Quick Takes: Will Trump Face a Government Shutdown On His 100th Day?

Quick Takes: Will Trump Face a Government Shutdown On His 100th Day?

The Washington Monthly

* While we’ve all been focused on the disaster of the Republican failure to repeal Obamacare and what that means for tax reform, a deadline is fast approaching. Last December, Congress passed a continuing resolution to keep the government funded. The trouble is, it runs out on April 28th. That means that Congress has exactly one month to figure out a budget, pass another continuing resolution, or face a government shutdown. The timing is interesting. Trump’s 100th day in office hits the very next day – April 29th.

* On Friday I suggested that we might have just witnessed the worst week ever for a first-term president. Walter Shapiro was thinking along the same lines:

From James Comey’s artfully cloaked shiv in last Monday’s congressional testimony to the head-for-the-lifeboats abandonment of Trumpcare on Friday, it is hard to recall a president who has had a worse week without someone being indicted.

* Similarly, as we head towards Trump’s 100th day in office and a possible government shutdown, here’s how a Republican strategist summed things up.

“No administration has ever been off to a worse 100-day start,” said Steve Schmidt, a longtime Republican strategist who served as a counselor to Vice President Dick Cheney.

* For an exclamation point on all that, here’s Gallup today:

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* Today AG Sessions attended the WH Press Briefing to threaten so-called “sanctuary cities.” David Kurtz nailed it with his commentary.

Perhaps the White House had planned all along for Attorney General Jeff Sessions to make an appearance at today’s press briefing to rail against sanctuary cities. But the timing is consistent with what I’ve long feared will be the impulse for the Trump administration: When the going gets rough (failed Obamacare repeal, low poll numbers, etc), it will fall back on appeals to racism and xenophobia to regain political footing.

With so much incompetence taking root, it’s not difficult to envision a scenario where those base appeals must become more amped up, extreme, and scurrilous to be “effective.” It threatens to turn into a vicious cycle the likes of which we’ve never seen in this country.

* The story about Devin Nunes’ revelation last Wednesday got even more bizarre today.

The day before he announced to reporters that Donald Trump may have been incidentally monitored by U.S. intelligence agencies during the transition, House Intelligence Committee Chairman Devin Nunes met with the source of that information at the White House, a Nunes spokesman told NBC News.

* Let’s hope this is one of several to come.

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* Finally, earlier today I suggested that the flip side of Trump’s failures will be the persistence of Obama’s legacy. Back in January, Jonathan Chait published a book titled, “Audacity: How Barack Obama Defied His Critics and Created a Legacy That Will Prevail.” After the election Chait took some heat for this focus that went against conventional wisdom, which had solidified around the idea that Obama’s legacy was toast. But he defended himself by titling an excerpt: “Barack Obama’s Legacy Is More Secure Than You, or the GOP, Think.” Right now Chait is looking a bit more prescient.

Trump may very well destroy the underpinnings of a system of government put in place more than two and a quarter centuries ago, and if he does, it will be not only Obama’s legacy that is repealed but the legacies of every president from Washington onward. But the future is not predetermined. It depends upon our actions and choices. Protecting, fulfilling, and, in some cases, restoring Obama’s legacy will require mustering the political will to rally around it. If Obama’s supporters defend the pillars of his legacy, rather than fatalistically accept their destruction, they stand a good chance of warding off the most frontal attacks. And where they fail, and Obama’s achievements are repealed, then they can set out to repeal the repeal when the opportunity presents itself.

And it will. Previous generations of Americans knew times when it seemed impossible to imagine slavery might be abolished, women given the right to vote, business subject to any government regulation. Progress tends to come in great dramatic bursts of action and then recede. Barack Obama’s presidency represented one of those great bursts. His was a vision and incarnation of an American future. His enemies long to restore a past of rigid social hierarchy, with a threadbare state that yields to the economically powerful. He, not they, represents the values of the youngest Americans and the world they will one day inhabit.

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Democratic Ideas on How to Improve Health Care Are Complicated Too

Democratic Ideas on How to Improve Health Care Are Complicated Too

The Washington Monthly

On the heels of the failure by Republicans to repeal Obamacare, a discussion has emerged about whether or not Democrats should advance their own plans to improve the system. The latest edition of the Washington Monthly featured three ideas Democrats could incorporateDavid Atkins noted that Bernie Sanders has revived his call for single payer, and Steven Waldman suggests a grand health care bargain.

One way to evaluate all the ideas that are being generated is to break them down into two broad categories. In most cases these proposals have to do with either (1) changing the way we get health insurance or (2) trying to reduce the costs of actual health care. The reason this is important is because the difference is often determined by where we see the biggest problem.

To be clear, most people that are advocating for a change in the way insurance is provided (i.e., single payer and public option) are doing so because they believe that it will not only increase access, but that it will reduce costs. That usually rests on the assumption that the main driver of why health care is so expensive in this country is because of private insurers. The corollary is that either a public option or single payer will make health insurance less expensive, along with more accessible.

Those who advocate ways to reduce the costs of actual care assume that the main driver of our health care costs is already baked into the system prior to a discussion about insurance. It is to be found in how/what we pay providers and how that care is delivered. Of course, that can overlap with the issue of insurers based on what it is they pay for.

So while there are big areas of overlap, a short way of saying all this is that your solutions are mostly driven by how it is you describe the problem and who is the identified villain. To oversimplify things, is it the insurers or the providers?

While Obamacare certainly wasn’t single payer and ultimately didn’t include a public option, most of it tackled the issue of how health insurance is provided. The expansion of Medicaid is a great example. And while many of the ideas being articulated now are important for Democrats to consider, it is also significant to remember that there are still 19 states that have refused to do so. Millions of Americans would have access to insurance and health care if that was tackled.

Beyond that, Obamacare attempted to solve the problem of how people access insurance in the individual market and it created reforms like ending denials for pre-existing conditions, the list of essential health benefits, and the requirement that preventative services be provided without any out-of-pocket expense for patients.

One huge change Obamacare implemented when it comes to insurance companies is the medical loss ratio (MLR) in which their overhead and profit are limited to 15% (20% in the individual market) of what they charge in premiums. But when it comes to the exchanges, that hasn’t even come into play because the insurance companies still aren’t making a profit there. So it’s hard to make them into the villains of this story.

I think David is right when he says that any movement on single payer is likely to come from the states in the near future. We know that Vermont tried and failed to make it work. It will be interesting to see whether or not a larger state like California can figure it out.

When it comes to the public option, it is important to remember that, among Democrats, there were three different factions on that issue when Obamacare was being negotiated. We heard mostly from conservative Senators who were completely against the idea of including one. I remember the day I knew that a public option was dead. It was when Blanche Lincoln took to the Senate floor to announce that she would not vote for a bill that included a public option. Of course there were others who joined her, but one vote was all it would take to fall short of the 60 needed for passage. A statement on the Senate floor was definitive. It wasn’t going to happen.

But that battle obscured the one that happened over the public option in the House. There the disagreement was over what kind of public option would be included. This is where the issues of insurance and cost of care overlapped. Progressive Democrats tended to support what came to be known as a “robust” public option. It would tie payment to providers to the Medicare payment system. Conservative Democrats favored a public option that allowed HHS to negotiate payments with providers. In the end, Conservative Democrats won and it was their plan which was included in the House bill and later removed via reconciliation with the Senate. Interestingly enough, CBO said that premiums for that public option would be slightly higher than the private plans offered in the exchange.

A later CBO report found that a “robust” public option would produce premiums that are 7-8% lower than private plans. Here is why that is important: Medicare doesn’t negotiate rates, it sets them. And overall, Medicare tends to pay 80% of what private insurers pay. That sounds like a good way to tackle the cost control problem, right?

But there is a potential problem with that. Providers tend to accept Medicare because the volume of treating elderly patients makes it worth doing so for fewer dollars per procedure. When it comes to younger more healthy people, will that hold? If Medicaid is any indicator, it might not. Since Medicaid is mostly administered by states, the comparison is difficult, but overall there are big problems in some states with finding providers who accept it. When we advocate for a public option, this is something to keep in mind.

On the cost control issue, Obamacare took a more experimental approach. The two most important inclusions were Comprehensive Primary Care (which reimburses providers for outcomes rather than the number of services provided) and the Medicare Payment Advisory Commission (which looks for innovation in cost controls with Medicare). Both of these initiatives are still in the early stages, but encapsulate some of the best thinking on how to rein in health care costs.

As Democrats consider proposals to continue improvement on health care access and costs, this information points to some key issues to pursue:

  • Keep pushing for Medicaid expansion
  • Let states experiment with single payer
  • Refine efforts to design a payment structure for a public option
  • Track the success of cost control mechanisms already underway via Obamacare and develop plans to take them up to scale

Obviously Donald Trump just learned that health care is complicated. Democrats should be well aware of that by now and avoid jumping on a bandwagon that simply sounds good.

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How a Tricky Tactic by Congressional Republicans Destroyed Trump’s Agenda

How a Tricky Tactic by Congressional Republicans Destroyed Trump’s Agenda

The Washington Monthly

You’ll be hearing a lot about something called the budget reconciliation process this week. My colleague is already on it. It’s wonky, confusing, and probably boring to most people, but if you want to understand it (and you should), the best place to start is by reading this explainer by David Reich and Richard Kogan of the Center for Budget and Policy Priorities. I refer you to them, in part, because I don’t want to have to explain it all myself but I need you to understand some basics in order to follow what I have to say about the resulting politics.

One part of the Republicans’ legislative plan for this year involves something that has never been done before. Back in November, Senate Majority Leader Mitch McConnell held a press conference to announce that he and House Speaker Paul Ryan would be passing two budget resolutions in one year. Forbes headlined this as “GOP To Use Previously Unheard Of Tactic To Slam Dunk Trump Agenda.” It looked like some kind of mad genius Jedi mind trick stuff, and it was hatched because the Republicans were trying to figure out how to enact things through the Senate without having them filibustered by the Democrats. The only way to do that is to attach instructions to privileged budget resolutions that only require a simple majority to pass. The instructions will tell one or more committees to figure out how to (usually) improve the budget by reducing spending. Then later in the year, those changes can be voted on again with a simple majority. It’s the second vote that is the reconciliation, because it reconciles the budget with what was intended at the beginning of the year. I can feel your eyes glazing over already, so let’s just put it this way: if you want to get around a filibuster, one way to do it is to attach your bill to the annual budget resolution.

But there are a bunch of limitations to what can be included in a budget reconciliation bill. It has to affect revenues, for example. And then there’s this (the bolded emphasis is mine and you can ignore that part about the debt limit):

Under Senate interpretations of the Congressional Budget Act, the Senate can consider the three basic subjects of reconciliation — spending, revenues, and debt limit — in a single bill or multiple bills, but it can consider each of these three in only one bill per year (unless Congress passes a second budget resolution). Consequently, in the Senate there can be a maximum of three reconciliation bills in a year, one for each of the basic subjects of reconciliation.

This rule is most significant if the first reconciliation bill that the Senate takes up affects both spending and revenues. Even if that bill is overwhelmingly devoted to only one of those subjects, no subsequent reconciliation bill can affect either revenues or spending because the first bill already addressed them.

In normal human language, what this means is that when the Republicans decided to use the Budget Reconciliation process to address the changes they wanted to make to the Affordable Care Act, they were doing something that would impact both revenues and spending. That means that they’ve already used up the Budget Resolution they passed in January. If they want to enact tax reform without worrying about the filibuster, they’ll need to pass a second Budget Resolution.

But how do you have two budgets for the same year? Has there been a tear in the space-time continuum?

Actually, no, as Forbes explained last November, this is just a gimmick made possible by a failure to pass a Budget Resolution last year.

This strategy is possible because Congress failed (or, in the case of the Senate, didn’t even try) to adopt a fiscal 2017 budget resolution when it was supposed to last April. As a result, and even though it would be way past the statutory deadline, Congress has the authority to pass one next year.

Congress did pass the fiscal year 2017 Budget Resolution this year. You can read a summary of that bill here, and the January 13th House roll call vote is here. What they just failed to do last Friday is to pass (or even vote on) a very early Budget Reconciliation bill that was meant to be the capstone on that first Budget Resolution.

Now, you’ve probably heard that the failure to pass the Obamacare-gutting Budget Reconciliation bill on Friday has “imperiled” or “jeopardized” or made it “much harder” for the Republicans to act on Trump’s plans for tax reform.  What you probably haven’t had adequately explained is why this is the case.

In one sense, the plan hasn’t changed. All along, the idea was that tax reform would get around the Senate filibuster by being attached to this unprecedented second Budget Resolution bill. There is more than one reason why they set things up this way, but one of them was they wanted to act so quickly to repeal Obamacare that it didn’t give them time to really consider this fiscal year’s budget.  That’s why they decided to use the empty shell of last year’s unenacted Budget Resolution for Obamacare repeal.

Still, even if Obamacare repeal and tax reform were separated, they needed to work in tandem.  And this part is pretty tedious to explain because it gets down in the weeds of something called the Byrd Rule. Here’s the Cliff Notes version. The Byrd Rule determines what can and cannot be included in a Budget Reconciliation bill in the Senate, and it has two important restrictions, one relating to the long-term deficit and one pertaining to the short-term deficit. On the long term deficit, the Byrd Rule prohibits the use of reconciliation for provisions that would increase the deficit beyond 10 years after the reconciliation measure. This is why President Bush’s tax cuts sunsetted after ten years.

On the short-term deficit, the Byrd Rule prohibits changes that would increase the deficit for a fiscal year beyond those covered by the reconciliation measure. In other words, overall, the bill cannot increase the deficit beyond ten years, and in any given year within that ten years, the increases must be authorized in the Budget Resolution.

These constraints present a variety of obstacles, and they are even greater when you consider what Tim Fernholz explained in an excellent Quartz article on March 10th.

…if your reconciliation bill isn’t revenue-neutral, like a tax cut, it will have to sunset in 10 years.
This is how former US president George W. Bush passed his massive tax-cut package in the first term of his presidency, and why it expired in 2013, setting up a massive fiscal showdown as Democrats attempted—and ultimately were able—to roll back some of the tax cuts on the wealthy.

But [Speaker Paul] Ryan and this generation of Republicans aim to avoid the fate of the Bush tax cuts. To do so, they’ll need to pass a reconciliation bill that is largely revenue-neutral. How will they get there with a plan to cut as much as $2.4 trillion in taxes over the next decade?

The answer was supposed to be that savings from gutting Obamacare would offset the costs of tax cuts, but those savings aren’t going to be available now.

Professor Rebecca M. Kysar of Brooklyn Law School explained in Slate recently why it’s bad policy to tackle something as complicated as tax reform in a Budget Reconciliation process, and one of her reasons was that tax cuts that are scheduled to sunset (but might not) create needless uncertainty in the economy. But she was assuming that the tax cuts would have to sunset. The plan, however, was designed to assure that they would not need to sunset. Whatever else you might say for the merits of Trump’s tax reform, the plan to enact them is now in tatters and a sunset provision cannot be avoided.

Another problem is political. While it’s possible to increase the deficit using budget reconciliation, the process is designed to do the opposite. As a result, opponents can raise points of order to object to provisions that raise the deficit unless those provisions are specifically authorized by the instructions given to the drafting committees in the Budget Resolution. This means, a majority in the Senate has to vote to increase the deficit before they even know the details of how the deficit will be raised. And it gets even more complicated when you realize that “the Byrd Rule prohibits changes that would increase the deficit for a (given) fiscal year beyond those covered by the reconciliation measure.” How do you anticipate the year-to-year deficit increases of a tax bill before you’ve even drafted it?

The non-eyes-glazing-over version of this is that it will be very hard to craft instructions in the next Budget Resolution bill that can survive challenges when the time comes to pass the next Budget Reconciliation bill.

So, these are some of the ways that the failure to gut Obamacare has imperiled the effort to enact tax reform using a simple majority in the Senate.

The drafters of the tax reform almost definitely will have to accept that their bill must sunset after ten years because they can’t demonstrate offsets that would make their bill deficit neutral. Politically, they need to convince their Freedom Caucus to authorize what looks like trillions of dollars in deficit spending on the front-end without being able to discuss the details. Technically, they’ll have to craft instructions for short-term year-to-year deficit spending that can survive Byrd Rule challenges, but they’ll have to do this blind before the bill is even marked up.

And if they can accomplish all of that, which seems exceedingly difficult but not technically impossible, they’ll have to make it into something that can pass the House and can avoid losing more than three members of their caucus in the Senate.

This is a challenge that looks a lot harder than getting dealt an inside straight. And that’s probably a big part of the reason that Reince Priebus went on “Fox News Sunday” yesterday and “held out the possibility of working with moderate Democrats” on tax reform.

We need to be clear that there is no way for Trump to work with any Democrats (moderate or otherwise) on tax reform if he’s still planning on using the Budget Reconciliation plan. And, I know that Treasury Secretary Steven Mnuchin tried to keep a stiff upper lip on Friday when he said that “health care is a very complicated issue,” but “in a way, tax reform is a lot simpler,” but that’s not even close to being true. The last real comprehensive tax reform plan was authored by Democratic Senator Bill Bradley for Ronald Reagan in 1986. It wasn’t easy then, and nothing that ambitious in this field has been accomplished since.

As I wrote over the weekend in my Trump Built His Own Prison piece, it’s not going to be a simple pivot for the president from his original plan to enact his agenda with nothing but Republican votes to asking the Democrats to join him on things like infrastructure and tax reform. In fact, I don’t think he’s capable of making that pivot and the Democrats are in no mood to welcome him with open arms.

In fact, I want to reiterate this point:

Of course, so far I’ve been ignoring the elephant in the room, which is the federal and congressional investigations of his campaign’s connections to the Russians. He needs the Republicans to be united enough behind him to create a line of defense that can hold. Having insulted so many key congressional Republicans, and running a foreign policy that is not trusted by the Republican establishment, and having made enemies of the Intelligence Community and the media, Trump can ill afford to give Republicans a reason to abandon him. That effectively cuts him off from running to Schumer and Pelosi and asking them to help him enact new tax reforms, infrastructure investment, and trade policies.

I do not feel sorry for him. But I also can’t see how he can navigate out of the prison he’s constructed for himself. He’s barely been in office for two months and he’s already cut off every possibility for success.

His administration had a plan. That plan is not going to work. The problem is, the way they pursued their initial plan has blocked them from finding a viable Plan B.

His tax reform is dead in the water and cannot be revived.

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Trump Is Facing Massive Failure, Leaving Much of Obama’s Legacy Intact

Trump Is Facing Massive Failure, Leaving Much of Obama’s Legacy Intact

The Washington Monthly

Following the 2016 election, conventional wisdom was that the Obama legacy would be short-lived. After all, Republicans won the presidency and maintained control of both houses of Congress and they were destined to undo much of what our 44th president accomplished.

But since Republicans didn’t gain a 60 vote majority in the Senate, any legislation they attempted to pass would still be subject to a filibuster by Democrats. Rather than try to work with the opposition party to enact legislation, the Republicans came up with a grand strategy on how to avoid a filibuster on their two main priorities: Obamacare repeal and tax reform. They would use the process of budget reconciliation, which only requires a simple majority.

In order to understand what the failure to repeal Obamacare using budget reconciliation means, it is important to keep a few facts in mind. Reconciliation must be tied to a budget resolution and can only be used once in any fiscal year. Because of that, Republicans didn’t use the reconciliation process in 2016. Instead, they saved it for this Congress and wrote rules into the FY17 budget resolution that tied it to the repeal of Obamacare. The plan was to follow that up immediately with a FY18 budget resolution and tie that one to tax reform.

As Evan Horowitz explained prior to the failure to repeal Obamacare, they have now squandered one of their two attempts to bypass the need to work with Democrats.

…Republicans don’t have the option of temporarily setting health care aside to take up tax reform. If they try, they will lose their shot at two reconciliation bills.

They can’t easily switch the order either, since they’ve already passed a resolution officially stating that they plan to use [FY17] reconciliation for health care reform.

This is why Speaker Ryan said, after they failed to garner enough votes to pass Obamacare repeal, that the law would be with us for the foreseeable future. Once they move on the the FY18 budget resolution and reconciliation process on tax reform, they have forfeited the ability to us the FY17 process for Obamacare repeal. It is possible that they could use this same process in subsequent years to try again, but that is highly unlikely.

Unlike what the Republicans claim, Obamacare is not about to implode. So the ball is now in HHS Secretary Price’s court to see if he can make it unravel via changes in the regulations. That means that the focus will likely shift to the courts as those actions are challenged. In other words, Republicans are in for a long, hard struggle to damage Obamacare.

Meanwhile, Congressional action will shift to tax reform. Because the plan is to use the same reconciliation process, the question is: will it be any easier than repealing Obamacare? Stan Collender says no.

Repealing and replacing the existing system rather than starting from scratch where there wasn’t one before means that, just like with Obamacare, tax reform will create losers as well as winners. It’s virtually guaranteed that the companies who will pay more because of the proposed changes will fight at least as hard as those that will pay less. That will make the tax reform debate longer, tougher and much nastier than anyone is currently assuming.

Collender goes on to explain that using reconciliation to pass tax reform will require Republicans to pass a budget resolution by May/June.

The January fiscal 2017 budget resolution was largely pro forma; it made no substantive policy changes and was done just to get reconciliation instructions in place for ACA repeal. Many House and Senate Republicans held their noses and voted for it even though it had high deficits and what they considered to be excessive spending levels only so the ACA repeal debate could get underway.

By contrast, the fiscal 2018 budget resolution that Congress will consider later this year will be the real thing, with deficits and spending levels that will be anything but acceptable to many representatives and senators.

Finally, Republicans will once again have to deal with CBO.

CBO (and the Joint Committee on Taxation) will play an even larger role in the tax reform debate because whether the plan adds to the budget deficit will be one of the biggest issues. As was the case with ACA, a bad score from CBO on tax reform could easily force the legislation’s drafters back to the drawing board and substantially reduce support for the overall effort.

That covers the policy issues Republicans will face in tackling tax reform. But there are also political challenges. Right now they are still engaged in finger-pointing over their failure to repeal Obamacare. But as Alan Rappeport reports, the Trump administration might be more engaged on this issue than they were last round, and their plans don’t necessarily align with Speaker Ryan’s. Beyond that, some of the major players in the White House are at odds with each other on tax reform as well as on other issues. None of that even gets to the division among Republicans in Congress.

Prior to the collapse of their effort to repeal Obamacare, it might have been possible to imagine Republicans overcoming these challenges. But they have squandered momentum and, for now, failure hangs in the air.

Those are the issues with which the Trump administration and Congress will be grappling through the spring, summer and into fall. Meanwhile, two of Trump’s other big promises will languish. As regular readers here know, I’ve always been bearish on whether or not his infrastructure plan would see the light of day. And as I wrote recently, finding the funds to pay for his border wall is only the first thing that could derail that whole effort. The reality is that, when it comes to governing, Trump might be about to learn that health care isn’t the only thing that is complicated.

The 100th day of Trump’s administration is only a little over a month away (April 29th). It is now clear that he won’t even begin to meet the promises he made about what he would accomplish by then. But if the first year of his presidency ends without any real movement on Obamacare repeal, tax reform, infrastructure and a border wall, it would represent a massive failure. And at least when it comes to these issues, Obama’s legacy would live on.

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This Local Government Innovation Could Help Cure Trumpism

This Local Government Innovation Could Help Cure Trumpism

The Washington Monthly

One of the many factors behind Donald Trump’s shocking victory was his ability to both tap into and stoke the sentiment that government is out to help itself, not regular Americans. This idea figured prominently in his inaugural address: “For too long, a small group in our nation’s Capital has reaped the rewards of government while the people have borne the cost.” Of course, there are reasons to doubt Donald Trump’s ability, resources, or motivations to make Washington less corrupt.

But there’s no denying that millions of Americans feel deeply alienated from government, and that this feeling enabled Trump and Trumpism. It’s a difficult problem to solve, because any individual person does not have much say over what happens in Washington. That’s why a key to fighting this deep mistrust and cynicism is to give citizens a bigger voice in local government, where it’s much easier for an ordinary person to have an impact.

One promising approach is something called participatory budgeting. Here’s how it works: neighborhood residents identify local spending priorities, sign up (or are elected) to craft viable budget proposals, and turn the proposals over to the community for a vote. Elected officials, in turn, pledge to implement the projects that the people have chosen. The project could be a community arts center designed by constituents, or funding for a park, or new computers for the local high school.

That may sound like small-scale policy change, but there’s a lot of power in giving people control over how money is spent in their immediate communities. In the spring of 2014, in a school gymnasium in East Boston, I watched young people aged 12-25 vote in a participatory budgeting decision. For many, this was their first vote. Some had heard about it from a flyer offering free pizza and democracy. While the pizza may have lured them in, many continued coming back to meetings because they were excited by meeting and working with members of their community to exercise genuine civic power. I heard teens incredulously ask a city official, “Do we really have say over $1 million dollars?” The city staff had to keep reassuring them: Yes, these are real taxpayer dollars and you have power over them! The Boston vote—the first youth-driven participatory budgeting exercise in the U.S.—resulted in funding for seven projects, including a playground upgrade, Chromebooks for three high schools, and security cameras for a park.

Participatory budgeting began in Porto Alegre, Brazil, in 1989, after a 20-year military dictatorship. Since then, it has spread to thousands of local governments around the world. (The non-profit Participatory Budgeting Project has been pushing for its adoption across the United States.) The process has proven to engage traditionally marginalized communities. It also produces good results. For example, Brian Wampler and Mike Touchton, political scientists at Boise State University, found that in Brazil, municipal governments that adopted participatory budgeting ended up spending more on education and sanitation and saw infant mortality decrease.

But apart from whether participatory budgeting leads to wise government expenditures, the process provides several important and potentially transformative impacts for civic life. One of the most powerful motifs in the “government elites ignore the people” narrative is the idea that a central government sucks up taxes and then spends it on things that don’t help the people who paid them. (Katherine J. Cramer documents this phenomenon in The Politics of Resentment.) By letting ordinary people set binding spending decisions, not merely advisory input that legislators can choose to ignore, participatory budgeting makes it harder for people to say that government is simply ignoring them. And letting people learn firsthand how governmental decisions get made can begin to repair institutional mistrust.

In the U.S., the largest participatory budgeting experiment so far has been in New York City. Starting in 2009 with a bipartisan group of four City Council members, the process in 2016 involved 28 (of the 51) council members and has a centralized support structure in the Speaker of the City Council’s office. The Community Development Project at the Urban Justice Center reports that in 2015, 51,362 New Yorkers allocated nearly $32 million in public dollars. More broadly, the Obama Administration incorporated commitments to support participatory budgeting through federal community development block grants given out by the Department of Housing and Urban Development. (I served as an advisor in the Obama White House Office of Science and Technology Policy to help spread the use of participatory budgeting and other community-led civic interventions.)

Perhaps the most important aspect of participatory budgeting in the U.S. has been the dialogue and deliberation that it forces people to engage in. Conversations with different members of the community enable people to engage first hand with their neighbors and public officials. In hundreds of interviews that I conducted while researching my book, people cited the ability to converse as crucial. People get to know their neighbors, often for the first time. They also get to know their elected officials and public servants. By coming together, weighing trade offs and learning about how much things cost people receive civic education in the most literal, hands-on sense: they learn what it actually takes to decide how the government should spend its money. They find out, for example, that their dream parks project costs much more than they imagined, or that it involves complex coordination across five agencies, or that the city is already working on similar improvements.

As you would expect, research has shown that participatory budgeting tends to lead to policies that voters prefer. But participatory budgeting isn’t merely a technocratic, good-government innovation. By including ordinary people in the core function of government—deciding how to spend money—it represents one of the most direct ways of making government literally of the people, by the people, and for the people. That makes it, along with other forms of participatory democracy, a potentially powerful way to combat the anti-government, anti-elite furor that has fueled Trump and Trumpism.

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A Grand Health Care Bargain: Let States Kill the Exchanges, but Add Public Options

A Grand Health Care Bargain: Let States Kill the Exchanges, but Add Public Options

The Washington Monthly

After President Trump hilariously blamed the failure of Trumpcare on the Democrats, no one but his most fervent supporters took it seriously. He and Paul Ryan never even tried to garner Democratic support to repeal Obamacare; nor did they have any right to expect Democrats to help repeal the first program ever passed to provide near universal health coverage. But then Trump said this: “when they come to make a deal,” he’ll be receptive. It could be total bullshit, but if Trump is genuinely willing to embrace an approach that’s not dependent on the Freedom Caucus (his new Worst Friends Forever), a very good grand bargain actually is possible.

To see the shape of one possible deal, one must start by understanding the Democrats’ actual views about Obamacare (as opposed to the caricatures fed by conservative media and politicians for seven years).

Democrats were divided in 2009 between those who wanted a single-payer system and those willing to accept more of a market-based approach, in which most insurance would still be provided by private companies. Obama pushed for the latter, based on Mitt Romney’s system in Massachusetts.

So while Democrats like many things about Obamacare, they don’t actually have a deep allegiance to the state exchanges, which have ended up as the most problematic part of the system. Democrats have defended them because right now they’re the only solution for the individual insurance market.

But Democrats should be willing to throw the state exchanges overboard for the right deal. Here’s an idea: let states kill the exchanges, but add a robust “public option” tied to Medicaid, Medicare or the Veterans Administration health system.

The concept of the public option has evolved. During the 2009 legislative process, progressives pushed hard for a provision allowing government-run insurance plans to be offered in the state exchanges. This, they argued, would help the exchanges would work better by providing a fall-back plan in counties where there were too few private insurance plans. And they viewed it as a step toward a single payer system. But conservative Democrats balked and the provision died.

In the 2016 presidential campaign, a new kind of public option was born. In response to Bernie Sanders’ advocacy of “Medicare for All”—a single-payer system run through the Medicare program—Hillary Clinton proposed a “Medicare buy in” plan.  Under her plan, people between the ages of fifty and sixty-five would be able to “buy in” to Medicare, paying discounted premiums and getting the Medicare benefit system.

In the days since Trumpcare’s failure, some Democrats have revived the idea of Medicare for All. As an opening gambit for bargaining, the idea makes some sense. But in addition to it being politically impossible right now, Medicare for All would be devilishly hard to make work and would likely spark immense political opposition not only from Republicans but from seniors jealous of sharing their “earned” benefits with others who haven’t paid into the system as they have.

A more plausible idea comes from an unlikely source: Christopher Ruddy, the publisher of the ultra-right-wing site NewsMax and a big Trump pal. Ruddy suggests that Trump give up on dealing with the conservative Republicans (since they don’t want universal coverage) and instead strike a bipartisan deal in which “an upgraded Medicaid system” would “become the country’s blanket insurer for the uninsured.” Ruddy doesn’t cast it as a buy-in, but it’s pretty close, since he wants to remove the income requirement on Medicaid, which currently is limited to the poor. He notes that Medicaid is actually better than Medicare at containing costs. Indeed, some of the most encouraging experiments—in terms of lowering costs and improving health outcomes—have come with Medicaid dollars. And because Medicaid is seen as insurance for the poor, rather than the elderly, opening a buy-in option for it is unlikely to trigger the same kind of political blowback from seniors.

A third government program that ought to be part of a deal is VA health care. As Phil Longman and others have noted in this magazine for more than a decade, the VA provides as good or better care at lower cost than virtually any other health care system in the country. That’s true today, despite all the (mostly false) horror stories we’ve been told about veterans dying as a result of long waits for doctor appointments. The VA has actually been far more successful than fee-for-service Medicare at containing costs and encouraging outcome-based medicine.

What if we combined these ideas?

First, require that states allow anyone to buy into Medicaid, with premiums tied to income.

Second, make all veterans, not just those with service-related medical conditions, eligible for VA care, and allow their spouses and children to buy into it as well. Politically, veterans’ groups would probably welcome this idea, because it would shore up demand for veterans’ facilities that is currently declining along the number of veterans.

Third, do as Clinton suggested and let Americans aged fifty and older buy into Medicare. (Over the long-term, Medicare itself needs to be reformed as a way of controlling overall medical cost inflation, but that’s for another day.)

With these options available, states could choose to shut down their state exchanges if they want. They could eliminate benefit requirements for the private insurance in the individual market. Let a wider variety of low-budget plans to proliferate as Republicans have advocated. If they’re not adequate people would have the safety net of being able to get government financed health care.

In truth, these three government programs are quite different. Over time, we’d develop a sense of which of the public models—Medicare, Medicaid or VA—works best. We would be able to compare their track records in terms of not only coverage and costs, but also health outcomes. The system could evolve in the direction of one of those approaches, or could result in a hybrid that combines private insurance with a robust public option.

But since it would be voluntary, no person would have to choose “government run health care.” Indeed, the private sector would be liberated to provide health insurance with less interference. As part of a deal, Democrats could allow for more selling of insurance across state lines (something the Obama administration was open to in some forms) and medical malpractice reform (which Obama had also expressed a willingness to negotiate on in exchange for something truly substantial).

In other words, Republicans can get a less regulated private insurance market in exchange for there being a powerful public option.

I’m obviously dramatically oversimplifying the particulars of what Trump called “the little shit,” i.e., how the systems actually work.  But the elements of a grand bargain are there.

One other possible advantage: it would drain some toxins from the health care debate. Conservative who hate government involvement in health care are free to choose private plans. Others would be free to try the government-backed approach. Yes, over time there would be debates about whether to expand one approach or the other. But the choices would be mostly made by consumers, not politicians.

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Dark Rhode: The Effort to Silence Sen. Sheldon Whitehouse

Dark Rhode: The Effort to Silence Sen. Sheldon Whitehouse

The Washington Monthly

It’s obvious why they want him gone.

If you watched last week’s Senate confirmation hearings for unqualified Supreme Court nominee Neil Gorsuch, you saw just how effective Senator Sheldon Whitehouse (D-RI) can be when it comes to challenging right-wing ideology. Gorsuch was intellectually overpowered by Whitehouse, a former US Attorney and state Attorney General.

Whitehouse is arguably the right’s biggest nuisance. Conservatives cannot stand his criticism of the special interests responsible for destroying democracy in the United States in the seven years since the Citizens United decision. They cannot stand his condemnation of the fossil fuel industry on the Senate floor, and his full-throated call for the return of bipartisan action on climate change. They cannot stand his strict scrutiny of the Trump administration.

If the Senate changes hands in the 2018 midterm elections, Whitehouse will have a more prominent platform to tear apart conservative claptrap. As David Bernstein noted last year, had Democrats won the Senate in 2016, Whitehouse would have likely become chair of the Committee on Environment and Public Works, currently in the clutches of arch-denier John Barrasso (R-WY). Whitehouse as EPW chair would be a nightmare for Carbon Inc.–a nightmare the fossil-fuel industry and its allied interests would rather avoid.

You may recall Marlon Brando’s line from Apocalypse Now, referring to Martin Sheen’s character as an “errand boy, sent by grocery clerks, to collect a bill.” It looks like right-wingers may have found their errand boy to go after Whitehouse next year:

[State Representative] Robert “Bobby” Nardolillo has decided to wait until May to publicly announce whether he is running for the U.S. Senate against the two-term Democratic incumbent, Sheldon Whitehouse.

On March 2, Nardolillo filed a statement of candidacy for the U.S. Senate with the Federal Elections Commission. The filing positioned him to start raising money toward a potential 2018 run for the seat Whitehouse has held since ousting then-Republican Lincoln D. Chafee in the November 2006 election. Nardolillo’s campaign committee name: “Bobby 4 Senate.”

Nardolillo’s Republican allies anticipated an announcement this coming Monday in his hometown of Coventry.

But Nardolillo, a 37-year-old funeral director, told The Journal on Monday: “This is an extremely important day for me. I really want my parents to be in attendance. They don’t return home from [Florida] until May. So, I’m [going to do] some work with my team and fundraising.”

Nardolillo shouldn’t have any problem raising money, considering the large number of polluters and plutocrats in this country who want rid of Whitehouse. Anyone who thinks New England Republicans are less reactionary than Republicans in other parts of the country may want to reconsider:

One of only 11 Republicans in the 75-member Rhode Island House of Representatives, Nardolillo has made “illegal immigration” one of his signature issues.

He is currently seeking support from the Democrat-dominated House for a resolution urging Congress to change federal law to allow proof of citizenship as a requirement for registering to vote.

Other Nardolillo bills seek to resurrect former Republican Gov. Donald Carcieri’s “E-Verify” executive order. One would require the state to use the federal government’s E-Verify program to electronically verify the validity of social security numbers “to ensure that all employees of the executive department are legally eligible to be employed in the United States.” Another would require sheriffs to verify the immigration status of every incarcerated person brought into court, and notify federal immigration officials of anyone “lacking legal immigration status.”

Of course, Nardolillo believes “Whitehouse spends too much time talking about climate change and not enough about the economy.” That the economy will be severely impacted by human-caused climate change seems to be lost on this fellow. However, that doesn’t necessarily mean he will lose.

Much like John Kingston’s likely challenge to Massachusetts Senator Elizabeth Warren, this is a race that progressives would be well-advised not to ignore. In a post-Citizens United world, one cannot take the outcome of any Senate race for granted. Don’t underestimate Big Oil’s desire to finally shut Whitehouse up and force him out of the Senate. Don’t underestimate Nardolillo’s ability to demagogue his way into a competitive contest, especially with millions of dollars in dark money serving as a megaphone for his malicious message. Don’t underestimate, for one second, the importance of this race.

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Trump’s Reality Distortion Field is Shattering

Trump’s Reality Distortion Field is Shattering

The Washington Monthly

Greg Sargent at the Washington Post has long been making the case that Trump’s main communications strategy is to assault the notion of shared objective reality itself. In Trumpworld, the only arbiter of crowd sizes or climate science or wiretapping is Donald Trump himself, and everything else is “fake news” regardless of what facts might invalidate his narrative.

And for a while, it was working. During the presidential campaign, Trump lied with reckless abandon but never seemed to suffer for it. That’s partly because his opponent also suffered from perceived credibility issues, but it’s mostly because the news media treats presidential elections like a game where any claim is in bounds as long as a candidate can get people to believe it. And because Trump is the sort of figure it’s hard to take one’s eyes off of, his tweets and pronouncement manage to derail news cycles and capture attention. It was thought that perhaps we were entering a new political era in which reality simply no longer mattered.

But campaigns are one thing. Governing is another. And Trump’s reality distortion field is failing him now that he has to grapple with something more than campaign coverage.

Sargent himself noted this fact almost a week ago, referencing reports that Trump’s tweets were no longer having the narrative-driving force they once did. But the failure of the Republican health plan has cemented the degree to which Trump is losing his ability to gaslight and confuse enough people to get his way.

Donald Trump has always carefully crafted the image of a tough guy negotiator, through ghostwritten books and reality TV show characters. But it’s not wholly clear that Trump has ever had more than a few tricks up his sleeve: bully people with money and influence, play hardball, pretend to refuse offers, and when all else fails swamp the opposition with attorneys. It’s not exactly a creative arsenal, and Trump wouldn’t have had it available to him in his business career without a lot of inherited wealth and strings pulled on his behalf.

But when he attempted to play those games with the Republican Congress, they simply laughed in his face. When he attempted similar gambits against the federal judiciary over his travel bans, the judges simply used his own words against him.

Now his tweets do less to drive national narratives in his favor than they do to cause him embarrassment and scandal, whether it’s promoting a Fox News show or claiming to be wiretapped by his predecessor.

The reality distortion field is breaking, and people are becoming immune to Trump’s simplistic mind games. Without them, it’s not clear what Trump has left. He’s certainly no policy expert, and he doesn’t have the relationships on Capitol Hill to sustain him. It must be miserable for him.

But then, reality does have a way of reasserting itself.

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Trump’s Provocation-Based Foreign Policy is Dangerous

Trump’s Provocation-Based Foreign Policy is Dangerous

The Washington Monthly

Today brings news that Donald Trump literally gave German chancellor Angela Merkel a $300 billion bill for NATO expenses last weekend:

Donald Trump handed the German chancellor Angela Merkel a bill — thought to be for more than £300bn — for money her country “owed” Nato for defending it when they met last weekend, German government sources have revealed.

The bill — handed over during private talks in Washington — was described as “outrageous” by one German minister.

“The concept behind putting out such demands is to intimidate the other side, but the chancellor took it calmly and will not respond to such provocations,” the minister said.

Never mind that this isn’t how NATO funding works. The gall of leveling such a juvenile stunt on a much-needed ally is appalling. But it’s not the first time. Trump has spent his presidency insulting a host of allied countries from Mexico to Australia to China to Sweden to Britain and others. And that doesn’t even mention potentially hostile powers like China and the countries included on his travel ban.

Of course, the only country that Trump explicitly declines to insult is Russia. Nor is it an accident that Trump seems so upset at funding an alliance designed to help European allies keep Russian military threats at bay. Beyond darker conspiratorial possibilities, Trump sees in Putin’s right-wing, authoritarian, explicitly nationalist, anti-globalist religious conservative leadership a natural ally for him, while he sees Europe as part of the problem. They can’t say it publicly, but Bannon and Trump see Russian oligarchs not just as potentially helpful hackers and destabilizers, but kindred political spirits. Nor is it an accident that both Trump and Putin engage in foreign policy by provocation.

The difference is that while Russia in its position of weakness and yearning for territorial expansion stands to gain from destabilizing the world order, the United States stands to lose. But Trump and Bannon don’t understand that. As racist nationalists, they see America as the victim of a world that takes advantage of trade deals to send away jobs, and allows immigration to dilute the racial and cultural purity of white western states.

Nor do Trump and Bannon seem to understand the consequences of their actions. They think it’s funny to throw their weight around and make demands, but as with their failure in negotiation with the Freedom Caucus over healthcare, they don’t seem to understand the weakness of their negotiating position.

For now, the world simply doesn’t take them seriously. Merkel can laugh off this stunt without a second’s thought.

But future incidents of provocation like this could lead to war. If Trump treats North Korea with the same insouciant aggression that he treats Germany, it could lead to a nuclear holocaust in Seoul or Tokyo.

But maybe Trump and Bannon don’t care. After all, it mostly wouldn’t hurt white people on American soil, right?

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Bernie’s Medicare-for-All Is Great–But the Real Work is in Blue States

Bernie’s Medicare-for-All Is Great–But the Real Work is in Blue States

The Washington Monthly

It’s midnight here on the West Coast, my power is out due to a scheduled outage until 9amPST that I forgot about, my laptop has only 30 minutes of battery, and I’m running my Internet on my mobile hotspot, so this post won’t be long or detailed–but I wanted to get the post up and the thought out for the East Coast morning crowd. So apologizes for the brevity and lack of links, but here goes:

Bernie Sanders is coming out with a Medicare-for-All proposal in the wake of the shipwreck that is Trumpcare. That is precisely the right idea and the right message. Rather than sit on the laurels of a victory sustained largely by the immense cruelty of the farthest reaches of the Republican caucuses, it’s best for Democrats to acknowledge that while Obamacare did improve the American healthcare system, it remains deeply broken. Sanders–whose popularity remains extremely high with the American public–is leading the party in the right direction on the issue.

However, at a national level this is purely a message bill. There’s an infinitesimal chance that Trump could realize that the best way to fulfill his populist pledges on healthcare is to move drastically to the left, leave the Freedom Caucus and Paul Ryan behind, and work with Democrats and moderate Republicans to install a public option, lower the age of Medicare eligibility, and get rid of some of the more gimmicky taxes in Obamacare for a “compromise” package. If Trump were smart, that’s what he would do. His base will follow him to the ends of the earth and will eat up the idea of a public option if he sells it to them, no matter how loudly Rush Limbaugh, Stuart Varney and the Koch Brothers may shriek. But it’s extremely unlikely. Rather, Medicare-for-All is likely to just be a message bill at the national level–a signal to voters that the Democratic Party is ready to move forward to really fix the American healthcare system if given a chance.

The real work toward single-payer healthcare is in the states. Back in the late 2000s, there was an aggressive push in many blue states for state-based single-payer systems. Many states came very close to implementing them. But the momentum was ironically thwarted federally by the passage of the Affordable Care Act. Democrats in blue states sidelined single-payer in order to help make the Affordable Care Act’s exchanges work, and so the movement toward Canadian-style healthcare in the United States fizzled out for years.

The one silver lining of the AHCA was that state-based initiatives would have gone forward quickly and with gusto. But even with its failure, Trump’s determination to sabotage Obamacare combines with the precarious ecosystem of the insurance exchanges–not because of problems with Obamacare itself, but because many insurers simply don’t see enough profit in them to continue cooperating. The Affordable Care Act will still be a boon if the exchanges fails because of the Medicaid expansion and the regulations on insurers (in addition to the redistributive taxes), but the uncertain future of the exchanges highlights the need for action toward state-based public options and single-payer alternatives.

The influx of Sanders-style progressives into the local and states Democratic parties is combining with the re-engaged activism of many long-frustrated single-payer advocates to reignite the flames of state-based single-payer systems. Watch for a raft of resolutions and actual legislation toward that end from blue states around the country in the coming months. That’s where the real work will be.

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