Posts Tagged ‘healthcare’

Health Care Back on Congress’s Front Burner

October 16, 2017

Trump’s move to stop subsidy payments ratchets up pressure for a bipartisan deal

WASHINGTON—The Senate this week will grapple with President Donald Trump’s decision to stop making subsidy payments to health insurers, with lawmakers seeking a deal that would keep the money flowing while Republicans try to fold in conservative-oriented health-care priorities.

It remains unclear whether a package could emerge that attracts support from a critical mass of senators and also from House Republicans. That could be put to the test quickly, as Sens. Lamar Alexander (R., Tenn.) and Patty Murray (D., Wash.) are expected to introduce a plan within days and Sen. Ron Johnson (R., Wis.) unveils his own, more-conservative-leaning version.

The result, driven by unexpectedly far-reaching moves by Mr. Trump on health care last week, could be a resumption or even escalation of the legislative battle that unfolded during Republicans’ attempts to repeal the 2010 Affordable Care Act. It comes as insurers press some state and federal officials to let them reset their rates for 2018 in light of the halting of the subsidies, while one state, Oregon, already has told insurers to jack up rates for their most popular plans.

On Monday, Mr. Trump is meeting with Senate Majority Leader Mitch McConnell (R., Ky.) to discuss budget and tax issues, with health care also a possible topic.

Mr. Trump met Saturday with Mr. Alexander, Sen. Lindsey Graham (R., S.C.) said on CBS , and he encouraged Mr. Alexander to pursue his deal, Mr. Graham said.

The “cost-sharing reduction” payments ended last week by Mr. Trump help insurers offset subsidies to low-income Americans. Many Republicans, fearing chaos in the insurance market if the payments stop, want to extend them as long as that is accompanied by moves such as relaxing regulations on some insurance plans.

“I think Congress should pass that short-term extension” of payments, Sen. Bill Cassidy (R., La.) said Sunday on Fox. “We absolutely have to think about that family around the kitchen table, which is why we should pass them”—but only if they are packaged with provisions that he said would lead to lower premiums.

Democrats say the Republican approach to lowering premiums involves stripping important consumer protections, allowing for insurance policies that provide insufficient coverage. Healthier, younger Americans may have access to lower premiums under the GOP approach, they say, but older and sicker consumers would see their costs go up.

Sen. Chris Murphy (D., Conn.) said Mr. Trump’s decision to end the payments was retaliation for Republicans’ inability to repeal the ACA. “This is the equivalent of health-care arson,” Mr. Murphy said on Fox. “He is literally setting the entire health care system on fire just because he is upset that Congress won’t pass a repeal bill supported by 17% of the public.”

Some Republicans say they are less concerned with the payments themselves than the fact that the Obama and Trump administrations have been making them without an appropriation from Congress, which they say is unconstitutional.

This week’s most closely watched event will likely be the unveiling of the Alexander-Murray plan, which the two senators have been discussing for months. In exchange for extending the insurer payments, the bill would give states permission to obtain waivers under the ACA, paving the way for more variation in insurance plans, according to people on Capitol Hill.

Mr. Johnson, for his part, is working on legislation that includes additional conservative measures, such as expanding the use of health-savings accounts and delaying the enforcement of the mandate that most employers provide insurance.

Mr. Johnson said he is seeking a bill House Republicans would accept. “We can do stuff in the Senate, but if it dies in the House, we haven’t done much,” he said in an interview.

Mr. Johnson said he recognized that many Republicans are hesitant to fund the payments. But ending them could result in higher premiums for consumers and more money spent by the government, which would have to provide larger subsidies to certain consumers, he said.

“Insurance companies get paid either way,” Mr. Johnson said, and he is “trying to find that sweet spot that will fund the cost-sharing reductions” and “restrain the growth in premiums.”

Conservative House Republicans have indicated any support for continuing the payments would depend upon significant concessions from Democrats on curbing the ACA.

If lawmakers reach a bipartisan deal on health care, it isn’t clear whether it would be voted on as a standalone bill or as part of complex negotiations looming in December.

The government’s current funding expires after Dec. 8, and other hot-button issues could get wrapped into the end-of-year discussions, including how to handle illegal immigrants brought to the country by their parents at a young age.

Democrats will have leverage in those talks because the spending bill, needed to avert a government shutdown, would need 60 votes to clear the Senate, where Republicans hold a 52-48 advantage.

For now, many in the health industry are reacting with alarm to the prospect of the subsidy payments ending. A diverse coalition representing health plans, doctors and businesses sent a letter to Congress Saturday asking lawmakers to “act immediately” to restore the payments.

In one example of the immediate impact of halting the payments, Oregon ordered insurers in the state who sell on the ACA’s exchanges to increase premium rates for 2018 for the most popular plans by 7.1%.

While some insurers had already filed rates for higher premiums with the expectation the payments might be discontinued, insurers in more than a dozen states filed rates that didn’t take into account the possibility. Some of those insurers are now saying they need to raise rates by 20% or more for next year, but the federal deadline for filing has already passed.

Before announcing late Thursday he would cut off the payments, Mr. Trump issued an executive order designed to bolster various alternative insurance arrangements, which are less regulated than traditional policies. Mr. Trump has he would continue using administrative action to try to dismantle the ACA, and Democrats are seeking ways to fight back, from litigation to legislation.

Sen. Susan Collins of Maine, a centrist Republican, said on ABC that for a deal on payments to work, “Democrats are going to need to step up to the plate and assist us.”

She added, “I’m very disappointed in the president’s actions this past week…But Congress needs to step in and I hope the president will take a look at what we’re doing.”

—Brody Mullins and Eric Morath contributed to this article.

Write to Stephanie Armour at and Kristina Peterson at


In Start to Unwinding the Health Law, Trump to Ease Insurance Rules

October 12, 2017

Directive is expected to expand the sale of less-expensive plans with fewer benefits

President Donald Trump is planning to sign an executive order Thursday to initiate the unwinding of the Affordable Care Act, paving the way for sweeping changes to health-insurance regulations by instructing agencies to allow the sale of less-comprehensive health plans to expand.

Mr. Trump, using his authority to accomplish some of what Republicans failed to achieve with their stalled congressional health-care overhaul, will direct federal agencies to take actions aimed at providing lower-cost options and fostering competition in the individual insurance markets, according to a Wall Street Journal interview with two senior White House officials. The specific steps included in the order will represent only the first moves in his White House’s effort to strike parts of the law, the officials said.

By boosting alternative insurance arrangements that would be exempt from some key ACA rules, the change would provide more options for consumers. But health-insurance experts say it could raise costs for sicker people by drawing healthier, younger consumers to these alternative plans, which could be less expensive and offer fewer benefits.

The executive order—which Mr. Trump plans to unveil in a signing ceremony in the Roosevelt Room Thursday, surrounded by cabinet officials and employer representatives—will aim to expand access to plans that let small businesses and possibly individuals band together to buy insurance. It will also lift limits on the sale of short-term insurance, which provides limited coverage and often appeals to healthier people. And it will seek to expand the ways in which workers use employer-funded accounts to buy their own insurance policies.

It will be months, rather than weeks, for even the most simple changes in the executive order to take effect, and the order leaves key details to the Labor Department, in particular, to determine after a formal rule-making process, including the solicitation of public comment.

But taken together, the instructions will amount to a reversal of the broad ACA approach, which seeks to guarantee that insurance policies offer a minimum level of benefits to all consumers regardless of their health history. Mr. Trump and other Republicans argue that such rules must be relaxed to bring down premiums, especially for healthier people who have seen costs rise under the ACA.

The order also will set the stage for potential future action, as Mr. Trump weighs whether to stop enforcing the ACA requirement that most Americans obtain insurance, for example, and whether to keep making payments that let insurers subsidize lower-income consumers.

And in a surprising move, the White House officials also said Wednesday night that the order would direct agencies to study and issue a report on federal and state policies that could contribute to rising health costs—including, potentially, the impact of health-care provider consolidation.

Health analysts predicted that Thursday’s order could tempt critics to pursue legal challenges, opening a new front in the health-care battle. But the order is likely to leave much of the implementation details to agencies, senior White House officials said Wednesday, and they said they didn’t believe the order could be litigated.

The action marks the biggest change to health care since the November election. The ACA, also called Obamacare, made sweeping changes to health insurance pricing that made insurance newly accessible for lower-income and sicker Americans, but also resulted in market turbulence and higher premiums for healthier and middle-income peo ple, in particular.

Republicans’ effort to repeal the ACA collapsed in Congress last month, and Mr. Trump hasn’t hidden his displeasure at GOP leaders for that failure or his desire to step into the gap. The White House officials said Wednesday night that the order was specifically crafted in the context of the failure of the repeal bid.

“Since Congress can’t get its act together on HealthCare, I will be using the power of the pen to give great HealthCare to many people – FAST,” Mr. Trump tweeted this week in signaling his intent to issue the executive order.

Democrats, however, warned the order could cause turbulence in the insurance market and overlooks the complexity of the health-care system. “It has the potential to be very disruptive,” said Rep. John Yarmuth of Kentucky, the top Democrat on the House Budget Committee. “I don’t think the insurance companies are prepared to actually deal with that.”

The order will direct the Labor Department to take steps that speed the way for small businesses, and possibly individuals, to band together in arrangements called association health plans. These insurance plans would be exempt from some regulations, such as the requirement that they offer a specific set of benefits and they would likely attract those with limited health needs.

The final decision about how far to expand the definition of an association and its members will be left to the agency, after a period of public comment, the two White House officials said. The officials said they supported a more expansive view of who might be considered to be eligible to sign up, but weren’t prescribing a specific legal definition—a significant factor in determining the impact of the change on insurance markets.

Supporters say such health plans can costs less, since they wouldn’t be subject to as many regulations. But critics say that leaves consumers at risk if they wind up with expensive health conditions that aren’t covered.

Currently, these self-insured health plans are typically led by trade groups that are subject to state regulation, but agency moves following the Trump order would free them from many of those rules.

In another move, the executive order will call for expanded access to short-term health plans whose availability was curtailed by the Obama administration. These plans have more flexibility than others allowed under the ACA, such as an ability to refuse coverage to people with pre-existing conditions.

The Obama administration limited these policies to less than three months, with no ability to renew them after that time because of concerns they were siphoning off healthier people from the ACA marketplaces.

As with association plans, supporters say short-term policies provide more options and carry lower premiums, while critics say they would attract the healthy and leave higher-risk people in more traditional plans that would become more costly since the population would be older and sicker.

Finally, the order will direct agencies to rescind an Obama-era guidance on employer-funded accounts that workers use for medical costs. Employees who have these accounts, called health reimbursement arrangements, will likely be allowed to use them to buy their own insurance plans, something that is now forbidden.

The Obama administration blocked the pretax dollars from being used to buy such plans because of concerns that would prompt employers to stop offering coverage of their own.

—Kristina Peterson contributed to this article.

Write to Louise Radnofsky at, Stephanie Armour at and Anna Wilde Mathews at

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Donald Trump, the President Without a Party

October 9, 2017

Estrangement from Republican leaders clouds the White House’s agenda

President Trump walked to board Marine One at the White House on Saturday.
President Trump walked to board Marine One at the White House on Saturday. PHOTO: SHAWN THEW/POOL/ZUMA PRESS

Increasingly, Donald Trump is a president without a party.

With virtually no Republican votes to spare in the Senate, where his agenda hangs in the balance, he has nonetheless become estranged from two key figures in his own party. First it was John McCain of Arizona, over his defiance of the president on health care. Next it was Bob Corker of Tennessee, who feuded with the president in a remarkable weekend of exchanged insults.

As it happens, Mr. McCain is chairman of the Senate Armed Services Committee; Mr. Corker is chairman of the Senate Foreign Relations Committee. Thus, the president is alienated from the two most important Senate figures on national security at a time when two critical national-security issues are coming to a boil: the fate of the nuclear deal with Iran and the increasingly dangerous standoff with North Korea.

Meanwhile, Mr. Trump backed the losing candidate in a Republican primary runoff in Alabama, finding himself trapped between the party establishment whose choice he supported and the social conservative foot soldiers who backed Roy Moore, the candidate who actually won.

Now, Mr. Trump’s once and perhaps current political guru, Steve Bannon, has set out to attack much of the rest of the Republican caucus in the Senate. He’s also gunning for the entire GOP congressional leadership, with which the president is himself increasingly disillusioned.

President Trump defied the Republican party this week by striking a deal with Democrats in Congress on raising the debt ceiling, keeping the government running and funding hurricane relief. The WSJ’s Gerald F. Seib explains whether this signals Trump will be more independent in the coming weeks. Photo: AP

After a conversation with Mr. Bannon in recent days, Robert Kuttner of the American Prospect summarized his agenda this way: “Bannon’s current obsession is to blow up Senate Majority Leader Mitch McConnell and Republican Senate incumbents whom he regards as hostile to his brand of nationalism.”

Mr. Trump has tried to adjust to this growing estrangement from leaders of his own party by opening the door to cooperation with Democrats on immigration and health care. But after seemingly striking a deal with Democrats to protect the legal status of so-called Dreamers—young immigrants brought here illegally as youths—he plotted strategy over how to follow through on that agreement with a group of Republican senators over a White House dinner last week.

What emerged was a list of demands that may well blow up any pending immigration deal. To get the Dreamers deal Democrats want, Mr. Trump called for, among other things, funding for a wall he wants along the Mexican border, new restrictions on those seeking asylum in the U.S. and punishment for localities that declare themselves “sanctuary cities.”

Those principles surely are negotiable. Still, they seem to leave Mr. Trump trapped in a kind of immigration no-man’s-land, between Democrats wanting a Dreamers fix and Republicans hoping to use that fix as a lever to push through broad immigration changes they’d like to make.

The question is: Where is this all supposed to lead?

There is an answer to that—in the long run. Mr. Trump would like to lead, and Mr. Bannon would like to create, a Republican Party different from the one that exists. It would be a party molded in the Trump image: nationalist, skeptical of immigration and trade agreements, dubious about the virtues of diplomacy and international negotiations, with economic strategies skewed to help workers in traditional American industries.

After all, Mr. Trump has said on several occasions—most notably at a conservative conference in February—that he wants the GOP to be the party “of the American worker.”

There are three problems with that vision, though. First, that party doesn’t exist today. The current version of the GOP was built largely by merging the interests of the business community with the agenda of social conservatives. Neither of those groups would win top billing in the vision for a new, Trump-inspired party.

The second problem is that it isn’t at all clear that such a new Republican Party would, in fact, be a majority party. There are disaffected people loitering in both current major parties—disgruntled blue-collar workers, fearful middle-class Americans, trade skeptics, those who feel culturally alienated from the current Democratic establishment—who are drawn to such a vision.

But ultimately, Mr. Trump failed to win the popular vote even as he won the presidency in 2016, and he has never come close to winning majority approval for the job he’s doing as president.

The third problem is that, while waiting for that Republican Party to emerge, Mr. Trump confronts the job of governing today. The current party has just 52 members in the Senate, and, as noted, Mr. Trump doesn’t have the loyal support of all of them. Mr. Bannon and his allies are threatening to challenge other Republican incumbents in primary elections next year, which won’t exactly keep those targeted at his side.

Meantime, Mr. Trump hasn’t forged reliable tactical alliances with enough Democrats to make up the difference. Which leaves him a leader in search of reliable followers.

Write to Gerald F. Seib at

Trump says he called Schumer on health care — Even a temporary deal would be good

October 8, 2017

Despite economic optimism, Americans worry about Trump and the future

October 5, 2017

Susan Page and Julia Fair, USA TODAY

Published 10:00 a.m. ET Oct. 5, 2017 | Updated 10:02 a.m. ET Oct. 5, 2017


(Photo: Jim Lo Scalzo, European Pressphoto Agency)

WASHINGTON — Americans overwhelmingly disagree with President Trump on just about everything from his military threats to North Korea to his combative stance toward NFL players who won’t stand for the National Anthem.

But a USA TODAY/Suffolk University poll also finds an unusual disconnect: Americans are increasingly optimistic about the nation’s economy.

“He’s just really intent on keeping the nation divided,” says William Reed, 52, of Cleveland Heights, Ohio, who voted for Democrat Hillary Clinton last year and was among those polled. “No empathy; no compassion; just all about him and tweeting.”

Trump’s defenders counter that he has faced tough problems and unrelenting opposition from his political foes. “It’s not a good climate out there, and he’s navigating through it,” John Sakach, 80, the owner of a construction-supply business in suburban Chicago, said in a follow-up interview.

For the first time during Trump’s presidency, a majority of Americans, 53%, say in the USA TODAY poll that the economy is in a recovery. That typically would lift views that the nation is headed in the right direction. But this time, nearly two-thirds, or 64%, also say the country is on the wrong track, up 21 percentage points since the beginning of the year and the highest of his tenure.

As Trump approaches the one-year anniversary of his election next month, his underwater approval ratings and the public’s anxiety hold perils for his presidency. They embolden his critics and make it harder for him to push legislative proposals such as a tax bill through Congress.

Historically, sagging presidential approval ratings also signal trouble for the party in power in midterm elections.

Those surveyed say, by 57%-33%, that they want to elect a Congress in 2018 that mostly stands up to Trump, not one that mostly cooperates with him. And that includes almost one in five Republicans, as well as the predictable partisan divide, with nine of 10 Democrats calling for an opposition Congress. Independents by 2-1 also hold that view.

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Diplomacy or military action?

When it comes to North Korea, Americans are more likely to agree with the embattled secretary of State, Rex Tillerson, than with his boss.

By 3-1, 61%-20%, Americans say the United States should pursue diplomacy to try to curtail North Korea’s nuclear program, not undertake military action. By an even wider margin, 69%-15%, they say the U.S. should launch military strikes only in response to a North Korea attack, not as a pre-emptive step.

“There’s a place for military, absolutely, but when dealing with nuclear weapons, you have to try diplomacy first,” says Annie Davis, 41, of Greenville, S.C., the manager of a veterinary clinic who was among those polled. “There are civilians on both sides.”

On Saturday, in Beijing, Tillerson said the United States had “made it clear that we hope to resolve this through talks,” saying his immediate goal was “to calm things down” with North Korea.

That brought an extraordinary public rebuke from Trump. “I told Rex Tillerson, our wonderful secretary of State, that he is wasting his time trying to negotiate with Little Rocket Man,” Trump tweeted on Sunday, a reference to North Korean leader Kim Jong Un. “Save your energy Rex, we’ll do what has to be done!”

Those surveyed disapprove of the president’s handling of North Korea by 56%-34%.

That said, both Trump supporters and critics agree that the president inherited a complicated and dangerous standoff with Pyongyang, with no easy path ahead. “This guy, Kim, is a very unstable man and has no respect for the nuclear issue, which goes all the way back to when Bill Clinton was in office,” says Doug Johnson, 54, of Hannibal, Mo. “If you could take care of that with diplomacy, I would be 100% for that, but I don’t think that’s the case here.”

The poll of 1,000 registered voters, taken by landline and cellphone from Sept. 27 to Oct. 1, has a margin of error of plus or minus 3 percentage points.

Obamacare redux

Americans hold just about everybody in politics in low esteem, not to mention the news media.

Congress gets a whopping unfavorable rating of 64%-17%. The Democratic Party is viewed unfavorably by double digits, 48%-37%. The GOP fares worse, 62%-23%. Vice President Pence’s unfavorable rating is better than Trump’s (57%-34%), but it’s still in negative territory, at 44%-36%.

The news media is viewed unfavorably by 54%-31%, worse than the already dismal 50%-37% unfavorable rating in the first poll of the year.

What’s getting more popular? The Affordable Care Act.

Six in 10 Americans, 59%, now say Congress should either leave Obamacare alone, or fix the problems with the program but leave its framework intact. That’s up 6 points since June, and in the wake of the failure last month of Senate Republicans to win approval of alternative programs — this after seven years of campaign promises to “repeal and replace” it.

Now 11% say Congress should repeal the Affordable Care Act even if a replacement isn’t ready; another 26% say a repeal should be passed but only when a replacement is ready to go.

Trust in Trump to protect the interests of Americans and their families on health care has fallen, to 15%. Only 10% say they trust congressional Republicans most; 43% trust congressional Democrats.

Those surveyed express dismay and bewilderment that legislators haven’t been able to work together.

“I want them speaking to each other, honestly and wholeheartedly working for a compromise,” says Meg Ashworth, 57, a homemaker from Lebanon, Ohio.

“If they don’t fix it,” says Willie Woods, 55, the owner of a trucking firm in Houston. “then we’ll be in the same boat this year and the next year.”

Good feeling gone

Gone is the good feeling after the president’s address to a joint session of Congress early in the year. Just after that, by 46%-43%, Americans were inclined to believe things were headed in the right direction. Now, by a yawning 40 percentage points, 64%-24%, they say things are on the wrong track.

That include a third of Republicans.

“He’s not doing his job the way he’s supposed to do,” worries Robert Pounds, 58, of Aiken, S.C., who voted for Trump last year. “I’d like to see him get health care figured out. I’d like him to stand up and get more jobs in America, like he said he would. I know he’s a rich fellow, but he needs to start helping America.”

Trump gets low marks even for his Twitter-fueled blasts at NFL players who have been dropping to one knee during the National Anthem before games. Two-thirds of those surveyed say the president’s call for NFL owners to fire the protesting players and for fans to boycott their games is inappropriate.

The president’s approval rating is 38%, the lowest of the year in the USA TODAY poll. His disapproval rating is 56%, the highest of the year. By 35%-13%, those who “strongly disapprove” of him outnumber those who “strongly approve.”

That means for nearly half of the country, feelings are inflamed for or against the president.

“A very to-the-point person” who has “held people accountable who have not been held accountable before,” Johnson says approvingly.

Woods couldn’t disagree more. “Getting worse and worse by the minute,” he laments.

With Timing Tight for GOP’s Graham-Cassidy Health-Law Effort, Opponents Rush to Mobilize

September 21, 2017

Critics step up attacks on latest bill amid narrow window for Senate vote

Republican Sen. Lindsey Graham and Rick Santorum in Washington on Wednesday.

Republican Sen. Lindsey Graham and Rick Santorum in Washington on Wednesday. PHOTO: REYNOLD/EPA-EFE/REX/SHUTTERSTOCK/EPA/SHUTTERSTOCK

Opponents of a Republican plan to dismantle most of the Affordable Care Act are scrambling to ramp up a resistance campaign before a possible Senate vote next week on a bill many never expected would gain traction.

With such a narrow window, consumer and other groups are seeking to pressure specific GOP senators they see as most likely to waver. They also assert that Republicans are trying to ram through a bill outside the normal process while reneging on a promise to preserve the ACA’s consumer protections, claims the bill’s sponsors reject.

Timing is clearly a challenge for the bill’s supporters, who must cobble together votes by a Sept. 30 deadline, when a parliamentary vehicle that enables the Senate to pass legislation with a simple majority expires. Senate Majority Leader Mitch McConnell (R., Ky.) has said he plans to hold a vote next week, by Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana.

But it also doesn’t leave much time for the bill’s opponents, who had weeks to build up resistance to previous ACA-repeal attempts, including legislation that failed in July to pass the Senate.

“This bill is complicated and far-reaching,” said Larry Levitt, a senior vice president at the Kaiser Family Foundation. “Interest groups don’t have a lot of time to mobilize and figure out what it means.”

Republican leaders have begun responding to the attacks on their bill to topple much of the ACA. They say it protects people with pre-existing conditions and returns control over health care to the states. They disagree with critics who say they have been secretive with the bill’s process, pointing out that they’re holding public hearings early next week on the legislation.

“Under Graham-Cassidy-Heller-Johnson, more people will have coverage and we protect those with pre-existing conditions,” Mr. Cassidy said Wednesday on CNN, referring to the other sponsors of the bill.

The attacks seek to hit the bill’s sponsors in areas of political vulnerability.

Save My Care, a health-care advocacy group, has launched ad campaigns in Nevada, Alaska, West Virginia, Maine, Tennessee and Arizona. An ad this week targets Sen. Dean Heller (R., Nev.) for co-sponsoring a bill that lets states waive ACA protections for people with pre-existing conditions. Nevada’s Republican Gov. Brian Sandoval opposes the legislation.

“We’re pulling out all the stops. We’re putting out a lot of phone calls,” said Brad Woodhouse, campaign director at Protect Our Care, an advocacy group focused on blocking the repeal. “Calls are going into Washington and state offices.”

The proposal would let states get waivers to end the ACA prohibition on insurers charging higher premiums to people with pre-existing health conditions. That was the situation before the ACA established the restriction.

A few months ago, Mr. Cassidy spoke out in favor of protections for people with pre-existing conditions. Mr. Cassidy has said the bill would protect these consumers because it stipulates that coverage must be affordable. Critics say that definition is so vague that rates for sick people still could become prohibitively expensive.

The bill is more far-reaching in some ways than earlier GOP repeal attempts. It would end the mandate that most people have coverage or pay a penalty and the requirement that many employers provide health insurance to workers.

The proposal essentially turns over federal ACA funding—estimated at more than $1 trillion through 2024—to states, allowing them to set up their own health-care systems. It would cut federal health funds to states by more than $4 trillion through 2026, according to a report Wednesday by Avalere Health, a health-care consulting firm.

States that expanded Medicaid under the ACA would see some of the largest cuts, according to the report.

With repeal possibly within Republicans’ grasp, a bipartisan group of 10 governors on Tuesday sent Mr. McConnell a letter saying they favored a bipartisan process instead of the repeal bill.

Planned Parenthood Federation of America, which the bill seeks to exclude from the federal Medicaid program, held a rally outside the Capitol on Tuesday, where senators and activists took turns speaking. The group has held rallies outside the offices of Sens. Lisa Murkowski (R., Alaska.) and John McCain (R., Ariz.), who are both undecided, as well as Sen. Shelley Moore Capito (R., W. Va.), who voiced concerns about previous repeal efforts.

Industry groups including the American Medical Association, the American Hospital Association, and America’s Health Insurance Plans, the major health insurers’ group, have come out against the proposal.

The repeal fight is likely to come down to a one-vote margin. If GOP leaders vote by Sept. 30, they will need 50 votes in the 100-member Senate, where they hold a 52-48 majority, with Vice President Mike Pence casting a potential tie-breaking vote. After Sept. 30, they would need 60 votes, which is unlikely given the unified Democratic opposition to GOP repeal efforts.

Sen. Rand Paul (R., Ky.) has said he will vote no, and Sen. Susan Collins (R., Maine) has signaled her serious reservations, meaning the bill’s sponsors cannot lose another vote.

Republican leaders maintain their bill presents the best chance GOP lawmakers have to deliver on a yearslong pledge to repeal the ACA.

“I’m giving you the chance to do something different than Obamacare because this is not working,” Mr. Graham said of his bill Wednesday. “It’s not working in Alaska, it’s not working in South Carolina.”

The latest Republican stab at overhauling the Affordable Care Act manages to be both more timid and more sweeping than previous efforts to replace Obamacare. Known as Graham-Cassidy, it was written by a quartet of Republican senators led by Lindsey Graham of South Carolina and Bill Cassidy of Louisiana.

In the timid sense, the proposal would keep much more of Obamacare’s taxes and spending in place than previous Republican plans this year. Yet Graham-Cassidy makes more sweeping changes by turning money currently used on insurance subsidies and the Medicaid expansion into block grants to states. This change would give states more flexibility to design their own health care systems.

The prospects for Graham-Cassidy remain in doubt, but the battle over whether states or the federal government should have more control over health care policy will remain no matter what happens in the coming weeks. There is a strong case for a system that takes a less Washington-centric approach to health care and turns more decisions over to the states.

Commentators often bemoan how divided the nation is, pointing to our bitter elections and the toxic nature of political discourse. But the current level of partisan and regional polarization is a natural consequence of a political system that cedes so much power to the federal government. When distant lawmakers and unelected bureaucrats are in a position to make decisions that have enormous implications for the entire nation, the stakes of any decision become much higher. This is especially true when it comes to health care policy, which has the most personal and life-altering effects on individuals and their families.

A more flexible system would give states latitude to pursue health care programs that are a better fit for their populations’ ideological sensibilities. And there are practical reasons to think of health care as a state-based issue: Every one has its own demographics, health challenges and other unique characteristics.

For instance, median household income is much higher in New Hampshire than in Arkansas; heart disease and obesity are much bigger problems in Mississippi than in Colorado; the opioid epidemic is much worse in West Virginia than in Nebraska. Relatively sparsely populated areas struggle with the closings of rural hospitals, leaving large geographic areas underserved, while urban areas have a high concentration of large hospitals, many of which struggle with overcrowding.

Some states have both major cities and vast rural areas. Some skew younger while others skew older. State-specific factors help explain why even under the centralized Obamacare, premium increases and the participation of insurers have varied widelyacross the country. It makes sense to allow states to set their priorities and direct their resources based on the characteristics of their populations.

As states come up with innovative solutions to their health care problems, it means there are 50 opportunities to experiment. States can test solutions that worked elsewhere, or steer clear of ideas that failed. This path makes more sense than having politicians and distant regulators impose one giant experiment on the entire nation that is harder to undo if it fails.

The idea of turning more power over to the states has long been advocated by conservatives, but there are compelling reasons for liberals to get behind devolving power from the federal government.

When Congress passed the Affordable Care Act in 2010, it left many of the details to the discretion of the Department of Health and Human Services, giving vast powers to the secretary to determine everything from fast-food menu labeling requirements to when individuals could purchase insurance. During the Obama years, the administration used its regulatory discretion — pushing and arguably exceeding the limits of the law — to prop up the president’s signature legislative accomplishment as the program ran into implementation problems.

When President Trump took office, he appointed Tom Price, a longtime foe of Obamacare during his time in Congress, to run H.H.S. In the past several months, liberals have shouted “sabotage” as they have witnessed Mr. Price take actions such as slashing Obamacare’s advertising budget, tweaking the rules on the types of plans insurers are allowed to offer and cutting in half— to six weeks — the program’s open enrollment period. Mr. Trump himself has created uncertainty over whether he will continue to authorize payments to insurers that congressional Republicans sued Mr. Obama over.

Any national health care system that assumes one party will control Washington for all eternity is doomed to fail. New Yorkers would have much less to fear about a Trump presidency if the president didn’t control agencies that set policies for the entire country.

From the perspective of somebody who wants to see genuine federalism in health care, Graham-Cassidy leaves a lot to be desired. Because it keeps many of Obamacare’s regulations on the books at the national level, it limits the amount of innovation that can occur at the state level. The fact that it keeps most of Obamacare’s taxes means that states preferring to take a more free market approach will still be paying for a big government footprint in other states. Under one scenario, for instance, Texans could be subsidizing single-payer health care in Vermont.

But the idea of giving states more control over their health care systems should survive no matter what happens with Graham-Cassidy.

McConnell Plans Vote on GOP Health Bill Next Week

September 20, 2017

Senate leader is still trying to secure enough Republican votes for Graham-Cassidy measure

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The latest proposal, written by Sens. Lindsey Graham (left) and Bill Cassidy (center), would turn federal health insurance funding into block grants for states. | Alex Brandon/AP

Senate Majority Leader Mitch McConnell plans to hold a vote next week on the latest GOP effort to unwind the Affordable Care Act, his spokesman said Wednesday, even though Republicans haven’t yet secured enough support to pass the legislation.

“It is the leader’s intention to consider Graham-Cassidy on the floor next week,” David Popp, a spokesman for Mr. McConnell, said Wednesday. The statement didn’t commit the Senate to a vote,…

McConnell spokeswoman: Senate to vote next week on Graham-Cassidy

The majority leader’s office does leave some wiggle room, however.


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

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

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

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

It’s still anyone’s guess whether the bill’s backers can get to 50 votes.

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

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

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

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

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

That uncertainty has kept many center-right senators on the sidelines, including McCain, Murkowski and Sens. Rob Portman (R-Ohio) and Shelley Moore Capito (R-W.Va.). Graham and Cassidy spent Wednesday morning meeting with McConnell and working on Murkowski and Sen. Dan Sullivan (R-Alaska), hoping to overcome their concerns that block grants could slash funding to Alaska.

“We’re very interested in helping Alaska because Alaska has 750,000 people. And a land mass bigger than Texas,” Graham said.

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

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

Healthcare: Senator Lindsey Graham pushing “fundamentally different approach than Obamacare.”

August 30, 2017



29 Aug 2017

Senator Lindsey Graham (R-SC) told Breitbart News in an exclusive interview that while the congressional  leadership’s healthcare bills kept Obamacare’s infrastructure in place, his coalition’s plan to repeal and replace “is truly and fundamentally a different approach than Obamacare.”

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Lindsey Graham. Credit J. Scott Applewhite for AP

Breitbart News reported on former Senator Rick Santorum’s plan to block grant Obamacare to the states. Santorum continues to work with Sen. Lindsey Graham, House Freedom Caucus Mark Meadows (R-NC), and Wisconsin Governor Scott Walker on a Republican alternative to the Affordable Care Act. These lawmakers’ support for the idea could culminate in a consensus that could allow the bill to pass through the Senate and fulfill Republicans’ promise to repeal and replace Obamacare. Meadows told Breitbart News Daily that the plan has “real merit.”

Santorum told Breitbart News that the plan could pass through the House and the Senate. Graham concurs with Santorum, suggesting that bill goes much further than the House-passed American Health Care Act (AHCA) and the Senate leadership’s Better Care Reconciliation Act (BCRA). Graham told Breitbart News:

Number one, we promised to repeal and replace, not to change the margins here. The House and the Senate bills were definitely improvements to Obamacare; however, it’s a stretch to say that they were a Replace because we did not really, the infrastructure stayed in place. This is truly and fundamentally a different approach than Obamacare. It relies upon the concept of federalism. Instead of Washington, D.C. managing Obamacare, having national exchanges, having payments going to insurance companies to prop up the system that cannot work. We’re going to block grant the health care to the states.

The House-passed AHCA and the Senate’s BCRA kept much of the infrastructure of Obamacare in place. Instead of the Obamacare subsidies for low-income Americans to purchase health insurance, congressional leadership swapped out the subsidies for refundable tax credits for Americans to purchase health insurance. Unlike the Santorum and Graham plan, the AHCA and the BCRA kept Obamacare’s federal exchanges and winded down Obamacare’s Medicaid expansion, although, Medicaid expansion was eliminating after several years. Graham’s plan eliminates Obamacare’s Medicaid expansion. Conservatives chided the original AHCA for not repealing enough of Obamacare, labelling the legislation, “Ryancare” and “Obamacare-Lite.”

Senator Graham explained to Breitbart News the construct behind the plan to repeal and replace Obamacare through block grants. Graham told Breitbart News:

They’ll have to cover pre-existing illnesses; they cannot use the money for roads and bridges or football stadiums. They have to spend the money on health care. It gives the consumer a voice they would never have in Obamacare. You can complain to your congressman or senator, but we do not run the program. Trying to find somebody in charge of your health care is almost impossible. Most of the people that run Obamacare are unelected bureaucrats. It is very hard to get their attention when things do not work well and Obamacare is based upon the idea of an unlimited printing press, you just keep printing money. Under the block grant approach, you can complain to somebody about the quality of your health care. That somebody would be your representative and the governor of the state. Chances are the person you are complaining has the same doctor that your family has. From a consumer’s point of view you have a much stronger voice, from an accountability perspective you have a much stronger voice in how it works because it will not be a 50 state conglomerate. There will be 50 different state solutions.

Here’s the construct. We are going to repeal the individual mandate, and the employer mandate. That generates about $200 billion in savings. The states can reemploy the individual mandate and the employer mandate if they would like but you cannot drag everyone else down with you. You can go to single-payer health care in a state if you wanted to, I think you would be foolish, but you cannot drag 49 other states with you.

So, what we did this will repeal the individual and employer mandate, and medical device tax. We left the other taxes in place and created a block grant. Under Obamacare, 4 states got 40% of the money. That’s New York, California, Maryland, and Massachusetts. They’re 20 percent of the population and so by 2026 our goal is to have parity. It will be roughly the same no matter whether you live in South Carolina or California. We help states that did not expand their Medicaid under Obamacare catch up. High-cost expansion states will have a glide path down to a number that will be parity by 2026.

Senator Graham told Breitbart News that key to getting the new Obamacare repeal plan to pass through Congress remains the governors’ support for the bill. Graham said, “So what we’re trying to do is get governors on board. The intellectual force behind this for governors has been Scott Walker from Wisconsin and Doug Ducey from Arizona. One expansion state and one non-expansion state. Most Republican states did not take Medicaid expansions. By 2026 we want to have parity. We’re trying to lock the formula down this week and send the text to CBO so they can score it.”

Senator Graham explained how the bill will increase flexibility for states to implement their own health care systems. Conservative states will have much greater freedom to implement their health care plans compared to Obamacare.

Graham continued: “There’s going to be three forms of flexibility. 1332 waivers from the HHS, which the governors like. There is going to be waivers through the children’s health program CHIP, which is a fairly flexible program, we’re going to be as flexible as possible with reconciliation and the parliamentarian. The fourth level of flexibility comes through the administration, Labor Department, HHS, they will have a wide ability to make waivers and grant flexibility.”

Increased flexibility with health insurance regulations could allow Republican states to design more innovative and more affordable health care plans.

Sen. Graham revealed that not only has he worked with Health and Human Services (HHS) Secretary Tom Price and Centers for Medicare and Medicaid (CMS) Administrator Seema Verma on a plan for his proposal, they have will also work to draft the formula used to figure out how much money every state gets for their local health care system.

“They have helped us design the formula. We have been working close with the administration to try to find a formula that would have been spent on Obamacare and block grant it back to the states and achieving parity by 2026, with as much flexibility as possible. This will be the end of single-payer health care, because the money and the policy making will be out of Washington,” the South Carolina senator said.

Graham told Breitbart News that he believes that the bill will score better than the House-passed American Health Care Act (AHCA) and the Senate leadership’s Better Care Reconciliation Act (BCRA). Graham told Breitbart News:

I think this bill will score very well. I think it will score well in terms of fiscal deficit impact. I think it will do as good as the House bill if not better. Once you repeal the individual and employer mandate, 14 million people will drop coverage because they no longer have to pay the fine. So 14 million just made a personal choice. I don’t feel like I’m denying anyone coverage because they made a choice.

Here’s what they can’t lose sight. Obamacare is a nightmare, it will never work, these exchanges cannot be propped up. It was always the plan to go to single-payer health care. It’s to make insurance so costly in the private sector that people will drop coverage and then pay the fine and their employees will join the exchanges and then people will have cradle to grave health care. I think that’s Obamacare goals was.

I think that the goal of Obamacare was to take over the patients that to exchange. This is a stake in the heart of Obamacare through a block grant.

Graham said that he believes that Sen. Lamar Alexander (R-TN) – the Health, Education, Labor, and Pensions (HELP) Committee chairman – will likely hold hearings in September on his proposed plan to repeal and replace Obamacare.

Graham also suggested that the plan could get to the 50 votes necessary for a repeal and replace legislation to pass through the Senate and perhaps a couple of votes from the Senate Democrats.

Graham explained, “When it comes to getting to 50, Alaska does very well under this approach. I think we can get Senator McCain, Senator Murkowski if it works out well for their states. So, conceptually John likes it if it’s good for Arizona. If you can get it to 50, I do not think that a Democrat is going to make it the 50th vote, but I do believe that once we get 50 Republicans there’s going to be a handful of Democrats that will vote for more money and more flexibility for their states.”

Graham criticized the House and Senate leadership’s approach to repealing and replacing Obamacare, arguing that the leadership “got too much in the weeds of tweaking Obamacare.” He argued that Republicans should have started from their principles to revert power back to the states, rather than tweaking the government’s power to hand out health care as an entitlement. Graham also said that he will continue to work with Senators Ted Cruz (R-TX) and Mike Lee (R-UT) on empowering states with more regulatory flexibility to implement their health care plans and lower premiums.

Graham also suggested that House Freedom Caucus members Mark Meadows and Sen. Bill Cassidy (R-LA), and former Senator Rick Santorum have been instrumental in pushing forward this strategy to empower states to create their own health care systems. Rick Santorum was instrumental in passing welfare reform in the 1990s, and Freedom Caucus chairman Mark Meadows led the drive that improved the AHCA enough for the bill to pass through the House.

Graham told Breitbart News:

I’m working with Mark Meadows in the House. The Freedom Caucus guys have been terrific. You know, this should have been our first idea, not our last idea. As Republicans, I think we got too much in the weeds of tweaking Obamacare. We should have went back to our basic philosophy of getting as much money and power out of Washington as possible. If we started with this concept, we would’ve had it done by now. I had a bill that would have allowed people to opt out of Obamacare and so Rick Santorum called me and said, ‘Why don’t we just block grant and instead opting out?’ So myself, Rick Santorum, and Mark Meadows started meeting and if this becomes law it will be because of Rick Santorum, he’s been indispensable. Bill Cassidy has been a great partner. Santorum has been instrumental, he knows his stuff backwards and forwards. We just need to remember this whole experience. When you [are] confronted with what happened in Washington you shouldn’t try to make Frankenstein look better, we should build something new.

Graham concluded, “This is may be the most important thing that I’ll ever do. If we can take money and power out Washington when it comes to health care, then we can achieve a great feat. Health care that is closest to the patient is the best health care.

Is The Republican Party Committing Suicide?

August 27, 2017

By Brent Bozell — For Breitbart

The Grand Old Party is about to commit suicide.

All this talk about Trump this, and Trump that, masks a far bigger political controversy. The Republican Party leadership in Washington, D.C., has fundamentally betrayed its constituents and they are about to learn that they’ve been double-crossed — for years.

Every Republican candidate’s stock speech sounds the same, the thunderous roar about a government out of control, federal spending out of control (insert charts and graphs and why, if you stack hundred dollar bills, they will reach the edge of the universe), federal taxes out of control (insert comparisons to socialist countries), the federal bureaucracy out of control (insert metaphors about chains, yokes, and the like), the family shattered with federal funding of abortion a crime against humanity (watch for it — there! The heart-wrenching sob), and our military is emasculated.

Two more items were added to the menu, courtesy of Obama. Obamacare Will Be Repealed! and Illegal Immigration Will Not Stand!

In 2009, the Democrats controlled everything, partly due to the Republicans’ cowardice on Capitol Hill, and in part because of some of the most inept candidates and campaigns America has seen in years. The Obama folks could have played it safe but went for socialist gold, using the power of the legislative and the executive branches (and later the judiciary, thank you Justice Roberts) to advance their agenda.

That included federal spending on a level unmatched in human history resulting ultimately in a $19 trillion in debt we simply cannot pay, and with so many tens of trillions of dollars in unfunded liabilities that “infinity” is not far behind. One seventh of the economy was confiscated by the federal government with the passage of Obamacare. Our national borders were declared open and discussions over our national sovereignty closed. And to top it off, the Democrats all but declared themselves above the law.

The GOP harrumphed that this would not stand, by God! If only… if only America would vote them into the majority.

In 2009, the Tea Party was born. The Grand Old Party was rejuvenated. Happy days were here again.

Just one year later, the Republicans captured the House, and with that, the power of the purse. They now had the authority to stop the insane spending on so many obnoxious and wholly unnecessary ventures. They could end Obamacare simply by not funding it.

Instead, under the “leadership” of John Boehner, it did absolutely nothing. Why, if only we had the Senate! Then we could take on the President!

So in 2014, after spending hundreds of millions of campaign dollars running hundreds of thousands of television and radio ads pledging to end illegal immigration while repealing Obamacare “root and branch” (author: Mitch McConnell), they were given control of the Senate.

And within a month McConnell re-authorized both, along with every single other thing Harry Reid and Obama wanted for yet another year.

But that’s because we can’t do what we promised until we have the Presidency! The excuse was as predictable as summer heat in the Sahara.

In 2016, they were given that too.

They were given everything.

In January of this year, they formally controlled both houses of Congress and the executive branch. Every single thing they’d ever promised was now possible.

They now had the power to enact every single spending cut they’d ever solemnly pledged. All those wasteful programs designed to fill the liberal sandbox — PBS, NPR, Planned Parenthood, NEH and the rest of the alphabet soup; all the hundreds of billions of dollars in corporate welfare to multi-billion-dollar corporations; all of the hundreds of billions of dollars directed toward leftist social engineering — poof! All of it could come to an end with a stroke of a pen.

They now had the power to restore fiscal tax sanity too. Remember the flat tax? The fair tax? Slashing the highest corporate taxes in the world? Giving you a tax break? All of it could be done with a snap of the fingers.

Repeal Obamacare? Check. End illegal immigration? Check. Build the wall? Check.

Crush the Deep State? Done, by God, done!

There was not a damn thing the Democrats could do to stop them from draining the swamp.

Except the Republican leadership didn’t mean it. With the exception of the Freedom Caucus in the House, and literally a handful in the Senate, the rank-and-file didn’t either. Not one word of it.

The opportunity arose for the vote to repeal Obamacare, and after huffing and puffing, and huffing and puffing some more, the dust settled and socialized health care remains the law of the land, perhaps permanently.

The opportunity arose for tax reform, to enact the cuts America desperately needs. It was never a matter of if, it was a matter of how much. It is now mid-August and nothing, absolutely nothing has been accomplished — even attempted!

And now we face the final test: the debt ceiling. Will we or won’t we stop the spending madness? Will the Republicans enact the cuts they’ve promised, or will they now be the ones to kick the can, piling evermore trillions of dollars of debt on their own grandchildren?

By every indication that’s precisely what they plan to do. The signal has come from President Trump, from Speaker Ryan, and from Majority Leader McConnell. The debt ceiling will be raised and no fiscal sanity will be restored.

There is no difference between Republicans and Democrats. Put them together. They are the swamp.

Just as Republicans have the power to enact the agenda they’ve pledged in toto, so too do they now own the federal government, in toto. It’s no longer Obamacare. It’s GOPcare. It’s no longer crazy liberal Democratic spending. It’s crazy liberal Republican spending. It’s no longer socialist Democratic Party taxation, it’s socialist Republican Party taxation. All the legislation authorizing all these programs, all the graft, all the waste, all the obscenity, all the immorality, and where Planned Parenthood is concerned, all the killing — all of it is now formally authored by the Republican Party.

Come the Congressional elections next year, and the presidential election in 2020, the Grand Old Party will once again bellow its hallowed promises. But this time it won’t work. This time there will be no straw men to blame. This time their voters will know those hallowed promises are not even hollow promises. They are lies.

These voters are tasting betrayal. They will not vote to swallow more vomit.

We are watching the GOP systematically committing suicide.

Brent Bozell is the Chairman of ForAmerica, a national grassroots organization whose mission is to use social media to reinvigorate the public with the principles of American exceptionalism: freedom, prosperity, and virtue. ForAmerica has over 9 million members and is a non-profit 501(c)4.

Thailand’s ‘lost decade’

August 25, 2017


© AFP/File | On Friday ex-premier Yingluck Shinawatra failed to show at a court date that could have seen her jailed. Speculation is rife that she may have fled the country

BANGKOK (AFP) – On Friday ex-premier Yingluck Shinawatra failed to show at a court date that could have seen her jailed.

Speculation is rife that she may have fled the country injecting fresh drama into a recent history littered by coups, long periods of autocracy and brief flowerings of democracy.

Here is a timeline of Thailand’s recent political history.

– 2001 –

Telecoms billionaire Thaksin Shinawatra wins elections in a landslide. He rolls out policies that are popular among the rural and urban poor, including universal healthcare, debt relief and farming subsidies.

– 2005 –

Thaksin becomes the first elected Thai prime minister to complete a four-year term. He goes on to win a second landslide.

– 2006 –

Opposition to Thaksin builds, sparked by accusations of corruption and nepotism within his family as well as his administration’s authoritarian streak.

Thaksin calls a snap election which is undermined by a large opposition boycott. The army seizes power while Thaksin is overseas — their first coup in 15-years.

– 2007 –

Fresh elections are held in December which are promptly won by a coalition of Thaksin allies, infuriating his opponents.

– 2008 –

Thaksin’s enemies — primarily Bangkok’s royalist middle classes and their allies among the city’s business and military elite — mobilise with huge and sometimes deadly street protests.

They are dubbed the “Yellow Shirts” and famously go on to occupy Bangkok’s main airports in a bid to unseat the government.

Courts kick two Thaksin-allied prime ministers from office and convict Thaksin in absentia of corruption, seizing more than $1 billion in assets.

British-born Abhisit Vejjajiva of the opposition Democrat Party is appointed premier in a parliamentary vote with army backing.

– 2010 –

Thaksin’s supporters rally en masse in Bangkok calling for fresh elections, arguing Abhisit’s government never won power through the ballot box.

They are mainly made up of rural farmers from the Shinawatras’ northern stronghold and Bangkok’s working class and are dubbed the “Red Shirts”.

Clashes between protesters and troops in April and May leave 90 dead, mostly demonstrators, in the worst civil violence in decades.

– 2011 –

Open elections are once again won by the Shinawatras with Thaksin’s youngest sister Yingluck becoming Thailand’s first female prime minister.

– 2013 –

Successors of the Yellow Shirts start holding mass protests against Yingluck’s government.

Bloody protests ensue, their anger fuelled by her government’s generous rice subsidy scheme and an attempt to push through a political amnesty that would allow Thaksin to return.

– 2014 –

As protests continue, Yingluck calls snap elections but her opponents block more than 10,000 polling stations. Tension builds. Yingluck and several cabinet ministers are removed from office by the Constitutional court.

Two weeks later army chief Prayut Chan-O-Cha, who repeatedly promised no coup was on the horizon, seizes power. The coup ushers in Thailand’s most autocratic government in a generation.

– 2015 –

Yingluck is retroactively impeached by the junta’s rubber stamp parliament over her government’s rice subsidy, banning her from politics for five years.

– 2016 –

Thailand’s junta hold a referendum on a new constitution which they say will reign in corrupt politicians and restore stability.

Critics say the new charter is a throwback to Thailand’s autocratic past when democracy was “steered” by powerful unelected bodies and the military.

In October the country’s widely revered King Bhumibol Adulyadej dies after seven decades on the throne, plunging Thailand into mourning.

The junta says fresh elections will be held in 2018.

– 2017 –

August 25: Yingluck skips a court date that could see her jailed for a decade over criminal negligence, sparking rumours that she has fled the country like her brother.