Tonight Is a Really Big Moment for the Repeal-and-Replace Effort

February 28, 2017

One-sixth of 2017 is done already!

Brace yourselves. . . the Not-The-State-of-the-Union-Address is tonight! (The first address of a new president is not considered a "State of the Union Address" but merely a "Joint Address to Congress.") What's the over/under on the number of times some congressional Democrat emulates Joe Wilson and yells out during Trump's speech? Does that lawmaker send out his first fundraising e-mail before the speech ends?

It is not reassuring to hear President Trump declare, "Nobody knew health care could be so complicated." Er, yes, Mr. President, just about anyone who spent more than ten minutes looking at the issues involved could see that coming.

You need enough young people to purchase health insurance that they're not likely to need and effectively overpay in order to cover the costs of the elderly and sick who will underpay. You need competition in plans in order to reduce prices, except most people find too many choices confusing and aren't great at predicting what kind of health-care costs they'll have in the future. You want to ensure no one is rejected from insurance for preexisting conditions and can afford their premiums, co-pays, and deductibles, but health insurance companies will tell you there's simply no way for them to make money on a customer like that.

You have a customer base that wants their insurance plans to cover all of the costs of birth control, neonatal care, breast pumps, trips to the emergency room, prescription drugs, pediatric services, lab tests, mental health care, and therapy… and they want low premiums.

Ideally, you would enact some kind of tort reform, to make it harder for ambulance-chasing lawyers to sue doctors; this would reduce doctors' expenses on malpractice insurance… but you don't want to make it too hard to win damages in cases of genuine malpractice.

The House Freedom Caucus wants to get rid of all of the taxes enacted in Obamacare: the medical-device tax, reduced deductions for generous "Cadillac" health-insurance plans, a ten percent tax on tanning-salon customers. Of course, without those, you have less money coming in to pay for everything the bill includes.

As noted in last week's interview with Scott Walker, one option is to take away the subsidy under Obamacare but replace it with a tax credit, ranging from $2,000 to $4,000. If that sounds like swapping out one form government assistance for another to you, a couple of North Carolina Republican members of Congress agree with you.

After examining a draft proposal that included that option, Representative Mark Walker declared, "the bill contains what increasingly appears to be a new health insurance entitlement with a Republican stamp on it." Representative Mark Meadows said Monday, "I'm opposed to refundable tax credits in the way the current draft, as I understand it, lays it out because it actually increases — provides for a new entitlement program."

If President Trump comes down heavily on one side or the other of this issue, it would probably persuade a portion of congressional Republicans. Trump could say, "Look, the people who elected me are angry because they feel like they can't afford anything anymore, including their health insurance. I'm not going to make my first major act as president to yank away the financial assistance they've got."

Or he could say, "A major reason health insurance is such a mess is the endless perception that somebody else will pay for most of the costs. Everybody's got to take responsibility for paying for their own health care. If we get enough competition among insurance providers, costs will go down."

Or he could just say, "It's gonna be terrific, you just wait and see," and not provide any details on these issues.

Under the Radar, Red-State Democrats Are Getting Pressured on Gorsuch Vote

Two big moves from outside groups aim to pump up grassroots support for the confirmation of Judge Neil Gorsuch to the Supreme Court.

Tonight, the Judicial Crisis Network will run ads on CNN and NBC around President Trump's address to the Joint Session of Congress. You can see the ad here.

Meanwhile, this week Concerned Veterans for America is launching a direct-mail campaign in seven states nationwide, asking citizens to urge their Senators to confirm Judge Neil Gorsuch without delay. The mailers will hit targeted markets in Colorado, Indiana, North Dakota, West Virginia, Missouri, Florida, and Montana.

Each piece of mail directs citizens to call a CVA switchboard where they are informed about Neil Gorsuch's record and then patched through to his or her Senator.

"The veteran community is deeply invested in ensuring that the next Supreme Court justice will respect the Constitution they fought and sacrificed to defend," said Mark Lucas, executive director of CVA. "We will continue mobilizing our activists to push their Senators to support Neil Gorsuch until the moment he is confirmed to the bench."

The Unlikely Storytelling Magic Trick of Miranda's War

When Adam Bellow asked me to take a look at Miranda's War, the latest novel from Liberty Island publishing, I wasn't immediately hooked. If I thought making life in the federal bureaucracy funny and dramatic and interesting was a challenge in The Weed Agency, then Howard Foster was attempting the literary equivalent of the triple-axel jump, setting his story in the local conservation commission of a small town in Massachusetts.

And yet somehow Foster pulls it off, by remembering that all politics and all stories are like Soylent Green: They're made of people. What starts out as a pair of mundane fights about a giant peace sign painted on a barn and the restoration costs of a historical estate escalates into a statewide clash of philosophies, ideologies, egos, and a struggle for power and a clear answer to that most fundamental question, the one that has rocked the world from Brexit to the 2016 presidential election: Who will decide on behalf of the people?

At first I wasn't even sure I liked the protagonist, the crusading gadfly Miranda Dalton; one of her aims is to keep public housing out of her town. As she says, "I know the academic progressive mind. I'm married to one. I joined the Conservation Commission to make us feel less guilty. Somebody needs to say we've done enough. Let us live our lives in this beautiful town." This book is a clear-eyed vivisection of a wealthy progressive's guilt and hypocrisy. Robert Frost said, "A liberal is a man too broadminded to take his own side in a quarrel." The residents of Lincoln, Massachusetts, are too worried about what others will think to stand up for their own rights.

But Foster wasn't afraid to make his heroine deeply flawed: Miranda is pushy, impatient, sometimes abrasive and one of those personalities who pursues a personal crusade at all costs — even increasingly sore feelings among her family. Bellow describes her as a "Trump-like figure." At one point she declares, "Formalism, adherence to a document that was written by people who are no longer here to judge our situation, all is repugnant to me," and I practically screamed at the book in my hands that that attitude is basically spitting on the Constitution.

But Miranda does hit on this dangerous de facto alliance of self-righteous regulatory bullies, ready to tell towns that they can't zone properties larger than half an acre because they've decided that will be too expensive, and a citizenry too distracted and timid to offer meaningful resistance. The more the town's "establishment" starts lining up against Miranda in defense of a status quo of legal appeasement, the more you find yourself rooting for her.

There's an outsider GOP congressional candidate who forms an awkward alliance with Miranda and has a bit of his own Bulworth moment, speaking to a crowd and tossing away his boilerplate and blurting out what he really thinks:

Rule number one, don't look to politicians for help. We only want to get elected. We'll tell you what we think you want to hear, that the Fed should raise interest rates twenty-five basis points but no more, that we can solve the healthcare crisis, that we know the proper amount of regulation. That's bull…. Rule number two, Whenever a politician likes a program and promotes it, scratch the surface and you'll find he's got skin in the game. Some friend is getting a subsidy from it, or some group of citizens, like senior citizens, expects it. Now, I'm not against every program, and I favor helping some senior citizens. But federal programs exist to help politicians first and foremost. The best Congressman or Congresswoman is the person who will look a constituent in the eye and say, "the federal government should not get involved in your problem."

Foster is a Chicago-based RICO attorney who grew up in Newton, Massachusetts, and he writes with a sharp, jaundiced eye about the idiosyncrasies of local politics. His ability to find great drama in conservation commissions and zoning laws reminded me of a comment from Twin Peaks co-creator Mark Frost about how most good stories are "really an examination of the nature of good and evil in people's hearts… You don't have to go to a big city or have famous characters to find that kind of divide."

ADDENDA: I'm scheduled to appear on CNN International today at 2:30 p.m. EST.