Republicans Run for Cover as Trump Pushes Health Care

Plus, Trump's $700 million foreign aid decision

Republicans Run for Cover as Trump Pushes Health Care

President Trump’s decision to relaunch the fight over the Affordable Care Act may have thrown Republican lawmakers for a loop, but the president isn’t backing down. “The cost of ObamaCare is far too high for our great citizens,” he tweeted Monday. “The deductibles, in many cases way over $7000, make it almost worthless or unusable. Good things are going to happen!”

It’s not clear, though, what those good things might be, or how and when they might happen. Here’s why.

Congressional Republicans aren’t on board: “Republicans have no intention of heeding President Trump’s urgent demands for a new health-care plan to replace the Affordable Care Act, fearing the potential political damage that such a proposal could cause in 2020 and hoping he will soon drop the idea, according to interviews with numerous GOP lawmakers, legislative staffers and administration aides,” The Washington Post’s Seung Min Kim and Josh Dawsey reported over the weekend. “Not only is there no such health-care overhaul in the works on Capitol Hill — there are no plans to make such a plan.”

Asked whether two Senate committees overseeing health care plan to draft another Obamacare replacement plan, Senate Finance Committee Chairman Chuck Grassley (R-IA) gave the Post a flat “No,” noting that the courts won’t decide Obamacare’s fate for a long time.

Even the senators supposedly working on a plan are hedging: Trump told reporters last week that Republican Sens. John Barrasso of Wyoming, Bill Cassidy of Louisiana and Rick Scott of Florida will be coming up with a health care plan that’s “really spectacular.” The president’s tweet Monday again mentioned those three senators along with Senate Majority Leader Mitch McConnell.

But there doesn’t appear to be a working group formally tasked with devising an Obamacare replacement plan. "I think the president just listed off the names of people he's spoken to on the phone about health care," one Senate Republican aide told CNN.

And when Chuck Todd, host of NBC’s “Meet the Press” on Sunday asked Barrasso a straightforward question — “Should the American people expect an actual health care plan alternative from the Republican Party this year?” — he got a less than straightforward answer. “The American people should expect to not have to be burdened with the incredible costs that are affecting them now, as a result of the healthcare law,” Barrasso said, deflecting.

Scott, on CBS’s “Face the Nation,” seemed to indicate he expects a proposal from the White House. “I look forward to seeing what the president's going to put out,” he said. He also told the Post that, while he’s going to try to get something done, “I think it accelerates everything if the White House had a plan.”

And Scott is probably not the best person to pitch the GOP as “the party of health care”: The Florida senator on Friday unveiled legislation aimed at reducing prescription drug prices, but his background opens him and the GOP up to easy criticism. Scott was CEO of the hospital group Columbia/HCA in the 1990s. The company later agreed to plead guilty to at least 14 corporate felonies and pay the government $1.7 billion for its actions while he was in charge, in what the Justice Department at the time called the “largest health care fraud case in U.S. history.” The Washington Post’s James Downie cracks that Scott is on Trump’s health care team “because no one knows how to fix U.S. health care better than a man who took in millions while overseeing a company committing massive Medicare fraud.”

Republicans are reportedly rooting for the lawsuit challenging the ACA to fail: Republicans may not like the Obama health care law, but they know that having it wiped off the books while Congress is divided could be a recipe for chaos. “If you’re looking strictly at political outcomes, it could be argued that a lot of members don’t want to see this struck down because they don’t want to deal with the fallout,” an unnamed “senior Republican senator” told The Hill.

Trump himself doesn’t think the lawsuit challenging the ACA will succeed: “Trump has privately said he thinks the lawsuit to strike down the Affordable Care Act will probably fail in the courts, according to two sources who discussed the matter with the president last week,” Axios’s Jonathan Swan reports.

But he wants to press ahead on health care anyway: Aides tell The Post that the idea is to address what Trump sees as his biggest political vulnerability heading into the 2020 elections. “Trump's view is that Democrats are going to bash him up on health care in 2020 regardless, so ignoring the issue won’t work,” Axios’s Swan says. So Trump wants to market the GOP as “the party of health care,” and he knows that repeating the message is key to selling it: “He plans to repeat this message again and again and again,” Swan says. Plan or no plan, the president may not be easily swayed by those Republicans looking to change the subject or simply wait out the White House.

And the White House just may come up with a plan: The White House has secretly been working on a health care proposal with three right-leaning think tanks — the Heritage Foundation, the Mercatus Center and the Hoover Institute — for months, the conservative Washington Examiner reports. Policy leaders at the think tanks told the Examiner than the plan would take concepts from previous GOP health care proposals. But a conservative policy analyst indicated that it may be quite some time before there’s a concrete plan. “I don’t think there’s anything that’s fully formed,” the analyst said. “I think a lot of the devil’s in the details.”

For now, the GOP health care agenda is still mostly talk.

Trump Cutting $700 Million in Aid to 3 Central American Countries

President Trump announced Friday that he is cutting aid to three Central American countries in response to a surge in the number of migrants headed north toward the U.S. in recent days.

“I’m not playing games. I've ended payments to Guatemala, to Honduras and to El Salvador,” Trump said. “No more money is going there anymore. We were giving them $500 million. We were paying them tremendous amounts of money, and we’re not paying them anymore because they haven’t done a thing for us. They set up these caravans.”

Trump also threatened to close the border with Mexico in a series of tweets on Friday and Saturday.

Here’s what you need to know about the Trump administration’s latest moves on immigration:

Why aid is being cut: Trump has accused the governments of the three central American countries of being complicit in the flow of migrants northward, and cutting aid is apparently intended to punish those governments. The president has repeatedly referred to foreign countries “sending” migrants to the U.S., most famously during the 2016 campaign, when he said: “When Mexico sends its people, they're not sending their best.” And Trump recently mocked the idea that Latin American migrants coming to the U.S. are fleeing violence. “It’s a big fat con job, folks,” Trump said at a rally in Michigan.

How much money is involved: Current estimates put the aid figure at roughly $700 million. The State department said Saturday that the money was appropriated in the 2017 and 2018 fiscal years, and that the department would be “be engaging Congress as part of this process” of cutting off the aid.

The U.S. Global Leadership Coalition, a group of retired diplomats, military leaders and lawmakers, said that “U.S. assistance to Central America is just 0.00035% of entire U.S. federal budget and has decreased by 20% in last two years.”

Will it work? Trump’s acting chief of staff, Mick Mulvaney, defended the president’s move over the weekend, dismissing the views of “career staffers” at the State Department while arguing that continued flows of immigrants from Guatemala, Honduras and El Salvador proves that the current U.S. strategy isn’t working. But administration officials were hard pressed to explain how, exactly, cutting off aid would improve the situation.

Critics were quick to point out that U.S. aid is intended to help stabilize the Central American countries and eliminating it could lead to more violence and more emigration. “You are shooting yourself in the foot. It’s an irresponsible policy that undermines efforts to help address the drivers of migration,” said Adriana Beltrán of the Washington Office on Latin America, a non-profit advocacy group, on Sunday. “Instead of helping stabilize the situation, it makes it worse by gutting programs that had a positive impact.”

Anita Isaacs and Anne Preston of Haverford College wrote in The New York Times that “Trump is half right” because “paltry” U.S. aid isn’t doing much good, although they do credit a violence-prevention program in El Salvador with reducing homicide and possibly migration to the U.S. as a result.

At the same time, eliminating aid altogether is no solution, Isaacs and Preston said. “Cutting off foreign assistance is unlikely to persuade Central American governments to take actions that reduce the migratory flow,” they wrote. “If the Trump administration is serious about forcing the hand of Central American governments, it can’t just cut off aid — an alternative policy approach is urgently required. Rather than turn a blind eye to creeping authoritarianism, it should pressure governments to become more democratic and less beholden to corrupt elites and criminal networks.”

Trump Doesn’t Want Congress to Cut a Spending Deal: Report

The White House is fine with having deep, automatic spending cuts take effect once again next year, Axios’s Jonathan Swan reports.

White House legislative affairs official Paul Teller told Hill staffers last week that “the president does not want a caps deal," Swan says. That “caps deal” refers to an agreement to lift caps on discretionary spending for both defense and non-defense areas, as Congress has done repeatedly in recent years. The Trump administration, however, is looking to cut non-defense spending while raising military spending to $750 billion.

The White House reportedly says it can achieve its goals by allowing steep, automatic spending cuts set up by the Budget Control Act of 2011 to take effect again in 2020 — and then offsetting the required defense cuts by using an off-the-books account that critics call a slush fund.

“Lawmakers from both parties are outraged, and most think there's no chance Congress would approve of Trump parking more than $100 billion in the slush fund, as his budget proposes,” Swan writes, adding that GOP lawmakers aren’t likely to go along with the White House plan. Instead, they’ll probably negotiate another deal with Democrats to increase spending above the caps.

Americans Don’t Support Higher Defense Spending

President Trump’s 2020 budget calls for giving national defense a big increase in funding, to about $750 billion. According to recent polls, however, most Americans believe that current funding levels are just fine.

Gallup’s Frank Newport said Monday that Americans are generally satisfied with the country’s level of military strength and preparedness. A majority of Gallup poll respondents in January said the U.S. either spends enough or too much on defense. “The results suggest that President Donald Trump's current call for a substantially increased military budget in future years is not congruent with American public opinion,” Newport wrote.

More generally, Newport found that support for higher defense spending tends to fall as defense budgets go up. Conversely, support for higher spending tends to rise in periods when the defense budget is falling. By speaking frequently about his greatly enhanced defense budgets over the last two years, Trump may have signaled to the public that military spending is about right now, or maybe a bit too high.

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