TRUMPS FIRST 100 DAYS with ABCs RICK KLEIN and VERONICA STRACQUALURSI

Day No. 50

The big story: Here at the halfway point of President Trumps first 100 days, a question looms: Which version of reality to believe? The one where the House is marching toward passing the big new health care plan, with Professor Paul Ryan outlining the way? Or the one where the united force of virtually every conservative policy shop and the House Freedom Caucus kill the bill faster than you can say CBO? Theres another big disconnect: The White House says its still in listening mode, publicly and privately. We're welcoming ideas and thoughts, White House press secretary Sean Spicer said. I didnt hear anything that said its a binary choice at the White House today, said Rep. Mark Meadows, chairman of the Freedom Caucus. But thats not the message from Ryan and company: This is the closest we will ever get to repealing and replacing Obamacare, the speaker said Thursday. For now, theres disagreement on whether this is a real negotiation, not to mention what a compromise from here would even look like.

The sleeper story: Michael Flynn is gone from the Trump administration, but hes not forgotten and with good reason. The disclosure that Flynn was paid more than half a million dollars to lobby on behalf of the government of Turkey work he performed in the run-up and immediate aftermath of the election is a stunner. As his ties to Russian officials continue to be scrutinized, what other foreign lobbying work was he being paid for directly or indirectly as he was about to be tapped to serve as President Trumps national security adviser? Did he disclose any such contracts to the presidents team when his name was under public and private consideration? Moreover, Vice President Mike Pences icy response It is an affirmation of the president's decision to ask Gen. Flynn to resign, he told Fox News Bret Baier on Thursday raises questions about what other aspects of Flynns behavior led to his dismissal. Recall that, after he asked him to go for misleading Pence about his contacts with Russia, the president himself called Flynn a wonderful man who was treated unfairly by the fake media.

The shiny story: EPA chief Scott Pruitt is now on record contradicting his own agency, and surely the vast majority of his employees, in questioning whether carbon dioxide is contributing to global warming. I would not agree that its a primary contributor to the global warming that we see, Pruitt said, falling back on the need to continue the debate and continue the review and the analysis. That may not align fully with what he told Congress at his confirmation hearings. But it should not be the least bit surprising. Pruitt has spent much of his career trying to undermine the core of what he has called the activist agenda of the agency he now leads. The question for career EPA officials as at other agencies that now have radically different leadership is whether they would feel more comfortable staying or going, given the current direction. But no one should truly be shocked by any of this elections, as they say, have consequences.

TLDR: The GOP health care plan has moved through two House panels, but there is a disconnect in the Republican Party of whether itll pass or be killed. And after remaining relatively quiet about the health care bill (except for a tweet yesterday), Trump will be meeting with House Committee chairmen to discuss health care today.

Photo of the day: With rolled-up sleeves and a PowerPoint slideshow, Paul Ryan took on the role of professor instead of House Speaker to explain the GOP plan to repeal and replace Obamacare step-by-step. But what Ryan probably didnt plan for was to fall victim to Photoshop and become a viral meme. (Credit: Dan Amira)

NOTABLES

--FBI Director James Comey meets Congressional leaders on wiretapping, leaks, Russia: FBI Director James Comey traveled to Capitol Hill Thursday to meet with congressional leaders on a number of national security issues, according to senior officials familiar with the situation. Comey was anticipating questions on a range of topics, including the recent WikiLeaks release of purported CIA files, Russian interference in the 2016 presidential election and President Donald Trump's assertion that former President Barack Obama ordered the wiretapping of Trump Tower last year. ABC's PIERRE THOMAS, JACK DATE and BENJAMIN SIEGEL have more: http://abcnews.go.com/Politics/fbi-director-james-comey-meets-congressional-leaders-wiretapping/story?id=46028619

--Inside the Senate GOP resistance to Trumpcare: Just as House Speaker Paul Ryan was rolling up his sleeves to give a presentation on the House Republican Obamacare replacement plan, on the other side of the Capitol, senators offering a full-throated defense of the bill were scarce. The House blueprint, which Ryan referred to as a "three-pronged approach" Thursday, includes some provisions that various Republican factions oppose; most notably, a plan to provide tax credits to individuals, which some critics have said amounts to a new entitlement, and an eventual cap on the amount of Medicaid funding states can receive, which worries some Republicans whose states accepted an Obama-era Medicaid expansion. ABCs ALI ROGIN has more: http://abcnews.go.com/Politics/inside-senate-gop-resistance-trumpcare/story?id=46029688

--The road to repealing and replacing Obamacare: After the House Energy and Commerce Committee and the Ways and Means Committee approved the GOPs health care plan yesterday, ABC's JOHN PARKINSON explains what happens next in the House. While Democrats have worked overtime to frustrate the legislations progress, they appear powerless so far to block its advancement. That privilege will fall to conservatives. http://abcnews.go.com/Politics/road-repealing-replacing-obamacare/story?id=46021299

This Week on This Week: George Stephanopoulos goes one-on-one with White House Office of Management and Budget director Mick Mulvaney, Sunday on This Week. Plus, Sen. Tom Cotton, R-Ark., and House Intelligence Committee ranking member Rep. Adam Schiff, D-Calif., come to This Week. And the Powerhouse Roundtable debates the week in politics, with National Review editor Rich Lowry, Democratic strategist Jamal Simmons, Republican pollster and ABC News contributor Kristen Soltis Anderson, and editor and publisher of The Nation Katrina vanden Heuvel.

Speed read with ABC's ABCs ADAM KELSEY

The 3 key provisions in the GOP health care bill that cause experts concern. Several health care industry experts have expressed serious concerns about three key areas of the Republican health care bill unveiled this week, proposed as a replacement for the Affordable Care Act (ACA), also known as "Obamacare." Some doctors and hospital groups worry that people with lower incomes or who are closer to retirement age would be likely to receive fewer tax credits from the government to help them buy their own insurance than they do through current ACA subsidies, writes ABC's MARYALICE PARKS. http://abcnews.go.com/Politics/key-provisions-gop-healthcare-bill-experts-concern/story?id=45991248

Spicer's rebuke puts spotlight on Congressional budget office amid GOP health care battle. White House press secretary Sean Spicer leveled stinging criticism against the nonpartisan Congressional Budget office Wednesday, assailing its accuracy amid Democratic complaints that the agency would not have an opportunity to review the new health care legislation before a vote. "If you're looking to the CBO for accuracy, you're looking in the wrong place," said Spicer. "They were way, way off last time in every aspect of how they scored and projected Obamacare." ABC's ADAM KELSEY has more: http://abcnews.go.com/Politics/spicers-rebuke-puts-spotlight-congressional-budget-office-amid/story?id=46017070

What the 400 additional US troops in Syria are up to. The addition of 400 Marines and Army Rangers to Syria will increase the number of American troops inside the country to 900, according to U.S. officials. Several hundred Marines have arrived in Syria to provide artillery support to U.S.-backed Syrian rebels preparing to retake Raqqa, ISISs de facto capital in Syria, a U.S. official said Wednesday. Last weekend, a contingent of Army Rangers arrived in Manbij to essentially act as a visible presence to prevent the Turkish military and Kurdish forces from fighting each other in the city retaken from ISIS months ago, explain ABC's LUIS MARTINEZ and ELIZABETH MCLAUGHLIN. http://abcnews.go.com/International/400-additional-us-troops-syria/story?id=46020582

Government ethics office 'concerned' over White House decision not to discipline Kellyanne Conway. The director of the Office of Government Ethics said he is "concerned" over the White House's decision not to discipline Kellyanne Conway for promoting Ivanka Trump's brand in a television appearance. In a letter to White House deputy counsel Stefan Passantino, OGE director Walter Shaub said the White House failed to discipline Conway despite conduct that may have violated a federal ethics rule prohibiting "using one's official position to endorse any product or service," ABC's ALEXANDER MALLIN notes. http://abcnews.go.com/Politics/government-ethics-office-concerned-white-house-decision-discipline/story?id=46026063

ACLU files complaint against Jeff Sessions. The American Civil Liberties Union on Wednesday filed an ethics complaint with the Alabama State Bar against U.S. Attorney General Jeff Sessions for testimony he made about Russian officials during his confirmation hearing, ABCs TOM KUTSCH reports. Mr. Sessions made false statements during sworn testimony on January 10, 2017, and in a subsequent written response to questions on January 17, 2017, the complaint reads. http://abcnews.go.com/Politics/aclu-files-complaint-jeff-sessions-russia-testimony/story?id=46036263

Sessions: Guantanamo Bay 'a very fine place' for terror suspects. During an interview Thursday with conservative radio host Hugh Hewitt, Attorney General Jeff Sessions was asked if either he or President Trump intend to shut down the facility. "Well, I have not favored that," Sessions said. "I've been there a number of times as a Senator, and it's just a very fine place for holding these kind of dangerous criminals. We've spent a lot of money fixing it up. And I'm inclined to the view that it remains a perfectly acceptable place. And I think the fact that a lot of the criticisms have just been totally exaggerated." ABCs DAVID CAPLAN has more: http://abcnews.go.com/Politics/jeff-sessions-guantanamo-bay-nice-place-holding-terror/story?id=46035561

Tillerson steps away from possible pipeline decisions. Secretary of State Rex Tillerson, who previously served as the CEO of oil and gas giant ExxonMobil, has recused himself from any decisions regarding the Keystone XL oil pipeline, according to ABCs CONOR FINNEGAN. In a letter sent to the environmental group Greenpeace Thursday, a State Department deputy legal adviser writes that Tillerson decided to recuse himself in early February...from working on issues related to TransCanada's application for a presidential permit for the proposed Keystone XL pipeline." http://abcnews.go.com/Politics/tillerson-steps-pipeline-decisions/story?id=46030356

Pence: Turkey lobbying 'an affirmation' of decision to fire flynn. Vice President Mike Pence called revelations that former national security adviser Michael Flynn's lobbying efforts may have benefited Turkey an "affirmation" that President Trump was right in firing him. Flynn's lobbying firm, Flynn Intel Group, did lobbying work in the months leading up to his White House appointment that may have benefited the Turkish government, according to a filing made on Tuesday, ABCs KATHERINE FAULDERS and JORDYN PHELPS report. http://abcnews.go.com/Politics/vp-pence-turkey-lobbying-affirmation-decision-fire-flynn/story?id=46029263

WHOS TWEETING?

@markknoller: It's Day 50 of his presidency. He last responded to a few questions from reporters 8 days ago; last interview 11 days ago.

@oliverdarcy: The Marine Corps' nude photo-sharing scandal is even worse than first realized, @PaulSzoldra reports http://www.businessinsider.com/nude-photo-marine-corps-pentagon-scandal-2017-3

@mj_lee: Nobody wants this GOP Obamacare bill named after them. Just asked Kevin Brady what he thinks of the names "Trumpcare" and "Ryancare."

@GlennKesslerWP: @realDonaldTrump has been president for 50 days. In that time, he has made 219 false or misleading statements. https://www.washingtonpost.com/graphics/politics/trump-claims/

@bgittleson: Trump is holding a CAMPAIGN rally in Nashville next Wednesday: https://www.donaldjtrump.com/schedule/

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The Note: Health care disconnect - ABC News

The Republican health care overhaul faces opposition from many in the medical establishment. J. Scott Applewhite/AP hide caption

The Republican health care overhaul faces opposition from many in the medical establishment.

The Republican health care overhaul working its way through the House is opposed by Democrats and by many Republican conservatives. It's none too popular with the people on the front lines of health care, either including doctors, nurses and hospitals.

The chief medical officer of Medicaid, Dr. Andrey Ostrovsky, tweeted out his opposition on Wednesday. "Despite political messaging from others at HHS, I align with the experts ... in opposition to #AHCA," the career staffer said.

Ostrovsky, who has been in his current job since September, has received praise from former Obama administration officials for speaking out.

Former Medicare and Medicaid chief Andy Slavitt called Ostrovsky a "hero."

Trump's Health and Human Services secretary, Tom Price, has been out front with other Republican leaders pitching the new bill. In a press briefing on Wednesday, he said the administration will be looking at Affordable Care Act regulations "and make certain that if they help patients, then we need to continue them. If they harm patients or increase costs, then obviously they need to be addressed."

The organizations Ostrovsky cited in his tweet that have voiced concerns are the American Academy of Family Physicians, the American Academy of Pediatrics and the American Medical Association.

The AMA sent a letter to congressional leaders saying it was unable to support the GOP bill largely due to the "expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations."

Among other things, the AMA cited the proposed rollback of Medicaid expansions that happened under the Affordable Care Act, which the group called "highly successful in providing coverage for lower income individuals"; the proposed repeal of the Prevention and Public Health Fund, also established by Obamacare; and provisions targeting Planned Parenthood.

In a similar letter, the American Nurses Association said the Republican plan "threatens health care affordability, access, and delivery for individuals across the nation." It points to changes the bill would make to Medicaid and says the measure "restricts million of women from access to critical health services." The ANA says the proposed changes "in no way will improve care for the American people."

The American Hospital Association also weighed in, pointing out the Congressional Budget Office has yet to provide a cost estimate for the measure or say how it would change coverage levels. Without such analysis and "needed transparency," the group said, Congress "should wait" before proceeding.

It also points to the proposed restructuring of Medicaid, saying it will "have the effect of making significant reductions in a program that provides services to our most vulnerable populations, and already pays providers significantly less than the cost of providing care."

The opposition to the GOP plan from health care groups, who say its provisions need to be more generous, puts GOP leaders in a quandary. On the other side of the equation, conservative House members are opposing the measure because they believe it is too generous and doesn't go far enough to repeal subsidies in the Affordable Care Act.

The bill's authors have responded to the criticism. "There's a pretty big the medical-industrial complex in America," Rep. Greg Walden of Oregon, chairman of the House Energy and Commerce Committee, told reporters. "And when you touch it, I've discovered, it touches back."

Read the rest here:

Medical, Hospital Groups Oppose GOP Health Care Plan - NPR

Are You Middle Class Enough to Deserve a Health Care Tax Break? New York Times My guess is that a majority of us would agree that health care is a bit more important than retirement savings and I.R.A.s, which in turn are more important than mortgage interest deductions for most people's long-term financial security. Encouraging ... and more »

Excerpt from:

Are You Middle Class Enough to Deserve a Health Care Tax Break? - New York Times

New York Times

The Republican Health Care Crackup New York Times Members and staff members on the House Energy and Commerce Committee finishing amendments to their portion of a health care bill on Thursday. Credit Stephen Crowley/The New York Times. The Republican health care bill could represent the moment ... and more »

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The Republican Health Care Crackup - New York Times

What to Know

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GOP Claims Momentum as Health Bill Clears Hurdles

Republican leadersdrove their long-promised legislation to dismantle Barack Obama's health care law over its first big hurdles in the House, claiming fresh momentum despite cries of protest from right, left and center. After grueling sessions, the Energy and Commerce and Ways and Means committees both approved their portions of the bill along party-line votes. The legislation, strongly supported by President Trump, would eliminate the unpopular tax penalties for the uninsured under the Affordable Care Act, replacing Obama's law with a conservative blueprint likely to cover far fewer people but Republicans hope increase choice. "This is the closest we will ever get to repealing and replacing Obamacare," Speaker Paul Ryansaid at a press briefing.

Legal Challenges to Trump's Travel Ban Mount From States

Legal challenges against President Trump'srevised travel banmounted as Washington state said it would renew its request to block the executive order. It came a day after Hawaii launched its own lawsuit, and Washington state Attorney General Bob Ferguson said both Oregon and New York had asked to join his state's legal action. Massachusetts Attorney General Maura Healey said the state is consolidating legal efforts and joining fellow states in challenging the revised travel ban. Trump's revised ban bars new visas for people from six predominantly Muslim countries: Somalia, Iran, Syria, Sudan, Libya and Yemen. It also temporarily shuts down the U.S. refugee program.

2 Die in Protests After South Korean President Ousted

In a unanimous ruling, South Korea's Constitutional Court formally removed impeachedPresident Park Geun-hye, the country's first female leader who rode a wave of lingering conservative nostalgia for her late dictator father to victory in 2012, from office over a corruption scandal that has plunged the country into political turmoil and worsened an already-serious national divide, prompting rowdy protests and celebrations that led to the death of two people. The ruling by the eight-member panel opens her up to possible criminal proceedings and makes her South Korea's first democratically elected leader to be removed from office since democracy replaced dictatorship in the late 1980s.

EPA Chief: CO2 Not Major Contributor to Warming

Environmental Protection Agency AdministratorScott Pruitt saidhe did not believe carbon dioxide was a primary contributor toglobal warming, a view contradicted by NASA and the National Oceanic and Atmospheric Administration, NBC News reported. It is also at odds with Pruitt's own promises during his nomination hearing before the U.S. Senate. But if Pruitt doubts the global scientist consensus that carbon dioxide is causing the Earth to warm, he did pledge during his confirmation hearing to regulate it in accordance with a U.S. Supreme Court ruling and an EPA finding that it was threatening public health.

Can Changing Weather Make You Sick?

Can the weather truly be to blame when you "feel under the weather?" "In a sense, yes,"says Dr. Michael Robinson, a family medicine resident at Louisiana's Lake Charles Memorial Health System. "Thecolder weathercauses people to go inside and be in closer proximity to each other, but as far as just becoming sick, the weather doesn't affect it." That means germs are spreading more indoors when the weather is less inviting outdoors. Still, some viruses replicate more easily in cooler weather, like the agents causing the common cold and influenza that spreads best when the air is cold and dry.

California Wants to Repeal HIV Laws

Exposing a person to HIV is treated more seriously under California law than infecting someone with any other communicable disease, a policy some lawmakers say is a relic of the decades-old AIDS scare that unfairly punishesHIV-positive peoplebased on outdated science. Several lawmakers are promoting a bill that would make it a misdemeanor instead of a felony to intentionally expose someone to HIV, the virus that causes the immune system-weakening disease AIDS. The change would treat HIV like other communicable diseases under California law.

Zuckerberg, Wife Expecting 2nd Girl

Mark Zuckerberg and his wife Priscilla Chan are expecting a second baby girl, theFacebook founderannounced in a post that paid tribute to his and his wife's sisters. In announcing his second daughter, Zuckerbergshared childhood family photosof their families and said what their sisters taught them: "to learn from smart, strong women" in Zuckerberg's case, "the importance of family, caring for others and hard work" in Chan's case.

Nicole Kidman Explains 'Seal Clap' at Oscars

Let's give Nicole Kidman a round of applause. Rather than come up with some excuse for her weird clapping during the 2017 Oscars, the "Lion" actress confirmed her Harry Winston rings were to blame. Kidman, who was nominated for Best Supporting Actress, wore119 caratsworth of Harry Winston diamonds, which included a cluster diamond ring. "It was really awkward!"she saidon "Kyle and Jackie O Show." "I was like, 'Gosh, I want to clap.' I don't want to not be clapping, which would be worse, right? 'Why isn't Nicole clapping?'"

Published 54 minutes ago | Updated 43 minutes ago

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Happening Today: Health Care, South Korea, Travel Ban, EPA, Zuckerberg - NBC New York

New York Times

After Halting Start, Trump Plunges Into Effort to Repeal Health Law New York Times Today marks the beginning of the end of Obamacare, Mr. Scalise declared after House committee votes to advance the Republican's health care bill. Credit Doug Mills/The New York Times. WASHINGTON President Trump, after a halting start, is now ... The Note: Trump in 'sell mode' on health careABC News all 31 news articles »

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After Halting Start, Trump Plunges Into Effort to Repeal Health Law - New York Times

NPR

Trump Tries To Sell Republican Health Care Plan To Conservatives NPR March 10, 20175:12 AM ET. Heard on Morning Edition. Conservatives are revolting against the GOP health care measure. David Greene talks to David Urban, president of American Continental Group, and a former adviser to the Trump presidential campaign.

See more here:

Trump Tries To Sell Republican Health Care Plan To Conservatives - NPR

Sen. Elizabeth WarrenElizabeth WarrenOvernight Finance: Budget ref caught in ObamaCare crossfire | Treasury chief urges Congress to raise debt limit | McConnell says tax reform unlikely by August Warren rips GOP healthcare plan: 'What planet are these guys living on?' Dems press White House on Jared Kushner's financial holdings MORE (D-Mass.) on Thursday blasted the GOP's healthcare plan, urging lawmakers to drop the legislation aimed at replacing the Affordable Care Act.

"A health care bill that destroys care & affordable coverage for millions seriously? What planet are these guys living on?!" Warren wrote in a tweet.

"Its time to junk this cruel #Trumpcare bill before massive numbers of Americans are hurt by it," she added.

A health care bill that destroys care & affordable coverage for millions seriously? What planet are these guys living on?!

The White House and GOP leaders have moved to aggressively pitch the legislation, dubbed the American Health Care Act, which they introduced on Monday and hope to vote on within weeks.

The healthcare bill has been met withintense criticismfrom numerous groups representing doctors and hospitals, as well as the American Medical Association, advocacy group AARP and an internal organization from the American Cancer Society.

Conservative groups such as Americans for Prosperity have also come out against the bill, while groups such as the U.S. Chamber of Commerce and Americans for Tax Reform have backed the GOP effort.

"Republicans seem intent on plowing ahead anyway pretending down is up, left is right, & #Trumpcare is somehow not a catastrophe," Warren argued on Twitter.

"The GOP have convinced people who never agree on ANYTHING docs, hospitals, economists, even insurance companies: #Trumpcare is a disaster."

Republicans seem intent on plowing ahead anyway pretending down is up, left is right, & #Trumpcare is somehow not a catastrophe.

The GOP have convinced people who never agree on ANYTHING docs, hospitals, economists, even insurance companies: #Trumpcare is a disaster.

Read more:

Warren rips GOP healthcare plan: 'What planet are these guys living on?' - The Hill

USA TODAY 4:25 p.m. ET March 9, 2017

House Speaker Paul Ryan during a news conference in Capitol Hill on March 9, 2017.(Photo: J. Scott Applewhite, AP)

Letter to the editor:

President Trump is starting to get a great lesson on the difference between campaigning and actually governing.

While campaigning you can hurl accusations like Obamacare is a disaster and it must be repealed and replaced immediately. When you win, as Trump did, you now have to deliver, and there is the rub. Delivering a health care product that is better, cheaper and still fair is an incredibly difficult task.

The far right of the presidents own party says the initial plan is simply Obamacare lite. The left says it will cause millions to lose their health care coverage. Meanwhile, the Congressional Budget Office is expected to project a very high price tag that undermines the promise of better and more affordable insurance.

You can readily question the political savvy of the Trump team. While its political capital was high, it could have chosen to start with the more popular and less controversial tax and regulatory reform. Then use these victories and resultant goodwill as a springboard to launch into health care reform. Its too soon to dub this foray Trumps Waterloo moment, but it clearly is a challenge to his young presidency.

Stay tuned to see how Trumpcare unfolds!

Ken Derow; Swarthmore, Pa.

Facebook comments are edited for clarity and grammar:

Why is it that people cannot accept that a public option fixes most of this? I do welcome the Republicans plan, but it doesnt solve the specific issues it needs to address to ensure coverage for all.

William Worsham

Just like with Obamacare, Congress is focused on the wrong problem: Who pays, instead of bringing down the total cost of the system. We need to bring competition to the health care system and increase supply faster than demand. That is the only way to bring down costs.

First, everyone from insurers to government employees to private individuals should have to pay the same rate. That rate should be posted, for everyone to see and encourage competition.

Second, you need to increase quality care faster than the cost of care, the opposite of what these expansions do. That will allow competition to drive these costs down. We need to get rid of all the bureaucratic hurdles.

Finally, if you are getting government assistance, you should be doing everything you can to keep the costs down. There should be a requirement to be fit medical conditions permitting.

Mathew Andresen

Republicans rename Obamacare, call it a day: #tellusatoday

Our followers shared their thoughts on the American Health Care Act. Tweets are edited for clarity and grammar:

Lets pass it so we can find out whats in it. #DemcratsPlaybook

@tngarrett

Comparisons between the Affordble Care Act and the AHCA are truly odious. Obamacare was too disastrous to ever fully implement, while Trumpcare is only partly formulated.

@billbradbrooke

I dont know how House Speaker Paul Ryan sleeps at night knowing the lower class is left in the cold.

@CathyScero

For more, follow @USATOpinion and #tellusatoday.

Read or Share this story: http://usat.ly/2mr3dev

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GOP learns health care is, indeed, complex: #tellusatoday - USA TODAY

New York Times

Follow the Health Care Money New York Times Many Americans over the age of 60 would have to pay more for health insurance under the Republican health care plan. Many low-income families would lose their insurance. Many disabled people, hepatitis patients and opioid addicts, among others, would ...

Read this article:

Follow the Health Care Money - New York Times

Is the money we're spending on health care keeping us alive?

On a certain level, that's the big test of any health-care systemand the United States isfailing.

According to abovechart, U.S. life expectancy continues to lag far behind other developed countries, despite spending way more on medical treatments aimed at keeping us alive.

The chart, courtesy of Oxford economist Max Roser, plots per-capita health-care spending against life expectancy for the world's wealthiest countries over the past 40-plus years. Each country gets one line, which plots its trajectory on those measures over time.

Looking at the chart, two things become clear: AsRoser notes, the big takeaway is that, in wealthy countries, more spending on health leads to a longerlife expectancy.

But there's a secondary finding: Not all health-care spending is created equal. In the United States, the inflation-adjusted per-capita annual health spending has exploded from1970, when it was less than $500 a year, to 2014, when it was about $9,000 a year.

That's $2,000 more per person per year than the second highest-spending country on the chart, Switzerland. But despite that big spending, growth in American life expectancy has been anemic. Essentially,we spend a lot of money but haven't seen much in the way of life expectancy gains because of it.

The comparison with Japan is instructive. In 1970, average life expectancy in Japan was 72 years, similar to the expectancy of 71 years in the United States. By 2014, U.S. life expectancy crept up by eightyears, to 79. But in Japan, life expectancy grew by a whopping 12 years to 84. And today the United States spends more than twice as much on health care, per capita, than does Japan.

There are a lot of factors influencing these numbers, particularly on the longevity side of the equation: differences in lifestyle and eating habits, exercise, culture, etc. But on the spending side there's an elephant in the room: According to the Organization for Economic Cooperation and Development, the United States is the only country on the chart that doesn't have universal health coverage.

Life expectancy isa great shorthand for overall health and well-being. After all, as economists David Cutler, Angus Deaton and Adriana Lleras-Muney wrote in 2006, The pleasures of life are worth nothing if one is not alive to experience them.

But the importance of life expectancy, and thecountry'sdismal standing in it, suggests the United Statesshould be more than a little skeptical when any politician as they so often do proclaims that any policy changes threaten to changethe greatest health care system in world history.

After all, if our health care is so great, why are we paying more and dying sooner?

Read more from the original source:

This chart is a powerful indictment of our current health-care system - Washington Post

Voters want politicians to be bold. They disrespect timidity. And trying to push every Californian into a government-run healthcare system is certifiably bold.

The voters desire for boldness has a caveat, of course: Theyve got to like what the politician is being bold about.

We really dont know how Californians feel about government-run universal healthcare. People havent been asked for a while.

The Public Policy Institute of California surveyed voters in January, however, and found that 54% opposed congressional repeal of the Affordable Care Act, or Obamacare.

But for generations, it has been the dream of many mostly Democrats to enact whatever you want to call it: single-payer, Medicare-for-all or socialized medicine.

Now, with congressional Republicans and President Trump trying to repeal and replace Obamacare, some Sacramento Democrats think they see an opening to finally adopt a California version of single-payer.

Under single-payer, healthcare costs are paid for by the government, rather than by private insurance. The healthcare itself is still delivered by private physicians.

Some version that would allow people to buy supplemental private insurance call it Medicare-for-all presumably could fit into the system these Democrats envision.

We really dont know because they havent actually proposed anything. Theyre promising details in two weeks. So far, theyve just tucked the concept of single-payer into an essentially hollow bill, SB 562, by Sens. Ricardo Lara (D-Bell Gardens) and Toni Atkins (D-San Diego).

The bill merely declares: It is the intent of the Legislature to enact legislation that would establish a comprehensive universal single-payer healthcare coverage program and a healthcare cost control system for the benefit of all residents of the state.

Yes, that means all whether theyre in the country legally or not.

Medi-Cal, the states enhanced version of federal Medicaid for poor people, already covers children here illegally. But not their parents.

Lara told me that he mentioned to one kid that the Legislature had extended Medi-Cal to undocumented children.

He said, Thank you senator, but what about my mom? Lara recalled. What about my dad? How do we get to healthcare for everyone?

With great difficulty, Id say. And the same for enacting any single-payer system.

Dreams can be good. But this dream especially with Trump and conservative Republicans controlling the national agenda seems like wishful fantasy, even in deep blue California.

The envisioned policy long has made sense. Cut out the insurance industry profiteering and reduce healthcare costs. Perhaps eliminate co-pays and deductibles, as Lara wants to do.

Even Medicare-for-all would be better than what most people have today. Ever hear a senior seriously complain about Medicare? I havent.

Most industrialized nations have some sort of government-run healthcare coverage either single-payer or a hybrid public-private system.

But good policy aside, there are two huge obstacles to a state going solo: financing and politics.

In California, it would cost the state tens of billions of dollars. Whod pay for that? Business, which presumably would no longer need to provide employees with health insurance? Wage earners through payroll withholding? Medical providers? How much would the federal government kick in? Anything?

That presumably will be in the bills details. Good luck.

And how would this legislation ever get passed? The politics are daunting. The insurance industry would fight with all it has meaning campaign money. So would many healthcare providers that historically have feared socialized medicine.

On the other side, the California Nurses Assn. is the bills chief sponsor. And that labor union has influence among liberals.

But nothing of this magnitude and controversy can pass the Legislature without a committed governor pushing strongly. And Gov. Jerry Brown hasnt said a peep about single-payer healthcare since he was elected in 2010. Moreover, the normally cautious skinflint is not likely to commit the state to such a financial gamble.

No other state has a single-payer plan. Vermont did briefly, but scrubbed it in 2014 because of high costs and unpopular taxes.

The California Legislature passed a single-payer bill sort of when Arnold Schwarzenegger was governor, but he vetoed it.

Actually, it wasnt a real single-payer plan anyway. It didnt include any financing. That was to be passed later and required a two-thirds supermajority vote. No way.

Updates from Sacramento

Democrats currently hold a supermajority in each house. But you can bet not all are inclined to vote for a tax increase. Possibly for highway repairs, but not for an untested, radical change in healthcare coverage.

The time is right, the time is now, insists Lara, whos thinking about running for state insurance commissioner next year. California can be the national laboratory for our country.

What everyone agrees on, he adds, is we need to have an alternative to threatened Obamacare.

But many Democrats believe their best hope is congressional gridlock and the blockage of repeal.

Perhaps Im like Alice in Wonderland, but I really am hopeful, says state Sen. Holly Mitchell (D-Los Angeles), the Budget Committee chairwoman. Theres an amazing groundswell of people showing up all over the country fighting to retain the Affordable Care Act.

What about single-payer? I honestly dont know.

Not a lot of enthusiasm there.

She sounds like other Democrats who privately believe the focus should be on preserving what they can of Obamacare, which has pumped nearly $24 billion annually into California healthcare and halved the number of uninsured.

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A state single-payer healthcare system? Nice idea, but it's just California dreaming - Los Angeles Times

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Vice President Pence will travel to the Louisville area Saturday to talk about health care and the economy with Kentucky Gov. Matt Bevin, according to the vice presidents office.

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Vice President Pence delivers remarks on the American Health Care Act to the news media after attending the Senate Republican policy luncheon on March 7, 2017.(Photo: Shawn Thew, European Pressphoto Agency)

WASHINGTON Vice President Pence will travel to the Louisville area Saturday to talk about health care and the economy with Kentucky Gov. Matt Bevin, according to the vice presidents office.

Details are expected to be released later Thursday.

Louisville airport officials had been told President Trump was coming, the Courier-Journal reported Wednesday.

Kentucky Sen. Rand Paul is among the conservative lawmakers who have criticized the House GOP bill to overhaulthe Affordable Care Act, saying it doesnt do enough to dismantle the law.

Trump tweeted Wednesday: I feel sure that my friend @RandPaul will come along with the new and great health care program because he knows Obamacare is a disaster!

Republicans have a slim margin in the Senate and will have a difficult time crafting health care legislation that can satisfy both conservatives and moderates. If three Republican senators oppose the bill, united Democratic opposition can stop it.

Pence has been making multiple media appearances and meeting with lawmakers to shore up support for the legislation, which is opposed by major health care groups such as the American Medical Association and the American Hospital Association.

Pence tweeted out his support Thursday morning for the House Ways and Means Committee, which worked through the night to markup its portion of the legislation

Read more:

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Who Wins and Who Loses Under Republicans' Health Care Plan New York Times Both Obamacare and the recent Republican replacement proposal use refundable tax credits to help people buy their health insurance. That is part of the reason the new G.O.P. bill is under fire from conservatives, who see it as a new entitlement program. Experts: The GOP Health Care Plan Just Won't WorkNBCNews.com New anti-Obamacare ads conflate the exchanges with the entire health-care systemWashington Post House panels to launch fight in Congress over Obamacare replacementReuters Business Insider -FiveThirtyEight -Huffington Post -Energy and Commerce Committee all 2,374 news articles »

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Who Wins and Who Loses Under Republicans' Health Care Plan - New York Times

Health workers slaughter chickens on a farm in Yunlin County, Taiwan in an image released on Feb. 15, 2017. Taiwan is killing tens of thousands of chickens, ducks and turkeys since discovering its first case of H5N6 bird flu in Hualien County. Yunlin Animal and Plant Disease Control Center / EPA

On Wednesday, the Association of State and Territorial Health Officials, or ASTHO, will try. It's bringing state health officials to Washington to make the case not only for the prevention fund, but also for increased public health funding.

They know it will be an uphill battle.

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"It's a tough sell," ASTHO Executive Director Michael Fraser said. "People know what it means to go to the doctor. They don't know what it means when public health agencies agencies keep you from getting bird flu or an E. coli."

They'll frame their message in terms they hope will get the attention of conservatives, using the language of national defense.

"This is national security. Public health is protecting Americans," said Amanda Jezek of the Infectious Diseases Society of America.

Fraser also hopes to tap into Trump's campaign promises about rebuilding American infrastructure.

"People think about bridges and roads. ... We need similar attention to the public health infrastructure," he said. "We want to get the message out that public health is part of homeland security, part of public safety. It's not just a bunch of pamphlets and health fairs."

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Dr. Jay Butler, Alaska's chief medical officer and president of the ASTHO, knows this is another tough sell.

"Public health infrastructure doesn't have same appeal as a bridge that could be named after you," he said.

Scary tactics might help, Fraser said.

"In terms of scaring the hell out of people, [we are] thinking about the spring and what we have to do around Zika, especially now that states are preparing for mosquito season," he said.

"When you have a burning airplane on the runway, that's not the time to start the discussion about whether you need to buy a firetruck."

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GOP Health Care Bill Would Cut CDC Fund to Fight Killer Diseases - NBCNews.com

NPR	Cokie Roberts Answers Your Health Care Questions NPR Email. March 8, 20175:05 AM ET. Heard on Morning Edition. Republicans have unveiled a new health care proposal. Commentator and columnist Cokie Roberts answers questions from listeners about the history of politics and health care in the U.S..

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Cokie Roberts Answers Your Health Care Questions - NPR

New York Times

'The Daily': Harry Truman and Newt Gingrich on Health Care New York Times We begin in 1948, when the United States started to debate whether to create a nationwide health care system. While national health care programs spread in Europe, the United States never enacted such sweeping legislation. In 2010, that changed. Margot ... and more »

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'The Daily': Harry Truman and Newt Gingrich on Health Care - New York Times

Senate Majority Leader Mitch McConnellMitch McConnellRight revolts on ObamaCare bill AARP rips GOP's 'harmful' healthcare legislation Healthcare bill faces steep climb in Senate MORE (R-Ky.) has only three weeks to unify conservatives and moderates in his conference behind an ObamaCare repeal and replacement bill.

The American Health Care Act, which Vice President Pence on Tuesday declared the framework for reform, will move first in the House, but it faces perhaps an even steeper climb in the Senate.

Republicans control 52 seats in the upper chamber and can only afford to lose two votes, since Pence can vote to break a 50-50 tie. So far, at least eight Republican senators have voiced concerns with aspects of the legislation.

Three conservatives, Sens. Mike LeeMike LeeRight revolts on ObamaCare bill GOP senators to Trump: Pledge to veto bills with earmarks Healthcare bill faces steep climb in Senate MORE (R-Utah), Ted CruzTed CruzDoes GOPs health plan keep Trumps promises? GOP senators to Trump: Pledge to veto bills with earmarks Healthcare bill faces steep climb in Senate MORE (R-Texas) and Rand PaulRand PaulFreedom Caucus members say GOP doesn't have votes to pass healthcare plan Right revolts on ObamaCare bill Trump: Rand Paul will 'come along' on GOP healthcare plan MORE (R-Ky.), are unhappy with parts of the House bill, which allied conservative groups have panned as not going far enough.

Lee blasted the House bill as a missed opportunity and a step in the wrong direction.

He warned that policymakers dont know how much tax credits proposed in the House legislation to help Americans buy insurance would wind up costing the federal government.

Paul dismissed the legislation as dead on arrival and a bailout for the insurance companies.

Cruz has been less vocal about his views on the bill. He skipped a press conference Tuesday afternoon that Paul and Lee held with House conservatives critical of the bill.

The Texas senator told reporters that he has a number of concerns but declined to say whether he would vote no.

The proper way to address those concerns is working with colleagues in the House, the Senate and the administration, and thats what Im doing right now, Cruz said.

Meanwhile, two influential Republican senators, Susan CollinsSusan CollinsHealthcare bill faces steep climb in Senate ObamaCare repeal bill would defund Planned Parenthood Planned Parenthood tells Trump it won't end abortions in exchange for continued funding MORE (Maine) and Lisa MurkowskiLisa MurkowskiAARP rips GOP's 'harmful' healthcare legislation Healthcare bill faces steep climb in Senate Overnight Energy: Another setback for Dakota Access opponents MORE (Alaska), have objected to including language in the bill defunding Planned Parenthood a top priority of House conservatives.

Collins and Murkowski told reporters Tuesday that they were reviewing the newly released legislation.

Three other Republican senators Rob PortmanRob PortmanAARP rips GOP's 'harmful' healthcare legislation Healthcare bill faces steep climb in Senate Conservative groups blast GOP healthcare plan MORE (Ohio), Shelley Moore CapitoShelley Moore CapitoAARP rips GOP's 'harmful' healthcare legislation Healthcare bill faces steep climb in Senate Conservative groups blast GOP healthcare plan MORE (W.Va.) and Cory GardnerCory GardnerAARP rips GOP's 'harmful' healthcare legislation Healthcare bill faces steep climb in Senate Conservative groups blast GOP healthcare plan MORE (Colo.) along with Murkowski sent a letter to McConnell Monday warning him that a draft House healthcare plan that leaked last month failed to ensure stability for hundreds of thousands of people in their states who were newly enrolled in Medicaid under ObamaCare.

Sen. Dean HellerDean HellerHealthcare bill faces steep climb in Senate On the commercialization path: New research supports women in STEM Overnight Cybersecurity: Sessions recuses himself from Russia probe | Bill would help states with cybersecurity | Typo took down Amazon cloud MORE (R-Nev.), widely considered the most vulnerable Senate Republican incumbent in 2018, has also raised concerns about rolling back the Medicaid expansion. On Tuesday he said he hadnt yet reviewed the House bill.

Taken together, its clear that there will be a large number Republican votes for McConnell to shore up by the week of March 27, when he plans to bring the American Health Care Act to the Senate floor, provided the legislation passes the House on schedule.

McConnell wants to get the bill done before the Senate begins debate on Supreme Court nominee Neil Gorsuch, who is scheduled to reach the floor the first week of April. Congress is scheduled to leave town April 7 for a two-week recess.

Democrats made clear Tuesday that GOP leaders shouldnt expect any votes from their side of the aisle.

Senate Democratic Leader Charles SchumerCharles SchumerWhy Jeff Sessions must resign Schumer promises Dems will try to defeat 'Trumpcare' Conway: Dems want 'to stop everything' Trump is trying to do MORE (N.Y.) vowed that his caucus would fight tooth and nail against TrumpCare.

TrumpCare means higher costs for less healthcare, plain and simple, he said. TrumpCare cuts taxes on the very wealthy while forcing average Americans to pay more. Premiums are going to go up.

McConnell called in the heavy artillery Tuesday by inviting Pence to a Senate GOP lunch to persuade wavering colleagues to get behind the House bill.

Pence told lawmakers pointedly that Trump supports the legislation, and while hes open to making changes, he will not scrap it and start over, as some conservatives would prefer.

Were certainly open to improvements and to recommendations in the legislative process, Pence told reporters after the meeting, though he emphasized that this is the bill.

Over the next several weeks McConnell and his leadership team will argue to colleagues that voters are expecting action from Congress, and this month presents them with a historic opportunity to deliver on their campaign promises to repeal ObamaCare.

The American people have given us an opportunity to govern. Were no longer floating ideas, McConnell said. We have an obligation now to the American people to deliver a replacement for ObamaCare that is better than the status quo.

He noted ObamaCare was a huge issue in the 2010, 2012, 2014 and 2016 elections.

Pence tried to reassure Republicans nervous about capping the Medicaid expansion that the House bill would return resources and flexibility to the states that will allow them to reform Medicaid so it can more effectively meet the needs of our most vulnerable citizens.

Gardner, who signed the letter to McConnell expressing concerns about Medicaid, said Tuesday hes still trying to understand the details of how the House bill would impact low-income constituents.

Were looking at it, he said.

Specifically, he wants to figure out whether new Medicaid enrollees starting in the year 2020 will still be eligible for the same federal subsidies that have covered the cost of expanding the program in 31 states under ObamaCare.

You can add new people to the program. At least, thats the way we initially understand it, he said.

Centrist Democrats showed no signs of being inclined to back the House GOP bill.

Sen. Jon TesterJon TesterHealthcare bill faces steep climb in Senate Liberals threaten to primary over Gorsuch Dem senator introduces bill to 'drain the swamp' MORE (D-Mont.), who is up for reelection next year in a state Trump won by 20 points, said he has serious reservations.

Some things theyre doing with Medicaid [are] not going to be helpful. Im not sure theyre helping with lowering premiums for people who are really getting gouged with big premiums, he said. On first blush, its certainly got some issues. Major issues.

Sen. Joe ManchinJoe ManchinHealthcare bill faces steep climb in Senate Liberals threaten to primary over Gorsuch Get wise, GOP. The healthcare groundswell isn't going away MORE (D-W.Va.), who is running next year in a state Trump won by nearly 42 points, said he was reviewing the bill.

Manchin said, however, that he would not vote for legislation he views as a straight repeal of ObamaCare.

Schumer told reporters that the House bill is an ObamaCare repeal, even though it will keep in place some of the laws reforms, such as allowing adults to stay on their parents health plans until age 26.

Republicans say it would also bar insurance companies from discriminating against people with pre-existing medical conditions, but Democratic leaders are disputing that claim.

Jessie Hellmann contributed.

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Healthcare bill faces steep climb in Senate - The Hill

NPR	Republicans Mixed On New Health Care Bill NPR Many Tea Party Republicans are raising objections to the new GOP-written health care bill, but Speaker Paul Ryan says he's guaranteeing it will pass the House in the coming weeks. Facebook; Twitter. Google+. Email ...

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Republicans Mixed On New Health Care Bill - NPR

A new Republican health care plan keeps much of the basic framework set up by Obamacare, but with a conservative twist, analysts say.

But it's full of holes, with no detail on how to pay for its provisions and no estimates at all of how much it will cost taxpayers.

While conservatives praised the emphasis on personal responsibility, liberals said it would take newly won health insurance away from millions and cost people protection from some of the worst abuses of the insurance industry.

And it's not even clear if all Republicans in Congress will vote for it. At best, analysts agreed, it's a work in progress.

"I think their basic overriding philosophy is to let the states decide a lot of things, which is sensible," said economist Douglas Holtz-Eakin, president of the American Action Forum and a former director of the Congressional Budget Office.

Related: Entry Ban Could Cause Doctor Droughts in Pro-Trump States

Moments after the House Energy and Commerce and Ways and Means committees unveiled their plans on Monday, Michigan Republican Rep. Justin Amash called it "Obamacare 2.0" on Twitter.

Kentucky Senator Rand Paul, another Republican, called it "Obamacare Lite."

"What they kind of have is a repeal plus," said healthcare expert Joe Antos of the American Enterprise Institute, who's done stints in the Congressional Budget Office and the Health and Human Services Department.

"This is a kind of a hodge podge and I don't see it's much different from what we saw a few weeks ago," Antos told NBC News.

The plan stops the unpopular mandate that required almost everyone to have some sort of health insurance. It replaces that by allowing health insurance companies to charge 30 percent higher premiums if customers had gone 63 days or more without health insurance.

Both provisions were meant to prevent people from waiting to buy health insurance until they were sick.

"That could encourage some healthy people to sign up initially," said Larry Levitt, a health policy expert at the nonpartisan Kaiser Family Foundation.

Related: Is Obamacare Collapsing?

The 2010 Affordable Care Act required health insurance companies to cover anyone who wanted to buy insurance, and is laid out a minimum list of conditions that had to be covered or services provided, from pregnancy care to cancer screenings.

It stopped a once-common practice of capping coverage once a customer started costing too much, and aimed to limit bare-bones plans that covered almost nothing.

Many of these appear to be preserved in the new plans, at least for a time, along with another popular provision that allowed young adults to stay on their parents' plans until they turned 26.

The new American Health Care Act would allow health insurance companies to charge older people five times as much as they charge younger clients the current limit is three times as much.

Taxes that paid for the old Obamacare subsidies, which helps an estimated 85 percent of people who bought private health insurance on the exchanges, are gone. Instead of subsidies, the plan provides tax credits for people making less than $75,000 a year.

There are few details on how the Republicans plan to pay for the tax credits, however.

"I don't understand where the money comes from. I understand what they have taken away, said Republican health economist Gail Wilensky, who now is a senior fellow at Project HOPE. "It's just a mystery."

Ron Pollack, executive director of Families USA, a strong supporter of Obamacare, said it will return many Americans to pre-Obamacare days.

"This bill would strip coverage from millions of people and drive up consumer costs. It shreds the Medicaid social safety net that serves more than 72 million people, including many children, senior citizens and people with disabilities," said Pollack. "And it once again leaves millions of people in America with chronic illness and disease at the mercy of insurance companies."

Senate Democratic Leader Chuck Schumer and House Democratic Leader Nancy Pelosi on Capitol Hill on Jan. 4. Kevin Lamarque / Reuters

House Democratic leader Nancy Pelosi of California called it a "Make America Sick Again" bill.

"Republicans even enable insurers to once again charge more or deny coverage to millions of Americans with pre-existing conditions, abandoning those families who lapse in coverage for any reason at all," she said

House Energy and Commerce Committee Ranking Member Frank Pallone, Jr., a New Jersey Democrat, and Ways and Means Committee Ranking Member Richard Neal of Massachusetts said they could would not support the plan.

"The Republican repeal bill would rip health care away from millions of Americans, ration care for working families and seniors, and put insurance companies back in charge of health care decisions contrary to everything President Trump has said he would do with his health care plan," they said in a joint statement.

The plan sets out a path to revising Medicaid, the joint state-federal health plan for low income people. It allows the 31 states plus Washington D.C. that expanded Medicaid under the Affordable Care Act to keep getting federal funding to do that but inexplicably leaves out the 19 most Republican states that refused to take part.

Instead, those states will get cash. It's not enough, said Wilensky. "I don't think $10 billion is enough," she said.

Baltimore City Health Commissioner Dr. Leana Wen says the changes to Medicaid will eventually leave many people out in the cold. "Medicaid provides the ultimate safety net for individuals who need it the most. I am extremely concerned about that," she said.

The ACA was designed to get health insurance to more Americans, and it did. At least 20 million more people have health insurance than before the law was enacted, about half of them on new exchanges set up to help people buy private health insurance, often with federal subsidies, and about half through an expansion of Medicaid.

In 2010, the year the law was signed, 48.6 million Americans or 16 percent of the population had no health insurance. The ACA brought that to below 9 percent.

Republicans are wary of making changes that will take health insurance away from millions of Americans, but are under pressure to make the reforms look more like a return to private industry, with less government oversight.

Antos said the plan may compromise too much.

"Some Republicans will say, 'No, you've gone too far (and) give things away' and other Republicans will say, especially in the Senate, 'you haven't gone far enough to say what you are going to replace it with'," he said.

"So it seems like there's a sweet spot here, but it's not a sweet spot that a politician would want to be in."

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Obamacare Lite? New GOP Health Care Bill Has Host of Critics - NBCNews.com