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Pence calls on GOP to ‘step up to the plate’ on health care bill

(CNN)Vice President Mike Pence is increasing the pressure for Republicans to pass health care legislation, calling on senators to “step up to the plate” and keep their seven-year promise.

The elevated rhetoric comes as the Republican health care legislation hangs by a tenuous thread.
The Senate is expected to vote on a plan to overhaul the Affordable Care Act next week, but what exactly that will be has yet to be announced. The Senate Republican leadership is urging members to pass a procedural vote to begin debate, but with Arizona Sen. John McCain out as he deals with newly diagnosed brain cancer, Majority Leader Mitch McConnell can only lose one member of his conference and still advance a bill.
    As of now, there’s no indication the votes are there.
    “We’re going to vote on whether to proceed to a bill,” Majority Whip John Cornyn of Texas said Thursday. “And I know people are fixated on what bill are we going to vote to proceed on — but the problem with that is that this is a unique process where every senator can offer amendments to change the bill. So it really is irrelevant what technical vehicle we proceed to. This is just strictly, are we going to start the debate, so people can offer amendments and so we can at some point finish.”
    President Donald Trump echoed Pence in a tweet Saturday morning.
    “The Republican Senators must step up to the plate and, after 7 years, vote to Repeal and Replace,” Trump wrote. “Next, Tax Reform and Infrastructure. WIN!”
    “ObamaCare is dead and the Democrats are obstructionists, no ideas or votes, only obstruction,” he continued in a follow-up tweet. “It is solely up to the 52 Republican Senators!”
    Pence reiterated the message Saturday night, saying he and the President “are going to keep fighting every single day until this Congress puts this bill on [Trump’s] desk.”
    “President Trump said it plainly the other day when he had every senator over to the White House,” Pence added. “He said he had pen in hand. He’s ready to act and the Senate health care bill, we believe, is the right bill at the right time to begin to repeal and replace Obamacare.”
    For now, the Trump administration is trying to come up with some kind of Obamacare replacement bill that will satisfy moderates. Centers for Medicare and Medicaid Services Administrator Seema Verma has been meeting in both group and individual settings with moderate hold-outs, hoping to convince them that there is a way to protect low-income people in their states once Medicaid expansion ends.
    A new Congressional Budget Office score Thursday showed that Republicans had more than $200 billion more to spend on health care and still make their budget target. That may give leaders and the White House some room to negotiate.
    But spending more money to win votes is making some Republicans uncomfortable.
    “It’s beginning to feel like there is a lack of coherency in what we’re doing, and it’s almost becoming a bidding process. Let’s throw $50 billion here, let’s throw $100 billion there. And again, it may write itself, but it’s making me uncomfortable right now,” said Tennessee Republican Sen. Bob Corker.

    Read more: http://www.cnn.com/2017/07/22/politics/pence-ohio-gop-dinner/index.html

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    Eight former CBO directors defend the agency amid Republican criticism

    (CNN)Eight former directors of the Congressional Budget Office sent a letter to congressional leadership Friday to underscore the agency’s importance and respond to criticism from Republican lawmakers and the White House.

    “We write to express our strong objection to recent attacks on the integrity and professionalism of the agency and on the agency’s role in the legislative process,” the letter said.
    The nonpartisan agency has come under fire in recent months for its analyses of several versions of the Republican House and Senate health care bills.
      Most recently, the CBO estimated Wednesday that the Senate bill to repeal but not replace the Affordable Care Act would leave 32 million more people uninsured by 2026 than under current law. A report Thursday estimated 22 million more would be uninsured under a full repeal and replace bill.
      Republicans have been openly critical of the CBO’s numbers. House Speaker Paul Ryan on Thursday called the CBO’s estimate “bogus” and “not credible.” Marc Short, the White House’s director of legislative affairs, and National Economic Council aide Brian Blase published an op-ed in The Washington Post on Sunday calling the CBO’s methodology “fundamentally flawed.”
      The White House even tweeted a video last week criticizing the CBO for inaccurately estimating ACA enrollment numbers. In May, White House Office of Management and Budget Director Mick Mulvaney questioned the agency’s very existence, asking the Washington Examiner, “Has the day of the CBO come and gone?”
      According to the signers of the letter to congressional leaders, the answer to Mulvaney’s question is no: The CBO has served the American people well for 42 years, the former directors contend.
      “As the House and Senate consider potential policy changes this year and in the years ahead, we urge you to maintain and respect the Congress’s decades-long reliance on CBO’s estimates in developing and scoring bills,” the letter said.
      Ryan and Senate Majority Leader Mitch McConnell did not immediately respond to a request for comment.
      The former directors include a number of scholars and executives of both conservative and liberal leanings: Dan Crippen, former executive director of the National Governors Association; Douglas Elmendorf, dean of the Kennedy school of Government at Harvard University; Douglas Holtz-Eakin, American Action Forum president; June O’Neill, Baruch College economics professor; Peter Orszag, managing director of Lazard; Rudolph Penner, Urban Institute fellow; Robert Reischauer, Urban Institute president emeritus; and Alice Rivlin, Brookings Institution senior fellow.
      Current CBO Director Keith Hall, a former staff economist for President George W. Bush, was chosen by GOP leaders in 2015. He did not sign the letter.
      While the signers acknowledged that not every CBO estimate is accurate, they argued that “such analysis does generate estimates that are more accurate, on average, than estimates or guesses by people who are not objective and not as well informed as CBO’s analysts.”
      The letter comes as McConnell plans to hold at least one vote on a Republican health care plan next week.

      Read more: http://www.cnn.com/2017/07/21/politics/former-cbo-directors-respond-criticism/index.html

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      Spicer’s exit will not lift White House siege as walls close in

      Washington (CNN)In a White House under siege, something had to change.

      Press secretary Sean Spicer’s resignation Friday let off a pressure valve, allowing an administration that is being pummeled on multiple and multiplying fronts the chance, at least for once, to dictate its own story.
      But Spicer’s departure after the most fraught six months of antagonism between the press and a West Wing that anyone can remember, is just one move in a shuffle of personnel and tactics that augurs an aggressive White House fightback that is likely to intensify the current discord in Washington.
        Trump has beefed up his legal team and escalated his rhetoric in an apparent attempt to discredit special counsel Robert Mueller, and any results of his probe into alleged collusion between his campaign team and Russian officials.
        Trump appears to be trying to revive his organization in an attempt to break out of a prolonged funk that has to a great extent wasted the first six months of his term — a time when presidents are usually at the apex of their power.
        But the reshuffle will not address what many critics see as the root of the crises that are assailing the White House the behavior and political conduct of the President himself. Scaramucci made that much clear.
        “The President himself is always going to be the President. I was in the Oval Office with him earlier today, and we were talking about letting him be himself, letting him express his full identity,” he said.
        “I think he’s got some of the best political instincts in the world, and perhaps in history.”
        Trump’s own behavior in recent days, in which he has all but declared war on both Mueller and his own Attorney General Jeff Sessions as well as revived questions over the Russia investigation in an astonishing interview with the New York Times, appeared at the least to call Scaramucci’s assessment of his political sense into question.
        His heated interventions also appear to be betraying the rising pressure inside the White House at the expanding allegations and investigations marching inexorably closer to the administration and the Trump family.
        News broken by CNN Friday that Mueller’s investigators asked the West Wing staff to preserve documents relevant to a meeting between Donald Trump Jr. and a Russian lawyer last year confirmed that the White House itself is now in Mueller’s crosshairs.
        Mueller is also moving inexorably closer to the thing Trump cares about most — his family — with both his son-in-law Jared Kushner and Donald Jr. under scrutiny over their past history of meetings with Russian intermediaries.
        Trump’s warning in the Times interview that it would be a “violation” if Mueller probed his personal finances, could indicate that he believes the special counsel is targeting tax returns he has refused to release.
        Trump’s position is that his and his family’s financial dealings are off limits, even though Mueller might view them as a possible tool to see whether his business history poses any conflicts of interests to the President’s current role.
        “The President’s point is that he doesn’t want the special counsel to move beyond the scope and outside of its mission,” Sanders told reporters after Scaramucci had vacated the podium. “And the President’s been very clear, as have his accountants and team, that he has no financial dealings with Russia.”
        The Russia pressure is not going to relent next week either.
        Key members of the Trump campaign team, including Donald Jr., Kushner and former campaign chair Paul Manafort have been asked to give testimony on Capitol Hill that would send Russia fever into overdrive.
        Meanwhile, the White House is still struggling for the kind of “wins” that Trump promised. Despite introducing new measures to curtail illegal immigration, there are few other obvious successes for the new communications team to trumpet. While jobs creation has remained steady and strong, the economy has not yet exploded into growth. And though the stock market has been on a bull run, many presidents find that tying their performance to the markets is a perilous practice.
        Scaramucci’s first job, in his first appearance at the podium in the White House Briefing Room on Friday, was to insist that the walls are not closing in around Trump. And he appeared to be performing as much for the President as the journalists in front of him and the audience watching at home.
        “I’ve seen this guy throw a dead spiral through a tire, I’ve seen him at Madison Square Garden with a topcoat on, standing in the key and hitting foul shots and swishing them — he sinks three-foot putts,” Scaramucci said.
        “I don’t see this as a guy who’s ever under siege. This is a very, very competitive person. Obviously there’s a lot of incoming that comes into the White House. But the President’s a winner and what we’re going to do is we’re going to do a lot of winning.”
        Scaramucci’s attitude to his new job appears, for public consumption at least to be that Trump is actually doing a great job as president, but that his successes have simply not been properly communicated to the nation.
        “When you look at the individual state by state polls, you can see the guy’s doing phenomenally well,” Scaramucci said. “It’s indicating to me that the president is really well loved. There seems to be a disconnect in terms of some of the things that are going on and we want to connect that.”
        Scaramucci’s smooth, urbane performance was in contrast to the antagonistic and defensive performances from the podium that characterized much of Spicer’s tumultuous tenure as White House spokesman.
        But it was a contrast in style more than it was a contrast in substance.
        He punted on the question of Trump’s unproven assertion that millions of illegal votes cost him victory in the popular vote against Hillary Clinton in last year’s election. But he was careful not to contradict the President in one of his most infamous falsehoods, suggesting that questions of credibility and truthfulness will continue to be an issue once he is running the show.
        “If the president says it, … let me do more research on it, My guess is that there’s probably some level of truth to that,” Scaramucci said.

        Read more: http://www.cnn.com/2017/07/21/politics/donald-trump-sean-spicer-crises/index.html

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        Trump’s blast of Sessions has ‘chilling’ effect inside West Wing

        Washington (CNN)For President Donald Trump, loyalty in Washington is a one-way street.

        Trump’s trashing of several of his administration’s top justice officials in an interview with The New York Times on Wednesday, including Attorney General Jeff Sessions, is causing deep alarm inside the West Wing, leading some to worry that their loyalty to Trump might not be reciprocated from the man in the Oval Office.
        There’s also a general sense of bewilderment as to why Trump gave the interview. Health care was the focus of the day. He actually got engaged — but then this.
          “It’s chilling,” one White House official said.
          Conversations with the official and one top Republican in frequent contact with the West Wing show a president who has long been angry with Sessions’ decision to recuse himself from the Russia probe, but rather than subsiding and moving on as Trump sometimes does, the anger has grown into a passionate rage.
          “No one was more loyal than Sessions. No one,” a White House official said, speaking confidentially to avoid drawing the President’s ire.
          The thinking goes: If this could happen to Sessions, it could happen to anyone. One official described the President’s blasting of Sessions as only intensifying the already low morale inside the West Wing.
          Trump faulted Sessions for accepting his offer to be attorney general and then recusing himself shortly thereafter due to undisclosed contacts he had with Russian officials during the campaign. The President said those actions were “very unfair” to him.
          “Sessions,” Trump told The New York Times, “should have never recused himself and if he was going to recuse himself he should have told me before he took the job and I would have picked somebody else.”
          He added: “How do you take a job and then recuse yourself? If he would have recused himself before the job, I would have said, ‘Thanks, Jeff, but I’m not going to take you.’ It’s extremely unfair — and that’s a mild word — to the President.”

          Loyalty

          The comments are a stunning rebuke from a president who craves loyalty, demanding it from those who work for him. Trump has written extensively about the trait in his books, as well, touting it as the most critical quality as person can have.
          But as Trump has eased into life in the White House, his demands for loyalty have proven to be unrequited, most recently shown by how he lashed out at Sessions, one of his earliest and most dedicated supporters.
          Sessions declined to hit back at Trump during a press briefing Thursday, telling reporters that he “plan(s) to continue to do so as long as that is appropriate.”
          Sessions loyalty to Trump has been unflinching for years. The conservative senator was his first Senate endorsement, long before any other Republican heavyweights were on board. The senator also stood by Trump after the Access Hollywood tape controversy, where Trump was heard making lewd comments about sexually assaulting women. And Sessions even helped fill Trump’s inner circle with confidants of his own, including Stephen Miller, Trump’s top policy aide, and Rick Dearborn, a top White House legislative aide.
          The acrimony between Trump and Sessions has long been simmering — Sessions tendered his resignation earlier this year but Trump declined to accept it — but Wednesday’s comments signal a shift in Trump’s leadership style, one that former employers used to say rested on unflinching loyalty to the company and, more importantly, the boss.
          Earlier in his career, during a question-and-answer session from The Learning Annex Wealth Expo, Trump was asked for the “key things” a boss should look for when hiring someone and building a team.
          “The thing that’s most important to me is loyalty,” Trump said. “You can’t hire loyalty. I’ve had people over the years who I swore were loyal to me, and it turned out that they weren’t. Then I’ve had people that I didn’t have the same confidence in and turned out to be extremely loyal. So you never really know.”

          One-way street

            Comey: Trump asked to lift ‘cloud’ of probe

          He brought those beliefs to Washington by bringing many of his own employees with him, but his credo now appears to be Trump asking for loyalty, not giving it back.
          Trump asked fired FBI Director James Comey for his loyalty during a January 27 dinner at the White House, Comey said in written testimony to the Senate earlier this year.
          “I need loyalty, I expect loyalty,” Comey recalled Trump saying, adding later that the soon-to-be fired FBI director offered him “honest loyalty.”
          Trump later fired Comey in May, citing his disloyalty as one of the reasons in later interviews.
          The President also asked Republicans in the House to stick with him on health care reform, touting the bill as “incredibly well crafted” during a Rose Garden ceremony after narrowly it passed the House. Weeks later, Trump went back on those comments and called the House health care bill “mean” in a meeting with senators.
          The remark shocked some lawmakers who stuck with Trump on health care, despite the political perils.
          Rep. Louie Gohmert, a Texas Republican and member of the conservative House Freedom Caucus, was flummoxed when CNN asked him what he thought of the President calling the bill “mean.”
          “The one,” he asked, “that he had us come over and celebrate?”

          Long-held belief

          Those close to Trump have long said loyalty is critical to him.
          Bill Zanker, the president and founder of The Learning Annex who wrote “Think Big: Make It Happen in Business and Life” with Trump in 2009, put it bluntly in his intro to the self-help book: “Loyalty is important to Trump and is a wonderful trait to have in business.”
          “I try to hire people who are honest and loyal. I value loyalty very much,” they wrote. “I put the people who are loyal to me on a high pedestal and take care of them very well … I go out of my way for the people who were loyal to me in bad times.”
          And former employees, who requested anonymity to speak bluntly, said Trump’s desire for loyalty is the reason why he brought someone like Keith Schiller, his longtime bodyguard and adviser, into the White House. Schiller is an asset to the White House, many who know him say, but his steadfast loyalty is his biggest asset to Trump.
          Trump’s love of loyalty stems, according to those close to him, to his mentor Roy Cohn, who stood by Trump and his family in the face of housing discrimination and grew into his guide through the rough New York real estate industry.
          “Sometimes I think that next to loyalty, toughness was the most important thing in the world to him,” Trump wrote of Cohn in his 1997 urtext “The Art of the Deal.”
          “He was a truly loyal guy — it was a matter of honor with him,” Trump wrote. “And because he was also very smart, he was a great guy to have on your side.”

          Read more: http://www.cnn.com/2017/07/20/politics/trump-loyalty-sessions-white-house/index.html

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          Mitch McConnell ‘master tactician’ label damaged after Senate health care fight

          (CNN)The looming defeat of the Senate health care bill marks a dramatic low point in the otherwise lofty political career of Mitch McConnell, the chamber’s majority leader who is often described as a disciplined “master tactician” of the Senate accustomed to methodically building legislative victories for Republicans.

          But repealing and replacing the Affordable Care Act — the hot button and emotionally-charged issue that sharply split his party — proved to be too difficult a task for now, something McConnell acknowledged at a crowded Capitol news conference where he was asked bluntly if his “leadership” had been “damaged” by the process.
          “This has been a very, very challenging experience for all of us,” McConnell replied. “A lot of people have been involved in the discussion and very passionate discussions. But everybody’s given it their best shot. And as of today, we just simply do not have 50 senators who can agree on what ought to replace the existing law.”
            It was a stunning admission for the GOP leader who made getting rid of Obamacare a mission since it was enacted seven years ago, and his top legislative priority for the past six months as Republicans controlled the White House and both chambers of Congress.
            Few people in Washington bet against McConnell, who successfully negotiated highly complex deals in the past like the 2011 fiscal cliff agreement during the administration of President Barack Obama. The 75-year-old, soft-spoken Kentuckian, who has led Republicans for the last 10 years, also had the political fortitude to block Obama when he tried to fill a Supreme Court vacancy and successfully kept it open for a year until it was filled by President Donald Trump.
            “Mitch McConnell knows how to do things, and I think we’re going to have some really great health care for a long time,” Trump said at a Rose Garden celebration after the House passed its version of the Obamacare repeal and sent it to the Senate.
            But McConnell drew immediate fire from some members of his Republican conference for his decision to bypass the “regular order” for health care, a process he so often advocates. Through that approach, committees of jurisdiction would hold public hearings and draft compromise legislation that could then move to the floor with significant support and momentum.
            “The Congress must now return to regular order, hold hearings, receive input from members of both parties, and heed the recommendations of our nation’s governors so that we can produce a bill that finally provides Americans with access to quality and affordable health care,” said Sen. John McCain in a statement Tuesday from Arizona, where he is recovering from surgery.
            Instead, McConnell created a small “working group” of about a dozen members, who happened to all be men, and huddled with leadership aides behind closed doors in his suite to try to cut a deal. Some Republicans were angered at being excluded and for the secrecy of the group.

              McConnell: We can’t agree on replacement

            The group invited in other members — like the handful of moderate Republicans from swing states concerned about potential cuts to Medicaid — but somehow the force of those wary moderates’ convictions didn’t resonate fully with McConnell who thought that in the end, their espoused disdain of Obamacare would secure their votes no matter what.
            In the end, it was that group of moderates that formed the bulwark against the bill, forcing McConnell to pull it from consideration before the July 4 recess and now to consider putting a revised bill on the floor where it appears destined for defeat.
            “I did not come to Washington to hurt people,” said Sen. Shelley Moore Capito, a West Virginia Republican, in a remarkable statement announcing her opposition to McConnell’s latest proposal. “My position on this issue is driven by its impact on West Virginians. With that in mind, I cannot vote to repeal Obamacare without a replacement plan that addresses my concerns and the needs of West Virginians.”
            Conservatives also chaffed at the deal. Sen. Rand Paul, the other Republican senator from Kentucky, never got on board, claiming McConnell’s approach never fully undid Obamacare.
            McConnell also suffered by not having a consistent partner in Trump. The President never fully engaged in the negotiations nor in selling the deal. He didn’t barnstorm the country selling the deal or hold many White House meetings to press wavering senators to get on board. Trump has invited all 52 GOP senators to 1600 Pennsylvania Avenue for lunch on Wednesday, a White Official told CNN.
            Senate Republicans also did little to promote their efforts. They organized few of the typical press events on the Hill where advocates talk about the need for reform and McConnell rarely did TV interviews and other events to promote the bill. A CNN whip list of GOP senators show 41 of 52 not publicly supporting the bill.
            Senate Republicans held a spirited closed-door caucus meeting in the Capitol at lunchtime. It was evident that senators were “upset,” according to one GOP source briefed on the meeting. But the anger “was not all directed at” McConnell for his handling of the bill in part because “there are so many different factions” in the conference on the healthcare issue, the source said.
            However, one conservative, Sen. Ron Johnson, R-Wisconsin, was furious with McConnell over reports the leader had said privately the long-term Medicaid reforms in the revised bill would never come to fruition, something McConnell denied.
            Johnson was asked by CNN Tuesday if he still had faith in McConnell as GOP leader and he would not answer yes.
            “I found those comments very troubling,” was all Johnson would say.
            Johnson appeared to be the only GOP senator so vocally upset with McConnell for his mishandling of the health care bill.
            As McConnell moves now to have final votes on the bill sometime early next week, he must decide whether to return to “regular order” and try again to build support to reverse Obamacare or let the issue go for now and turn to other pressing business, like tax reform, government spending, an increase in the debt ceiling and other legislation.
            Asked how he will explain to voters the defeat of health care after such a long commitment to passing it, McConnell was hopeful.
            “Well, we have a new Supreme Court justice,” he said. “We have 14 repeals of regulations. And we’re only six months into it. Last time I looked, Congress goes on for two years.”

            Read more: http://www.cnn.com/2017/07/18/politics/mitch-mcconnell-health-care-fight/index.html

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            Sen. Ron Johnson unsure if he will support motion to proceed now

            (CNN)Sen. Ron Johnson — who opposed the first version of the GOP health care bill — told reporters last week that he would at the very least vote “yes” on whether to debate the GOP’s newest version of the bill on the floor.

            Now, however, it appears the Wisconsin Republican has had a change of heart.
            “Last week I was strongly urging colleagues to vote motion to proceed,” Johnson told reporters on Capitol Hill Monday evening. “I’m not doing that right now.”
              Johnson said he became concerned about supporting the leadership’s health care bill after reading a report in the Washington Post that cited an anonymous lobbyist saying that Majority Leader Mitch McConnell was telling moderate Republicans that steep cuts to Medicaid would never go into effect. Under the GOP health care bill, the growth rate in Medicaid would change from medical inflation to standard inflation beginning after 2025. The standard inflation rate is less generous than the medical inflation one.
              McConnell responded to Johnson’s comments Monday night.
              “I prefer to speak for myself, and my view is that the Medicaid per capita cap with a responsible growth rate that is sustainable for taxpayers is the most important long-term reform in the bill. That is why it has been in each draft we have released,” McConnell said in a statement.
              According to the Post’s source, McConnell had told senators that probably wouldn’t ever happen in an attempt to win their support.
              “He’s trying to sell the pragmatists like (Sen. Rob) Portman, like (Shelley Moore) Capito on ‘the CPI-U will never happen,'” the GOP lobbyist told the Post.
              Johnson, who has been supportive of overhauling Medicaid, said that he personally confirmed McConnell had made the assurances to some of his colleagues and that he was deeply troubled by the report.
              “You know I was strongly in favor of doing that last week before I read the comments by Sen. McConnell,” Johnson said. “I’ve confirmed those from senators that those comments were made too so I find those comments very troubling, and I think that really does put in jeopardy the motion to proceed vote.”
              He added later that the comments were “a real breach of trust.”
              Johnson said that he plans to tell McConnell he has concerns during the GOP lunch Tuesday. McConnell’s health care bill was already hanging on by a thread and after Republican Sen. John McCain of Arizona had to have surgery for a blood clot, leadership had to delay the vote. McConnell can only afford to have two Republican senators vote against the motion to proceed. One more and the legislation cannot be advanced.

              Read more: http://www.cnn.com/2017/07/17/politics/ron-johnson-health-care-support/index.html

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              Lindsey Graham: John McCain is like his old self again after surgery

              (CNN)Sen. Lindsey Graham said his closest friend in the Senate, Sen. John McCain, is like his old self again after surgery Friday to remove a blood clot above his left eye.

              Graham said he spoke with McCain by phone on Sunday after the surgery in Arizona. He said McCain was doing much better and already itching to get back to Washington, though his doctors have told him he can’t fly for a week while he recovers.
              “He sounded like a different person. He clearly was a hurting guy,” Graham said. “I think they relieved the pressure and he sounded like the old John McCain, dying to get back and talking about driving across the country. I said no.”
                Graham told CNN’s Manu Raju that McCain had not been feeling well in the run-up to the surgery and was “getting forgetful.”
                “He’d been traveling a lot, we wrote it off that he was tired, but he was getting forgetful — and you know he just wore himself out traveling all around the world,” Graham said. “I’m glad they found out what I thought was the cause.”
                Later on Monday, Graham told CNN he wanted to retract that statement, saying that he did not mean to say that McCain was getting forgetful.
                The Senate has delayed consideration of the health care bill this week with McCain’s absence, as his vote at the moment would almost surely be needed for Republicans to get to 50 “yes” votes to pass the bill. McCain’s office has said he’ll be out at least a week.
                Graham, a South Carolina Republican, spoke to McCain again by phone on the way to Monday evening’s Senate vote — the first that McCain was missing following the surgery .
                Graham said it was a major surgery, but also has led a good outcome.
                “He’s got to heal up or he’ll take a step backwards,” Graham said. “I think they don’t want him to fly for a week. But I think he would walk back if they’d let him. … He’s dying to get back and for the sake of his family I hope he doesn’t have to stay there over a week.”
                In addition to the health care vote, McCain is supposed to lead debate on the annual National Defense Authorization Act on the Senate floor.
                Graham said it wasn’t clear yet if McCain would be back next week.
                “I don’t know. If it were up to him, he’d be on his way now,” he said. “But he … for once in his life, listen to his doctors. … He’s been hit pretty hard so it’s going to take a while.”

                Read more: http://www.cnn.com/2017/07/17/politics/lindsey-graham-john-mccain/index.html

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                Mike Pence’s two misleading Medicaid claims

                Washington (CNN)Vice President Mike Pence was sent to the National Governors Association’s meeting in Rhode Island on Friday to convince skeptical Republican governors to back the Senate GOP’s health care bill.

                But two of his claims — one broad defense of how the GOP bill would handle Medicaid, and one much more specific comment about waiting lists in Ohio — have Pence facing criticism from his own party.
                In both cases, Pence omitted critical context.
                  Those omissions go to the heart of the concerns about the bill among many within the GOP. In at least two cases, Republicans cited Pence specifically in voicing their displeasure with the bill in recent days.

                  ‘Strengthens and secures Medicaid’

                  Pence’s broad defense of the bill included this line: “President Trump and I believe the Senate health care bill strengthens and secures Medicaid for the neediest in our society, and this bill puts this vital American program on a path to long-term sustainability.”
                  Behind closed doors, Pence and top Trump health officials who met with governors stuck to the technically true claim that Medicaid spending would continue to increase under the GOP bill.
                  However, the Senate Republican plan would spend $772 billion less on Medicaid over the next 10 years when compared to current law, according to the Congressional Budget Office. That’s a 26% cut in the year 2026 from what would be spent under current law.
                  And starting in 2025, it would attach growth in Medicaid spending to the Consumer Price Index instead of tying it to medical inflation. Standard inflation has grown at a much slower rate than medical inflation.
                  The CBO projected this would force states to shrink their Medicaid programs — leading to 15 million fewer Medicaid enrollees within the next decade. Many Republicans are preemptively discrediting the CBO’s analysis, though, ahead of a new score expected this week.
                  The plan maintains many of Obamacare’s subsidies to help people pay for individual insurance and provides money to stabilize the Obamacare market over the next few years. And, Pence and other top Republicans have argued, the Trump administration would grant states much more flexibility to make cost-saving changes to the traditional Medicaid program. Pence cited a plan he expanded in Indiana as one example.
                  “States across the country will have an unprecedented level of flexibility to reform Medicaid and bring better coverage, better care, and better outcomes to the most vulnerable in your states,” Pence said.
                  However, Democratic governors mocked the notion that increased flexibility could make up for major cuts in federal spending.
                  “They repeatedly pretended that the federal government saving hundreds of billions of dollars won’t translate to actual cuts,” Connecticut Gov. Dan Malloy told CNN on the sidelines of the NGA meeting, after governors met privately with Health and Human Services Secretary Tom Price and Centers for Medicare and Medicaid Services Administrator Seema Verma. “I was told that I’ll innovate sufficiently to save them hundreds and hundreds of billions of dollars.”
                  Maine Republican Sen. Susan Collins also took issue with Pence’s claims on CNN’s “State of the Union” Sunday.
                  “I would respectfully disagree with the vice president’s analysis,” Collins said. “This bill would impose fundamental, sweeping changes in the Medicaid program, and those include very deep cuts. That would affect some of the most vulnerable people in our society, including disabled children, poor seniors. It would affect our rural hospitals and our nursing homes. And they would have a very difficult time even staying in existence.

                  ‘Stuck on waiting lists’

                  Pence cited by name another Republican who has criticized the GOP bill — Ohio Gov. John Kasich — while claiming his state, which is among the 31 states and the District of Columbia to expand Medicaid under Obamacare, now faces steep waiting lists for coverage.
                  Here’s what Pence said: “Obamacare has put far too many able-bodied adults on the Medicaid rolls, leaving many disabled and vulnerable Americans at the back of the line. It’s true, and it’s heartbreaking. I know Gov. Kasich isn’t with us, but I suspect that he’s very troubled to know that in Ohio alone, nearly 60,000 disabled citizens are stuck on waiting lists, leaving them without the care they need for months or even years.”
                  Experts from the Kaiser Family Foundation say that waiting lists for these services are longer in states that have not expanded Medicaid under Obamacare than they are in states that have expanded.
                  Kasich didn’t attend the meeting. But back in Ohio, his aides lashed out, noting that the waiting lists are related to Medicaid’s home and community-based services and have nothing to do with Ohio’s decision to expand Medicaid under Obamacare.
                  “The claim is not accurate. It’s been fact checked twice,” Kasich’s communications department said on Twitter, linking to fact-checks from The Los Angeles Times and the Columbus Dispatch.
                  Kasich consultant John Weaver took to Twitter to urge Pence to “stop spreading Fake News to further dishonest sales pitch on health care bill which hurts millions!”
                  Pence’s office has not responded to CNN’s request for comment on the Kasich camp’s criticism.

                  Read more: http://www.cnn.com/2017/07/17/politics/mike-pence-medicaid-fact-check/index.html

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                  Governors skeptical after ‘pretty atrocious’ session with top Trump health officials

                  Providence, Rhode Island (CNN)Governors confronted President Donald Trump’s top health officials over the cost of the Republican health care push to their states in a tense, closed-door session here Saturday.

                  Vice President Mike Pence, Health and Human Services Secretary Tom Price and Centers for Medicare and Medicaid Services Administrator Seema Verma made a frantic bid at the National Governors Association meeting Friday and Saturday to win over — or at least silence — skeptical GOP governors.
                  But their efforts left major questions unanswered, Republican and Democratic governors said.
                    And Pence’s speech Friday resulted in the vice president openly feuding with Ohio Gov. John Kasich, a Republican who didn’t attend the governors’ meeting.
                    Price and Verma had been dispatched to the meeting in Rhode Island to convince governors that their states could absorb the elimination of enhanced Medicaid funding for low-income adults who received coverage under the Affordable Care Act and the reduction of federal support for their overall Medicaid programs.
                    They urged governors to ignore Congressional Budget Office estimates that 15 million fewer people would be covered by Medicaid by 2026 and that $772 billion would be cut from the program, compared to current law, under a Senate Republican bill that would eliminate Obamacare’s expansion of the program.
                    Their argument: States would gain flexibility to overhaul their traditional Medicaid programs through block grants or per-enrollee caps, allowing them to save money that could be used to stave off losses of coverage.
                    But the closed-door session with Price and Verma on Saturday was “pretty atrocious,” said Connecticut Democratic Gov. Dan Malloy.
                    “They repeatedly pretended that the federal government saving hundreds of billions of dollars won’t translate to actual cuts,” he said. “I was told that I’ll innovate sufficiently to save them hundreds and hundreds of billions of dollars.”
                    Republicans also emerged from the meeting saying they remain concerned about the long-term financial fallout of the bill.
                    “I think there’s disagreement on the outcomes and what that means and whether that is manageable,” said Arkansas Gov. Asa Hutchinson, a Republican whose state expanded Medicaid.
                    “It is a huge challenge for us in terms of communicating what the future is going to be like to our health care providers,” Hutchinson told CNN after the meeting. “That is the challenge for governors — we’re on the front lines here. … It’s the long term that people want to know about.”
                    Another key governor, Nevada Republican Brian Sandoval, told reporters afterward that he remained concerned about the bill’s elimination of funding for Obamacare’s Medicaid expansion, which led 210,000 Nevadans to gain coverage. Nevada Republican Sen. Dean Heller has closely linked his vote to Sandoval’s position.
                    Malloy said he argued with Price and Verma when — after Verma had taken issue with the Congressional Budget Office forecasts of coverage losses — Price cited the CBO analysis to back up a separate point.
                    “They were incredibly inconsistent between themselves,” he said. “They support what they like from CBO, and they attack CBO. But at least the secretary was forced to admit that’s the only public generated analysis.”
                    Just before Price and Verma spoke Saturday morning, the consulting firm Avalere Health delivered a presentation that forecast cuts in federal Medicaid funding to the states of 27% to 36% by 2036 under the Senate legislation when compared to current law.
                    Some governors said that presentation left them less certain about the Trump administration’s claims that Medicaid funding would not decline.
                    “I think there’s still some confusion on numbers,” said Wyoming Gov. Matt Mead, a Republican. “And so, frankly, I wish we would have had more time this morning to ask questions. There’s still a lot of questions from Republicans and Democrats.”
                    Mead said there is a clear divide among GOP governors based on whether their states expanded Medicaid. Mead’s state did not. But he said he’s still struggling with a “state of flux” on Capitol Hill over health care.
                    At the center of the case Pence, Price and Verma made to governors was increased flexibility to make changes to their states’ Medicaid programs. Under the bills, states could opt to receive a lump sum of money — known as a block grant — to cover certain Medicaid recipients. They would receive more control over their programs in exchange.
                    The bill’s critics, however, say that cash-strapped states won’t be able to make up for the losses in federal funding even with the additional flexibility. States would be forced to cut enrollment, benefits or provider rates, they argue.
                    The Trump administration has pledged to aggressively grant states’ requests for waivers that would allow them to deviate from traditional Medicaid, and the House and Senate health care bills would give federal officials even further authority to grant those waivers, giving states additional freedom to craft their own programs using federal dollars.
                    That, Republican governors said, is good news. Hutchinson said Price and Verma gave governors “a number of new ideas that had not been considered before.”
                    Pence’s speech Friday drew a tepid reception from Republicans and Democrats in attendance.
                    He made a reference to Kasich, saying, “I suspect that he’s very troubled to know that in Ohio alone, nearly 60,000 disabled citizens are stuck on waiting lists, leaving them without the care they need for months or even years.”
                    That claim, though, is bogus, Kasich’s office said. The waiting lists are related to Medicaid’s home and community-based services and had nothing to do with Ohio’s decision to expand Medicaid under Obamacare.
                    “The claim is not accurate. It’s been fact checked twice,” Kasich’s communications department said on Twitter, linking to fact-checks from The Los Angeles Times and the Columbus Dispatch.
                    At the same time Price and Verma were attempting to win over governors, the White House was circulating a new op-ed in The Washington Post in which Trump aides Marc Short and Brian Blase argued that Americans and lawmakers should give “little weight” to CBO projections that millions would lose coverage under the Senate GOP bill.
                    “The CBO’s methodology, which favors mandates over choice and competition, is fundamentally flawed,” the two argued. “As a result, its past predictions regarding health-care legislation have not borne much resemblance to reality. Its prediction about the Senate bill is unlikely to fare much better.”

                    Read more: http://www.cnn.com/2017/07/15/politics/trump-health-care-governors/index.html

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                    McConnell delays health care vote while McCain recovers from surgery

                    (CNN)Senate Majority Leader Mitch McConnell announced Saturday that the Senate will delay consideration of the Republican health care bill while Sen. John McCain recovers from surgery for a blood clot.

                    McConnell tweeted that the Senate will work on other legislative issues and nominations next week and “will defer consideration of the Better Care Act” while McCain is recovering.
                    McCain is in Arizona after having a blood clot removed from above his left eye. His office said the clot was discovered during an annual physical and removed Friday at the Mayo Clinic Hospital in Phoenix.
                      “Thanks to @MayoClinic for its excellent care — I appreciate your support & look forward to getting back to work!” McCain’s verified account tweeted Saturday.
                      Senate Republicans unveiled a revised version of their health care bill Thursday, and GOP leaders had planned a vote, or at least to take the procedural steps toward a vote, in the upcoming week.
                      That procedural vote could have come as early as Tuesday.
                      McConnell needs the support of 50 of 52 GOP senators to proceed to a floor debate on the bill, and two senators — Susan Collins of Maine and Rand Paul of Kentucky — have already said they will not support that motion.
                      McCain said in a statement Thursday: “The revised Senate health care bill released today does not include the measures I have been advocating for on behalf of the people of Arizona.” McCain said that he would file amendments that would address concerns of leaders from his state about how the bill would affect Medicaid.
                      His office released a statement saying McCain, 80, is resting at his home.
                      “His Mayo Clinic doctors report that the surgery went ‘very well’ and he is in good spirits,” his office said. “Once the pathology information is available, further care will be discussed between doctors and the family.”
                      Doctors ordered a week of rest, the statement from McCain’s office said.
                      The other Republican senator from Arizona praised McCain.
                      “I have never known a man more tenacious and resilient than John McCain,” Jeff Flake said. “I look forward to seeing him back at work soon. In the meantime, Cheryl and I extend our best wishes to John, Cindy and the entire McCain family and pray for his speedy recovery.”
                      Senate Minority Leader Chuck Schumer, a New York Democrat, tweeted: “Praying for a speedy recovery for my friend @SenJohnMcCain.”

                      Read more: http://www.cnn.com/2017/07/15/politics/john-mccain-blood-clot/index.html