Citizen Cartwright

Will John Kelly last longer as Trump's chief of staff than Priebus did?

As the retired Marine Corps general and former Homeland Security chief starts his job Monday, the question is whether he can "rein in an unpredictable president and put a lid on the steady stream of drama at the White House,” as Politico puts it.

Any chief of staff has to find the "tricky balance between serving the president and managing the building, between being an adviser and being a boss — tasks all the more challenging in President Trump’s faction-filled White House,” says The New York Times.

Kelly lacks experience working on Capitol Hill or in the White House, but that "fits well with an administration that doesn’t value those skills,” says FiveThirtyEight.

"Kelly’s success in a chaotic White House will depend on how much authority he is granted and whether Trump’s dueling aides will put aside their rivalries to work together," says The Associated Press. "Also unclear is whether a new chief of staff will have any influence over the president’s social media histrionics."

"There is little indication the belligerents in [the White House] war plan to stand down, particularly with the arrival of communications director Anthony Scaramucci, whose willingness to do Trump’s dirty work with reckless abandon has only increased the sense of volatility,” says The Weekly Standard.

"The thing that General Kelly should do is not try to change Donald Trump,” says Corey Lewandowski, a former campaign manager to Trump. "Anybody who thinks they're going to change Donald Trump doesn't know Donald Trump."

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John McCain begins and ends Senate's healthcare debate

The Arizona Republican’s dramatic return to the Capitol after brain cancer surgery provided the crucial vote Tuesday to enable the Senate to debate the repeal of Obamacare — and the crucial vote in the early hours of Friday to prevent that repeal.

McCain joined GOP Sens. Susan Collins of Maine and Lisa Murkowski of Alaska and all the Democrats in a 51-49 vote against the “skinny bill.”

The measure would have repealed a mandate that most individuals get health insurance and would have suspended a requirement that large companies provide coverage to their employees. It also would have suspended a tax on medical devices and denied funding to Planned Parenthood for a year.

In addition, the measure would have increased the limit on contributions to tax-favored health savings accounts. It would have made it much easier for states to waive federal requirements that health insurance plans provide consumers with a minimum set of benefits such as maternity care and prescription drugs. It would have eliminated funds provided under Obamacare for a wide range of prevention and public health programs.

The bill’s momentum began to collapse Thursday as McCain and others sought an iron-clad guarantee from House Speaker Paul Ryan, R-Wis., that, if the Senate approved the skinny bill, the House wouldn’t just approve it — but instead would engage in a broad House-Senate conference negotiation for a wider rollback of the law.

“If moving forward requires a conference committee, that is something the House is willing to do,” Ryan said in a statement. “The reality, however, is that repealing and replacing Obamacare still ultimately requires the Senate to produce 51 votes for an actual plan.”

But Ryan left open the possibility that if a compromise measure failed in the Senate, the House still could pass the stripped-down Senate health bill. That helped push McCain to “no,” says The New York Times.

“We must now return to the correct way of legislating and send the bill back to committee, hold hearings, receive input from both sides of aisle, heed the recommendations of [the] nation’s governors, and produce a bill that finally delivers affordable health care for the American people,” said McCain in a statement explaining his vote. “We must do the hard work our citizens expect of us and deserve.”

“It’s time to move on,” said Senate Majority Leader Mitch McConnell, Ky., He said the Senate would take up other legislation next week.

President Trump tweeted: “3 Republicans and 48 Democrats let the American people down. As I said from the beginning, let Obamacare implode, then deal. Watch!”

“It’s time to turn the page,” said Senate Minority Leader Chuck Schumer, N.Y. “We are not celebrating. We are relieved.”

Kudos to The Hill, whose reporters stayed up later into the night to put out an article on what happens next.

One track is letting the Senate health committee’s chairman, Sen. Lamar Alexander, R-Tenn., and top Democrat, Patty Murray, Wash., work on fixes to the healthcare system in committee.

Alexander previously has said the Senate Health, Education, Labor and Pensions committee would hold hearings in the next few weeks to explore stabilizing the individual market — and that the hearings would happen “however the votes come out on the Senate healthcare bill.”

Republicans will have to act quickly if they want to stabilize the Obamacare markets. Insurers have to make decisions by September on whether they'll leave the Obamacare exchanges or increase premiums.

“The wildcard is what the president does,” says Sen. Bill Cassidy, R-La.

The Trump administration could end Obamacare’s cost-sharing reduction payments to insurers.

The insurers have been “begging" for long-term certainty over these payments, which the administration has been making on a month-to-month basis, says the Hill.

Another option for Trump is to stop enforcing the individual mandate, which experts say could cause the insurance markets to collapse. The mandate is intended to bring in healthy enrollees to balance out sick ones. But if healthy people have no incentive to buy insurance, only the sickest will do so, sending premiums soaring.

Trump administration’s pressure on Murkowski could backfire

On Wednesday, the president tweeted his displeasure that Alaska GOP Sen. Lisa Murkowski voted against debating Obamacare repeal.

By that afternoon, Ryan Zinke, the Interior secretary, had called both Murkowski and Alaska’s other GOP senator, Dan Sullivan, “letting them know the vote had put Alaska’s future with the administration in jeopardy,” The Alaska Dispatch News reported.

“I’m not going to go into the details, but I fear that the strong economic growth, pro-energy, pro-mining, pro-jobs and personnel from Alaska who are part of those policies are going to stop,” Sullivan said.

"But the leverage goes both ways,” notes The New York Times.

Murkowski is the chairwoman of the Senate Energy and Natural Resources Committee, which has oversight of the Interior Department. She also is the chairwoman of the Senate Appropriations subcommittee with jurisdiction over the department.

"She likely can do more to Mr. Zinke than he can do to her,” says the Times.

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Senate rejects repeal-only healthcare bill, eyes ‘skinny’ option

The vote was 55-45 on Wednesday against the measure that would have repealed major parts of Obamacare but wouldn't have provided a replacement.

The vote signals that the “clean repeal” bill conservatives have wanted — to eliminate Obamacare “root and branch” — can't get through Congress.

Seven Republicans voted against the measure: Sens. Shelley Moore Capito of West Virginia, Susan Collins of Maine, Dean Heller of Nevada, John McCain of Arizona, Rob Portman of Ohio, Lamar Alexander of Tennessee and Lisa Murkowski of Alaska.

(By the way, President Trump tweeted against Murkowski on Wednesday; but she isn’t beholden to the GOP, notes The New York Times. She lost a primary race to a Tea Party challenger in 2010 and was essentially abandoned by the Republican Party. She went on to victory in a write-in campaign.)

Senate Republicans appear increasingly likely to try to pass a “skinny” measure, to get to conference with the House. That measure likely would repeal only provisions of the Obamacare law such as the tax on medical devices and requirements that most people have insurance and that large employers offer coverage to workers.

Sen. Chuck Schumer, N.Y., the Democratic leader, calls that “a ruse to get to full repeal” and warns that hard-line Republicans in the House would apply pressure to reluctant moderate Republicans in the Senate.

In a letter on Wednesday, 10 governors — five Republicans and five Democrats — urged the Senate to reject a “skinny” repeal measure. The Blue Cross Blue Shield Association, a major insurance trade group, warned senators about the consequences of repealing the mandate that most people have health coverage without otherwise incentivizing people to get and keep coverage.

Republicans are aiming for a vote on Friday on their final plan after an unlimited amendment process known as a vote-a-rama, which is expected to begin sometime Thursday, says Politico.

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Senate Obamacare repeal votes: Trump wins one, loses one

The win: All the drama over whether the Senate would even debate Obamacare repeal ended on Tuesday afternoon with ailing Sen. John McCain, R-Ariz., casting a crucial vote in favor of opening debate.

Two Republicans, Sens. Susan Collins of Maine and Lisa Murkowski of Alaska, voted against the motion to proceed to debate. Democrats were united against it.

Vice President Pence’s vote to begin debate broke senators' 50-50 tie.

“I was surprised that there was just two of us in the end,” Collins said of her and Murkowski’s opposition. “But that’s OK. We’ll proceed from here and see where we end up.”

The loss: On Tuesday night, senators voted 57-43 against Republican leaders’ most comprehensive plan to replace Obamacare.

That measure contained a proposal by Sen. Ted Cruz, R-Texas, that would have allowed insurers to sell stripped-down health plans, without maternity care or other benefits required under Obamacare, if they also sold plans that included those benefits.

The amendment also included a proposal by Sen. Rob Portman, R-Ohio, and senators from other states that have expanded Medicaid under Obamacare. It would have provided money to help pay out-of-pocket medical costs for low-income people, including those who bought private insurance after losing their Medicaid coverage as a result of the Senate bill.

The “no” votes — "in rough order of least to most surprising,” according to Nate Silver of FiveThirtyEight — were Collins; Rand Paul, R-Ky.; Murkowski; Dean Heller, R-Nev.; Mike Lee, R-Utah; Jerry Moran, R-Kans; Lindsey Graham, R-S.C.; Bob Corker, R-Tenn.; and Tom Cotton, R-Ark.

"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,” says The New York Times.

A vote is expected on Wednesday on an amendment that would repeal much of Obamacare.

And there’s nothing to prevent the Senate’s Republican leadership from offering another repeal and replace amendment.

Meanwhile, the Senate parliamentarian ruled on Tuesday that more parts of the Obamacare repeal bill will need 60 votes for passage. Here are details, from the Senate Budget Committee Democrats.

It’s not clear what leaders will present as the final bill, but it seems likely to be a “skinny” repeal, intended mainly to get senators to a conference with the House, says The Hill.

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