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GERMANY'S CRISIS: Now anti-migrant AfD become second largest party in shock poll

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Boris Blow: Biden may not attend G7 in Cornwall unless Covid-19 restrictions are lifted

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JOE BIDEN may not attend the UK G7 meeting under current Covid restrictions, according to a top White House official.

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Obamacare would get a big (and quiet) overhaul in the Covid relief bill

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WASHINGTON — The $1.9 trillion coronavirus relief package that passed the House on Saturday would make one of the biggest changes to the Affordable Care Act in over a decade, and it could set the stage for a broader overhaul of the health care program — but don’t be surprised if you haven’t heard much about it.

The reforms, which would include temporarily expanding subsidies to purchase insurance and making them available to people of all incomes for the first time, have gotten little attention from either party.

For Democrats, who spent last year debating whether to move to a single-payer system, the more minor changes are uncontroversial and are therefore discussed less than other features of the bill.

Republicans, who have increasingly downplayed their opposition to the ACA, otherwise known as Obamacare, have made little mention of them in messaging against the bill.

And industry groups, which spent tens of millions of dollars on ads and lobbying campaigns against previous Democratic health care proposals, are largely supportive this time.

“These ACA changes have really flown under the radar and not attracted major opposition from Republicans,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, a nonprofit health policy research organization.

The biggest ACA-related item in the American Rescue Plan, which the House passed last week, would address one of the most persistent complaints about the law among customers and political opponents alike: sky-high premiums for people who don’t qualify for federal tax credits to help pay them.

The tax credits can go a long way for those who qualify — in many cases, it’s possible to find a plan with zero premiums. But everyone making more than 400 percent of the federal poverty line ($51,520 for an individual) falls off a “subsidy cliff” and has to pay full price. Premiums vary widely depending on local health care costs, and plans often are so expensive that customers forgo insurance.

For the next two years, the American Rescue Plan would expand the tax credits to higher earners and cap the maximum premium anyone is expected to pay at 8.5 percent of their income. It would boost tax credits at lower incomes, as well: People making less than 150 percent of the federal poverty line ($19,320 for an individual) would be expected to pay $0 in premiums for a benchmark plan, for example.

For those with lower incomes, the bill would boost incentives for states to expand Medicaid by having the federal government pick up the tab for new recipients. Twelvestates, including Florida, Georgia and Texas, have refused to accept Medicaid dollars through the ACA. It’s unclear whether the bill would affect their calculations.

The changes, which would be temporary, closely mirror Joe Biden’s health care agenda from the presidential campaign, and Democrats are expected to try to make them permanent down the line.

But they also are low-hanging fruit politically. Unlike with other health care reforms, there are few obvious “losers” beyond fiscal hawks worried about adding to the deficit. The U.S. Chamber of Commerce and top lobbying groups representing insurers, hospitals and doctors have all endorsed the measures, which would pump more money into the system without asking them to cut costs or pay new taxes.

“The industry has been generally supportive of the ACA coverage provisions in the covid relief bill,” Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University, said in an email.

Brian Blase, a National Economic Council member in the Trump administration, described the overall Democratic approach as “talk about how evil health insurance companies are but continue to funnel them money.”

The nonpartisan Congressional Budget Office estimates that the added subsidies would cost $34 billion and that they would insure 1.3 million more people by next year. Blase said that if the subsidies are extended permanently, they could cost the government significantly more by encouraging smaller businesses to offload their workers onto the ACA exchanges.

While some conservative policy thinkers like Blase have criticized the proposal over its cost, congressional Republicans seem less sure how to message against it. House Minority Leader Kevin McCarthy of California never brought it up in his floor speech opposing the relief legislation, focusing instead on other elements of the $1.9 trillion bill.

Many Republicans faced attack ads in 2018 and 2020 for their opposition to the ACA, and the party has largely pivoted to attacking “Medicare for All” instead, even as the Supreme Court considers a Republican-led lawsuit to overturn Obamacare.

But the detente among Democrats, Republicans and big business may not last long.

Democrats are already discussing creating a public insurance option that would compete with private insurers in a future bill. There’s also a push to allow some older Americans to buy into traditional Medicare.

Past public option frameworks have called for reimbursing doctors and hospitals at rates tied to Medicare, which tend to be much lower than what private insurance pays. Proponents argue that that would pressure insurers and providers alike to lower prices. Polls have long found broad bipartisan support for the idea, and Biden has called for both a public option and lowering the Medicare age to 60.

But moving more Americans to government plans is likely to mean less money for doctors, hospitals and specialists. While some proposed versions would adjust rates upward somewhat to ease the transition, a coalition of health care industry groups spent big on ads opposing a public option last year and would be likely to do the same again. Republicans, who have shown little enthusiasm for the idea, would be sure to follow suit.

“The health care industry would fight a public option with everything they have,” Levitt said.

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White House pulls the nomination of embattled budget chief pick Neera Tanden

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WASHINGTON —The White House is withdrawing Neera Tanden’s Office of Management and Budget nomination, marking the first major personnel defeat for President Joe Biden.

Tanden ran into trouble after Democratic Sen. Joe Manchin of West Virginia came out against her, citing her “overtly partisan statements” that he said would “have a toxic and detrimental impact on the important working relationship” between Congress and the influential budget office.

Biden had hoped a moderate Republican would give Tanden the support she needed, but that appeared unlikely.Tanden, who would have been the first nonwhite woman to run the office, was criticized because of her previous posts on Twitter targeting Republicans and Democrats in the Senate

“I have accepted Neera Tanden’s request to withdraw her name from nomination for Director of the Office of Management and Budget,” President Joe Biden said in a statement. “I have the utmost respect for her record of accomplishment, her experience and her counsel, and I look forward to having her serve in a role in my Administration. She will bring valuable perspective and insight to our work.”

Manchin’s objection meant Democrats, who control 50 seats in the evenly split chamber, would need at least one Republican vote to confirm her nomination. But there were no takers.

After Manchin, multiple Republicans including Sen. Susan Collins of Maine, Sen. Mitt Romney of Utah and Sen. Rob Portman of Ohio came out against Tanden, expressing similar concerns about her ability to work across the aisle, and all but closing her path.

“Unfortunately, it now seems clear that there is no path forward to gain confirmation, and I do not want continued consideration of my nomination to be a distraction from your other priorities,” Tanden said in a letter released Tuesday by the White House.

Two Democratic-controlled Senate committees canceled votes planned for Wednesday to advance the nomination. It made Tanden the latest victim of her Twitter feed, on which she had a history of leveling criticism of Republicans and progressive figures, which drew heavy scrutiny from senators.

Tanden apologized for her tweets earlier this month, saying, “I deeply regret and apologize for my language.” But that wasn’t enough for some senators.

Tanden would have made history as the first nonwhite woman to lead OMB. Some progressives accused her critics of a double standard, citing some of President Donald Trump’s nominees who were approved by the Senate — including frequent Twitter sniper Richard Grenell for Ambassador to Germany, and Brett Kavanaugh for the Supreme Court after his at-times intemperate testimony in response to allegations of attempted sexual assault.

Senate Budget Chair Bernie Sanders, I-Vt., had clashed with Tanden, a former adviser to Hillary Clinton, during his two presidential runs. He did not take a position on Tanden.



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