one large national carrier, already offer these plans, which are not subject to most of the Affordable Care Act’s rules. The plans don’t have to include mental health coverage, maternity care, full prescription coverage or other benefits the ACA deems essential. The insurers selling them are free to charge higher prices or deny coverage altogether to people with pre-existing conditions.
The three-month limit came from the Obama administration, which worried the short-term plans would draw away consumers in relatively good health, causing state insurance markets to split in two. Taken together, the actions that Trump’s Thursday order envisions could have precisely that result.
Opening The Door To Cheap, Skimpy Insurance Plans
On one side of the split would be those short-term policies as well as special “association” plans available to small businesses and, in some cases, individuals.
Those association plans exist today but must abide by a variety of state and federal regulations. Trump’s order would effectively lift some of those restrictions so that, among other things, they could exclude some of the ACA’s essential benefits. (The order will not specify whether individuals can enroll in the newly deregulated plans, according to the Journal; the Labor Department will have to make that decision when it writes the new rules.)
Because they wouldn’t cover as much and be less available to people with the highest medical bills, the policies in this part of the insurance market would be cheaper and likely popular with people in relatively good health. This is one of the big selling points that Trump and Republicans like Sen. Rand Paul (R-Ky.), who worked with the administration to craft its proposal, keep emphasizing: the possibility of giving consumers new and cheaper ways to get insurance.
But the other side of the insurance market, with the plans that continue to meet the Affordable Care Act’s standards, could be in trouble. These plans would have all the essential benefits and be available, at uniform prices, to everybody regardless of pre-existing conditions. The insurers operating these plans would have to raise prices, because they would be losing healthy consumers whose premiums pay the bills of people with serious medical conditions.
Most people who buy coverage through or one of the state-run exchanges would not feel the effects right away, because they qualify for tax credits that insulate them from premium spikes. But if the migration into the less regulated plans was severe, some insurers would give up and abandon markets altogether, quite possibly leaving even the subsidized consumers, including the healthy ones, with no source of comprehensive coverage.
A key variable in how Trump’s order plays out is the future the Affordable Care Act’s individual mandate, which imposes a financial penalty on people who do not obtain insurance. The mandate is unpopular with the public generally and positively toxic among some conservatives, but experts and insurers say it’s an essential piece of the Affordable Care Act’s architecture because it encourages relatively healthy people to enroll.
The Trump administration has already indicated it will look for ways to weaken that penalty. If it decides, for example, that people who buy the temporary insurance plans will not face the penalty ― an option the Obama administration specifically rejected ― that could make those policies a lot more popular, putting new pressure on insurers to raise prices or drop plans.
All of this should sound familiar because it’s what pretty much every reliable authority, including scholars at the Brookings Institution and the trade group representing America’s health insurance industry, have repeatedly warned would happen if GOP repeal legislation were to become law.
Just how much of the repeal agenda Trump can now achieve on his own will depend on a few things: the details of the regulations that the agencies end up writing, the pressure they feel from members of Congress and other interest groups as they go through that process, the fate of the inevitable legal challenges, and the actions of state officials who would retain at least some power to regulate insurance on their own.
The public’s reaction could make a huge difference, as well, though it remains to be seen whether the arcane, drawn-out process of writing regulations will generate the same kind of backlash that GOP legislative efforts to pass a repeal bill have had.
Creating Conditions For An Insurance Market Collapse
Trump, Paul, and other Republicans who support the executive order have said it is necessary because the Affordable Care Act is “failing.” Insurers are jacking up premiums even more for next year, they note, and large swathes of the country already have just one insurer. In states like Iowa and Tennessee, the newly reformed private insurance markets have teetered on the edge of collapse.
Even the Affordable Care Act’s staunchest defenders concede that the new insurance markets have struggled in some states ― and that, particularly for people who don’t qualify for the law’s tax credits, coverage has gotten too expensive.
But particularly in states like California and Michigan, where officials have committed themselves to the program’s success, the markets have worked well. Except in isolated rural pockets, consumers still have plenty of choices and prices are comparable to, if not better than, equivalent employer coverage.
And as of the beginning of this year, markets even in struggling states seemed to be stabilizing, with insurers reducing losses or posting profits as they finally figured out how to design and price their markets properly.
Now, markets in some of those states are suddenly looking shaky again, but officials and insurers have said that’s to a large extent because of actions the Trump administration has taken, like threatening to cut off key funds for insurers, slashing the outreach and advertising budget for the Affordable Care Act, and weakening the individual mandate.
With Thursday’s executive order, Trump could push the whole system even closer to collapse.
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Jonathan Cohn
Senior National Correspondent, HuffPost
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