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The day's best health policy blogging

Herding Cats - Mar 09, 2010

Bloggers continue to be consumed with whether Democratic leaders will garner the votes needed to pass a health overhaul bill. Check in with The Hill to see the most up-to-date vote counts.

Heritage’s Conn Carroll declares, “Another day, another stream of health care fantasy from the White House. A quick look at two health care events from yesterday, one in Glenside, Pennsylvania, and the other in Tawas City, Michigan, clearly exposes the yawing gap between the Obama administration’s health care rhetoric and cold hard legislative reality.”

Keith Hennessey makes a similar point, saying, “Public signs of optimism from the President, his team, and Democratic Congressional leaders tell us little.  We don’t know if they actually think they will have the votes, or if they are asserting that to try to make it true.  Imagine the impact if Speaker Pelosi were to tell the press ‘We might not succeed.’  Doing so would further embolden those marginal Members she is trying to convince to vote aye.  They are telling us they think they will succeed, but they have to say this whether or not it’s true.”

Politico Pulse’s James Hohmann reports that Secretary of Health and Human Services Kathleen Sebelius spoke Tuesday to the National Association of Counties annual legislative conference,saying, “We are calling on Congress to step up, have an up-or-down vote, help us pass comprehensive health reform once-and-for-all and begin to change a system that’s broken and not serving many Americans.”

Bob Laszewski wants to know “Just where is the moral imperative in ramming a trillion dollar entitlement expansion through knowing full well it will make our long-term deficit nightmare even worse—for those now uninsured and for everyone else?”

Reason’s Peter Suderman looks at reports that Rep. Bart Stupak, D-Mich., might reach a compromise on the abortion language that will ultimately be put forward, but thinks “no one really knows for sure, and what we’re left with is a waiting game.”

Should Democrats muster the votes to pass a bill, Time’s Adam Sorenson says “I’m very skeptical of Senator McConnell’s assertion that every election in November will be a referendum on the issue. The notion that health care will totally overshadow jobs and the economy is far-fetched and, as Kate suggested, Republicans are probably just saying this to spook skittish House Dems.”

And The Washington Post’s Ezra Klein appears on The Colbert Report to explain budget reconciliation.

The Colbert Report Mon – Thurs 11:30pm / 10:30c
Action Center – Health Care Bill – Ezra Klein
www.colbertnation.com
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How Will Stupak’s Coalition Vote? - Mar 08, 2010

Bloggers are trying to guess which members of the House of Representatives are aligned with Rep. Bart Stupak, D-Mich, and his promise to vote against the Senate version of a health overhaul bill because of its less stringent language on abortion funding.

TPMDC’s Brian Beutler tries to “to whittle down a list of likely suspects” of Stupak’s 12 representatives who pledged to vote against the bill. Beutler says, “with leadership and the White House teaming up to twist arm, it’s hard to imagine all of [Stupak's] supporters will stick together. But at the same time, there’s some indication that when Stupak says 12, he’s not far off,” and provides a list of the lawmakers who might vote “no.”

Hot Air’s Ed Morrissey looks at news that one of Stupak’s cohorts, Rep. Dan Lipinksi, D-Ill., says he will vote “no” on the Senate bill and says, “So far, Stupak appears to have accurately described his caucus. There is still a core group of pro-life Democrats who refuse to get rolled by the Senate, especially after going out on a limb and succeeding in passing the Stupak amendment. It will only take a few of them to flip to No to stop the Senate bill from passing the House.” Morrissey cautions, however, that “we have to wait and see whether they remain firm in that opposition.”

Heritage’s Chuck Donovan thinks there’s reason for the pro-life Dems to vote “no” — and calls the current strategy to address abortion language in a reconciliation bill a “pie crust promise.” Donovan says, “The pro-life House members are being asked to believe that once the Senate-passed bill is adopted in toto by the House and signed by President Obama, the Senate, with its pro-abortion majority, will proceed to enact a permanent abortion funding limitation and other provisions that it did not deem wise to include in its own bill, which will be the law of the land.”

But if Speaker Nancy Pelosi manages to crack Stupak’s coalition and garner enough votes to pass a bill, Republicans have a strategy for that scenario too.

ABC News’ Rick Klein reports that “the chairman of the National Republican Senatorial Committee said today that GOP candidates will coalesce around a pledge to repeal a health care bill that’s passed by the Democratic controlled Congress this year.” But a number of prominent Republican Senate candidates haven’t signed on to the idea yet.

The National Review’s Mark Steyn argues that “Nobody has ever attempted this level of centralized planning for an advanced society of 300 million people.” He continues, “A bigtime GOP consultant was on TV crowing that Republicans wanted the Dems to pass Obamacare because it’s so unpopular it will guarantee a GOP sweep in November. Okay, then what? You’ll roll it back — like you’ve rolled back all those other unsustainable entitlements premised on cobwebbed actuarial tables from 80 years ago?”

The Washington Post’s Ezra Klein disagrees with one part of Steyn’s argument, saying, “calling it centralized planning suggests that Steyn doesn’t know what the words ‘centralized’ or ‘planning’ mean. But this is what people on the right are reading. No wonder they’re scared.”

Elsewhere, Open Left’s Chris Bowers lists progressive priorities that were included and ditched in the health overhaul bills, and says, “Still, it is an impressive list that should make any progressive activist who participated in the health reform fight proud, even if dissatisfied.  You really did improve the bill, and have the opportunity to keep improving it.”

And a frustrated Karen Tumulty reports (or at least tries to) from Obama’s health care speech in Glenside, Pa. this morning. According to Tumulty, the press corps was sequestered from attendees, “So all I can report is this: The President gave a speech on health care this morning. People applauded and cheered. What motivated them to be here, and what bearing this issue might have on their individual lives — well, I can’t answer that.”


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Will Health Reform Pass? - Mar 05, 2010

Bloggers are wondering whether a health overhaul bill can actually pass — and most are focused on Speaker Nancy Pelosi’s ability to drum up enough votes in the House.

Time’s Karen Tumulty says Democratic lawmakers are caught in a “prisoners’ dilemma.”  According to Tumulty, “Every endangered member will be trying to figure out not only his or her own vote, but also which way colleagues are likely to go. This one is going to be so difficult to predict–right up until the very last minute.”

Five Thirty Eight’s poll reader extraordinaire Nate Silver points out that InTrade’s bettors set the bill’s odds for passage at just better than even — which has moved up “fairly significantly in the past 72 hours.” Silver examines what’s changed in the last several weeks, and decides: “That’s a lot of evidence to weigh. My head says yes — Pelosi will squeak this through — while my gut frankly says no. Either way, I’m not sure there’s a lot of arbitrage against that 52 percent number at Intrade, but I’d hesitate to call the bill a favorite to pass.”

Health Beat’s Maggie Mahar says she’s “all but certain” that a health overhaul bill will pass. Her reasoning? “Unless the president and Pelosi have signed a secret political suicide pact, they wouldn’t be doing this unless they were quite sure they could pull it off. ”

Huffington Post’s Sam Stein reports that Democratic leaders estimate they are short between 6-12 votes in the House, so “To convince these lawmakers, House leadership is preparing a whip operation described as “all hands on deck.” Pelosi and Rep. James Clyburn (D-S.C.) will dispatch loyal lieutenants to help rub elbows and twist arms. Once the party settles on a final set of reconciliation changes, leaders in the labor community are set to launch a major campaign to help with the whipping, officials say.”

Slate’s Chris Beam explains how a Congressional whip actually works: “They count votes. The principle task of a party whip, formally known as ‘assistant party leader,’ is to keep track of the number of votes for and against a piece of legislation. They’re also responsible, along with the party’s leader, for “whipping up” support for a particular position.”

The American Spectator’s Philip Klein notes that a resigning Republican House member is delaying leaving his post so he can vote no on health reform, which means Pelosi still needs 217 votes to pass a bill.

But Hot Air’s Ed Morrissey thinks another scenario altogther may unfold: “The real nightmare scenario isn’t that the House might pass the Senate bill now, or in April.  It’s that Democrats might get stymied now, and then pass the Senate bill after the midterms in late November, and allow Obama to sign it into law well after the time when voters have held them accountable for their radical agenda.”


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Irreconcilable Differences - Mar 04, 2010

Bloggers take in President Barack Obama’s speech urging the passage of the health reform bill, in part through budget reconciliation, by Easter. But there’s still vehement disagreement over the legislations’ substance.

Heritage’s Conn Carroll reacted to yesterday’s event, saying, “there is one huge difference between the Senate bill and what the President kept referring to as my/our proposal: the Senate bill actually exists. For all the talk in Washington about Democrats in the Senate using reconciliation to pass a final version of Obamacare, one key fact has been overlooked: no reconciliation bill exists. Not in the House. Not in the Senate. Nowhere. It simply has not yet been written, and there are plenty of reasons to believe it never will.”

The Washington Post’s Ezra Klein emphasized that this speech seemed different than Obama’s previous presidential statements: “What’s important about this speech is that it didn’t leave any paths open. It attacked the Republican bills, the arguments for piecemeal reform, and the idea that procedural impediments are sufficient to excuse the further delay of a verdict. This is the end of the line.”

Critical Condition’s Jeffrey Anderson says Obama’s claims about what his health plan will do are false, and argues “In reality, here are the three main things that Obamacare would change about the current health system:  One, it would reduce freedom. Two, it would raise costs. Three, it would ultimately reduce costs in the only way that a government-controlled system can: by rationing care.”

Cato’s Michael Cannon says Obama’s move to include health savings accounts in his new plan didn’t gain any Republican support, and “it may have cost him some Democratic support — or at least frayed the nerves of a few House Democrats.”

 Elsewhere, Brad Wright of Wright on Health hosts the newest edition of Health Wonk Review, a biweekly compendium of health policy blogging, where he charts the cyber chatter surrounding key developments feeding into the health reform dynamic — everything from the fracas surrounding insurance premium hikes to an analysis of the good and bad ideas that emerged at the president’s health summit.

The New Republic’s Jonathan Cohn looks at a new ad from a conservative group that urges Democrats to vote against a reform bill.  Cohn thinks the add is “a vivid illustration of why changing votes is such a bad idea. Just read that script again. But, this time, stop after the first paragraph. That’s the ad conservatives will run against these members even if they change their votes. And it’s still devastating.”

Wonk Room’s Igor Volsky fact-checks statements on abortion funding from Rep. Bart Stupak, who authored an amendment restricting funding of abortions in the health bills.  Volsky says: “Stupak is just shifting the goal posts. First he complained about taxpayer funding for abortion and once Democrats strengthened the Senate language, he began arguing that private funds will not go towards abortion coverage. He simply can’t have it both ways.”

And Slate’s Timothy Noah created a ‘Mix-Up’ of health care statements from President Obama and former Gov. Mitt Romney, R-Mass.


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Obama Interjects Again - Mar 03, 2010

President Barack Obama gave a speech this afternoon that some have deemed his “last, best chance to move forward.” But opponents of reform are not enthused with his effort to include a handful of GOP health care ideas.

Cato’s Michael Cannon, reacting to Obama’s insertion of some Republican ideas after last weeks’ summit, says, “Dropping a few Republican ideas into a government takeover of health care is like sterilizing the needle before a lethal injection: a nice thought, but the ultimate outcome is the same.”

Heritage’s Conn Carroll agrees with Cannon, writing: “Simply adjusting the magnitude of the existing proposals or adding so-called conservative provisions does not change this fundamental direction.”

Hot Air’s Ed Morrisey doesn’t think adding a few GOP ideas is good politics either: “This looks like yet another miscalculation, a gambit that will keep Congress tied up on ObamaCare well into the spring and perhaps the summer.”

Critical Condition’s Grace-Marie Turner says, “The president is expected to ask the Senate to twist its rules to force its health-overhaul legislation through a process designed exclusively for budget and spending-related issues. These are desperate, hard-ball political tactics.”

The Washington Post’s Ezra Klein interviews Senate Budget Committee Chairman Kent Conrad about that process, known as budget reconciliation. Conrad rejects Republican concerns that using reconciliation is a break from precendent and points to a number of Republican uses of the tactic.

Time’s Jay Newton-Small profiles Alan Frumin, the current Senate parlamentarian, and looks at how both parties have been prepping to get their way in a reconciliation debate.

Open Congress’ Donny Shaw compiled a list of provisions that were rejected under reconciliation in past years.

And the Huffington Post’s Ryan Grim reports that Ted Kaufman, D-Del., is the 34th senator to sign a letter in support of including a public option in a reconciliation bill.


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Talking Strategy - Mar 02, 2010

Bloggers are trying to keep up with rapidly shifting strategy options under consideration to pass a final health overhaul bill.

The Weekly Standard’s Matthew Continetti thinks Democrats are “making one of the biggest political gambles in American history. They’re betting that overhauling one-sixth of the American economy against the public’s wishes and by a partisan vote is going to pay off in the end. They have doubled down, and are hoping the house busts.”

The New Republic’s Jonathan Cohn details a Democratic memo that lays out a timeline for passing reform: “The gist is pretty simple: The House takes up the Senate bill and passed it by March 19. A few days later it passes a reconciliation bill and sends it over to the Senate, which starts the voting process on March 26.”   Cohn warns that schedules “remain in flux” and the GOP has  the option to offer endless amendments during a reconciliation process, even though the debate time is limited.

But The Huffington Post’s Sam Stein reports that there might be a way around endless votes: “Two experts in the arcane rules of the Senate said on Monday that, as president of the Senate, Biden has the capacity not just to overrule any ruling that the parliamentarian may make but also to cut off efforts by Republicans to offer unlimited amendments.”

Keith Hennessey lists seven challenges Democratic leaders would face by following a “two bill strategy,” including the sequence of votes (House or Senate first?) and a “voterama” where senators will have to vote up or down on proposed amendments.

Heritage’s Conn Carrol thinks a House passage is still up in the air, saying Speaker Pelsoi doesn’t currently have enough votes for reform, and “if you were watching the television yesterday it quickly became apparent that the leadership in the House has no idea how they are going to get them.”

Critical Condition’s Jim Capretta argues that Democrats can pass a smaller bill, despite talking points that stress the opposite.  Capretta continues, “Still, the very existence of the Obama team’s fallback plan should embolden those Democrats who are now resisting their leadership’s pressure to take up the full Obamacare package in coming weeks and pass it.

And The Washington Post’s Ezra Klein takes a thorough look at claims from Rep. Paul Ryan, R-Wisc., that the health care porposals won’t control rising health costs or reduce the deficit.  Klein says, “before we dive so deep into the weeds that we’re seeing earthworms, here’s the basic conclusion: Ryan’s critique scores some clean points and also deploys a couple of dirty tricks, but it doesn’t damage the bill’s claim to reduce deficits and doesn’t even engage whether the bill controls costs.”


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Health Summit Still Reverberating - Mar 01, 2010

Bloggers continue to analyze the health care summit, while others look at what’s next.

The Heritage Foundation compiled a “four-minute guide” video to last week’s summit.

The Daily Caller’s Jon Ward reports that “President Obama has taken a new line of attack against Republicans to neutralize their argument that his reforms would pose a government takeover of the health-care sector, arguing subtly that the GOP is committed more to the insurance industry than they are limited government.”

Hot Air’s Allah Pundit links to videos of Obama’s weekly address and the Republican response from Sen. Tom Coburn, R-Okla. They both spoke about the health care bills.

Health Beat’s Maggie Mahar looks at comments from a North Carolina college student about why she opposes the health reform bills and says, “These are the ‘philosophical differences’ that Obama acknowledged at the summit. I think it is important to recognize that not only Republican politicians but a fair number of our fellow citizens share this point of view.”

Time’s Karen Tumulty surveys a New York Times article looking at the vote count in the House and declares, “I think a major health care bill is more likely than not to pass. After what [Speaker Nancy Pelosi] managed to get her caucus to do last year, I would never, ever bet against the Speaker on a vote. And she is looking pretty determined on this one.”

The Washington Post’s Ezra Klein takes a look at budget reconciliation, including use in the past on health issues: “The Children’s Health Insurance Program was created in reconciliation, and so too was COBRA. The law stating that hospitals who take Medicare and Medicaid money have to see all patients who walk into their emergency room was also passed in reconciliation…”

Wonk Room’s Igor Volsky looks at  a proposal by Sen. John McCain, R-Ariz., to exclude Medicare from the budget reconciliation process and concludes, “But on the whole, this is really a cynical move (and highly unlikely, since any rule change would require 67 votes). Republicans have consistantly supported far larger cuts to the Medicare program than what Democrats are currently proposing and are always complaining that the Medicare “entitlement” program will bankrupt the nation.”

 And The Incidental Economist’s Austin Frakt posts an analysis and graph visualing over-payments to Medicare Advantage plans.


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Taking In The Summit - Feb 26, 2010

It was a long day of commentary for many health policy bloggers, who concluded that President Barack Obama signaled his intention to push forward with the current proposals, though who will score the most political points from the seven hour health care summit remains contentious.

The Washington Post’s Ezra Klein: “The big story out of the summit is not that Republicans and Democrats extended their hands in friendship, but that the White House has dug its heels into the dirt. The Democrats are not taking reconciliation off the table, they are not paring back the bill, and they are not extricating themselves from the issue. They think they’re right on this one, and they’re going to try and pass this bill.”

The New Republic’s Jonathan Cohn: “Yes, there was some common ground. But not a lot. And while Obama offered to accommodate the Republicans further on issues like malpractice reform, I didn’t hear the Republicans offering to reciprocate. Their mantra at the end seemed to be the same as it was at the start: Scrap the bill and start over… [Obama] believes, as he has long believed, that ‘baby steps’ won’t do.”

The American Spectator’s Philip Klein: “Despite 7 hours of talking, Thursday’s White House health care summit ultimately did nothing to change the dynamics of the debate. President Obama, at least for now, ruled out the idea of scrapping the current health care bill and taking ‘baby steps.’ And Republicans won’t be willing to sign on to the current health care bill with a few mere cosmetic add ons to create the illusion that Obama wants to integrate GOP ideas.”

Time’s Kate Pickert says, “Let no one question that President Obama is still hoping to push health care reform across the finish line – he stayed put and moderated the entire seven and a half hour bipartisan summit on the issue today.”

Critical Condition’s James Capretta: “The president is trying to make it seem like the only cuts in the Medicare program he is advocating are for Medicare Advantage (MA) plans. That’s demonstrably not true. The chief actuary has raised concerns about the payment-rate reductions that the Democrats are pushing for hospitals in the traditional program. He believes those cuts will harm access to care. That’s one of the points Rep. Paul Ryan made earlier.”

Wonk Room’s Igor Volsky: “This morning, Sen. John Cornyn (R-TX) refused to say what Republicans would be willing to ‘to give in return’ if Democrats accepted GOP proposals after the bipartisan health care summit. Cornyn insisted that the Democrats must scrap the current legislation and start from scratch if they hope to win bipartisan support.”

The New Health Dialogue’s Joanne Kenen says Republicans used almost identical talking points after the summit as before it began, and notes: “Senate Republican Leader Mitch McConnell urged the president to scrap the whole bill and predicted not a single Republican would vote for the bill. We’ll see what happens, but the ball, and the bill, may be back in the Democrats’ court.”

The Huffington Post rounded up a group of experts and commentators, including the National Women’s Health Network’s Amy Allina, who was one of few who mentioned statements on abortion: “I understand why the President didn’t want to spend the small amount of time they have left refuting all the misstatements that Boehner made. But unfortunately, the result is that the falsehoods were stated and the facts weren’t. And it’s also unfortunate that none of the prochoice members of Congress at the summit has found time to point out how damaging the abortion restrictions in the bill will be for the health of women and our families.”

Cato’s health care experts live-blogged the meeting.

The Heritage Foundation’s health experts provided reaction. Nina Owcharenko argued, “Simply adjusting the magnitude of these proposals or adding new ‘conservative’ provisions as suggested in the President’s latest proposal does not change their fundamental direction.”

The Daily Caller’s Jon Ward live-blogged the summit.

And TPM’s Josh Marshall looks at reported live streams, which were lower than the State of the Union, and notes, “But over the years I’ve gotten a pretty good feel for how different kinds of political events bump traffic on TPM. And there was a much bigger bump than I would have expected for an event like this.”


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Readying For The Summit - Feb 24, 2010

Commentary is accelerating as bloggers get ready for Thursday’s bipartisan health care summit.

Time’s Kate Pickert posts the list of expected attendees.

The Washington Post’s Ezra Klein looks toward tomorrow’s event and doesn’t forsee much Republican compromise, arguing, “Republicans got these substantive concessions [to the current health overhaul bills]  not by making a deal, but by not making a deal.”

The National Journal’s Marilyn Werber-Serafini queries her experts about Obama’s new health reform plan.  Responders came out in droves, including Michael Cannon, Paul Ginsburg, Robert Greenstein, Karen Ignagni, Darrell Kirch, Elizabeth McGlynn, Sally Pipes, John Sheils, Andy Stern, Janet Trautwein and Grace-Marie Turner.

James Capretta of the New Atlantis thinks public opinion is working against Democrats, and they seem not to care: “The White House and its allies have apparently made their choice. They are going to try to jam their bill through, despite overwhelming public opposition. This will have the entirely predictable result of triggering a backlash of epic proportions. Voters will be beyond irate at the arrogance of it all.”

Heritage’s Curtis Dubay says Obama’s plan represents “taxes, taxes everywhere” — and lists them.

John Goodman takes to the Health Affairs Blog to argue for selling health insurance across state lines, saying it would expand consumer protetctions.

And Economix’s Casey Mulligan asks if Americans are “overpaying Grandpa” and argues that the amount of subsidies seniors receive doesn’t reflect their often higher income levels.  He concludes, “The question for the future of Medicare is this: Are families ready to triple their spending on the health care of their highest-income members?”


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Can The House Pass It? - Feb 23, 2010

Many commentators are analyzing support in the House of Representatives after President Obama released his new health overhaul proposal yesterday.

The American Spectator’s Philip Klein performs some calculations to estimate the number of House votes Speaker Pelosi could lose in the House.  Klein thinks election pressure and the Senate bill’s abortion provisions could lead to more Democratic defectors, and regaining them won’t be easy: “Pelosi will have to make up for any votes she loses by picking off members among the 39 Democrats who already voted ‘no.’”

Hot Air’s Allah Pundit lays it out more starkly: “Stupak called Obama’s abortion language “unacceptable” this morning. Assuming he’s not bluffing about those 10 to 12 pro-life Dems, Pelosi now needs roughly a dozen more yeses while not losing a single moderate or progressive.”

The Washington Post’s Ezra Klein lists five reasons he’s worried about health reform passing, including: “The House and the Senate hate each other: And for health-care reform to pass, they’re going to have to trust each other, at least a little bit.”

But Wonk Room’s Igor Volsky found some optimism in words from House Majority Whip James Clyburn, who hinted yesterday that the bill has enough votes in the House, saying, “So I do believe there is more fertile soil today than there was when we first took this up.” 

Elsewhere, a few others have chimed in with their reaction to Obama’s new proposal.

Heritage’s Conn Carroll is disappointed: “The problem is, the plan the President released yesterday is not a ’start over’ … it is just a continuation and expansion of the same Washington-centric policies that the American people have clearly rejected over the past year. There still is a chance for Obama to save his presidency, but yesterday’s plan will not do it.”

Keith Hennessey offers a detailed analysis of the bill’s provisions and politics, and says, “Somebody in the Administration put a lot of work into this proposal.  It is extremely detailed, and it reads like a best effort to find a fair middle ground between two warring legislative bodies.  All that substantive work is subsumed by the apparent lack of strategic coordination and substantive agreement with Members of his own party.”

Health Beat Blog’s Maggie Mahar seems to approve of the proposal, but says, “I’m not going to bet how this will turn out. I’m just glad that the White House hasn’t given up.”

And Bob Laszewski says the plan is “not a game changer” and continues, “the President ought to say, ‘Deal.’ Then call on the Republicans to join he and the Democratic leadership in 60 days of intensive negotiations to get a bipartisan deal. That would really put the Republicans on the spot—and Democrats as well.”


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