The Pronk Pops Show 934, July 24, 2017, Breaking — Breaking — Story 1: Pence Breaks Tie — Senate Will Debate How To Proceed With Obamacare Repeal and Replace — Videos — Story 2: Congress Overwhelming Passes New Sanctions on Russia, Iran and North Korea — Long Overdue — Videos — Story 3: Trump Again Critical Of Attorney General Sessions Apparently For Not Prosecuting Leakers and Going After Clinton Foundation Crimes — What about Obama Administration’s Spying On Trump — An Abuse of Power Using Intelligence Community for Political Purposes — Will Trump Dump Sessions? If He Does Trump Will Start To Lose His Supporters in Talk Radio and Voter Base — Direct Deputy Attorney Rod Rosenstein To Fire Mueller — If He Won’t Fire Him — Fire Both Mueller and Rosenstein —  Punish Your Enemies and Reward Your Friends President Trump! — “In Your Guts You Know He is Nuts” — Videos

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The Pronk Pops Show Podcasts

Pronk Pops Show 934,  July 25, 2017

Pronk Pops Show 933,  July 24, 2017

Pronk Pops Show 932,  July 20, 2017

Pronk Pops Show 931,  July 19, 2017

Pronk Pops Show 930,  July 18, 2017

Pronk Pops Show 929,  July 17, 2017

Pronk Pops Show 928,  July 13, 2017

Pronk Pops Show 927,  July 12, 2017

Pronk Pops Show 926,  July 11, 2017

Pronk Pops Show 925,  July 10, 2017

Pronk Pops Show 924,  July 6, 2017

Pronk Pops Show 923,  July 5, 2017

Pronk Pops Show 922,  July 3, 2017 

Pronk Pops Show 921,  June 29, 2017

Pronk Pops Show 920,  June 28, 2017

Pronk Pops Show 919,  June 27, 2017

Pronk Pops Show 918,  June 26, 2017 

Pronk Pops Show 917,  June 22, 2017

Pronk Pops Show 916,  June 21, 2017

Pronk Pops Show 915,  June 20, 2017

Pronk Pops Show 914,  June 19, 2017

Pronk Pops Show 913,  June 16, 2017

Pronk Pops Show 912,  June 15, 2017

Pronk Pops Show 911,  June 14, 2017

Pronk Pops Show 910,  June 13, 2017

Pronk Pops Show 909,  June 12, 2017

Pronk Pops Show 908,  June 9, 2017

Pronk Pops Show 907,  June 8, 2017

Pronk Pops Show 906,  June 7, 2017

Pronk Pops Show 905,  June 6, 2017

Pronk Pops Show 904,  June 5, 2017

Pronk Pops Show 903,  June 1, 2017

Pronk Pops Show 902,  May 31, 2017

Pronk Pops Show 901,  May 30, 2017

Pronk Pops Show 900,  May 25, 2017

Pronk Pops Show 899,  May 24, 2017

Pronk Pops Show 898,  May 23, 2017

Pronk Pops Show 897,  May 22, 2017

Pronk Pops Show 896,  May 18, 2017

Pronk Pops Show 895,  May 17, 2017

Pronk Pops Show 894,  May 16, 2017

Pronk Pops Show 893,  May 15, 2017

Pronk Pops Show 892,  May 12, 2017

Pronk Pops Show 891,  May 11, 2017

Pronk Pops Show 890,  May 10, 2017

Pronk Pops Show 889,  May 9, 2017

Pronk Pops Show 888,  May 8, 2017

Pronk Pops Show 887,  May 5, 2017

Pronk Pops Show 886,  May 4, 2017

Pronk Pops Show 885,  May 3, 2017

Pronk Pops Show 884,  May 1, 2017

Pronk Pops Show 883 April 28, 2017

Pronk Pops Show 882: April 27, 2017

Pronk Pops Show 881: April 26, 2017

Pronk Pops Show 880: April 25, 2017

Pronk Pops Show 879: April 24, 2017

Pronk Pops Show 878: April 21, 2017

Pronk Pops Show 877: April 20, 2017

Pronk Pops Show 876: April 19, 2017

Pronk Pops Show 875: April 18, 2017

Pronk Pops Show 874: April 17, 2017

Pronk Pops Show 873: April 13, 2017

Pronk Pops Show 872: April 12, 2017

Pronk Pops Show 871: April 11, 2017

Pronk Pops Show 870: April 10, 2017

Pronk Pops Show 869: April 7, 2017

Pronk Pops Show 868: April 6, 2017

Pronk Pops Show 867: April 5, 2017

Pronk Pops Show 866: April 3, 2017

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Breaking — Story 1: Pence Breaks Tie — Senate Will Debate How To Proceed With Obamacare Repeal and Replace — Videos —

Senate votes to start debate on health care bill

Senate Dems Stage Strange Protest During ObamaCare Vote

Protesters Chant “Kill The Bill! Don’t Kill Us!” At Senate Debate Vote To Repeal Obamacare | TIME

Senate to vote on Obamacare repeal today

Senate Vote On Health Care Debate In Yet Another Effort To Repeal And Replace Obamacare | TIME

 

The Senate majority leader, Mitch McConnell of Kentucky, at the Capitol on Tuesday.CreditGabriella Demczuk for The New York Times

WASHINGTON — The Senate voted narrowly on Tuesday to begin debate on a bill to repeal major provisions of the Affordable Care Act, but hours later, Republican leaders suffered a setback when their most comprehensive plan to replace President Barack Obama’s health law fell far short of the votes it needed.

The Tuesday night tally needed to reach 60 votes to overcome a parliamentary objection. Instead, it fell 43-57. The fact that the comprehensive replacement plan came up well short of even 50 votes was an ominous sign for Republican leaders still seeking a formula to pass final health care legislation this week.

For Republicans, the failure ended the day on a sour note, hours after a more triumphant scene on the Senate floor. Lawmakers from both parties had risen to their feet in the afternoon and applauded when Senator John McCain, Republican of Arizona, showed up in the chamber despite his diagnosis of brain cancer. He cast a crucial vote in favor of opening what promises to be a freewheeling, hard-fought debate over the future of the Affordable Care Act.

The 51-50 vote to start debate, with Vice President Mike Pence breaking a tie, came only a week after the Republican effort to dismantle a pillar of former President Barack Obama’s legacy appeared all but doomed. It provided an initial win for President Trump, who pushed, cajoled and threatened senators in recent days to at least begin debating the repeal of the health care law.

But the victory could be fleeting: Senate Republicans still have no agreement on a repeal bill that they can ultimately pass to uproot the law that has provided health insurance to millions of Americans.

How Each Senator
Voted on Full Obamacare
Repeal-and-Replace

Republican leaders brought the first of several expected amendments to a vote Tuesday night.

The Senate is now moving ahead with debate, amendments and ultimately a final vote in the coming days on legislation that would have a profound effect on the American health care system — roughly one-sixth of the United States’ economy. But it is entirely possible that by week’s end, they will have passed nothing.

“Now we move forward towards truly great health care for the American people,” Mr. Trump said from the White House Rose Garden, where he was holding a news conference with the visiting prime minister of Lebanon. “This was a big step.”

Only two Republicans, Susan Collins of Maine and Lisa Murkowski of Alaska, voted against the procedural motion, though at least several other Republicans had been seen as possible holdouts. No Democrats voted in favor of the motion.

The Tuesday night vote was on a comprehensive amendment that included disparate proposals calculated to appeal to conservatives and moderates in the Republican caucus.

One proposal, offered by Senator Ted Cruz, Republican of Texas, would have allowed insurers to sell stripped-down health plans, without maternity care or other benefits required by the Affordable Care Act, if they also sold plans that included such benefits.

“You shouldn’t have to buy what the federal government mandates you must buy,” Mr. Cruz said. “You should choose what meets the needs for you and your family.”

Three major proposals are being discussed.

The amendment also included money to help pay out-of-pocket medical costs for low-income people, including those who buy private insurance after losing Medicaid coverage as a result of the Senate bill. This proposal was devised by Senator Rob Portman, Republican of Ohio, and other senators from states that have expanded Medicaid under the Affordable Care Act.

But nine Republicans, spanning the party’s ideological spectrum, voted against the package.

The debate to come will have broad implications for health care and households in every state, and emotions are high.

Before senators voted to start the debate in midafternoon, protesters in the Senate gallery chanted, “Kill the bill, don’t kill us!” and “Shame, shame, shame!”

Despite his vote to move ahead, Mr. McCain offered harsh words for the secretive process by which Senate Republican leaders came up with their bill to repeal and replace the health law, and he delivered a pessimistic take on its chances.

“Asking us to swallow our doubts and force it past a unified opposition — I don’t think that’s going to work in the end, and probably shouldn’t,” Mr. McCain said, adding that it “seems likely” that the current repeal effort would end in failure. Still, Mr. McCain voted with Republican leaders in favor of the comprehensive replacement plan on Tuesday night.

Arizona is one of the 31 states that expanded Medicaid under the Affordable Care Act, and Mr. McCain’s remarks could reflect concerns of other senators from states that expanded Medicaid, including the junior Republican senator from his state, Jeff Flake.

 

Senator John McCain, who was recently diagnosed with brain cancer, spoke to the Senate after casting his vote to begin debating legislation to repeal the Affordable Care Act.

By THE ASSOCIATED PRESS. Photo by Gabriella Demczuk for The New York Times. Watch in Times Video »“We are ground zero for the failure of the exchanges, but we are also an expansion state,” Mr. Flake said. “I think all of us are concerned that we don’t pull the rug out from people.”

Just before the Senate vote, the Democratic leader, Chuck Schumer of New York, made an impassioned plea to Republicans.

“We know that A.C.A. is not perfect,” Mr. Schumer said. “But we also know what you’ve proposed is much worse. We can work together to improve health care in this country. Turn back now before it’s too late and millions and millions and millions of Americans are hurt so badly in ways from which they will never, ever recover.”

Given the divisions within their caucus, Senate Republican leaders were considering a new approach to keeping their repeal quest alive: They could try to reach agreement on a slimmed-down bill that would repeal a few major provisions of the Affordable Care Act, like the penalties imposed on people who go without insurance and businesses that do not offer insurance to their employees. Republican leaders would not intend for such a bill to become law, but they believe that it could win approval in the Senate.

That “skinny” bill could then be a basis for negotiations with the House.

Republican leaders in Congress have struggled all year to fulfill their promise of repealing the 2010 health care law. By a vote of 217 to 213, the House approved a repeal bill in early May, but only after Republicans overcame their own difficulties in that chamber.

Mr. Trump kept up pressure on the Senate on Tuesday with Twitter posts. After the procedural vote, he applauded the Senate, but was cutting toward Ms. Collins and Ms. Murkowski: “We had two Republicans that went against us, which is very sad, I think. It’s very, very sad for them.”

Majority needed to pass YES NO
Republicans 51 2
Democrats 0 48
Total 51 50

The successful procedural vote was also a moment of redemption, at least temporarily, for Mr. McConnell, who just last week appeared to have failed in his effort to put together a health bill that could squeak through the narrowly divided Senate.

That said, it remained far from certain whether Republicans would be able to agree on a bill in the days to come — and what exactly the contents of that bill would be. Mr. McConnell promised an “open amendment process” in which members of both parties could propose changes.

“This is just the beginning,” Mr. McConnell said. “We’re not out here to spike the football.”

For weeks, Mr. McConnell has been promoting and revising a comprehensive bill that would repeal the health law while also replacing it, but he has struggled to nail down the support needed to pass that measure. The nonpartisan Congressional Budget Office has yet to assess the most complete version of that legislation, which includes the proposals by Mr. Cruz and Mr. Portman.

Without that assessment, the measure needed 60 Senate votes, and it failed that test on Tuesday night.

The Senate is also expected to vote on a measure that would repeal the health law without putting in place any replacement, but that approach does not appear to have enough support to pass, either.

That proposal resembles a bill passed by the Senate in 2015 and vetoed by Mr. Obama in early 2016. But it would increase the number of people who are uninsured by 32 million in 2026, the budget office said.

Mr. Portman had anguished for weeks over provisions of Mr. McConnell’s repeal bill that would make deep cuts in projected Medicaid spending and roll back the expansion of the program under the Affordable Care Act.

Mr. Portman voted to move ahead with the debate on Tuesday after being assured that the Senate would vote on his plan to provide financial assistance to people moving from an expanded state Medicaid program to private health insurance.

States could have used the money, totaling $100 billion, to help low-income people pay deductibles and other out-of-pocket costs when they receive medical care.

Mr. Portman worked on the plan with the Trump administration and with several other Republican senators from states that have expanded Medicaid, including Shelley Moore Capito of West Virginia and Dean Heller of Nevada.

Mr. Heller voted Tuesday to open the debate, but he made no commitment to vote for the repeal bill itself.

“If the final product isn’t improved for the state of Nevada, then I will not vote for it,” Mr. Heller said. “If it is improved, I will support it.”

https://www.nytimes.com/2017/07/25/us/politics/senate-health-care.html

 

Senate Passes Vote to Begin Debate on Obamacare Repeal

Image: Senate Passes Vote to Begin Debate on Obamacare Repeal

By Todd Beamon   |   Tuesday, 25 Jul 2017 03:06 PM

The Senate voted Tuesday to begin debate on the plan to repeal Obamacare outright and replace it within two years — after Vice President Mike Pence voted to break a 50-50 tie and an ailing Arizona Sen. John McCain returned to slam the chamber’s secretive process.

“On this vote, the yeas are 50 and the nays are 50,” Pence said. “The Senate being equally divided, the vice president votes in the affirmative and the motion is agreed to.”

Moderate Republican Sens. Susan Collins of Maine and Lisa Murkowski of Alaska voted against the motion, which Senate Majority Leader Mitch McConnell of Kentucky proposed after two previous versions of a healthcare bill failed to attract enough votes.

Several senators switched their positions after saying as recently as last week that they would not support a complete Obamacare repeal without replacement.

They were Sens. Shelly Moore Capito of West Virginia, Ron Johnson of Wisconsin, Rob Portman of Ohio and Dean Heller of Nevada – considered the party’s most vulnerable incumbent going into next year’s congressional elections.

McCain, 80, who was diagnosed with brain cancer after undergoing surgery 11 days ago, returned to the Senate to vote for the procedural motion.

He was the first to speak on the floor during debate.

“I voted for the motion to proceed to allow debate to continue and amendments be offered,” McCain said. “I will not vote for this bill as it is today.

“It’s a shell of a bill right now. We all know that.”

He called for both parties to work together to bring forth legislation that would improve healthcare for all Americans.

“We keep trying to win without help from the other side of the aisle,” McCain said. “We are getting nothing done, my friends, we’re getting nothing done.

“All we’ve managed to do was make more popular a policy that wasn’t very popular,” he said, referring to Obamacare.

“The administration and congressional Democrats shouldn’t have forced through Congress without any opposition a program that brought forth social and economic change as massive as Obamacare.

“And we shouldn’t do the same with ours.

“If this process ends in failure, which seems likely, then let’s return to regular order,” McCain said.

“What a great honor, an extraordinary opportunity it is to serve in this body,” he concluded. “It’s a privilege to serve with all of you. I mean it.

“I hope to impress on you again that it is an honor to serve the American people in your company.”

McCain’s comments were greeted with a standing ovation.

President Donald Trump afterward thanked McCain for coming from Arizona to cast his vote to move the healthcare motion forward, calling him a “very brave man.”

“He made a tough trip to get here and vote,” Trump said at the start of a joint news conference with Lebanese Prime Minister Saad Hariri in the White House Rose Garden. “We want to thank Sen. McCain and all of the Republicans.

“We passed it without one Democrat vote,” the president added. “And that’s a shame, but that’s the way it is. And it’s very unfortunate.

“But I want to congratulate the American people, because we’re going give you great healthcare.”

The Senate last voted to repeal Obamacare in 2015, but it was vetoed by then-President Barack Obama. The House has voted more than 50 times to end the healthcare program.

President Trump has vowed to sign any bill that repeals the Affordable Care Act.

Before the procedural vote, McConnell encouraged Republicans to take action to end Obamacare after promising to do so for seven years.

“We have a duty to act,” he said. “The president’s ready with his pen.

“The House has passed legislation. Today, it’s the Senate’s turn.

“That starts with a vote we’ll take momentarily. The critical first step in that process, the motion to proceed.

“It’s the vote that determines whether this debate can proceed at all,” McConnell said. “Whether we’ll even take it up.”

But Minority Leader Chuck Schumer pleaded with Republicans to reject the procedural vote and work with his party – saying that beginning debate on the repeal motion would eventually lead to the end of Obamacare.

“The best the majority leader’s been able to cook up is a vague plan to do whatever it takes to pass something — anything — to get the bill to a House and Senate conference on healthcare,” the New York Democrat said before McConnell spoke.

“My colleagues, plain and simple, it’s a ruse,” Schumer continued. “The likeliest result of a conference between the House and Senate is full repeal of the Affordable Care Act or something very close to it.”

He slammed Republicans for crafting the healthcare plan under “much cloak-and-dagger legislating” and for locking Democrats out of the process.

“Their plan all along was to keep their bill hidden for as long as possible, evade scrutiny, hide the truth from the American people, and then jam the bill through in the dead of night on a party line,” Schumer said.

McConnell emphasized that the motion opens the debate on repealing Obamacare – and that any legislation could be amended during the debate process.

“President Obama vetoed what we passed before,” he said. “President Trump will sign what Congress passes this time.

“All we have to do today is to have the courage to begin the debate with an open amendment process and let the voting take us where it will.”

http://www.newsmax.com/Headline/senate-passes-healthcare-vote/2017/07/25/id/803717/

Story 2: Bipartisan Congress Overwhelming Passes New Sanctions on Russia, Iran, and North Korea — Long Overdue — Trump Will Sign Bill in Near Future or Face Congressional Override of Veto — Videos

 

House overwhelmingly passes Russia sanctions bill

The Situation Room With Wolf Blitzer 07/25: NEW RUSSIA SANCTIONS PASS HOUSE WITH VETO-PROOF MARGIN

Bipartisan Russia sanctions clear tough hurdle MSNBC

Congress to vote on sanctions against Russia, 

Senators confident they could override a Trump veto on bill upping Russian sanctions for el

Story 3: Trump Again Critical Of Attorney General Sessions Apparently For Not Prosecuting Leakers and Going After Clinton Foundation Crimes — What about Obama Administration’s Spying On Trump — An Abuse of Power Using Intelligence Community for Political Purposes — Will Trump Dump Sessions? If He Does Trump Will Start To Lose His Supporters in Talk Radio and Voter Base — Direct Deputy Attorney Rod Rosenstein To Fire Mueller — If He Won’t Fire Him — Fire Both Mueller and Rosenstein —  Punish Your Enemies and Reward Your Friends President Trump! — “In Your Guts You Know He is Nuts” —  Videos

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Shapiro Nails It

Ben Shapiro Show 347 | Begun The Sessions War Has

Tucker Carlson criticized Trump for ‘Nuts’ Attacks on ‘Humiliated’ Ally Jeff Sessions

Hume: Trump has peculiar concept of attorney general’s job

Trump continues attack on AG Jeff Sessions in new tweets

ANTHONY SCARAMUCCI REACTS TO TRUMP CALLING OUT AG SESSIONS | ANTHONY SCARAMUCCI FULL INTERVIEW

‘AG’s job isn’t to ‘have your back’:CNN’s Jake Tapper Dismantles Trump’s frustration with Sessions

CNN’s Don Lemon laughs out loud at Trump’s claim he’s more presidential than anyone except Lincoln

Under attack from the president, Attorney General Sessions still advancing conservative agenda

Mark Levin: If Trump pushes AG Jeff Sessions out, it will be a terrible mistake (July 24 2017)

Mark Levin: Jeff Sessions recuses himself from investigation of Donald Trump’s alleged Russian ties

Trump Says He Will Appoint Special Prosecutor To Investigate Clinton

Trump: “[The Clintons] are good people. I don’t want to hurt them” vs. Marx

Trump vs Sessions: How POTUS turned on his AG

Sessions to stay on the job despite Trump’s criticism

News Wrap: Trump tweets new criticism of Sessions

President Trump: “I Am Disappointed In The Attorney General” 7/25/17

Trump Calls Sessions ‘Weak’ as Criticism Continues

Shep Smith Rips President Trump Over Jeff Sessions “I can’t find a time Situation like this upon us”

Rush Limbaugh: How Donald Trump can shut down the Mueller probe (audio from 07-21-2017)

Roger Stone: Trump Should Fire Mueller And Rosenstein

Exclusive: Roger Stone Reveals Sessions On Way Out – Here’s The Short List For Next AG

 

Trump trashes his attorney general yet again: Sessions just wanted to be a part of my big crowds

BOB BRIGHAM

President Donald Trump has once again openly bashed his Attorney General.

Jeff Sessions was the only Senator to endorse Trump in the primary, but President Trump is no longer giving him credit for his political support, claiming Sessions only endorsed him because of Trump’s crowd sizes.

“When they say he endorsed me, I went to Alabama,” Trump said in an interview with The Wall Street Journal. “I had 40,000 people.”

“But he was a senator, he looks at 40,000 people and he probably says, ’What do I have to lose?’ And he endorsed me,” Trump explained. “So it’s not like a great loyal thing about the endorsement.”

“I’m very disappointed in Jeff Sessions,” Trump added.

President Trump is also now openly talking of firing Attorney General Sessions, but won’t reveal if he plans to oust him.

“I’m just looking at it,” Trump said when asked why he has criticized Sessions without firing him. “I’ll just see. It’s a very important thing.”

Trump “was joined by his daughter and White House adviser Ivanka Trump, National Economic Council Director Gary Cohn, Chief of Staff Reince Priebus, Communications Director Anthony Scaramucci and Hope Hicks, the White House director of strategic communications,” The Wall Street Journal reports.

http://www.rawstory.com/2017/07/trump-trashes-his-attorney-general-yet-again-sessions-just-wanted-to-be-a-part-of-my-big-crowds/

 

GOP backlash to Trump attacks on Attorney General Jeff Sessions signals political danger

WASHINGTON — President Trump’s firing of former FBI director James Comey set in motion a chain of events that’s proven politically devastating to his White House. The same could happen if he fires or forces out U.S. Attorney General Jeff Sessions.

“It’s stunning to me that he looks at what happened over the firing of Comey and his idea is to fire Sessions,” said Rob Jesmer, a longtime Republican strategist who is also a former executive director of the Republican Senatorial Campaign Committee.

“That firing’s been a disaster” that led to the appointment of special prosecutor Robert Mueller, said Jesmer. It also raised questions about potential obstruction of justice, since Trump later acknowledged he fired Comey because of the Russia investigation. “It’s made his life worse,” said Jesmer.

Signaling the potential political danger ahead, the diversity of conservatives rallying behind Sessions is significant. It ranges from the alt-right Breitbart News and conservative talk host Rush Limbaugh to family values and anti-immigration groups.

On the Hill, the “reverberations would be that this is a White House that thinks it’s above the law,” said Heye.

“What I don’t understand is what he thinks the end game is,” said Jesmer. “Russia is not going away.”

Latest Trumpian tweet storm

In a series of tweets, Trump has taken aim at Sessions for failing to pursue more investigations of Hillary Clinton’s email server and called Sessions “beleaguered.” In an interview with the New York Times, he also berated Sessions for recusing himself from the FBI investigation in to Trump’s ties to Russia.

Outside conservative groups and media figures who are emissaries to critical voting blocs, including religious and constitutional conservatives, are speaking out on behalf of Sessions. That raises the specter that Trump’s actions could hurt his support among some of his most loyal supporters and voters.

Jim DeMint, chairman of the Conservative Partnership Institute and a former senator, said he hopes Trump “sees Jeff Sessions is a great leader that will defend Constitution and rule of law.”

Trump right about media’s Russia obsession. Hope he sees Jeff Sessions is a great leader that will defend Constitution & rule of law.

Family Research Council President Tony Perkins issued a statement saying Sessions “understands the importance of all of our God-given rights, respects the law, and is making tremendous progress to restore our nation to greatness.”

Rush Limbaugh, the firebrand conservative talk host, called Trump’s continued attackson Sessions “unseemly.”

The Federation for American Immigration Reform said Sessions “deserves your support, not criticism.”

.@RealDonaldTrump AG Sessions has restored confidence & integrity to U.S. immigration policy. He deserves your support, not criticism.

Even Breitbart, the news organization formerly headed by Trump’s senior adviser Steve Bannon, fired a shot across the bow on Tuesday. It said Trump’s attacks on Sessions are showing his own “weak” stance.

The attacks are “likely to fuel concerns from his base who see Sessions as the best hope to fulfill Trump’s immigration policies,” the article said.

“The question is what does a republican senator or member of the House do” if Trump follows through by firing or forcing Sessions to resign, said Heye.

Whether there will be any official reaction from congressional Republicans if Trump fires Sessions remains to be seen. It might take Trump going further, including pardoning himself or others or angling to fire special counsel Robert Mueller, for Congress to step in as many lawmakers worry the president is abusing his powers as president by targeting institutions and officials investigating him and his family.

Yet the consequences in Congress could nevertheless be manifold.

In addition to angering many lawmakers, making it harder to work with them, Sessions is a favorite of the House Freedom Caucus, the conservative group that has proven Trump’s most formidable negotiating challenge on repealing and replacing Obamacare. The faction of House conservatives will also pose a big challenge in reaching a deal to keep the government funded this fall.

https://www.usatoday.com/story/news/politics/2017/07/25/gop-backlash-trump-attacks-attorney-general-jeff-sessions-signals-political-danger/509182001/

 

Attorney General Jeff Sessions will recuse himself from any probe related to 2016 presidential campaign

Amid demands, Sessions recuses himself from all campaign probes
Attorney general Jeff Sessions recused himself from all investigations involving the presidential campaign after officials from both parties called for it. The outcry came after news broke that then-Sen. Sessions failed to disclose that he met with a Russian envoy during his confirmation hearings to become attorney general. (Gillian Brockell, Jenny Starrs/The Washington Post)
 March 2
Attorney General Jeff Sessions said Thursday that he will recuse himself from investigations related to the 2016 presidential campaign, which would include any Russian interference in the electoral process.Speaking at a hastily called news conference at the Justice Department, Sessions said he was following the recommendation of department ethics officials after an evaluation of the rules and cases in which he might have a conflict.“They said that since I had involvement with the campaign, I should not be involved in any campaign investigation,” Sessions said. He added that he concurred with their assessment and would thus recuse himself from any existing or future investigation involving President Trump’s 2016 campaign.

The announcement comes a day after The Washington Post revealed that Sessions twice met with Russian Ambassador Sergey Kislyak during the campaign and did not disclose that to the Senate Judiciary Committee during his confirmation hearing in January.

The Washington Post’s Karoun Demirjian brings us up to speed on Jeff Sessions’s decision to recuse himself from all investigations into the 2016 presidential campaign. (Zoeann Murphy/The Washington Post)

It also represents a departure from Sessions’s previous statements, including one on Monday, when he declined to say whether he would recuse himself. “I would recuse myself on anything I should recuse myself on,” Sessions said then. “That’s all I can tell you.”

Democrats have been calling for him to do so for weeks; on Thursday, after publication of The Post’s article, some high-level Republicans joined them. At his news conference, Sessions offered a new explanation: that discussions about his recusal had begun before the revelation of his meetings with Kislyak, that he and ethics officials had agreed on Monday to meet for a final time Thursday, and that at that final meeting he had accepted their recommendation.

The responsibility to oversee the FBI’s Russia investigation will now be handled by Sessions’s deputy attorney general, the department’s second-highest-ranking official. The acting deputy attorney general is Dana Boente, a longtime federal prosecutor and former U.S. attorney for the Eastern District of Virginia, who stepped in when Trump fired Sally Yates in January.

Trump’s nominee for deputy attorney general, Rod J. Rosenstein, is scheduled to appear before the Senate Judiciary Committee for his confirmation hearing on March 7. Rosenstein, the former U.S. attorney in Baltimore and the longest-serving U.S. attorney, was the sole holdover from the George W. Bush administration.

The revelations about Sessions’s meetings with Kislyak brought new scrutiny to the attorney general’s confirmation hearing in January, when he was asked by Sen. Al Franken (D-Minn.) what he would do if he learned of any evidence that anyone affiliated with the Trump campaign had communicated with the Russian government in the course of the 2016 campaign. He replied: “I have been called a surrogate at a time or two in that campaign, and I did not have communications with the Russians.”

On Thursday, Sessions defended those remarks as “honest and correct as I understood it at the time,” though he also said he would “write the Judiciary Committee soon — today or tomorrow — to explain this testimony for the record.” His explanation, he said, was that he was “taken aback” by Franken’s question, which referred to a breaking news story at the time about contacts between Trump surrogates and Russians.

“It struck me very hard, and that’s what I focused my answer on,” he said. “In retrospect, I should have slowed down and said I did meet one Russian official a couple times, and that would be the ambassador.”

Here’s what you need to know about Russia’s ambassador to the U.S.
Sergey Kislyak’s contacts with Trump advisers roiled the new administration and led to one resignation and calls for another. Among D.C. insiders, Russia’s long-serving ambassador to the United States is known for trying to develop relationships with top U.S. officials. (The Washington Post)

Later, in an interview on Fox News, Sessions notably declined to say that he thought Russian President Vladimir Putin and the Russian government favored Trump over Hillary Clinton in the presidential campaign. A declassified report from U.S. intelligence agencies released in January concluded just that, saying, “Putin and the Russian government aspired to help President-elect Trump’s election chances when possible by discrediting Secretary Clinton and publicly contrasting her unfavorably to him.”

“Did the campaign believe that the Russian government, the Putin government, favored Trump over Clinton in this race?” Fox News host Tucker Carlson asked.

“I have never been told that,” Sessions responded.

“Do you think they did?” Carlson said.

“I don’t have any idea, Tucker, you’d have to ask them,” Sessions said.

In a statement issued Wednesday night, Sessions said he “never met with any Russian officials to discuss issues of the campaign. I have no idea what this allegation is about. It is false.” A spokeswoman confirmed his meetings with Kislyak but said there was nothing misleading about what Sessions said to Congress.

The spokeswoman, Sarah Isgur Flores, said Sessions did not meet with Kislyak as a Trump supporter but, rather, in his capacity as a member of the Armed Services Committee. One meeting was in September; the other in July, when Sessions was approached after an event on the sidelines of the Republican National Convention.

A Justice Department official said Wednesday of the September meeting: “There’s just not strong recollection of what was said.”

On Thursday, though, Sessions outlined fairly extensive details of the encounter, which included two senior Sessions staffers. He said he talked with the ambassador about a trip he made to Russia in 1991, terrorism and Ukraine — a major policy issue, given Russia’s annexation of Crimea and the imposition of U.S. and European Union sanctions on Russia for its actions.

At one point, Sessions said, “it got to be a little bit of a testy conversation.” He said the ambassador invited him to lunch, but he did not accept.

“Most of these ambassadors are pretty gossipy, and they like to — this was in the campaign season, but I don’t recall any specific political discussions,” Sessions said.

Earlier Thursday, Trump said that he had “total” confidence in Sessions. Speaking aboard the aircraft carrier USS Gerald R. Ford in Newport News, Va., Trump told reporters that he was not aware of Sessions’s contact with the Russian ambassador. Trump also said that Sessions “probably” testified truthfully during his confirmation hearing in January before the Senate Judiciary Committee.

Asked whether Sessions should recuse himself, Trump added: “I don’t think so.”

Trump issued a statement later Thursday as well: “Jeff Sessions is an honest man. He did not say anything wrong. He could have stated his response more accurately, but it was clearly not intentional.” Trump added that Democrats are “overplaying their hand” by criticizing Sessions, and he called their attacks a “total witch hunt!”

Several Republican lawmakers had already called on Sessions to recuse himself — and some of them applauded him after he did so. Sen. Ben. Sasse (R-Neb.) called it the “right decision.”

Democrats, however, were less complimentary. Several of them had begun the day demanding Sessions’s resignation and accusing him of lying under oath during the confirmation hearing. After his announcement that he would recuse himself, House Minority Leader Nancy Pelosi (D-Calif.) declared the decision “totally inadequate.” Senate Minority Leader Charles E. Schumer (D-N.Y.) said: “Attorney General Sessions is right to recuse himself, but the fact is that he should have done so the moment he was sworn in.”

The episode marks the second time in Trump’s nascent administration when the truthfulness of one of its top officials has come under scrutiny. In February, Trump fired his national security adviser, Michael Flynn, after The Post reported he had not fully disclosed his contacts with Russian officials.

Sessions’s meetings with Kislyak occurred during the height of concerns about Russian interference in the U.S. election and at a time when Sessions was a member of the Senate Armed Services Committee, as well as a top Trump surrogate and adviser.

The swift response among some Republicans, although more muted than Democrats, signaled increasing concern about the potential political fallout.

House Oversight and Government Reform Committee Chairman Jason Chaffetz (R-Utah) tweeted early Thursday that “AG Sessions should clarify his testimony and recuse himself.”

Chaffetz later told reporters: “Let’s let him clarify his statement, and I do think he should recuse himself.” Asked whether his committee would investigate the matter, he said, “There are things we are looking at.”

House Speaker Paul D. Ryan (R-Wis.) defended Sessions, noting that ongoing investigations have found no evidence that “an American or a person in the Trump campaign was involved or working with the Russians.”

House Majority Leader Kevin McCarthy (R-Calif.) shared conflicting views on Sessions during back-to-back television interviews Thursday. Asked whether Sessions should recuse himself, he told MSNBC’s “Morning Joe,” “I think the trust of the American people — you recuse yourself in these situations, yes.”

But McCarthy later told Fox News: “I’m not calling on him to recuse himself. I was asked on ‘Morning Joe’ if he needs to recuse himself as going forward. As you just heard, Attorney General Sessions said he would recuse himself going forward — appropriate, and that’s all my answer was.”

Sessions has focused his response to the allegations on the substance of his conversations with Kislyak, which he said did not include talk about the campaign.

Many Democrats considered that a direct contradiction of Sessions’s testimony in January, when he told Franken that he had not spoken to Russian officials.

But Sen. Lindsey O. Graham (R-S.C.), who considers Sessions a close friend, said, “I don’t think Jeff Sessions is a liar” and argued that Sessions had not misled the Judiciary Committee “because all of the questions were about campaign contacts.”

But Sessions “does owe it, quite frankly, to all of us to tell us what he talked about” with Kislyak, Graham said.

Fallout from Sessions’s statements came as FBI Director James B. Comey made a previously scheduled visit to Capitol Hill to meet with the House Intelligence Committee. But Comey was once again unwilling to confirm whether the FBI is exploring ties between Trump campaign officials and the Russian government, according to Rep. Adam B. Schiff (D-Calif.), the committee’s top Democrat.

“We can’t do a complete job unless the director is willing to discuss anything that they are investigating,” Schiff said. “At this point we know less than a fraction of what the FBI knows.”

But Rep. Devin Nunes ­(R-Calif.), the committee’s chairman, said Comey was “very upfront” with lawmakers.

“There’s a lot more information . . . the FBI and intelligence agencies need to provide to our committees” to aid ongoing congressional investigations, Nunes said. He added that he had “no reason to believe that any information” would be withheld from his committee.

Senators who deal regularly with defense, foreign affairs or intelligence matters often meet with foreign officials. But as a member of the Senate Armed Services Committee, Sessions was less likely to meet with foreign ambassadors than foreign military leaders. The Post has spoken to all senators who served on the armed services panel in 2016. None of them other than Sessions met with Kislyak one-on-one last year, they said.

Schumer said that the Justice Department’s inspector general should investigate whether Sessions made any attempts to thwart any ongoing Russia-
related investigations.

Some Democratic senators called on Sessions to appear again before the Judiciary Committee to explain his relationship and conversations with Russian officials under oath. Others are encouraging congressional tax-writing committees to use their authority to review Trump’s tax returns for any sign of Russian connections.

Abby Phillip, Mike DeBonis, Adam Entous and Ellen Nakashima contributed to this report.

https://www.washingtonpost.com/powerpost/top-gop-lawmaker-calls-on-sessions-to-recuse-himself-from-russia-investigation/2017/03/02/148c07ac-ff46-11e6-8ebe-6e0dbe4f2bca_story.html?utm_term=.ad5603343d98

 

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The Pronk Pops Show 919, June 27, 2017, Part 1 — Story 1: Breaking BIG — Big Interventionist Government — Obamacare and Obamacare Lite — The Progressive Two-Party Tyranny of The Democratic and Republican Parties — Fake Repeal and Fake Replace Is Not Real Repeal of Obamacare and All Obamacare Regulations and Replace With Free Enterprise Individual Health Insurance Markets Not Centralized Federal Control and Regulation with Massive Subsidies Of Health Insurance Industry — Collectivists vs Individualists — Replace The C, D, F BIG Progressive Republican Senators and Representatives — The Party’s Over — Videos

Posted on June 27, 2017. Filed under: American History, Breaking News, Budgetary Policy, Communications, Countries, Defense Spending, Donald J. Trump, Donald J. Trump, Donald Trump, Economics, Education, Elections, Employment, Fiscal Policy, Freedom of Speech, Government, Government Dependency, Government Spending, Health, Health Care Insurance, History, Human, Labor Economics, Law, Life, Media, Medicare, Monetary Policy, News, People, Philosophy, Photos, Politics, Polls, President Barack Obama, President Trump, Pro Life, Progressives, Raymond Thomas Pronk, Regulation, Rule of Law, Scandals, Security, Social Security, Success, Tax Policy, Taxation, Taxes, Terror, Terrorism, Unemployment, United States Constitution, United States of America, Videos, Wealth, Wisdom | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

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The Pronk Pops Show Podcasts

Pronk Pops Show 919,  June 27, 2017

Pronk Pops Show 918,  June 26, 2017 

Pronk Pops Show 917,  June 22, 2017

Pronk Pops Show 916,  June 21, 2017

Pronk Pops Show 915,  June 20, 2017

Pronk Pops Show 914,  June 19, 2017

Pronk Pops Show 913,  June 16, 2017

Pronk Pops Show 912,  June 15, 2017

Pronk Pops Show 911,  June 14, 2017

Pronk Pops Show 910,  June 13, 2017

Pronk Pops Show 909,  June 12, 2017

Pronk Pops Show 908,  June 9, 2017

Pronk Pops Show 907,  June 8, 2017

Pronk Pops Show 906,  June 7, 2017

Pronk Pops Show 905,  June 6, 2017

Pronk Pops Show 904,  June 5, 2017

Pronk Pops Show 903,  June 1, 2017

Pronk Pops Show 902,  May 31, 2017

Pronk Pops Show 901,  May 30, 2017

Pronk Pops Show 900,  May 25, 2017

Pronk Pops Show 899,  May 24, 2017

Pronk Pops Show 898,  May 23, 2017

Pronk Pops Show 897,  May 22, 2017

Pronk Pops Show 896,  May 18, 2017

Pronk Pops Show 895,  May 17, 2017

Pronk Pops Show 894,  May 16, 2017

Pronk Pops Show 893,  May 15, 2017

Pronk Pops Show 892,  May 12, 2017

Pronk Pops Show 891,  May 11, 2017

Pronk Pops Show 890,  May 10, 2017

Pronk Pops Show 889,  May 9, 2017

Pronk Pops Show 888,  May 8, 2017

Pronk Pops Show 887,  May 5, 2017

Pronk Pops Show 886,  May 4, 2017

Pronk Pops Show 885,  May 3, 2017

Pronk Pops Show 884,  May 1, 2017

Pronk Pops Show 883 April 28, 2017

Pronk Pops Show 882: April 27, 2017

Pronk Pops Show 881: April 26, 2017

Pronk Pops Show 880: April 25, 2017

Pronk Pops Show 879: April 24, 2017

Pronk Pops Show 878: April 21, 2017

Pronk Pops Show 877: April 20, 2017

Pronk Pops Show 876: April 19, 2017

Pronk Pops Show 875: April 18, 2017

Pronk Pops Show 874: April 17, 2017

Pronk Pops Show 873: April 13, 2017

Pronk Pops Show 872: April 12, 2017

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Pronk Pops Show 870: April 10, 2017

Pronk Pops Show 869: April 7, 2017

Pronk Pops Show 868: April 6, 2017

Pronk Pops Show 867: April 5, 2017

Pronk Pops Show 866: April 3, 2017

Pronk Pops Show 865: March 31, 2017

Pronk Pops Show 864: March 30, 2017

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Pronk Pops Show 862: March 28, 2017

Pronk Pops Show 861: March 27, 2017

Pronk Pops Show 860: March 24, 2017

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Pronk Pops Show 856: March 20, 2017

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Pronk Pops Show 849: March 1, 2017

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National Debt Clock 

http://www.usdebtclock.org/

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Part 1 — Story 1: Breaking BIG — Big Interventionist Government — Obamacare and Obamacare Lite — The Progressive Two-Party Tyranny of The Democratic and Republican Parties — Fake Repeal and Fake Replace Is Not Real Repeal of Obamacare and All Obamacare Regulations and Replace With Free Enterprise Individual Health Insurance Markets Not Centralized Federal Control and Regulation with Massive Subsidies Of Health Insurance Industry — Collectivists vs Individualists — Replace The C, D, F BIG Progressive Republican Senators, and Representatives — The Party’s Over — Videos

 

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Image result for how many americans are in employer paid health insurance v. individual health insurance

Judy Holliday – The Party’s Over

Judy Holliday The Party’s Over Lyrics

The party’s over
It’s time to call it a day
They’ve burst your pretty balloon
And taken the moon away.

It’s time to wind up

The masquerade
Just make your mind up
The piper must be paid.

The party’s over
The candles flicker and dim
You danced and dreamed

Through the night
It seemed to be right
Just being with him.

Now you must wake up
All dreams must end
Take off your makeup

The party’s over
It’s all over, my friend.

Now you must wake up
All dreams must end
Take off your makeup
The party’s over
It’s all over, my friend.

President Trump Holds Meeting with GOP Senators After Delayed Healthcare Vote 6/27/17

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Milton Friedman – Collectivism

Milton Friedman on universal health care

Milton Friedman – The Social Security Myth

Milton Friedman – The Welfare Establishment

Milton Friedman – Tyranny of the Status Quo – Part 1 – Beneficiaries

Milton Friedman – Tyranny of the Status Quo – Part 2 – Bureaucrats

Milton Friedman – Tyranny of the Status Quo – Part 3 – Politicians

Milton Friedman – Why Tax Reform Is Impossible

Milton Friedman – Health Care Reform (1992) pt 1/4

Milton Friedman – Health Care Reform (1992) pt 2/4

Milton Friedman – Health Care Reform (1992) pt 3/4

Milton Friedman – Health Care Reform (1992) pt 3/4

Milton Friedman – Health Care Reform (1992) pt 4/4

Milton Friedman – Morality & Capitalism

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Republicans have one major problem on Obamacare

Why Can’t America Have a Grown-Up Healthcare Conversation?

Is Obamacare Working? The Affordable Care Act Five Years Later

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How Health Insurance Works

Senate postpones health care bill vote

Individual Health Insurance VS. Group Health Insurance

Published on Aug 14, 2009

Ok so lets contrast individual vs. group health insurance. One thing that a lot of people get wrong is individual health insurance, number one isn’t as good coverage and number two, cost more than a group coverage. Well, these two things are wrong. The first one, lets talk about cost. We find that individual health insurance is about 40% less than any group plan. You can load it up with all the features and benefits you are looking for in a group

Group vs. Individual Health Insurance: Health Insurance Facts & More

Published on Aug 16, 2012

Trump triumphs, CNN implodes, the Russian myth is destroyed and the Alt-Left Media haven’t a clue.

How Demented and Sick Our Republic Has Become By Design

‘We’re Amending Obamacare. We’re Not Killing It’

The Senate bill coming out Thursday would do many things to health care in the U.S., but it won’t get rid of the Affordable Care Act, and Mitch McConnell won’t claim that it does.

The health-care bill Senate Republicans plan to unveil on Thursday likely will make substantial changes to Medicaid and cut taxes for wealthy Americans and businesses. It will eliminate mandates and relax regulations on insurance plans, and it will reduce the federal government’s role in health care.

What it won’t do, however, is actually repeal the Affordable Care Act.

Lost in the roiling debate over health care over the last several weeks is that Republicans have all but given up on their longstanding repeal-and-replace pledge. The slogan lives on in the rhetoric used by many GOP lawmakers and the Trump White House but not in the legislation the party is advancing. That was true when House Republicans passed the American Health Care Act last month, which rolled back key parts of Obamacare but was not a full repeal. And it is even more true of the bill the Senate has drafted in secret, which reportedly will stick closer to the underlying structure of the law.

“We’re amending Obamacare. We’re not killing it,” a frustrated Jason Pye of the conservative group FreedomWorks told me earlier this month as the murky outlines of the Senate proposal were beginning to emerge.

Like the House bill, the Senate plan is expected to repeal the ACA’s employer and individual insurance mandates and most if not all of the tax increases Democrats levied to pay for new programs and benefits. But the Senate bill likely will only begin a years-long phase-out of the ACA’s Medicaid expansion in 2020 rather than end it as the House measure does.

The Senate also is expected to include more generous tax credits than the House bill that more closely resemble the system already in place under Obamacare. But the funding levels would still be lower than the current law. And according to Axios, the bill would allow states to opt out of some ACA insurance regulations, but it would do so by loosening existing waivers within the current law rather than follow the House in creating a new waiver system. And the Senate proposal would require that states adhere to more of Obamacare’s regulations than the House bill.Senate Majority Leader McConnell has quietly abandoned the language of “repeal-and-replace” that his office originated seven years ago in the immediate aftermath of the ACA’s enactment. In more than a dozen speeches on health care that McConnell has delivered on the Senate floor since the House passed its bill in early May, he hasn’t uttered the word “repeal” a single time, according to transcripts provided by the majority leader’s office. Nor has he repeated his own pledge to rip out Obamacare “root and branch.” “We’re going to make every effort to pass a bill that dramatically changes the current health care law,” McConnell told reporters on Tuesday, setting a new standard for the bill Republicans plan to release on Thursday.

When the year started, legislation leaving Obamacare substantially in place would have been dead on arrival with hardliners in the House and Senate, who demanded that party leaders expand on a bill that former President Barack Obama vetoed in 2015. That measure did not fully repeal the ACA either, bowing to Senate budget rules limiting how much of the law Republicans could scrap without a filibuster-proof 60 votes. But it eliminated the tax credits and subsidies undergirding the law’s insurance exchanges along with its tax increases and mandates. And with Republicans now in control of both Congress and the White House, conservatives in the House Freedom Caucus this spring began pushing the leadership to go further by repealing Obamacare’s core consumer protections guaranteeing the coverage of essential health benefits and prohibiting insurers from charging higher rates to people with preexisting conditions.

The deal that ultimately allowed the AHCA to pass the House was an under-appreciated turning point in the health-care debate. The concession that Speaker Paul Ryan and a few key moderates made to the Freedom Caucus was to allow states to opt out of some of Obamacare’s insurance regulations, most crucially on equal treatment for pre-existing conditions. But the concession that conservative lawmakers and outside groups made in return was just as significant: They agreed to back off their demand for full repeal and endorse—or at least not fight—a bill that fell far short of that goal.“While this legislation does not fully repeal Obamacare, it’s an important step in keeping that promise to lower healthcare costs,” the Freedom Caucus said in its statement upon passage of the AHCA. It was a message echoed by outside groups like FreedomWorks, Heritage Action, and the Club for Growth, who agreed to drop their opposition to the bill, a move that gave Republicans additional cover to vote for it. Conservatives had embraced an incrementalist approach to Obamacare. The new standard they adopted for health-care legislation was not whether it eliminated the Affordable Care Act but whether it would lower premiums for most consumers.One key question for McConnell is whether the most outspoken conservatives in his caucus—Senators Rand Paul of Kentucky, Ted Cruz of Texas, and Mike Lee of Utah—will judge the Senate bill by that more modest baseline. Republicans can lose no more than two votes to secure passage, and a group of moderate senators is proving just as difficult for party leaders to nail down. To this point, Paul has been the most critical of the GOP approach and the most likely to oppose the proposal from the right. The House bill, he complained, already kept 90 percent of Obamacare’s subsidies. “If this gets any more subsidies in it, it may well be equal to what we have in Obamacare. So it really wouldn’t be repeal,” Paul said on Tuesday, according to Bloomberg. Even so, the Kentucky conservative wouldn’t rule out supporting the bill until he read the text.Cruz and Lee have participated in the Senate process as members of the 13-man working group, and aides have said both have bought into McConnell’s incremental approach. But the two have each complained about the emerging draft in recent days, either on the substance or the top-down, secretive process used to write the bill. “We’re not there yet,” Cruz said Tuesday on Fox News. “The current draft doesn’t do nearly enough to lower premiums.”The Congressional Budget Office projected that in states that opted out of Obamacare’s insurance requirements under the waivers allowed in the House bill, average premiums would drop significantly. But the tradeoff is that people with preexisting conditions would face sharply higher costs or be priced out of insurance entirely. Conservatives have argued that the high cost of adhering to the ACA’s minimum coverage requirements has forced insurers to raise premiums in order to make a profit.Conservative activists briefly held out hope that the health-care bill would move further to the right in the Senate, buoyed by efforts by Cruz and Lee to have Republicans override parliamentary rulings limiting how much of Obamacare they could repeal through the budget reconciliation process. But party leaders never seriously considered that option, which moderate Republicans were likely to oppose.In recent weeks, conservatives have instead focused on demanding that the Senate preserve—or deepen—the reforms to Medicaid in the House bill while still repealing all of Obamacare’s tax hikes. “It is clear that significant portions of the Republican Party have no intention of actually repealing Obamacare despite campaigning on that objective for years,” Mike Needham, CEO of Heritage Action, said in a statement on Wednesday.

“Conservatives will evaluate legislative language when it becomes available, looking particularly at whether the legislation empowers states to get out of the onerous insurance mandates imposed by Obamacare, maintains and improves the House’s Medicaid reforms, and repeals Obamacare’s stifling taxes.”

Make no mistake, Republicans aren’t merely tinkering around the edges of the health-care system, or Obamacare. The Senate proposal that will come out on Thursday will significantly alter the federal funding of Medicaid and, in all likelihood, would result in millions fewer Americans having health insurance over the next decade, as projected by the CBO. And while they won’t be excited by the bill, conservative senators and activists might well come around to support it. They’d vote for the plan as a step in the right direction, a weakening of Obamacare. But like McConnell, they won’t be calling it something that it’s not: repeal.

https://www.theatlantic.com/politics/archive/2017/06/senate-republican-bill-obamacare-repeal/531108/

What’s in the Senate Republican Health-Care Bill

Like the House version, Mitch McConnell’s proposal would slash taxes, cut Medicaid, and eliminate Obamacare’s insurance mandates for individuals and employers.

The Senate Republican health-care bill is finally out in the open.

After weeks of secretive deliberations, party leaders on Thursday released a 142-page proposal that would slash taxes on the wealthy and businesses; reduce federal funding for Medicaid and phase out its expansion under the Affordable Care Act; and limit the tax credits available to help people purchase insurance on the individual market. The legislation, titled the Better Care Reconciliation Act of 2017, is officially labeled a “discussion draft,” but Senate Majority Leader Mitch McConnell wants Republicans to debate and vote on the bill by the end of next week.

Like the American Health Care Act that passed the House in May, the Senate bill is a substantial revision to Obamacare but not a wholesale repeal. And while Senate Republicans had vowed to start over rather than work off the unpopular House proposal, their version is structured the same way. The Senate measure mirrors the House bill in eliminating the ACA’s employer and individual insurance mandates and most of the tax increases it imposed to pay for new programs. Both proposals call for an overhaul of Medicaid funding that would allow states to institute work requirements and end the program’s status as an open-ended entitlement. The Senate bill would go further than the House’s $800 billion in cuts by reducing its growth rate beginning in 2025, but unlike the House version, it would begin a three-year phase-out of the program’s expansion in 2020. The AHCA would cut off the expansion entirely that year.

As expected, Democrats assailed the proposal as a draconian measure that would strip health insurance from millions all for the goal of providing tax cuts for the rich. They seized on comments that President Trump reportedly made to Republican senators in which he called the House proposal “mean.”
“Simply put: This bill will result in higher costs, less care, and millions of Americans will lose their health insurance, particularly through Medicaid,” Senate Minority Leader Charles Schumer said. “It’s every bit as bad as the House bill; in some ways, it’s even worse.”

But the McConnell was never intended to appeal to Democrats. Instead, the majority leader and the Senate policy staffers who wrote the bill were trying to strike a delicate balance between conservatives bent on ripping up Obamacare and moderate Republican senators who, though they campaigned on repeal, now want to preserve its central benefits. Whether McConnell achieved that middle ground is unclear, as few Republican senators leapt to embrace his proposal in the immediate aftermath of its release. The first official holdouts to emerge were a group of four conservatives: Senators Rand Paul of Kentucky, Ted Cruz of Texas, Mike Lee of Utah, and Ron Johnson of Wisconsin.“Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor,” they said in a joint statement. “There are provisions in this draft that represent an improvement to our current health care system, but it does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs.”Their statement was significant because together, their opposition alone could sink the bill given the GOP’s narrow, 52-48 majority in the Senate. But its careful wording left a lot of room for any or all of the conservatives to come around by the time the bill hits the floor next week. Paul, who has been a critic of the GOP approach for months, was more harsh in a pair of tweets he sent on his own. “The current bill does not repeal Obamacare. It does not keep our promises to the American people,” he wrote. Paul had long been considered a likely no vote, as it is unlikely McConnell could move the bill far enough to the right to get his support without losing moderates.
The draft will also face the test of whether its provisions pass muster under the Senate’s complex rules for budget reconciliation, which would allow Republican to circumvent a Democratic filibuster. Aides on Thursday acknowledged that “there will be ongoing discussions with the Parliamentarian” in the Senate about certain parts of the bill.The Senate proposal targets abortion coverage by prohibiting the use of tax credits to buy insurance plans that cover the procedure, and it would ban funds from going to Planned Parenthood. Those provisions could jeopardize the support of two moderate Republicans, Senators Susan Collins of Maine and Lisa Murkowski of Alaska, who have said they oppose restricting federal funding to Planned Parenthood. A spokeswoman for Collins, Annie Clark, said Thursday she would be reviewing the bill into the weekend. “She has a number of concerns and will be particularly interested in examining the forthcoming CBO analysis on the impact on insurance coverage, the effect on insurance premiums, and the changes in the Medicaid program,” Clark said.The Senate bill also allows states to opt out of some of Obamacare’s insurance regulations, but it does not allow waivers that would let insurance companies charge higher rates to people with preexisting conditions. “We’re not touching preexisting conditions,” one top GOP staffer told reporters on a Thursday conference call. While the House bill created a new waiver system aimed at allowing states to get around Obamacare requirements, the Senate expands an existing waiver in the current law to make it easier for states to apply. The provision, aides said, would allow insurance companies in states that obtain waivers to sell plans that do not provide essential health benefits, including maternity care, hospitalization, and mental-health treatment.Unlike the House bill, the Senate proposal contains funding for cost-sharing payments for insurers to help stabilize the faltering individual insurance market under Obamacare. They would continue through 2019 before being repealed entirely. The payments are the subject of a lawsuit that House Republicans filed against the Obama administration three years ago, and while the Trump administration has continued the subsidies, its refusal to guarantee them over the long term has prompted more insurers to exit the ACA exchanges.McConnell has drawn criticism from senators in both parties for writing the bill behind closed doors without public hearings, though it’s unclear if the mounting frustration among some Republican senators about the process will threaten the legislation’s passage. In a floor speech on Thursday morning, the majority leader said senators would have “ample time” to review and amend the bill before a final vote. The Congressional Budget Office said it would release its analysis of the Senate bill’s cost and impact on insurance early next week. It found that the House bill would leave 23 million more people uninsured over the next decade while reducing average premiums depending on whether states opted out of Obamacare’s insurance regulations.“We debated many policy proposals. We considered many different viewpoints,” McConnell said. “In the end, we found that we share many ideas about what needs to be achieved and how we can achieve it. These shared policy objectives and the solutions to help achieve them are what make up the health care discussion draft that we talked through this morning.”Senate budget rules call for what’s known as a “vote-a-rama” where members of either party offer amendments in a single session. And in many ways, it appears McConnell’s draft is designed to be amended. The bill, for example, does not include funding for the opioid crisis that Senators Rob Portman of Ohio, Shelley Moore Capito of West Virginia, and others were demanding. Nor does it adopt their proposal for a longer, seven-year phase-out of the Medicaid expansion. But by omitting those provisions at the front end, McConnell could be inviting Portman, Capito, and other wavering senators to add them by amendment so they can claim credit for improving the bill when it comes to the floor. Similarly, the statement Paul, Cruz, Lee, and Johnson appeared to be a play for changes that could win their ultimate support.Republicans have a razor-thin majority of 52 seats, and McConnell can lose no more than two votes to pass the bill with a tie-breaker from Vice President Mike Pence. The majority leader will also face difficulty securing support from conservatives who feel the proposal doesn’t go far enough in dismantling Obamacare.https://www.theatlantic.com/politics/archive/2017/06/whats-in-the-senate-republican-health-care-bill/531258/
Mark Levin’s new book, “Rediscovering Americanism,” an assault on the media and progressives and a call for Americans to take back their country, debuts today at No. 1 on Amazon.

Showing the draw of the New York Times bestselling author and top syndicated radio host, his book is already on the way to becoming another big seller.

“My new book covers a lot of territory — philosophy, history, economics, law, culture, etc. And I look deeply into what is meant by Americanism, republicanism, individualism, capitalism. What do we mean by natural law, unalienable rights, liberty, and property rights? From where do these principles come? Why are they important?” he told Secrets.

It follows in the path of his other books and the nation: Liberty and Tyranny: A Conservative Manifesto; Ameritopia: The Unmaking of America; The Liberty Amendments; and Plunder and Deceit.

Secrets reviewed “Rediscovering Americanism”last week and wrote:

In the book, Levin attacks the embrace by the media, politicians, and academia of progressive promises of a “utopia” defined by the end of personal freedom and individuality.

He has a grim name for it: “The Final Outcome.” Levin wrote, “They reject history’s lessons and instead are absorbed with their own conceit and aggrandizement in the relentless pursuit of a diabolical project, the final outcome of which is an oppression of mind and soul.”

Levin added, “the equality they envision but dare not honestly proclaim, is life on the hamster wheel, where one individual is indistinguishable from the next.”

Paul Bedard, the Washington Examiner’s “Washington Secrets” columnist, can be contacted at pbedard@washingtonexaminer.com

http://www.washingtonexaminer.com/mark-levin-book-condemning-media-progressives-debuts-no-1-amazon/article/2627178

Dems face identity crisis

Democrats are grappling with how to keep their progressive base happy while winning over white working-class voters who left the party in the 2016 elections.

Defections by blue-collar voters cost Democrat Hillary Clinton the states of Michigan, Pennsylvania and Wisconsin, all of which went to President Trump. It was the first time since 1988 that a GOP presidential candidate had won Michigan or Pennsylvania, and the first time since 1984 in Wisconsin.

The fallout has created an identity crisis for a Democratic Party seeking to find its way forward in the post-Obama era.

A string of House special election losses culminating in Democrat Jon Ossoff’s disappointing defeat in Georgia last week has only intensified the scrutiny and second-guessing of Democratic strategy, to say nothing of the hand-wringing by party activists craving a victory.

“I’m not convinced we know what the best thing is for the party right now,” said Democratic strategist Jim Manley. “I’m not convinced we have the answers.”

Democrats trying to figure out what they’re doing wrong are focused on how they’ve seemingly lost a significant part of the Democratic base all while failing to turn out enough progressives.

There are different views about what to do across the party, with some questioning whether the white working-class voters can be won back by a party that seems to be tilting leftward with the rise of Sen. Bernie Sanders(I-Vt.) and other liberal voices.

“I’ve spoken to some folks who think we have to only choose one or the other,” said one former senior aide to President Barack Obama. “And after this election cycle, I think there are some who believe there may be some truth to that.”

A lot depends on whether the party can find the right candidate with the right message, particularly in 2020.

“Democrats need a reason for showing up. Give them a reason to believe, and we won’t be having this discussion,” the former Obama aide said.

Democrats say there is a way to appeal to both progressives and white working-class voters.

“Everybody is being too simplistic,” Democratic strategist Jamal Simmons said. “Voters are much more complex.”

Simmons said it’s not a matter of choosing to talk about police violence and climate change or the minimum wage and creating jobs.

Progressives, he said, want Democrats to talk about all of that.

They “want politicians to say something about Black Lives Matter and equality — they also want to know how they’re going to get their kids through college, pay off their house and get a better job,” he said. “The thing that’s most frustrating to me is this either-or dichotomy.”

Obama’s victories in 2008 and 2012 show Democrats can win over both groups, say some Democrats.

“This crisis is Democrats not realizing their own strengths, or being scared of articulating their core principles, rather than a crisis of having no agenda,” said Julian Zelizer, a professor of history and public affairs at Princeton University.

He said a focus on economics, climate change and being anti-Trump would animate the party.

“These are the places that 2018 candidates need to focus on, because they are ways to distinguish themselves from the GOP and its agenda,” he added. “Then they should continue to use Trump as a unifying theme. Often experts downplay this, but Republicans were very effective at using Obama that way.”

In recent days, particularly since the Ossoff loss, Democrats have been doing a lot of finger-pointing.

There’s been a movement to stop blaming the 2016 presidential election loss on Russia. And there have been calls to cut ties with current Democratic leaders like House Minority Leader Nancy Pelosi (D-Calif.). Some of those calls, within the House, come from lawmakers such as Rep. Tim Ryan (D-Ohio), who is worried about losing the white working class.

On the other end of the spectrum, some say Sanders’s bashing of Democrats has only deepened wounds.

“A lot of people are sick of it,” said Manley, a former adviser to then-Senate Majority Leader Harry Reid (D-Nev.). “The mainstream part of the party has had it up to here with what he’s been saying.”

Some Democrats are seeking to build a bridge between the two groups.

In an interview Sunday on ABC’s “This Week,” Senate Minority Leader Charles Schumer (D-N.Y.) said the party will unveil a “strong, bold, sharp-edged and commonsense economic agenda” in the coming weeks.

Addressing both wings of his party, he added, “I’m talking to Bernie Sanders. I’m talking to Joe Manchin. This is going to be really something that Democrats can be proud of, and I’m excited about it.”

Manchin, a Democratic senator from West Virginia, is among the most centrist members of Schumer’s conference.

Michael Tyler, a spokesman for the Democratic National Committee, said Democrats will look to expand their support across the party.

He acknowledged in an email to The Hill that in order to win elections, Democrats “have to focus on broadening and turning out our base and on reaching out to Americans who cast ballots for Donald Trump or didn’t vote at all.”

Tyler said Democrats are in the process of rebuilding a party “from an organization whose mission was solely to elect the president of the United States to one that organizes to elect Democrats up and down the ballot, from school board to Senate.”

But it may not be as easy as that, some strategists say.

Asked how the party rebounds and lures both working-class and progressive Democrats, Manley admitted: “I don’t have the faintest idea in this point in time. I’m still trying to digest what happened.”

http://thehill.com/homenews/campaign/339577-dems-face-identity-crisis

Replacing Obamacare is a make-or-break moment for Republicans

 June 25

Sen. Dean Heller (R-Nev.) threw himself off a political cliff last week when he declared full-throated opposition to the Senate version of the Obamacare repeal bill, and it remains to be seen if Heller is hanging by a limb out of sight and can climb back to electoral sanity or has hit rock bottom in his public career.Individual Senate Republicans face different political realities, but the caucus must somehow get the votes necessary to return the revised Obamacare “repeal and replace” bill to the House. To fail to do so is to condemn not only Heller and Arizona’s Sen. Jeff Flake to certain doom but probably others among the eight GOP senators up for reelection. The grass roots’ disgust with this betrayal will be so deep as to endanger every senator, even in deep red states such as Mississippi, Texas and Utah.The political crosswinds and upheavals in the country are already beyond predicting anything, so to add even more cause for grievance by betraying the central promise of the congressional GOP is beyond irresponsible. It is political insanity. Shut the door to the consultants, and throw out the polling senators. If the GOP defaults on its core promise, it is doomed as a party to minority status, probably as early as 2018 and certainly in 2020.

To fail this week almost certainly forfeits the House majority in next year’s midterm elections but perhaps also the Senate’s, and with the latter, the ability to confirm Supreme Court justices and lower court judges, pass budgets under reconciliation, have any chance at serious tax reform and of course approve the crucial repeal of the Defense Department sequestration.

This is of course an imperative vote on saving American health care. Next year, for example, there potentially will be at least 18 counties in Ohio without even a single option for an individuals seeking coverage. The swaths of America where there is only one provider are large and growing. “Choice for consumers” is a delusion, and soaring deductibles have made health care an illusion to millions more.

Obamacare is a catastrophe on its own terms, but the consequences of not passing its repeal are worse even beyond those awful health-care outcomes. It will forfeit every other Republican goal because failing to deliver on the central promise of eight years of debates and campaigns will shatter the credibility every Republican, not just those who block the bill. The party as a whole will be gravely wounded, perhaps beyond healing for a generation or more.

I don’t have to guess about this. I have been talking to the center-right of the country for three hours a day Monday through Friday for the past 17 years. I know the central argument of the conservative activists everywhere in the United States is that Beltway Republicans cannot be trusted to do anything hard. That argument was dented by the discipline with which the GOP put up with the mainstream media and Democrats’ slings and arrows in the fight over replacing Justice Antonin Scalia. Majority Leader Mitch McConnell (Ky.) rightly calculated that to surrender that hill would be to lose not just a political battle but the political war stretching long into the future. It was that big of a deal to the base.

The same is true of Obamacare. To vote “no” on whatever compromise arrives is to express contempt for the Republican Party as a whole – and its grass-roots activists and base voters — and for those ideas it stands for on all major matters, from a strong defense to low taxes to an originalist Supreme Court.

Thus Heller seemed to declare himself a hollow man when he said he could not vote for it, a man without any core beliefs because with his rambling statement he endangered all alleged core GOP beliefs, and thus the GOP will not support him. It isn’t about primaries; primary opponents need not materialize. It is about millions of conservatives who will simply give up on politics.

This is a make-or-break moment for Senate Republicans and the party itself. Sadly, for this conservative, the tone-deafness of Heller may not be unique. It may not even turn out to be particularly rare. We will know in a week. And not one GOP senator will be able to say he or she wasn’t warned.

https://www.washingtonpost.com/opinions/replacing-obamacare-is-a-make-or-break-moment-for-republicans/2017/06/25/c5f7775a-59c9-11e7-9fc6-c7ef4bc58d13_story.html?utm_term=.602544feab43

Patient Protection and Affordable Care Act

From Wikipedia, the free encyclopedia
Patient Protection and Affordable Care Act
Great Seal of the United States
Long title The Patient Protection and Affordable Care Act
Acronyms(colloquial) PPACA, ACA
Nicknames Affordable Care Act, Health Insurance Reform, Healthcare Reform, Obamacare
Enacted by the 111th United States Congress
Effective March 23, 2010; 7 years ago
Most major provisions phased in by January 2014; remaining provisions phased in by 2020
Citations
Public law 111–148
Statutes at Large 124 Stat. 119 through 124 Stat. 1025(906 pages)
Legislative history
  • Introduced in the House as the “Service Members Home Ownership Tax Act of 2009” (H.R. 3590byCharles Rangel (DNYon September 17, 2009
  • Committee consideration by Ways and Means
  • Passed the House on October 8, 2009 (416–0)
  • Passed the Senate as the “Patient Protection and Affordable Care Act” on December 24, 2009 (60–39with amendment
  • House agreed to Senate amendment on March 21, 2010 (219–212)
  • Signed into law by President Barack Obama on March 23, 2010
Major amendments
Health Care and Education Reconciliation Act of 2010
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
United States Supreme Court cases
National Federation of Independent Business v. Sebelius
Burwell v. Hobby Lobby
King v. Burwell

The Patient Protection and Affordable Care Act, often shortened to the Affordable Care Act (ACA) and nicknamed Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Under the act, hospitals and primary physicians would transform their practices financially, technologically, and clinically to drive better health outcomes, lower costs, and improve their methods of distribution and accessibility.

The Affordable Care Act was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage and reduce the costs of healthcare. It introduced mechanisms including mandates, subsidies, and insurance exchanges.[1][2] The law requires insurers to accept all applicants, cover a specific list of conditions and charge the same rates regardless of pre-existing conditions or sex.[3]

The ACA has caused a significant reduction in the number of people without health insurance, with estimates ranging from 20–24 million additional people covered during 2016.[4][5] Increases in overall healthcare spending have slowed since the law was implemented, including premiums for employer-based insurance plans.[6] The Congressional Budget Office reported in several studies that the ACA would reduce the budget deficit, and that repealing it would increase the deficit.[7][8]

As implementation began, first opponents, then others, and finally the president himself adopted the term “Obamacare” to refer to the ACA.[9]

The law and its implementation faced challenges in Congress and federal courts, and from some state governmentsconservative advocacy groupslabor unions, and small business organizations. The United States Supreme Court upheld the constitutionality of the ACA’s individual mandate as an exercise of Congress’s taxing power,[10] found that states cannot be forced to participate in the ACA’s Medicaid expansion,[11][12][13] and found that the law’s subsidies to help individuals pay for health insurance are available in all states, not just in those that have set up state exchanges.[14]

Together with the Health Care and Education Reconciliation Act amendment, it represents the U.S. healthcare system‘s most significant regulatory overhaul and expansion of coverage since the passage of Medicare and Medicaid in 1965.[15][16][17][18]

Provisions

The President and White House Staff react to the House of Representatives passing the bill on March 21, 2010.

The ACA includes provisions to take effect between 2010 and 2020, although most took effect on January 1, 2014. Few areas of the US health care system were left untouched, making it the most sweeping health care reform since the enactment of Medicare and Medicaid in 1965.[15][16][17][19][18] However, some areas were more affected than others. The individual insurance market was radically overhauled, and many of the law’s regulations applied specifically to this market,[15] while the structure of Medicare, Medicaid, and the employer market were largely retained.[16] Most of the coverage gains were made through the expansion of Medicaid,[20] and the biggest cost savings were made in Medicare.[16] Some regulations applied to the employer market, and the law also made delivery system changes that affected most of the health care system.[16] Not all provisions took full effect. Some were made discretionary, some were deferred, and others were repealed before implementation.

Individual insurance

Guaranteed issue prohibits insurers from denying coverage to individuals due to pre-existing conditions. States were required to ensure the availability of insurance for individual children who did not have coverage via their families.

States were required to expand Medicaid eligibility to include individuals and families with incomes up to 133% of the federal poverty level, including adults without disabilities or dependent children.[21] The law provides a 5% “income disregard”, making the effective income eligibility limit for Medicaid 138% of the poverty level.[22]

The State Children’s Health Insurance Program (CHIP) enrollment process was simplified.[21]

Dependents were permitted to remain on their parents’ insurance plan until their 26th birthday, including dependents that no longer live with their parents, are not a dependent on a parent’s tax return, are no longer a student, or are married.[23][24]

Among the groups who remained uninsured were:

  • Illegal immigrants, estimated at around 8 million—or roughly a third of the 23 million projection—are ineligible for insurance subsidies and Medicaid.[25][26] They remain eligible for emergency services.
  • Eligible citizens not enrolled in Medicaid.[27]
  • Citizens who pay the annual penalty instead of purchasing insurance, mostly younger and single.[27]
  • Citizens whose insurance coverage would cost more than 8% of household income and are exempt from the penalty.[27]
  • Citizens who live in states that opt out of the Medicaid expansion and who qualify for neither existing Medicaid coverage nor subsidized coverage through the states’ new insurance exchanges.[28]

Subsidies

Households with incomes between 100% and 400% of the federal poverty level were eligible to receive federal subsidies for policies purchased via an exchange.[29][30] Subsidies are provided as an advanceable, refundable tax credits.[31][32] Additionally, small businesses are eligible for a tax credit provided that they enroll in the SHOP Marketplace.[33] Under the law, workers whose employers offer affordable coverage will not be eligible for subsidies via the exchanges. To be eligible the cost of employer-based health insurance must exceed 9.5% of the worker’s household income.

Subsidies (2014) for Family of 4[34][35][36][37][38]
Income % of federal poverty level Premium Cap as a Share of Income Incomea Max Annual Out-of-Pocket Premium Premium Savingsb Additional Cost-Sharing Subsidy
133% 3% of income $31,900 $992 $10,345 $5,040
150% 4% of income $33,075 $1,323 $9,918 $5,040
200% 6.3% of income $44,100 $2,778 $8,366 $4,000
250% 8.05% of income $55,125 $4,438 $6,597 $1,930
300% 9.5% of income $66,150 $6,284 $4,628 $1,480
350% 9.5% of income $77,175 $7,332 $3,512 $1,480
400% 9.5% of income $88,200 $8,379 $2,395 $1,480
a.^ Note: In 2014, the FPL was $11,800 for a single person and $24,000 for family of four.[39][40] See Subsidy Calculator for specific dollar amount.[41] b.^ DHHS and CBO estimate the average annual premium cost in 2014 would have been $11,328 for a family of 4 without the reform.[36]

Premiums were the same for everyone of a given age, regardless of preexisting conditions. Premiums were allowed to vary by enrollee age, but those for the oldest enrollees (age 45-64 average expenses $5,542) could only be three times as large as those for adults (18-24 $1,836).[42]

Mandates

Individual

The individual mandate[43] is the requirement to buy insurance or pay a penalty for everyone not covered by an employer sponsored health planMedicaidMedicare or other public insurance programs (such as Tricare). Also exempt were those facing a financial hardship or who were members in a recognized religious sect exempted by the Internal Revenue Service.[44]

The mandate and the limits on open enrollment[45][46] were designed to avoid the insurance death spiral in which healthy people delay insuring themselves until they get sick. In such a situation, insurers would have to raise their premiums to cover the relatively sicker and thus more expensive policies,[43][47][48] which could create a vicious cycle in which more and more people drop their coverage.[49]

The purpose of the mandate was to prevent the healthcare system from succumbing to adverse selection, which would result in high premiums for the insured and little coverage (and thus more illness and medical bankruptcy) for the uninsured.[47][50][51] Studies by the CBOGruber and Rand Health concluded that a mandate was required.[52][53][54] The mandate increased the size and diversity of the insured population, including more young and healthy participants to broaden the risk pool, spreading costs.[55] Experience in New Jersey and Massachusetts offered divergent outcomes.[50][53][56]

Business

Businesses that employ 50 or more people but do not offer health insurance to their full-time employees pay a tax penalty if the government has subsidized a full-time employee’s healthcare through tax deductions or other means. This is commonly known as the employer mandate.[57][58] This provision was included to encourage employers to continue providing insurance once the exchanges began operating.[59] Approximately 44% of the population was covered directly or indirectly through an employer.[60][61]

Excise taxes

Excise taxes for the Affordable Care Act raised $16.3 billion in fiscal year 2015 (17% of all excise taxes collected by the Federal Government). $11.3 billion was an excise tax placed directly on health insurers based on their market share. The ACA was going to impose a 40% “Cadillac tax” on expensive employer sponsored health insurance but that was postponed until 2018. Annual excise taxes totaling $3 billion were levied on importers and manufacturers of prescription drugs. An excise tax of 2.3% on medical devices and a 10% excise tax on indoor tanning services were applied as well.[62]

Insurance standards

Essential health benefits

The National Academy of Medicine defined the law’s “essential health benefits” as “ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care”[63][64][65][66][67][68][69] and others[70] rated Level A or B by the U.S. Preventive Services Task Force.[71] In determining what would qualify as an essential benefit, the law required that standard benefits should offer at least that of a “typical employer plan”.[68] States may require additional services.[72]

Contraceptives

One provision in the law mandates that health insurance cover “additional preventive care and screenings” for women.[73] The guidelines issued by the Health Resources and Services Administration to implement this provision mandate “[a]ll Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity”.[74] This mandate applies to all employers and educational institutions except for religious organizations.[75][76] These regulations were included on the recommendations of the Institute of Medicine.[77][78]

Risk management

ACA provided three ways to control risk for insurers in the individual and business markets: temporary reinsurance, temporary risk corridors, and permanent risk adjustment.

Risk corridor program

The risk-corridor program was a temporary risk management device defined under the PPACA section 1342[79]:1 to encourage reluctant insurers into the “new and untested” ACA insurance market during the first three years that ACA was implemented (2014–2016). For those years the Department of Health and Human Services (HHS) “would cover some of the losses for insurers whose plans performed worse than they expected. Insurers that were especially profitable, for their part, would have to return to HHS some of the money they earned on the exchanges”[80][81]

According to an article in Forbes, risk corridors “had been a successful part of the Medicare prescription drug benefit, and the ACA’s risk corridors were modeled after Medicare’s Plan D.”[82] They operated on the principle that “more participation would mean more competition, which would drive down premiums and make health insurance more affordable” and “[w]hen insurers signed up to sell health plans on the exchanges, they did so with the expectation that the risk-corridor program would limit their downside losses.”[80] The risk corridors succeeded in attracting ACA insurers. The program did not pay for itself as planned with “accumulated losses” up to $8.3 billion for 2014 and 2015 alone. Authorization had to be given so that HHS could pay insurers from “general government revenues”. Congressional Republicans “railed against” the program as a ‘bailout’ for insurers. Then-Rep. Jack Kingston (R-Ga.), on the Appropriations Committee that funds the Department of Health and Human Services and the Labor Department “[slipped] in a sentence” — Section 227 — in the “massive” appropriations Consolidated Appropriations Act, 2014 (H.R. 3547) that said that no funds in the discretionary spending bill “could be used for risk-corridor payments.” This effectively “blocked the administration from obtaining the necessary funds from other programs”[83] and placed Congress in a potential breach of contract with insurers who offered qualified health plans, under the Tucker Act[79] as it did not pay the insurers.[84][84]

On February 10, 2017, in the Moda Health v the US Government, Moda, one of the insurers that struggled financially because of the elimination of the risk corridor program, won a “$214-million judgment against the federal government”. Justice Thomas C. Wheeler stated, “the Government “made a promise in the risk corridors program that it has yet to fulfill. Today, the court directs the Government to fulfill that promise. After all, ‘to say to [Moda], ‘The joke is on you. You shouldn’t have trusted us,’ is hardly worthy of our great government.”[85]

Temporary reinsurance

Temporary reinsurance for insurance for insurers against unexpectedly high claims was a program that ran from 2014 through 2016. It was intended to limit insurer losses.[citation needed]

Risk adjustment

Of the three risk management programs, only risk adjustment was permanent. Risk adjustment attempts to spread risk among insurers to prevent purchasers with good knowledge of their medical needs from using insurance to cover their costs (adverse selection). Plans with low actuarial risk compensate plans with high actuarial risk.[citation needed]

Other provisions

In 2012 Senator Sheldon Whitehouse created this summary to explain his view on the act.

The ACA has several other provisions:

  • Annual and lifetime coverage caps on essential benefits were banned.[86][87]
  • Prohibits insurers from dropping policyholders when they get sick.[88]
  • All health policies sold in the United States must provide an annual maximum out of pocket (MOOP) payment cap for an individual’s or family’s medical expenses (excluding premiums). After the MOOP payment cap is reached, all remaining costs must be paid by the insurer.[89]
  • A partial community rating requires insurers to offer the same premium to all applicants of the same age and location without regard to gender or most pre-existing conditions (excluding tobacco use).[90][91][92] Premiums for older applicants can be no more than three times those for the youngest.[93]
  • Preventive care, vaccinations and medical screenings cannot be subject to co-paymentsco-insurance or deductibles.[94][95][96] Specific examples of covered services include: mammograms and colonoscopies, wellness visits, gestational diabetes screening, HPV testing, STI counseling, HIV screening and counseling, contraceptive methods, breastfeeding support/supplies and domestic violence screening and counseling.[97]
  • The law established four tiers of coverage: bronze, silver, gold and platinum. All categories offer the essential health benefits. The categories vary in their division of premiums and out-of-pocket costs: bronze plans have the lowest monthly premiums and highest out-of-pocket costs, while platinum plans are the reverse.[68][98] The percentages of health care costs that plans are expected to cover through premiums (as opposed to out-of-pocket costs) are, on average: 60% (bronze), 70% (silver), 80% (gold), and 90% (platinum).[99]
  • Insurers are required to implement an appeals process for coverage determination and claims on all new plans.[88]
  • Insurers must spend at least 80–85% of premium dollars on health costs; rebates must be issued to policyholders if this is violated.[100][101]

Exchanges

Established the creation of health insurance exchanges in all fifty states. The exchanges are regulated, largely online marketplaces, administered by either federal or state government, where individuals and small business can purchase private insurance plans.[102][103][104]

Setting up an exchange gives a state partial discretion on standards and prices of insurance.[105][106] For example, states approve plans for sale, and influence (through limits on and negotiations with private insurers) the prices on offer. They can impose higher or state-specific coverage requirements—including whether plans offered in the state can cover abortion.[107] States without an exchange do not have that discretion. The responsibility for operating their exchanges moves to the federal government.[105]

State waivers

From 2017 onwards, states can apply for a “waiver for state innovation” that allows them to conduct experiments that meet certain criteria.[108] To obtain a waiver, a state must pass legislation setting up an alternative health system that provides insurance at least as comprehensive and as affordable as ACA, covers at least as many residents and does not increase the federal deficit.[109] These states can be exempt from some of ACA’s central requirements, including the individual and employer mandates and the provision of an insurance exchange.[110] The state would receive compensation equal to the aggregate amount of any federal subsidies and tax credits for which its residents and employers would have been eligible under ACA plan, if they cannot be paid under the state plan.[108]

In May 2011, Vermont enacted Green Mountain Care, a state-based single-payer system for which they intended to pursue a waiver to implement.[111][112][113] In December 2014, Vermont decided not to continue due to high expected costs.[114]

Accountable Care Organizations

The Act allowed the creation of Accountable Care Organizations (ACOs), which are groups of doctors, hospitals and other providers that commit to give coordinated, high quality care to Medicare patients. ACOs were allowed to continue using a fee for service billing approach. They receive bonus payments from the government for minimizing costs while achieving quality benchmarks that emphasize prevention and mitigation of chronic disease. If they fail to do so, they are subject to penalties.[115]

Unlike Health Maintenance Organizations, ACO patients are not required to obtain all care from the ACO. Also, unlike HMOs, ACOs must achieve quality of care goals.[115]

Others

Legislative history

President Obama signing the Patient Protection and Affordable Care Act on March 23, 2010

Background

An individual mandate coupled with subsidies for private insurance as a means for universal healthcare was considered the best way to win the support of the Senate because it had been included in prior bipartisan reform proposals. The concept goes back to at least 1989, when the conservative The Heritage Foundation proposed an individual mandate as an alternative to single-payer health care.[125] It was championed for a time by conservative economists and Republican senators as a market-based approach to healthcare reform on the basis of individual responsibility and avoidance of free rider problems. Specifically, because the 1986 Emergency Medical Treatment and Active Labor Act (EMTALA) requires any hospital participating in Medicare (nearly all do) to provide emergency care to anyone who needs it, the government often indirectly bore the cost of those without the ability to pay.[126][127][128]

President Bill Clinton proposed a healthcare reform bill in 1993 that included a mandate for employers to provide health insurance to all employees through a regulated marketplace of health maintenance organizations. Republican Senators proposed an alternative that would have required individuals, but not employers, to buy insurance.[127]Ultimately the Clinton plan failed amid an unprecedented barrage of negative advertising funded by politically conservative groups and the health insurance industry and due to concerns that it was overly complex.[129] Clinton negotiated a compromise with the 105th Congress to instead enact the State Children’s Health Insurance Program (SCHIP) in 1997.[130]

John Chafee

The 1993 Republican alternative, introduced by Senator John Chafee as the Health Equity and Access Reform Today Act, contained a “universal coverage” requirement with a penalty for noncompliance—an individual mandate—as well as subsidies to be used in state-based ‘purchasing groups’.[131] Advocates for the 1993 bill included prominent Republicans such as Senators Orrin HatchChuck GrassleyBob Bennett and Kit Bond.[132][133] Of 1993’s 43 Republican Senators, 20 supported the HEART Act.[125][134] Another Republican proposal, introduced in 1994 by Senator Don Nickles (R-OK), the Consumer Choice Health Security Act, contained an individual mandate with a penalty provision;[135] however, Nickles subsequently removed the mandate from the bill, stating he had decided “that government should not compel people to buy health insurance”.[136] At the time of these proposals, Republicans did not raise constitutional issues with the mandate; Mark Pauly, who helped develop a proposal that included an individual mandate for George H. W. Bush, remarked, “I don’t remember that being raised at all. The way it was viewed by the Congressional Budget Office in 1994 was, effectively, as a tax.”[125]

Mitt Romney’s Massachusetts went from 90% of its residents insured to 98%, the highest rate in the nation.[137]

In 2006, an insurance expansion bill was enacted at the state level in Massachusetts. The bill contained both an individual mandate and an insurance exchange. Republican Governor Mitt Romney vetoed the mandate, but after Democrats overrode his veto, he signed it into law.[138] Romney’s implementation of the ‘Health Connector’ exchange and individual mandate in Massachusetts was at first lauded by Republicans. During Romney’s 2008 presidential campaign, Senator Jim DeMint praised Romney’s ability to “take some good conservative ideas, like private health insurance, and apply them to the need to have everyone insured”. Romney said of the individual mandate: “I’m proud of what we’ve done. If Massachusetts succeeds in implementing it, then that will be the model for the nation.”[139]

In 2007, a year after the Massachusetts reform, Republican Senator Bob Bennett and Democratic Senator Ron Wyden introduced the Healthy Americans Act, which featured an individual mandate and state-based, regulated insurance markets called “State Health Help Agencies”.[128][139] The bill initially attracted bipartisan support, but died in committee. Many of the sponsors and co-sponsors remained in Congress during the 2008 healthcare debate.[140]

By 2008 many Democrats were considering this approach as the basis for healthcare reform. Experts said that the legislation that eventually emerged from Congress in 2009 and 2010 bore similarities to the 2007 bill[131] and that it was deliberately patterned after Romney’s state healthcare plan.[141]

Healthcare debate, 2008–10

Healthcare reform was a major topic during the 2008 Democratic presidential primaries. As the race narrowed, attention focused on the plans presented by the two leading candidates, Hillary Clinton and the eventual nominee, Barack Obama. Each candidate proposed a plan to cover the approximately 45 million Americans estimated to not have health insurance at some point each year. Clinton’s proposal would have required all Americans to obtain coverage (in effect, an individual mandate), while Obama’s proposal provided a subsidy but rejected the use of an individual mandate.[142][143]

During the general election, Obama said that fixing healthcare would be one of his top four priorities as president.[144] Obama and his opponent, Sen. John McCain, proposed health insurance reforms though they differed greatly. Senator John McCain proposed tax credits for health insurance purchased in the individual market, which was estimated to reduce the number of uninsured people by about 2 million by 2018. Obama proposed private and public group insurance, income-based subsidies, consumer protections, and expansions of Medicaid and SCHIP, which was estimated at the time to reduce the number of uninsured people by 33.9 million by 2018.[145]

President Obama addressing Congress regarding healthcare reform, September 9, 2009

After his inauguration, Obama announced to a joint session of Congress in February 2009 his intent to work with Congress to construct a plan for healthcare reform.[146][147] By July, a series of bills were approved by committees within the House of Representatives.[148] On the Senate side, from June to September, the Senate Finance Committee held a series of 31 meetings to develop a healthcare reform bill. This group — in particular, Democrats Max BaucusJeff Bingaman and Kent Conrad, along with Republicans Mike EnziChuck Grassley and Olympia Snowe— met for more than 60 hours, and the principles that they discussed, in conjunction with the other committees, became the foundation of the Senate healthcare reform bill.[149][150][151]

Congressional Democrats and health policy experts like MIT economics professor Jonathan Gruber[152] and David Cutler argued that guaranteed issue would require both community ratingand an individual mandate to ensure that adverse selection and/or “free riding” would not result in an insurance “death spiral”.[153] This approach was taken because the president and congressional leaders had concluded that more progressive plans, such as the (single-payer) Medicare for All act, could not obtain filibuster-proof support in the Senate. By deliberately drawing on bipartisan ideas — the same basic outline was supported by former Senate majority leaders Howard BakerBob DoleTom Daschle and George J. Mitchell—the bill’s drafters hoped to garner the votes necessary for passage.[154][155]

However, following the adoption of an individual mandate, Republicans came to oppose the mandate and threatened to filibuster any bills that contained it.[125] Senate minority leader Mitch McConnell, who led the Republican congressional strategy in responding to the bill, calculated that Republicans should not support the bill, and worked to prevent defections:[156]

It was absolutely critical that everybody be together because if the proponents of the bill were able to say it was bipartisan, it tended to convey to the public that this is O.K., they must have figured it out.[157]

Republican Senators, including those who had supported previous bills with a similar mandate, began to describe the mandate as “unconstitutional”. Journalist Ezra Klein wrote in The New Yorker that “a policy that once enjoyed broad support within the Republican Party suddenly faced unified opposition.”[128] Reporter Michael Cooper of The New York Times wrote that: “the provision … requiring all Americans to buy health insurance has its roots in conservative thinking.”[127][134]

Tea Party protesters at the Taxpayer March on Washington, September 12, 2009

The reform negotiations also attracted attention from lobbyists,[158] including deals between certain lobby groups and the advocates of the law to win the support of groups that had opposed past reforms, as in 1993.[159][160] The Sunlight Foundation documented many of the reported ties between “the healthcare lobbyist complex” and politicians in both parties.[161]

During the August 2009 summer congressional recess, many members went back to their districts and held town hall meetings on the proposals. The nascent Tea Party movement organized protests and many conservative groups and individuals attended the meetings to oppose the proposed reforms.[147] Many threats were made against members of Congress over the course of the debate.[162][163]

When Congress returned from recess, in September 2009 President Obama delivered a speech to a joint session of Congress supporting the ongoing Congressional negotiations.[164] He acknowledged the polarization of the debate, and quoted a letter from the late Senator Edward “Ted” Kennedy urging on reform: “what we face is above all a moral issue; that at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.”[165] On November 7, the House of Representatives passed the Affordable Health Care for America Act on a 220–215 vote and forwarded it to the Senate for passage.[147]

Senate

The Senate began work on its own proposals while the House was still working. The United States Constitution requires all revenue-related bills to originate in the House.[166] To formally comply with this requirement, the Senate used H.R. 3590, a bill regarding housing tax changes for service members.[167] It had been passed by the House as a revenue-related modification to the Internal Revenue Code. The bill became the Senate’s vehicle for its healthcare reform proposal, discarding the bill’s original content.[168] The bill ultimately incorporated elements of proposals that were reported favorably by the Senate Health and Financecommittees. With the Republican Senate minority vowing to filibuster, 60 votes would be necessary to pass the Senate.[169] At the start of the 111th Congress, Democrats had only 58 votes; the Senate seat in Minnesota ultimately won by Al Franken was still undergoing a recount, while Arlen Specter was still a Republican (he became a Democrat in April, 2009).

Negotiations were undertaken attempting to satisfy moderate Democrats and to bring Republican senators aboard; particular attention was given to Republicans Bennett, Enzi, Grassley and Snowe. On July 7 Franken was sworn into office, providing a potential 60th vote. On August 25 Ted Kennedy—a longtime healthcare reform advocate—died. Paul Kirk was appointed as Senator Kennedy’s temporary replacement on September 24.

After the Finance Committee vote on October 15, negotiations turned to moderate Democrats. Majority leader Harry Reid focused on satisfying centrists. The holdouts came down to Joe Lieberman of Connecticut, an independent who caucused with Democrats, and conservative Nebraska Democrat Ben Nelson. Lieberman’s demand that the bill not include a public option[153][170] was met,[171] although supporters won various concessions, including allowing state-based public options such as Vermont’s Green Mountain Care.[171][172]

Senate vote by state.

  Democratic yes (58)
  Independent yes (2)
  Republican no (39)
  Republican not voting (1)

The White House and Reid addressed Nelson’s concerns[173] during a 13-hour negotiation with two concessions: a compromise on abortion, modifying the language of the bill “to give states the right to prohibit coverage of abortion within their own insurance exchanges”, which would require consumers to pay for the procedure out of pocket if the state so decided; and an amendment to offer a higher rate of Medicaid reimbursement for Nebraska.[147][174] The latter half of the compromise was derisively termed the “Cornhusker Kickback”[175] and was repealed in the subsequent reconciliation amendment bill.

On December 23, the Senate voted 60–39 to end debate on the bill: a cloture vote to end the filibuster. The bill then passed, also 60–39, on December 24, 2009, with all Democrats and two independents voting for it, and all Republicans against (except Jim Bunning, who did not vote).[176] The bill was endorsed by the AMA and AARP.[177]

On January 19, 2010, Massachusetts Republican Scott Brown was elected to the Senate in a special election to replace Kennedy, having campaigned on giving the Republican minority the 41st vote needed to sustain Republican filibusters.[147][178][179] His victory had become significant because of its effects on the legislative process. The first was psychological: the symbolic importance of losing Kennedy’s traditionally Democratic Massachusetts seat made many Congressional Democrats concerned about the political cost of passing a bill.[180][181]

House

House vote by congressional district.

  Democratic yes (219)
  Democratic no (34)
  Republican no (178)
  No representative seated (4)

Brown’s election meant Democrats could no longer break a filibuster in the Senate. In response, White House Chief of Staff Rahm Emanuel argued that Democrats should scale back to a less ambitious bill; House Speaker Nancy Pelosi pushed back, dismissing Emanuel’s scaled-down approach as “Kiddie Care”.[182][183]

Obama remained insistent on comprehensive reform. The news that Anthem Blue Cross in California intended to raise premium rates for its patients by as much as 39% gave him new evidence of the need for reform.[182][183] On February 22, he laid out a “Senate-leaning” proposal to consolidate the bills.[184] He held a meeting with both parties’ leaders on February 25. The Democrats decided that the House would pass the Senate’s bill, to avoid another Senate vote.

House Democrats had expected to be able to negotiate changes in a House-Senate conference before passing a final bill. Since any bill that emerged from conference that differed from the Senate bill would have to pass the Senate over another Republican filibuster, most House Democrats agreed to pass the Senate bill on condition that it be amended by a subsequent bill.[181] They drafted the Health Care and Education Reconciliation Act, which could be passed by the reconciliation process.[182][185][186]

As per the Congressional Budget Act of 1974, reconciliation cannot be subject to a filibuster. But reconciliation is limited to budget changes, which is why the procedure was not used to pass ACA in the first place; the bill had inherently non-budgetary regulations.[187][188] Although the already-passed Senate bill could not have been passed by reconciliation, most of House Democrats’ demands were budgetary: “these changes—higher subsidy levels, different kinds of taxes to pay for them, nixing the Nebraska Medicaid deal—mainly involve taxes and spending. In other words, they’re exactly the kinds of policies that are well-suited for reconciliation.”[185]

Jim Clyburn and Nancy Pelosi celebrating after the House passes the amended bill on March 21

The remaining obstacle was a pivotal group of pro-life Democrats led by Bart Stupak who were initially reluctant to support the bill. The group found the possibility of federal funding for abortion significant enough to warrant opposition. The Senate bill had not included language that satisfied their concerns, but they could not address abortion in the reconciliation bill as it would be non-budgetary. Instead, Obama issued Executive Order 13535, reaffirming the principles in the Hyde Amendment.[189] This won the support of Stupak and members of his group and assured the bill’s passage.[186][190] The House passed the Senate bill with a 219–212 vote on March 21, 2010, with 34 Democrats and all 178 Republicans voting against it.[191] The next day, Republicans introduced legislation to repeal the bill.[192] Obama signed ACA into law on March 23, 2010.[193] Since passage, Republicans have voted to repeal all or parts of the Affordable Care Act over sixty times; no such attempt by Republicans has been successful.[194] The amendment bill, The Health Care and Education Reconciliation Act, cleared the House on March 21; the Senate passed it by reconciliation on March 25, and Obama signed it on March 30.

Impact

Coverage rate, employer market cost trends, budgetary impact, and income inequality aspects of the Affordable Care Act.

This chart illustrates several aspects of the Affordable Care Act, including number of persons covered, cost before and after subsidies, and public opinion.

Coverage

Affordable Care Act (ObamaCare). County By County Projected Insurer Participation in Health Insurance Exchanges.

The law has caused a significant reduction in the number and percentage of people without health insurance. The CDC reported that the percentage of people without health insurance fell from 16.0% in 2010 to 8.9% during the January–June 2016 period.[195] The uninsured rate dropped in every congressional district in the U.S. between 2013 and 2015.[196] The Congressional Budget Office reported in March 2016 that there were approximately 12 million people covered by the exchanges (10 million of whom received subsidies to help pay for insurance) and 11 million made eligible for Medicaid by the law, a subtotal of 23 million people. An additional 1 million were covered by the ACA’s “Basic Health Program,” for a total of 24 million.[4] CBO also estimated that the ACA would reduce the net number of uninsured by 22 million in 2016, using a slightly different computation for the above figures totaling ACA coverage of 26 million, less 4 million for reductions in “employment-based coverage” and “non-group and other coverage.”[4]

The Department of Health and Human Services (HHS) estimated that 20.0 million adults (aged 18–64) gained healthcare coverage via ACA as of February 2016, a 2.4 million increase over September 2015. HHS estimated that this 20.0 million included: a) 17.7 million from the start of open enrollment in 2013-2016; and b) 2.3 million young adults aged 19–25 who initially gained insurance from 2010-2013, as they were allowed to remain on their parent’s plans until age 26. Of the 20.0 million, an estimated 6.1 million were aged 19–25.[5] Similarly, the Urban Institute issued a report in in December 2016 that said that about 19.2 million non-elderly Americans had gained health insurance coverage from 2010 to 2015.[197] In March 2016, the CBO reported that there were approximately 27 million people without insurance in 2016, a figure they expected would range from 26-28 million through 2026. CBO also estimated the percentage of insured among all U.S. residents would remain at 90% through that period, 92-93% excluding unauthorized immigrants.[4]

Those states that expanded Medicaid had a 7.3% uninsured rate on average in the first quarter of 2016, while those that did not expand Medicaid had a 14.1% uninsured rate, among adults aged 18 to 64.[198] As of December 2016 there were 32 states (including Washington DC) that had adopted the Medicaid extension, while 19 states had not.[199]

By 2017, nearly 70% of those on the exchanges could purchase insurance for less than $75/month after subsidies, which rose to offset significant pre-subsidy price increases in the exchange markets.[200] Healthcare premium cost increases in the employer market continued to moderate. For example, healthcare premiums for those covered by employers rose by 69% from 2000-2005, but only 27% from 2010 to 2015,[6] with only a 3% increase from 2015 to 2016.[201]

The ACA also helps reduce income inequality measured after taxes, due to higher taxes on the top 5% of income earners and both subsidies and Medicaid expansion for lower-income persons.[202] CBO estimated that subsidies paid under the law in 2016 averaged $4,240 per person for 10 million individuals receiving them, roughly $42 billion. For scale, the subsidy for the employer market, in the form of exempting from taxation those health insurance premiums paid on behalf of employees by employers, was approximately $1,700 per person in 2016, or $266 billion total in the employer market. The employer market subsidy was not changed by the law.[4]

Insurance exchanges

As of August 2016, 15 states operated their own exchanges. Other states either used the federal exchange, or operated in partnership with or supported by the federal government.[203]

Medicaid expansion

Medicaid expansion by state, as of September 1, 2015.[204]

  Adopted the Medicaid expansion
  Medicaid expansion under discussion
  Not adopting Medicaid expansion

As of December 2016 there were 32 states (including Washington DC) that had adopted the Medicaid extension, while 19 states had not.[199] Those states that expanded Medicaid had a 7.3% uninsured rate on average in the first quarter of 2016, while those that did not expand Medicaid had a 14.1% uninsured rate, among adults aged 18 to 64.[198] Following the Supreme Court ruling in 2012, which held that states would not lose Medicaid funding if they didn’t expand Medicaid under the ACA, several states rejected expanded Medicaid coverage. Over half of the national uninsured population lived in those states.[205] In a report to Congress, the Centers for Medicare and Medicaid Services (CMS) estimated that the cost of expansion was $6,366 per person for 2015, about 49 percent above previous estimates. An estimated 9 million to 10 million people had gained Medicaid coverage, mostly low-income adults.[206] The Kaiser Family Foundation estimated in October 2015 that 3.1 million additional people were not covered because of states that rejected the Medicaid expansion.[207]

States that rejected the Medicaid expansion could maintain their Medicaid eligibility thresholds, which in many states were significantly below 133% of the poverty line.[208] Many states did not make Medicaid available to childless adults at any income level.[209] Because subsidies on exchange insurance plans were not available to those below the poverty line, such individuals had no new options.[210][211] For example, in Kansas, where only able-bodied adults with children and with an income below 32% of the poverty line were eligible for Medicaid, those with incomes from 32% to 100% of the poverty level ($6,250 to $19,530 for a family of three) were ineligible for both Medicaid and federal subsidies to buy insurance. Absent children, able-bodied adults were not eligible for Medicaid in Kansas.[205]

Studies of the impact of state decisions to reject the Medicaid expansion calculated that up to 6.4 million people could fall into this status.[212] The federal government initially paid for 100% of the expansion (through 2016). The subsidy tapered to 90% by 2020 and continued to shrink thereafter.[213] Several states argued that they could not afford their 10% contribution.[213][214] Studies suggested that rejecting the expansion would cost more than expanding Medicaid due to increased spending on uncompensated emergency care that otherwise would have been partially paid for by Medicaid coverage,[215]

A 2016 study led by Harvard University health economics professor Benjamin Sommers found that residents of Kentucky and Arkansas, which both accepted the Medicaid expansion, were more likely to receive health care services and less likely to incur emergency room costs or have trouble paying their medical bills than before the expansion. Residents of Texas, which did not accept the Medicaid expansion, did not see a similar improvement during the same period.[216] Kentucky opted for increased managed care, while Arkansas subsidized private insurance. The new Arkansas and Kentucky governors have proposed reducing or modifying their programs. Between 2013 and 2015, the uninsured rate dropped from 42% to 14% in Arkansas and from 40% to 9% in Kentucky, compared with 39% to 32% in Texas. Specific improvements included additional primary and preventive care, fewer emergency departments visits, reported higher quality care, improved health, improved drug affordability, reduced out-of-pocket spending and increased outpatient visits, increased diabetes screening, glucose testing among diabetes patients and regular care for chronic conditions.[217]

A 2016 DHHS study found that states that expanded Medicaid had lower premiums on exchange policies, because they had fewer low-income enrollees, whose health on is worse than that of those with higher income.[218]

Healthcare insurance costs

U.S. healthcare cost information, including rate of change, per-capita, and percent of GDP. (Data source: Centers for Medicare and Medicaid Services[219])

The law is designed to pay subsidies in the form of tax credits to the individuals or families purchasing the insurance, based on income levels. Higher income consumers receive lower subsidies. While pre-subsidy prices rose considerably from 2016 to 2017, so did the subsidies, to reduce the after-subsidy cost to the consumer. For example, a study published in 2016 found that the average requested 2017 premium increase among 40-year-old non-smokers was about 9 percent, according to an analysis of 17 cities, although Blue Cross Blue Shield proposed increases of 40 percent in Alabama and 60 percent in Texas.[220] However, some or all of these costs are offset by subsidies, paid as tax credits. For example, the Kaiser Foundation reported that for the second-lowest cost “Silver plan” (a plan often selected and used as the benchmark for determining financial assistance), a 40-year old non-smoker making $30,000 per year would pay effectively the same amount in 2017 as they did in 2016 (about $208/month) after the subsidy/tax credit, despite large increases in the pre-subsidy price. This was consistent nationally. In other words, the subsidies increased along with the pre-subsidy price, fully offsetting the price increases.[221]

Healthcare premium cost increases in the employer market continued to moderate after the implementation of the law. For example, healthcare premiums for those covered by employers rose by 69% from 2000-2005, but only 27% from 2010 to 2015,[6] with only a 3% increase from 2015 to 2016.[201] From 2008-2010 (before passage of the ACA) health insurance premiums rose by an average of 10% per year.[222]

Several studies found that the financial crisis and accompanying recession could not account for the entirety of the slowdown and that structural changes likely share at least partial credit.[223][224][225][226] A 2013 study estimated that changes to the health system had been responsible for about a quarter of the recent reduction in inflation.[227] Paul Krawzak claimed that even if cost controls succeed in reducing the amount spent on healthcare, such efforts on their own may be insufficient to outweigh the long-term burden placed by demographic changes, particularly the growth of the population on Medicare.[228]

In a 2016 review of the ACA published in JAMA, Barack Obama himself wrote that from 2010 through 2014 mean annual growth in real per-enrollee Medicare spending was negative, down from a mean of 4.7% per year from 2000 through 2005 and 2.4% per year from 2006 to 2010; similarly, mean real per-enrollee growth in private insurance spending was 1.1% per year over the period, compared with a mean of 6.5% from 2000 through 2005 and 3.4% from 2005 to 2010.[229]

Effect on deductibles and co-payments

While health insurance premium costs have moderated, some of this is because of insurance policies that have a higher deductibleco-payments and out-of-pocket maximums that shift costs from insurers to patients. In addition, many employees are choosing to combine a health savings account with higher deductible plans, making the impact of the ACA difficult to determine precisely.

For those who obtain their insurance through their employer (“group market”), a 2016 survey found that:

  • Deductibles grew by 63% from 2011 to 2016, while premiums increased 19% and worker earnings grew by 11%.
  • In 2016, 4 in 5 workers had an insurance deductible, which averaged $1,478. For firms with less than 200 employees, the deductible averaged $2,069.
  • The percentage of workers with a deductible of at least $1,000 grew from 10% in 2006 to 51% in 2016. The 2016 figure drops to 38% after taking employer contributions into account.[230]

For the “non-group” market, of which two-thirds are covered by the ACA exchanges, a survey of 2015 data found that:

  • 49% had individual deductibles of at least $1,500 ($3,000 for family), up from 36% in 2014.
  • Many marketplace enrollees qualify for cost-sharing subsidies that reduce their net deductible.
  • While about 75% of enrollees were “very satisfied” or “somewhat satisfied” with their choice of doctors and hospitals, only 50% had such satisfaction with their annual deductible.
  • While 52% of those covered by the ACA exchanges felt “well protected” by their insurance, in the group market 63% felt that way.[231]

Health outcomes

Insurance coverage helps save lives, by encouraging early detection and prevention of dangerous medical conditions. According to a 2014 study, the ACA likely prevented an estimated 50,000 preventable patient deaths from 2010 to 2013.[232] City University public health professors David Himmelstein and Steffie Woolhandler wrote in January 2017 that a rollback of the ACA’s Medicaid expansion alone would cause an estimated 43,956 deaths annually.[233]

Federal deficit

CBO estimates of revenue and impact on deficit

The CBO reported in several studies that the ACA would reduce the deficit, and that repealing it would increase the deficit.[7][8][234][235] The 2011 comprehensive CBO estimate projected a net deficit reduction of more than $200 billion during the 2012–2021 period:[8][236] it calculated the law would result in $604 billion in total outlays offset by $813 billion in total receipts, resulting in a $210 billion net deficit reduction.[8] The CBO separately predicted that while most of the spending provisions do not begin until 2014,[237][238] revenue would exceed spending in those subsequent years.[239] The CBO claimed that the bill would “substantially reduce the growth of Medicare’s payment rates for most services; impose an excise tax on insurance plans with relatively high premiums; and make various other changes to the federal tax code, Medicare, Medicaid, and other programs”[240]—ultimately extending the solvency of the Medicare trust fund by 8 years.[241]

This estimate was made prior to the Supreme Court’s ruling that enabled states to opt out of the Medicaid expansion, thereby forgoing the related federal funding. The CBO and JCT subsequently updated the budget projection, estimating the impact of the ruling would reduce the cost estimate of the insurance coverage provisions by $84 billion.[242][243][244]

The CBO in June 2015 forecasted that repeal of ACA would increase the deficit between $137 billion and $353 billion over the 2016–2025 period, depending on the impact of macroeconomic feedback effects. The CBO also forecasted that repeal of ACA would likely cause an increase in GDP by an average of 0.7% in the period from 2021 to 2015, mainly by boosting the supply of labor.[7]

Major new sources of increased tax receipts include:[95] higher Medicare taxes; annual fees on insurance providers; fees on the healthcare industry such as manufacturers and importers of brand-name pharmaceutical drugs and certain medical devices; limits on tax deductions of medical expenses and flexible spending accounts; a 40% excise tax on plans with annual insurance premiums in excess of $10,200 for an individual or $27,500 for a family; revenue from mandate penalty payments; a 10% federal sales tax on indoor tanning services. Predicted spending reductions included a reduction in Medicare reimbursements to insurers and drug companies for private Medicare Advantagepolicies that the Government Accountability Office and Medicare Payment Advisory Commission found to be excessively costly relative to government Medicare;[245][246] and reductions in Medicare reimbursements to hospitals that failed standards of efficiency and care.[245]

Although the CBO generally does not provide cost estimates beyond the 10-year budget projection period because of the degree of uncertainty involved in the projection, it decided to do so in this case at the request of lawmakers, and estimated a second decade deficit reduction of $1.2 trillion.[240][247] CBO predicted deficit reduction around a broad range of one-half percent of GDP over the 2020s while cautioning that “a wide range of changes could occur”.[248]

Opinions on CBO projections

The CBO cost estimates were criticized because they excluded the effects of potential legislation that would increase Medicare payments by more than $200 billion from 2010 to 2019.[249][250][251] However, the so-called “doc fix” is a separate issue that would have existed whether or not ACA became law – omitting its cost from ACA was no different from omitting the cost of other tax cuts.[252][253][254]

Uwe Reinhardt, a Princeton health economist, wrote. “The rigid, artificial rules under which the Congressional Budget Office must score proposed legislation unfortunately cannot produce the best unbiased forecasts of the likely fiscal impact of any legislation”, but went on to say “But even if the budget office errs significantly in its conclusion that the bill would actually help reduce the future federal deficit, I doubt that the financing of this bill will be anywhere near as fiscally irresponsible as was the financing of the Medicare Modernization Act of 2003.”[255] Douglas Holtz-Eakin, CBO director during the George W. Bush administration, who later served as the chief economic policy adviser to U.S. Senator John McCain‘s 2008 presidential campaign, alleged that the bill would increase the deficit by $562 billion because, he argued, it front-loaded revenue and back-loaded benefits.[256]

Scheiber and Cohn rejected critical assessments of the law’s deficit impact, arguing that predictions were biased towards underestimating deficit reduction. They noted that for example, it is easier to account for the cost of definite levels of subsidies to specified numbers of people than account for savings from preventive healthcare, and that the CBO had a track record of overestimating costs and underestimating savings of health legislation;[257][258] stating, “innovations in the delivery of medical care, like greater use of electronic medical records[259] and financial incentives for more coordination of care among doctors, would produce substantial savings while also slowing the relentless climb of medical expenses… But the CBO would not consider such savings in its calculations, because the innovations hadn’t really been tried on such large scale or in concert with one another—and that meant there wasn’t much hard data to prove the savings would materialize.”[257]

In 2010 David Walker, former U.S. Comptroller General then working for The Peter G. Peterson Foundation, stated that the CBO estimates are not likely to be accurate, because they were based on the assumption that the law would not change.[260] The Center on Budget and Policy Priorities objected that Congress had a good record of implementing Medicare savings. According to their study, Congress followed through on the implementation of the vast majority of provisions enacted in the past 20 years to produce Medicare savings, although not the payment reductions addressed by the annual “doc fix”.[261][262]

Economic consequences

CBO estimated in June 2015 that repealing the ACA would:

  • Decrease aggregate demand (GDP) in the short-term, as low-income persons who tend to spend a large fraction of their additional resources would have fewer resources (e.g., ACA subsidies would be eliminated). This effect would be offset in the long-run by the labor supply factors below.
  • Increase the supply of labor and aggregate compensation by about 0.8 and 0.9 percent over the 2021-2025 period. CBO cited the ACA’s expanded eligibility for Medicaid and subsidies and tax credits that rise with income as disincentives to work, so repealing the ACA would remove those disincentives, encouraging workers to supply more hours of labor.
  • Increase the total number of hours worked by about 1.5% over the 2021-2025 period.
  • Remove the higher tax rates on capital income, thereby encouraging additional investment, raising the capital stock and output in the long-run.[7]

In 2015 the Center for Economic and Policy Research found no evidence that companies were reducing worker hours to avoid ACA requirements[263] for employees working over 30 hours per week.[264]

The CBO estimated that the ACA would slightly reduce the size of the labor force and number of hours worked, as some would no longer be tethered to employers for their insurance. Cohn, citing CBO’s projections, claimed that ACA’s primary employment effect was to alleviate job lock: “People who are only working because they desperately need employer-sponsored health insurance will no longer do so.”[265] He concluded that the “reform’s only significant employment impact was a reduction in the labor force, primarily because people holding onto jobs just to keep insurance could finally retire”, because they have health insurance outside of their jobs.[266]

Employer mandate and part-time work

The employer mandate requires employers meeting certain criteria to provide health insurance to their workers. The mandate applies to employers with more than 50 employees that do not offer health insurance to their full-time workers.[267] Critics claimed that the mandate created a perverse incentive for business to keep their full-time headcount below 50 and to hire part-time workers instead.[268][269] Between March 2010 and 2014 the number of part-time jobs declined by 230,000, while the number of full-time jobs increased by 2 million.[270][271] In the public sector full-time jobs turned into part-time jobs much more than in the private sector.[270][272] A 2016 study found only limited evidence that ACA had increased part-time employment.[273]

Several businesses and the state of Virginia added a 29-hour-a-week cap for their part-time employees,[274][unreliable source?][275][unreliable source?] to reflect the 30-hour-or-more definition for full-time worker.[267] As of yet, however, only a small percent of companies have shifted their workforce towards more part-time hours (4% in a survey from the Federal Reserve Bank of Minneapolis).[269] Trends in working hours[276] and the effects of the Great Recessioncorrelate with part-time working hour patterns.[277][278] The impact of this provision may have been offset by other factors, including that health insurance helps attract and retain employees, increases productivity and reduces absenteeism; and the lower training and administration costs of a smaller full-time workforce over a larger part-time work force.[269][276][279] Relatively few firms employ over 50 employees[269] and more than 90% of them offered insurance.[280] Workers without employer insurance could purchase insurance on the exchanges.[281]

Most policy analysts (on both right and left) were critical of the employer mandate provision.[268][280] They argued that the perverse incentives regarding part-time hours, even if they did not change existing plans, were real and harmful;[282][283] that the raised marginal cost of the 50th worker for businesses could limit companies’ growth;[284] that the costs of reporting and administration were not worth the costs of maintaining employer plans;[282][283] and noted that the employer mandate was not essential to maintain adequate risk pools.[285][286] The effects of the provision generated vocal opposition from business interests and some unions not granted exemptions.[283][287]

A 2013/4 survey by the National Association for Business Economics found that about 75 percent of those surveyed said ACA hadn’t influenced their planning or expectations for 2014, and 85 percent said the law wouldn’t prompt a change in their hiring practices. Some 21 percent of 64 businesses surveyed said that the act would have a harmful effect and 5 percent said it would be beneficial.[288]

Hospitals

From the start of 2010 to November 2014, 43 hospitals in rural areas closed. Critics claimed that the new law caused these hospitals to close. Many of these rural hospitals were built using funds from the 1946 Hill–Burton Act, to increase access to medical care in rural areas. Some of these hospitals reopened as other medical facilities, but only a small number operated emergency rooms (ER) or urgent care centers.[289]

Between January 2010 and 2015, a quarter of emergency room doctors said they had seen a major surge in patients, while nearly half had seen a smaller increase. Seven in ten ER doctors claimed that they lacked the resources to deal with large increases in the number of patients. The biggest factor in the increased number of ER patients was insufficient primary care providers to handle the larger number of insured patients.[290]

Insurers claimed that because they have access to and collect patient data that allow evaluations of interventions, they are essential to ACO success. Large insurers formed their own ACOs. Many hospitals merged and purchased physician practices. The increased market share gave them more leverage in negotiations with insurers over costs and reduced patient care options.[115]

Public opinion

Prior to the law’s passage, polling indicated the public’s views became increasingly negative in reaction to specific plans discussed during the legislative debate over 2009 and 2010. Polling statistics showed a general negative opinion of the law; with those in favor at approximately 40% and those against at 51%, as of October 2013.[291][292] About 29% of whites approve of the law, compared with 61% of Hispanics and 91% of African Americans.[293]Opinions were divided by age of the person at the law’s inception, with a solid majority of seniors opposing the bill and a solid majority of those younger than forty years old in favor.[294]

Congressional Democrats celebrating the 6th anniversary of the Affordable Care Act in March 2016 on the steps of the U.S. Capitol.

Congressional Democrats celebrating the 6th anniversary of the Affordable Care Act in March 2016 on the steps of the U.S. Capitol.

Specific elements were popular across the political spectrum, while others, such as the mandate to purchase insurance, were widely disliked. In a 2012 poll 44% supported the law, with 56% against. By party affiliation, 75% of Democrats, 27% of Independents and 14% of Republicans favored the law overall. 82% favored banning insurance companies from denying coverage to people with pre-existing conditions, 61% favored allowing children to stay on their parents’ insurance until age 26, 72% supported requiring companies with more than 50 employees to provide insurance for their employees, and 39% supported the individual mandate to own insurance or pay a penalty. By party affiliation, 19% of Republicans, 27% of Independents, and 59% of Democrats favored the mandate.[295] Other polls showed additional provisions receiving majority support, including the creation of insurance exchanges, pooling small businesses and the uninsured with other consumers so that more people can take advantage of large group pricing benefits and providing subsidies to individuals and families to make health insurance more affordable.[296][297]

In a 2010 poll, 62% of respondents said they thought ACA would “increase the amount of money they personally spend on health care”, 56% said the bill “gives the government too much involvement in health care”, and 19% said they thought they and their families would be better off with the legislation.[298] Other polls found that people were concerned that the law would cost more than projected and would not do enough to control costs.[299]

Some opponents believed that the reform did not go far enough: a 2012 poll indicated that 71% of Republican opponents rejected it overall, while 29% believed it did not go far enough; independent opponents were divided 67% to 33%; and among the much smaller group of Democratic opponents, 49% rejected it overall and 51% wanted more.[295] In June 2013, a majority of the public (52–34%) indicated a desire for “Congress to implement or tinker with the law rather than repeal it”.[300] After the Supreme Court upheld the individual mandate, a 2012 poll held that “most Americans (56%) want to see critics of President Obama’s health care law drop efforts to block it and move on to other national issues”.[301]A 2014 poll reported that 48.9% of respondents had an unfavorable view of ACA vs. 38.3% who had a favorable view (of more than 5,500 individuals).[302]

A 2014 poll reported that 26% of Americans support ACA.[303] Another held that 8% of respondents say that the Affordable Care Act “is working well the way it is”.[304] In late 2014, a Rasmussen poll reported Repeal: 30%, Leave as is: 13%, Improve: 52%.[305]

In 2015, a CBS News / New York Times poll reported that 47% of Americans approved the health care law. This was the first time that a major poll indicated that more respondents approved ACA than disapproved of it.[306] The recurring Kaiser Health Tracking Poll from December 2016 reported that: a) 30% wanted to expand what the law does; b) 26% wanted to repeal the entire law; c) 19% wanted to move forward with implementing the law as it is; and d) 17% wanted to scale back what the law does, with the remainder undecided.[307]

Separate polls from Fox News and NBC/WSJ both taken during January 2017 indicated more people viewed the law favorably than did not for the first time. One of the reasons for the improving popularity of the law is that Democrats who opposed it in the past (many prefer a “Medicare for All” approach) have shifted their positions since the ACA is under threat of repeal.[308]

A January 2017 Morning Consult poll showed that 35% of respondents either believed that “Obamacare” and the “Affordable Care Act” were different or did not know.[309] Approximately 45% were unsure whether the “repeal of Obamacare” also meant the “repeal of the Affordable Care Act.”[309] 39% did not know that “many people would lose coverage through Medicaid or subsidies for private health insurance if the A.C.A. were repealed and no replacement enacted,” with Democrats far more likely (79%) to know that fact than Republicans (47%).[309]

A 2017 study found that personal experience with public health insurance programs leads to greater support for the Affordable Care Act, and the effects appear to be most pronounced among Republicans and low-information voters.[310]

Political aspects

“Obamacare”

The term “Obamacare” was originally coined by opponents as a pejorative. The term emerged in March 2007 when healthcare lobbyist Jeanne Schulte Scott used it in a health industry journal, writing “We will soon see a ‘Giuliani-care’ and ‘Obama-care’ to go along with ‘McCain-care’, ‘Edwards-care’, and a totally revamped and remodeled ‘Hillary-care‘ from the 1990s”.[9][311] According to research by Elspeth Reeve, the expression was used in early 2007, generally by writers describing the candidate’s proposal for expanding coverage for the uninsured.[312] It first appeared in a political campaign by Mitt Romney in May 2007 in Des Moines, Iowa. Romney said, “In my state, I worked on healthcare for some time. We had half a million people without insurance, and I said, ‘How can we get those people insured without raising taxes and without having government take over healthcare?’ And let me tell you, if we don’t do it, the Democrats will. If the Democrats do it, it will be socialized medicine; it’ll be government-managed care. It’ll be what’s known as Hillarycare or Barack Obamacare, or whatever you want to call it.”[9]

By mid-2012, Obamacare had become the colloquial term used by both supporters and opponents. In contrast, the use of “Patient Protection and Affordable Care Act” or “Affordable Care Act” became limited to more formal and official use.[312] Use of the term in a positive sense was suggested by Democrat John Conyers.[313] Obama endorsed the nickname, saying, “I have no problem with people saying Obama cares. I do care.”[314]

In March 2012, the Obama reelection campaign embraced the term “Obamacare”, urging Obama’s supporters to post Twitter messages that begin, “I like #Obamacare because…”.[315]

In October 2013 the Associated Press and NPR began cutting back on use of the term.[316] Stuart Seidel, NPR’s managing editor, said that the term “seems to be straddling somewhere between being a politically-charged term and an accepted part of the vernacular”.[317]

Common misconceptions

“Death panels”

On August 7, 2009, Sarah Palin pioneered the term “death panels” to describe groups that would decide whether sick patients were “worthy” of medical care.[318] “Death panel” referred to two claims about early drafts.

One was that under the law, seniors could be denied care due to their age[319] and the other that the government would advise seniors to end their lives instead of receiving care. The ostensible basis of these claims was the provision for an Independent Payment Advisory Board (IPAB).[320] IPAB was given the authority to recommend cost-saving changes to Medicare by facilitating the adoption of cost-effective treatments and cost-recovering measures when the statutory levels set for Medicare were exceeded within any given 3-year period. In fact, the Board was prohibited from recommending changes that would reduce payments to certain providers before 2020, and was prohibited from recommending changes in premiums, benefits, eligibility and taxes, or other changes that would result in rationing.[321][322]

The other related issue concerned advance-care planning consultation: a section of the House reform proposal would have reimbursed physicians for providing patient-requested consultations for Medicare recipients on end-of-life health planning (which is covered by many private plans), enabling patients to specify, on request, the kind of care they wished to receive.[323] The provision was not included in ACA.[324]

In 2010, the Pew Research Center reported that 85% of Americans were familiar with the claim, and 30% believed it was true, backed by three contemporaneous polls.[325] A poll in August 2012 found that 39% of Americans believed the claim.[326] The allegation was named PolitiFact‘s “Lie of the Year”,[318][327] one of FactCheck.org‘s “whoppers”[328][329] and the most outrageous term by the American Dialect Society.[330] AARP described such rumors as “rife with gross—and even cruel—distortions”.[331]

Members of Congress

ACA requires members of Congress and their staffs to obtain health insurance either through an exchange or some other program approved by the law (such as Medicare), instead of using the insurance offered to federal employees (the Federal Employees Health Benefits Program).[332][333][334][335][336]

Illegal immigrants

ACA does not provide benefits to illegal immigrants.[337] It explicitly denies insurance subsidies to “unauthorized (illegal) aliens”.[25][26][338]

Exchange “death spiral”

One argument against the ACA is that the insurers are leaving the marketplaces, as they cannot profitably cover the available pool of customers, which contains too many unhealthy participants relative to healthy participants. A scenario where prices rise, due to an unfavorable mix of customers from the insurer’s perspective, resulting in fewer customers and fewer insurers in the marketplace, further raising prices, has been called a “Death Spiral.”[339]During 2017, the median number of insurers offering plans on the ACA exchanges in each state was 3.0, meaning half the states had more and half had fewer insurers. There were five states with one insurer in 2017; 13 states with two; 11 states with three; and the remainder had four insurers or more. Wisconsin had the most, with 15 insurers in the marketplace. The median number of insurers was 4.0 in 2016, 5.0 in 2015, and 4.0 in 2014.[340]

Further, the CBO reported in January 2017 that it expected enrollment in the exchanges to rise from 10 million during 2017 to 13 million by 2027, assuming laws in place at the end of the Obama administration were continued.[341]Following a 2015 CBO report that reached a similar conclusion, Paul Krugman wrote: “But the truth is that this report is much, much closer to what supporters of reform have said than it is to the scare stories of the critics–no death spirals, no job-killing, major gains in coverage at relatively low cost.”[342]

Opposition

Opposition and efforts to repeal the legislation have drawn support from sources that include labor unions,[343][344] conservative advocacy groups,[345][346] Republicans, small business organizations and the Tea Party movement.[347]These groups claimed that the law would disrupt existing health plans, increase costs from new insurance standards, and increase the deficit.[348] Some opposed the idea of universal healthcare, viewing insurance as similar to other unsubsidized goods.[349][350] President Donald Trump has repeatedly promised to “repeal and replace” it.[351][352]

As of 2013 unions that expressed concerns about ACA included the AFL-CIO,[353] which called ACA “highly disruptive” to union health care plans, claiming it would drive up costs of union-sponsored plans; the International Brotherhood of TeamstersUnited Food and Commercial Workers International Union, and UNITE-HERE, whose leaders sent a letter to Reid and Pelosi arguing, ” ACA will shatter not only our hard-earned health benefits, but destroy the foundation of the 40-hour work week that is the backbone of the American middle class.”[344] In January 2014, Terry O’Sullivan, president of the Laborers’ International Union of North America (LIUNA) and D. Taylor, president of Unite Here sent a letter to Reid and Pelosi stating, “ACA, as implemented, undermines fair marketplace competition in the health care industry.”[343]

In October 2016, Mark Dayton, the governor of Minnesota and a member of the Minnesota Democratic–Farmer–Labor Party, said that the ACA had “many good features” but that it was “no longer affordable for increasing numbers of people” and called on the Minnesota legislature to provide emergency relief to policyholders.[354] Dayton later said he regretted his remarks after they were seized on by Republicans seeking to repeal the law.[355]

Legal challenges

National Federation of Independent Business v. Sebelius

Opponents challenged ACA’s constitutionality in multiple lawsuits on multiple grounds.[356][357][not in citation given] In National Federation of Independent Business v. Sebelius, the Supreme Court ruled on a 5–4 vote that the individual mandate was constitutional when viewed as a tax, although not under the Commerce Clause.

The Court further determined that states could not be forced to participate in the Medicaid expansion. ACA withheld all Medicaid funding from states declining to participate in the expansion. The Court ruled that this withdrawal of funding was unconstitutionally coercive and that individual states had the right to opt out without losing preexisting Medicaid funding.[358]

Contraception mandate

In March 2012 the Roman Catholic Church, while supportive of ACA’s objectives, voiced concern through the United States Conference of Catholic Bishops that aspects of the mandate covering contraception and sterilization and HHS‘s narrow definition of a religious organization violated the First Amendment right to free exercise of religion and conscience. Various lawsuits addressed these concerns.[359][360]

On June 25, 2015, the U.S. Supreme Court ruled 6–3 that federal subsidies for health insurance premiums could be used in the 34 states that did not set up their own insurance exchanges.[361]

House v. Price

In United States House of Representatives v. Price (previously United States House of Representatives v. Burwell) the House sued the administration alleging that the money for premium subsidy payments to insurers had not been appropriated, as required for any federal government spending. The ACA subsidy that helps customers pay premiums was not part of the suit.

Without the cost-sharing subsidies, the government estimated that premiums would increase by 20 percent to 30 percent for silver plans.[362] In 2017, the uncertainty about whether the payments would continue caused Blue Cross Blue Shield of North Carolina to try to raise premiums by 22.9 percent the next year, as opposed to an increase of only 8.8 percent that it would have sought if the payments were assured.[363]

Non-cooperation

Officials in Texas, Florida, Alabama, Wyoming, Arizona, Oklahoma and Missouri opposed those elements of ACA over which they had discretion.[364][365] For example, Missouri declined to expand Medicaid or establish a health insurance marketplace engaging in active non-cooperation, enacting a statute forbidding any state or local official to render any aid not specifically required by federal law.[366] Other Republican politicians discouraged efforts to advertise the benefits of the law. Some conservative political groups launched ad campaigns to discourage enrollment.[367][368]

Repeal efforts

ACA was the subject of unsuccessful repeal efforts by Republicans in the 111th112th, and 113th Congresses: Representatives Steve King (R-IA) and Michele Bachmann (R-MN) introduced bills in the House to repeal ACA the day after it was signed, as did Senator Jim DeMint (R-SC) in the Senate.[369] In 2011, after Republicans gained control of the House of Representatives, one of the first votes held was on a bill titled “Repealing the Job-Killing Health Care Law Act” (H.R. 2), which the House passed 245–189.[370] All Republicans and 3 Democrats voted for repeal.[371] House Democrats proposed an amendment that repeal not take effect until a majority of the Senators and Representatives had opted out of the Federal Employees Health Benefits Program; Republicans voted down the measure.[372] In the Senate, the bill was offered as an amendment to an unrelated bill, but was voted down.[373]President Obama had stated that he would have vetoed the bill even if it had passed both chambers of Congress.[374]

2017 House Budget

Following the 2012 Supreme Court ruling upholding ACA as constitutional, Republicans held another vote to repeal the law on July 11;[375] the House of Representatives voted with all 244 Republicans and 5 Democrats in favor of repeal, which marked the 33rd, partial or whole, repeal attempt.[376][377] On February 3, 2015, the House of Representatives added its 67th repeal vote to the record (239 to 186). This attempt also failed.[378]

2013 federal government shutdown

Strong partisan disagreement in Congress prevented adjustments to the Act’s provisions.[379] However, at least one change, a proposed repeal of a tax on medical devices, has received bipartisan support.[380] Some Congressional Republicans argued against improvements to the law on the grounds they would weaken the arguments for repeal.[283][381]

Republicans attempted to defund its implementation,[365][382] and in October 2013, House Republicans refused to fund the federal government unless accompanied with a delay in ACA implementation, after the President unilaterally deferred the employer mandate by one year, which critics claimed he had no power to do. The House passed three versions of a bill funding the government while submitting various versions that would repeal or delay ACA, with the last version delaying enforcement of the individual mandate. The Democratic Senate leadership stated the Senate would only pass a “clean” funding bill without any restrictions on ACA. The government shutdown began on October 1.[383][384][385] Senate Republicans threatened to block appointments to relevant agencies, such as the Independent Payment Advisory Board[386] and Centers for Medicare and Medicaid Services.[387][388]

2017 repeal effort

During a midnight congressional session starting January 11, 2017, the Senate of the 115th Congress of the United States voted to approve a “budget blueprint” which would allow Republicansto repeal parts of the law “without threat of a Democratic filibuster.”[389][390] The plan, which passed 51-48, is a budget blueprint named by Senate Republicans the “Obamacare ‘repeal resolution.'”[391] Democrats opposing the resolution staged a protest during the vote.[392]

House Republicans announced their replacement for the ACA, the American Health Care Act, on March 6, 2017.[393] On March 24, 2017 the effort, led by Paul Ryan and Donald Trump, to repeal and replace the ACA failed amid a revolt among Republican representatives.[394]

On May 4, 2017, the United States House of Representatives voted to pass the American Health Care Act (and thereby repeal most of the Affordable Care Act) by a narrow margin of 217 to 213, sending the bill to the Senate for deliberation.[395] The Senate has indicated they will write their own version of the bill, instead of voting on the House version.[396]

Implementation history

Once the law was signed, provisions began taking effect, in a process that continued for years. Some provisions never took effect, while others were deferred for various periods.

Existing individual health plans

Plans purchased after the date of enactment, March 23, 2010, or old plans that changed in specified ways would eventually have to be replaced by ACA-compliant plans.[citation needed]

At various times during and after the ACA debate, Obama stated that “if you like your health care plan, you’ll be able to keep your health care plan”.[397][398] However, in fall 2013 millions of Americans with individual policies received notices that their insurance plans were terminated,[399] and several million more risked seeing their current plans cancelled.[400][401][402]

Obama’s previous unambiguous assurance that consumers’ could keep their own plans became a focal point for critics, who challenged his truthfulness.[403][404] On November 7, 2013, President Obama stated: “I am sorry that [people losing their plans] are finding themselves in this situation based on assurances they got from me.”[405] Various bills were introduced in Congress to allow people to keep their plans.[406]

In the fall of 2013, the Obama Administration announced a transitional relief program that would let states and carriers allow non-compliant individual and small group policies to renew at the end of 2013. In March 2014, HHS allowed renewals as late as October 1, 2016. In February 2016, these plans were allowed to renew up until October 1, 2017, but with a termination date no later than December 31, 2017.[citation needed]

2010

In June small business tax credits took effect. For certain small businesses, the credits reached up to 35% of premiums. At the same time uninsured people with pre-existing conditions could access the federal high-risk pool. Also, participating employment-based plans could obtain reimbursement for a portion of the cost of providing health insurance to early retirees.[407]

In July the Pre-Existing Condition Insurance Plan (PCIP) took effect to offer insurance to those that had been denied coverage by private insurance companies because of a pre-existing condition. Despite estimates of up to 700,000 enrollees, at a cost of approximately $13,000/enrollee, only 56,257 enrolled at a $28,994 cost per enrollee.[407]

2011

As of September 23, 2010, pre-existing conditions could no longer be denied coverage for children’s policies. HHS interpreted this rule as a mandate for “guaranteed issue“, requiring insurers to issue policies to such children.[citation needed] By 2011, insurers had stopped marketing child-only policies in 17 states, as they sought to escape this requirement.[408]

The average beneficiary in the prior coverage gap would have spent $1,504 in 2011 on prescriptions. Such recipients saved an average $603. The 50 percent discount on brand name drugs provided $581 and the increased Medicare share of generic drug costs provided the balance. Beneficiaries numbered 2 million[409]

2012

In National Federation of Independent Business v. Sebelius decided on June 28, 2012, the Supreme Court ruled that the individual mandate was constitutional when the associated penalties were construed as a tax. The decision allowed states to opt out of the Medicaid expansion. Several did so,[410] although some later accepted the expansion.[411][412]

2013

In January 2013 the Internal Revenue Service ruled that the cost of covering only the individual employee would be considered in determining whether the cost of coverage exceeded 9.5% of income. Family plans would not be considered even if the cost was above the 9.5% income threshold. This was estimated to leave 2–4 million Americans unable to afford family coverage under their employers’ plans and ineligible for subsidies.[413][414]

A June 2013 study found that the MLR provision had saved individual insurance consumers $1.2 billion in 2011 and $2.1 billion in 2012, reducing their 2012 costs by 7.5%.[415] The bulk of the savings were in reduced premiums, but some came from MLR rebates.

On July 2, 2013, the Obama Administration announced that it would delay the implementation of the employer mandate until 2015.[280][416][417]

The Community Living Assistance Services and Supports Act (or CLASS Act) was enacted as Title VIII of the ACA. It would have created a voluntary and public long-term care insurance option for employees.[121][123] In October 2011 the administration announced it was unworkable and would be dropped.[418] The CLASS Act was repealed January 1, 2013.[419]

The launch for both the state and federal exchanges was troubled due to management and technical failings. HealthCare.gov, the website that offers insurance through the exchanges operated by the federal government, crashed on opening and suffered endless problems.[420] Operations stabilized in 2014, although not all planned features were complete.[421][422]

CMS reported in 2013 that, while costs per capita continued to rise, the rate of increase in annual healthcare costs had fallen since 2002. Per capita cost increases averaged 5.4% annually between 2000 and 2013. Costs relative to GDP, which had been rising, had stagnated since 2009.[423] Several studies attempted to explain the reductions. Reasons included:

  • Higher unemployment due to the 2008-2010 recession, which limited the ability of consumers to purchase healthcare;
  • Out-of-pocket costs rose, reducing demand for healthcare services.[424] The proportion of workers with employer-sponsored health insurance requiring a deductible climbed to about three-quarters in 2012 from about half in 2006.[223]
  • ACA changes[223] that aim to shift the healthcare system from paying-for-quantity to paying-for-quality. Some changes occurred due to healthcare providers acting in anticipation of future implementation of reforms.[120][224]

2014

On July 30, 2014, the Government Accountability Office released a non-partisan study that concluded that the administration did not provide “effective planning or oversight practices” in developing the ACA website.[425]

In Burwell v. Hobby Lobby the Supreme Court exempted closely held corporations with religious convictions from the contraception rule.[426] In Wheaton College vs Burwell the Court issued an injunction allowing the evangelical college and other religiously affiliated nonprofit groups to completely ignore the contraceptive mandate.[427]

A study found that average premiums for the second-cheapest ( silver) plan were 10-21% less than average individual market premiums in 2013, while covering many more conditions. Credit for the reduced premiums was attributed to increased competition stimulated by the larger market, greater authority to review premium increases, the MLR and risk corridors.[citation needed]

Many of the initial plans featured narrow networks of doctors and hospitals.[428][not in citation given]

A 2016 analysis found that health care spending by the middle class was 8.9% of household spending in 2014.[429]

2015

By the beginning of the year, 11.7 million had signed up (ex-Medicaid).[430] On December 31, 2015, about 8.8 million consumers had stayed in the program. Some 84 percent, or about 7.4 million, were subsidized.[431]

Bronze plans were the second most popular in 2015, making up 22% of marketplace plan selections. Silver plans were the most popular, accounting for 67% of marketplace selections. Gold plans were 7%. Platinum plans accounted for 3%. On average across the four metal tiers, premiums were up 20% for HMOs and 18% for EPOs. Premiums for POS plans were up 15% from 2015 to 2016, while PPO premiums were up just 8%.[citation needed]

A 2015 study found 14% of privately insured consumers received a medical bill in the past two years from an out-of-network provider in the context of an overall in-network treatment event. Such out-of-network care is not subject to the lower negotiated rates of in-network care, increasing out-of-pocket costs. Another 2015 study found that the average out-of-network charges for the majority of 97 medical procedures examined “were 300% or higher compared to the corresponding Medicare fees” for those services.[citation needed]

Some 47% of the 2015 ACA plans sold on the Healthcare.gov exchange lacked standard out-of-network coverage. Enrollees in such plans, typically received no coverage for out-of-network costs (except for emergencies or with prior authorization). A 2016 study on Healthcare.gov health plans found a 24 percent increase in the percentage of ACA plans that lacked standard out-of-network coverage.[citation needed]

The December spending bill delayed the onset of the “Cadillac tax” on expensive insurance plans by two years, until 2020.[432]

The average price of non-generic drugs rose 16.2% in 2015 and 98.2% since 2011.[429]

2016

As of March 2016 11.1 million people had purchased exchange plans,[citation needed] while an estimated 9 million to 10 million people had gained Medicaid coverage, mostly low-income adults.[206] 11.1 million were still covered, a decline of nearly 13 percent.[433] 6.1 million uninsured 19-25 year olds gained coverage.[434]

Employers

A survey of New York businesses found an increase of 8.5 percent in health care costs, less than the prior year’s survey had expected. A 10 percent increase was expected for 2017. Factors included increased premiums, higher drug costs, ACA and aging workers. Some firms lowered costs by increasing cost-sharing (for higher employee contributions, deductibles and co-payments). 60% planned to further increase cost-sharing. Coverage and benefits were not expected to change. Approximately one fifth said ACA had pushed them to reduce their workforce. A larger number said they were raising prices.[435]

Insurers

The five major national insurers expected to lose money on ACA policies in 2016.[436] UnitedHealth withdrew from the Georgia and Arkansas exchanges for 2017, citing heavy losses.[203] Humana exited other markets, leaving it operating in 156 counties in 11 states for 2017.[437] 225 counties across the country had access to only a single ACA insurer. A study released in May estimated that 664 counties would have one insurer in 2017.[438][not in citation given]

Aetna cancelled planned expansion of its offerings and following an expected $300 million loss in 2016 and then withdrew from 11 of its 15 states.[439] In August 2016 Anthem said that its offerings were losing money, but also that it would expand its participation if a pending merger with Cigna was approved.[440] Aetna and Humana’s exit for 2017 left 8 rural Arizona counties with only Blue Cross/Blue Shield.[441]

Blue Cross/Blue Shield Minnesota announced that it would exit individual and family markets in Minnesota in 2017, due to financial losses of $500 million over three years.[442]

Another analysis found that 17 percent of eligibles may have a single insurer option in 2017. North Carolina, Oklahoma, Alaska, Alabama, South Carolina and Wyoming were expected to have a single insurer,[443] while only 2 percent of 2016 eligibles had only one choice.[444]

Aetna, Humana, UnitedHealth Group also exited various individual markets. Many local Blue Cross plans sharply narrowed their networks. In 2016 two thirds of individual plans were narrow-network HMO plans.[428]

One of the causes of insurer losses is the lower income, older and sicker enrollee population. One 2016 analysis reported that while 81% of the population with incomes from 100-150% of the federal poverty level signed up, only 45% of those from 150-200% did so. The percentage continued to decline as income rose: 2% of those above 400% enrolled.[445]

Costs

The law is designed to pay subsidies in the form of tax credits to the individuals or families purchasing the insurance, based on income levels. Higher income consumers receive lower subsidies. While pre-subsidy prices rose considerably from 2016 to 2017, so did the subsidies, to reduce the after-subsidy cost to the consumer. For example, a study published in 2016 found that the average requested 2017 premium increase among 40-year-old non-smokers was about 9 percent, according to an analysis of 17 cities, although Blue Cross Blue Shield proposed increases of 40 percent in Alabama and 60 percent in Texas.[220] However, some or all of these costs are offset by subsidies, paid as tax credits. For example, the Kaiser Foundation reported that for the second-lowest cost “Silver plan” (a plan often selected and used as the benchmark for determining financial assistance), a 40-year old non-smoker making $30,000 per year would pay effectively the same amount in 2017 as they did in 2016 (about $208/month) after the subsidy/tax credit, despite large increases in the pre-subsidy price. This was consistent nationally. In other words, the subsidies increased along with the pre-subsidy price, fully offsetting the price increases.[221]

Cooperatives

The number of ACA nonprofit insurance cooperatives for 2017 fell from 23 originally to 7 for 2017. The remaining 7 posted annual losses in 2015. A General Accountability Report found that co-ops’ 2015 premiums were generally below average. At the end of 2014, money co-ops and other ACA insurers had counted on risk corridor payments that didn’t materialize. Maryland’s Evergreen Health claims that ACA’s risk-adjustment system does not adequately measure risk.[citation needed]

Medicaid

Newly elected Louisiana Governor John Bel Edwards issued an executive order to accept the expansion, becoming the 32nd state to do so. The program was expected to enroll an additional 300,000 Louisianans.[446]

2017

More than 9.2 million people signed up for care on the national exchange (healthcare.gov) for 2017, down some 400,000 from 2016. This decline was due primarily to the election of President Trump, who pulled advertising encouraging people to sign up for coverage, issued an executive order that attempts to eliminate the mandate, and has created significant uncertainty about the future of the ACA. Enrollments had been running ahead of 2016 prior to President Obama leaving office, with 9.8 million expected to sign-up, so President Trump’s actions potentially cost about 600,000 national enrollments (i.e., 9.8 million expected − 9.2 million actual = 0.6 million impact).[447] Of the 9.2 million, 3.0 million were new customers and 6.2 million were returning. The 9.2 million excludes the 11 states that run their own exchanges, which have signed up around 3 million additional people.[447] These figures also exclude the additional coverage due to the Medicaid expansion, which covers another approximately 10 million persons, as described in the impact section above.

In February, Humana announced that it would withdraw from the individual insurance market in 2018, citing “further signs of an unbalanced risk pool.”[448] That month the IRS announced that it would not require that tax returns indicate that a person has health insurance, reducing the effectiveness of the individual mandate, in response to an executive order from President Donald Trump.[449]

Aetna CEO Mark Bertolini stated that ACA was in a “death spiral” of escalating premiums and shrinking, skewed enrollment.[450] However, a U.S. judge found that the Aetna CEO misrepresented why his company was leaving the exchanges; an important part of the reason was the Justice Department’s opposition to the intended merger between Aetna and Humana. Aetna announced that it would exit the exchange market in all remaining states.[451] It stated that its losses had grown from $100M in 2014 to $450M in 2016.[452] Wellmark withdrew from Iowa in April.[453] As of May, no insurer had indicated its intention to offer ACA insurance in Nebraska.[451] Also in May Blue Cross and Blue Shield of Kansas City announced it would withdraw from Missouri and Kansas’s individual markets in 2018, potentially leaving nearly 19,000 residents in Western Missouri without a coverage option.[454] Anthem announced plans to withdraw from Ohio[455] and later Wisconsin[456] and Indiana,[457] describing the market as “volatile” and referring to the difficulty in pricing its plans “due to the shrinking individual market as well as continual changes in federal operations, rules and guidance.”[455]

The CBO reported in March 2017 that the healthcare exchanges were expected to be stable; i.e., they were not in a “death spiral.”[458] In June, Centene announced that it intended to initiate coverage in Nevada, Kanasa and Missouri and expand coverage in Ohio and Florida.[459]

Molina Healthcare, a major Medicaid provider, said that it was considering exiting some markets in 2018, citing “too many unknowns with the marketplace program.” Molina lost $110 million in 2016 due to having to contribute $325 million more than expected to the ACA “risk transfer” fund that compensated insurers with unprofitable risk pools. These pools were established to help prevent insurers from artificially selecting lower-risk pools.[460]

In May the United States House of Representatives voted to repeal the ACA.[461][462]

See also

https://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act

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The Pronk Pops Show 885, May 3, 2017, Breaking — Story 1: FBI Director James Comey On Decision To Speak, Conceal or No Action On Clinton Emails On Weiner Laptop — Videos — Story 2: Time For President Trump To Instruct Attorney General Sessions To Appoint Independent Special Prosecutor To Pursue The Many Clinton Crimes Before Statue of Limitations Runs Out In February 2018! — Videos — Breaking — Story 3: Will There Be A House Vote to Repeal and Replace Obamacare? Only If Republican Have The Votes! — Breaking — Republican Videos

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Breaking — Story 1: FBI Director James Comey On Decision To Speak, Conceal or No Action On Clinton State Department Emails On Weiner Laptop — Videos

Image result for Hillary Clinton interview women to women internationalImage result for cartoons branco on comey and emails on clintonImage result for cartoons branco on comey and emails on clintonImage result for cartoons branco on comey and emails on clintonImage result for cartoons branco on comey and emails on clinton

Clinton blames Comey, Russia for election loss

Comey on Clinton: Concealing in my view would have been catastrophic

Comey reveals why he announced a new Clinton investigation 11 days before the election

WOW: Comey Answers WHY He Announced Hillary Clinton Email Investigation 11 Days Before Election

James B. Comey, the F.B.I. director, described his decision to reopen an investigation into Hillary Clinton’s emails in October during questioning by Senator Dianne Feinstein at a hearing on Wednesday.

By THE NEW YORK TIMES on Publish Date May 3, 2017. Photo by Gabriella Demczuk for The New York Times. Watch in Times Video »

WASHINGTON — James B. Comey, the F.B.I. director, sharply defended his rationale for notifying Congress about new emails related to the Hillary Clinton investigation less than two weeks before Election Day, saying Wednesday that any suggestion he affected the vote’s outcome made him “mildly nauseous.”

Mr. Comey’s comments at a Senate Judiciary Committee oversight hearing were his first public explanation for his actions, which roiled the presidential campaign in its final days and cast a harsh spotlight on the F.B.I. director.

Mr. Comey said he went public on Oct. 28 because he believed that the emails found by his agents might provide insight into Mrs. Clinton’s reasons for using a private server as secretary of state and might change the outcome of the investigation. Failing to inform Congress, Mr. Comey said, would have a required an “act of concealment.”

“Concealment, in my view, would have been catastrophic,” he said, adding later that he knew the decision would be “disastrous for me personally.”

What Mr. Comey viewed as concealing, Justice Department officials viewed simply as following the rules. The F.B.I. does not normally confirm ongoing investigations. Senior Justice Department officials urged him not to send a letter to Congress informing them that the bureau was examining the new emails.

When Mr. Comey recounted that confrontation to Congress in 2007, he was calm and confident. But in his testimony on Wednesday, he appeared more animated — even, at times, defensive — as committee members peppered him with questions. And while the hospital room showdown earned him bipartisan praise, Mr. Comey has instead gotten bipartisan criticism for his decisions in the final days of the 2016 campaign.

Unlike a House Intelligence Committee hearing in March in which Mr. Comey took the extraordinary step of confirming the existence of an investigation into Russian meddling in the election, the hearing Wednesday was supposed to be a more routine congressional oversight proceeding. But little has been routine for the F.B.I. over the past 10 months, as the dramatic moment from Mr. Comey showed.

The tone of the opening statements from both the top Republican and the top Democrat on the committee made clear that they wanted answers from Mr. Comey on a number of issues, including Mrs. Clinton’s emails, the Russia investigation, leaks to the news media and the use of wiretapping as an investigative tool.

“We need the F.B.I. to be accountable because we need the F.B.I. to effective,” said Senator Charles E. Grassley, Republican of Iowa and the chairman of the committee.

Senator Dianne Feinstein, the ranking Democrat on the panel, immediately pounced on Mr. Comey, saying he took an enormous gamble in sending the letter to Congress on Oct. 28 informing them that the F.B.I. was examining new Clinton-related emails without knowing how the messages might shape the Clinton investigation.

“We need to hear how the F.B.I. will regain that faith and trust,” Ms. Feinstein said. “We need straightforward answers to our questions and we want to hear how you’re going to lead the F.B.I. going forward. We never, ever want anything like this to happen again.”

She demanded to know why he treated the investigations so “dramatically different.”

Mr. Comey rejected her assertion.

He said that the F.B.I. had confirmed the existence of an investigation into Mrs. Clinton’s emails months after the bureau began it, and that it said no more until after it was closed. Similarly, Mr. Comey said, the F.B.I. revealed there was an investigation into Russian efforts to influence the election months after it was opened in July, and only after it had been widely reported in the media. And as in the Clinton investigation, the F.B.I. has refused to talk about what it has found.

“We’re not going to say another peep about it until we’re done,” Mr. Comey said, acknowledging that the inquiry into Russian meddling is ongoing. “And I don’t know what will be said when we’re done, but that’s the way we handled the Clinton investigation, as well.”

Mr. Comey’s handling of the Clinton email investigation continues to shadow him. Not even President Trump seems keen to forget the decisions the F.B.I. director made during the election. On Tuesday night, the president criticized him in a Twitter post, writing that Mr. Comey was “the best thing that ever happened to Hillary Clinton in that he gave her a free pass for many bad deeds!”

Mr. Trump also played down the F.B.I.’s investigation into Russian efforts to help his campaign.

“The phony Trump/Russia story was an excuse used by the Democrats as justification for losing the election,” the president wrote on Twitter, apparently in reaction to Mrs. Clinton’s comments on Tuesday in which she heaped blame on the F.B.I. and Russian-backed hackers for her election loss. She also said Mr. Trump was unprepared for the presidency.

Mr. Comey was also pressed Wednesday about leaks to journalists and whether F.B.I. agents in New York revealed information during the election to former federal law enforcement and elected officials, including Rudolph W. Giuliani, the onetime New York City mayor. Three days before Mr. Comey’s announcement in October, Mr. Giuliani, an adviser to Mr. Trump’s campaign, said on Fox News that the campaign had “a couple of surprises” in store.

After Mr. Comey’s letter was made public, putting Mr. Giuliani’s comments in a new light, a Trump campaign spokesman said the former mayor had been simply “having fun.” But Mr. Giuliani later undermined that assertion, saying he knew in advance that the F.B.I. had found new emails related to Mrs. Clinton. His comments reinforced suspicions that some F.B.I. agents were out to get her.

“If I find out that people were leaking information about our investigations, whether to reporters or private parties, there will be severe consequences,” Mr. Comey told the questioner, Senator Patrick J. Leahy, Democrat of Vermont.

The warm reception Mr. Comey once received on Capitol Hill, where he was applauded for his efforts to keep the country safe, has cooled considerably in recent months.

Mr. Comey plunged himself into last year’s campaign when he announced at a news conference in July that the F.B.I. was closing the Clinton email investigation. Though he said he would not recommend charging Mrs. Clinton or her aides, he also criticized her for how she had handled government information.

The criticism angered Democrats. Months later, they fumed anew over Mr. Comey’s decision to send the letter to Congress — less than two weeks before Election Day — saying the F.B.I. had found more emails pertinent to the investigation. The emails turned out not to change the outcome of the investigation, but that revelation upended the election and later prompted accusations from some Clinton supporters that Mr. Comey had cost her the White House.

In March, Democrats got some satisfaction when Mr. Comey acknowledged before the House Intelligence Committee that the F.B.I. had opened an investigation over the summer into Russian meddling in the presidential election and whether any Trump associates were involved. But they also criticized Mr. Comey for not confirming the existence of that inquiry sooner.

Republicans have grilled Mr. Comey over his decision not to recommend charges in the Clinton email investigation and over a string of leaks to the news media from unnamed officials that were seen as damaging to Mr. Trump in the early days of his administration and in the weeks before the inauguration.

Mr. Comey has tried to keep a low profile since the March hearing, where he talked about the Russia investigation and dismissed Mr. Trump’s claim that he had been wiretapped by President Barack Obama.

Later that month, Mr. Comey spoke to national security experts at a dinner that members of the news media attended. His agenda then was clear.

“I’m determined not to make news,” he said.

https://www.nytimes.com/2017/05/03/us/politics/james-comey-fbi-senate-hearing.html?_r=0

Comey says classified Clinton emails were forwarded to Anthony Weiner

Comey on Clinton investigation: ‘I would make the same decision’

FBI Director James Comey responded, May 3, before the Senate Judiciary Committee to a question from Sen. Dianne Feinstein (D-Calif.) on his announcement about re-opening the probe into Hillary Clinton’s use of a private email server days before the election.(Reuters)
May 3 at 12:47 PM
Hillary Clinton emails containing classified information were forwarded to former congressman Anthony Weiner, the director of the FBI testified Wednesday as he defended his handling of politically sensitive probes surrounding the last year’s presidential race.Under questioning from the senior Democrat on the committee, Sen. Dianne Feinstein (D-Calif.), James B. Comey revealed more details about how Clinton’s emails ended up on Weiner’s computer.Weiner, a New York Democrat, was married to a top aide to Clinton, Huma Abedin. Weiner was being investigated separately for possible inappropriate communications with a minor.

“Somehow, her emails were being forwarded to Anthony Weiner, including classified information,” Comey said, adding later, “His then-spouse Huma Abedin appears to have had a regular practice of forwarding emails to him for him to print out for her so she could deliver them to the secretary of state.”

Here is the opening statement from FBI Director James B. Comey at a Senate Judiciary Committee hearing on May 3. (Photo: AP/Reuters)

The two were investigated for possible mishandling of classified material, but the FBI ultimately dropped the matter without seeking charges because they could not show either of them intended to violate the law, Comey said.

“Really the central problem we had with the whole email investigation was proving people… had some sense they were doing something unlawful. That was our burden and we were unable to meet it,’’ he said.

The director defended his decision to notify Congress that he had reopened the Clinton email probe just days before the election, saying he was forced to choose between saying something or concealing what he knew — or, as he put it, “between really bad and catastrophic.’’

He added: “It makes me mildly nauseous to think we might have had some impact on the election.”

Comey said he has been interviewed by the Justice Department’s inspector general as part of an internal investigation into how the FBI handled the Clinton case.

“I want that inspection, I want my story told,’’ he said. “If I did something wrong, I want to hear that.’’

But he added that he still thinks he behaved appropriately and had no regrets about his decisions.

FBI Director James B. Comey described the difference between investigative journalism and what he called “intelligence porn” released by WikiLeaks, speaking to the Senate Judiciary Committee on May 3 at the Capitol. (Reuters)

“Lordy, has this been painful,’’ he said. “I’ve gotten all kinds of rocks thrown at me and this has been really hard, but I think I’ve done the right thing at each turn.’’

Comey has been under intense pressure from both Republicans and Democrats to explain his decision-making, and he faced more criticism in Wednesday’s hearing before the Senate Judiciary Committee. The hearing was scheduled to conduct general congressional oversight of the FBI, but politically sensitive investigations quickly became the focus of lawmakers’ questions.

The chairman of the committee, Sen. Charles E. Grassley (R-Iowa), opened the hearing by saying that “a cloud of doubt hangs over the FBI.” He demanded that the bureau reveal more about how it has handled the probes.

“We need to know whether there was anything improper going on between the Trump campaign and the Russians, or if these allegations are just a partisan smear campaign that manipulated our government into chasing conspiracy theories,” Grassley said.

Comey began his prepared testimony by praising the work of the FBI, citing the recent successful investigations of bomb threats against Jewish community centers, hacking networks and doctors accused of female genital mutilation.

“I love this work, I love this job, and I love it because of the mission and the people I get to work with,’’ he said.

Grassley’s first question to Comey was about leaks, asking Comey if he had ever been an anonymous source for stories about Clinton or Trump.

“Never,’’ Comey said. Asked if he had authorized someone else to speak anonymously to reporters about those cases, the director said no.

Sen. Lindsey Graham (R-S.C.) asked Comey what threat Russia posed to future U.S. elections. “In my view the greatest threat of any nation on earth given their intention and their capability,’’ Comey answered, adding that while Russia did not alter vote tallies in 2016, they have tried to do so in other countries and he said U.S. officials should expect them to try to do so in future U.S. elections.One of the lessons that particularly the Russians may have drawn from this is that it works,’’ Comey said.

Democrats repeatedly pressed Comey about his decision to notify Congress just days before the election that he was reopening the probe into Clinton’s use of a private email server for her work as secretary of state. Democrats are particularly upset about that decision because after the election, Comey acknowledged that the FBI had begun secretly investigating in late July whether any Trump associates might be working with Russian officials to meddle with the presidential campaign.

“It’s still very unclear — and I hope, director, that you will clear this up — why the FBI’s treatment of these two investigations was so dramatically different,” Feinstein said.

The FBI has already concluded that Russian intelligence hacked into Democratic computer systems and email accounts, stealing information that was published by WikiLeaks during the campaign.

Asked about WikiLeaks, Comey said he thought the anti-secrecy group was engaged in something more sinister than journalism.

“To my mind, it crosses a line when it moves from being trying to educate the public and instead becomes about intelligence porn, quite frankly,’’ said Comey. A “huge portion’’ of WikiLeaks’ activities “has nothing to do with legitimate news activity,’’ he said, “… but is simply about releasing classified information to damage the United States of America.’’

The Washington Post reported last month that the Justice Department is trying to determine if it can bring criminal charges against those working for the anti-secrecy group.

On Tuesday, Clinton said the move by Comey on Oct. 28 to tell Congress that his investigators were looking at a new batch of Clinton emails helped alter the outcome of the presidential election.

“If the election had been on October 27, I would be your president,” she said at an event in New York. Clinton said that as the candidate on the ballot, she took responsibility for the loss. But she added that she was “on the way to winning until a combination of Jim Comey’s letter on October 28 and Russian WikiLeaks raised doubts in the minds of people who were inclined to vote for me and got scared off.”

Tuesday night, Trump tweeted a fresh broadside at Comey and Clinton, saying the FBI director “was the best thing that ever happened to Hillary Clinton in that he gave her a free pass for many bad deeds.” In a second tweet, he added that the “phony Trump/Russia story was an excuse used by the Democrats as justification for losing the election.”

https://www.washingtonpost.com/world/national-security/fbi-director-james-comey-begins-testimony-to-congress/2017/05/03/9e3244bc-3006-11e7-9534-00e4656c22aa_story.html?utm_term=.3db1fe1a3f76

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Here’s how a special prosecutor investigating Trump and Russia would get appointed

donald trump
President Donald Trump in a meeting with business leaders.Photo by Chip Somodevilla/Getty Images

After revelations Wednesday that Attorney General Jeff Sessions had two conversations with Russia’s ambassador to the US during the 2016 campaign, lawmakers renewed calls for a special prosecutor to investigate ties between Trump associates and Russian operatives.

House Oversight Committee Chair Rep. Jason Chaffetz, a Republican from Utah, tweeted Thursday morning “AG Sessions should clarify his testimony and recuse himself.”

Democratic senators have called repeatedly for a special prosecutor, more often called an independent or special counsel, to be appointed.

But what exactly is a special prosecutor, how does he or she get appointed, and what happens next? We broke it down.

Who appoints a special prosecutor?

Jeff Sessions

Secretary of State Rex Tillerson (L) and Attorney General Jeff Sessions (R) arrive for US President Donald Trump’s first address to a joint session of Congress on the floor of the House of Representatives in Washington, U.S., February 28, 2017.REUTERS/Jim Lo Scalzo/Pool

A special counsel could be appointed by either Sessions himself or by Congress to investigate potential ties between Trump’s inner circle and Russia, said Professor William Banks, the founding director of the Institute for National Security and Counterterrorism at Syracuse University.

A “special counsel” is a modern day term for a “special prosecutor,” according to Banks, and any investigation would likely use the term “special counsel.” The term “special prosecutor” was used up through the 1980s, after which the laws around special prosecutors expired and were not renewed, therefore retiring the term.

Banks said there may be pressure on Sessions not to appoint a special counsel, given that he was appointed by Trump. “We would hope [Sessions] would exercise independent judgment about the efficacy of having a special counsel,” Banks told Business Insider.

Democratic lawmakers, led by Senate Minority Leader Chuck Schumer, have requested Sessions recuse himself from any investigations multiple times, renewing the call on Thursday following news about Sessions’ meeting with the Russian ambassador. (After the latest revelations, Schumer said he should resign.) House Majority Leader Kevin McCarthy said on Thursday that “it would be easier” if Sessions recused himself.

“I think, the trust of the American people, you recuse yourself in these situations,” McCarthy said, according to Politico. “I just think for any investigation going forward, you want to make sure everybody trusts the investigation … that there’s no doubt within the investigation.”

Sessions has previously said that he would recuse himself on anything requiring him to do so, but he has asserted that he sees no need to remove himself from any Trump-Russia investigations.

The Department of Justice does have a rule that could affect Sessions’ role in a special counsel investigation:

“No DOJ employee may participate in a criminal investigation or prosecution if he has a personal or political relationship with any person or organization substantially involved in the conduct that is the subject of the investigation or prosecution, or who would be directly affected by the outcome.”

chuckschumer

Senate Minority Leader Chuck SchumerMario Tama/Getty Images

If the attorney general recuses himself, it falls to the deputy attorney general to appoint an independent counsel, according to the Code of Federal Regulations. The appointment of a special counsel by the attorney general or deputy attorney general is “unreviewable,” according to the Center for Legal and Economic Studies.

Preliminary investigations are currently underway in the Senate and House intelligence committees, but Banks said he believes it is unlikely a special counsel would be created until those investigations conclude.

The other way to establish an independent counsel goes through Congress.

Congress could initiate the process to create a different independent counsel for investigations by passing a law, as it did in 1978, when the Ethics in Government Act was passed. The law dictated that a three-judge panel based at the US Court of Appeals in DC would appoint the counsel. The law, which was reauthorized several times until its sunset in 1999, was used more than a dozen times to initiate investigations, according to PBS Frontline. It was used most famously in the 1990s to appoint attorney Kenneth Starr to oversee investigations in to President Bill Clinton.

Such a law would have to be either signed by Trump or, in the event of a presidential veto, overridden by a two-thirds majority of both houses of Congress. There is precedent, however, for a president to sign an independent counsel law amid scrutiny. Clinton signed a reauthorization of the 1978 law in 1994 with a number of alleged scandals brewing.

Congress could, however, launch its own investigation into the executive branch without legislation because such authority is implicit in the appropriations power, Banks said. If Congress decided to act on its own, it is much more likely that it would establish a commission or committee to investigate, rather than passing ethics legislation, Banks added.

What kinds of people are appointed to a special counsel?

Special counsels tend to be highly respected lawyers or judges. Examples, according to Banks, include: highly experienced private practice lawyers, retired judges, and former Justice Department prosecutors.

How long would a special counsel investigation take to complete?

A special counsel investigation would likely take between six to nine months, according to Banks, who said that such investigations tend to be extremely complicated by nature. With so much classified information, intelligence agency officials that need to be interviewed, and hard to obtain information, it takes a while to sort out.

What does a special counsel have access to?

A special counsel investigation would involve arranging access to classified documents. This could be achieved by either declassifying information or creating clearance to classified documents for the purpose of the investigation only. If the latter is done, it is unlikely the public would see the documents obtained.

A special counsel would also be expected to interview a vast range of people with knowledge of or connection to the investigation.

flynn trump and bannon

President Donald Trump speaks on the phone with Australian Prime Minister Malcolm Turnbull in the Oval Office of the White House, January 28, 2017 in Washington, DC. Also pictured at right, National Security Advisor Michael Flynn and White House Chief Strategist Steve Bannon.Drew Angerer/Getty Images

In the case of the Trump-Russia allegations, a special counsel would look into any and all classified or declassified documents that the FBI, CIA, and various police departments and investigation groups might have the incident.

This would include human or digital intelligence, and the dossier delivered by British intelligence. Extensive interviews would be run with anyone close to the situation, including Trump’s inner circle, and anyone who had access to digital or technical related information, said Banks. The special counsel themselves would ultimately determine which evidence to use.

What happens after the special counsel investigation concludes?

What happens next depends in part on who appoints a special counsel. Attorney General Jeff Sessions would decide whether the special counsel appointed under him had enough evidence to prosecute Trump or implicated officials.

If Congress created an office for an independent or special counsel, it is likely that the counsel would refer results of the investigation to Congress, though that could change depending on the legislation passed. If Congress initiated an investigation through a commission or committee, it would fall to the attorney general to decide whether to prosecute based on the results provided.

Why are people asking for a special counsel?

Trump and his inner circle have been accused of having close ties to Russia. The White House has denied many of those accusations. Business Insider has previously reported that:

  • Trump and several associates continue to draw intense scrutiny for alleged ties to and communications with the Russian government.
  • A dossier of unverified claims alleged serious misconduct in the final months of the 2016 presidential campaign. The White House has dismissed the dossier as fiction, and most of the claims remain unverified.
  • Trump’s campaign aides were accused of having frequent contact with Russia in a report released by the New York Times.
  • A report published on Wednesday by the Washington Post said that Attorney General Jeff Sessions met with the Russian Ambassador twice during the 2016 election.

White House press secretary Sean Spicer has argued that Trump and his aides have been sufficiently investigated already, and that no evidence of wrongdoing has been found.

Michelle Mark contributed reporting on this article.

Special prosecutor

From Wikipedia, the free encyclopedia

A special prosecutor (or special counsel or independent counsel) is a lawyer appointed to investigate and possibly prosecute a specific legal case of potential wrongdoing for which a conflict of interest exists for the usual prosecuting authority. For example, the investigation of an allegation against a sitting president or attorney general might be handled by a special prosecutor rather than an ordinary prosecutor, who would otherwise be in the position of investigating their own boss. Investigations into others connected to the government but not in a position of direct authority over the prosecutor, such as cabinet secretaries or election campaigns, have also been handled by special prosecutors.

The term is not specific to the United States,[1] or to the federal government. According to Harriger, the concept originates in state law: “state courts have traditionally appointed special prosecutors when the regular government attorney was disqualified from a case, whether for incapacitation or interest.”[2] While the most prominent special prosecutors have been those appointed since the 1870s to investigate presidents and those connected to them, the term can also be used to refer to any prosecutor appointed to avoid a conflict of interest or appearance thereof. For example, because district attorneys’ offices work closely with police, some activists argue that cases of police misconduct at the state and local level should be handled by “special prosecutors”.[3]

The term special counsel as used here is distinct from the United States Office of Special Counsel, which is a permanent government agency (unlike special counsels, who are appointed for specific, temporary assignments), which protects government whistleblowers, among other things.

Terminology

The terms “special prosecutor”, “independent counsel”, and “special counsel” have the same fundamental meaning, and their use (at least at the federal level in the US) is generally differentiated by the time period to which they are being applied. The term “special prosecutor” was used throughout the Watergate era, but was replaced by the less confrontational “independent counsel” in the 1983 reauthorization of the Ethics in Government Act.[4] Those appointed under that act after 1983 are generally referred to as independent counsels. Since the independent counsel law expired in 1999, the term special counsel has generally been used. This is the term used in the current US government regulations concerning the appointment of special counsels.[5]

While the term special prosecutor is sometimes used in historical discussions of all such figures before 1983, the term special counsel appears to have been frequently used as well, including, for example, in contemporary newspaper accounts[6] describing the first presidentially appointed special counsel in 1875.

United States appointment at the federal level

History of appointments

Pre-Watergate

The first federal special prosecutor, John B. Henderson, was appointed by Ulysses Grant in 1875 to investigate the Whiskey Ring scandal. After attempting to stifle Henderson’s investigation of the president’s personal secretary, Grant fired Henderson on the basis that Henderson’s statements to a grand jury regarding Grant were impertinent.[7] Following criticism, Grant appointed a new special prosecutor, James Broadhead, to continue the investigation.

James Garfield appointed the next special prosecutor, William Cook, in 1881 to investigate the Star route scandal. Cook continued his investigation into the Chester Arthur administration. Under the Theodore Roosevelt administration, special prosecutors were appointed to investigate two scandals. In 1903, Roosevelt appointed two special prosecutors (a democrat and a republican) to investigate allegations of bribery at the Post Office department. In 1905, Roosevelt’s attorney general, Philander Knox,[8] appointed Francis Heney special prosecutor to investigate the Oregon land fraud scandal.

Calvin Coolidge appointed two special counsels, Atlee Pomerene and Owen Roberts to investigate the Teapot Dome scandal. This appointment was unique in that it was made under a special Congressional resolution, and was subject to approval in the Senate.[9]

In 1952, Harry Truman appointed Newbold Morris “special assistant to the Attorney General” to investigate the corruption at the Bureau of Internal Revenue following Congressional pressure and calls for a special prosecutor.[10]After Morris submitted a lengthy questionnaire on personal finances to be completed by all senior executive officers, he was fired by Attorney General Howard McGrath, who was in turn fired by the president. Following the appointment of a new attorney general, the investigation was continued through regular channels.

Watergate

In May 1973, Richard Nixon‘s attorney general, Elliott Richardson, appointed Archibald Cox special prosecutor to investigate the Watergate scandal after Richardson had agreed in his senate confirmation hearing to appoint a Watergate special prosecutor. As part of his investigation, in July of that year, Cox first requested and then subpoenaed the Nixon White House tapes, secret recordings Nixon had made of conversations in the Oval Office and elsewhere. The Nixon administration refused to produce the tapes citing executive privilege, and the dispute was fought in court until October. After a Court of Appeals instructed the president to comply with the special prosecutor’s subpoena, Nixon ordered the special prosecutor fired. In what became known as the Saturday Night Massacre, both the attorney general and deputy attorney general (who had both made promises regarding the special prosecutor in their senate confirmations) resigned rather than carry out the order to fire Cox. Solicitor General Robert Bork, who was third in line at the Department of Justice, then fired Cox.

Initially, the Nixon Whitehouse announced that the office of the special prosecutor had been abolished, but after public outcry Nixon instead had Bork appoint Leon Jaworski as the second Watergate special prosecutor, less than two weeks after the Saturday Night Massacre. Jaworski continued Cox’s pursuit of the White House tapes, which were ultimately released following the supreme court decision in United States v. Nixon. Jaworski resigned after just under a year as special prosecutor, about two and a half months after Nixon’s own resignation, to be replaced by his (and Cox’s) deputy, Henry Ruth Jr. Ruth in turn resigned in 1975, leaving Charles Ruff the fourth and final Watergate special prosecutor. Acting under his existing appointment as Watergate special prosecutor, Ruff conducted an unrelated investigation into whether Gerald Ford had misused campaign funds while a congressman, clearing the president of any wrongdoing.[11]

Independent counsel law

Inspired in part by Watergate, in 1978 Congress passed the Ethics in Government Act, which among other things established formal rules for the appointment of a special prosecutor. The special prosecutor provisions in the bill were temporary, but were reauthorized by Congress in 1983 and 1987, expiring five years later in 1992, then were reinstated for another five years in 1994 before expiring again in 1999. The appointment of special prosecutors under the Ethics in Government Act varied in important ways from appointments made before and since. Most notably, although the decision to appoint a special prosecutor was still made by the attorney general, the actual selection of the special prosecutor was made by a three-judge panel.[12]

Roughly twenty special prosecutors (called independent counsels after 1983) were appointed under the Ethics in Government Act and its reauthorizations[13] during each of the Jimmy Carter, Ronald Reagan, George HW Bush, and Bill Clinton administrations. These include significant investigations into the Iran–Contra affair and the Whitewater controversy, the latter of which ultimately led to the impeachment of Bill Clinton over the Lewinsky scandal. Numerous smaller investigations into cabinet secretaries for relatively minor offenses, such as drug use, were also carried out by special prosecutors during this period.

During the period 1992–1994 when the independent counsel provisions were not in force, Attorney General Janet Reno appointed Robert Fiske special counsel to investigate Whitewater. When the law was reauthorized in 1994, Reno invoked it to order an independent counsel be appointed to investigate Whitewater, and suggested Fiske continue in that role. Instead, Ken Starr was given the job by the three-judge panel. Starr resigned and was replaced by Robert Ray in 1999 just before the expiration of the independent counsel statute.[14] Ray formally concluded the Whitewater investigation in 2003.

Since 1999

Since the expiration of the independent counsel statute in 1999, there is no federal law governing the appointment of a special prosecutor, as was the case until 1978. With the law’s expiration in 1999, the Justice Department, under Attorney General Reno, promulgated procedural regulations governing the appointment of special counsels. These regulations were used that year by Reno to appoint John Danforth special counsel to investigate the FBI’s handling of the Waco siege.[15]

In 2003 during the George W Bush administration, Patrick Fitzgerald was appointed special counsel by Deputy Attorney General James Comey, acting after the recusal of Attorney General John Ashcroft, to investigate the Plame affair.

Legal authority

The legal authority under which special prosecutors are appointed has changed over the years.

In the case of the Teapot Dome investigation, Congress passed a special joint resolution requiring the appointment of a special counsel for the case, and requiring confirmation of the special counsels by the Senate, similarly to a cabinet appointment.[9] This process was unique in the history of federal special prosecutors.

Special prosecutors have also been appointed under special one-time regulations issued by the attorney general. This was the case, for example, for the Watergate special prosecutors.[16]

Passed partly in response to the events of Watergate, the Ethics in Government Act of 1978 created a statutory basis for the appointment of special prosecutors, and specifically restricted the authority of the president or attorney general, for example, to fire the independent counsel once appointed. The independent counsel provisions of the law were in effect during the periods 1978–1992 and 1994–1999.

With the expiration of the independent counsel authority in 1999, the Department of Justice under Attorney General Janet Reno promulgated regulations for the future appointment of special counsels. As of 2017, these regulations remain in effect as 28 CFR section 600.[5] While the regulations place limits on the authority of the attorney general, for example to fire the special counsel once appointed, they are internal Department of Justice regulations without an underlying statutory basis. It is thus unclear whether the limits these regulations place on the attorney general would prove binding in practice.

The existence of a law or regulations specifying one process to appoint a special prosecutor does not preclude the attorney general (or acting attorney general) from using their inherent authority to appoint a special prosecutor by other means, as has happened twice. Despite the passage of the Ethics in Government Act the previous year, Paul Curran was appointed to investigate Jimmy Carter’s peanut business in 1979 under the attorney general’s inherent authority (and was selected by him rather than by a three-judge panel as under the law), ostensibly because the alleged wrongdoing preceded the passage of the act.[7] Patrick Fitzgerald’s appointment as special counsel in 2003 was specifically not made under the 28 CFR 600 regulation.[17] The special counsel regulations specify that a special counsel must be a lawyer from outside the US government, while Fitzgerald was already a federal prosecutor at the time of his appointment.

Initiating a special prosecutor investigation

The decision to appoint a special prosecutor rests with the attorney general (or acting attorney general), or, historically, with the president. Under the independent counsel statute that expired in 1999, Congress could formally request the attorney general to appointment a special prosecutor (see role of legislative and judicial branches); however the law only required the attorney general to respond in writing with a decision and reasons, and in any event it is no longer in force.[16] Similarly, under the statute, the choice of who to appoint as special prosecutor was made by a three-judge panel of the Court of Appeals. This is no longer the case, and the decision of who to appoint now rests entirely with the attorney general.

The current special counsel regulations specify that:[5]

The Attorney General, or in cases in which the Attorney General is recused, the Acting Attorney General, will appoint a Special Counsel when he or she determines that criminal investigation of a person or matter is warranted and—

  • (a) That investigation or prosecution of that person or matter by a United States Attorney’s Office or litigating Division of the Department of Justice would present a conflict of interest for the Department or other extraordinary circumstances; and
  • (b) That under the circumstances, it would be in the public interest to appoint an outside Special Counsel to assume responsibility for the matter.

The attorney general sets the subject jurisdiction of the special counsel:

The jurisdiction of a Special Counsel shall be established by the Attorney General. The Special Counsel will be provided with a specific factual statement of the matter to be investigated. The jurisdiction of a Special Counsel shall also include the authority to investigate and prosecute federal crimes committed in the course of, and with intent to interfere with, the Special Counsel’s investigation, such as perjury, obstruction of justice, destruction of evidence, and intimidation of witnesses; and to conduct appeals arising out of the matter being investigated and/or prosecuted.

The choice of who to appoint is to be made by the attorney general with the following guidelines:

An individual named as Special Counsel shall be a lawyer with a reputation for integrity and impartial decisionmaking, and with appropriate experience to ensure both that the investigation will be conducted ably, expeditiously and thoroughly, and that investigative and prosecutorial decisions will be supported by an informed understanding of the criminal law and Department of Justice policies. The Special Counsel shall be selected from outside the United States Government. Special Counsels shall agree that their responsibilities as Special Counsel shall take first precedence in their professional lives, and that it may be necessary to devote their full time to the investigation, depending on its complexity and the stage of the investigation.

Terminating a special prosecutor investigation

Generally, the special prosecutor him or herself decides when an investigation will terminate, with or without formal charges being pursued. The special prosecutor typically issues a final report on their investigation at this time. The current special prosecutor regulations specify that[5] “At the conclusion of the Special Counsel’s work, he or she shall provide the Attorney General with a confidential report explaining the prosecution or declination decisions reached by the Special Counsel.”

Firing the special prosecutor

Three special prosecutors have been fired before they had completed their investigations. President Grant fired the special prosecutor investigating the Whiskey Ring scandal on charges of impudence against the president, but later replaced him following public pressure. President Truman’s attorney general fired Newbold Morris when Morris submitted a lengthy questionnaire to be filled out by all senior executive officers. Truman later fired the attorney general, and concluded the investigation through ordinary means. President Nixon fired special prosecutor Archibald Cox after Cox subpoenaed the White House tapes. Controversy over the propriety and legality of this last firing sparked a constitutional crisis, dubbed the Saturday Night Massacre. The firing was ruled illegal in the case of Nader v. Bork, but, as a new special prosecutor had already been appointed, the case was already moot when decided, and the decision was never appealed past the district court.[18]

The independent counsel law originally enacted in the Ethics in Government Act did not allow independent counsels appointed under the law to be removed except under specific circumstances such as wrongdoing or incapacitation. This law is no longer in effect.

The current special counsel regulations specify that:[5]

The Special Counsel may be disciplined or removed from office only by the personal action of the Attorney General. The Attorney General may remove a Special Counsel for misconduct, dereliction of duty, incapacity, conflict of interest, or for other good cause, including violation of Departmental policies. The Attorney General shall inform the Special Counsel in writing of the specific reason for his or her removal.

Unlike the independent counsel law, however, the current special counsel regulations were promulgated by the Justice Department and have no underlying statutory basis. Thus their force to constrain the attorney general is uncertain.

Role of the legislative and judicial branches

The decision to appoint a special prosecutor is made by the executive branch, historically by the president or attorney general (or acting attorney general). The only exception to this was the Teapot Dome special prosecutors, whose appointment was mandated by a joint resolution of Congress.[9]

Under the independent counsel statute, majorities of either party within the House or Senate Judiciary Committee could formally request the attorney general to appoint an independent counsel on a particular matter, but the decision of whether or not to appoint the independent counsel remained with the attorney general and was not reviewable in court. If the attorney general decided not to appoint an independent counsel in response to such a request, they were only required to respond in writing with the reasons.[16] Although under the statute the attorney general made the decision of whether or not to appoint an independent counsel, the actual selection of the individual to serve in this role was made by a three-judge panel of the US Court of Appeals.[which?][12]

Since the expiration of the independent counsel laws, as was the case before 1978, neither Congress nor the courts have any official role in the appointment of a special counsel; however Congress can use other powers to pressure an administration into appointing a special counsel. This happened, for example, in the appointment of Watergate special prosecutor Archibald Cox; senators secured a promise from Attorney General nominee Richardson to appoint a Watergate special prosecutor as a condition of his confirmation. Congress also has independent authority to investigate the president and his or her close associates through Congressional hearings as part of its government oversight role.[16]

Constitutionality

The appointment of a special prosecutor raises inherent separation of powers questions under the US Constitution. Since the special prosecutor is a member of the executive branch, it has been argued that the special prosecutor is ultimately answerable to the president, and can therefore be fired by them. Richard Nixon, for example, argued that he could not be compelled by a subpoena issued by his own subordinate.

The constitutionality of the independent counsel law was affirmed by an 7–1 decision of the supreme court in the case of Morrison v. Olson.

Calls for a special counsel to investigate Russian interference in the 2016 US election

On December 21, 2016, Democratic Congresswoman Nydia Valázquez wrote a letter to Attorney General Loretta Lynch asking Lynch to appoint a special counsel to investigate Russian interference in the 2016 United States election. Such an appointment would have been unusual in that the conflict of interest to be addressed was anticipated, following the inauguration of Donald Trump as president, rather than immediate.[19]

On February 24, 2017, Republican Congressman Darrell Issa called for the appointment of a special counsel on the Real Time with Bill Maher show.

On March 2, 2017, Attorney General Jeff Sessions recused himself from the investigation regarding Russian interference in the 2016 election following revelations that he had had meetings with the Russian ambassador while a Trump campaign surrogate, and had falsely testified otherwise in his senate confirmation hearing. The decision over whether to appoint a special counsel thus devolved to his deputy, currently Acting Deputy Attorney General Dana Boente. In senate confirmation hearings for Rod Rosenstein to replace Boente as Deputy Attorney General, ongoing in March 2017, several Democratic senators have sought to make the confirmation conditional on Rosenstein’s agreement to appoint a special counsel. Rosenstein has declined to make such a commitment, and because Democrats are in the minority, this is unlikely to prevent his confirmation.[20]

United States appointment at the state level

Special prosecutors are appointed in state court with greater frequency than federal, and most often in cases where a conflict of interest arises or to avoid even the appearance such a conflict exists. In local state governments, special prosecutors are appointed by a judge, government official, organization, company or group of citizens to prosecute violations of law committed by one or more governmental agents and procure indictments for actions taken under color of state law.[21] Unlike in courts having federal jurisdiction, where the terms “special counsel” and “independent counsel” have a uniform definition, in state court meanings of legal terms continually vary, but with “special prosector” referencing the appointment of an attorney (supra) in contemplation of representation and prosecution of one or more government agent(s) for unlawful conduct.

References

  1. Jump up^ “South Korea prosecutor paves way for charges against Park if impeachment upheld”. Reuters. 2017-03-06. Retrieved 2017-03-14.
  2. Jump up^ Harriger, Katy (1992). The Federal Special Prosecutor in American Politics. Lawrence, KS: University Press of Kansas. p. 3. ISBN 0-7006-0535-5.
  3. Jump up^ “Policy 11: Special or Independent Prosecutors | Justice in Policing Toolkit”. http://www.justiceinpolicing.com. Retrieved 2017-03-14.
  4. Jump up^ “The Office – A Brief History Of The Independent Counsel Law | Secrets Of An Independent Counsel | FRONTLINE | PBS”. http://www.pbs.org. Retrieved 2017-03-14.
  5. ^ Jump up to:a b c d e e-CFR: TITLE 28—Judicial Administration, retrieved 2017-03-14
  6. Jump up^ “THE WHISKY RING FRAUDS.; THE PROSECUTIONS IN ST. LOUIS. INDICTMENT OF GEN. BABCOCK–LETTER OF THE GRAND JURY TO THE PRESIDENT THANKING HIM FOR THE SUPPORT GIVEN THEM BY HIM–THE SPECIAL COUNSEL–MR. HENDERSON’S CASE. MR. HENDERSON’S ATTACK ON THE PRESIDENT–HE SAYS HE WAS INCORRECTLY REPORTE–THE REPORTED DISPATCH OF SENATOR MORTON.”. Retrieved 2017-03-14.
  7. ^ Jump up to:a b “OIC Smaltz: Speeches and Articles: Georgetown Law Journal: A View From Inside”. govinfo.library.unt.edu. Retrieved 2017-03-14.
  8. Jump up^ Greenberg, Gerald (2000). Historical Encyclopedia of U.S. Independent Counsel Investigations. Westport, CT: Greenwood Press. pp. 164–166. ISBN 0-313-30735-0.
  9. ^ Jump up to:a b c “A summary of the Teapot Dome scandal from the Brookings Institution”. academic.brooklyn.cuny.edu. Retrieved 2017-03-14.
  10. Jump up^ Greenberg, Gerald (2000). Historical Encyclopedia of U.S. Independent Counsel Investigations. Westport, CT: Greenwood Press. pp. 231–233. ISBN 0-313-30735-0.
  11. Jump up^ Greenberg, Gerald (2000). Historical Encyclopedia of U.S. Independent Counsel Investigations. Westport, CT: Greenwood Press. pp. 293–295. ISBN 0-313-30735-0.
  12. ^ Jump up to:a b “The Office – What Is The Special Division? | Secrets Of An Independent Counsel | FRONTLINE | PBS”. http://www.pbs.org. Retrieved 2017-03-14.
  13. Jump up^ “The Office – Independent Counsel Investigations, 1978 To The Present | Secrets Of An Independent Counsel | FRONTLINE | PBS”. http://www.pbs.org. Retrieved 2017-03-14.
  14. Jump up^ Post, From the Washington (1999-10-17). “Starr’s Chosen Successor Draws Praise, Criticism”. Los Angeles Times. ISSN 0458-3035. Retrieved 2017-03-14.
  15. Jump up^ “09-09-99: PRESS CONFERENCE WITH ATTORNEY GENERAL JANET RENO RE: APPOINTMENT OF FORMER SENATOR JOHN DANFORTH TO HEAD WACO PROBE”. http://www.justice.gov. Retrieved 2017-03-14.
  16. ^ Jump up to:a b c d Maskell, Jack (June 20, 2013). “Independent Counsels, Special Prosecutors, Special Counsels, and the Role of Congress” (PDF).
  17. Jump up^ “December 30, 2003 Letter from Deputy Attorney General James B. Comey to Patrick J. Fitzgerald” (PDF).
  18. Jump up^ “Nader v. Bork, 366 F. Supp. 104 (D.D.C. 1973)”. Justia Law. Retrieved 2017-03-14.
  19. Jump up^ “House Democrat appeals for special counsel to probe Russian hacking”. Washington Post. Retrieved 2017-03-14.
  20. Jump up^ “Grilled on Russia probe, deputy attorney general pick sidesteps Democrats’ calls for special prosecutor”. Washington Post. Retrieved 2017-03-14.
  21. Jump up^ Black’s Law Dictionary (8th ed. 2004) Prosecutor.

Further reading

  • Doyle, James (1977). Not Above the Law: the battles of Watergate prosecutors Cox and Jaworski. New York: William Morrow and Company. ISBN 0-688-03192-7.

External links

https://en.wikipedia.org/wiki/Special_prosecutor

Story 3: Will There Be A House Vote to Repeal and Replace Obamacare? Only If Republican Have The 216 Votes! —  Until The Twelfth of Never — Breaking — Republican Have 216+ Votes — Videos

Image result for cartoons branco repeal of obamacare

Image result for cartoons branco repeal of obamacareImage result for cartoons branco repeal of obamacare

Image result for preexisting conditions

 The Truth Behind the Affordable Care Act – Learn Liberty

Obamacare: Goals vs. Outcomes- Learn Liberty

Rand Paul Questions Tom Price on Replacing Obamacare

Molyneux and Schiff For Liberty – Discrimination and Pre-Existing Conditions in Health Insurance

The GOP Has A Pre-Existing Condition | All In | MSNBC

MSNBC: Dr Jason Johnson on Trump’s Effort to Sway GOP Votes to Repeal and Replace Obamacare 5/3/17

Republicans could vote on health care this week

King: Leave pre-existing conditions to states

Rep. Jim Jordan: Pre-Existing Conditions Covered In GOP Healthcare Bill | MTP Daily | MSNBC

White House Continues To Work To Save Healthcare Bill

Pre-existing conditions mandate threatens Republican health care bill

Sources say WH aiming for health reform vote on Wednesday

President Trump guarantees pre-existing condition coverage in new health care bill

Published on Apr 30, 2017

President Trump says the new health care bill promises coverage for Americans with pre-existing conditions. “We have a specific clause that guarantees,” Trump tells CBS News’ John Dickerson.

CNN graphic nails Trump for lying about preexisting conditions

Trump Again Leads Effort To Repeal Affordable Care Act

Pre-existing condition

Politics Unusual: Washington Gridlock

12th of never

“the 12th of never” is used as the date of a future occurrence that will never come to pass.

JOHNNY MATHIS The Twelfth Of Never

Twelfth of Never
You ask me how much I need you, must I explain?
I need you, oh my darling, like roses need rain
You ask how long I’ll love you, I’ll tell you true
Until the Twelfth of Never, I’ll still be loving you
Hold me close, never let me go
Hold me close, melt my heart like April snow
I’ll love you ’til the bluebells forget to bloom
I’ll love you ’til the clover has lost its perfume
I’ll love you ’til the poets run out of rhyme
Until the Twelfth of Never and that’s a long, long time
Until the Twelfth of Never and that’s a long, long time
Songwriters: Jerry Livingston / Paul Webster

ObamaCare repeal gains votes and momentum

Reps. Fred Upton (R-Mich.) and Billy Long (R-Mo.) on Wednesday said they would support the GOP’s ObamaCare repeal-and-replace bill with the addition of an amendment, giving the effort new momentum as GOP leaders push toward a floor vote.

The two Republicans made the announcement at the White House after meeting with President Trump.

“I think it is likely now to pass the House,” Upton said.

But Upton added he’s “not on the whip team” and can’t definitively say there are enough votes for it to pass.

Both Upton and Long dealt a setback to the health care measure earlier this week, when they came out against it because they said it failed to protect people with pre-existing conditions.

The new amendment from Upton would provide $8 billion over five years to help people with pre-existing conditions afford their premiums in states that are granted a waiver from ObamaCare’s protections.

The liberal Center for American Progress estimated on Tuesday that the high-risk pools are underfunded by much more: $200 billion over 10 years.

The GOP bill already includes $130 billion over 10 years, which was not swaying many moderates as of Tuesday.

Upton himself said on Tuesday afternoon that more money for the high-risk pools “does not do the trick,” but he appeared to have a change of heart on Wednesday.

GOP leaders are whipping aggressively in favor of the healthcare bill in hopes of holding a vote before a one-week recess.

Upton said votes in the House Rules Committee, which would set up debate of the bill on the floor, could be held as soon as Thursday.

If the House votes on the bill this week, there would not be time for a new Congressional Budget Office analysis of Upton’s changes or of an amendment from Rep. Tom MacArthur (R-N.J.) that won over the House Freedom Caucus.

The MacArthur amendment set off moderates’ concerns in the first place. It allows states to waive ObamaCare protections that prevent people from being charged higher premiums based on their health. If those were repealed, insurers could go back to charging exorbitant premiums to sick people, which could put coverage out of reach for many.

Supporters of the bill argue high-risk pools could fill the gap, and note that people with pre-existing conditions would still be protected if they had no gaps in coverage.

It is not immediately clear how many other moderates Upton’s changes will sway. The moderate Tuesday Group was set to meet at 2 p.m. Wednesday.

Centrist Reps. Charlie Dent (R-Pa.) and Ryan Costello (R-Pa.) said Wednesday they are still opposed to the bill even after the changes.

Rep. Mike Coffman (R-Colo.) said in a statement Wednesday he could support the bill “if House leadership will work to tighten protections for those with pre-existing conditions.”

GOP Reps. Barbara Comstock (Va.), Frank LoBiondo (N.J.), Dan Donovan (N.Y.), Jaime Herrera Beutler (Wash.) and Ileana Ros-Lehtinen (Fla.) are all still opposed to the bill after the changes, their respective offices told The Hill on Wednesday.

A spokesman for Rep. John Faso (N.Y.) said he is still undecided.

But in a key development for Republican leaders, the ultraconservative House Freedom Caucus has indicated it will continue to back the bill with the Upton amendment as long as it contains only additional funds and no policy changes.

On conservative host Hugh Hewitt’s radio show Wednesday, Speaker Paul Ryan (R-Wis.) praised Upton’s efforts, calling his amendment something that “nobody has a problem with.”

“Fred Upton identified something he thinks will make the bill better,” Ryan said. “What we’re doing is listening to our members, finding where that sweet spot of consensus is and driving there.”

Illustrating the pressure from the White House, Office of Management and Budget Director Mick Mulvaney called for a vote on Fox News Wednesday morning.

Mulvaney said that if he were Speaker of the House, “I’d probably go to the floor today, because it’s just that close.”

The healthcare legislation was abruptly pulled from the House floor in late March after it became clear that a planned vote would have failed.

The underlying bill also has several provisions some moderates object to, such as deep Medicaid cuts. The Congressional Budget Office estimated the overall legislation would result in 24 million more people becoming uninsured over a decade.

Democrats and some health policy experts have also raised concerns that $8 billion will not be enough to cover everyone with pre-existing conditions who would lose their insurance coverage.

But Trump is hungry for a major legislative achievement after not securing one during his first 100 days in office, and the White House is in full court press to rally support behind the healthcare plan.

After announcing he was a “no” vote, Long said Trump called him multiple times to plead for his support. “The president said, ‘Billy, we really need you, we need you, man,’” the congressman said.

Upton said he and Long went to the White House to sell Trump on their amendment. The Michigan lawmaker said during their meeting he read Trump his comments during a Bloomberg News interview in which he said the health bill “will be every bit as good on pre-existing conditions as ObamaCare.”

“I want him to keep that pledge,” Upton said. “This amendment allows that to happen.”

– Scott Wong contributed. Updated 1:18 p.m.

http://thehill.com/policy/healthcare/331755-obamacare-repeal-gains-votes-and-momentum

Pre-existing condition

From Wikipedia, the free encyclopedia
This article is about the term in health insurance. For medical use of the term, see Complication (medicine).

In the context of healthcare in the United States, a pre-existing condition is a medical condition that started before a person’s health insurance went into effect. Before 2014 some insurance policies would not cover expenses due to pre-existing conditions. These exclusions by the insurance industry were meant to cope with adverse selection by potential customers. Such exclusions are prohibited after January 1, 2014, by the Patient Protection and Affordable Care Act.

Definitions

The University of Pittsburgh Medical Center defines a pre-existing condition as a “medical condition that occurred before a program of health benefits went into effect”.[1] J. James Rohack, president of the American Medical Association, has stated on a Fox News Sunday interview that exclusions, based upon these conditions, function as a form of “rationing” of health care.[2]

Conditions can be broken down into two further categories, according to Lisa Smith of Investopedia:[3]

Most insurance companies use one of two definitions to identify such conditions. Under the “objective standard” definition, a pre-existing condition is any condition for which the patient has already received medical advice or treatment prior to enrollment in a new medical insurance plan. Under the broader, “prudent person” definition, a pre-existing condition is anything for which symptoms were present and a prudent person would have sought treatment.

Which definition may be used was sometimes regulated by state laws. Some states required insurance companies to use the objective standard, while others required the prudent person standard. 10 states did not specify either definition, 21 required the “prudent person” standard, and 18 required the “objective” standard.[4]

Regulation

Regulation of pre-existing condition exclusions in individual (non-group) and small group (2 to 50 employees) health insurance plans in the United States is left to individual U.S. states as a result of the McCarran–Ferguson Act of 1945 which delegated insurance regulation to the states and the Employee Retirement Income Security Act of 1974 (ERISA) which exempted self-insured large group health insurance plans from state regulation. After most states had by the early 1990s implemented some limits on pre-existing condition exclusions by small group (2 to 50 employees) health insurance plans, the Health Insurance Portability and Accountability Act (KassebaumKennedy Act) of 1996 (HIPAA) extended some minimal limits on pre-existing condition exclusions for all group health insurance plans—including the self-insured large group health insurance plans that cover half of those with employer-provided health insurance but are exempt from state insurance regulation.[5][6][7][8][9][10]

Current federal regulation

Patient Protection and Affordable Care Act (Pub.L. 111-148) enacted March 23, 2010[11]
  • Immediate reform: effective June 21, 2010 (90 days after enactment)
    • National high-risk pool for individuals with a pre-existing condition who have been uninsured for the prior 6 months
      • Premium to be set at a standard rate for a standard population
      • Premium for older individuals allowed to be up to 4 times the premium for younger individuals
      • Premium for tobacco users allowed to be up to 1.5 times the premium for non-tobacco users
  • Immediate reform: effective September 23, 2010 (6 months after enactment)
    • Group health insurance plans and new (non-grandfathered) individual health insurance plans[12]
      • Pre-existing condition exclusions prohibited for children under age 19
  • Reform delayed for 4 years: effective January 1, 2014
    • Individual and group health insurance plans
      • Pre-existing condition exclusions prohibited in all health insurance plans
      • Prohibit treating acts of domestic violence as a pre-existing condition
      • Waiting period for enrollment in new health insurance plans limited to 90 days
    • Grandfathered existing health insurance plans must prohibit pre-existing condition exclusions by January 1, 2014

Former regulation

Individual (non-group) health insurance plans[13][14]
Small group (2 to 50 employees) health insurance plans[15]
Large group (self-insured) health insurance plans
  • Maximum pre-existing condition exclusion period
    • 12 months: 50 states + DC
  • Maximum look-back period for pre-existing conditions
    • 6 months: 50 states + DC

Pre-existing condition exclusions were prohibited for HIPAA-eligible individuals (those with 18 months continuous coverage unbroken for more than 63 days and coming from a group health insurance plan).

Individual (non-group) health insurance plans could exclude maternity coverage for a pre-existing condition of pregnancy.[2]

Group health insurance plans sponsored by employers with 15 or more employees were prohibited by the Pregnancy Discrimination Act of 1978 from excluding maternity coverage for a pre-existing condition of pregnancy; this prohibition was extended to all group health insurance plans by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).[2]

Practices and effects

Advocates against pre-existing condition rules argue that they cruelly deny needy people treatment. State Farm spokeswoman K.C. Eynatten has said, “We realized our position was based on gut feelings, not hard numbers… we became aware that we were part of the reason a woman and her children might not leave an abuser. They were afraid they’d lose their insurance. And we wanted no part of that.”[16] Jerry Flanagan, health-care policy director of Consumer Watchdog, has stated that “insurance companies want premiums without any risk” and go to extreme “lengths… to go to make a profit”.[17] InsureMe, an insurance quote provider website, has argued that even though health insurance is basically to protect people from very high costs of health care, the commercial health insurance system is not playing fair and are always trying to avoid risk in order to boost their profits.[18]

Some practices by some health insurance companies, such as determining domestic violence to be an excludable pre-existing condition, have been called abuses by Maria Tchijov, a Service Employees International Union new media coordinator, and by an Office of Rural Health Policy report.[16][19][20]

The rationale behind pre-existing condition clauses, according to those who defend the policies, is that they reduce the cost of health insurance coverage for those who still receive it, thus giving more people an opportunity to afford insurance in the first place.[16][21] The San Francisco Chronicle has reported that “[c]osts for those with coverage could go up because people in poor health who’d been shut out of the insurance pool would now be included… they would get medical care they could not access before.”[21] Senator Mike Enzi, a Republican from Wyoming, has voted to allow insurance companies to consider domestic violence as a pre-existing condition and supported his vote by saying that covering such people could raise insurance premiums to the point where it would preclude others from buying it. He has remarked that “If you have no insurance, it doesn’t matter what services are mandated by the state”.[16][22]

According to the California-based advocacy group Consumer Watchdog, other possible situations falling under pre-existing condition clauses are chronic conditions as acne, hemorrhoids, toenail fungus, allergies, tonsillitis, and bunions, hazardous occupations such as police officer, stunt person, test pilot, circus worker, and firefighter, and pregnancy and/or the intention to adopt.[17]

Commentary by lawmakers

According to a Reason.com libertarian opinion blog by Peter Suderman, the ‘Pledge to America‘ issued by the Republican Party in September 2010 stated, “Health care should be accessible for all, regardless of pre-existing conditions or past illnesses…. We will make it illegal for an insurance company to deny coverage to someone with prior coverage on the basis of a pre-existing condition.”[23] In a March 3, 2010, address, President Barack Obama said that coverage denied to those with pre-existing conditions is a serious problem that would only grow worse without major reforms.[24] In a September 2010 visit with Falls Church, Virginia, residents, Obama referred to a woman with an eye condition and a woman with non-Hodgkin’s lymphoma as personal examples in the audience of those benefiting from changing pre-existing condition rules.[25]

Public opinion

A Time Magazine-Abt SRBI poll in late July 2009 found that a large majority of Americans (80%) favored a requirement that insurance companies insure people even if they suffer from pre-existing conditions.[26]

In September 2009, the monthly Kaiser Health Tracking Poll report said:[27]

The public’s most unanimous and bipartisan support is saved for a proposal to have the federal government require that health insurance companies cover anyone who applies, even if he/she has a pre-existing condition. Overall, eight in ten back the proposal, including 67 percent of Republicans, 80 percent of political independents and 88 percent of Democrats.

See also

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The Pronk Pops Show 878, April 21, 2017, Story 1: French Confirm Killing of Police Officer By Radical Islamic Terrorist Killer, Karim Cheurfi, Connected To Islamic State, — Videos — Story 2: Will Marine Le Pen Win In The First Round of French Presidential Election? First Round –Yes — — Making France Great Again — Second Round –Marine Le Pen May Be First Woman President or Emmannuel Marcon The Youngest — Videos — Story 3: Trump Administration Rolls Out New Tax Reform Plan and House Votes On Repeal and Replace Compromise Bill — By Day 100 — American People Want The FairTax And Full Repeal of Obamacare and Republican Establishment Wants Partial Repeal of Obamacare and Border Adjustment Tax — Stupid Party? — Videos — Story 4: Democrats Want To Shut-down Government Over Trump’s Wall — Republicans Pass Continuing Resolution — Videos

Posted on April 21, 2017. Filed under: American History, Banking System, Blogroll, Breaking News, Budgetary Policy, Communications, Computers, Congress, Corruption, Countries, Culture, Donald J. Trump, Donald J. Trump, Donald Trump, Donald Trump, Economics, Education, Elections, Federal Government, Fiscal Policy, Foreign Policy, Free Trade, Government, Health Care, Health Care Insurance, History, House of Representatives, Human, Illegal Immigration, Immigration, Independence, Insurance, Investments, Labor Economics, Law, Legal Immigration, Life, Media, Monetary Policy, News, Philosophy, Photos, Politics, Polls, President Trump, Presidential Appointments, Progressives, Radio, Raymond Thomas Pronk, Regulation, Rule of Law, Tax Policy, Terror, Terrorism, U.S. Negotiations with Islamic Republic of Iran, United States of America, Videos, Wealth, Wisdom | Tags: , , , , , , , , , |

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Pronk Pops Show 878: April 21, 2017

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Pronk Pops Show 830: February 2, 2017

Pronk Pops Show 829: February 1, 2017

Pronk Pops Show 828: January 31, 2017

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Pronk Pops Show 826: January 27, 2017

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Pronk Pops Show 820: January 19, 2017

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Pronk Pops Show 817: January 13, 2017

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Pronk Pops Show 813: January 9, 2017

Masked police officers were photographed standing on top of a vehicle on the Champs Elysees following an incident which left one officer deadEmmanuel Macron and Marine Le Pen.Image result for trump omb director mike mulveney

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Story 1: French Confirm Killing of Police Officer By Radical Islamic Terrorist Killer, Karim Cheurfi, Connected To Islamic State,  — Videos — 

ISIS Reportedly Claims Responsibility For Paris Attack That Left 1 Officer Dead | TODAY

Is Marine Le Pen the Donald Trump of France?

Paris shooting: Gunman was ‘focus of anti-terror’ probe – BBC News

Police search home of shooting suspect in Paris suburb

Raw: Memorial For Officer Killed In Paris Shooting

Geert Wilders message for Europe

Revealed: ISIS terrorist who shot dead cop in Paris attack was arrested TWO MONTHS ago for threatening to kill police and served 15 years for trying to murder two officers

  • Policeman Xavier Jugele, 37, was killed last night after being ‘targeted’ on the Champs Elysees in central Paris
  • The attacker was eventually shot dead after French police officers rushed to the scene in the heart of the city
  • The gunman’s Audi contained a pump action shotgun, knives and ID of known ‘extremist’ Karim Cheurfi 
  • Two other police officers were ‘seriously injured’ and a ‘female foreign tourist’ was wounded in the incident
  • A note declaring allegiance to ISIS was discovered on the Champs Elysees and is being investigated by police 

French security services are today facing troubling questions as to how they failed to prevent an ISIS gunman from slaughtering one policeman and wounding two other officers in Paris when he was arrested as recently as February.

Karim Cheurfi, 39, had served 15 years of a 20-year jail sentence for attempting to kill two officers in 2001, before his release last year.

In February, the terrorist tried to obtain weapons and made threats to kill police officers, but was let go in early March due to lack of evidence.

On Thursday night, the fanatic was killed by police after he got out of his Audi and opened fire at police who had stopped at a red light on Champs Elysees. His car was packed with more weapons, including a pump action shotgun and knives. A copy of the Koran was also found in the vehicle.

Traffic officer Xavier Jugele, 37, died instantly with a shot to the head, while the other two were hurt before Cheurfi himself was gunned down by nearby armed police. A ricocheting bullet fired by the terrorist also wounded a female foreign tourist passing by.

ISIS has claimed responsibility for the attack and nicknamed the attacker ‘Abu Yousuf al-Belgiki’, which translates to ‘the Belgian’ in Arabic – a name which was listed in uncovered documents from the terror group last year.

A note declaring allegiance to ISIS was discovered on the Champs Elysees and is being investigated by police. Its presence and the speed at which ISIS claimed responsibility may suggest the attack was directed by the jihadist group rather than carried out by a lone supporter.

Karim Cheurfi

Pictured is the suspected ISIS gunman, who has been identified locally as 39-year-old father Karim Cheurfi

Pictured (left and right) is the suspected ISIS gunman, who has been identified locally as 39-year-old Karim Cheurfi

The alleged ISIS gunman, identified as 39-year-old Karim Cheurfi - who was jailed for 20 years for trying to kill officers in 2001 - parked his Audi and opened fire after police stopped at a red light on the world famous avenue. Pictured is his arrest warrant from last month, when he was detained for trying to obtain weapons 'to kill police'

The alleged ISIS gunman, identified as 39-year-old Karim Cheurfi – who was jailed for 20 years for trying to kill officers in 2001 – parked his Audi and opened fire after police stopped at a red light on the world famous avenue. Pictured is his arrest warrant from last month, when he was detained for trying to obtain weapons ‘to kill police’

Traffic officer Xavier Jugele (pictured), 37, died instantly with a shot to the head, while the other two were hurt before Cheurfi himself was gunned down by nearby armed police

Traffic officer Xavier Jugele (pictured), 37, died instantly with a shot to the head, while the other two were hurt before Cheurfi himself was gunned down by nearby armed police

Pictured is armed police crowded two other officers, believed to have been shot in the attack, on Champs Elysees on Thursday night

Pictured is armed police crowded two other officers, believed to have been shot in the attack, on Champs Elysees on Thursday night

French police leave the home of ISIS gunman Karim Cheurfi in the suburb of Chelles, in Paris, following last night's attack

French police leave the home of ISIS gunman Karim Cheurfi in the suburb of Chelles, in Paris, following last night’s attack

A woman places a flower near the spot on the Champs Elysees where the shooting occurred last night in the French capital

A woman places a flower near the spot on the Champs Elysees where the shooting occurred last night in the French capital

A body is removed from the scene after a traffic officer was killed by an ISIS gunman in central Paris last night

A body is removed from the scene after a traffic officer was killed by an ISIS gunman in central Paris last night

French police officers and forensic teams searched a vehicle which was close to the scene on the Champs Elysees in Paris

French police officers and forensic teams searched a vehicle which was close to the scene on the Champs Elysees in Paris

A police lorry seized the Audi which the attacker was driving, before he got out and shot at traffic officers last night

A police lorry seized the Audi which the attacker was driving, before he got out and shot at traffic officers last night

A still image from video footage shows police forensic investigators inspect the car used by the attacker in Paris last night

A still image from video footage shows police forensic investigators inspect the car used by the attacker in Paris last night

In the latest developments after the attack:

  • French police have this morning arrested three family members of ISIS gunman Karim Cheurfi 
  • Police are hunting a second suspect, who was brought to their attention by Belgian authorities 
  • A man whose image appeared on social media as ‘second suspect’ handed himself to police in Antwerp claiming he was not linked to the plot. Detectives have said this man had nothing to do with the attack 
  • Far-right presidential candidate Marine Le Pen called for all French terror suspects to be expelled
  • France’s government has reviewed its already extensive election security measures and says it is ‘fully mobilised’ and nothing will stop Sunday’s presidential vote
  • US President Donald Trump believes the attack will have a ‘big effect’ on the outcome of the election 
  • British Prime Minister Theresa May has sent condolences to the French president following the latest attack but the pair have not spoken directly since last night 
  • Iran’s foreign secretary Bahram Ghasemi said France was feeling a blowback for its support of rebels in Syria 

French officials revealed that Cheurfi was detained in Meaux, 24 miles east of Paris, on February 23 this year, after it emerged he was trying to buy weapons ‘to kill police’.

On Friday night, but prosecutors tonight denied that he was on a security watch list and added the terrorist showed no signs of radicalisation before the attack.

He reportedly used the alias ‘Abu Yousuf the Belgian’ and reportedly made threats to murder officers using the social media app Telegram, an instant messaging service.

Despite having a long list of police-hating convictions, he was able to obtain a Kalashnikov, a pump action shotgun and several knives ahead of last night’s attack.

He had been jailed for 20 years in 2005 for trying to kill two policemen.  He opened fire five times with a .38 revolver following a car chase in 2001, leaving the officers and a third victim wounded. All three survived the attack in Roissy-en-Brie, in the Seine-et-Marne department of northern France.

An armed police officer hoists his weapon as they storm the streets of Paris after the latest terror attack to hit the city

An armed police officer hoists his weapon as they storm the streets of Paris after the latest terror attack to hit the city

Armed police outside a shop in central Paris after an ISIS gunman killed a traffic officer and injured three other people

Armed police outside a shop in central Paris after an ISIS gunman killed a traffic officer and injured three other people

Armed police officers on the streets of Paris after a gunman killed a traffic cop and seriously injured two others last night

Armed police officers on the streets of Paris after a gunman killed a traffic cop and seriously injured two others last night

Armed police officers stood guard after they rushed to the scene in the centre of the capital following the incident which left frightened witnesses sprinting for their lives 

Armed police officers stood guard after they rushed to the scene in the centre of the capital following the incident which left frightened witnesses sprinting for their lives

A team of forensic detectives examine the Audi, which the gunman was driving. ID of Karim Cheurfi was found in the vehicle

A team of forensic detectives examine the Audi, which the gunman was driving. ID of Karim Cheurfi was found in the vehicle

Cheurfi, who was born in France, was a recluse who blamed police for ruining his life, a friend of the family revealed today.

OFFICER SHOT DEAD GUARDED BATACLAN AT ITS REOPENING

By Sam Tonkin for MailOnline 

The policeman killed by an ISIS gunman on the Champs-Elysees was today named as Xavier Jugelé, a 37-year-old Paris officer who defiantly said ‘no to terrorists’ at the reopening of the Bataclan theatre last November.

He was shot in the head when the terrorist – identified today as French national Karim Cheurfi, 39 – launched his attack on three police officers at around 9pm last night.

Jugelé, who was a proud defender of gay rights, was named as the victim who died by French newspaper Le Parisien.

It has since emerged that Jugelé was on duty at the reopening of the Bataclan theatre on November last year - a year on from the Paris attacks which left 130 dead.
Jugelé

It has since emerged that Jugelé (pictured left and right) was on duty at the reopening of the Bataclan theatre on November last year – a year on from the Paris attacks which left 130 dead

It has since emerged that Jugelé was on duty at the reopening of the Bataclan theatre on November last year – a year on from the Paris attacks which left 130 dead.

As British singer Sting marked the occasion with a performance at the concert hall, Jugelé defiantly told PEOPLE.com that he was there ‘to say no to terrorists’.

The policeman added: ‘I’m happy to be here. Glad the Bataclan is reopening. It’s symbolic.

‘We’re here tonight as witnesses. Here to defend our civic values. This concert’s to celebrate life. To say no to terrorists.

‘It doesn’t feel strange, it feels important,’ he added. ‘Symbolic.’

He did not attend formal mosque prayer services and became fascinated by jihadist propaganda via the internet, a confident of his mother claimed.

‘Karim did not pray, he drank alcohol and watched jihadist propaganda,’ neighbour Hakim, 50, told MailOnline.

‘He was not a good Muslim, he was a lost soul. He had no friends, no girlfriend, he never went out. He stayed at home all day watching stuff on the internet.’

Another neighbour added: ‘Karim didn’t go to the mosque. He just stayed at home. You never saw him.’

Hakim continued: ‘Karim blamed the police for ruining his life. He fired (a pistol) at police during a burglary and got sentenced to 15 years prison.

‘He was only 20 at the time. He hated the police, he said they had ruined his life. He was ‘anti-cop’. He would swear at officers in the street, call them bastards. He didn’t care.’

Hakim, whose family is close to Cheurfi’s mother, said the gunman had only recently returned to the quiet residential street after spending years behind bars.

Cheurfi lived separately from his mother in a purpose-built apartment in the front of the property.

Hakim added: ‘He lived in the studio in the garden. The mother lived in the big house.’

Cheurfi’s Algerian-born mother had divorced his father and had married a Frenchman with who she had second son. She later divorced her second son.

Another neighbour said: ‘His parents split up but they stayed living at the same property.

‘The father Salat lived in the apartment in the front of the garden and the mother lived in the house at the back of the property.

‘The mother married again, to a Frenchman, and they had a son together but the father stayed living at the property.

‘So it was a bit complicated but that’s life. Karim got on well with his half brother who is called Stephane.

‘But he went to live in the apartment with his father when he got of prison.’

Another neighbor added: ‘The mother is not here. She is in Algeria. She goes there every few months to visit relatives. She’s not been well.’

Officers have been searching the home of Karim in east Paris and arrested three of his family members.

A French government spokesman said the ISIS gunman began firing against police using ‘a weapon of war’.

The fatal incident unfolded as presidential candidates, including National Front party leader Marine Le Pen, debated on a TV show nearby before Sunday’s election.

Paris police search the suspected Champs-Elysee attacker’s house

A French police officer has been shot dead on the Champs Elysees in Paris (pictured) - just days before the French presidential election 

A French police officer has been shot dead on the Champs Elysees in Paris (pictured) – just days before the French presidential election

People held their hands up as they walked towards officers close to the scene where a policeman was fatally shot in Paris

People held their hands up as they walked towards officers close to the scene where a policeman was fatally shot in Paris

Police closed off the popular avenue (pictured) after a policeman was killed during a shooting incident in the French capital

Police closed off the popular avenue (pictured) after a policeman was killed during a shooting incident in the French capital

Pictured is the scene of a restaurant in Paris when the gunman opened fire on the streets outside. Diners are seen cowering on the ground in fear

Pictured is the scene of a restaurant in Paris when the gunman opened fire on the streets outside. Diners are seen cowering on the ground in fear

An armed policeman speaks to diners in a nearby Parisien restuarant, who cowered to the floor in fear of the ISIS gunman

An armed policeman speaks to diners in a nearby Parisien restuarant, who cowered to the floor in fear of the ISIS gunman

The gunman has been identified by police but they will not officially reveal his name until investigators determine whether he had accomplices, according to the Paris prosecutor.

Prosecutor Francois Molins said: ‘The identity of the attacker is known and has been checked. I will not give it because investigations with raids are ongoing.

‘The investigators want to be sure whether he had or did not have accomplices.’

The Interior Ministry spokesman said the officers were deliberately targeted and the police union added that the policeman was killed while sat in a car at a red light.

US President Donald Trump said: ‘It looks like another terrorist attack. What can you say? It never ends.’

The attack which took place on the Champs Elysees (pictured) comes just three days before the first round of balloting in France's tense presidential election

The attack which took place on the Champs Elysees (pictured) comes just three days before the first round of balloting in France’s tense presidential election

A French police officer stood guard on the Champs Elysees in central Paris following the fatal shooting, which has been described as 'terrorist related' 

A French police officer stood guard on the Champs Elysees in central Paris following the fatal shooting, which has been described as ‘terrorist related’

Police officers secured the area after a gunman got of an Audi vehicle and targeted officers by firing an automatic gun towards them 

Police officers secured the area after a gunman got of an Audi vehicle and targeted officers by firing an automatic gun towards them

A man and a woman put their hands in the air as armed officers stood just yards away from them following the incident in the city 

A man and a woman put their hands in the air as armed officers stood just yards away from them following the incident in the city

Officers searched the home of the suspected gunman on Thursday evening after they travelled to his home in the east part of the capital 

Officers searched the home of the suspected gunman on Thursday evening after they travelled to his home in the east part of the capital

People were seen running away from the area after Thursday night's attack, which has been described as being 'terrorist related'

People were seen running away from the area after Thursday night’s attack, which has been described as being ‘terrorist related’

Police officers searched the home of the suspected gunman in east Paris following the attack in the capital on Thursday 

Police officers searched the home of the suspected gunman in east Paris following the attack in the capital on Thursday

The Audi which is believed to belong to the attacker was taken away from the scene on the back of a lorry as police rushed to the popular avenue 

The Audi which is believed to belong to the attacker was taken away from the scene on the back of a lorry as police rushed to the popular avenue

Forensic experts and police officers were seen examining evidence from a van on the Champs Elysees in central Paris 

Forensic experts and police officers were seen examining evidence from a van on the Champs Elysees in central Paris

ISIS claimed responsibility for the attack and dramatic video footage showed the immediate aftermath of the incident which left one policeman dead.

Pierre-Henry Brandet, spokesman for the French Interior Ministry, confirmed that both injured officers in hospital were now ‘out of danger’ and ‘stable’, while the female tourist was far less badly hurt.

Mr Brandet did not name any of the victims, but praised the officers for ‘helping to avoid a bloodbath’ by ‘neutralising’ the attacker as quickly as possible.

French President Francois Hollande said the attack was ‘terrorist related’ and scheduled an emergency meeting following the shootings on Thursday evening.

Mr Hollande said a national tribute will be paid to the policeman and added that a ‘passerby was hit’ before the ‘assailant was neutralised’.

Conservative contender Francois Fillon, who has campaigned against ‘Islamic totalitarianism,’ said on France 2 television that he was canceling his planned campaign stops Friday.

Far-right candidate Le Pen, who campaigns against immigration and Islamic fundamentalism, took to Twitter to offer her sympathy for law enforcement officers ‘once again targeted.’

She canceled a minor campaign stop, but scheduled another.

Centrist candidate Emmanuel Macron offered his thoughts to the family of the dead officer.

Socialist Benoit Hamon tweeted his ‘full support’ to police against terrorism.

Le Pen and Francois Fillon announced that they have both cancelled their campaigning on Friday.

Paris gunman’s neighbour speaks out as police raid suspect’s home

French presidential election candidate Jean-Luc Melenchon (pictured) took part in the TV show just days before the election 

French presidential election candidate Jean-Luc Melenchon (pictured) took part in the TV show just days before the election

French presidential candidates, including National Front party leader Marine Le Pen (pictured), took part in a key debate

French presidential candidates, including National Front party leader Marine Le Pen (pictured), took part in a key debate

Mr Brandet said ‘all lines of investigation were being pursued’, while intelligence sources said the dead assailant was a known radical on a so-called S-file, for ‘State-security’.

This means he would have been under surveillance, because he was a known risk to the country.

An eyewitness, called Chelloug, said: ‘It was a terrorist. He came out with a Kalashnikov and started shooting, but he could’ve shot us on the pavement and killed more people with a spray of shots.

‘But he targeted the policemen and fortunately there were the policemen who killed him.’

Another witness said: ‘I saw someone shoot at the police officers. They returned fire, they killed him, he fell on the floor. And then the emergency services came.

‘It took place by Zara and there was a CRS (Republican Security Companies) van parked up and the man shot the police officers. He took out a weapon and shot them.

‘I think the police officer was killed on the spot and his colleagues fired back and killed the individual.’

The attack comes just three days before the first round of balloting in France’s tense presidential election.

A witness, identified only as Ines, told BFM that she heard a shooting, saw a man’s body on the ground and the area was quickly evacuated by police.

It comes just two days after police arrested two men in southern Marseille with weapons and explosives who were suspected of preparing an attack to disrupt the first-round of the presidential election on Sunday.

France is in a state of emergency and at its highest possible level of alert since a string of terror attacks that began in 2015, which have killed over 230 people.

Thousands of troops and armed police have been deployed to guard tourist hotspots such as the Champs Elysees or other potential targets like government buildings and religious sites.

Police officers quickly secured the area - which is popular with tourists and Parisians - after the attack and the road was on lockdown by 9pm 

Police officers quickly secured the area – which is popular with tourists and Parisians – after the attack and the road was on lockdown by 9pm

Police search the car reportedly used in Paris attack

Police officers took positions near the Champs Elysees avenue in Paris after the gunman - who was known to the security services - launched the attack 

Police officers took positions near the Champs Elysees avenue in Paris after the gunman – who was known to the security services – launched the attack

An armed soldier spoke to a man a told him to leave the area following the fatal shooting close to the Arc de Triomphe (pictured) 

An armed soldier spoke to a man a told him to leave the area following the fatal shooting close to the Arc de Triomphe (pictured)

French soldiers secure the Champs Elysees Avenue after a police officer was killed when a gunman opened fire in Paris

French soldiers secure the Champs Elysees Avenue after a police officer was killed when a gunman opened fire in Paris

French police officers searched the area after some of their colleagues were shot in the heart of Paris on Thursday evening

French police officers searched the area after some of their colleagues were shot in the heart of Paris on Thursday evening

French President Francois Hollande (pictured) said the attack was 'terrorist related' and scheduled an emergency meeting following the shootings

French President Francois Hollande (pictured) said the attack was ‘terrorist related’ and scheduled an emergency meeting following the shootings

‘Stay back, stay back!’ Police warn after shooting in Paris

LE PEN ACCUSED OF ‘EXPLOITING’ ATTACK FOR VOTES

By Thomas Burrows for MailOnline 

French Prime Minister Bernard Cazeneuve has accused far-right candidate Marine Le Pen of ‘exploiting’ the Champs-Elysees terror attack to win votes ahead of Sunday’s presidential election.

In the wake of the shooting Le Pen called for foreign terror suspects to be expelled immediately and claimed France needed a ‘presidency which acts and protects us.’

Responding to that, Cazeneuve, a Socialist, said Le Pen’s National Front (FN) ‘after each attack, seeks to exploit it and use it for purely political means.’

Experts believe the shooting last night could boost Le Pen’s chances of getting elected just days before France goes to the polls.

Le Pen today called for foreign terror suspects to be kicked out the country despite the fact the ISIS gunman was French

Le Pen today called for foreign terror suspects to be kicked out the country despite the fact the ISIS gunman was French

Voters could flock to far-right candidate Marine Le Pen following the latest terror attack

Voters could flock to far-right candidate Marine Le Pen following the latest terror attack

In last night’s attack a police officer was killed and two more were injured after a gunman opened fire close to the Champs-Elysees.

Le Pen today called for foreign terror suspects to be kicked out the country despite the fact the ISIS gunman was French. The 39-year-old had used the war name ‘Abu Yousuf the Belgian’.

Officials confirmed the homegrown fanatic was a French national despite his nickname.

A manhunt is underway for the second suspect who travelled by train to France from Belgium.

The Champs-Elysees terror attack could boost far-right candidate Marine Le Pen's chances of getting elected, experts believe

The Champs-Elysees terror attack could boost far-right candidate Marine Le Pen’s chances of getting elected, experts believe

The shooting took place just four days before the French election and experts believe it could bolster Le Pen’s chances of being elected.

Le Pen has made immigration and security the core part of her campaign. She has pledged to tighten French borders controls and build more jails, and claimed authorities were not doing enough to protect citizens from terror attacks.

More than half of police officers in France had already said they were voting for Le Pen because of her strong anti-terror stance, according to an IFOP poll.

Experts believe it could increase her chances of winning Sunday’s election.

Fredrik Erixon, director at the European Centre for International Political Economy, told CNBC: ‘[It could lead to] a greater performance of Marine Le Pen than otherwise would have been the case.

‘It’s difficult to see how this attack will not play into the hands of political forces that want this campaign to be focused only on issues around migration and terrorism.’

Vishnu Varathan, senior economist at Mizuho Bank, added: ‘The Paris gunman attack may well swing support in her favor; and this may not be picked up by the polls in a timely manner.’

Armed police officers were quick on the scene and closed the world famous avenue following the incident which shocked the city

Armed police officers were quick on the scene and closed the world famous avenue following the incident which shocked the city

The world famous was shut at around 9pm and it is believed police are still searching for a second suspect in relation to the attack 

The world famous was shut at around 9pm and it is believed police are still searching for a second suspect in relation to the attack

Police officers blocked the access of a street near the Champs Elysees in Paris after the fatal shooting on Thursday, April 20

Police officers blocked the access of a street near the Champs Elysees in Paris after the fatal shooting on Thursday, April 20

Officers were wearing vests and helmets as they patrolled the area close to where the fatal shooting took. A 39-year-old man is believed to be responsible for the shooting 

Officers were wearing vests and helmets as they patrolled the area close to where the fatal shooting took. A 39-year-old man is believed to be responsible for the shooting

The world famous street was put on lockdown by 9pm and officers guarded the area in central Paris (pictured, the Eiffel Tower in the background) 

The world famous street was put on lockdown by 9pm and officers guarded the area in central Paris (pictured, the Eiffel Tower in the background)

A policeman attended the scene and was armed with a gun following the incident. Police have reportedly issued a warrant for a second attacker

A policeman attended the scene and was armed with a gun following the incident. Police have reportedly issued a warrant for a second attacker

Up until now, polls showed voters more concerned about unemployment and their spending power than terrorism or security, though analysts warned this would change in the event of further bloodshed.

For weeks, centrist former banker Le Pen has been out in front but opinion polls now show there is a chance that any of the four leading candidates could reach the second-round runoff on May 7.

Scandal-plagued conservative Fillon and far-left firebrand Jean-Luc Melenchon have closed the gap substantially in the last two weeks.

A COUNTRY UNDER SIEGE: TIMELINE OF FRANCE TERROR

By Rory Tingle for MailOnline 

March, 18, 2017 – Convicted criminal with links to radical Islam shouted ‘I am here to die for Allah, there will be deaths’ seconds before he was shot dead during an attack at Orly airport. The 39-year-old, named locally as career criminal Ziyed Ben Belgacem, was killed after wrestling a soldier’s gun from her and fleeing into a McDonald’s. He sent a text message to his brother and father stating ‘I shot the police’, shortly before he was killed.

February 3, 2017 – A man is shot five times outside the Louvre museum in the heart of Paris after attempting to storm the historic art gallery.

July 14, 2016 – Amid Bastille Day celebrations in the Riviera city of Nice, a large truck is driven into a festive crowd. Some 86 people from a wide variety of countries are killed. The driver is shot dead. Islamic State extremists claim responsibility for the attack. The state of emergency in France is extended and extra protection, including robust barriers to prevent similar attacks, is put in place at major sites in France.

June 13, 2016 – Two French police officers are murdered in their home in front of their 3-year-old son. Islamic State claims responsibility for the slaying, which was carried out by a jihadist with a prior terrorist conviction. He is killed by police on the scene.

Nov. 13, 2015 – Islamic State militants kill 130 people in France’s worst atrocity since World War II. A series of suicide bomb and shooting attacks are launched on crowded sites in central Paris, as well as the northern suburb of Saint-Denis. Most of those killed are in a crowded theater where hostages are taken. Islamic State extremists claim responsibility and say it was in retaliation for French participation in airstrikes on the militant group’s positions in Syria and Iraq. It leads to the declaration of a state of emergency in France. Police powers are expanded.

Jan. 7, 2015 – Two brothers kill 11 people inside the Paris building where the satirical magazine Charlie Hebdo is headquartered in what Islamic State extremists claim is retaliation for the publication of cartoons about the Prophet Muhammad. More are killed subsequently in attacks on a kosher market in eastern Paris and on police. There are 17 victims in all, including two police officers. The attackers are killed.

The UK Foreign Office said: ‘The British Embassy is in contact with local authorities and urgently seeking further information following reports of a shooting incident on the Champs-Elysees in Paris.

‘You should remain vigilant and follow the advice of the local security authorities and/or your tour operator.

‘If you’re in the area and it is safe to do so, contact your friends and family to tell them you are safe.’

 were photographed standing on top of a vehicle on the Champs Elysees following an incident which left one officer dead

French police officers reacted after the shooting which left one officer dead and two more seriously injured in Paris 

French police officers reacted after the shooting which left one officer dead and two more seriously injured in Paris

French soldiers were armed with guns (pictured) and stood guard at the Arc de Triomphe near the Champs Elysees in Paris

French soldiers were armed with guns (pictured) and stood guard at the Arc de Triomphe near the Champs Elysees in Paris

Heavily armed officers had flooded the area following the gunshots which were heard in a busy part of the French capital 

Heavily armed officers had flooded the area following the gunshots which were heard in a busy part of the French capital

Reports have suggested that two police officers have been killed on the Champs Elysees in central Paris (pictured) this evening

Reports have suggested that two police officers have been killed on the Champs Elysees in central Paris (pictured) this evening

It was originally believed the other officer was seriously wounded while the attacker was killed on the world famous avenue (pictured)

It was originally believed the other officer was seriously wounded while the attacker was killed on the world famous avenue (pictured)

The incident last night comes as France remains in a state of emergency following the Paris attacks in 2015 and the Bastille Day killings in Nice in 2016.

The shooting comes just hours after one of the busiest roads in Paris was closed off by police as officers dealt with a ‘suspicious package’.

Reports suggested that items were discovered by officers as Rue de Rivoli remained shut. Stunned witnesses described seeing a large police presence on the two-mile-long road.

Rue de Rivoli is a busy commercial street just north of the River Seine which is home to some of the most fashionable shops in the world.

CHAMPS-ELYSEES: THE MOST BEAUTIFUL AVENUE IN THE WORLD

By Thomas Burrows for MailOnline 

The Champs-Elysees – the scene of Thursday night’s terror attack – is the beating historic heart of Paris.

It has been described as the ‘most beautiful avenue’ in the world and is visited by millions of tourists every year.

Tens of thousands of people daily throng the tree-lined 1.2 mile avenue that is home to luxury stores and chain stores, cafes, cinemas and high-end offices.

A tourist draw as famed as the Eiffel Tower just across the River Seine, the avenue, stretching from the Arc de Triomphe down to Concorde Square, was first laid out in 1670.

Over the decades people have gathered there to mark momentous moments in French history.

During the French Revolution in 1789 an angry mob set off from the avenue to march on Versailles, Louis XVI’s opulent retreat.

It was also the site chosen by General Charles de Gaulle to celebrate the August 25, 1944, liberation of Paris from the Germans during World War Two.

More recently, hundreds of thousands congregated along the avenue to celebrate France’s 1998 World Cup victory (sealed with a 3-0 win over Brazil) on home soil.

The Champs Elysees is famously the finish line for the world’s toughest cycling race, the Tour de France.

Thursday was not the first time violence has been visited on the avenue.

In 1986, it witnessed two attacks – the first, on February 3, seeing one death and eight injured at the Claridge shopping arcade.

A second attack on March 20 at the Point Show arcade killed two and injured 29. Both attacks were linked to Middle East terrorism.

On Bastille Day in 2002, president Jacques Chirac survived an assassination attempt by a right-wing extremist who fired off one shot from a rifle hidden in a guitar case before bystanders wrestled him to the ground.

http://www.dailymail.co.uk/news/article-4429938/Paris-terror-attack-video-shows-police-shoot-gunman.html#ixzz4evbT4kjq

Story 2: Will Marine Le Pen Win In The First Round of French Presidential Election? First Round –Yes — — Making France Great Again —  Second Round –Marine Le Pen May Be First Woman President or Emmanuel Marcon The Youngest President — Videos

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“Marine Le Pen will be the next French President” – Christopher Dickey

Dear French People | French Presidential Election 2017

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RT – Why Marine Le Pen is The Only Way to Save Europe #Frexit #EndEU

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Marine Le Pen will not put up with any nonsense from BBC reporter

Marine Le Pen gets poll boost after Paris attack as Donald Trump says her chances of victory have improved

Donald Trump Marine Le Pen

Donald Trump has said the Paris terrorist attack would boost Marine Le Pen’s presidential chances after a last-minute poll gave her a modest increase in support.

The US president said the shooting would “probably help” Ms Le Pen in Sunday’s election, because she is “strongest on borders, and she’s the strongest on what’s been going on in France.”

“Whoever is the toughest on radical Islamic terrorism, and whoever is the toughest at the borders, will do well in the election,” he said.

Marine Le Pen at a campaign rally in Marseille
Marine Le Pen at a campaign rally in Marseille CREDIT: EPA

US presidents typically avoid weighing in on specific candidates running in overseas election. But Mr Trump suggested his opinion was no different from an average observer, saying: “Everybody is making predictions on who is going to win. I’m no different than you.”

Cancelling visits and meetings on Friday, candidates traded blows across the airwaves as it emerged that the Isil-backed gunman had been kept in custody just 24 hours in February despite attempts to procure weapons to murder police.

Xavier Jugelé, 37, a policeman who had been deployed in the 2015 Bataclan attack, was killed in the shooting.

This undated image provided on Friday, April 21, 2017, by FLAG, an association of LGBT police officers, shows French police officer Xavier Jugele
This undated image provided on Friday, April 21, 2017, by FLAG, an association of LGBT police officers, shows French police officer Xavier Jugele CREDIT: FLAG VIA AP

Ms Le Pen, the far-Right candidate, blasted the mainstream “naive” Left and Right for failing to get tough on Islamism, calling for France to instantly reinstate border checks and expel foreigners who are on the watch lists of intelligence services.

François Fillon, the mainstream conservative candidate, pledged an “iron fist” in the fight against “Islamist totalitarianism” – his priority if elected. “We are at war, it’s either us or them,” said the conservative, whose campaign has been weighed down by allegations he gave his British wife a “fake job”.

Meanwhile, Emmanuel Macron, the independent centrist, whom critics dismiss as a soft touch, hit back at claims shutting borders and filling French prisons would solve the problem, saying: “There’s no such thing as zero risk. Anyone who pretends (otherwise) is both irresponsible and deceitful.”

Sticking to his campaign agenda, far-Left candidate Jean-Luc Mélenchon told everyone to keep a “cool head” as he took part in a giant picnic.

A last-minute Odoxa poll taken after the attack suggested that Mr Macron was still on course to come first in Sunday’s first round, with Ms Le Pen just behind and through to the May 7 runoff.

However, Mr Fillon and Mr Mélenchon were still snapping at their heels.

The government on Friday announced elite units would join 50,000 police and troops to guard polling booths on Sunday in France’s first presidential election to be held in a state of emergency.

Matthieu Croissandeau, editor of Nouvel Obs magazine, said the French are now thicker-skinned after two years of bloodshed. “The French are unfortunately getting used to terror attacks on home soil and I don’t think this latest one created the shock and awe that might have made a significant difference,” he said.

Ms Le Pen has struggled to get the campaign to focus on her party’s pet issues of security, Islam and immigration. By contrast, she has been thrown on the defensive over her position to pull out of the eurozone.

After the attack, she called on the “notoriously feeble” socialist, President François Hollande, to instantly reinstate border checks and expel foreigners who are on the watch lists of intelligence services. She said: “We cannot afford to lose this war. But for the past 10 years, Left-wing and Right-wing governments have done everything they can for us to lose it.

“We need a presidency which acts and protects us,” she said from her Paris campaign headquarters. Elected French president, I would immediately, and with no hesitation, carry out the battle plan against Islamist terrorism and against judicial laxity.”

Marine Le Pen reacts to the terror attack in Paris
But Ms Le Pen was not the only one to issue stern pledges. Mr Fillon, who also talks tough on security, said the fight against “Islamist totalitarianism” should be the next president’s priority.

“It will require an unyielding determination and a cool head,” the former prime minister said. “We are at war, there is no alternative, it’s us or them.”

Mr Fillon, though knocked off his initial course towards victory by incessant allegations involving “fake job” payments to his British wife, promised to govern with “an iron fist”.

But the moderate Mr Macron, whom other candidates have portrayed as too inexperienced, took a different tack, warning against any attempts to use the shooting for political gain. “I think we must once and for all have a spirit of responsibility at this extreme time and not give in to panic and not allow it to be exploited, which some might try to do,” he told French radio.

Karim Cheurfi had been detained in February after reports that he had threatened police 
Karim Cheurfi had been detained in February after reports that he had threatened police 

Ms Le Pen’s solutions, he said, were woefully simplistic and “would not protect France”. And he added that to promise a “zero risk” scenario “is both irresponsible and deceitful”.

He also took a swipe at Mr Fillon, saying that intelligence had been depleted on his watch as the prime minister in Nicolas Sarkozy’s presidency.

Meanwhile, Bernard Cazeneuve, the Socialist prime minister, accused Le Pen of “shamelessly seeking to exploit fear and emotion”.

Footage shows moments after suspected terrorist is shot in Paris

00:24

Opinion polls have for months forecast that Le Pen would make it through to the run-off, but then lose in the final vote. Given the margin of error, none of the leading four candidates is a sure bet to reach the final. All hope to woo the third of French voters still undecided.

Previous terror attacks ahead of elections – such as the November 2015 attacks in Paris before regional ballots – did not effect those ballots.

Analyst Who Predicted Trump’s Ascendancy Bets on Le Pen Win

April 21, 2017, 3:41 AM CDT April 21, 2017, 5:42 AM CDT
  • Undecided voters bad news for Macron, says GaveKal’s founder
  • Recommends overweight sterling, large-caps; bond shorts
 How Will Markets React to Elections in France?

Don’t bank on a relief rally in the euro area anytime soon.

Markets are underpricing the prospect of Marine Le Pen emerging victorious in the French election as a sea of undecided voters throws into sharp relief pronounced apathy for center-leftist Emmanuel Macron — the front-runner by a whisker — and the backlash against the European Union project.

That’s the conclusion drawn by Charles Gave, founder of Hong-Kong based asset-allocation consultancy GaveKal Research, who predicted the triumph of Donald Trump in the U.S. election, and is now betting on a win for the anti-euro National Front candidate.

“Le Pen’s momentum is a slow-moving reaction against the men of Davos — as we have seen with Brexit and Trump — but markets don’t want to believe it,” he said by phone before the first round of the French poll on April 23.

Given the prospect of a Le Pen victory, Gave, who has been researching tactical asset allocation for more than 40 years, is advising clients to adopt long positioning in the pound as the U.K. would benefit from haven bids, and shorts on inflation-linked German bonds amid the risk of deflation in the euro area.

Safer Bet

The French economist also recommends bets on the likely outperformance of publicly-listed European multinationals, given their outsize share of income in foreign currencies. In effect, for investors obliged to invest liquidity in euros, Gave says a basket of high-quality stocks is a safer bet than euro-denominated government bonds.

“The market is talking about the nightmare scenario but it’s not pricing it in” said Mark Tinker, head of AXA Framlington Asia. Tinker’s a GaveKal client, and admirer of Gave’s tail-risk warnings over the past year. “After Sunday, we will have more information to make a considered risk-return wager to trade and hedge, but high-quality European companies and German bonds look like an attractive bet,” Tinker said.

Markets are pining for a scenario that would preserve the status quo: Macron, an independent candidate, defeating Le Pen in the second round on May 7. Thursday saw something of a French relief rally, with strong demand at a government debt auction, while France’s benchmark CAC 40 Index rose 1.5 percent aspolls showed Macron pulling marginally ahead of Le Pen.

The euro held steady on Friday and French bonds gained after a police officer was shot in Paris, which may influence the outcome of the first-round vote, according to some analysts. The CAC 40 dropped for the first time in three days, declining 0.5 percent.

The stars, however, appear to be aligning for the National Front candidate, said Gave. The fact two candidates for the runoff are likely to be determined by voters who have yet to make up their minds — as many as 40 percent — is a bad omen for the centrist contender, he said.

Momentum Curtailed

At least half of the far-left and half of the center-right won’t vote for Macron in the second round if he is pitted against Le Pen, believing he is“tainted” by his association with Francois Hollande’s government, and would rather abstain, Gave said.

Supporters of Francois Fillon, a center-right candidate whose momentum has been curtailed by graft charges, and a sizable chunk of Macron’s followers would probably rally to Le Pen’s cause if she were to face leftist Jean-Luc Mélenchon in the final round, according to Gave. He sees only Fillon with a chance to defeat Le Pen in the run-off.

If she emerges victorious, the euro would tank as markets would price in the prospect of its dissolution, rather than focus on Le Pen’s legislative hurdles to exit the single-currency bloc. French and Italian bonds will be “unquotable” given vanishing bids, and the European banking system would be beset by seismic turmoil, he said.

https://www.bloomberg.com/news/articles/2017-04-21/analyst-who-predicted-trump-ascendancy-is-betting-on-le-pen-win

French Elections: Marine Le Pen Backed By Quiet Army of Women

Image: Marine Le Pen campaign rally in Paris

Le Pen waves at the audience after speaking at a rally in Paris on April 17. Christophe Petit Tesson / EPA

COGOLIN, France — Muslims preoccupy Jennifer Troin.

“I’m worried about my nieces having to wear the veil,” said the soft-spoken 29-year-old.

This fear has helped propel the young mother to the far-right of the political spectrum ahead of key presidential elections Sunday — and into the arms of the hard-line National Front party.

Troin sells children’s clothes at a store in Cogolin, a town of 11,000 a few miles from the jet-set resorts of the French Riviera. In 2014, Cogolin became one of a handful of communities nationwide to elect mayors from the National Front, which is also known by the acronym FN.

Image: Jennifer Troin, 29, is a sales assistant in a children's clothes store in Cogolin on April 13, 2017

Jennifer Troin, 29, is a sales assistant in a children’s clothes store in Cogolin, France on April 13, 2017.Saphora Smith / for NBC News

Troin told NBC News that it wasn’t just the FN’s stance on Islam and immigration that attracted her, but also the party’s populist take on the economy.

But most of all, it was the party’s charismatic leader, Marine Le Pen, who captured Troin’s loyalty.

“She fights for women’s rights against Islam,” she said. “I vote because of Marine.”

Troin is part of a quiet army of female National Front supporters, who could well tip the balance of the election and give the presidency to the hard-right.

An FN victory would rewrite the continent’s political playbook, given the party’s pledge to take France out of the European Union. Were it to win, it would not have been an easy ride for a movement that peaked in 2002 when founder Jean Mari Le Pen — Marine Le Pen’s father — reached the second and final round of the presidential election.

French voters flocked to the polls in the runoff to ensure Le Pen did not win, instead electing former President Jacques Chirac with a resounding 78 percent of the vote. Most pollsters expect a similar outcome in May’s second-round vote, predicting moderate voters to rally once again to shut out the FN.

But few doubt that the party’s anti-immigrant and anti-establishment platform is resonating.

The Front’s anti-Islamic message is especially potent in France, whose 4.7 million Muslims make up around 7.5 percent of the population. Islamist militant attacks have killed more than 230 people over two years and plunged the country into a long-term state of emergency.

Play
Marine Le Pen: Mass Immigration Is a Tragedy for France 1:00

This anxiety deepened on the eve of the election after a gunman ambushed three Parisian police officers on the Champs-Elysees late Thursday, killing one and wounding two others. ISIS claimed responsibility for the shooting and French President Francois Hollande said it was likely a terrorist attack.

Meanwhile, the FN’s influence has spread from its heartlands along the Mediterranean coast and in the rust-belt north, into rural “forgotten” France.

‘Marine is different’

Polling institute Elabe recently predicted that 22 percent of women would vote for the National Front in the first round Sunday — almost 5 percent more than in 2012.

With just days to go, polls show the race is tightening. Centrist Emmanuel Macron is edging his way ahead on 24 percent and Le Pen is a fraction behind on 22.5 percent, according to Bloomberg polling.

Just below them, hard-left candidate Jean-Luc Melenchon has enjoyed a late surge and scandal-hit conservative Francois Fillon has hung in there despite a slew of allegations that he paid thousands of euros to his British-born wife for assistance she allegedly did not provide. A third of voters remain undecided.

Image: French far-right Front National leader Marine Le Pen is kissed by her father Jean-Marie Le Pen
Front National leader Marine Le Pen is kissed by her father Jean-Marie Le Pen after being re-elected as president of the party on Nov. 30, 2014.Laurent Cipriani / AP, file

The FN’s ability to motivate French women could be decisive. Traditionally, it has struggled to attract female voters amid accusations of sexism, racism and anti-Semitism.

In its early years under Jean-Marie Le Pen, the party advocated a traditional image of women, opposed abortion rights and developed a reputation for a macho, strongman culture.

This bias showed. The FN was far less successful at attracting women than men. During Jean-Marie Le Pen’ time in charge, around 12 percent of French women supported the party compared with 17 percent of men, according toSciences Po Cevipof, a political institute based in Paris.

Marine Le Pen changed this.

Since taking over in 2011, she has softened the party’s image, steering the FN away from some of its overtly anti-Semitic and racist rhetoric in an effort to broaden its electoral base. In 2015, she expelled her father after he repeated his view that the Holocaust was a “detail of history.”

In the run up to the this year’s election, Le Pen dropped her last name from campaign handouts, referring to herself simply as Marine.

More recently, she specifically targeted the female vote. She has published special pamphlets and a campaign video that describes her as a woman and a mother and shows her flicking through family photo albums. She has also changed the party’s logo from a flame to a blue rose.

‘Hitler-like figure’

For Troin, the children’s clothes seller in Cogolin, her interest in the National Front has grown with Marine Le Pen’s rise. While immigration, job security and her fear of Islam remained underlying motivators, she was also attracted to the party’s re-brand.

For her, the former leader “was too outspoken, too offensive. He was a Hitler-like figure,” Troin said. “But Marine is different.”

In the last presidential election in 2012 — the first with Marine Le Pen as leader — the party’s gender gap closed to 1.5 percentage points. It’s what Cevipof professor and FN expert Nonna Mayer called the “Marine Le Pen effect.”

The party has long advocated clamping down on immigration and securing borders, and throughout her campaign Le Pen has consistently made the country’s Muslims a target.

Image: Marine Le Pen supporters cheer
Marine Le Pen supporters cheer at a rally in the southern city of Marseille on Wednesday.Jeff J Mitchell / Getty Images

“In France we respect women, we don’t beat them, we don’t ask them to hide themselves behind a veil as if they were impure. We drink wine when we want, we can criticize religion and speak freely,” she said during a rally Monday night, comments clearly aimed at Muslims.

During the rally, Le Pen pledged to suspend all visas from non-European migrants hoping to join their families in France — often code for immigrants from mainly Muslim North Africa and the Middle East.

After Thursday night’s attack in Paris, she again singled out what she sees as the threat posed by Islam.

“It is a war in which there can be no retreat because all our population and all our territory are exposed,” she said.

And for all her rebranding, Marine Le Pen can also fall back into the older, harsher style of messaging.

Cathy, a 50-year-old dental assistant who was shopping for groceries in Cogolin, said she was all set to vote FN but was taken aback by Le Pen’s recent comments that the French were not to blame for the anti-Jewish policies of the government during the Nazi occupation in World War II.

Referring to the “Vel d’Hiv” roundup of Jews by French police in July 1942, in which nearly 13,000 were detained and deported to concentration camps, Le Pen told French radio earlier this month she thought France was “not responsible.”

Cathy, who didn’t want to be identified by her second name, said Le Pen’s remarks had made her pause.

“Perhaps she has the same ideas as her father but they’re just hidden behind good PR skills,” she said. “So I’m still thinking.”

Others needed no time to reflect.

“The FN is xenophobic, racist and anti-feminist,” said retired teacher Mireille Escarrat. “For me it feels like the 1930s. We’re going backwards.”

‘I don’t talk politics here’

Many of the National Front supporters interviewed by NBC News were reluctant to admit it, and others were concerned about being named.

“I don’t talk politics here,” a local woman said, having led the way into a backroom of her business in the town. The 60-year-old asked not to be named or for her business to be described because she felt that admitting her loyalty to the FN would damage her reputation.

“I wouldn’t mind if it weren’t for my business,” she added, out of earshot of her customers. “But this is somewhere everyone can come whether you vote communist or for the right.”

Even in this town — where 53 percent of the population voted FN in 2014 — voting Le Pen still carries a social stigma. There’s no telling just how many closet female FN voters there may be.

The party’s marriage of socialist economic policy and right-wing identity politics is working in the town, which sits in the FN’s traditional southern heartland. With the decline of traditional industries and unemployment at 18 percent, locals worry Cogolin is being reduced to a seasonal economy dependent on rich resort communities.

Newly-converted women at the FN’s regional headquarters in neighboring Sainte-Maxime said Sunday’s election would be the first time they voted for the Front in a presidential race.

“We didn’t vote for Jean-Marie Le Pen because he scared us,” said Monique Guckert, 67, a retired shop assistant. “His ideas were too fascist, too racist. It was too much.”

Image: Mayor Marc Etienne Lansade sits at his desk
Cogolin’s mayor Marc Etienne Lansade sits at his desk.Saphora Smith / for NBC News

Even the FN mayor of Cogolin, Marc Etienne Lansade, admitted his mother would never have voted for Jean-Marie Le Pen.

“He drove her crazy,” he said. “Women understand Marine Le Pen, she’s divorced, she has three children, she works — she’s a modern woman,” he added, sitting in his second-floor office in the town hall.

Still, not all women appreciate Le Pen’s message. On Monday, a topless protester carrying flowers charged the candidate during a rally northern Paris.

Le Pen does not try to make out that she is a feminist. Of her 144 manifesto pledges, only one addresses women’s issues. In it, she promises to defend women’s rights by fighting against Islam, implementing a plan for equal pay and combating social and job insecurity.

“She’s a fake feminist,” said Camille Froidevaux-Metterie, a political scientist and expert on women in politics at the University of Reims.

Asked if a Le Pen win would be a victory for women, she said that though symbolically “it would not be nothing.” She said it would mean France is ready for a female president but would have elected one on a non-feminist agenda.

“It’s a sort of paradox,” she said.

http://www.nbcnews.com/news/world/french-elections-marine-le-pen-backed-quiet-army-women-n748136

French elections: New poll shows Macron’s lead over Le Pen is narrowing

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