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Finally, Senate GOP release their health care plan

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WASHINGTON — Senate Republicans launched their plan for shriveling Barack Obama’s health care law Thursday, edging a step closer to their dream of repeal with a bill that would slice and reshape Medicaid for the poor, relax rules on insurers and end tax increases on higher earners that have helped finance expanded coverage for millions.

Four conservative GOP senators quickly announced initial opposition to the measure and others were evasive, raising the specter of a jarring rejection by the Republican-controlled body. But Senate Majority Leader Mitch McConnell, R-Ky., indicated he was open to discussion and seemed determined to muscle the measure through his chamber next week.

Release of the 142-page proposal ended the long wait for one of the most closely guarded bills in years. McConnell stitched it together behind closed doors, potentially moving President Donald Trump and the GOP toward achieving perhaps their fondest goal — repealing former President Obama’s 2010 statute, his proudest domestic legacy.

On Twitter, Trump said he was “very supportive” of the bill. On Facebook, Obama said at the heart of the bill was “fundamental meanness.”

The bill would end Obama’s tax penalties on people who don’t buy insurance — effectively ending the so-called individual mandate — and on larger companies that don’t offer coverage to their workers. It would offer less generous subsidies for people than Obama’s law but provide billions to states and insurance companies to buttress markets that in some areas have been abandoned by insurers.

McConnell must navigate a narrow route in which defections by just three of the 52 Republican senators would doom the legislation. He and others said the measure would make health insurance more affordable and eliminate Obama coverage requirements that some people find onerous.

“We have to act,” McConnell said. “Because Obamacare is a direct attack on the middle class, and American families deserve better than its failing status quo.”

Democrats said the measure would result in skimpier policies and higher out-of-pocket costs for many and erode gains made under Obama that saw roughly 20 million additional Americans gain coverage.

“We live in the wealthiest country on earth. Surely we can do better than what the Republican health care bill promises,” said Senate Minority Leader Chuck Schumer, D-N.Y.

Four conservative senators expressed opposition but openness to talks: Ted Cruz of Texas, Kentucky’s Rand Paul, Mike Lee of Utah and Ron Johnson from Wisconsin. They said the measure falls short, missing “the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs.”

On the other hand, Sens. Dean Heller of Nevada, facing a competitive 2018 re-election battle, Ohio’s Rob Portman and Shelley Moore Capito of West Virginia expressed concerns about the bill’s cuts to Medicaid and drug addiction efforts. And Susan Collins of Maine reiterated her opposition to language blocking federal money for Planned Parenthood, which many Republicans oppose because it provides abortions.

Late Thursday, Trump tweeted, “I am very supportive of the Senate #HealthcareBill. Look forward to making it really special! Remember, ObamaCare is dead.”

In an interview later with Fox News Channel, Trump was asked about the four conservatives opposing the bill. “Well, they’re also four good guys, four friends of mine and I think that they’ll probably get there,” he said. “We’ll have to see.”

Obama was more than skeptical.

“If there’s a chance you might get sick, get old or start a family, this bill will do you harm,” he wrote. He said “small tweaks” during the upcoming debate “cannot change the fundamental meanness at the core of this legislation.”

The House approved its version of the bill last month. Though Trump lauded its passage in a Rose Garden ceremony, he called the House measure “mean” last week.

The nonpartisan Congressional Budget Office said under the House bill, 23 million fewer people would have coverage by 2026. The budget office analysis of the Senate measure is expected early next week.

The Senate legislation drew support from the U.S. Chamber of Commerce, which said it would “stabilize crumbling insurance markets” and curb premium increases. The American Medical Association, the American Hospital Association and AARP, representing older people, all criticized the measure.

The Senate bill would phase out extra money Obama’s law provides to 31 states that agreed to expand coverage under the federal-state Medicaid program. Those additional funds would continue through 2020, then gradually fall and disappear entirely in 2024.

Ending Obama’s expansion has caused major rifts among GOP senators. Some from states that have expanded have battled to delay the phase-out, while conservative Republicans have sought to halt the funds quickly.

Beginning in 2020, the Senate measure would also limit the federal funds states get each year for Medicaid. The program currently gives states all the money needed to cover eligible recipients and procedures.

The Senate bill largely uses people’s incomes as the yardstick for helping those without workplace coverage to buy private insurance. That would focus the aid more on people with lower incomes than the House legislation, which bases its subsidies on age.

Caroline Pearson, a senior vice president of the consulting firm Avalare Health, said the Senate subsidies would be smaller than Obama’s because they’re keyed to the cost of a bare-bones plan and because additional help now provided for deductibles and copayments would eventually be discontinued.

The bill would let states get waivers to ignore some coverage requirements under Obama’s law, such as specific health services insurers must now cover.

States could not get exemptions to Obama’s prohibition against charging higher premiums for some people with pre-existing medical conditions, but the subsidies would be lower, making coverage less affordable, Pearson said. States would also have to retain Obama’s requirement that family insurance cover children up to age 26.

Tax boosts Obama levied on upper income people and medical industry companies would be repealed, and another on costly employer-provided health insurance would be delayed.

The bill would bar using tax credits to buy coverage that includes abortions. That language could be forced out of the bill for procedural reasons, which would threaten support from conservatives, but Republicans would seek other ways to retain the restriction.

For the next two years, the Senate would also provide money that insurers use to help lower out-of-pocket costs for millions of lower income people. Trump has been threatening to discontinue those payments, and some insurance companies have cited uncertainty as a reason they are abandoning some markets and boosting premiums.

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Push to legalize marijuana upends governor’s race in New Mexico

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ALBUQUERQUE, N.M. — Democratic gubernatorial candidate Jeff Apodaca on Thursday called for the expansion of New Mexico’s medical marijuana program and for legalization of recreational use, saying the poverty-stricken state is missing out on millions of dollars in tax revenues and jobs that could be spurred by the industry.

Apodaca released his plan solidifying his position as a supporter of legalization as the race for governor heats up.

Apodaca pointed to New Mexico’s history as the first state to allow for research and experimentation with marijuana as a therapeutic drug. It was his father, then-Gov. Jerry Apodaca, who signed that legislation in 1978.

The research program stalled and it wasn’t until 2008 that New Mexico rolled out its medical cannabis program.

“Why are we shooting for being the last to legalize cannabis for adult use?” Apodaca said.

The push for legalization comes as New Mexico’s medical marijuana program has grown exponentially in just the last two years. Producers licensed under the program reported record sales of more than $86 million in 2017 and the number of patients enrolled now tops 50,000.

“We know the medical benefits of it. And we also know the opportunities of legalization for adult use,” Apodaca said, suggesting expansion of the long-standing medical marijuana program along with legalization could result in an estimated $200 million of additional tax revenues for the state.

The state’s largest producer, Ultra Health, announced that it has acquired farmland in southern New Mexico and has plans for what the industry says could be the largest cultivation facility in North America.

The property spans nearly one-third of a square mile (81 hectares) in Otero County. It will include 20 acres (8 hectares) of indoor cultivation, 80 acres (32 hectares) of outdoor cannabis fields and another 100 acres (40 hectares) of outdoor hemp fields.

Ultra Health president and CEO Duke Rodriguez said the company is preparing for a future in which New Mexico stands to benefit from expanded medical use and possibly recreational use.

Apodaca’s plan calls for lifting the current limits on the number of plants producers can grow and reducing costly licensing fees.

Other Democratic candidates have been more cautious.

U.S. Rep. Michelle Lujan Grisham said she would work with state lawmakers to ensure there are adequate health, safety and enforcement measures in place. She called for a “thorough analysis” of recreational pot programs in other states as part of that effort.

Lujan Grisham was in charge of the state Health Department when the medical marijuana program began. Aside from the legalization debate, she said supporting producers to create the latest medicines and methods to help patients would help create jobs and expand the industry.

State Sen. Joseph Cervantes, another Democratic candidate, has sponsored unsuccessful legislation to decriminalize possession of small quantities of pot but has said the state is lacking infrastructure and isn’t ready yet to legalize.

Cervantes recently lauded efforts at the local level by the state’s largest city — Albuquerque — to decriminalize possession of small amounts. He said he would do the same as governor and that it would mark a first step.

Republican congressman and gubernatorial candidate Steve Pearce expressed reservations about legalization at a forum earlier this month. He said it might create a stumbling block for people trying to climb out of poverty and addiction to other drugs.

“I just don’t see how it fits that we’re going to deal with addiction and yet we’re going to tell people, ‘This one is OK.’ I’ve watched it for a lifetime. I just am very nervous with recreational marijuana,” he said.

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‘For fun’ killing reveals vulnerability for homeless Native Americans in New Mexico

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The morning a homeless man was shot and killed in Albuquerque, police say surveillance videos showed him running down a street before sunrise, and then gunfire flash in the dark.

Native Americans make up only 4 percent of the population, but account for 44 percent of people living on the streets, raising the likelihood they will be victimized when there is an attack on the homeless.

Ronnie Ross, a 50-year-old from the Navajo Nation town of Shiprock, had been shot a dozen times, including once in the forehead and temple, and four times in the back, according to a criminal complaint. Police say the two teenage suspects charged with murder this week apparently shot him “for fun” as they came and went from a hotel party nearby.

The homicide marked the latest in a series of brazen killings and assaults of homeless Native Americans in the city. In Albuquerque, Native Americans make up only 4 percent of the population, but account for 44 percent of people living on the streets, raising the likelihood they will be victimized when there is an attack on the homeless.

A 2014 survey showed 75 percent of homeless Native Americans in Albuquerque had been physically assaulted.

“Just being harassed is part of everyday life, but it’s not as much harassment as it is overgrown bullying,” said Gordon Yawakia, who works at the Albuquerque Indian Center and was once homeless himself. “What do you do when people are against you and then the authorities are against you and you’ve got nobody, you know?”

In 2014, Allison Gorman and Kee Thompson, both Navajo, were beaten to death as they slept in a vacant lot. While authorities did not say the men were targeted because they were Native American, activists disagreed and the deaths spurred the creation of a city task force to address Native American homelessness that now-former Mayor Richard Berry said could set the stage for changes for the population across the Southwest.

Now, Ross’ death is underscoring how difficult it may be to protect and find solutions for the city’s Native American homeless population.

“When I hear a story like this it adds fuel to the fire,” said Dawn Begay, who is the city’s tribal liaison, and works with the homeless through a local nonprofit. “Where we’re headed is a good direction but it has to happen faster.”

Ross’ killing in March came three months after the body of Audra Willis was found decapitated in an area not far from the Sandia Mountains that line the city’s east side. The 39-year-old had come from To’hajiilee, a tiny Navajo community west of Albuquerque, and records show she had multiple addresses during her time in the city, including at the Albuquerque Indian Center.

Willis’ especially grisly death sent shockwaves through Albuquerque, just as the beatings of Thompson and Gorman had three years earlier.

The two men had been killed on a July 2014 night when authorities say three boys — ages 15, 16 and 18_returned home from a night of drinking and decided to attack them as they slept on a mattress. The men were beaten with a wooden table leg, cinder blocks, and other objects, police said. One young suspect later told authorities that the teens had beaten dozens of homeless people, though apparently none others fatally.

In Ross’ death, the complaint filed against the 15- and 17-year-old suspects does not identify a motive, but says the two teenagers bragged to friends about the shooting.

According to police, friends and acquaintances of the boys — whom The Associated Press is not naming because of their ages — said the suspects had been showing off a gun at the party, and had said to others that they had shot a man. At one point, the younger boy also said to a close friend at the party that he shot a “hobo” in the back.

The boys made one more stop at the scene to find Ross still alive, prompting the older boy to shoot him multiple times, according to the complaint.

“It’s completely disturbing,” said Officer Simon Drobik, an Albuquerque police spokesman, said Tuesday. “They just shot this guy for fun.”

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The Last Castro; Raul retires as Cuban president

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Raul Castro turned over Cuba’s presidency Thursday to a 57-year-old successor he said would hold power until 2031, a plan that would place the state the Castro brothers founded and ruled for 60 years in the hands of a Communist Party official little known to most on the island.

Castro’s 90-minute valedictory speech offered his first clear vision for the nation’s future power structure under new President Miguel Mario Diaz-Canel Bermudez. Castro said he foresees the white-haired electronics engineer serving two five-year terms as leader of the Cuban government, and taking the helm of the Communist Party, the country’s ultimate authority, when Castro leaves the powerful position in 2021.

“From that point on, I will be just another soldier defending this revolution,” Castro said. The 86-year-old general broke frequently from his prepared remarks to joke and banter with officials on the dais in the National Assembly, saying he looked forward to having more time to travel the country.

In his own half-hour speech to the nation, Diaz-Canel pledged to preserve Cuba’s communist system while gradually reforming the economy and making the government more responsive to the people.

“There’s no space here for a transition that ignores or destroys the legacy of so many years of struggle,” Diaz-Canel said. “For us, it’s totally clear that only the Communist Party of Cuba, the guiding force of society and the state, guarantees the unity of the nation of Cuba.”

Diaz-Canel said he would work to implement a long-term plan laid out by the National Assembly and communist party that would continue allowing the limited growth of private enterprises like restaurants and taxis, while leaving the economy’s most important sectors such as energy, mining, telecommunications, medical services and rum- and cigar-production in the hands of the state.

“The people have given this assembly the mandate to provide continuity to the Cuban Revolution during a crucial, historic moment that will be defined by all that we achieve in the advance of the modernization of our social and economic model,” Diaz-Canel said.

Cubans said they expected their new president to deliver improvements to the island’s economy, which remains stagnant and dominated by inefficient, unproductive state-run enterprises that are unable to provide salaries high enough to cover basic needs. The average monthly pay for state workers is roughly $30 a month, forcing many to steal from their workplaces and depend on remittances from relatives abroad.

“I hope that Diaz-Canel brings prosperity,” said Richard Perez, a souvenir salesman in Old Havana. “I want to see changes, above all economic changes allowing people to have their own businesses, without the state in charge of so many things.”

But in Miami, Cuban-Americans said they didn’t expect much from Diaz-Canel.

“It’s a cosmetic change,” said Wilfredo Allen, a 66-year-old lawyer who left Cuba two years after the Castros’ 1959 revolution. “The reality is that Raul Castro is still controlling the Communist Party. We are very far from having a democratic Cuba.”

After formally taking over from his older brother Fidel in 2008, Raul Castro launched a series of reforms that led to a rapid expansion of Cuba’s private sector and burgeoning use of cellphones and the internet. Cuba today has a vibrant real estate market and one of the world’s fastest-growing airports. Tourism numbers have more than doubled since Castro and President Barack Obama re-established diplomatic relations in 2015, making Cuba a destination for nearly 5 million visitors a year, despite a plunge in relations under the Trump administration.

Castro’s moves to open the economy even further have largely been frozen or reversed as soon as they began to generate conspicuous displays of wealth by the new entrepreneurial class in a country officially dedicated to equality among its citizens. Foreign investment remains anemic and the island’s infrastructure is falling deeper into disrepair. The election of President Donald Trump dashed dreams of detente with the U.S., and after two decades of getting Venezuelan subsidies totaling more than $6 billion a year, Cuba’s patron has collapsed economically, with no replacement in the wings.

Castro’s inability or unwillingness to fix Cuba’s structural problems with deep and wide-ranging reforms has many wondering how a successor without Castro’s founding-father credentials will manage the country over the next five or 10 years.

“I want the country to advance,” said Susel Calzado, a 61-year-old economics professor. “We already have a plan laid out.”

Most Cubans have known their new president as an uncharismatic figure who until recently maintained a public profile so low it was virtually nonexistent. Castro’s declaration Thursday that he saw Diaz-Canel in power for more than a decade was likely to resolve much of the uncertainty about the power the new president would wield inside the Cuban system.

“The same thing we’re doing with him, he’ll have to do with his successor,” Castro said. “When his 10 years of service as president of the Council of State and Council of Ministers are over, he’ll have three years as first secretary in order to facilitate the transition. This will help us avoid mistakes by his successor, until (Diaz-Canel) retires to take care of the grandchildren he will have then, if he doesn’t have them already, or his great-grandchildren.”

Cuban state media said Russian President Vladimir Putin congratulated Diaz-Canel and thanked Castro for the many years of cooperation between the two countries, while Chinese President Xi Jinping also reaffirmed his country’s friendship with Cuba and expressed interest in deeper ties.

At the U.S. State Department, spokeswoman Heather Nauert expressed disappointment at the handover, saying Cuban citizens “had no real power to affect the outcome” of what she called the “undemocratic transition” that brought Diaz-Canal to the presidency.

Vice President Mike Pence tweeted at Castro that the U.S. won’t rest until Cuba “has free & fair elections, political prisoners are released & the people of Cuba are finally free!”

Diaz-Canel said his government would be willing to talk with the United States but rejected all demands for changes in the Cuban system.

With Castro watching from the audience, Diaz-Canel made clear that for the moment he would defer to the man who founded the Cuban communist system along with his brother Fidel. He said he would retain Castro’s cabinet through at least July, when the National Assembly meets again.

“I confirm to this assembly that Raul Castro, as first secretary of the Communist Party, will lead the decisions about the future of the country,” Diaz-Canel said. “Cuba needs him, providing ideas and proposals for the revolutionary cause, orienting and alerting us about any error or deficiency, teaching us, and always ready to confront imperialism.”

Diaz-Canel first gained prominence in central Villa Clara province as the top Communist Party official, a post equivalent to governor. People there describe him as a hard-working, modest-living technocrat dedicated to improving public services. He became higher education minister in 2009 before moving into the vice presidency.

In a video of a Communist Party meeting that inexplicably leaked to the public last year, Diaz-Canel expressed a series of orthodox positions that included somberly pledging to shutter some independent media and labeling some European embassies as outposts of foreign subversion.

But he has also defended academics and bloggers who became targets of hard-liners, leading some to describe him a potential advocate for greater openness in a system intolerant of virtually any criticism or dissent. International observers and Cubans alike will be scrutinizing every move he makes in coming days and weeks.

As in Cuba’s legislative elections, all of the leaders selected Wednesday were picked by a government-appointed commission. Ballots offered only the option of approval or disapproval and candidates generally receive more than 95 percent of the votes in their favor. Diaz-Canel was approved by 604 votes in the 605-member assembly. It was unclear if he had abstained or someone else had declined to endorse him.

The assembly also approved another six vice presidents of the Council of State, Cuba’s highest government body. Only one, 85-year-old Ramiro Valdes, was among the revolutionaries who fought with the Castros in the late 1950s in the eastern Sierra Maestra mountains.

___

Associated Press writer Ben Fox contributed to this report.

 

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