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Q&A: Tax bill impacts ‘Obamacare’ and Medicare
Wednesday, December 6, 2017
AP Photo/LM Otero, File
In this 2015 file photo, U.S. Immigration and
Customs Enforcement agents enter an apartment
complex looking for a specific undocumented
immigrant convicted of a felony during an early
morning operation in Dallas.
border arrests fall
in Trump’s first year
WASHINGTON (AP) —
President Donald Trump’s
immigration crackdown has
produced a spike in deten-
tions by deportation officers
across the country during his
first months in office. At the
same time, arrests along the
Mexican border have fallen
sharply, apparently as fewer
people have tried to sneak
into the U.S.
Figures released by the
Department of Homeland
Security on Tuesday show
Trump is delivering on
his pledge to more strictly
control immigration and
suggest that would-be
immigrants are getting the
message to not even think
about crossing the border
Even as border crossings
decline, however, Trump
continues to push for his
promised wall along the
border — a wall that critics
say is unnecessary and a
waste of cash.
The new numbers, which
offer the most complete
snapshot yet of immigration
enforcement under Trump,
show that Border Patrol
arrests plunged to a 45-year
low in the fiscal year that
ended Sept. 30, with far
fewer people being appre-
hended between official
In all, the Border Patrol
made 310,531 arrests in
fiscal 2016, down 25 percent
from a year earlier and the
lowest level since 1971.
Officials have credited
that drop to Trump’s harsh
recognition by would-be
immigrants that the U.S. is
not hanging up a welcome
sign,” said Michelle Mittel-
stadt, of the non-partisan
Migration Policy Institute
think tank. She pointed to
Trump’s rhetoric, as well as
But Mittelstadt also
stressed that the numbers
are part of a larger trend that
began well before Trump’s
improving economy and
more opportunities at home
have stemmed the tide of
people flowing across the
border for work.
“You’ve really had a
realignment in migration
from Mexico,” she said,
noting that the numbers of
Mexicans apprehended in
2017 fell by 34 percent from
the previous year.
The decline in border
crossings continues a trend
that began during the Obama
administration, and marks
a dramatic drop from 2000,
when more than 1.6 million
people were apprehended
crossing the southwest
WASHINGTON — The tax overhaul
Republicans are pushing toward final
votes in Congress could undermine the
Affordable Care Act’s health insurance
markets and over time add to the finan-
cial squeeze on Medicare.
Lawmakers will meet this week to
resolve differences between the House-
and Senate-passed bills in hopes of
getting a finished product to President
Donald Trump’s desk around Christmas.
Also in play are the tax deduction for
people with high medical expenses,
and a tax credit for drug companies that
develop treatments for serious diseases
affecting relatively few patients.
The business tax cuts that are the
centerpiece of the legislation would
benefit many health care companies, but
there’s also concern among hospitals,
doctors and insurers about the impact on
coverage. Here are some questions and
answers on how the tax bill intersects
with health care:
Q: Trump has said he won’t cut
Medicare, and the program doesn’t
even seem to be mentioned in the
tax bill. Why is AARP saying that
health insurance for seniors could be
A: The tax bill would increase
federal deficits by about $1 trillion over
10 years, even after stronger economic
growth expected from tax cuts. More
red ink means higher borrowing costs
for the government, and that would
reduce options for policymakers when
Medicare’s long-postponed financial
reckoning comes due.
Medicare’s giant fund for inpatient
care isn’t expected to start running out
until 2029, more than a decade away.
But an anti-deficit law currently in effect
could trigger automatic cuts as early
as next year — about $25 billion from
House Speaker Paul Ryan, R-Wisc.,
and Senate Majority Leader Mitch
McConnell, R-Ky., said in a joint state-
ment last week that such speculation is
unfounded. “This will not happen,” the
GOP leaders said. Congress has previ-
ously waived such cuts, they explained,
and there’s no reason to think this time
would be different.
Nonetheless others see an increased
risk to Medicare.
“The greater concern is even if the
automatic cuts don’t take place, the tax
bill just exacerbates the pressure on the
federal deficit and Republicans have
been pressing for cuts in Medicare for
some time,” said Paul Van de Water, a
policy expert with the Center on Budget
and Policy Priorities, which advocates
for low-income people.
AP Photo/Jon Elswick
In this Dec. 4 photo, part of the Republican Senate bill “Tax Cuts and Jobs
Act” is photographed in Washington.
Other safety net programs, including
Medicaid and Children’s Health Insur-
ance would also come under greater
Q: How did “Obamacare” wind up
in the tax bill?
A: The Senate version repeals the
Affordable Care Act’s tax penalties on
people who don’t have health insurance.
That actually saves the government
money, since fewer consumers would
apply for taxpayer-subsidized coverage.
GOP tax writers got nearly $320 billion
over 10 years to help pay for tax cuts.
Repealing the fines would deal a blow
to “Obamacare” after a more ambitious
Republican takedown collapsed earlier
Q: Those fines have been very
unpopular, so how could repealing
them undermine the health law?
Other parts of the ACA will remain
on the books.
A: Premiums will go up, and that’s
The fines were meant to nudge
healthy people to get covered. Because
insurance markets work by pooling
risks, premiums from healthy people
subsidize care for the sick.
Without some arm-twisting to get
covered, some healthy people will stay
out of the pool.
That’s likely to translate to a 10
percent increase in premiums for those
left behind, people more likely to have
health problems and need comprehen-
sive coverage, says the Congressional
The CBO also estimated that 13
million more people would be unin-
sured in 2027 without the penalties. If
they have a serious accident or illness,
uninsured people get slammed with big
bills, and taxpayers wind up indirectly
subsidizing the cost.
Q: So just taking away an unpop-
ular penalty would destabilize the
health insurance law?
A: Repealing the fines is part of a
The Trump administration slashed
the advertising budget for ACA sign-ups
this year, while also cutting the enroll-
ment window in half. The administration
is working on rules that would allow
broader sale of skimpy insurance plans
with lower premiums. That, too, would
also draw healthy people away from the
health law markets.
“The program would still exist, but
it would be quite hobbled at this point,”
said Larry Levitt of the nonpartisan
Kaiser Family Foundation.
A separate bipartisan bill to stabilize
health insurance markets is still pending
in the Senate, and it remains unclear
where the markets will settle out.
Q: Taxes and health care are
connected. Anything else to flag in the
A: The House bill repeals the tax
deduction for people with high medical
expenses not covered by insurance. The
Senate bill would make the deduction
more generous than what’s currently
allowed. People could deduct amounts
that exceed 7.5 percent of their income.
The differences would have to be
resolved in conference.
In order to raise money to pay for
lower tax rates, the House bill eliminates
a tax credit available to drug companies
that develop medications for people
with rare diseases; the Senate bill scales
back the tax credit. Organizations repre-
senting patients are pushing to keep the
Conyers resigns from Congress
amid harassment allegations
DETROIT (AP) — Democratic Rep. John Conyers
resigned from Congress on Tuesday after a nearly 53-year
career, becoming the first Capitol Hill politician to lose his
job in the torrent of sexual misconduct allegations sweeping
through the nation’s workplaces.
The 88-year-old civil rights leader and longest-serving
member of the House announced what he referred to as his
“retirement” on Detroit talk radio, while continuing to deny
he groped or sexually harassed women who worked for him.
“My legacy can’t be compromised or diminished in
any way by what we’re going through now,” said the
congressman, who called into the radio show from the
hospital where he was taken last week after complaining
of lightheadedness. “This, too, shall pass. My legacy will
continue through my children.”
He endorsed his son John Conyers III to succeed him.
Conyers, who was first elected in 1964 and went on to
become a founding member in 1971 of the Congressional
Black Caucus, easily won re-election last year to his 27th
term in his heavily Democratic district in and around Detroit.
GOP leaders now backing Moore,
WASHINGTON (AP) — Republican leaders in
Washington are coming to grips with the possibility —
perhaps even probability — that Alabama’s Roy Moore will
win his election next Tuesday and join them in the capital.
Looking past allegations of sexual misconduct with
Alabama teenagers, President Donald Trump formally
endorsed Moore, and the Republican National Committee
quickly followed suit, transferring $170,000 to the Alabama
Republican Party to bolster Moore’s candidacy.
“I think he’s going to do very well. We don’t want to have
a liberal Democrat in Alabama, believe me,” Trump said
Tuesday during a lunch with Republican senators. “We want
strong borders, we want stopping crime, we want to have the
things that we represent and we certainly don’t want to have
a liberal Democrat that’s controlled by Nancy Pelosi and
controlled by Chuck Schumer, we don’t want to have that for
Senate GOP leader Mitch McConnell, who once called on
Moore to get out of the race, changed his rhetoric over the
weekend to say that Alabama voters should decide.
Trump forges ahead on
Jerusalem-as-capital despite warnings
WASHINGTON (AP) — President Donald Trump
forged ahead Tuesday with plans to recognize Jerusalem as
Israel’s capital despite intense Arab, Muslim and European
opposition to a move that would upend decades of U.S.
policy and risk potentially violent protests.
Trump also told the leaders of the Palestinian Authority
and Jordan in phone calls that he intends to move the U.S.
Embassy in Israel from Tel Aviv to Jerusalem. It remains
unclear, however, when he might take that physical step,
which is required by U.S. law but has been waived on
national security grounds for more than two decades.
Trump is to publicly address the question on Wednesday.
U.S. officials familiar with his planning said he would
declare Jerusalem as Israel’s capital, a rhetorical volley
that could have its own dangerous consequences. The
United States has never endorsed the Jewish state’s claim of
sovereignty over any part of Jerusalem and has insisted its
status be resolved through Israeli-Palestinian negotiation.
The mere consideration of Trump changing the status
quo sparked a renewed U.S. security warning on Tuesday.
America’s consulate in Jerusalem ordered U.S. personnel and
their families to avoid visiting Jerusalem’s Old City or the
West Bank, and urged American citizens in general to avoid
places with increased police or military presence.
Mueller details $6.7M spent
in early months of Russia probe
WASHINGTON (AP) — The special counsel
investigation into possible coordination between President
Donald Trump’s campaign and Russia during the 2016
presidential election has cost more than $6.7 million so far,
according to a financial report released Tuesday.
The release of the report by special counsel Robert
Mueller’s office comes as the investigation appears to be
gaining steam: Prosecutors have gained a key cooperator in
their investigation and revealed that they are keenly focused
on the actions of the president and his inner circle.
Of the overall price tag, only about $3.2 million was spent
directly by the special counsel’s office. An additional $3.5
million was paid out by the Justice Department to support
the investigation, though the special counsel’s office says that
money would have been spent on ongoing probes anyway,
even if Mueller had not been appointed.
Mueller incorporated several active investigations within
the Justice Department including those of Trump campaign
contacts with Russia, former Trump campaign chairman Paul
Manafort’s business activities and former national security
adviser Michael Flynn.
Freedom Caucus deals brush-back pitch
to House GOP leaders
WASHINGTON (AP) — The House Freedom Caucus
has been on its best behavior these past few months. The
group of about three dozen hard-right Republicans has a
penchant for fighting with GOP leaders over tactics and
strategy, and helped topple Speaker John Boehner. But it has
played nice in the party’s drive this fall to cut taxes.
Washington’s agenda has shifted to the budget,
immigration and other contentious issues — and that has
set off alarm bells inside the Freedom Caucus, which fears
being on the losing end as GOP leaders and President Donald
Trump turn to Democrats to resolve those issues.
So on Monday night several members in the group,
including its chairman, Rep. Mark Meadows, R-N.C., threw
a brush-back pitch. On what normally would have been a
routine — but crucial — vote to send the all-important tax
bill to a House-Senate conference committee, Meadows and
about a dozen other Republicans held back their support.
The conservatives were trying to get the attention of
House leaders, who were marching ahead with a plan for a
pre-Christmas budget agreement that has the potential for
dealing conservatives losses on immigration, health care, and
money for domestic agencies and hurricane recovery.
In Europe, Tillerson carries on,
but with diminished standing
BRUSSELS (AP) — What do you do when you’re
America’s top diplomat, fourth in line to the presidency, and
the White House makes it publicly known you’re living on
borrowed time? If you’re Secretary of State Rex Tillerson,
you brush it off, pack a suitcase and hop a flight to Europe,
as if nothing had happened.
On the surface, at least, Tillerson carried on in ordinary
fashion Tuesday on his first day in the Belgian capital,
stoically sauntering from meeting to meeting in his
characteristically subdued style. He praised President
Donald Trump repeatedly for holding Iran to account and
demanding equal contributions from NATO allies, even
as he acknowledged getting “a little criticism” over his
management of his agency.
Arriving at NATO headquarters for a gathering of foreign
ministers, Tillerson ignored a question from a journalist
about whether he still spoke for the president.
Tillerson’s tenuous future in the Trump administration has
followed him to Europe days after the White House signaled
he might be fired — possibly soon. White House officials
told multiple news organizations last week a plan was afoot
to replace Tillerson with CIA Director Mike Pompeo, a
humiliating disclosure that cast a shadow over the secretary
as he tries to sell Trump’s policies to the rest of the world.
Protesters decry corruption in Ukraine,
prevent arrest of opposition leader
MOSCOW (AP) — Hundreds of protesters clashed
with police in Kiev and called for the ouster of Ukraine’s
president following a botched attempt Tuesday by authorities
to arrest Mikheil Saakashvili, a former Georgian president-
turned-Ukrainian opposition leader.
The turmoil is just the latest challenge for the Ukrainian
government, which has been weakened by months of
political infighting and accused of not halting official
Tuesday’s standoff began when officers of Ukraine’s
Security Service went to Saakashvili’s home to detain him.
Trying to resist the arrest, he climbed onto the roof and
threatened to jump off, but SBU agents took him down
and put him into a van. Several hundred protesters then
surrounded the vehicle and blocked it from moving. They
clashed with police, who unsuccessfully tried to disperse the
demonstrators with tear gas.