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The latest news on Obamacare from Business Insider

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    mitch mcconnell

    After a repeated series of false starts, Senate Republicans are meeting again Wednesday night in an attempt to bring their healthcare bill back from the dead.

    The renewed attempt comes amid a flurry of mixed signals form leadership and whiplash-inducing shifts from President Donald Trump.

    According to reports, GOP senators who opposed the first two versions of the Better Care Reconciliation Act (BCRA) will hold a meeting Wednesday night in an attempt to hash out their differences on the plan.

    The first two versions of the bill were opposed by both conservative and moderate members. Moderates thought the bill's cuts to Medicaid and the potential for massive coverage losses under the BCRA went too far. Conservatives felt the bill did not go far enough in its rollback of the Affordable Care Act's regulatory structure.

    Senate Majority Leader Mitch McConnell has attempted to bring the two sides to a compromise but has faced two rounds of defections that have killed different versions of the legislation.

    Given this state of play, McConnell told reporters after a Senate GOP conference meeting at the White House that he would move forward with a key procedural vote to begin debate on the bill sometime next week.

    Four Republican senators have said they would oppose such a motion on the latest version of the BCRA, effectively killing it Monday.

    At the same time, Sen. John Cornyn — the second-highest ranking Republican in the Senate — said leadership may bring more than just the BCRA to the floor. If that does not work, Cornyn said, the Senate could vote on a repeal-only bill.

    "We’re discussing that," Cornyn said when asked if the BCRA would make a comeback. "I’m more optimistic that that would be the case. But if there’s no agreement, then we’ll still vote on the motion to proceed but it’ll be to the 2015 just-repeal bill."

    A repeal-only bill would likely have even less support, according to members.

    Sen. Lamar Alexander, chair of the Senate's health committee, said after the White House meeting that he doesn't "think there are 40 votes."

    The lack of clarity has many Republican members unsure about the state of the bill and their support.

    "There’s so many moving parts on this I don’t want to commit to anything at this point," Sen. Dean Heller, a key holdout, said after the White House meeting.

    Sen. Lindsey Graham said the White House meeting was "great," but said members were not yet on board.

    "The gap has been closed in terms of member objections but we aren’t there yet," Graham said in a statement. "The current McConnell bill is much better than Obamacare."

    According to Axios' Jonathan Swan and Caitlin Owens, the GOP senators invited to attend the meeting on Wednesday night are: Shelley Moore Capito, Ted Cruz, Jerry Moran, Bill Cassidy, Mike Enzi, James Lankford, Ron Johnson, Mike Rounds, John Thune, Lamar Alexander, Bob Corker, Lindsey Graham, Rob Portman, and Mike Lee.

    Interestingly, this list leaves out opponents like Heller, Susan Collins, Rand Paul, and Lisa Murkowski. Collins, at least, told reporters after the White House meeting that she has another commitment Those four are more than enough to defeat the bill.

    Trump on Wednesday suggested senators should stay in Washington and delay their August recess until they get a repeal and replace done, another shift in his position on the matter. On Monday, Trump said Republicans should simply repeal Obamacare now repeal and replace later. And on Tuesday, Trump said he would support letting Obamacare stay in place and allowing it to fail.

    SEE ALSO: It sounds like the White House's attempts to help the GOP healthcare bill were a disaster

    Join the conversation about this story »

    NOW WATCH: A mother and daughter stopped speaking after Trump was elected — here's their emotional first conversation 6 months later

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    mitch mcconnell

    The Congressional Budget Office on Wednesday projected a Republican backup healthcare plan would leave millions more uninsured in the coming years and hike premiums significantly.

    The Republican legislation, which would repeal the Affordable Care Act and give Republicans time to work out a replacement, is a near-identical copy to the 2015 repeal-only bill vetoed by President Barack Obama. It has been advanced as an alternative to the stalled Better Care Reconciliation Act, which would repeal and replace the law known as Obamacare.

    According to the CBO, the bill — the Obamacare Repeal Reconciliation Act (ORRA) — would leave 17 million more Americans without healthcare insurance in 2018 compared to the current system. That would ramp up to 27 million more uninsured by 2020 and 32 million more uninsured by 2026.

    The numbers were similar to the projections the last time Republicans advanced the legislation in 2015.

    Under the ORRA, repeal would not kick in until 2020 but would then go into effect immediately, rather than phasing out Obamacare's provisions. The CBO score does not take into account any replacement that may be passed during that two-year period.

    According to the CBO, the impact on premiums would be similarly devastating.

    "Average premiums in the non-group market (for individual policies purchased through the marketplaces or directly from insurers) would increase by roughly 25% — relative to projections under current law — in 2018," said the report. "The increase would reach about 50% in 2020, and premiums would about double by 2026."

    The bill would also decrease the federal deficit by $473 billion by 2026, while cutting Medicaid spending by $842 billion in that same timeframe.

    Republicans are trying to revive their healthcare push in a meeting Wednesday night where both the ORRA and the Better Care Reconciliation Act will be considered.

    A number of members already expressed concerns over the coverage losses in the BCRA, which were projected to be 22 million by 2026.

    SEE ALSO: Republicans are holding an emergency meeting to revive their healthcare bill — but it already sounds like a mess

    Join the conversation about this story »

    NOW WATCH: People on Twitter are loving how baffled Buzz Aldrin appeared by Trump's 'space' talk

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    heller trump

    When Donald Trump was elected president and Republicans retained control of both chambers of Congress, there was a sense that the Republican agenda — lowering taxes, repealing Obamacare, decreasing regulation — would be unleashed.

    Roughly six months into the Trump presidency, however, little movement on that agenda has started to lead to boiling frustration within the party.

    The repeal of Obamacare, a central tenet of the last seven years of GOP policy, has become bogged down in the Senate. The replacement bill is the least popular piece of legislation in decades.

    Tax reform has yet to get off the ground. Major Obama-era regulations like the Dodd-Frank Act are still in place.

    Throw all that on top of that the swirling, seemingly constant revelations around the Russia investigation, and some Republican lawmakers are starting to shift their moods on Trump.

    "I don't even pay any attention to what is going on with the administration because I don't care. They're a distraction. The family is a distraction, the president is a distraction," Rep. Mike Simpson of Idaho told Politico. "At first, it was, 'Well yeah, this is the guy we elected. He'll learn, he'll learn.' And you just don't see that happening."

    One unnamed senator told the New York Times' Glenn Thrush and Maggie Haberman that Trump's ability to influence the healthcare debate, currently in a deadlock between moderates and conservatives in the GOP conference, is minimal.

    According to the Times, the senator said Trump "scares no one in the Senate, not even the pages."

    After the Senate healthcare bill stalled the first time, Sen. Susan Collins expressed frustration with Trump's inability to work well with Congress.

    "This president is the first president in our history who has had neither political nor military experience,"Collins said. "Thus, it has been a challenge to him to learn how to interact with Congress and how to push his agenda forward. I also believe it would have been better had the president started with infrastructure, which has bipartisan support, rather than tackling a political divisive and technically complicated issue like healthcare."

    Lawmakers have also continually expressed frustration at Trump's lack of engagement on the healthcare push and his seeming lack of knowledge on the issue when he does attempt to assist on the bill.

    SEE ALSO: Republicans are holding an emergency meeting to revive their healthcare bill — but it already sounds like a mess

    Join the conversation about this story »

    NOW WATCH: 5 of the best memes from Trump's trip to the G20 Summit

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    broken arm cast

    Lawmakers in the United States spent the past few months trying and failing to roll back some health-insurance requirements, but much of the rest of the world has been living under universal healthcare for decades. Nearly all developed nations provide insurance or require their citizens to buy a policy.

    But how those programs work and how much people pay varies widely. In some cases, patients would leave the hospital with no bill at all. In others, they'd owe lots of money.

    Business Insider has 14 editions around the world, so we asked our international colleagues what would happen if they were to break an arm in their countries.

    Here's what they told us.

    SEE ALSO: America is less divided than you may think

    Sweden: Government insurance with a private boost

    Where would you go?

    The main option is urgent care at a regional hospital, which is run and funded by the county council. (There are 20 in Sweden.)

    You can also go to a local emergency unit, also known as a walk-in center, for which there are both private (for-profit) and public (nonprofit) options. Doctor's offices and primary care units do not provide urgent care.

    How long would it take to get there and to get treatment once you're there?

    Most Swedes live within an hour's drive from the nearest hospital or local emergency unit. You can call the emergency number 112 to get an ambulance to remote locations. Once you've checked in, urgent care at a hospital usually takes four to six hours in all, depending on severity. Local emergency units are faster and provide care within a couple of hours.

    How much would the broken arm cost you? How much would it cost you if you didn't have insurance?

    All emergency healthcare in Sweden is funded by the government (i.e., the county council). The patient will need to pay $35 to $45 for a hospital emergency-clinic visit. If they have If P&C insurance, this fee could be covered afterward. The Swedish — and Nordic — principle of equal healthcare access for all means you can't pay extra to get preferential treatment.

    How does your insurance work? Do you pay for it? Do you get it from your employer, the government, or somewhere else?

    All Swedish residents, including expats, are covered by a government-funded universal healthcare insurance. Employers and labor unions may offer private group insurance, but these will generally not cover urgent cases such as fractures.

    Some 650,000 out of 10 million Swedes currently have private healthcare insurance — a number that is likely to increase because of a shortage of nurses and other skilled medical staff.

    A patient can freely choose between public and private primary healthcare providers, as far as local capacity permits. This policy has resulted in a steady increase in the amount of private healthcare options in Sweden. Healthcare in Sweden is decentralized to local county councils and municipalities. About 90% of the work of Swedish county councils concerns healthcare, but they also deal with other areas such as culture and infrastructure.

    — Tom Turula, BI Nordic

    Italy: No cost at the hospital

    Where would you go?

    If I were to break my arm, I would go to a public hospital.

    How long would it take to get there and to get treatment once you're there?

    It depends on the seriousness — on average, for such an accident, within a day.

    How much would the broken arm cost you? How much would it cost you if you didn't have insurance?

    I would pay zero.

    How does your insurance work? Do you pay for it? Do you get it from your employer, the government, or somewhere else?

    In Italy, you don't need to have insurance. Some employers — for example, journalists — have special insurances that enable them to go to private hospitals, but that's something more, an additional option. Because if you break an arm, you can go to a public structure and obtain there everything you need.

    — Carlotta Scozzari, BI Italy

    United Kingdom: Fully government-run insurance

    Where would you go?

    I would go to the National Health Service's A&E (accident and emergency) department, which is funded by the British government.

    How long would it take to get there and to get treatment once you're there?

    In London, there would generally be one that is accessible. The waiting times can vary. It could be hours.

    How much would the broken arm cost you? How much would it cost you if you didn't have insurance?

    The medical care would have no cost. It's funded by taxpayers through an NHS tax.

    How does your insurance work? Do you pay for it? Do you get it from your employer, the government, or somewhere else?

    Employers can provide supplementary private medical insurance. You may be taxed at a higher rate by signing up for private health insurance. You generally have to visit an NHS general practitioner before your private health insurance will approve a private visit. Each treatment/office visit is assessed individually by your insurer.

    — Dina Spector, Business Insider UK 

    See the rest of the story at Business Insider

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    donald trump

    In an in an interview with the New York Times on Wednesday, President Donald Trump offered a bizarre example of the US healthcare system while discussing Republican reform efforts.

    During a discussion about the difficulty Republicans are having repealing and replacing Obamacare, Trump addressed the issue of preexisting condition protections. 

    Here are his comments:

    "So preexisting conditions are a tough deal. Because you are basically saying from the moment the insurance, you're 21 years old, you start working and you're paying $12 a year for insurance, and by the time you're 70, you get a nice plan. Here’s something where you walk up and say, 'I want my insurance.' It’s a very tough deal, but it is something that we’re doing a good job of."

    The actual cost of health insurance for a 21-year-old person is vastly more expensive.

    Using the health plan comparison tool, a 21-year-old in Charlotte, North Carolina, making $35,000 annually would have to pay a minimum of $200 a month for the cheapest healthcare plan. Even after a monthly tax credit of $169 under Affordable Care Act provisions, the plan would still cost $31 a month — nearly triple what Trump said insurance costs for the year.

    As for Trump's other comment, many 70-year-olds the US are on Medicare, a government-run program that some Democrats want to expand to most people in the US.

    Many healthcare experts worry that an amendment from Sen. Ted Cruz to the Senate healthcare bill would allow insurers to get around protections for preexisting conditions for many people or charge more for plans that protect them.

    SEE ALSO: 'The president is a distraction': Republican lawmakers start to turn on Trump as his agenda flounders

    Join the conversation about this story »

    NOW WATCH: A mother and daughter stopped speaking after Trump was elected — here's their emotional first conversation 6 months later

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    Donald Trump

    CHICAGO (AP) — President Donald Trump's administration has ended Affordable Care Act contracts that brought assistance into libraries, businesses and urban neighborhoods in 18 cities, meaning shoppers on the insurance exchanges will have fewer places to turn for help signing up for coverage.

    Community groups say the move, announced to them by contractors last week, will make it even more difficult to enroll the uninsured and help people already covered re-enroll or shop for a new policy. That's already a concern because of consumer confusion stemming from the political wrangling in Washington and a shorter enrollment period. People will have 45 days to shop for 2018 coverage, starting Nov. 1 and ending Dec. 15. In previous years, they had twice that much time.

    Some see it as another attempt to undermine the health law's marketplaces by a president who has suggested he should let "Obamacare" fail. The administration, earlier this year, pulled paid advertising for the sign-up website, prompting an inquiry by a federal inspector general into that decision and whether it hurt sign-ups.

    Now insurers and advocates are concerned that the administration could further destabilize the marketplaces where people shop for coverage by not promoting them or not enforcing the mandate compelling people to get coverage. The administration has already threatened to withhold payments to insurers to help people afford care, which would prompt insurers to sharply increase prices.

    "There's a clear pattern of the administration trying to undermine and sabotage the Affordable Care Act," said Elizabeth Hagan, associate director of coverage initiatives for the liberal advocacy group Families USA. "It's not letting the law fail, it's making the law fail."

    Two companies — McLean, Virginia-based Cognosante LLC and Falls Church, Virginia-based CSRA Inc. — will no longer help with the sign-ups following a decision by Centers for Medicare and Medicaid Services officials not to renew a final option year of the vendors' contracts. The contracts, awarded in 2013, were never meant to be long term, said CMS spokeswoman Jane Norris in an email.

    "These contracts were intended to help CMS provide temporary, in-person enrollment support during the early years" of the exchanges, Norris said. Other federally funded help with enrollment will continue, she said, including a year-round call center and grant-funded navigator programs. The existing program is "robust" and "we have the on-the-ground resources necessary" in key cities, Norris said.

    affordable care act obamacare

    But community advocates expected the vendors' help for at least another year. "It has our heads spinning about how to meet the needs in communities," said Inna Rubin of United Way of Metro Chicago, who helps run an Illinois health access coalition.

    CSRA's current $12.8 million contract expires Aug. 29. Cognosante's $9.6 million contract expires the same date.

    Together, they assisted 14,500 enrollments, far less than 1 percent of the 9.2 million people who signed up through, the insurance marketplace serving most states. But some advocates said the groups focused on the healthy, young adults needed to keep the insurance markets stable and prices down.

    During the most recent open enrollment period, they operated in the Texas cities of Dallas, Houston, San Antonio, Austin, McAllen and El Paso; the Florida cities of Miami, Tampa and Orlando; Atlanta; northern New Jersey; Phoenix; Philadelphia; Indianapolis; New Orleans; Charlotte, North Carolina; Cleveland and Chicago.

    The insurance exchanges, accessed by customers through the federal or state-run sites, are a way for people to compare and shop for insurance coverage. The health law included grant money for community organizations to train people to help consumers apply for coverage, answer questions and explain differences between the insurance policies offered.

    In Illinois, CSRA hired about a dozen enrollment workers to supplement a small enrollment workforce already in the state, Rubin said. The company operated a storefront enrollment center in a Chicago neighborhood from November through April.

    "It was a large room in a retail strip mall near public transit with stations set up where people could come in and sit down" with an enrollment worker, Rubin said.

    CSRA spokesman Tom Doheny in an email said the company "is proud of the work we have accomplished under this contract." He referred other questions to federal officials.

    Cognosante worked on enrollment in nine cities in seven states, according to a June 6 post on the company's website. The work included helping "more than 15,000 Texas consumers" and staffing locations "such as public libraries and local business offices." A Cognosante spokeswoman referred questions to federal officials.

    The health care debate in Congress has many consumers questioning whether "Obamacare" still exists, community advocates said.

    "What is the goal of the Trump administration here? Is it to help people? Or to undermine the Affordable Care Act?" said Rob Restuccia, executive director of Boston-based Community Catalyst, a group trying to preserve the healthcare law.

    SEE ALSO: The CBO says the newest Senate healthcare bill will leave 22 million uninsured — but it's missing a key piece

    Join the conversation about this story »

    NOW WATCH: JIM ROGERS: The worst crash in our lifetime is coming

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    Donald Trump Tom Price

    President Donald Trump's administration has been quietly waging a public relations campaign to undermine public support for Obamacare, former President Barack Obama's signature legislation, according to a new Daily Beast report.

    Using social media and a series of video testimonials, the Department of Health and Human Services, led by Tom Price, is amplifying criticism of the Affordable Care Act, commonly known as Obamacare, and discouraging enrollment in the program.

    Using funds earmarked for "consumer information and outreach," HHS has produced and released 23 videos of Americans talking about their difficulties with Obamacare, according to The Daily Beast. 

    In one video, an Illinois mother, Christine Chalkey, says that her 22-year-old son, Jacob, who was born with a severe development disability, almost died as a result of the state's 2012 cuts to Medicaid, which insured Jacob. Chalkey blames Jacob's loss of coverage on Obamacare, which she says stretched the limits of the state's Medicaid funding to its breaking point, denying Jacob the medicine he needed.

    The videos also highlight horror stories of skyrocketing premiums and deductibles in the private marketplace. 

    Ryan Stanton, a Kentucky physician who was featured in an HHS testimonial, told The Daily Beast that he felt pressured to speak more critically of the health law than he wanted to. 

    "I don't think mine was the exact message they were looking for of, 'Oh, let's march against Obamacare,'" he said. "It was clearly an effort to push the repeal and replace."

    HHS's website has also removed and altered information about the healthcare law. One page on the site, entitled "Empowering Patients" reads: "with skyrocketing premiums and narrowing choices, the Affordable Care Act (ACA) has done damage to this market and created great burdens for many Americans."

    Twitter accounts run by HHS and Price have also been used to criticize Obamacare and promote Republican repeal and replacement legislation. 

    While HHS is allowed to spend money on efforts to educate the public, it is illegal for the agency to engage in direct advocacy, or "purely partisan activity," including promoting legislation. 

    "You're not hired into the administration to decide whether you agree with the law you're asked to execute. That's not your job," Andy Slavitt, the former acting administrator at the Centers for Medicare and Medicaid Services, told The Daily Beast. "Congress appropriates funds for you to carry out laws that they passed, not to spend those funds on activities that counteract those laws."

    Over the last several months, Democratic lawmakers in Congress havesentletters to Price, the HHS inspector general, and the Government Accountability Office requesting more information about the government's "actions to undermine the ongoing implementation" of Obamacare.

    Former Obama administration officials argue that these efforts are part of the administration's broader plan to either repeal and replace Obamacare or "let Obamacare fail,"as Trump has most recently advocated.

    "I’m on a daily basis horrified by leaders at the Department of Health and Human Services who seem intent on taking healthcare away from the constituents they are supposed to serve," former HHS Secretary Kathleen Sebelius told The Daily Beast. "We always believed that delivering health and human services was the mission of the department. That seems to not be the mission of the current leadership."

    SEE ALSO: The CBO just delivered a devastating score for the GOP's Plan B on healthcare

    SEE ALSO: For the 2nd time in less than 24 hours, Republicans' healthcare plans have gone down in flames

    Join the conversation about this story »

    NOW WATCH: 'You're inflaming everybody!': Watch reporters clash with Sanders over press coverage

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    mitch mcconnell

    The Republican leadership's plan to repeal and replace Obamacare — or just repeal it, depending whom you ask — ended the week in a state of flux that has left more questions than answers.

    Consider what has happened just since Monday. Two plans have seemingly fallen apart, then been at least partially revived. The Congressional Budget Office issued scores on two different bills. And President Donald Trump adjusted his desired outcome for the debate three different times.

    One thing is clear, however: The Better Care Reconciliation Act (BCRA), the GOP bill to repeal and replace the law known as Obamacare, does not appear to be any closer to passage than it was at the start of the week.

    On Friday, after a week of twists and turns, the BCRA got more bad news: The Senate parliamentarian ruled that many of its key provisions, under Senate rules, would require 60 votes to pass. That will likely mean some provisions aimed at enticing Republican members will need to be stripped from the bill.

    "This will greatly tie the majority leader's hands as he tries to win over reluctant Republicans with state-specific provisions," Senate Minority Leader Chuck Schumer said. "We will challenge every one of them."

    What is the plan?

    Led by Senate Majority Leader Mitch McConnell, Republicans appear to be pushing two different plans.

    One is the BCRA, which would repeal Obamacare and immediately replace it. It's the plan that the GOP conference has been haggling over for the past several weeks.

    The legislation appeared to be no longer viable as of Monday, when two more Republican senators said they would not vote for a key procedural vote to bring it to the floor. It meant four GOP defections from the legislation, two more than leadership could afford to move the legislation forward.

    The other plan is the Obamacare Repeal Reconciliation Act (ORRA), which would repeal Obamacare with a two-year delay with no immediate replacement. McConnell said the delay would give enough time for Congress to come up with a replacement plan.

    Leadership and rank and file Republicans so far haven't confirmed which of these plans is going to be advanced to a vote, but they're targeting movement next week.

    What would be the effect of the plans?

    On Wednesday and Thursday, the CBO released scores for the ORRA and the BCRA, respectively. Here's a rundown of how they said the current plans would affect coverage and more:

    • Coverage: The ORRA would result in 32 million more uninsured Americans by 2026 than under the current system. That number is 22 million under the BCRA.
    • Premiums: With no replacement, average premiums in the individual market would double by 2026 under the ORRA. Under the BCRA, premiums would decrease by 30%, but out-of-pocket costs would soar for older and sicker people.
    • Deficit reduction: The ORRA would lead to $473 billion in deficit savings for the federal government through 2026. The BCRA would result in $442 billion in savings over the same timeframe. Most of the savings would come from cuts to the federal Medicaid program.

    The CBO's score of the BCRA did not include a key provision advanced by Sen. Ted Cruz. The Consumer Freedom amendment would allow insurers to sell plans that do not abide by two major Obamacare regulations. Health experts say the provision could undermine protections for people with preexisting conditions and cause trouble in the individual insurance market.

    Are there enough votes for either plan?

    It doesn't seem that way.

    On Wednesday night, Republican senators held an emergency meeting and left without a consensus. Additionally, neither Sen. Susan Collins nor Sen. Rand Paul were present at the meeting. Both Republicans have been vocal in their distaste for the BCRA in all of its iterations so far.

    Dean Heller and Susan Collins

    In terms of the repeal and delay plans, it doesn't seem that the three senators who opposed it on Tuesday — Collins, Lisa Murkowski, and Shelley Moore Capito — have changed their opinion in the interim. Additionally, reports have indicated that many more members could vote against the plan if it got to the floor.

    The advancement of two different plans does seem to have caused some confusion among the conference, but it appears the primary goal is trying to find a deal on the BCRA.

    Complicating factors is the absence of Sen. John McCain, who announced his brain cancer diagnosis on Wednesday night. McCain promised to return to the Senate soon, but it's unclear when While it is a difficult situation, there is also the political reality that any healthcare plan can only lose a single vote in order to pass now. This makes passage even more improbable.

    Sen. John Cornyn, the second-highest ranking member of the GOP leadership, has said senators will take a key procedural vote early next week. Also on Thursday, Sen. John Thune, another member of the leadership, was asked by reporters which plan would be introduced after the motion.

    "Who knows?" he said.

    SEE ALSO: 'The president is a distraction': Republican lawmakers start to turn on Trump as his agenda flounders

    Join the conversation about this story »

    NOW WATCH: Watch Jared Kushner speak publicly for the first time since joining Trump's administration

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    President Donald Trump addressed what the White House referred to as "Obamacare victims" during a healthcare speech on Monday, erroneously saying that the former president's signature legislation had been in place "for 17 years."

    "For the past 17 years, Obamacare has wreaked havoc on the lives of innocent, hard-working Americans," Trump said.

    The law has in fact been in place for seven years.

    MSNBC immediately fact-checked the error during their broadcast of the speech.

    Trump said that "every pledge" of the law formally known as the Affordable Care Act "turned out to be a lie."

    "It was a big fat ugly lie," Trump said.

    He said that Obamacare's "lies" have caused "nothing but pain."

    During his statement, Trump has repeatedly slammed Republicans in Congress for not yet repealing and replacing the law.

    SEE ALSO: Some of the most powerful people in the US are talking about a massive change to healthcare

    Join the conversation about this story »

    NOW WATCH: Watch Jared Kushner speak publicly for the first time since joining Trump's administration

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    Trump with

    President Donald Trump stepped up his pressure on Republican senators to pass a new healthcare bill during a speech before a gathering of so-called Obamacare "victims" at the White House on Monday.

    Trump's speech, which came a day before the Senate is scheduled to vote on a motion to proceed to debate on an Obamacare replacement bill, combined several of the administration's tactics in pressuring lawmakers to pass new legislation.

    The president pressured Republicans to uphold their campaign promises to repeal Obamacare, threatened that the healthcare system will eventually collapse if Obamacare is left in place, and claimed that the Republican replacement bill, known as the Better Care Reconciliation Act, would lower premiums, increase flexibility for states, and more effectively protect poor Americans.;

    "For Senate Republicans, this is their chance to keep their promise," Trump continued. "Over and over again, they said repeal and replace, repeal and replace. But they can now keep their promise to the American people to provide emergency relief to those in desperate need of help and to improve healthcare for all Americans."

    Central to the GOP's messaging surrounding their healthcare legislation is their assertion that Obamacare, former President Barack Obama's signature legislation that is formally known as the Affordable Care Act, is a "disaster" and has "wreaked havoc" on American families, as Trump claimed on Monday. Trump has even said it would be "easier" for Republicans if they simply "let Obamacare fail" before drafting a replacement law.

    But Trump's overarching message is that keeping Obamacare in place will be devastating to the healthcare system and to Republicans politically. On Sunday, Trump tweeted, "If Republicans don't Repeal and Replace the disastrous ObamaCare, the repercussions will be far greater than any of them understand!"

    "Obamacare is death," Trump said, hammering home his argument that the law has hurt more Americans than it's helped. "It's broken, it's collapsing, it's gone. And now it's up to us to get great healthcare for the American people."

    The president has openly threatened Republican lawmakers to support the Better Care Reconciliation Act — targeting Sen. Dean Heller, who has been critical of the bill, among others, through White House-approved attack ads and more direct warnings.

    During his White House speech Monday, Trump framed the vote as a choice between Obamacare's Democratic "architects" and "its forgotten victims," and warned Republicans that a "no" vote would signal their support for the status quo.

    "Any senator who votes against starting debate is telling America that you are fine with the Obamacare nightmare," Trump said.

    SEE ALSO: Trump kicks off healthcare speech by erroneously saying Obamacare has been in place for '17 years'

    SEE ALSO: An obscure Senate rule just put the GOP healthcare bill in even bigger peril

    Join the conversation about this story »

    NOW WATCH: 'What you feel isn't relevant': Sen. Angus King grills intel leaders on whether Trump tried to influence them

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    John McCain Jack Reed

    With a vote to proceed on repealing Obamacare less than 24 hours away — and with most senators completely in the dark on what they'll be voting on and whether they even have enough support to start the debate — GOP leadership is floating the idea that they can ship a bedridden Sen. John McCain (R-AZ) across the country to cast the deciding vote. 

    McCain recently found out that he has an extremely aggressive form of brain cancer and took an indefinite leave of absence from the Senate.

    Still, GOP Whip Sen. John Cornyn (R-TX) insisted to reporters on Monday that there is a chance McCain could be flown to DC tomorrow. "We have not yet gotten word, but we're hopeful," he said. "Knowing him, I know he wants to come back as soon as he can physically make it."

    Asked if there is even time to get a doctor to sign off on the journey and make the arrangements for the trip, Cornyn snapped: "I'm not a doctor. I quit after organic chemistry."

    Sen. Roger Wicker (R-MS) went into more graphic detail about McCain's condition, saying that his travel plans hinge on "whether his incision has healed to the extent that he can sit in a pressurized cabin for four hours."

    "He might get the go-ahead from his doctors this afternoon," Wicker added. "We don't know just yet."

    Though McCain has reportedly been in frequent contact with his close friends in the Senate, namely Sen. Lindsey Graham (R-SC), it is unclear if Senate leaders have spoken to him about whether he wants to risk a trip back to DC to vote to proceed on an unknown health care bill he quite recently criticized for threatening his state's Medicaid recipients.

    "I called him yesterday but got his voice message," Sen. John Barrasso (R-WY) said with a chuckle Monday evening.

    Sen. John Thune (R-SD), another member of the GOP leadership team, threw cold water on the idea. "I would love it if he would be here, but I don't expect that," he wearily told reporters.

    McCain's office did not respond to TPM's question of whether McCain is able to and willing to travel to DC for Tuesday's vote.

    With support crumbling for all of the Republican health care plans currently on the table and senators wary of voting to proceed without knowing what they will proceed to, GOP leaders offered mixed responses to whether their success or failure hinges on flying an octogenarian cancer patient across the country.

    "We sure need him," Wicker said.

    Cornyn disagreed and said McCain's unlikely appearance would not make or break the vote. "I think we can get to the motion to proceed without him, but it certainly would help if he's here," he said.

    SEE ALSO: The Senate is planning to vote on a healthcare bill this week — we just don't know which one

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    Donald Trump Ryan Zinke Rick Perry Tom Price

    Speaking at the National Boy Scout Jamboree, President Donald Trump jokingly admonished Health and Human Services Secretary Tom Price over the looming vote on the Republican healthcare bill currently being considered by the Senate.

    "You going to get the votes?" Trump asked during his remarks.

    "He better get them," Trump said, turning back to the audience.

    "He better get them ... otherwise I'll say, 'Tom, you're fired," Trump continued, pointing a finger-gun at the crowd, which greeted the comment with laughter and applause.

    Trump's comments come after a speech earlier on Monday at the White House held with so-called Obamacare victims. The president called on Republican legislators to fulfill their promise to repeal Obamacare, saying that it would collapse if left in place and touting the benefits the GOP say would come from passing its bill, known as the Better Care and Reconciliation Act.

    The Senate is scheduled to vote on Tuesday on a motion to proceed with debate on an Obamacare replacement legislation.

    SEE ALSO: 'All options are on the table' for Trump to go after Venezuela, but the side effects could be severe

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    Donald Trump Sonny Perdue

    The Senate is voting Tuesday whether or not to move forward with a debate to repeal Obamacare and President Donald Trump has indicted he's ready to sign anything.

    "ObamaCare is torturing the American People. The Democrats have fooled the people long enough. Repeal or Repeal & Replace! I have pen in hand,"Trump tweeted Tuesday morning.

    Earlier Tuesday, Trump said we're about to see if the GOP is "willing to step up to the plate."

    "Big day for HealthCare. After 7 years of talking, we will soon see whether or not Republicans are willing to step up to the plate!,"Trump tweeted.

    It is still unclear what exactly a GOP healthcare bill from the Senate would look like.

    The Senate vote received a burst of drama Monday night when Senator John McCain announced his return to Washington on Tuesday, nearly a week after his office announced he was diagnosed with brain cancer.

    With McCain voting, Senate Majority Leader Mitch McConnell can afford two Republican "no" votes and still move forward with debate.

    Trump welcomed McCain back to Washington Tuesday morning with a tweet.

    "So great that John McCain is coming back to vote. Brave - American hero! Thank you John,"Trump tweeted.

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    John Boehner

    Former House Speaker John Boehner said at a business event last week that Republicans were "not going to repeal and replace Obamacare" because "the American people have gotten accustomed to it," according to video footage obtained by The Washington Post.

    "Here we are, seven months into this year, and yet they've not passed this bill. Now, they're never — they're not going to repeal and replace Obamacare," Boehner said at the event.

    Boehner said the best option for Republicans was to repeal parts of Obamacare, the healthcare law officially known as the Affordable Care Act, like the employer and individual mandates and certain tax provisions. He added that popular parts of the law, like its Medicaid expansion, should remain.

    It was not the first time Boehner had suggested a Republican push to repeal Obamacare would not be successful. In February, the former House speaker said at a healthcare conference in Florida that the Republican plan to do away with Obamacare was "not going to happen."

    He added that talk of repealing the law was "happy talk."

    Boehner's comments last week came amid a struggle by the GOP to jump-start its stalled effort on repealing and replacing Obamacare, which Republicans attempted to do more than 60 times when President Barack Obama was in office.

    The House of Representatives passed its own version of a repeal-and-replace bill, the American Health Care Act, in May, but the Senate has since been working on its own version.

    The first two versions of the Senate's bill, the Better Care Reconciliation Act, were opposed by some conservative and moderate members alike. The moderates thought the bill's cuts to Medicaid and the potential for massive coverage losses went too far. Conservatives, on the other hand, felt the bill did not go far enough in its rollback of the Affordable Care Act's regulatory structure.

    As a result, four Republican senators said they would oppose a motion for a key procedural vote, seemingly killing it last Monday.

    But it looked as if the GOP's repeal push may be geared up for a comeback when Sen. John McCain, of Arizona, who recently learned he had an aggressive form of brain cancer, announced on Monday that he would be returning to Capitol Hill to continue working to overhaul the healthcare system.

    Bob Bryan contributed reporting.

    SEE ALSO: The GOP healthcare bill went through another perilous week that has its supporters saying, 'Who knows?'

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    susan collins

    Republican Sen. Susan Collins of Maine was caught on a hot mic Tuesday calling Republican Rep. Blake Farenthold of Texas "unattractive" during a legislative session Tuesday morning.

    Last week, Farenthold singled out"female senators from the Northeast" as being responsible for hampering the Senate's effort to repeal and replace the Affordable Care Act, the healthcare law better known as Obamacare.

    Collins, along with Republican Sens. Shelley Moore Capito of West Virginia and Lisa Murkowski of Alaska, has opposed the Senate's proposed healthcare overhaul.

    Farenthold said "if it was a guy from south Texas" opposing the legislation, "I might ask him to step outside and settle this Aaron Burr-style."

    Collins mentioned Farenthold's comments Tuesday morning while speaking with a male senator during a subcommittee hearing.

    "Did you see the one who challenged me to a duel?" Collins asked her colleague.

    "I know," he replied. "Trust me — you know why he challenged you to a duel? Because you could beat the s--- out of him."

    Collins laughed and added, "He is so unattractive, it's unbelievable."

    She later asked her colleague, "Did you see the picture of him in his pajamas next to this bunny?" before the microphone cut off.

    Collins was most likely referring to this photo:

    The other senator wasn't immediately identified, but many reporters on Twitter speculated it was Sen. Jack Reed, the ranking Democratic member of the subcommittee.

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    mitch mcconnell

    On Monday night, Sen. John McCain said he would return to Washington to vote on key issues — most notably the Senate's push to overhaul the US healthcare system.

    McCain's dramatic return a week after announcing his diagnosis of brain cancer seems to indicate that the vote on the Senate's healthcare push, expected on Tuesday, is extremely close for Republican leaders.

    Senate Majority Leader Mitch McConnell said on the floor of the Senate Tuesday that the body will take up a motion to proceed, a key procedural vote to begin debate on the healthcare bill, later in the day.

    McConnell pushed Republicans to vote for the motion, since many members have been on the fence about the vote.

    "Any senators who votes against starting debate is telling American you are just fine with the Obamacare nightmare," McConnell said. 

    After a rush of confusion leading up to the vote, it appears that McConnell's tactics are starting to come into view.

    Based on statements from various members, McConnell's current plan is to allow a vote on an Obamacare repeal-only bill to go first and likely fail. Then, they will vote on the Better Care Reconciliation Act (BCRA) which would be a repeal and replace.

    Additionally, the BCRA may also include two amendments, one from Sen. Ted Cruz and one from Sen. Rob Portman. If these are included, the bill would need 60 votes to pass and thus would likely fail.

    (If you want a full breakdown of the three major pathways and their potential effects, Business Insider's Lydia Ramsey has everything you need to know here.)

    After those two ideas fail, it seems that McConnell will move on to a "skinny repeal." This would cobble together some amendments to repeal certain parts of Obamacare, like the individual mandate and medical device tax.

    If the Senate passes this skinny bill, the thinking goes, lawmakers from the House and Senate can come together to work on a compromise bill in a conference committee. What that would look like is unknown, but it would at least advance the bill and give McConnell some sort of victory.

    Despite this newly formed plan, few GOP senators knew before Tuesday what the details of the vote or the plan would be.

    "If you don't know of those things before you go in, you're sort of voting in a blind fashion," Sen Rand Paul, a conservative-leaning member of the conference, said on Monday. "I think we need more information. CBO needs to have scored the whole bill."

    Paul was then assured by McConnell that repeal-only bill and a skinny repeal bill would come up, putting him in favor of the motion.

    "I don't have a clue what we're gonna be voting on," said Sen. Ron Johnson, a Republican from Wisconsin. "I just need to know what I'm going to vote on. I'm not real happy with the process."

    It appears McConnell has the backing of President Donald Trump, who met on Monday with a moderate skeptic of the BCRA, Sen. Shelley Moore Capito, in her home state of West Virginia. On Tuesday, Trump launched into an early-morning tweetstorm urging senators to move forward with the process.

    "Big day for HealthCare," Trump tweeted. "After 7 years of talking, we will soon see whether or not Republicans are willing to step up to the plate!"

    When the Senate does "step up to the plate" on Tuesday, here's a rough outline of how the process is expected to go down:

    • McConnell will call for a motion to proceed on the House's American Health Care Act. Since every Democrat is expected to vote against this, no more than two GOP senators could do so. Sen. Susan Collins has said she will vote against it, leaving McConnell little room for error.
    • If the motion succeeds, 20 hours of debate — in legislative time — will begin, split equally between Democrats and Republicans.
    • The first amendment to be voted on is likely to be the ORRA to satisfy Paul and other conservatives. This plan is likely to be shot down by moderates.
    • The first amendment to be offered procedurally — but the second to be voted on, the news website Axios reported — would be the BCRA, which was last updated on Thursday. Again, Republicans can afford only two defections.
    • According to reports, there is an agreement between Sen. Rob Portman, a more moderate holdout, and Sen. Ted Cruz, a conservative, on an amendment that would keep the structure of the BCRA but allow insurers to sell non-Obamacare-compliant policies and throw in $100 billion to the state stabilization fund. But since that would require 60 votes to pass, and it has not been scored by the Congressional Budget Office, it is almost certainly doomed, since there are only 52 Republicans in the Senate.
    • There could then be a series of amendments to the House bill, including those from Democrats. Additionally, other healthcare legislation could be slotted in for a vote.
    • Finally, McConnell will try to push the Senate to pass a bundle of smaller amendments focused on repealing aspects of Obamacare like the individual mandate and medical-device tax. After this, the House and the Senate would flesh out a full replacement bill in a conference committee.

    According to a press release from McCain's office, the senator will be in the chambers to vote on the motion around 2:45 p.m. ET. This indicates the motion will be brought to the floor around that point.

    SEE ALSO: The Senate is planning to vote on a healthcare bill this week — we just don't know which one

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    Senate protester

    Protesters chanting "Kill the bill! Don't kill us!" and "Shame!" interrupted the Senate's vote on a motion to proceed to debate on the GOP healthcare bill on Monday afternoon. 

    Hundreds of protesters, organized by activist groups including the Center for Popular Democracy, gathered inside the Hart Senate building as Republican lawmakers narrowly passed the motion, overcoming the first major hurdle in the GOP's efforts to repeal and replace Obamacare. 

    Vox's Jeff Stein reported the demonstrators included physicians and Medicaid recipients, some in wheelchairs, chanting and waving signs in the lobby and hallways of the building.  

    Stein said that one group attempted to carry a coffin into the Senate building, but were blocked by security. 

    Another reporter on the scene, Jennifer Bendery of HuffPost, said that officials in the Senate were ordering protesters not to take photos and to delete photos that had been taken. Photography is prohibited in certain parts of the Senate. 

    Bendery also tweeted that reporters were blocked from the areas of the building where protesters were gathered. 

    Following the vote, Democratic senators gathered on the steps of the Capitol building to speak to a crowd of protesters. 

    "We came out here because we understand one thing," Sen. Elizabeth Warren called out through a megaphone. "The power is not in there, the power is out here. It's with the people."


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    mitch mcconnell protesterOn Tuesday, just as Senate Republicans were meeting behind closed doors to make their final case for a motion to proceed on debate of the health care bill, hundreds of protesters with ADAPT, a grassroots organization that fights for the rights of Americans with disabilities, were planning a massive sit-in at the lobby of one of the Senate office buildings, ADAPT spokesman Adam Prizio said in a phone interview.

    Before the vote to proceed passed, ADAPT vowed that if the Senate proceeded to the repeal vote, the organizations’ protesters would occupy the Hart building indefinitely — or until “police arrest [them], one-by-one.”

    “At 2 p.m., a few hundred of us will be holding a vigil in the Hart Senate Office Building pending outcome of the motion to proceed,” Prizio said. “If the vote passes, ADAPT will be very disappointed. America has seen what that looks like.”

    According to the ADAPT Twitter account, after the Senate passed the motion to proceed, the police circled protesters in the atrium of the Hart building. An organizer told Mic that at least 25 protesters have been arrested so far.

    This isn’t the first time ADAPT has organized protests against Senate Republicans over their mission to repeal and replace the Affordable Care Act. In June, dozens of protesters with the grassroots organization stormed the office of Senate Majority Leader Mitch McConnell, demanding that the Republican senator “stop the attacks on disabled people’s freedom.”

    In the press release for that protest, ADAPT argued that the Medicaid cuts in the bill would prove fatal to some Americans with disabilities.

    “The [bill] caps and significantly cuts Medicaid, which will greatly reduce access to medical care ... for elderly and disabled Americans who will either die or be forced into institutions,” the statement said. “Our lives and liberty shouldn’t be stolen to give a tax break to the wealthy.”

    That protest made national headlines when footage emerged from the scene of law enforcement physically removing protesters with disabilities.

    A reporter at the scene noted that police left a trail of blood as they dragged a man away from McConnell’s office.

    According to the Associated Press, dozens were arrested at that day of action.

    Republicans on Tuesday passed the motion to proceed to debate to repeal the ACA. The Senate is expected to vote on the repeal itself on Wednesday.

    SEE ALSO: 11 images show police forcibly removing disabled people during 'die-in' protest over Senate health care bill

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    Mitch McConnell, accompanied by Senator John Cornyn and Senator John Barrasso

    Senate Republicans will continue their debate on their efforts to reshape the US healthcare system, with the focus likely to shift to a straight repeal of the Affordable Care Act.

    The discussion has so far yielded one defeat after a vote on the latest version of a plan to repeal and replace Obamacare failed. The amended version of what's called the Better Care Reconciliation Act failed 57-43, as nine Republican senators joined all Democrats in opposing it. It needed 60 votes to advance.

    The debate began earlier Tuesday, and the Senate has 20 hours of legislative time to debate, time that's split equally between Democrats and Republicans, and some of which was used on Tuesday.

    Among the other options likely to be floated Wednesday are the Senate's plan to strictly repeal Obamacare. There's also the chance of a "skinny repeal" bill, which would repeal certain aspects of the ACA and, if passed, lead to the House and Senate working together to compromise on one final bill. 

    We'll be updating this post as the debate continues. 

    SEE ALSO: There's a 'looming healthcare crisis for the millennial generation' — and it's just getting started

    DON'T MISS: Americans are facing rising out-of-pocket healthcare costs — here's why

    1:10 p.m. - Senator Joe Donnelly introduces his motion to strip the bill of its Medicaid provisions.

    The second vote that's happening this afternoon will be on Donnelly's motion. The motion would send the bill back to the Senate Finance Committee to take out the provisions that cut Medicaid, end the Medicaid expansion, or shift costs toward states.

    The Better Care Reconciliation Act bill would cut $756 billion from Medicaid through 2026 and phases out the Medicaid expansion, while the repeal-only bill would cut $842 billion from Medicaid by 2026.   

    12:15 p.m. - Senate pushes back vote on repeal-only bill.

    The bill will now be voted on at 3:30 p.m. 

    11 a.m. - Debate ahead of vote on Obamacare repeal bill focuses on "skinny repeal."

    During the morning debate session, Democrats were the main voices on the floor. The senators, including Sens. Elizabeth Warren of Massachusetts and Senator Christopher Murphy of Connecticut used their time to attack a last-ditch effort to get a bill passed. The so-called "skinny repeal" bill, which would repeal certain aspects of the ACA — specifically the individual and employer mandates — and, if passed, lead to the House and Senate working together to compromise on one final bill. 

    Starting at 11:30 a.m., the Senate will start to vote on a repeal-only bill. The vote will be procedural, like the one that took place last night on a version of the repeal and replace plan. If it doesn't pass, it won't be the end of the road for the bill, but it should give a sense of what would happen to it if it came up for the full vote. 

    See the rest of the story at Business Insider

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    Sherry Glied, Dean of New York University's Robert F Wagner Graduate School of Public Service, and former assistant secretary for planning and evaluation at the Department of Health and Human Services, reveals the two things she wishes more people understood about their healthcare. Following is a transcript of the video.

    DR. SHERRY GLIED:There's two things about the healthcare system that people don't appreciate enough. One of them is how extremely concentrated healthcare costs are.

    If I take any random group of 100 people, the hundred people you work with, the hundred people you go to school with, one of those people in any given year is going to account for 25% of the costs of the whole group. Half of those people are going to account for 3% of the costs of the whole group.
    If you're an insurance company, and you can insure the half that's only going to cost 3%, you're doing a lot better than the insurance company that just happens to be unlucky enough to get that one person who turns out to be sick.
    That makes healthcare really hard to deal with because it's like playing hot potato. Who's going to be stuck with the person who's really sick at the end of the day? And there's a lot of waste in the system that consists of just moving that person around.
    And there's a lot of waste in the system that consists of just moving that person around.
    The second thing I wish people understood is that the reason healthcare costs get higher and higher every year — and this is different from why US healthcare costs are higher than other countries, this is a problem that's true everywhere in the world — is that we are able to do so much more for people than we were able to in the past.
    People are living longer lives, they're on the whole, living healthier lives. We see older people playing tennis. We see all kinds of extraordinary innovations in healthcare.
    People with Hepatitis C who had a death sentence just five or eight years ago and now can just finish their drugs and walk away with it. People surviving cancer — that all costs an awful lot of money, and it's money we didn't have to spend 50 years ago 'cause we didn't know how to do any of those things and those people just died or suffered.
    So, we get a lot for our dollar and that's part of what makes this so hard too. We're taking away something that's really valuable and important to people.

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