Essential Politics: In healthcare debate, is it about cost or coverage?

Essential Politics: In healthcare debate, is it about cost or coverage?
(Los Angeles Times)

At some point soon, supporters of the Republican congressional healthcare plan are going to have to settle on a strategy.

Do they contest the methodology used in this week's big analysis? Or do they insist that the most important outcome of their sweeping plan is the cost to the government and not how many people end up with coverage?


Good morning from the state capital. I'm Sacramento Bureau Chief John Myers, and there are a lot of people here in California still sifting through the numbers when it comes to the American Health Care Act.

Few states have as much at stake, with more than 4 million Californians receiving healthcare coverage through the law championed by former President Barack Obama — most of those through the expansion of Medi-Cal, the state's version of Medicaid.


The debate, of course, fundamentally shifted on Monday with the Congressional Budget Office estimate of less federal government spending and more Americans who would be uninsured.

Critics of the plan are squarely focused on the CBO projection that 14 million Americans would join the ranks of the uninsured next year, 24 million over the next decade.

In California, the effects of the plan are starting to take shape. The state's health insurance exchange, Covered California, pointed out those buying individual plans in the northern part of the state could be hit particularly hard.


For Republicans, repealing and replacing Obamacare is something they've preached and promised for years. But Monday's blockbuster report has only further fueled speculation that the current plan is all but dead in the Senate and in deep trouble in the House of Representatives.

One California Republican, Rep. Darrell Issa (R-Vista), said that the party can do better than what House leaders put forward, and he's not sure he can support the bill.

Democrats were only too happy to put a fine point on the issue.

"Is there anyone left in the country who actually likes it?" asked Senate Minority Leader Charles E. Schumer (D-N.Y.), reading the lists of doctors, hospital organizations and others on Tuesday that have registered opposition.

The political path forward could be especially tricky for President Trump, given his campaign assurances that he would provide "insurance for everybody."

Now, according to Trump spokesman Sean Spicer, it's a plan that "offers more people the option to get healthcare."



Here in Sacramento, state Senate Democrats ripped the Republican Obamacare replacement plan in a non-binding resolution on Monday. And just as quickly, Republican legislators told them to quit whining.


There are a lot of variables to consider when placing the Republican plan alongside the existing Affordable Care Act. Check out Noam N. Levey and Kyle Kim's side-by-side look at how the two visions of healthcare stack up.

And you could have predicted this: GOP criticism of the Congressional Budget Office, even though its director was handpicked two years ago by Republican leaders. Even with the shots fired over these past 36 hours, the independent analysts are widely seen as impartial and credible.


And then, in the middle of a news cycle dominated by healthcare, came Tuesday night's unexpected revelation of the president's tax returns from 2005. At least the first two pages of the document.

The document, sent to journalist David Cay Johnston, appears to show Trump paying more than $36.5 million on income of $150 million.

The White House seemed to not only confirm the document but also took aim at MSNBC for broadcasting its contents. And regardless of how it all came out, it certainly offered the president's team a diversion away from healthcare reporting.


Get ready for more Trump action today with a major effect on the Golden State. The president is expected to direct the Environmental Protection Agency to scrap the aggressive vehicle fuel economy targets that are baked into California's climate change efforts.

The president is expected to make the announcement in Detroit. And yes, this one could ultimately spark the most important legal squabble so far between California and the Trump administration.


At the state Capitol, lawmakers are scheduled to hold a hearing today to consider Gov. Jerry Brown's request to extend California's cap-and-trade program — the centerpiece of the state's battle against global warming.

Although the program has been operating for the last few years, it's facing a new round of scrutiny this year. Consider the debate over "carbon offsets," green-friendly projects that are funded by polluters to meet state requirements for reducing greenhouse gas emissions.

Chris Megerian looks at how the changing political dynamic in California and the increasing clout of environmental justice advocates could shape this year's debate.


The race among 23 candidates in next month's special congressional election in Los Angeles is being heavily influenced by Vermont Sen. Bernie Sanders, who won in the 34th Congressional District over Hillary Clinton in California's presidential primary.


At least three candidates say Sanders, in part, inspired them to run. Sanders hasn't made an endorsement in the race, and there's no clear standard-bearer for his wing of the party. But observers say this contest could demonstrate how "Berners" might affect future Democratic races across the country.


-- America's chief executives like what they see when it comes to Trump.

-- Just call him "Wayne Tracker." Secretary of State Rex Tillerson used an alias for emails about climate change as CEO of Exxon.

-- The U.S. Department of Justice wants more time to provide evidence to back up the president's allegations of campaign wiretapping.

-- California government officials haven't sufficiently checked the criminal histories of workers in child care and senior facilities, according to a new state audit.

-- Crime victims testified on Tuesday in support of a California bill that would expand the collection of DNA in criminal cases.

-- A state Senate panel voted on Tuesday to push a ballot measure banning the state from taking money from vehicle fees and gas taxes and using it on non-transportation programs.

--The Times' editorial board endorsed Maria Cabildo, a longtime affordable housing developer and advocate.


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