By Yasmeen Abutaleb and Susan Cornwell
WASHINGTON (Reuters) – Twenty-two million Americans would lose insurance over the next decade under the U.S. Senate Republican healthcare bill, a nonpartisan congressional office said on Monday, complicating the path forward for the already-fraught legislation.
After the Congressional Budget Office (CBO) score, Senator Susan Collins, a moderate Republican, said she could not support moving forward on the bill as written.
Collins’ opposition highlights the delicate balance that Senate Majority Leader Mitch McConnell must strike as he tries to deliver a legislative win to President Donald Trump by reconciling the Republican Party’s moderate and conservative wings.
Moderate senators are concerned about millions of people losing insurance. Key conservative senators have said the Senate bill does not do enough to repeal Obamacare.
The CBO assessment that an additional 15 million people would be uninsured in 2018 under the bill and its prediction that insurance premiums would skyrocket over the first two years prompted concern from both sides.
McConnell’s goal was to have a vote on the bill before the July 4 recess that starts at the end of this week. But several Republicans, including Collins, have said they would not approve a procedural motion that would clear the way for a vote.
McConnell can afford to lose just two Republican senators from their 52-seat majority in the 100-seat Senate, which would allow passage of the bill with Vice President Mike Pence casting the tie-breaking vote.
“If you are on the fence … this CBO score didn’t help you, so I think it’s going to be harder to get to 50, not easier,” Republican Senator Lindsey Graham said of the bill’s prospects.
The CBO score is also likely to amplify criticism from industry groups such as the American Medical Association, which said earlier on Monday that the Senate’s bill violated the doctors’ precept of “first, do no harm.”
The CBO is only able to assess the impact of legislation within a 10-year window, but it said that insurance losses are expected to grow beyond 22 million due to deep cuts to the Medicaid insurance program for the poor and disabled that are not scheduled to go into effect until 2025.
Trump and Republicans in Congress made repealing and replacing Obamacare, former Democratic President Barack Obama’s signature domestic legislation, a central campaign promise. The pressure is on for them to deliver now that they control the White House, House of Representatives and Senate.
Republicans view Obamacare as costly government intrusion and say that individual insurance markets are collapsing. Obamacare expanded health coverage to some 20 million Americans by expanding Medicaid and mandating that individuals obtain health insurance.
The CBO score was released just hours after Republicans revised the bill, adding a measure that would penalize people who let their insurance coverage lapse for an extended period. The move followed criticism that the original bill would result in a sicker – and more expensive – insurance pool.
WHITE HOUSE ROLE
At least four conservative Republicans – Senators Ted Cruz, Rand Paul, Ron Johnson and Mike Lee – have expressed opposition to the Senate legislation.
Moderate Republicans have warned against replacing Obamacare with legislation that is too similar to the version passed by the House, saying it would cause too many people, especially those with low incomes, to lose health coverage.
The CBO estimated that the House bill would cause 23 million people to lose insurance. Trump had called the House bill “mean” and asked Senate Republicans to come up with “more generous” legislation.
Democrats uniformly oppose both the House and Senate versions of the bill.
“CBO’s report today makes clear that this bill is every bit as ‘mean as the House bill,” Senator Chuck Schumer, the Democratic leader, told reporters.
The White House in a statement on Monday criticized the CBO for issuing a “flawed report” and said its assessments should not be “trusted blindly.”
Trump and McConnell have been working to shore up support.
The president called key conservative senators over the weekend, White House spokesman Sean Spicer said.
Both Cruz and Johnson said they were concerned about CBO estimates that insurance premiums would initially rise as much as 30 percent over the first two years before declining.
“Doesn’t help the people whose premiums skyrocket next year,” Cruz told reporters.
“Kind of a problem, isn’t it?” Johnson said of the short-term premium increase.
Johnson and Paul have said they will oppose the procedural motion that would allow the Senate to move forward to a vote. Cruz is drafting suggested fixes. Paul remains opposed to the bill.
The first moderate Republican to oppose the bill, Senator Dean Heller, is already facing political fallout. America First Policies, a political group run by former Trump campaign staffers, said it would air healthcare-related attack ads against Heller, who faces a competitive re-election race in Nevada next year.
Senator Rob Portman, of Ohio, who has not said whether he supports the bill, was “dressed down” by McConnell during a Monday leadership meeting, a senior Republican aide told Reuters.
Ohio participates in Obamacare’s Medicaid expansion, and Republican Governor John Kasich has criticized the Senate bill. Portman’s office did not respond to a request to comment.
Senator Marco Rubio of Florida said his governor, fellow Republican Rick Scott, would be on Capitol Hill this week to discuss the bill’s impact on the state.
Constituent and industry groups have been critical of the Senate bill’s proposal to reduce the Medicaid healthcare program for the poor and point to the CBO analysis that it would disproportionately affect older adults.
Under Senate rules, the bill must replicate savings projected in the House version that passed last month. It cleared that critical hurdle, with the CBO estimating it would decrease the budget deficit by $321 billion over 2017-2026.
A revision to the bill that imposes a penalty for prolonged lapses in insurance coverage addresses the original bill’s provision to drop the Obamacare penalty on those who do not have insurance. Experts had warned that canceling the fine could lead to a sicker insurance pool because young and healthy people would not face consequences for failing to purchase insurance.
The bill would impose a six-month waiting period for anyone who lets their health insurance lapse for over 63 days and then wants to re-enroll in a plan in the individual market.
The 15 million people the CBO estimates would be uninsured in 2018 is largely due to the repeal of the penalty associated with being uninsured. The CBO did not evaluate the revised version that included the new waiting period.
Insurer Blue Cross and Blue Shield said it was encouraged by the inclusion of incentives for continuous coverage. Molina Healthcare said it preferred the Obamacare mandate, said that and the Senate bill, even after revised, would simply delay care.
If the Senate passes a bill, it will either have to be approved by the House, the two chambers would have to reconcile their differences in a conference committee, or the House could pass a new version and bounce it back to the Senate.
(Writing by Amanda Becker, Richard Cowan and Frances Kerry; Additional reporting by Richard Cowan, Eric Walsh and Amanda Becker; Editing by Leslie Adler)
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WASHINGTON (Reuters) – The White House said on Monday it appears the Syrian government is preparing for another chemical weapons attack and it warned Syrian President Bashar al-Assad he and his military would “pay a heavy price” if it conducts such an attack.
The White House statement said preparations by Syria were similar to those undertaken before an April 4 chemical attack that killed dozens of civilians and prompted President Donald Trump to order a cruise missile strike on a Syrian air base.
Trump ordered the strike on the Shayrat airfield in Syria in April in reaction to what Washington said was a poison gas attack by Assad’s government that killed at least 70 people in rebel-held territory. Syria denied it carried out the attack.
The strike was the toughest direct U.S. action yet in Syria’s six-year-old civil war, raising the risk of confrontation with Russia and Iran, Assad’s two main military backers.
U.S. officials at the time called the intervention a “one-off” intended to deter future chemical weapons attacks and not an expansion of the U.S. role in the Syrian war.
The United States has taken a series of actions over the past three months demonstrating its willingness to carry out strikes, mostly in self-defense, against Syrian government forces and their backers, including Iran.
The United States ambassador to the United Nations Nikki Haley said on Twitter: “Any further attacks done to the people of Syria will be blamed on Assad, but also on Russia and Iran who support him killing his own people.”
Since the April military strike, Washington has repeatedly struck Iranian-backed militia and even shot down a drone threatening U.S.-led coalition forces. The U.S. military also shot down a Syrian jet earlier this month.
Trump has also ordered stepped-up military operations against the Islamic State militant group and delegated more authority to his generals.
(Reporting by Eric Beech; Additional reporting by Michelle Nichols; Writing by Yara Bayoumy; Editing by Sandra Maler and Paul Tait)
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By Terrence Edwards
ULAANBAATAR (Reuters) – There was no outright winner in Mongolia’s presidential election on Monday, forcing the country’s first ever second-round run-off between the two leading candidates, the country’s General Election Committee said of Tuesday.
The populist former martial arts star Khaltmaa Battulga of the opposition Democratic Party won the most votes, but failed to secure the majority required, the committee said.
After the final districts were counted overnight, Battulga emerged with 517,478 votes, 38.1 percent of the total, according to Mongolian state television.
Ruling Mongolian People’s Party (MPP) candidate Miyeegombo Enkhbold, regarded as pro-investment and market-friendly, scraped through to the second round with 411,748 votes, 30.3 percent of the total.
The election was seen as referendum on the government’s economic recovery plans and China’s role in the country.
Battulga is regarded as a resource nationalist who is suspicious of neighbouring China, while Enkhbold, an establishment politician and parliamentary speaker, appears to have suffered as a result of his party’s austerity policies.
The new MPP administration raised interest rates and slashed public spending last year to try to cope with heavy debts and a precipitous fall in the value of Mongolia’s currency, the tugrik.
Enkhbold, the pre-election favourite, was trailing in third place for much of the count after a stronger than expected performance by Sainkhuu Ganbaatar of the breakaway Mongolian People’s Revolutionary Party (MPRP).
Ganbaatar finished with 30.2 percent, trailing Enkhbold by fewer than 2,000 votes, but is expected to be eliminated from the second round.
All three presidential candidates promised to pull the country out of its current crisis, but their campaigns were clouded by corruption allegations.
Mongolia, a remote, resource-rich land known as the birthplace of Mongol emperor Genghis Khan, is a parliamentary democracy. The government is run by the prime minister, but the president has powers to veto legislation and make judicial appointments.
(Reporting by Terrence Edwards, Writing by David Stanway; Editing by Gareth Jones and Michael Perry)
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MACON, Ga. (AP) — A Georgia man will avoid prison after pleading guilty to statutory rape of a 13-year-old girl he was initially charged with raping.
The Macon Telegraph reports that 21-year-old Tremayne Octavious Driskell Jr., of Macon, was also charged with child molestation. As part of a plea deal, Driskell was sentenced to five years’ probation. The molestation charges will be dismissed.
According to an arrest warrant, Driskell was visiting a home in February 2016 when he went into the girl’s bedroom, allegedly forced her to have sex and told her “not to tell anyone because he didn’t want to go to jail.”
Prosecutors say the girl didn’t tell until a couple of months later.
Driskell was sentenced as a first offender, must pay a $500 fine and $500 in attorney’s fees.
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CHICAGO (Reuters) – A U.S. judge should order Illinois to pay Medicaid providers about $1 billion a month to ensure medical care continues for the three million recipients of the health program after talks with the state reached an impasse, according to a court filing on Monday.
The move would cause a huge problem for the cash-strapped state, which has accumulated a $15 billion bill backlog due to a budget stalemate between its Republican governor and Democrats who control the legislature. It could force Illinois to stop making full payments on other state-mandated or court-ordered spending such as pensions and payroll.
The filing in U.S. District Court by attorneys representing Medicaid recipients asked Judge Joan Lefkow to order the state to pay $500 million a month for four months to start reducing a $3.1 billion pile of unpaid bills owed to managed care organizations that turn pay doctors and others.
As long as Illinois remains without an enacted budget, the proposed order calls for the state to spend an additional $586 million a month to cover Medicaid-related bills incurred after June 30, 2017.
The proposed order noted that federal reimbursements for Medicaid would reduce Illinois’ outlay to $543 million a month.
The two sides are scheduled to appear on Wednesday before Lefkow, who previously ruled Illinois’ minimal payments to managed care organizations did not comply with federal consent decrees that resulted from two cases filed against the state in 1992. The judge had ordered negotiations aimed at getting Illinois to “substantial” compliance with the decrees, noting the state has managed to make its monthly bond and pension payments on time and in full.
Monthly payments related to the Medicaid and other consent decrees have totaled only about $160 million.
In the wake of Lefkow’s order, Illinois general obligation bond prices plummeted and yields soared in U.S. municipal market trading, although the bonds subsequently clawed back some losses. The state comptroller last week pledged to not delay or diminish debt service payments.
There was no immediate reaction to the court filing from the Illinois Attorney General’s office.
Rauner ordered lawmakers back into a special session, which began June 21 and is scheduled to end on Friday, to pass a budget before fiscal 2018 begins on Saturday.
Entering a third-straight fiscal year without a spending plan could sink Illinois’ credit ratings to “junk,” a first for any U.S. state.
(Reporting By Karen Pierog)
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