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In this edition, a look at the GOP’s 2024 health care plans. ͏‌  ͏‌  ͏‌  ͏‌  ͏‌  ͏‌ 
thunderstorms Washington
cloudy East Palestine
snowstorm Munich
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February 17, 2023


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Steve Clemons
Steve Clemons

The annual Munich Security Conference, where world leaders gather to discuss defense spending and global threats, will start today with an online address from Ukrainian President Volodymyr Zelenskyy. Vice President Kamala Harris and French President Emmanuel Macron will both make Ukraine the anchor topic of their speeches. The support for Ukraine in the conflict runs so deep that the conference abandoned its typical practice of welcoming even the most despised world leaders and uninvited Russia and Iran. And while the VP is managing the Ukraine portfolio, President Biden plans to chat with Chinese President Xi Jinping about spy balloons.

Back on the homefront: After using it as a political punching bag for years, Republicans no longer look eager to attack the Affordable Care Act heading into 2024. But what will be on their health care agenda? As Joseph Zeballos-Roig writes today, that’s far less clear. Meanwhile, Jordan Weissmann explains one big way the catastrophic train derailment in East Palestine, Ohio is already causing lawmakers to rethink rail safety laws.

PLUS: Morgan Chalfant has One Good Text with former Southern District of New York prosecutor Elie Honig on the Georgia Grand Jury investigating Donald Trump.

We hope you have an energizing Presidents Day holiday weekend and see you on Tuesday.

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White House: Biden said he plans to speak with Chinese President Xi Jinping to “get to the bottom” of the spy balloon that traversed the U.S. earlier this month. He also said that there isn’t evidence the other objects shot down by the U.S. military were connected to China or surveillance of any kind.

Chuck Schumer: The Senate majority leader offered support for Sen. John Fetterman, D-Pa., who sought treatment for clinical depression at Walter Reed earlier this week, according to his office.

Mitch McConnell: McConnell has a message for Americans questioning support for Ukraine: he said on Fox News it amounts to only a fraction of GDP and that the U.S. is conducting close oversight of the funds. “I want to reassure the American people that this is enormously important,” McConnell said.

Kevin McCarthy: In his first visit to the border as speaker, McCarthy held a press conference in Cochise County, Ariz. He urged Homeland Security Secretary Alejandro Mayorkas to rewind federal regulations back to the Trump era.

Hakeem Jeffries: The minority leader caps off his Texas tour in Laredo where he’ll examine border operations, discuss challenges and opportunities with local stakeholders and participate in a night tour of the U.S.-Mexico border. Along with Henry Cuellar, D-Texas, he’ll attend the Abrazo Ceremony, a shared tradition where American and Mexican officials meet in the middle of the Juarez-Lincoln International Bridge.

Need to Know
REUTERS/Kevin Lamarque

Fox News’ biggest stars openly mocked Donald Trump’s stolen election conspiracies — and his legal team — behind the scenes while amplifying the claims on air, according to a eye-popping new brief filed by Dominion Voting Systems in its defamation case against the network. The filing includes a trove of revealing personal messages between the organization’s prime time hosts and executives. “Sidney Powell is lying. Fucking bitch,” host Tucker Carlson told his producer in one exchange. Rupert Murdoch described Rudy Giuliani’s performance at a press conference as “really crazy stuff.” At the same time, Fox figures fretted about angering the former president as he attempted to reverse the election’s outcome (Carlson called him “a demonic force, a destroyer.”) To win its case, Dominion will have to prove that Fox knowingly broadcast false information about its role in the election. A Fox spokesperson responded to the filing by accusing Dominion of cherry-picking out-of-context quotes. “There will be a lot of noise and confusion generated by Dominion and their opportunistic private equity owners,” they said.

Speaking of 2020: A special grand jury investigating Trump’s efforts to overturn the results in Georgia concluded that there was no widespread voter fraud in the state and that “one or more” witnesses may have perjured themselves during their inquiry. In response, the former president claimed “total exoneration” and described his call to Georgia Secretary of State Brad Raffensperger — during which he pressed the top elections official to “find” the votes needed to overturn the results — as a “perfect phone call.” Legal experts say Trump is not out of the woods yet.

President Biden’s physician released a memo declaring him “fit for duty” after an annual checkup. The doctor did not describe any major changes to the 80-year-old president’s health since his 2021 physical (it notes, for instance, that he still has a-fib, acid reflux, and a stiff gait) though a small lesion was removed from his chest and sent out for a biopsy. Biden works out “at least five days per week,” according to the report, and has lost a few pounds since his last doctor’s visit. Polls show Democrats are wary of renominating Biden, with his age the biggest factor.

The Supreme Court has canceled oral arguments in the case over Title 42, the Trump-era border policy that allowed for faster expulsion of migrants during the pandemic, after the Biden administration announced that the president would end the COVID-19 emergencies in May. There wasn’t an explanation given.

The Pentagon’s Deputy Assistant Secretary of Defense for China is visiting Taiwan, according to the Financial Times, the first visit by a senior U.S. defense official to the island in years. It comes at a time of high tensions between the U.S. and China.

Morgan Chalfant and Jordan Weissmann

Beltway Newsletters

Punchbowl News: Sen. John Fetterman’s decision to disclose a battle with depression is a “dramatic departure from the norm” in Congress, where lawmakers aren’t always upfront about their health challenges.

Playbook: Journalists at CNN were angry at host Don Lemon’s comments on air about Nikki Haley and similarly-aged women being past their “prime” and made the case to Politico that it’s part of a pattern of sexist behavior.

The Early 202: Rep. John Garamendi, D-Calif. predicted Congress would look to pass another Ukraine assistance package in “late spring.” While he acknowledged it would be difficult to pass with waning Republican support for Ukraine aid, he told the Washington Post it will “get done.”

Joseph Zeballos-Roig

2024 Republicans are done with the Affordable Care Act. It might not be done with them.

Donald Trump
REUTERS/Randall Hill


Republican presidential hopefuls are firing up crowds with attacks on President Biden’s age, his spending and border policies, and “wokeness” writ large. But one go-to applause line from the last several campaigns has gone missing: Obamacare.

The 2024 Republican primary is likely to be the first in which the Affordable Care Act is treated as settled law.

“I would be surprised if it isn’t,” Sen. J.D. Vance, R-Ohio, told Semafor. “I haven’t seen any evidence that people are looking to relitigate at this point a 12-year-old law.”

It’s a dramatic shift from 2016, when GOP candidates vying for the White House regularly trashed Obamacare, and 2020, when President Trump was leading efforts to overturn the law in court.

With Obamacare repeal no longer a unifying goal, it’s not clear where candidates will end up positioning themselves on access to health coverage. Trump and Nikki Haley made no mention of health care in their announcement speeches.

We reached out to seven current and possible candidates with a detailed list of questions about their positions on the Affordable Care Act, Medicare, and Medicaid. Only New Hampshire Gov. Chris Sununu responded, saying through a spokesman that “a repeal to the Affordable Care Act cannot happen until a viable, free market solution is on the table that lowers costs and reduces government bloat.”


It may be possible to skate through the Republican primaries without getting into too much detail on health care. But Republicans will have to address the issue sooner or later.

Democrats have only grown more confident running on protecting the ACA, Medicaid, and Medicare and are clearly signaling they will be major issues in the general election.

In addition to Trump and then-Vice President Mike Pence’s ACA repeal attempts in the White House, Florida Gov. Ron DeSantis voted to repeal the ACA as a GOP congressman and was part of a conservative faction that resisted an early repeal-and-replace plan in 2017 until it allowed insurers in some states to raise prices for people with pre-existing conditions whose coverage lapsed.

Haley and DeSantis also rejected expanding Medicaid in their states through the law as governors. Sununu reauthorized his own state’s Medicaid expansion, with some changes.

Biden already seems eager to make Republicans pay a political price for blocking Medicaid dollars. “The only reason Medicaid expansion hasn’t happened here is politics,” he said at an event in Florida last week.

For their part, Republicans appear less interested in pursuing major health care reform again after failing to undo Obamacare and overhaul Medicaid, wary of the enormous political backlash it generated at the time.

“Healthcare has always been this big complicated minefield that if you say the wrong thing, you get hurt politically,” Chris Pope, a senior healthcare fellow at the right-leaning Manhattan Institute, told Semafor. “I think that is the dominant mood among Republicans.”

So far leading Republicans have mostly talked about more incremental ideas that are less polarizing, like more price transparency for hospital services, along with some conservative mainstays like work requirements for Medicaid.

Pence tweeted out an op-ed this week by former Trump health official Seema Verma calling for Medicare and Medicaid to pay hospitals a fixed amount based on a patient’s diagnosis, a favorite of many health care wonks.

The America First Policy Institute, a think-tank organized by Trump administration veterans, released a platform last year that did not include repealing Obamacare, but called for changes like encouraging telemedicine, giving states more flexibility with Medicaid programs, and expanding access to more barebones coverage outside of the ACA.

James Capretta, a senior fellow at the conservative American Enterprise Institute, described the ideas in play as relatively modest.

“American health care is a $4.3 trillion supertanker,” he told Semafor. “This is like a flea on the side of the supertanker.”

But Democrats will have ways to force the debate back to the ACA. Under President Biden, Democrats in Congress beefed up the Affordable Care Act’s subsidies, which have lowered premiums and pushed the uninsured rate down to record lows. They expire in 2025, setting up a general election fight over whether to continue them that’s so far flown under the political radar.


Some conservatives see an opportunity to go on offense against Biden’s boost to ACA subsidies by framing them as a corporate giveaway.

“We don’t think health insurance companies should get the vast majority of the revenue from taxpayers,” Brian Blase, a former Trump healthcare adviser, told Semafor. “We think they should have to compete for consumer dollars.”

— Shelby Talcott contributed reporting.

East Palestine

Why Norfolk Southern’s explosive train wasn’t classified as ‘highly hazardous’

NTSBGov/Handout via REUTERS

Lawmakers on Capitol Hill are only just beginning to grapple with the catastrophic train derailment in East Palestine, Ohio. But some ideas for improving rail safety already seem to be catching on.

A relatively simple one? Treating trains with explosive cargo like they might, you know, explode.

Since 2015, the federal government has applied special safety rules to what are known as “high-hazard flammable trains” — locomotives that move combustible freight like crude oil or ethanol. Among other things, they face certain speed limits and tank car specifications, and are required to proactively alert local governments along their route about their cargo in case of an accident.

Despite being loaded with chemicals capable of burning into a toxic cloud, the Norfolk Southern train that veered off its tracks last week was not classified as a “high-hazard flammable train” — a fact that Ohio Gov. Mike DeWine described as “absurd” during a press conference this week before calling on Congress to look into the issue.

Why wasn’t it? The rules are very much a product of the mid-2010s fracking boom, and were largely crafted to help mitigate spills by oil trains traveling from North Dakota. As a result, they only apply to trains that carry at least 20 consecutive cars full of so-called “Class 3 flammable liquids,” such as petroleum products (the minimum is 35 cars if they aren’t all in a row). The Norfolk Southern train was mostly hauling other kinds of hazardous materials, most notably vinyl chloride gas.

Even in 2015, some thought the definition of a “high-hazard” train was too narrow. The National Transportation Safety Board argued for a broader rule that would have included trains loaded with cargo like vinyl chloride, but the idea was turned down. (Industry lobbying may well have played a big role there).

Post East Palestine, there seems to be some bipartisan interest in expanding the rule to cover more dangerous trains. Sen. J.D. Vance, R-Ohio has now asked about it in two separate letters to the Department of Transportation — one written with fellow Republican Sen. Marco Rubio, and another with Sens. Sherrod Brown, R-Ohio, John Fetterman, D-Pa., and Bob Casey, D-Pa.

Notably, the letters also ask about potentially requiring high-hazard trains to install modern, electronic brakes that might reduce accidents. That requirement was part of the original 2015 regulation, until Congress and the Trump administration reversed it.

Jordan Weissmann

Foreign Influence

U.S. lawmakers and officials will be at the Munich Security Conference over the next few days, where Russia’s war in Ukraine and the international community’s response will dominate the agenda. The attendees include the Senate leaders, Vice President Kamala Harris, and Secretary of State Antony Blinken.

Senate minority leader Mitch McConnell, R-Ky. said on the Senate floor yesterday that he plans to appeal to European allies to boost their defense spending. “The rest of NATO must do more to follow our lead,” he said.

Harris will give a speech tomorrow during which she’ll make the case that Ukraine, America, and its allies have “risen to the occasion” and will lay out the stakes for keeping up support for Kyiv, according to a White House official. Biden will head to Poland next week, in advance of the one-year anniversary of Russia’s assault.

Morgan Chalfant

One Good Text

Elie Honig is a CNN legal analyst and a former federal prosecutor in the Southern District of New York. He is the author of Untouchable: How Powerful People Get Away with It.


Stories that are being largely ignored by either left-leaning or right-leaning outlets, according to data from our partners at Ground News.

WHAT THE LEFT ISN’T READING: Florida Gov. Ron DeSantis announced plans for a “digital bill of rights” that would make it harder for tech companies to collect data on users in Florida — he accused Big Tech of “surveilling” Americans — and would protect free speech online.

WHAT THE RIGHT ISN’T READING: State and federal officials are warning that foreign powers like Russia, Iran, and China are still a threat to meddle in the 2024 election. They’re particularly concerned about cyber threats to local voting jurisdictions.

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— Steve Clemons