Monthly Archives: September 2017

Tom Price’s Use Of Private Jets Wasn’t His Only Big Political Mistake

Tom Price resigned Friday, about 10 days after Politico first reported he had used private jets to travel as health and human services secretary, costing taxpayers more than $1 million.That includes his use of government planes too, which came to light after Politico’s first report.

“>1 Price likely jumped before he could be pushed, and I suspect Trump’s aides will argue that he would still be running HHS if not for the planes controversy.

That might be true. But the bigger story of Price’s tenure — and why Trump may have viewed him as expendable — was the GOP’s failure to repeal Obamacare. When Price was picked to run HHS by Trump, much of the coverage focused on his long time as a congressman on Capitol Hill and his expertise in health care from being an orthopedic surgeon, the kind of resume that could make him vital to getting some kind of repeal-and-replace bill passed. As The New York Times wrote on Nov. 28, after Trump’s transition team named Price as its pick to run HHS:

If President-elect Donald J. Trump wanted a Cabinet secretary who could help him dismantle and replace President Obama’s health care law, he could not have found anyone more prepared than Representative Tom Price, who has been studying how to accomplish that goal for more than six years.

Early in his tenure as HHS secretary, Price was deeply involved in talks with congressional Republicans on Obamacare repeal. But by early this week, when congressional Republicans again abandoned an Obamacare repeal effort, Price did not seem to be playing a major role in the process. It was driven by Senate Republicans, with White House aides like legislative director Mark Short touting the proposal publicly. If Price were more actively involved, it was kept under wraps.

And if you think Trump wouldn’t blame Price for the failure of Obamacare repeal, remember that the president said in a speech in late July, in a joking-not-joking kind of way, “He better get the votes. Otherwise I will say, ‘Tom, you’re fired.’”

A few days after that speech, an Obamacare repeal bill was voted down in the Senate, with three Republicans joining Democrats to block it.

Of course, Trump may have decided that this plane travel controversy was a firing offense even if Republicans had successfully repealed Obamacare. But Price had failed in his major task for the administration and then gotten himself into a scandal that both made the administration look bad and — unlike, say, the controversy over Trump’s aides use of personal email — was easy for the public to understand. That’s a bad combination.

Price’s resignation, moreover, isn’t the end of the story. There are two lingering questions.

First, does this mean all Cabinet members who took controversial flights will be subject to dismissal?

There are reports that several other Cabinet members have used private or military aircraft and billed taxpayers for trips that they could have taken at much lower costs on commercial airlines. Interior Secretary Ryan Zinke, for example, reportedly chartered a plane at taxpayer expense to take him to his Montana home after attending an event in Las Vegas in June. (Though it’s not clear other Cabinet members have used private planes on the taxpayer’s dime as much as Price did.)

There have been no previous indications that Trump is determined to run a super-ethical administration. So I think Price’s firing will be an exception. But Trump’s dismissal of Price has set a standard, so I will be curious if the president applies it to others.

Second, will Price’s replacement be as hell-bent on weakening Obamacare as Price was?

Price wasn’t able to get an Obamacare repeal through Congress. But the department he led, Health and Human Services, is in charge of implementing the Affordable Care Act, and under Price it was doing very little to support the law: reducing funding to encourage enrollment, cutting back the hours when people can enroll through and blasting the ACA whenever possible.

I suspect not implementing the ACA is a policy that comes from Trump — Price’s departure may not change much, and Price’s replacement will also be unlikely to take steps to help Obamacare. But that remains to be seen.

Trump’s Latest Travel Order Still Looks A Lot Like A Muslim Ban

Supporters of President Trump’s latest travel restrictions argue that they can no longer be described as a Muslim ban because North Korea and Venezuela have been added to the list of targeted countries. Critics, however, say that the impact of the new order will be essentially unchanged from the effects of the previous two. Our estimates, based on visas issued for U.S. travel last year, show that majority-Muslim countries would likely still be the most affected by the new travel rules.

We looked at visas granted last year to see how the new rules would have affected travelers from the eight countries named in the latest order — Chad, Iran, Libya, North Korea, Syria, Venezuela, Yemen and Somalia. We found that if these rules had been in place in 2016, they would have stopped more than 65,000 visas from being issued in seven of the eight countries named. About 90 percent of those visas were issued to visitors from Iran, Syria and Yemen — and that total does not include refugees, as it is not yet clear whether they will be affected. If the ban had been applied to North Korea last year, it would have affected just 61 visas.

The eighth country, whose affected visas were not included in our 65,000 total, is Venezuela. Because the directive leaves some room for interpretation in terms of how it will be implemented in that country, it is virtually impossible to know how many visas the Venezuela restrictions would affect. But the way the rules are written suggest that they will apply to a relatively narrow segment of the Venezuelan population, compared to the broader restrictions being applied to the other seven countries.We are looking at the 2016 numbers because that is the last set of data that is unaffected by any of Trump’s previous sets of travel restrictions. However, the number of visas issued for each country would likely vary from 2016 to 2017, both for reasons unrelated to the travel restrictions and because the rules would likely discourage people from applying for visas if they expected to be rejected.


The newest restrictions, announced by the White House on Sunday, still target mostly majority-Muslim countries, but they drop Sudan from the list and add Chad, Venezuela and North Korea. The latest directive also made the restrictions indefinite, rather than temporary, and distinguished between categories of visa holders in determining who would be excluded. The administration said in its announcement Sunday night that the countries included were found to lack adequate processes for ensuring that those entering the U.S. didn’t pose a security threat. We wanted to understand who would be affected by this versionThe new order will be issued in two phases. From now until Oct. 18, nationals of four of the eight affected countries (Iran, Libya, Syria, and Yemen) will be barred from travel to the U.S. unless they have a relationship with “close family” — including parents, spouses, siblings and grandparents — or a U.S. entity. For Somalia, only immigrant visas and diversity visas are subject to the relationship rule; nonimmigrant visas will be not be affected. Starting on Oct. 18, the ban will go into effect for all countries named in the directive, and relationship exemptions will no longer be available.

‘>2 — though the courts blocked the implementation of many aspects of his previous orders, and this one could face legal challenges as well.The Supreme Court on Monday scrapped a hearing on the old restrictions and asked lawyers to instead submit arguments on whether the whole issue is moot now that there’s a new policy.


We looked at State Department numbers on how many visas were granted during the 2016 fiscal year, before Trump took office and began issuing travel restrictions.The Department of State’s Bureau of Consular Affairs maintains public data on the number and types of visas issued by the U.S. to citizens of other countries. The 2016 fiscal year runs from Oct. 1, 2015, through Sept. 30, 2016.

“>4 The figures used in our analysis count visas, not people, but one person could theoretically be issued multiple visas in the same fiscal year.

Iran, Syria and Yemen, three majority-Muslim countries that have been targeted in all versions of Trump’s travel restrictions, would have been hit hardest by the new restrictions had they been in effect in 2016. Somalia and Libya, also majority-Muslim countries and the other two nations included in both previous versions of the travel restrictions, would have had a few thousand visas blocked. Of the three new countries added to the list in this round, we were only able to confirm that one — Chad, the other Muslim-majority country — would have had more than a few hundred visas affected. While the new rules block nearly all visas from North Korea (diplomatic visas are the exception), the U.S. doesn’t receive many visitors from that country, so only 61 would actually have been rejected in 2016.

Venezuela, however, is a special case. Our data doesn’t show how many people the restrictions might have affected last year because the new rules don’t apply just to certain classes of visas, like they do for other countries, but also to a certain class of people, in this case officials in a handful of government agencies, plus members of their immediate families.According to the proclamation, the ban applies to “officials of government agencies of Venezuela involved in screening and vetting procedures — including the Ministry of the Popular Power for Interior, Justice and Peace; the Administrative Service of Identification, Migration and Immigration; the Scientific, Penal and Criminal Investigation Service Corps; the Bolivarian National Intelligence Service; and the Ministry of the Popular Power for Foreign Relations — and their immediate family members.”

“>5 Officials and their family members would only be turned down for tourist visas, not for a separate class of visa reserved for government agents traveling on state business. The State Department data breaks down visas issued by type, but it does not keep statistics on things like how many government officials requested tourist visas. A spokesperson for the State Department’s Bureau of Consular Affairs said the agency is unable to predict how many affected people would apply for visas.

Asked to estimate how many Venezuelans might fall into the category of people whose travel to the U.S. would be restricted, Dany Bahar, a Venezuelan economist with the Brookings Institution, said, “I haven’t seen such numbers, probably given the ban is written in such lousy terms. In theory it applies to all government officials and their family members. It’s not clear if it is only high-ranking officials or every government employee. If the latter, it could be tens of thousands, if not more.”

In a country of over 31 million residents, even tens of thousands of people is a relatively narrow slice of the overall population. In all seven other countries named in the latest round of travel restrictions, any citizen who applied for certain types of visas would be rejected.

Number of U.S. visas granted by category in 2016

Red indicates groups facing travel restrictions under the new rules

Iran 32,278 7,727 23,678 4,368 485 873 87%
Yemen 16,931 12,998 3,933 914 222 134 93
Syria 11,584 2,633 7,980 478 145 493 99
Somalia 1,797 1,797 233 66 88 64 80
Libya 1,828 383 1,445 417 320 125 68
Chad 940 40 900 122 323 10 67
North Korea 61 9 52 0 48 0 56
Venezuela 2,471 145,331** 4,791 563 5,676

* Diplomatic, NATO, UN, and other government visas are exempted from the nonimmigrant visa restrictions.
** The ban for Venezuela only applies to tourist visas for government officials in certain agencies, plus members of their immediate families. It’s unclear how many visas were issued to those groups.

Source: Department of State

The restrictions applied to each nation vary by visa type:

How the new travel ban affects each country

Restrictions on types of visas to the U.S.

Somalia All barred Not affected
Syria All barred All barred
N. Korea All barred All barred
Iran All barred All barred except student visas
Yemen All barred Tourist visas barred
Libya All barred Tourist visas barred
Chad All barred Tourist visas barred
Venezuela Not affected No tourist visas for officials from at least five government agencies, plus members of their immediate families

*Diplomatic visas are exempt from these restrictions.

Source: Department of State

Visas are broadly divided into “immigrant” and “nonimmigrant” categories, depending on whether a person is planning to move to the U.S. or simply visit. Many immigrant visas are issued based on the applicant’s family connections in the U.S., while others are allocated on the basis of employment. Another prominent subclass of immigrant visa is the diversity visa; those are given out via a lottery system to people from countries with historically low rates of immigration to the U.S.

Trump’s new rules ban immigrant visas from every targeted country except Venezuela. For nonimmigrant visas — which are issued to visitors for temporary travel to the U.S. for tourism, business or study — only North Korea and Syria face a complete ban. In 2016, about 11,500 travel visas from Syria would have been affected, but only 61 from North Korea would have been.

This new set of rules, like its predecessors, is likely to go through court challenges that may prevent the enforcement of some or all of its provisions. But until that happens, and assuming 2016 is a good indicator of travel flow, the ban as it currently stands is likely to affect lots of people — and most of them will still be from predominantly Muslim countries.

Tax Policy Should Be Easier For Republicans. But Nothing Has Been Easy.

Making changes to American tax policy has the potential to be the big achievement of 2017 for President Trump and Republicans in Congress.

In theory, tax reform could be much easier to accomplish than reforming health care: The Republicans could put forward a tax plan (as the party has successfully passed in the past) that cuts taxes for tens of millions of people across economic brackets and ignores whatever implications that might have for the deficit. That might get some level of pushback from budget hawks, but unlike the Obamacare repeal effort, it would have no obvious mass constituency of angry people worried that something was going to be taken away from them. And Republicans tend to be in more agreement among themselves on tax policy (lower is better), which could defuse some of the internal divisions that made health care so difficult for them.

But nothing has been easy for Trump and the Republicans in Congress this year. And the early signs are that the Republicans running Washington, who debuted an outline of their tax policy Wednesday, are taking many of the same steps that plagued their health care efforts.

1. Cutting a lot of taxes on the very wealthy while cutting some benefits for people less rich

Many of the early versions of the GOP’s Obamacare repeal bills included rollbacks of taxes put in the original Affordable Care Act, almost all targeting the most wealthy Americans. The result was headlines saying Republicans were cutting Medicaid while at the same time reducing taxes for the rich.

The new GOP tax plan, while including income tax cuts for millions of middle-class Americans, also calls for cutting estate taxes (which primarily affect those with significant wealth to pass on), reducing the top individual tax rate from just under 40 percent to 35 percent and cutting the rate for certain kinds of smaller businesses.

I don’t think a broad-based tax cut that also benefits wealthy taxpayers is a huge political problem. But Republicans are floating the idea of finding ways to increase taxes, too, in order to reduce the amount that this proposal raises the budget deficit.

The idea that party leaders seem to have have landed on — even though it was not part of Wednesday’s outline — is cutting some federal tax deductions, particularly the cost of state and local income taxes. This provision is likely to raise the taxes of upper-middle-class people (it would also hit the very rich, but not only them) in high-tax states like California and New York. (It’s not yet clear if other parts of Trump’s tax proposal would ensure that people affected by the elimination of this deduction still come out paying fewer taxes because the increase was offset by other cuts.)

Sure, those are blue states. But Republicans are risking the problem of a family making $200,000 facing a tax increase (or getting a pretty small tax cut) because it can no longer deduct local taxes, while people who make $4 million get a huge windfall on balance.

2. Relying on a slim majority

Trump has been meeting with some Democrats on tax policy. But the people who have been writing the tax legislation behind the scenes so far are an all-GOP group, and there is little sign that Democratic ideas are being considered.

Senate Majority Leader Mitch McConnell has publicly suggested that Republicans would seek to move taxes through Congress using the so-called reconciliation budget rules, which would require only 50 votes in the Senate (plus the tie-breaking vote from Vice President Mike Pence) and therefore no Democratic support. But the party holds the Senate majority by such a narrow margin that even the reconciliation process requires nearly every GOP senator (50 of 52) to sign on.

It’s not yet clear who might emerge in the Senate as a roadblock on taxes. I will be closely watching Tennessee’s Bob Corker and Arizona’s John McCain, members who have expressed concerns about the growing deficit and national debt before and are in some ways freed from bowing to the demands of Trump or Republican leaders in Congress. (Corker just announced he’s not running for re-election, and McCain’s brain cancer diagnosis means he is unlikely to seek another term.) McCain actually voted against George W. Bush’s major tax cut bill in 2001, one of only two Republican senators to do so.

In the House, the Freedom Caucus, could demand that GOP leaders enact the largest possible tax cut without regard to the deficit. Such a move would put the caucus in direct tension with more deficit-conscious members.

3. Cutting out the Democrats

There are also the bad political optics — though they shouldn’t be overstated, as both parties have used the reconciliation method for passing major legislation before. More fundamentally, though, the Republican-only focus seems a tactical mistake. Trump does not seem particularly grounded in Republican orthodoxy on tax policy (or really any policy). He could probably reach an agreement with some Democrats on taxes.

I would argue that a broadly popular tax cut focused on the middle class would be hard for some Democratic senators to oppose, particularly those in red states and up for re-election in 2018, like Missouri’s Claire McCaskill and West Virginia’s Joe Manchin.

A tax cut supported by at least some Democrats in the Senate would both have the imprimatur of bipartisanship and also shift the policy left in a way that Trump might like, even if more conservative Republicans in Congress did not. And Trump has shown that he’s willing to cut a deal across the aisle even if his own party stalwarts don’t like it.

4. Saying one thing while doing another

Republicans and the administration spent months writing bills that reduced Medicaid spending and loosened regulations, like the requirement under Obamacare not to charge people more for coverage if they have pre-existing conditions. These provisions were not surprising, and they reflected conservative views on health insurance policy. But perhaps because of Trump’s promises that all Americans would get coverage that was better than Obamacare, Republicans throughout the Obamacare repeal process insisted that they were not actually cutting Medicaid or loosening rules on insurance policies.

On taxes, Republican orthodoxy calls for making cuts — on corporations, small businesses, estates, people of all income brackets — as reflected in Wednesday’s tax plan outline. That combination of policies will tend to tilt tax cut benefits toward the wealthy, since low-income people aren’t usually paying as much in federal income taxes. But Trump in particular seems determined to sell this tax policy as one benefiting the middle class and not the rich.

Miscasting the plan on offer was politically problematic during the health care process. It effectively forced Republicans to criticize the nonpartisan Congressional Budget Office as it repeatedly released analyses of the repeal proposals contradicting GOP rhetoric. That phenomenon led to the unusual viral spectacle of comedian Jimmy Kimmel accusing the author of one of the Obamacare repeal bills of lying to him about the legislation.

5. Setting unrealistic timelines

Remember how Obamacare repeal would pass Congress in early January and be signed by Trump on his first day in office? Now, Trump aides reportedly think that tax reform can be passed by the House by the end of October, and the president’s legislative director publicly suggested that Trump would sign this provision into law by the end of the year.

The idea that America’s tax policy will be overhauled in two months seems very optimistic — a kind of time pressure that was not overly helpful to Republicans in the health care process.

None of this is to say that Republicans can’t pass some kind of major tax overhaul in the next few months or early next year. Tax reform has the potential to be simply a party-line issue, like the Supreme Court nomination of Neil Gorsuch, where Democratic opposition didn’t transform the vote into a huge national controversy. And I don’t expect the left to be as organized in opposing a bill largely made up of tax cuts, rather than one that takes away billions of dollars from Medicaid while gutting one of President Obama’s signature achievements.

That said, the start to tax reform seems awfully similar to the start of Obamacare repeal.

The Republican Establishment And The Terrible, No Good, Very Bad Day

Senate Majority Leader Mitch McConnell and the Republican establishment had a terrible day on Tuesday. First, Senate Republicans’ latest effort to repeal and replace the Affordable Care Act was shelved. Then Republican Sen. Bob Corker of Tennessee announced he wouldn’t run for reelection in 2018. And finally, on Tuesday night, ex-Alabama Supreme Court Chief Justice Roy Moore defeated McConnell-endorsed Sen. Luther Strange in Alabama’s Republican Senate runoff.

None of these outcomes were particularly surprising, yet all three point in the same direction: The GOP establishment finds itself in a particularly uncertain moment — in control of all of government but unable to get anything done or control the forces that helped elect President Trump.

While it’s true that Trump also endorsed Strange, it’s best to see the race as a referendum on McConnell and the establishment in general. Moore made an issue of Strange’s appointment to the seat by then Gov. Robert Bentley, who had to resign his seat after a sex scandal. Moore argued that McConnell needed to be displaced as majority leader and that Trump was disconnected from the base that elected him. Voters indicated that McConnell’s backing made them less likely to cast a ballot for Strange.

Trump, who has had several run-ins with McConnell, is still well liked by Republican voters. National polls show his approval rating with Republicans at around 80 percent. Polls of Alabama Republicans showed something similar. Despite Trump’s endorsement, Strange was defeated. Why?

Moore won, in large part, because he was the more Trumpian candidate in this race. Like Trump, Moore has a history of taking on the establishment. He ran against an incumbent Republican governor in 2006. Moore also has a history of making controversial and racially tinged statements, and was backed by a number of the most pro-Trump elements of the Republican Party, including Steve Bannon and Sarah Palin.

A last-minute campaign stop by Trump in Alabama on Friday provided some hope for Strange — perhaps Trump’s personal touch could move the race in Strange’s direction. But if anything, it seemed to move voters in Moore’s direction. Some voters may have felt that Trump gave them permission to pull the lever for Strange when he said he may have “made a mistake” in endorsing the senator. Polls showed that despite Trump backing his opponent, Moore generally polled best among those who approved most of Trump.

Strange’s defeat and Corker’s departure earlier in the day were just the latest sign that more mainstream conservatives have a problem among Republican voters. Of course, Trump won the GOP nomination last year despite resistance from many elected Republicans. But even before that, a number of high-profile Republicans were either defeated in primaries, such as former House Majority Leader Eric Cantor, or came close to being defeated, such as Corker’s colleague from Tennessee, Sen. Lamar Alexander. Polls showed that Corker himself might have run into trouble in a 2018 primary. Trump had called out Corker on Twitter, and Trump-friendly voters may have taken him out as they did Strange on Tuesday. It could be really bad for McConnell and Senate Republicans if other Republican senators see what happened to Strange and it starts a wave of retirements.

The question now for Alabama, though, is whether the pro-Trump forces that still represent a majority among Republicans represent a majority among voters at-large. Moore is the Republican nominee, but he still needs to win the general election against Democrat and former U.S. Attorney Doug Jones in December. Alabama is, of course, a very red state. Trump won it by 28 percentage points against Hillary Clinton in 2016, and no Democrat has won a Senate race in the state since 1992.

Still, Democrats are probably hoping that Moore’s candidacy gives Jones a chance. They can point to polling that has, at times, found Moore with only a single-digit lead over Jones. Additionally, Moore won his last statewide election in 2012 for the state supreme court by less than 4 percentage points, even as Republican Mitt Romney was winning over Democrat Barack Obama by over 20 points. Don’t be surprised if Jones receives a fundraising boost from Democrats nationwide looking to beat Trump, and expect some Democrats with potential presidential aspirations, like Joe Biden, to campaign for Jones in the fall.

But let’s not mince words: Alabama is solid GOP territory. Moore’s victory on Tuesday puts him on the verge of winning a U.S. Senate seat. Not bad for a guy who got defeated in two previous Republican primaries for governor. Moore’s win, along with the defeat of Graham-Cassidy and Corker’s retirement, just shows how weak the Republican establishment is right now.

Politics Podcast: Trump vs. The NFL



Over the weekend, President Trump repeatedly targeted the NFL, calling on owners to fire or suspend players for protesting during the national anthem and telling his supporters to boycott the league. The FiveThirtyEight Politics podcast crew assesses the motivations and repercussions for Trump, after owners and players alike responded negatively. FiveThirtyEight’s Kyle Wagner also joins the podcast to talk about the the ongoing NFL protests and the history of protests in sports. Plus, Clare Malone shares a rundown of potential wild card Senate races to look forward to in 2018.

You can listen to the episode by clicking the “play” button above or by downloading it in iTunes, the ESPN App or your favorite podcast platform. If you are new to podcasts, learn how to listen.

The FiveThirtyEight Politics podcast publishes Monday evenings, with occasional special episodes throughout the week. Help new listeners discover the show by leaving us a rating and review on iTunes. Have a comment, question or suggestion for “good polling vs. bad polling”? Get in touch by email, on Twitter or in the comments.

The War Over Obamacare May Never End

The latest version of Obamacare repeal seems dead or on life support, with Arizona Sen. John McCain declaring on Friday that he will not support the Graham-Cassidy legislation. Maine’s Susan Collins, Alaska’s Lisa Murkowski and Kentucky’s Rand Paul are also leaning against voting for the bill, which would put the Republicans two votes shy of passage, so it’s not clear whether Graham-Cassidy will even be taken up for a vote next week.

But I don’t think the Obamacare wars are over — or even close to over. We tend to think there are only two possible futures for the Affordable Care Act: It remains in place or Republicans in Congress repeal it. But there are really four paths:

  1. Repeal and replace succeeds. Republicans in Congress find a way to repeal or partially repeal Obamacare. Sen. Orrin Hatch of Utah has already floated the idea of adopting a reconciliation bill for 2018 that includes tax reform and an Obamacare repeal. This would allow Republicans to attempt to accomplish both major GOP goals using a single bill that would require only 50 votes to pass. It would be hard to pull off, but the fac that Hatch is floating the idea suggests that Republicans may not give up trying to pass an Obamacare repeal with 50 votes, even if they can’t use the 2017 reconciliation process, which expires after Sept 30.
  2. Executive branch undermines Obamacare. President Trump’s administration could do a number of things — such as cutting the advertising budget for the Obamacare marketplaces (which has already happened) or refusing to pay insurers for cost-sharing subsidies (which Trump has not yet done) — that don’t outright repeal the law, but that severely weaken its effect and over four years might add up to a partial repeal.
  3. Bipartisanship. A bipartisan congressional effort to fix the law — along the lines of the bill Republican Sen. Lamar Alexander of Tennessee and Democratic Sen. Patty Murray of Washington were working on until GOP leaders decided this week to focus on Graham-Cassidy — could still gain traction.
  4. Trump implements Obamacare. In this scenario, the Trump administration and Republican governors decide to give up on repeal and instead implement Obamacare. This would mean Trump’s team would need to encourage insurers to remain in the program and some of the 19 states that have not yet expanded Medicaid under Obamacare, nearly all of which are led by Republicans, would likely opt to do so.

Congressional Republicans and the Trump administration, in trying to pass an Obamacare repeal for much of the year, have essentially been vacillating between these four approaches. The White House has taken steps, like paying out the cost-sharing subsidies owed to insurers under the law, that move in the direction of approach No 4. But cutting the Obamacare ad funding is more like No. 2, a kind of Obamacare sabotage. And the Trump administration didn’t formally oppose Alexander’s bipartisan approach until this week, when it seemed like Graham-Cassidy could pass.

It’s hard to say which path Republicans will take, even next week. And this is not because party leaders are stupid or confused about their goals, but because each of these paths is fraught for Republicans.

Repeal and replace succeeds: It’s not an accident that Republicans keep coming up a handful of votes short. The party’s ideology keeps pushing it toward approaches that would cut Medicaid and leave millions more people uninsured. But those ideas are unpopular with the public, and the Obamacare provision that ensures people with pre-existing conditions can get affordable coverage has become a kind of political red line that can’t be crossed,

So Republicans keep trying to advance bills that cut Obamacare’s regulations, rules and costs without leaving more people uninsured or pricing out people with pre-existing conditions. These bills annoy more moderate GOP members (Collins) and also more conservative members (the House Freedom Caucus and Paul) by trying to split the difference between divergent views of health care. The goals (keep the good parts of Obamacare while repealing Obamacare) also fall apart under scrutiny from policy analysts like the Congressional Budget Office, creating some incentive for rushed, opaque processes that annoy more institutionalist Republicans (McCain, Murkowski).

Obviously, this option goes away if Democrats win control of the House or Senate in 2018 or if Republicans no longer occupy the Oval Office.

Executive branch undermines Obamacare: Millions of Americans are already buying insurance through Obamacare exchanges or living in states that have expanded Medicaid. Cutting off the advertising budget for Obamacare is most likely to affect potential beneficiaries of the law, that is, people who have not yet signed up. So I would argue Trump is on safer political ground there.

But any steps that take health care away from people who already have it are more politically complicated. Arkansas, West Virginia and Kentucky all expanded Medicaid under Democratic governors but now have GOP chief executives. All those states could withdraw themselves from the Medicaid expansion. None of them have, because those governors know such a move would be politically perilous.

If Trump’s team used the executive branch to take steps that would gut protections for people already getting coverage through Obamacare, they would face similar political challenges.

Bipartisanship: Even if Senate Republicans drop their Obamacare repeal effort and never come back to it again, I’m skeptical that a bipartisan Obamacare “fix” can pass Congress. Republican members of the House and Senate have spent almost a decade attacking this law. They have told party activists it is terrible. Key groups within the party, like Americans for Prosperity, are deeply committed to ending Obamacare. Would House Speaker Paul Ryan want to bring some kind of “Obamacare stabilization” legislation to the floor and watch it pass even as the majority of Republican House members vote against it? I doubt it.

Trump implements Obamacare: To me, this is the easiest path — or at least the one with the fewest land mines. Team Trump would ratchet down the Obamacare wars, stop criticizing the law and take some steps to implement the ACA, but in a conservative way. (This might include measures like having the 19 states that have not currently expanded Medicaid opt in to the expanded program, but require recipients to have jobs or be in college or a training program, plus pay some small premiums.) Some of Trump’s remarks about Obamacare (he seems open to signing a bill that doesn’t really repeal the law as long as he can claim he fixed it) suggest that the president would not be opposed to such a path. And if he can flip-flop on DACA even though it involves one of his signature issues (tough immigration policies), surely he can flip on health care. Trump could then say that he fixed American health care.

Related: Politics Podcast

Emergency Politics Podcast: McCain Is A No On Graham-Cassidy

But Trump’s Health and Human Services Department is run by Tom Price, who has been a consistent and fervent opponent of Obamacare. I doubt Price would favor such an approach. In fact, I think Trump’s HHS staff would slow-walk a pro-Obamacare strategy (think of how Trump’s national security staff seems to be trying to stop him from withdrawing the U.S. from the Iran nuclear deal) if the president called for one.

The news of this week suggests that Republicans won’t pass an Obamacare repeal by Sept. 30, although that could change if Collins, Murkowski or Paul suddenly switch positions. But Republicans, I would argue, only have hard choices on Obamacare. And that’s why the last seven months in Washington have felt like Groundhog Day.

Dick Vermeil Retired A Decade Ago. Will You Please Stop Using His Damn 2-Point Conversion Chart?

Before the Super Bowl in February, we published a fairly comprehensive guide for when to go for 2, simplified into one slightly complicated (but very easy to use once you get the hang of it!) chart. In addition to hopefully demystifying how to judge a lot of borderline situations, we identified some fairly clear-cut cases in which NFL coaches should choose to go for 2 but don’t. Ever.

My hope, of course, was that teams would read this (or figure it out on their own) and that we’d see an immediate and cataclysmic shift in 2-point strategy — like going for it when down 4, 8, or 11 after scoring a touchdown late (which are not only real cases, but ones that are usually clear-cut and significant). But, alas, no such luck.

The logic is pretty simple: If you can estimate your team’s chances of winning with an X point lead/deficit (X points being how many points you are up or down following a touchdown) and your chances of winning with X+1 and X+2, the decision follows from simple arithmetic. In fact, given that 2-point attempts and extra-point attempts taken from the 15-yard line (under the new rules implemented in 2015) now have roughly the same expected point value (both around 0.95 points), the choice is easier than ever. Simply calculate (or estimate):

  • The improvement in win percentage if your point margin changed from X to X+1.
  • The improvement in win percentage if your point margin changed from X+1 to X+2.

If the first number is greater, kick the extra point. If the second is, go for 2.

Now, you can estimate or intuit these differences on your own on the fly, or you can use a fancy win probability model like we have,Specifically, a version of the model built by Brian Burke of ESPN’s Stats & Information Group.

“>1 but the logic is the same.

Of course, we’ve taken it a bit further — our chart uses multiple sets of assumptions to create a range for each scenario covering teams that are relatively better or worse at 2-point conversions than our baseline. In case you missed it, here’s the chart:You should be able to use this chart to pretty accurately assess most decisions you see. If you’re skeptical of the chart, you could intuit your own using the method outlined in that article.


A quick note on reading this chart: It may look a little “loud,” but that’s a feature for looking up scenarios lightning-fast. For a quick approximation, you first look at the minichart corresponding to the point spread (after the touchdown). If the quarter you’re in is shaded bright purple, you probably want to kick; if it’s bright orange, you should probably go for it. If you’re in a rush, you could stop there and be in pretty decent shape.

Through the first two weeks of this NFL season, teams have gone for 2 (from the 2-yard line) eight times overall. More importantly, of the 30 times that the numbers say they should have gone for 2, they did so just four times, for a rate of 13 percent. Since 2015, in the regular season and playoffs, teams that should have gone for 2 have done so around 15 percent of the time.

Now, of course it’s possible that some teams are better or worse at going for 2 than average, but it isn’t possible that 85 percent of teams are worse than average. I’ve also calculated how often teams should “clearly” go for 2 — meaning situations in which they should go for it even if they are relatively quite bad at 2-point attemptsI set this threshold at a 40 percent expected conversion rate (the same as the bottom of the range lines in the chart above). Or 7.5 percentage points lower than the baseline conversion rate assumption of 47.5 percent. This is a rough best estimate (after discussion with Burke, among others) for how bad teams who are very bad at 2-point conversions actually are).

“>3 — and there have been 16 such cases through Week 2:For this season’s scenarios, I’ve analyzed each attempt individually (down to the second), while the chart above is calculated minute by minute, so there may be slight variations between the two.


Times when teams clearly should have gone for 2

2017 NFL season through Week 2

1 Cleveland Pittsburgh 4 3:36 -5 2.23
1 L.A. Chargers Denver 4 7:00 -4 1.62
1 Chicago Atlanta 4 7:26 -4 1.33
1 Detroit Arizona 3 3:07 -2 1.28
2 Arizona Indianapolis 4 7:38 -4 1.28
1 N.Y. Jets Buffalo 3 2:00 -2 1.24
1 Detroit Arizona 4 9:27 4 0.43
1 L.A. Chargers Denver 4 8:10 -11 0.43
1 Jacksonville Houston 2 0:49 18 0.29
1 Baltimore Cincinnati 2 1:28 16 0.29
1 Houston Jacksonville 3 9:09 -13 0.24
2 Cleveland Baltimore 2 4:56 -8 0.24
2 New Orleans New England 4 5:04 -17 0.10
2 Tennessee Jacksonville 3 2:49 19 0.05
2 Dallas Denver 4 14:24 -19 0.05
2 Philadelphia Kansas City 4 0:08 -8 0.05

Magnitude is the amount that a team’s expected win percentage is improved by making the right decision.

Source: ESPN Stats & Information Group.

Teams made the correct decision in four of those 16 cases, for a 25 percent rate. (For comparison: Since 2015, regular season and playoffs combined, teams have gone for 2 points 27 percent of the time in “clear go” scenarios.)

Of course, a decision being clear-cut doesn’t mean that it matters a whole lot, but note that even among the decisions with the most significant consequences, teams are still making the wrong choices regularly (most likely because of adherence to Dick Vermeil’s rigid and outdated system that leads them to repeat the same mistakes over and over). In particular, the aforementioned scenarios of being down 4, 8, or 11 points late are both quite clear and quite important.

Another significant case is when a team scores to pull within 2: Go for 2! This may seem like an obvious one, but since 2015, teams in this situation have chosen to kick the extra point as late as the fourth quarter (once, which is way too many times), and they’ve done so half the time in the third quarter (6 of 12, and still very bad) and 77 percent of the time in the second quarter (10 of 13, and still pretty bad, especially for such an early decision).

This season, teams down 4, 8 or 11 late are holding steady at a 0 percent correct rate, having attempted extra points five out of five times when they “clearly” should have gone for it. That means that over the past three season, they’ve gotten these right exactly zero times in 105 chances.

On a slightly brighter note, teams have been down 2 points after a touchdown twice this season — both in the third quarter — and they’ve correctly tried to tie the game both times! It’s not quite the revolution — it isn’t really even shots fired. But maybe, just maybe …

The New Health Care Bill Is Not So Great For States That Like Obamacare

Senate Republicans championing a final effort to pass a bill to repeal and replace parts of the Affordable Care Act are selling it as a way to offer more flexibility to states. But while it would provide new possibilities for states that have largely rejected the ACA, the states that have embraced the law would be stuck designing a new health system with far less money.

The law would upend the way the federal government currently helps pay for health insurance — covering some of the cost of commercial insurance for some groups and funding Medicaid for others — and give states more open-ended dollars. To get the funds, governors would be forced to take on the political third rail of drafting, passing and enacting health insurance legislation that would change coverage for millions of people. And they would have just two years to do it.

The latest GOP legislation, known as Graham-Cassidy for Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, is expected to be brought up for a vote in the Senate next week. It includes several provisions found in previous bills that failed to make it through the Senate this year: It would end many of the rules and regulations of the Affordable Care Act that are very unpopular, including the mandate that most individuals have insurance or pay a fine, as well as the requirement that most businesses offer insurance to their employees. It would also allow states to waive the rules requiring insurers to sell comprehensive coverage and requiring them to provide the same coverage to people with pre-existing conditions as people with fewer health problems. This gives states that have been unhappy with the Affordable Care Act’s regulations more leeway in structuring health insurance coverage.

But the Graham-Cassidy bill would also end the expansion of Medicaid, the health insurance program for people with low incomes, essentially reverting eligibility limits back to what they were before the ACA. The bill would also cap federal spending on those parts of the program that existed before the Affordable Care Act. It would additionally get rid of the subsidies that help low-income people who don’t get insurance from an employer buy coverage and prevent federal money from going to Planned Parenthood for a year. States that want to keep helping the people these programs cover would have to come up with new ways to do so.

That’s largely because the bill departs from previous Republican legislation on the ACA by providing a new block grant, or lump sum, of federal money to states with far fewer strings attached. Governors wouldn’t have to use it to help cover the same people, but they’d have to create new programs if they wanted to spend it.

In essence, the Graham-Cassidy bill would work like this:

The Affordable Care Act made three main pots of money available to states.There’s a fourth funding stream for basic health plans, state-administered insurance programs for people earning up to 200 percent of the federal poverty line that are used in Minnesota and New York.

‘>1 One expanded Medicaid,The law opened up the program to more people in all states, but a Supreme Court case left it up to states whether to expand the program. Nineteen states chose not to do so.

‘>2 opening up federal dollars for states to cover more people (everyone earning below 138 percent of the federal poverty line, about $16,600 in 2017). Another pot brings down the cost of insurance premiums for people earning between 100 percent and 400 percent of the federal poverty line who don’t get insurance from their employer. The third brings down the cost of things like copays and deductibles for a subset of those people.Called cost-sharing subsidies, they are available to people who earn between 100 percent and 250 percent of the federal poverty line and buy insurance on the ACA marketplaces.


All of those funds target low-income people, who have historically been much less likely to have health insurance coverage.

Graham-Cassidy would take those pots of money, pool them together and then redistribute some reduced amount of the total to states as a lump sum. The formula for how much money states would get is complicated, but by 2026, it would largely be based on what share of the lowest-income people in the country live in a given state, with some additional adjustments. But unlike with the ACA, the money wouldn’t have to go to those with the lowest incomes.

In many cases, states that did not expand Medicaid would end up with more money than they currently get, and states that did expand the program would get less. Since states’ decisions to expand Medicaid largely fell along party lines, that means more money for many Republican-leaning states and less money for many Democrat-leaning states.

But in some cases, it also means less money for some of the states with the most successful Obamacare marketplaces, where many people who don’t get insurance from an employer can buy subsidized health insurance, regardless of whether they expanded Medicaid. Florida is perhaps the most extreme example — although state politicians chose not to expand Medicaid and the governor has been vehemently opposed to the law since it passed, the state’s insurance marketplaces have thrived. Florida has had among the highest rates of enrollment among eligible individuals of any state and experienced smaller rate increases than many other states. Yet the state would likely lose federal funding under Graham-Cassidy, according to an analysis from the left-leaning think tank the Center on Budget and Policy Priorities (others, including conservative-leaning health policy consultant Robert Laszewski, have said they believe these are good ballpark figures).

And it’s impossible to say how states would use the funding they do get. The law has few requirements on how the funds would be spent at the same time that it effectively ends Medicaid expansion and the insurance marketplaces, which require the subsidies and regulations to run as designed. The Congressional Budget Office, which provides analyses of bills for Congress, has said that it will provide some preliminary estimates of the bill’s overall costs next week but that the analysis it normally does on how many people will have insurance coverage and how much that coverage will cost won’t be available “for at least several weeks.”

What might those state-run systems look like? At least one Republican has suggested that the bill could lead to some states employing a single-payer system, under which the state would essentially be in charge of paying for all health care (though not delivering it). But that’s unlikely. The ACA already allows states to establish single-payer systems, but none has applied to do so. Part of the reason is cost; they’re expensive to run, as Vermont found out when it attempted to enact one. The states that have floated single-payer bills in the past, such as Hawaii, New York and California, would be among those most likely to see cuts in their federal funding under the Graham-Cassidy bill. (Sen. John Kennedy of Lousiana has also reportedly proposed an amendment to the bill to forbid using the money for a single-payer system.)

Similarly, with fewer funds, states would be hard-pressed to continue with the structure created by the Affordable Care Act — particularly the ones that might be the most inclined to do so.

Take California, for example. The state has touted its success under the ACA, noting that just 3.6 percent of the population is currently uninsured (if undocumented immigrants, who don’t qualify for most of the provisions of the ACA, are excluded). But in 2026, the state would receive $27.8 billion less than it would under current law, according to the CBPP analysis. California would have to not only make up for that funding shortfall but also design and set up a new program to cover those who currently qualify for Medi-Cal, the state’s Medicaid program, under the expansion. And California, which is one of 12 states that runs its own health insurance marketplace and therefore already has its own infrastructure in place, has a leg up on many other states that would have to build out that platform in order to keep it going.

Additionally, Congress would have to renew the funding in Graham-Cassidy for it to continue past 2026. The possibility that money for new programs could disappear so quickly could makes states wary of creating them.

But to get the funding, states would have to come up with some sort of system to distribute it by the time the block grants go into effect in 2020. That puts legislators in all 50 states debating the contours of a state insurance program in the run-up to the next presidential election, likely making it an even more difficult task. The Graham-Cassidy bill might free some states and people of unpopular Obamacare regulations, but it would also saddle them with the complicated task of dealing with health insurance legislation for years to come.

Why Hurricane Maria Surprised Forecasters By Getting So Strong So Fast

Hurricane Maria, currently headed for Puerto Rico, stunned forecasters by rapidly intensifying from a Category 1 storm to a Category 5 within a 15-hour period on Monday, battering the island of Dominica in the process. Indeed, the forecast error for Maria’s wind speed is one of the worst for a 24-hour hurricane forecast in the past five years.

The National Hurricane Center expected Maria to intensify, but not anywhere close to the degree that it did. The center’s 11 p.m. forecast on Sunday night said Maria would be a low-end Category 3 storm with maximum sustained winds of 115 mph when it got close to Dominica on Monday evening. In reality, the wind speed ended up being 160 mph, a forecasting error of 45 mph. The difference in these wind speeds can be the difference between life and death. The National Hurricane Center says that in storms with Category 3 winds, homes will sustain major damage. Category 5 winds can destroy entire homes and leave areas uninhabitable for weeks or months.

Forecast intensity errors like what occurred with Maria happen very rarely. The average National Hurricane Center 24-hour forecast error for tropical cyclone wind speed from 2012 to 2016 was 9 mph. According to this graphic put together by the National Hurricane Center, more than 95 percent of 24-hour storm forecasts have a smaller wind speed error than the Sunday evening forecast for Maria did.

To be clear, it’s not as though forecasters didn’t expect Maria’s wind speeds to increase. Jeff Masters of Weather Underground wrote on Monday morning that the conditions for the storm to develop into a stronger hurricane were there: There was little wind shear (changes in wind direction over short distances), the ocean was warm and the mid-levels of the atmosphere were moist. But forecasters were playing catchup. By late Monday morning, the National Hurricane Center projected Maria to be a Category 4 storm by the time it hit Dominica about 12 hours later — a smaller underestimation than the forecast the night before. A large part of the problem was that weather forecasting models were consistently underestimating how the favorable conditions for hurricane intensification would boost Maria’s wind speeds.

Brian Tang, a meteorologist at the University at Albany, told me via email that hurricane models are not good at predicting rapid intensification events such as Maria because so few of them occur. He pointed out, as did forecaster Ian Livingston of The Washington Post’s Capital Weather Gang in an email to me, that this is especially the case for hurricanes with compact cores like Maria’s. Philippe Papin, also a meteorologist at the University at Albany, noted that one model showed Maria had a far greater chance than normal of rapid intensification, even if it wasn’t the most likely outcome.

Maria is arguably the second hurricane this season that caught forecasters at least a little off guard before making landfall. Although Hurricane Harvey’s location and wind speed were fairly well forecast in the immediate lead-up to landfall in Texas, the storm essentially came out of nowhere 60 hours earlier. No forecasts for Harvey were even issued by the National Hurricane Center from the evening of Aug. 19 to the morning of Aug. 23. The storm made landfall on the evening of Aug. 25. Even in the 11 p.m. Aug. 23 forecast, Harvey was expected to be only a Category 1 hurricane with maximum sustained winds of about 75 mph on the evening of Aug. 25. Instead, right before landfall, it was a Category 4 storm with 130 mph winds, a forecast error of 55 mph. The average forecast wind speed error from 2012 to 2016 was just 13 mph. A look at the graphic above shows that a 48-hour forecast wind speed error of 55 mph (or about 48 knots) happens less than 5 percent of the time.

Unfortunately, the conditions that helped Maria strengthen so quickly are still in place. That means Maria likely won’t weaken much before it hits Puerto Rico. Forecasters and residents are preparing for the very worst.

Republicans Really Could Repeal Obamacare This Time

Republicans are only a handful of votes short in the party’s latest attempt to repeal the Affordable Care Act. And one of the key “no” votes from July, Sen. John McCain of Arizona, could flip to “yes,” since Arizona Gov. Doug Ducey has endorsed this latest repeal legislation. (McCain has suggested he would be more likely to vote for a Ducey-backed bill.)

But there are not yet 50 Republicans publicly backing the newest Obamacare repeal bill, known as Graham-Cassidy. And the GOP has always been a handful of votes short. Those final few votes are the hardest, and it’s not clear Republicans can get them before Sept. 30, the day of an important deadline that will limit GOP options to repeal Obamacare afterward.

What’s surprising about the potential passage of this legislation is that it is in some ways more conservative than the bill that almost passed in July. Written by Sens. Bill Cassidy (Louisiana), Lindsey Graham (South Carolina), Dean Heller (Nevada) and Ron Johnson (Wisconsin), the legislation — unlike previous Obamacare repeal proposals — gives a lot of power to states to set their own healthcare policies. Before we get to how likely it is to pass, here are some of its policy highlights (I borrowed from analyses from the website Health Affairs by Washington and Lee University’s Timothy Jost and George Washington University’s Sara Rosenbaum):

  • Obamacare’s tax revenue — instead of paying for subsidies and tax credits to individuals and extra Medicaid funding — would go toward block grants for each state.
  • The total amount of money going to states will likely be less than if Obamacare stayed in place, according to an analysis by the left-leaning Center on Budget and Policy Priorities.
  • In effect, this legislation would take the money that goes to the 31 states that expanded Medicaid under Obamacare and spread it to 50.And D.C.

    “>1 So California would likely end up with tens of billions of dollars less, but Texas (which did not expand Medicaid) much more.

  • A state could require everyone to have health insurance and subsidize private insurance targeted at low-income people, like Obamacare. But a conservative state could create a system with few regulations, even allowing insurance companies to set higher prices for people with pre-existing conditions. (Graham-Cassidy only explicitly bars setting higher rates based on gender or race.)
  • There would be a cap on national spending on Medicaid outside of Obamacare, likely leading to the kind of cuts to the program that were estimated under previous GOP efforts at Obamacare repeal.

Democrats hate this proposal, as you might expect, since it includes several ideas from earlier GOP proposals that would cut Medicaid and potentially remove some patient protections as well as dramatically reduce the number of people with insurance.

So why are we going through this exercise again? For two reasons. First, Cassidy and Graham have been persistent. Senate Majority Leader Mitch McConnell, who had essentially said the party was done with attempting to repeal Obamacare after the most recent failed effort in July, is reportedly at least open to spending this week seeing if the bill can pass.

Second, this may be Republicans’ last opportunity to repeal Obamacare — at least for a while. The so-called reconciliation budget language, under which Republicans can pass bills that affect budgetary policy with 51 votesFifty senators plus a tie-breaking vote cast by Vice President Mike Pence.

“>2 rather than 60, expires on Sept 30. The Senate can use the reconciliation process only once per fiscal year for a complicated bill like this and the GOP intends to use the 2018 reconciliation vote on the party’s tax reform proposal. So the next two weeks are likely the GOP’s last chance to pass an Obamacare repeal with 51 votes before the 2018 midterms, after which the GOP may not control both houses of Congress.

Remember the math. For a bill to pass the Senate, assuming all 48 Democrats and Democratic-leaning independents vote against this, as expected, the GOP needs 50 of its 52 senators, so Vice President Pence can cast a potentially tie-breaking 51st vote.

Almost certain to vote yes: 41 Senate Republicans

In July, Republicans pushed three different repeal bills: a narrow, “skinny” version that would have left much of Obamacare in place; a more conservative bill that would have repealed essentially the entire law; and a piece of legislation written by McConnell that tried to split the difference between those approaches. Of the 52 Republicans, 39 voted for all three versions of the legislation. I think it’s safe to assume that this group will support virtually any anti-Obamacare bill.

The two senators that get us to 41 are Heller and Graham. Heller opposed two of the three previous Obamacare repeal bills, arguing that they cut Medicaid too deeply. (He backed the “skinny” repeal.) But Heller has now reversed course; he’s co-sponsoring this legislation even though it also cuts Medicaid funding. And Graham, another co-sponsor, is also obviously fully on board after opposing one of the repeal proposals in July.

Likely to vote yes: 5 Senate Republicans

Tennessee’s Lamar Alexander, West Virginia’s Shelley Moore Capito, Tennessee’s Bob Corker, Arkansas’s Tom Cotton and Ohio’s Rob Portman each cast essentially symbolic votes against one of the three Obamacare repeal provisions in July. (Capito and Portman, in particular, expressed concerns about Medicaid cuts). In a scenario in which an Obamacare repeal bill actually had the chance to pass, they would likely vote for it.

So that puts this legislation at 46 likely “yes” votes. It needs four of the other six Republicans. And that’s where the math gets harder …

Almost certain to vote no: 1 Senate Republican

Maine’s Susan Collins has been opposed to virtually every GOP effort to repeal the ACA, including all three bills that came up for a vote. Collins attacked them in scathing terms for potentially cutting billions from Medicaid and leaving millions more people uninsured.

Likely to vote no: 1 Senate Republican

Alaska’s Lisa Murkowski also voted against all three versions of repeal in July, criticizing what she viewed as an overly secretive and partisan process to write the various bills and raising concerns about the Medicaid cuts. She has not slammed the GOP repeal effort as aggressively as Collins, but she does not sound especially inclined to back Cassidy-Graham.

So if Collins and Murkowski are “no” votes, Republicans need all four members below to vote “yes.”

Wild Cards: 4 Senate Republicans

Utah’s Mike Lee and Kentucky’s Rand Paul have been continual roadblocks for Republicans during the repeal process, fighting it from the right and essentially opposing any legislation that leaves Obamacare’s rules and regulations in place. Lee has been noncommittal about Cassidy-Graham. But Paul has attacked it, arguing that it still gives states the choice and ability to effectively leave Obamacare in place. He sounds like a hard “no” right now, but I’m skeptical he would cast the deciding vote to block an Obamacare repeal bill. The reason: Paul has cultivated a brand as a strong conservative, so a vote that would, in effect, save Obamacare would not be ideal for him.

Kansas’ Jerry Moran, meanwhile, has been a vocal defender of Medicaid, so it’s not clear if he would back a bill that cuts Medicaid as much as Graham-Cassidy does.

McCain, for his part, was a key vote against Obamacare repeal in July and it seemed like a capstone to the Arizona senator’s career as a self-described maverick. He urged Republicans just this Sunday not to engage in a hurried process that skips over the relevant committees and doesn’t include Democrats. Cassidy-Graham is being rushed, hasn’t gone through the committees for hearings and has no Democratic support.

What could switch McCain to a “yes”? Graham and McCain are extremely close friends, perhaps the tightest relationship of any two members of the Senate. I have some doubt that McCain would vote down a bill that Graham has advocated so strongly for. And the Ducey endorsement of this legislation could also move the Arizona senator towards supporting it.

So yes, the Republicans are close to having the votes to repeal Obamacare. But, as Politico’s Jennifer Haberkorn wrote recently, “Any Obamacare repeal bill has 45-46-47 votes in the Senate. The issue for the GOP has always been the last few to get to 50.”

By the time this legislation gets a CBO score (which is likely to predict that it would leave millions of additional people uninsured), Democrats and activists whip up opposition to it, and the press writes a bunch of stories about who will not be covered under its provisions — three things that have happened each time Republicans have neared Obamacare repeal this year — a “yes” vote will be harder for wavering GOP senators than it seems today.

Also, this bill — even if it passes the Senate — must still be approved by the House. So Republicans seem close to repealing Obamacare. But that’s what everyone has been saying for months. Will they finally do it? Stay tuned.