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GOP Senate candidates come out swinging in Alabama debate

MONTGOMERY, Ala. — Sen. Luther Strange and former state Chief Justice Roy Moore squared off in a heated debate Thursday evening just days before a close Republican primary runoff for U.S. Senate in this deep-red state.

For much of the beginning of the debate, the candidates stuck to two themes. Again and again Strange pointed out that he had the support of President Donald Trump and Vice President Mike Pence.

“The president supports me,” Strange said in his opening remarks as he stressed how, in a short time, he has become close with Trump. “Why would he do that? Because we’ve developed a close personal friendship.”

Moore, meanwhile, refrained from attacking Trump directly but bashed Strange as a career lobbyist and a product of insiders and corruption in Washington.

“My entire political career has been serving the state of Alabama,” Moore said. “My opponent has been a professional lobbyist for over 20 years.”

And as Strange tried to leave no air between him and the president, Moore worked to highlight their differences. The judge noted that while he himself has always opposed abolishing the Senate filibuster, Strange, after signing a letter opposing getting rid of it, reversed course. Moore noted that Trump opposes “the 60-vote rule” — the threshold needed to cut off debate and proceed to a vote.

So why did Strange switch positions? Moore asked rhetorically. “He’ll do anything to get this job, and that’s called lack of character,” he said, answering his own question.

Both public and private polls show a tightening race, though most have Moore leading slightly. The debate also comes as top surrogates for the two candidates swoop in to give each a last-minute boost.

Former Alaska Gov. Sarah Palin was set to appear with Moore in a rally on Thursday after the debate. Trump is scheduled to hold a rally for Strange on Friday, and Pence plans to campaign for the senator on Monday.

Moore is leading in the contest despite millions spent by the Senate Leadership Fund, a super PAC aligned with Senate Majority Leader Mitch McConnell (R-Ken.), to boost Strange’s chances. Sen. Richard Shelby of Alabama and a number of other Senate Republicans have also taken steps to help Strange.

But Moore has remained a competitive opponent of Strange, and over the past two weeks the former judge and firebrand conservative has methodically rolled out endorsements from members of Congress.

Further complicating the divide between Strange and Moore is Steve Bannon, the former White House chief strategist now running Breitbart News, who has actively endorsed the former judge and stayed in contact with him during the runoff. Moore has also been endorsed by conservative grass-roots favorites like Palin and Phil Robertson, star of the reality TV show “Duck Dynasty.”

As a result, the runoff has become a sort of proxy war between competing factions of the Republican Party. The Senate seat is likely to stay in GOP hands, but Moore’s winning the primary on Tuesday would energize anti-incumbent Republicans. Allies of McConnell argue that if Strange wins, it will show lockstep support among Trump supporters for Senate leadership.

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Price’s private-jet travel breaks precedent

In a sharp departure from his predecessors, Health and Human Services Secretary Tom Price last week took private jets on five separate flights for official business, at a cost of tens of thousands of dollars more than commercial travel.

The secretary’s five flights, which were scheduled between Sept. 13 and Sept. 15, took him to a resort in Maine where he participated in a Q&A discussion with a health care industry CEO, and to community health centers in New Hampshire and Pennsylvania, according to internal HHS documents.

The travel by corporate-style jet comes at a time when other members of the Trump administration are under fire for travel expenditures, and breaks with the practices of Obama-era secretaries Sylvia Mathews Burwell and Kathleen Sebelius, who flew commercially while in the continental United States.

Price, a frequent critic of federal spending who has been developing a plan for departmentwide cost savings, declined to comment.

HHS spokespeople declined to confirm details of the flights or respond to questions about who paid for them, with a spokesperson saying only that Price sometimes charters planes when commercial flights aren’t feasible. All three organizations that hosted Price last week — the Massachusetts-based health IT firm athenahealth, Goodwin Community Health Center in New Hampshire and the Mirmont Treatment Center in Pennsylvania — told POLITICO they did not pay for his flights or other travel costs.

“As part of the HHS mission to enhance and protect the health and well-being of the American people, Secretary Price travels on occasion outside Washington to meet face to face with the American people to hear their thoughts and concerns firsthand,” an HHS spokesperson said, adding, “When commercial aircraft cannot reasonably accommodate travel requirements, charter aircraft can be used for official travel.”

Price’s spokespeople declined to comment on why he considered commercial travel to be unfeasible. On one leg of the trip — a sprint from Dulles International Airport to Philadelphia International Airport, a distance of 135 miles — there was a commercial flight that departed at roughly the same time: Price’s charter left Dulles at 8:27 a.m., and a United Airlines flight departed for Philadelphia at 8:22 a.m., according to airport records.

Sample round-trip fares for the United flight ranged from $447 to $725 per person on United.com, though the price would have been lower if booked in advance or if Price’s party received government discounts. Similarly priced commercial flights also left from Reagan National Airport and Baltimore Washington International. By contrast, the cost of chartering the plane was roughly $25,000, according to Ultimate Jet Charters, which owns the Embraer 135LR twin jet that ferried Price and about 10 other people to the clinic event.

In addition, Amtrak ran four trains starting at 7 a.m. that left Washington’s Union Station and arrived at Philadelphia’s 30th Street Station no later than 9:58 a.m. The least-expensive ticket, on the 7:25 a.m. train, costs $72 when booked in advance. It is just a 125-mile drive from HHS headquarters in downtown Washington to the Mirmont Treatment Center outside of Philadelphia, where Price spoke. Google Maps estimates the drive as about 2½ hours. A one-way trip was estimated by travel planners to be about $30 in gasoline per SUV plus no more than $16 in tolls.

An HHS spokesperson declined to answer questions on how many private charter flights Price has taken since being confirmed as secretary on Feb. 10, but wrote in an emailed response, “Official travel by the secretary is done in complete accordance with Federal Travel Regulations.”

Current and former staffers, speaking on the condition of anonymity, say Price has been taking private jets to travel domestically for months.

Ethics experts say the use of private charters by government officials, while legal, is highly dubious and in most cases a misuse of taxpayer funding.

“I can understand why the secretary might have to use a charter flight to get to a hurricane-devastated region, but Philadelphia is not one of those regions this year,” said Walter Shaub, who was director of the United States Office of Government Ethics until July. “I find it hard to believe he couldn’t find a suitable commercial flight to Philadelphia.”

“This wasteful conduct reflects disdain for the ethical principle of treating public service as a public trust,” said Shaub, who was appointed by former President Barack Obama. “Public office isn’t supposed to come with frivolous perks at taxpayer expense.”

Shaub said that the trips violate the “spirit” of the Federal Travel Regulations, citing the express guidance contained in the regulations that “taxpayers should pay no more than necessary for your transportation.”

Members of the Trump administration have come under scrutiny for excessive use of government travel resources. The president and his family have rung up travel expenses at a faster rate than previous presidential families. The inspector general of the Environmental Protection Agency recently announced a probe into Administrator Scott Pruitt’s frequent travel to his home state of Oklahoma. The Treasury Department’s inspector general is looking into Secretary Steve Mnuchin’s use of a government jet on a trip to Fort Knox, Kentucky, that involved viewing the solar eclipse. Most recently, ABC News reported that Mnuchin had requested a government plane to take him on his overseas honeymoon. The request was withdrawn on the grounds that it was unnecessary.

Price is an orthopedic surgeon who served in the U.S. House for 12 years representing a district in suburban Atlanta. After President Donald Trump nominated him to be HHS secretary in January, Price came under fire from Democrats and ethics watchdogs for having made stock trades in health-care companies while serving on a House panel overseeing Obamacare and other health issues.

He has also positioned himself as a champion of fiscal efficiency, backing major spending reductions to agencies he oversees and legislation that would cull hundreds of billions of dollars from health entitlement programs. This month, Price had been scheduled to submit a department reform plan to the White House that is expected to propose new spending and staffing cuts. He also backed a nearly $6 billion proposed cut to the National Institutes of Health in March, and an overall 18 percent spending cut to HHS included in Trump’s first budget proposal.

“Tough choices had to be made to identify and reduce spending within the department,” Price said in a statement to Congress about his budget request. “Our goal is to … [try] to decrease the areas where there are either duplications, redundancies or waste … and get a larger return for the investment of the American taxpayer.”

Price’s travel itinerary last week included five charter flights that charter operators estimated would cost at least $60,000. The itinerary, according to airport records and sources with knowledge of Price’s travels, began on Wednesday, Sept. 13 (arrows do not represent actual flight paths):

• Price and staff took a private charter that left Dulles that Wednesday at 2:26 p.m. and arrived in Waterville, Maine, at 3:37 p.m., where he then traveled to the Point Lookout resort and spent the night.

• On Thursday, Sept. 14, Price held a fireside chat with the CEO of athenahealth at the Point Lookout resort. He then took a private jet that departed Waterville, Maine, at 11:41 a.m. and arrived in Portsmouth, New Hampshire, at 12:09 p.m. for a scheduled visit to nearby Goodwin Community Health Center.

• Later on Thursday, Price made an announcement about grants for fighting the opioid epidemic, after which he took a private jet that left Portsmouth at 2:34 p.m. and arrived at Washington Dulles at 3:45 p.m.

• On Sept. 15, Price, accompanied by White House counselor Kellyanne Conway, left Dulles aboard a charter at 8:27 a.m. and touched down at Philadelphia International Airport at 9:01 a.m. for a scheduled visit to Mirmont Treatment Center, a local addiction treatment facility.

• Also on Sept. 15, Price, Conway and other staff departed Philadelphia aboard a charter plane at 12:39 p.m. and touched down at Dulles at 1:19 p.m., where the plane was met on the tarmac by two SUVs and a police escort.

The round trip to the Philadelphia airport, which is about 15 miles from Mirmont Treatment Center, where Price and Conway met with staff and patients — cost about $25,000, an official with the charter agency told POLITICO.

Eddie Moneypenny of Ultimate Jetcharters, who confirmed that his company’s 30-seat jet was used for a Dulles-Philadelphia roundtrip last week, said he wasn’t aware that the trip was for a government official and the charter had been booked through a third party.

Other charter services confirmed that charter flights between Washington and Philadelphia run tens of thousands of dollars when retaining the same plane.

“I’ve been doing this for seven years,” said Jake Sheeley of EvoJets, another charter service. “I’ve never seen a flight like this for less than $20,000.” Sheeley also estimated that an itinerary modeled on Price’s three-flight trip between Washington, Maine and New Hampshire would cost about $40,000.

Several former HHS staffers who had close knowledge of the travel plans of former HHS secretaries Burwell and Sebelius could not recall booking a charter flight for short-haul travel.

Staff for Burwell and Sebelius said booking even a single charter flight was, in the words of one, a “non-starter” within the department. For example, for last year’s Obamacare enrollment kick-off, HHS staff had planned a multi-city tour for Burwell to urge Americans to sign up for coverage. The effort, which would have required charter aircraft, was ultimately scrapped because of its estimated $60,000 cost.

“We were worried about the optics and the cost to taxpayers,” said one former staffer involved in the planning.

In her more than five years as a Cabinet secretary, Sebelius says she took a charter flight only to get to remote areas in Alaska, which she and staff said were otherwise inaccessible.

“The basic rules that our scheduling team worked under were, you flew commercial and you flew economy,” she said in an interview. “That’s just what they did.”

Tracking Price’s travel and meetings has been much more difficult than tracking those of his predecessors. His office only recently began informing reporters of trips ahead of time, and have declined to post most of his remarks and speeches to the HHS website despite his frequent speaking engagements.

Nonetheless, he’s spent much of his tenure on the road. POLITICO identified at least 24 separate flights that Price has taken to conduct HHS business in the past four months alone. Those flights don’t include Price’s weekend trips home to Georgia. An HHS spokesperson said, “Secretary Price pays for personal travel out of his own pocket.”

One of those unannounced trips was to last week’s conference hosted by athenahealth, the health information company, at the Point Lookout resort in Maine. Price held a wideranging fireside chat with athenahealth CEO Jonathan Bush, the nephew of former President George H.W. Bush and first cousin of former President George W. Bush.

The HHS secretary apparently used his remarks to tweak the government’s role as would-be reformers.

“Don’t assume the federal government is gonna do the right thing in health care,” Price said, according to one account of his talk.

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Democrats request inspector general investigate Price's use of charter planes

House and Senate Democrats on Wednesday formally requested that the HHS inspector general investigate HHS Secretary Tom Price’s use of private planes for government business.

Five Democrats asked the inspector general to review Price’s adherence to federal regulations on traveling by government employees, following a POLITICO investigation that found Price used charter planes to conduct official business within the United States. The request — sent by Reps. Frank Pallone and Richard Neal and Sens. Patty Murray, Ron Wyden and Gary Peters — asks the office to probe how many times Price used government or charter aircraft, the costs of the trips and whether HHS personnel raised internal concerns about Price’s use of private planes.

“American taxpayers deserve assurances that their tax dollars are not wasted by the government’s highest officials, and we are committed to holding Secretary Price to his stated pledges to reduce waste throughout the department,” they wrote.

Price last week took private jets on five separate flights for official business, at a cost of tens of thousands of dollars more than commercial travel. The destinations included Maine, New Hampshire and the Philadelphia area in Pennsylvania. It was a sharp departure from his predecessors, who flew commercial.

HHS on Wednesday defended Price’s travel, with the department’s top spokesperson saying “commercial travel is not always feasible.”

“Within an incredibly demanding schedule full of 13-plus hour days, every effort is being made to maximize Secretary Price’s ability to travel outside Washington to meet with the American people and carry out HHS’s missions,” said Charmaine Yoest, HHS’ assistant secretary for public affairs.

Yoest later confirmed to POLITICO that if Price travels “for official business, that comes from the HHS budget.”

Earlier on Wednesday, Murray, the top Democrat on the Senate HELP Committee, said Price’s use of charter planes shows “a clear willingness to skirt basic ethics rules” and invites a “greater conversation” about his conduct in public office. During Price’s confirmation process to be HHS secretary, Democratic lawmakers and ethics experts scrutinized his investments in health care companies that could have benefited from legislation he supported.

The former Republican congressman from Georgia frequently called for fiscal responsibility, and as HHS Secretary has backed massive spending cuts to the health agencies he oversees.

“There could not be a clearer statement of the Trump administration’s priorities,” Sen. Maggie Hassan (D-N.H.) said in a statement.

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Senate girds for final Obamacare repeal vote

The Senate will vote next week on the latest bill to repeal Obamacare — but the outcome is anything but certain.

Senate Majority Leader Mitch McConnell (R-Ky.) plans to put a bill written by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) to a vote, hoping that a looming Sept. 30 deadline to pass the bill with just 50 votes will create enough pressure to finally pass a repeal of the health care law, his office said.

“It is the leader’s intention to consider Graham/Cassidy on the floor next week,” a spokeswoman said.

McConnell has told colleagues he will only bring up the bill if it will succeed. The statement does leave some wiggle room to not proceed with a vote.

It’s still anyone’s guess whether the bill’s backers can get to 50 votes. One Republican senator suggested that McConnell may ultimately decide to bring the bill up for another failed vote, in part to show GOP donors and President Donald Trump that the Senate GOP tried again.

Trump himself joined the ongoing debate Wednesday night, tweeting that Graham-Cassidy was a “great Bill.”

“I would not sign Graham-Cassidy if it did not include coverage of pre-existing conditions. It does!” Trump tweeted, alluding to recent attacks on the bill that it won’t protect patients with congenital or pre-existing illnesses.

Sens. Rand Paul (R-Ky.) and Susan Collins (R-Maine) are viewed as hard “no’s.” And Sens. John McCain (R-Ariz.) and Lisa Murkowski (R-Alaska), who opposed a previous iteration of repeal in July, are not sold on the proposal.

In an interview, McCain sounded like he could end up tanking a bill written by Graham, his close friend.

“Nothing has changed. If McConnell wants to put it on the floor, that’s up to McConnell,” McCain said. “I am the same as I was before. I want the regular order.”

Asked if that means he’s a “no” vote, McCain said: “That means I want the regular order. It means I want the regular order!”

Paul, who has come under criticism from fellow Republican senators and Trump himself for his adamant opposition to the Graham-Cassidy measure, showed no sign of backing off Wednesday. In an interview, the Kentucky senator said he plans to demand a vote next week — should the bill actually come to the floor — on an amendment that would simply repeal the entirety of the health care law.

That amendment would go further than a vote Paul secured in July that repealed the main pillars of Obamacare, including the coverage mandates and the Medicaid expansion.

“My objection is that it keeps the vast majority of Obamacare spending and then just redistributes it in a different formula. That, to me, isn’t what I promised,” Paul said. “I’m going to have a vote on repealing the whole thing and we’ll see how people stand on that.”

Murkowski said Wednesday that she is still undecided, stressing that she needs “full understanding as to numbers and formulas” under the Graham-Cassidy bill.

“Just last evening, late, my team was on the phone with the folks from [Health and Human Servies] because we’ve got hard questions about numbers that we feel that we deserve an answer to,” Murkowski said. “So we’ve been working through that.”

The latest proposal would turn federal health insurance funding into block grants for states, wind down Obamacare’s Medicaid expansion and rescind the law’s coverage mandates. Notably, there will be no complete analysis by the Congressional Budget Office by the time a vote comes up, leaving lawmakers unsure what the bill’s effects on premiums and coverage will be.

That’s been a major critique from Senate Democrats, who are again chastising Republicans not only for the substance of the Graham-Cassidy bill but how Republicans are scrambling to pass it before Sept. 30. Senate Minority Whip Dick Durbin of Illinois said Wednesday that “we’re going to do everything we can to make it clear how bad this bill is, offer the appropriate amendments and hope that three Republicans will join us in stopping it.”

The uncertainty surrounding the last-ditch repeal push has kept many center-right senators on the sidelines, including McCain, Murkowski and Sens. Rob Portman (R-Ohio) and Shelley Moore Capito (R-W.Va.). However, at a party lunch on Tuesday before leaving for the week, the vast majority of senators expressed support for holding a vote on the bill, according to an attendee.

The party’s chief vote-counter, Majority Whip John Cornyn of Texas, said party leaders are delivering an urgent message to wavering Republicans.

“It really seems to be picking up some momentum. And I think it’s happening pretty quickly,” Cornyn said in an interview. “We don’t have long to act so that’s why things seem to have sprung up here after people thought health care was dead. This is our last opportunity.”

Cassidy and Graham have been working feverishly to educate senators about the bill, working with CBO to get them the most information possible, a source familiar with the process said. The duo, along with former Sen. Rick Santorum (R-Pa.), spent Wednesday morning meeting with McConnell and working on Murkowski and Sen. Dan Sullivan (R-Alaska), hoping to overcome their concerns that block grants could slash funding to Alaska.

“We’re very interested in helping Alaska because Alaska has 750,000 people. And a land mass bigger than Texas,” Graham said, referring to a provision in the bill that could help low-density states such as Alaska.

Most of the whipping will focus on McCain and Murkowski. Both took an immense political risk in rejecting the GOP’s “skinny” repeal in July, and Republican senators believe that if the two of them support the bill, the rest of the undecided Republicans will fall in line.

“It’s going well,” Cassidy said of the discussions with McCain and Murkowski. “I don’t want to say in play … but they are open to these discussions.”

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Left on ‘full war footing’ to stop Obamacare repeal

The liberal activists roused into the streets by President Donald Trump are revving up for one last campaign to save Obamacare.

The sudden resurgence of Republicans’ repeal push appeared to catch Democrats and their base by surprise. But ahead of Senate Majority Leader Mitch McConnell’s plans to vote next week on a new bill to dismantle the health law, the Democratic grass roots is on what one leading activist called “full war footing.”

From a new six-figure advertising campaign by the pro-Obamacare group Save My Care to a flurry of rallies planned on the ground, the left is throwing everything it can at the new repeal bill from Sens. Bill Cassidy (R-La.) and Lindsey Graham (R-S.C.).

“The reality is that the progressive coalition has never been more unified or determined than they are right now,” Organizing for Action spokesman Jesse Lehrich said in an interview.

The liberal group UltraViolet Action will launch an aerial banner campaign on Thursday targeting Sens. John McCain (R-Ariz.), Lisa Murkowski (R-Alaska) and Susan Collins (R-Maine), who brought down the most recent GOP repeal plan.

Save My Care’s TV and digital ad buys are also up and running to urge McCain, Murkowski and Collins to vote no, as well as Sens. Lamar Alexander (R-Tenn.), Dean Heller (R-Nev.) and Shelley Moore Capito (R-W.Va.). OFA has its own digital ad push starting Thursday in key 15 states.

Liberal organizers say that their members are bombarding swing-vote Republicans with nearly as many health care calls as they made in July, at the peak of the last Obamacare battle.

“We definitely feel better today than we felt yesterday, but not because we feel like we’ve won, not at all,” said Angel Padilla, policy director at the anti-Trump group Indivisible. “This is going to go down to the wire.”

After the stunning defeat of the GOP’s previous repeal effort earlier this summer, some on the left moved ahead to take up battles over immigration and Trump’s tax plan, or lay the groundwork for single-payer health care.

Padilla said Indivisible had planned to stage an event during this week’s short recess on helping undocumented immigrant Dreamers but is instead reorienting its grassroots machine to talk health care.

Ben Wikler, Washington director of MoveOn.org, also vowed that activists would return to Capitol Hill for daily events next week as McConnell squeezes his members who are on the fence to support the bill, which would transform Obamacare funding into block grants for states, make deep cuts to Medicaid and undermine protections for people with pre-existing conditions.

The prospect of another repeal vote “hadn’t even raised its ugly head” last week, Senate Minority Leader Chuck Schumer (D-N.Y.) told reporters Tuesday. “But now, the groups are really mobilized.”

Schumer, who predicted a “huge mobilization” of pushback against repeal this weekend, has spent the past several days talking frequently with progressive groups to coordinate activity in the days ahead of next week’s vote, a senior Democratic aide said.

As Democrats digest just how close they are to losing a health care fight that has united them to an unprecedented degree, what had been a simmering internal debate over tactics can wait for another day.

“There’s nothing like an existential threat to the entire American health care system to dissolve any would-be tensions,” said Lehrich. “We’re all fighting tooth-and-nail, hand-in-hand, to stymie this would-be catastrophe.”

While Senate Democrats are weighing a procedural onslaught on the floor next week to try to push Republicans past their Sept. 30 deadline to pass repeal with 50 votes, activists believe they have to stop the bill before that because McConnell could blow through any stalling tactics.

“The painful fact is that if McConnell has the votes and decides he wants to do this, there are no procedural levers to pull to stop it,” Wikler said. “The only way this attack on millions of people’s health care is defeated is through massive constituent pressure coming from the states.”

Although the nonpartisan Congressional Budget Office has said it cannot provide a comprehensive analysis of the legislation by next week, other projections show the new GOP plan would result in large-scale losses of health insurance by axing Obamacare’s individual mandate and ending the requirement that insurers cover individuals with pre-existing conditions.

Cassidy countered on Wednesday that “the best way to get people covered is not through a mandate, through penalties, but through getting a governor engaged.”

“Our bill gives the governor responsibility, which he or she may not want, but that’s the best way to get people covered,” Cassidy told CNN.

But in addition to on-the-ground fury from the liberal base and opposition from much of the medical industry, Democrats are banking on resistance from some governors — including Cassidy’s own — to help make the difference and defeat the bill.

House Minority Leader Nancy Pelosi (D-Calif.) also said Wednesday that she thinks vulnerable House Republicans from populous blue states would help defeat the repeal bill if the Senate passes it, given that their states stand to lose big.

California and New York would lose nearly $50 billion in federal health care funding over the next decade — dollars that would be redistributed to conservative states — according to an analysis from the Center on Budget and Policy Priorities, a left-leaning think tank.

The House passed its Obamacare repeal bill earlier this summer with only one vote to spare, with several California Republicans in districts Clinton won and moderates from other parts of the country backing the measure.

Pelosi said she wouldn’t expect that to happen this time around.

“I think we have a really good chance to stop it in the House because it does such serious violence to the health care of people in California, New York and other places,” Pelosi told reporters.

House Democrats are planning a “day of action” Saturday with rallies across the country in protest of the GOP effort, but otherwise can do little to stop the legislation if Republicans round up the votes.

“This is really a stinkeroo, this bill,” she said. “I don’t think most Republicans have the faintest idea what’s in that bill. And if they do, how could they possible do that to the people of their states?”

Pelosi also dismissed criticism from some on the left, now growing quieter as the Obamacare fight resumes, that the fiscal deal Democratic leaders cut with Trump earlier this month helped revive the Republican repeal push by effectively clearing the calendar for the rest of this month.

“They’re not even related,” she said. “It isn’t that at all.”

Heather Caygle contributed to this report.

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Did Trump Just Do 'Rocket Man' a Favor?

When President George H. W. Bush was staring down Saddam Hussein after the Iraq dictator’s invasion of Kuwait in 1990, the former diplomat spoke in grand terms about international order and rule of law.

But Bush also made the conflict personal. In public speeches, he referred to the Iraqi tyrant only by his first name, as “Saddam”—a pointed discourtesy that drew global attention. For good measure, he mispronounced it—“Sad-um” instead of “Sa-dam”—in a way that sounded like the Arabic word for a barefoot beggar.

The ensuing conflict went America’s way: Iraq was quickly ejected from Kuwait in the 1990 Gulf War, a lightning-fast defeat that left the dictator humbled. But in hindsight, some Bush officials consider the way the president had talked about it – particularly his decision to personalize the conflict with man-to-man taunts— to have been a mistake. American troops stopped well before reaching Baghdad, Hussein clung to power, and the result was a clean victory that didn’t quite feel like one.

“All the emphasis on Saddam made it harder for [Bush] to justify ending the war with Saddam still in power,” said Richard Haass, a top Bush White House national security official at the time.

More than 25 years later, Donald Trump has quickly found himself in his own standoff with a blowhard dictator across the world, and has personalized far more than Bush ever did. Twice in the past week, on Twitter Sunday and in his Tuesday address to the United Nations, Trump has dubbed North Korean dictator Kim Jong Un “Rocket Man,” in an apparent reference to a 1972 Elton John ballad that Trump often played at his campaign rallies – an exercise in high-level name-calling with little modern precedent.

Whether any larger strategy lies behind Trump’s mockery is unclear. Trump has long used nicknames to belittle and intimidate opponents, from Atlantic City business rivals to his 2016 challengers—including “Low Energy Jeb” Bush, “Little Marco” Rubio and “Crooked Hillary” Clinton. But experts and former U.S. officials warn that what worked in the Iowa primaries is liable to backfire on the larger and more complicated global stage, especially when it comes to nuclear diplomacy with millions of lives on the line.

For a dictator accustomed to honorifics like “Brilliant Leader” and “Guiding Sun Ray,” the nickname “will be perceived as an embarrassment of the highest order” in North Korea, said Ken Gause, an Asia analyst with the nonprofit research organization CNA.

“The relationship is already so bad that I’m not sure how much worse it could get,” added Joel Wit, a Koreas expert at Columbia University and the Johns Hopkins University’s School for Advanced International Studies. “But if there’s something guaranteed to make it worse, it’s hurling personal insults at their leader.”

Human psychology is an undeniable element of high-stakes international conflict, as any student of the Cuban Missile Crisis can explain, and world leaders can successfully unnerve one another. But the strategy can also backfire. In 1986, President Ronald Reagan branded the Libyan dictator Muammar Gaddafi “the mad dog of the Middle East,” prompting the African strongman to retort that he would not bend to the “insults” of an “old man.” (Reagan wound up bombing Gaddafi into submission.)

President Barack Obama considered it a mistake to personalize foreign policy, though he couldn’t resist saying in 2013 that Russian President Vladimir Putin’s “slouch” during their meetings made the Russian look like “the bored kid in the back of the classroom.” Putin was reportedly infuriated by the remark, which did nothing to improve faltering U.S.-Russia relations.

And as Bush discovered, it can be hard to close the door on a foreign policy problem once you’ve turned it into a man-to-man fight. With North Korea, a successful diplomatic solution might leave Kim in power—and Trump in much the same position as Bush: as a leader claiming a win even as critics cast him as a guy who couldn’t finish the shoving match he started

It remains unclear whether Trump’s remark is intended to unnerve Kim, whom he has previously both insulted (“a maniac”) and complimented (“a smart cookie”)—or whether it’s just to look tough to his domestic political base. Whatever the motive, there’s little sign it came from — or even ran through — key administration officials crafting North Korea policy.

Trump’s own national security adviser, H.R. McMaster, seemed caught off guard after Trump sent a tweet Sunday morning in which he described talking to South Korea’s leader about an unnamed “Rocket Man.” On an a Sunday interview with ABC News, host George Stephanopoulos asked McMaster, “I assume ‘Rocket Man’ is Kim Jong-un?”

“Well, it’s — it appears to be so,” McMaster said haltingly. “That is where the rockets and missiles are coming from, is North Korea.”

Since then, Trump officials have embraced the moniker more enthusiastically—even if they offer few particulars about how it aids America’s strategic position. A “President Trump original,” White House press secretary Sarah Huckabee Sanders said Wednesday. “As you know, he’s a master in branding.”

“Look, this is a way of, like, you know, getting people to talk about him,” Trump’s United Nations Ambassador, Nikki Haley, told ABC Wednesday.

A National Security Council spokesman did not respond when asked how Trump’s advisers feel about the nickname, and what effect Trump hopes it will have. Several Asia analysts said there would be no confusion about the name’s hostile intent among North Korea’s leaders. The insular county’s population is a different story. Even the few North Koreans familiar with Elton John wouldn’t likely have heard about Trump’s crack: The nation’s state media has yet to report the line, according to Adam Cathcart, an Asia historian at the University of Leeds.

Cathcart added that the country’s propaganda machine might even turn the line to Kim’s advantage, at least domestically, in a nation whose missile program is a point of pride.

“Insults like that generally don’t translate well,” he said, “and if anything the [North Korean] state media has made a habit of rephrasing things in a way that they want their people to hear them. So we might ultimately see some reference to Trump’s publicly stated fear of the ‘intercontinental missile capability advancing at extreme speed’ or something along those lines.”

Kim and his inner circle will have a clearer understanding of Trump’s intended meaning. But experts doubt that a North Korean leader whose family has defied the West for decades under threat of carpet bombing will be rattled by a reference to a 1970s pop hit. Some even worry that by focusing on Kim personally—something President Barack Obama avoided doing—Trump could elevate the North Korean leader’s stature and inflate his ego.

This kind of bluster will not only not deter North Korea, but Kim will call Trump’s bluff and conduct more weapons tests,” said Sung-Yoon Lee, a North Korea specialist at the Fletcher School of Law and Diplomacy at Tufts University.

Moreover, Lee added, name-calling is typically the hallmark of the North Korean regime itself. Pyongyang’s blustery propaganda machine has branded George W. Bush “human scum,” Barack Obama a “wicked black monkey,” and Trump himself “a psychopath.”

“For the U.S. to descend to North Korea’s level is demeaning,” Lee said.

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Backlash throws last-ditch Obamacare repeal effort into doubt

Republicans hoping to jam a last-minute Obamacare repeal plan through the Senate are confronting a rising tide of opposition as health care groups, patient advocates and even some red-state governors join forces against a bill they worry would upend the nation’s health care system.

The wide-ranging backlash threw the GOP’s repeal push into fresh doubt on Tuesday, even as White House officials and Senate Republican leaders insist they are on the verge of winning the 50 votes needed to dismantle Obamacare under a reconciliation bill that expires in two weeks.

Opponents of the proposal co-authored by Sens. Bill Cassidy of Louisiana and Lindsey Graham of South Carolina seized on its plan to overhaul Obamacare’s subsidized insurance and Medicaid expansion and replace those with block grants to the states — a mass restructuring they warned would sow chaos in insurance markets. They panned its new regulatory flexibilities as a backdoor route to undermining key patient protections — including safeguards for those with pre-existing conditions.

And in the biggest blow, several Republican governors urged the GOP to abandon a plan that would force states to swallow potentially billions in funding cuts — and instead to focus on stabilizing Obamacare.

“The Graham-Cassidy bill is not a solution that works for Maryland,” said Maryland Gov. Larry Hogan, one of the half-dozen GOP governors to come out against the bill so far. “We need common-sense, bipartisan solutions that will stabilize markets and actually expand affordable coverage.”

The red-state criticism adds another complication to an already fraught process for Senate Republicans facing a tight deadline to repeal Obamacare. GOP leaders — once skeptical of the Graham-Cassidy plan’s chances — are now all in on a bid to speed it through the Senate.

In a clear bid to boost the bill’s prospects Tuesday, House Speaker Paul Ryan and the White House came out in opposition to a bipartisan plan to stabilize Obamacare being written by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash). The intention was to put pressure on Republican senators to back the last-ditch effort to gut Obamacare.

Alexander later announced he’d abandoned work on that effort after failing to find consensus. He has said he’d “like to” be able to support Graham-Cassidy and is still reviewing the bill.

Senate Majority Leader Mitch McConnell also backed the approach Tuesday, although he declined to commit to bring it to the floor.

“We’re in the process of discussing all of this,” McConnell said. “Everybody knows that the opportunity expires at the end of the month.”

All of which has amped up the pressure on GOP lawmakers who are eager to fulfill their seven-year repeal vow but who remain puzzled about what the bill would actually mean for their home states — especially since the Congressional Budget Office said it will not have details about the practical implications of the bill, including how many people could lose coverage and the impact on insurance premiums, “for at least several weeks.”

“The kind of status quo on money, or more money to states and more control to states — that’s very appealing, very simple,” said Alaska Sen. Dan Sullivan, who added that he’s still poring over the bill’s effects. “What I’m very focused on as we speak is figuring out the dollar amounts, frankly, and the formula and how it impacts my state.”

Cassidy — the chief architect of the bill’s proposal to take Obamacare’s federal funding and redistribute it to states in equal amounts — has spent the past several days reassuring senators that their states wouldn’t see major funding cuts under the block grant plan.

But that rosy view has met with increasingly harsh pushback from policy analysts, industry groups and state officials — including some in the Louisiana Republican’s own state.

“The legislation you’ve introduced this past week gravely threatens health care access and coverage for our state and its people,” Louisiana Health Secretary Rebekah Gee wrote in a letter to Cassidy, estimating that the bill’s block grant system would slash $3.2 billion in health funding for the state over a decade.

That figure tracks with early estimates published by the left-leaning Center on Budget and Policy Priorities, showing that only 15 states would end up better off financially under Graham-Cassidy compared with the current law — while those that have been most successful at enrolling residents in coverage would face tens of billions in cuts.

Another state-by-state analysis, set to be released Wednesday by health care consultancy Avalere, will similarly show most states losing federal funds through the bill.

“That is definitely the case,” Avalere Vice President for Policy and Strategy Caroline Pearson said. “The vast majority of states will get less money.”

The projected financial hit to states has pitted some Republican governors against their own Senate delegation. Nevada Gov. Brian Sandoval — in a break with bill co-sponsor Dean Heller — and Ohio Gov. John Kasich both signed onto a 10-governor letter urging the GOP to abandon Graham-Cassidy in favor of propping up Obamacare. Louisiana Gov. John Bel Edwards, a Democrat, opposed the bill too.

The state-level objections echoed the message from across the health community — a diverse group of industry, patient and public health advocates that have nevertheless remained largely united against the GOP’s repeated repeal efforts.

Sixteen patient and provider groups, from the American Heart Association to the March of Dimes, slammed the bill in a joint letter over worries it would gut Medicaid and undermine protections for those with pre-existing conditions. A raft of other powerful health lobbies, including the American Medical Association and American Academy of Family Physicians, piled on throughout the day on Tuesday, each urging the GOP to abandon repeal in favor of bipartisan fixes.

Hospitals and insurers — until this week largely convinced the repeal fight was over — sprang back into action as well, criticizing the prospect of creating 50 wildly different state health care systems as unworkable and irresponsible, with minimal vetting of the bill’s merits ahead of time.

“Could you have imagined any other Senate in our modern history that would even consider this process?” one health care lobbyist vented, calling it the worst GOP proposal yet. “We’re talking about such a tremendous portion of the United States economy. Real people’s lives. The reverberations are just so huge.”

To date, not one major health care industry or advocacy group has expressed support for the Graham-Cassidy plan.

The hits are going to keep coming. Activist groups that Democrats credited for helping derail the last repeal bill are ramping up their efforts, targeting holdouts like Sens. John McCain of Arizona and Susan Collins of Maine.

And comedian Jimmy Kimmel, who lauded Cassidy in May for his promise to vote against any bill that undermined protections for people with pre-existing conditions, is expected to go after the senator Tuesday night for breaking his promise. Graham-Cassidy would let states obtain waivers that allow plans to charge higher premiums based on individuals’ health status.

Cassidy has defended the provision by noting that states would be required to ensure “affordable and adequate” coverage options for sick enrollees.

The sudden scrutiny has heightened tensions in a Senate that last week seemed resigned to simply shoring up Obamacare for the short term.

“I have nothing to say,” McCain, a key swing vote, retorted Tuesday when asked about his position on the bill. “I have nothing to say, OK? Did you hear me?”

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Graham-Cassidy health care bill: What you need to know

Block grants would radically change how health care is funded in the U.S.

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Twitter Trump and Teleprompter Trump merge on global stage

NEW YORK — President Donald Trump often functions in one of two modes. One is the unshackled, quick-to-feel-slighted contrarian who believes in two eyes for an eye and retweets videos that suggest violence against opponents like Hillary Clinton and CNN.

The other is a president who is able to strike a unifying tone, stay on a script and deliver — at least in set pieces — performances that are in line with the way the country has come to expect its leader to behave in high-stakes moments. (See: his generally appropriate remarks to those displaced by massive hurricanes in Texas and Florida, or his first address before a joint session of Congress in February.)

But on Tuesday, in his first address in front of the United Nations General Assembly, Trump was his least bifurcated self. Teleprompter Trump and Twitter Trump seemed to become one in an address that feinted at a foreign policy doctrine but ultimately struggled to materialize into a coherent worldview.

Trump stuck to a script written by his top policy aide, Stephen Miller, and reviewed beforehand by Secretary of State Rex Tillerson and U.S. Ambassador to the United Nations Nikki Haley, among others.

After a rare night spent in his apartment in Trump Tower, he appeared relaxed, reading from two teleprompters in a steady tone. But the script also included distinctly Trumpian flourishes. The hall, filled with world leaders, hummed as he said aloud the nicknames and catchphrases he has used on Twitter — “Rocket Man” for North Korean dictator Kim Jong Un, “loser terrorists” for people from the Middle East perpetuating violence around the globe.

“Some lines were very Trumpian, but he also had an argument,” said Elliott Abrams, a neoconservative foreign policy expert who served in the George W. Bush administration. That argument, Abrams said, was a globalized version of the “America First” doctrine, one that cast the U.N. not as a world government but as a collection of sovereign states.

But Trump went on to make the case for American intervention in global hot spots like North Korea, Iran and Venezuela.

“They’re grappling with the question of how can you be leader of the free world,” Abrams added. “This was not a Bannon-ite ‘to hell with all of you’ speech. But they still don’t have an answer to that question. They’re groping.”

To Trump’s detractors, the speech was ultimately a reminder that there really is no Trump foreign policy doctrine — whether he is behaving as his freewheeling or his scripted self. “There was no uniting principle that gave our allies something to rally behind and our enemies something to fear,” said Brian Fallon, who served as press secretary of Clinton’s 2016 campaign. “North Korea is evil, but you have to have a unifying worldview. They would say having nuclear ambitions is exercising their sovereign right.”

In his speech, the president went beyond his “fire and fury” remarks aimed at North Korea, vowing that if the United States “is forced to defend itself or its allies, we will have no choice but to totally destroy North Korea.” He also made his strongest hints yet that he intends to pull America out of the 2015 Iran deal, saying that it is “an embarrassment to the United States, and I don’t think you’ve heard the last of it.”

After touting the importance of each country in the world looking out primarily for itself and not imposing its views on the rest of the world, Trump said that in Venezuela, where people are starving, the “situation is completely unacceptable, and we cannot stand by and watch.”

“It was the international edition of his inaugural speech on American carnage,” said Jake Sullivan, a former senior State Department official who helped lay the groundwork for the Iran deal. “Dark and selfish replaces ‘shining city on a hill.’”

Still, the speech appeared to be in line with how Trump often behaves when addressing an international audience — adopting a more serious and moderated exterior while dropping stealth grenades. In Brussels last spring, during his first address before NATO, Trump failed to reaffirm Article 5 — the one-for-all, all-for-one commitment of mutual defense of members of the alliance, in an otherwise by-the-book speech. (He went on to state his commitment to the doctrine at a speech in Warsaw in July, after the resulting uproar.)

“The rest of his speech was normal,” recalled Ilan Goldenberg, a former State Department official during the Obama administration, “but he did this thing that terrified everyone. He often has this veil of normalized stuff, with these little tidbits that are fundamentally undercutting basic tenets that are part of the global order. This is one of the real windows into what the Trump presidency is.”

Trump gamely followed the standard script throughout the day in New York. At a luncheon hosted by the U.N. secretary general, he toasted “the great, great potential of the United Nations,” even appearing to take a sip of red wine. Trump famously does not drink, and for years he has been a fierce critic of the U.N.

At his table, he chatted with one of his favorite foreign leaders, Prime Minister Shinzo Abe of Japan, over a lunch of pan-seared wagyu beef tenderloin and chocolate ganache mousse. For his third event of the day, Trump was scheduled to hold a bilateral meeting with the emir of Qatar.

Meanwhile, former aides who have been ousted under the new regime of chief of staff John Kelly were quick to try to take credit for the content of Trump’s morning address — one they claimed was vintage Trump.

“The speech was a great demonstration that the external team is succeeding in countering the non-MAGA voices inside the White House,” former West Wing aide Sebastian Gorka, now chief strategist of the newly created MAGA Coalition, said in a text message.

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Did Democrats jump the gun with single-payer splash?

Last week, a group of Senate Democrats rallied behind single-payer health care at a splashy news conference. This week, the same group is scrambling to beat back the GOP’s latest Obamacare repeal blitz.

The contrast shows the chasm between the two parties’ approach to health care: Republicans claim that Bernie Sanders’ “Medicare for All” pitch fueled their revived repeal effort, an argument that even Democratic single-payer foes dismiss as untrue. Yet some Democrats wish more attention had been paid to protecting the Affordable Care Act before some of the party’s biggest names turned to single payer.

It’s also a reminder that in Washington you can never underestimate the power of a president, even if they don’t always win. President Donald Trump wanted one last shot at repealing Obamacare, and Democrats are now struggling to preserve a victory they thought they’d already won.

“I thought that anyone who believed that you should take your eye off the ball before Sept. 30 wasn’t being smart,” said Sen. Heidi Heitkamp (D-N.D.), who does not support single-payer. “So it doesn’t surprise me that this is coming back.”

Sen. Tom Carper (D-Del.) acknowledged that “maybe” the single-payer rollout had been premature, recalling a Methodist minister who once advised him as governor that “the main thing is to keep the main thing the main thing.”

“In this case the main thing is stabilizing the [Obamacare] exchanges, so people in every state, every county, can have better health insurance at a better cost,” said Carper, who has not signed on to Sanders’ bill. “That’s what we should be about right now.”

Sanders’ single-payer plan drew support from no fewer than five fellow potential challengers to Trump in 2020. Liberal activists crowed that any Democrat who wants the party’s next presidential nod would have to support a path to universal health care.

The same cast of liberal luminaries, including Sens. Kamala Harris (D-Calif.), Cory Booker (D-N.J.) and Elizabeth Warren (D-Mass.), is now turning to stoking grass-roots fury about the new Republican repeal plan.

Senate Minority Whip Dick Durbin (D-Ill.), the minority whip, said it “remains to be seen” whether Democrats shifted too quickly to debating single-payer even as Obamacare repeal was still lurking.

Sens. Bill Cassidy (R-La.) and Lindsey Graham (R-S.C.) were crafting their latest version of a repeal measure “even as Bernie was working on his press conference” on single payer, Durbin added, “so it’s been around a while.”

Though no Democratic senator faulted single payer’s supporters, some in the party lamented the choice to unveil single payer before the GOP reached its deadline to repeal Obamacare with a simple majority vote. Trump and Senate Majority Leader Mitch McConnell (R-Ky.) are working hard to lock down Republican support for repeal, and they’re close. A climactic vote could come next week, as the clock runs out on any hope of getting rid of Obamacare.

“Doing it when he did it was a gift to the repealers,” one Democratic strategist said of Sanders’ single-payer push. “It took focus off them and put it on us at an unhelpful time.”

One Senate Democratic aide wondered whether the single-payer splash could have waited until next month, when the GOP’s window to repeal Obamacare with 50 votes will have closed.

“It’s the timing that’s the problem,” the aide said. “If this was introduced Oct. 1, that’d be one thing, but this is almost perfectly timed to make it harder to defend the ACA.”

“We should be trying to save the most progressive health care overhaul in decades, because it’s really at risk. But instead, they’re riling up the base over single payer, making the perfect the enemy of the good at the worst possible moment,” the person added.

A liberal activist whose group supports single-payer health care sounded a similar note, saying that the timing of Sanders’ rollout had handed “Republicans a lot of space” to quietly twist arms on the Cassidy-Graham repeal plan.

If the GOP can push through that repeal legislation, which would scrap Obamacare’s individual mandate and slash its Medicaid expansion, second-guessing about single payer promises to grow louder. Senate Minority Leader Chuck Schumer (D-N.Y.) and House Minority Leader Nancy Pelosi (D-Calif.) did not endorse Sanders’ health care plan, but their short-term government funding and debt limit deal with Trump earlier this month also helped clear space for Senate Republicans’ new repeal effort.

Sanders, for his part, joined Schumer at a Tuesday rally of progressive activists against the new repeal bill. The 2016 presidential candidate also recorded a video slamming the Cassidy-Graham plan to be circulated on his social media platforms. Sanders is likely to participate in more pro-Obamacare events over the next 10 days and considers the defeat of repeal his No. 1 priority right now, an aide said.

“Our job over the next five to 10 days is to get the word out about this horrific legislation and do everything we can to defeat it,” Sanders tweeted on Tuesday.

Sen. Brian Schatz (D-Hawaii), a single-payer supporter, agreed that the party should wait to talk further about its vision for the future of health care until after the latest Republican repeal effort is defeated.

“Let me put it this way: We need all hands on deck to try to save the Affordable Care Act, and there will be a time when this is over to talk about our own proposals to improve the health care system,” Schatz said in an interview. “But right now they are trying to destroy the American health care system, and we have to stop them.”

Sen. Jon Tester (D-Mont.), who has not signed on to single-payer, said that “whether it’s a distraction or not, I think the focus really does need to be on the smoke and mirrors they’re trying to do with this bill.” Tester slammed the Cassidy-Graham plan as “the worst” version of Obamacare repeal that Republicans have offered.

Democrats continued their campaign against the Cassidy-Graham measure on Tuesday, with the pro-Obamacare group Save my Care launching a six-figure TV ad buy targeting moderate Republican senators. Meanwhile, Pelosi is rallying her caucus from afar.

“This is an all-out red alert,” she told members of her leadership team.

John Bresnahan and Heather Caygle contributed to this report.

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