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New CBO Report Says the Senate GOP Health Care Would Make Obamacare’s Problems Worse

In January of this year, as congressional Republicans were ramping up legislation to repeal, or at least rewrite, Obamacare, Mitch McConnell, the top Republican in the Senate, went on Face the Nation to make his case against the current health care law.

“What you need to understand is that there are 25 million Americans who aren’t covered now,” he said. “If the idea behind Obamacare was to get everyone covered, that’s one of the many failures. In addition to premiums going up, copayments going up, deductibles going up. And many Americans who actually did get insurance when they did not have it before have really bad insurance that they have to pay for, and the deductibles are so high that it’s really not worth much to them. So it is chaotic. The status quo is simply unacceptable.”

McConnell’s case against Obamacare, highlighted at the time by Vox’s Ezra Klein, was that it didn’t cover enough people, that premiums were too expensive, that out of pocket payments and deductibles were too large, and that the system as a whole, with its unstable health exchanges, was too chaotic. Something would have to change.

McConnell’s argument had the virtue of being essentially true. Health insurers have exited the exchanges. Deductibles in Obamacare plans run high. Premiums for typical plans under the law went up 22 percent last year. The current system has increased coverage, but it has not covered everyone, and those who do have coverage have reported frustrations with the expense and limitations of their plans.

At the time, Republicans had not released their own health care legislation, or shared the framework for their plan. But now they have, and it is hard to square McConnell’s criticisms of Obamacare with the legislation his office helped produce. According to a Congressional Budget Office (CBO) estimate released this afternoon, the Senate health care bill, the Better Care Reconciliation Act (BCRA), would make every single one of the issues that McConnell mentioned worse.

Essentially, the CBO’s report concludes that the Senate GOP’s health care bill would not solve any of the problems that Mitch McConnell said he wanted to solve. Like the Senate health care bill itself, it highlights the cynicism and emptiness of Republican thinking on health care policy.

Let’s start with coverage. McConnell complained that “one of the many failures” of Obamacare was that it left 25 million uncovered. According to CBO, however, under the Senate health care plan 15 million fewer people would have coverage next year than under current law. By 2026, the CBO estimates that the figure would rise to 22 million. McConnell couched this criticism in a caveat—”if the idea behind Obamacare was to get everyone covered”—which perhaps suggests that this is only a failure if the idea is to cover everyone. But Republicans did not and do not have another idea. Indeed, around the same time, President Trump promised that the Republican plan would provide insurance for everyone.

McConnell also hit Obamacare for rising premiums. But the Senate health plan would not halt those increases either. CBO estimates that if the plan were to become law, premiums would be about 20 percent higher next year than under Obamacare. To be clear, that’s a 20 percent increase above and beyond what is already projected. In 2019, premiums would be 10 percent higher than under current law. Starting in the next decade, CBO estimates that premiums would be lower than under current law by about 30 percent. But that’s after several years of significant hikes.

Which brings us to one of McConnell’s other criticisms, that the insurance provided under Obamacare isn’t very valuable. According to CBO, the biggest reason why premiums would be lower, relatively speaking, in the next decade is because, on average, health plans would cover significantly less than they do now.

The Senate bill pegs its subsidies to health plans with lower actuarial values than Obamacare does; these plans are known as benchmark plans. The actuarial value is the percentage of expected health costs that a plan must pay. What this means is that the Senate legislation is built around standard plans that offer less generous coverage than under Obamacare. At the same time, it leaves many of Obamacare’s insurance regulations in place. So in order for health insurers to offer standard plans that also comply with Obamacare’s regulations, they end up having to include high deductibles. Under Obamacare, plans that resemble the Senate bill’s standard plans typically have deductibles of about $6,000, meaning that beneficiaries have to pay that amount before using their coverage.

In some cases, the deductibles would be high enough that they would limit the value of plans, according to the CBO, especially to low-income individuals. “As a result,” the report states, “despite being eligible for premium tax credits, few low-income people would purchase any plan.”

You might summarize this by saying, for example, that the Senate bill might result in people having “really bad insurance that they have to pay for, and the deductibles are so high that it’s really not worth much to them.”

Do they have to pay for it? The Senate health care bill does eliminate Obamacare’s individual mandate. But it includes a workaround, intended to synthesize the mandate’s effects, by penalizing people who go without coverage for 63 days in a different way—prohibiting them from obtaining insurance coverage for six month.

And what about insurance markets? Today’s CBO report expects that under the Senate plan, individual insurance markets would continue to be stable in “most parts of the country”—emphasis on the “most.” This is another way of saying that the Senate bill would not significantly improve on the conditions we are seeing under Obamacare. The CBO also notes, with some uncertainty, that some of the provisions in the Senate bill could cause insurers to exit the market, or refuse to enter. So it would not be less chaotic. It might be more so.

Are the CBO’s estimates perfectly accurate? Almost certainly not. As point estimates, they are quite likely to be wrong. And the CBO’s models sometimes miss complex economic feedback effects.

But the single point estimates are less important than the broader shifts the agency foresees. CBO’s projections are likely to be directionally accurate: higher premiums and deductibles, fewer people with coverage and lingering questions about market stability. CBO’s report is a picture of an insurance market that has all of the flaws that Mitch McConnell diagnosed in Obamacare, but worse.

As with the structure of the Senate health care bill—a dysfunctional rewrite masquerading as repeal—what CBO’s report exposes is the GOP’s unwillingness to think beyond the parameters of Obamacare.

Republicans did not respond to the failures of Obamacare with a different vision of how the health care system should be organized. They did not build a case for policies with different goals about the health care system. Instead, they criticized Obamacare for not living up to its own goals, for failing on its own terms. Even in their criticisms, they bought into to its premises. They had no policy goals of their own to promote.

So it is hardly surprising that when it came time to repeal and replace Obamacare, they instead produced legislation that simply rewrote it, offering the same thing, but less of it. And it is even less surprising that the legislation they have released undercuts the criticisms that McConnell and others have made of Obamacare, because their plan has the same problems—but even more acute.

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D.C.’s Dysfunctional Metro System Is a National Embarrassment

Beginning this week, passengers on the District of Columbia’s Metrorail network—the six-line, spontaneous fire-prone train system known here as the D.C. Metro— can expect fare increases and service cuts.

As you might imagine, few in the area are pleased. A few days ago, the Washington Examiner declared that the city’s rapid-transit system “is the worst in the world.” I’ll be generous and not go that far. The D.C. Metro is definitely not the dirtiest system I’ve ever experienced (I’m looking at you New York City), but the system is hardly a model of success, either. Deferred maintenance, poor planning by the original designers, a dysfunctional governance structure, and general incompetence and negligence on the part of management and staff have taken their toll since its 1976 opening.

All of these problems came to a head in 2009, when a crash near the Fort Totten station in Northeast D.C. killed nine people, including the train’s operator, and injured 80. Following the accident, the National Transportation Safety Board (NTSB) released a report that identified failures at almost every level of The Washington Metropolitan Area Transit Authority (WMATA), including actions taken by the train operator, maintenance workers, senior management, and control room operators.

The severity of this incident prompted a $5 billion capital improvement program, with nearly half of the money coming from federal grants. Metro finally had the funds it needed to make significant improvements, but as time dragged on it would become apparent that absent major structural reforms in how the WMATA functioned, that money would not be well spent.

In 2015 another headline-grabbing incident occurred near L’Enfant Plaza, in D.C.’s Southwest quadrant. An electrical malfunction caused a train to get stuck in a smoke-filled tunnel. One woman died and another 86 people were sent to the hospital. With public trust in the system at a new low, ridership dropped significantly.

As someone who has ridden plenty of rapid-tranist systems outside of the U.S., I can attest to just how bad the D.C. Metro compares. Having ridden the Shanghai Metro for the past two years while a student at New York University Shanghai, I can recall a train stopping in between stations only once and for ten seconds at most. By contrast, my morning train into downtown D.C. last Friday stopped a total of five times between stations, the longest delay being almost five minutes. And this isn’t event that bad comparitively, according to stories I’ve heard from longtime residents.

Some might gripe that making comparisons between D.C.’s system and those in Asia or even New York’s sprawling network are unfair. After all, D.C. is neither as populated nor as dense as Shanghai, Tokyo, or New York. But even taking into account these differences, a lot of the Metro’s dysfunction defies logic.

Shanghai’s system, for instance, handles far more people and is way more overcrowded than the D.C. Metro. Yet in Shanghai, rush-hour headways—the amount of time between trains on the same track—can be as little as two minutes, with trains moving seamlessly from station to station at full speed. In D.C., the Metro has six minute headways during rush hour—at least on paper—which will soon increase to eight. Yet trains often run behind schedule and frequently have to stop in tunnels for trains in front of them to move.

If people wanted the experience of frequent breaking while crawling to their destination, they could just drive their cars during rush hour. Subways exist to provide public transportation that, unlike a bus, isn’t subject to traffic jams. Unfortunately, the D.C. Metro has perfected the art of replicating the traffic woes above ground in the tunnels below. This is despite all the years and additional money the WMATA has had to fix the maintenance problems behind these daily delays.

As I write this, part of the Red Line, the system’s busiest, has been shutdown. From mid-May to mid-June, all Orange Line stations in Maryland, as well as some in D.C., were shut down. There are weekends where all six lines are impacted by track work.

At least some of the dysfunction stems from the WMATA’s awful work culture. “Consciously or subconsciously, everyone at Metro knows they’ve got a job for life, unless they sit there and smoke crack in the middle of the platform,” a former WMATA mechanic told the Washingtonian in 2015.

Falsified safety inspection reports are rampant—last December, nearly half of the system’s track inspection department were facing facing disciplinary action over faslified safety records that came to light after a July 2016 derailment near the East Falls Church Metro station in northern Virginia.

Meanwhile, an employee who falsified inspection-records regarding ventilation fans near L’Enfant Plaza, where the deadly accident in 2015 occurred, may be getting his job back, thanks to the Amalgamated Transit Union Local 689. “The public is safer with [Seyoum] Haile, an experienced, proven, competent mechanic, chastened to ensure accurate records of his work, than with some unknown, untested and likely less skilled mechanic,” union lawyers claimed.

An arbitration panel decided that instead of firing him, Haile should get a six-month suspension. The court found in April that Metro didn’t meet its legal burdens for overturning the arbitration ruling, even though the judge deciding the case openly admitted that Mr. Haile’s termination “may even have been the more just outcome here.”

The Amalgamated Transit Union Local 689 is the union that employs a significant majority of WMATA workers. If you read an article recently published in the Washington Post by the union president, Jackie Jeter, you would think the union had nothing to do with the problems at the WMATA. It’s demonstrably false.

Jeter, along with other union representatives, has recently been touting the union’s plan to fix the WMATA. The plan has some grand ideas, but few well-thought-out ones. The most notable is the call for a $2 flat fare. Not only is this not feasible with the WMATA’s current financial situation, but it’s terribly misguided. If there’s one thing the Metro has going for it, it’s the current distance-based pricing system with surge pricing during rush hour. Arguments could be made that fares at all levels are too high, but the fare structure itself is not a problem.

The union decries the current system as “too complicated” and points out that most U.S. rail systems use flat fares. That’s actually true, but most major systems in other countries use distance-based pricing and for good reason: flat fares create an incredibly distortionary price environment.

If the fare is set at the highest distanced-based fare, only people with long commutes would use the system. If the fare is set at the lowest distance-based fare, the system wouldn’t make any money. What results is a fare that is somewhere in the middle and that’s not as good as it sounds. Riders who only go short distances and/or use the system when it’s not rush hour end up subsidizing people with long commutes during peak times. Conversely, long and/or rush hour commutes are much cheaper than they should be and people who otherwise might avoid commuting at those hours would be incentivized to do so, further excerbating overcrowding.

Jeter has been highly critical of WMATA General Manager Paul J. Wiedefeld for “blaming labor costs for Metro’s problems,” but the fact of the matter is 74 percent of the agency’s operating costs are labor-related. To not address that would be foolish. If the agency wants to be able to spend more money on fixing the sorry state of its rail infrastructure, then bloated pensions, excessive overtime payments, and six-figure salaries for some of the agency’s employees need to be addressed.

Privatization would be the best idea. In Hong Kong and Tokyo, private companies run clean, efficient systems that don’t cost a fortune. These systems, which use distance-based pricing, have farebox recovery ratios—the percentage of operating costs covered by fare revenue—that are far higher than the D.C. Metro. Hong Kong’s MTR, in particular, makes a healthy profit just from fare revenue. Contrary to those who claim the WMATA suffers because of a lack of dedicated government funding, reliance on fare revenue actually incentivizes improved service. Until the WMATA’s byzantine governance structure is overhauled and its labor contracts rewritten, any revenue promises should be tied to the implementation of major reforms.

Of course, advocates for privatization face a long, uphill battle. The Amalgamated Transit Union certainly would not be on board. “Privatizing Metro can only make our troubled rail system worse,” wrote Jeter. As if that were even possible.

Maybe one day our nation’s capital will have a Metro to be proud of. One that has on-time trains, a good safety record, and a clean balance sheet. A commuter can dream can’t he? Until then, the city that serves as the headquarters of our federal government will, fittingly, have the Metro it deserves: a slow and expensive one.

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Travel Bans, Gay Wedding Cakes, Gun Rights, and Border Shootings: Special All Supreme Court P.M. Links

  • Supreme CourtToday was the Supreme Court’s final day of releasing orders and decisions for the term, and it was a bit of a doozy. Top news: The court allowed most of President Donald Trump’s travel ban to take effect except in cases of those who have “bona fide” relationships with the United States. This is not a “ruling,” though. It’s a temporary lifting of the injunction until they hear the case in October.
  • The Supreme Court also ruled that Missouri cannot refuse to grant public funds to a church simply because it is a religious institution, as this is a violation of the free exercise clause of the Constitution. The case was about whether a church could have access to a grant to help pay the costs of resurfacing a playground.
  • The Supreme Court also decided it will hear whether a baker can, due to his religious beliefs, refuse to bake and sell a wedding cake to same-sex couples.
  • The Supreme Court also decided it would refuse to hear a case from California to rule on whether the Second Amendment protected the right to carry firearms in public.
  • Rather than deciding whether the family of a Mexican teenager killed by a federal agent can sue over a fatal shooting that took place across the U.S.-Mexico border, the Supreme Court kicked it back down to a lower court.
  • The Supreme Court also struck down a law in Arkansas that caused officials to refuse to list both members of same-sex couples as parents on birth certificates. Note that the law does allow for non-biological fathers to be listed as parents in heterosexual cases, so this wasn’t a matter of actual genetic parentage.

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Jake Tapper: ‘We Are Not the Resistance, We Are Not the Opposition’

Not #TheResistance ||| L.A. Press ClubEven before Donald Trump leveled a Jack Lambert-style hit onto the collective psyche of The Fourth Estate, journalism awards galas were schizophrenia-inducing adventures for those of us willing participants who nonetheless maintain a heightened sensitivity to media pomposity and political class elbow-rubbing. It was nearly a lifetime ago, and I still shudder involuntarily at the memory of hundreds of working reporters standing to sing “God Bless America” to Dan Rather back in 2001.

In the two years since Trump’s famous escalator ride into national politics, the awards-dinner genre’s inherent self-importance and ideological homogeneity has been enough to make even the biggest All the President’s Men romantic feel at least a little bit like a staff writer for The Federalist. Last night’s entertaining Southern California Journalism Awards, for example, began with a first-person plural statement of professional sympathy from Los Angeles Mayor Eric Garcetti. “I think this is probably [so] well-attended tonight because all of us—no matter whether journalists, or those of us who interact with journalists, who consume the work of journalists—we all feel that there is something bigger under attack than just journalism and news,” Garcetti said. “The very values that we stand for, who we are, what we want to be, and whether or not we will come together.”

Incredulous-face, ranked: 1) Moynihan, 2) Carlson, 3) Tapper. ||| CNNThis is pretty much boilerplate for political-class gatherings these days. National Press Club Chairman Jeff Ballou spent a good deal of his remarks last night making the defiant claim that “We ARE the Constitution!” Andrea Mitchell in her speech spent paragraphs cataloguing the Trump administration’s violations against basic Washington norms and decency. It’s not that she’s necessarily wrong, it’s that it always feels awkward to be in any room, let alone one populated by journalists, where so many people so vigorously agree on political matters.

That’s why the speech given by CNN anchor Jake Tapper, who was accepting the L.A. Press Club’s President’s Award, was so contextually refreshing and I think nationally relevant to the ongoing push-pull between Trump and the media. Tapper warned implicitly against the journalistic first-person plural, and explicitly in favor of the seemingly obvious yet nonetheless timely reminder that “we really need to stand up and make sure that we get our facts right.”

Since it was George Orwell’s birthday, Tapper started with that great quote you might have seen online commemorating the occasion:

[citation needed] ||| izquotes

The main problem here? There’s no evidence Orwell ever said or wrote such a thing. Tapper used that fact as a jumping-off point to reflect on how sloppiness, side-taking, and social media are combining to undermine many journalists’ anti-Trump goals:

“We need to rise to the moment and make sure that when we quote somebody we know it’s actually correct,” Tapper said. “We don’t need to give the enemies of the Fourth Estate any ammunition. That means we need to be squeaky clean−we’re not the resistance, we’re not the opposition, we’re here to tell the truth, report the facts, regardless of whom those facts favor one way or the other.”

Crazy talk! More from Tapper’s speech as delivered (you can read the somewhat different version as written here):

I know it’s difficult, and I know that it’s easy to get swept up into the stance of opposition when a politician declares war not only on journalism, but on the very concept of empirical fact, and sometimes when that politician declares war on the very concept of basic decency. And we need to stand up for fact and truth and decency.

But when we look our kids in the eye, our grandkids in the eye, in two decades, and tell them what we did during this era, we need we need to make sure that we were also maintaining the integrity of journalism. […]

If the president does something good, we need to report that. When the president does something right, we need to report that. When we tweet every single emotion we have the very moment we have them, we undermine that foundation. And we can’t afford to do that in this day and age.

While I’m confident many readers will still be put off by Tapper’s set of assumptions here (and a perhaps overlapping group will scoff at his alleged false equivalence), this is a message I’m convinced my professional colleagues need to hear. Anti-Trump fervor is producing bouts of pointless hyperventilation and backlash-inducing error, helping cement anti-media sentiment as the most powerful glue left in the Republican coalition (aside from the taste of power, sweet power). Confirmation bias is arguably the greatest generator of journalistic inaccuracy (mine included), so avoiding the false lure of blanket opposition seems to me a sound strategy for producing fewer false positives.

But then, that could be my own bias talking….

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Democrats Accuse Republicans of Mass Murder: New at Reason

So the Democrats, after opposing Donald Trump in the 2016 election partly out of what they claimed was concern about his incivility and coarseness, are now pursuing a debate about health care legislation in Washington by characterizing the Republicans who disagree with them about policy details as mass murderers.

Think that’s an exaggeration? Hillary Clinton, the Democratic Party’s 2016 presidential candidate who remains among its most prominent and mainstream voices, tweeted Friday: “If Republicans pass this bill, they’re the death party.” Sen. Elizabeth Warren (D-Massachusetts) tweeted, “I’ve read the Republican ‘health care’ bill. This is blood money. They’re paying for tax cuts with American lives.” Ezra Levin, an influential Washington organizer of the resistance to Trump, tweeted Sunday, “TrumpCare will kill tens of thousands of working class people, and with the savings it cuts taxes for billionaires.”

This line of argument carries a powerful emotional charge. However, Ira Stoll argues, it isn’t a particularly useful, constructive, or clear-minded way to think or talk about writing laws.

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Democrats Accuse Republicans of Mass Murder

So the Democrats, after opposing Donald Trump in the 2016 election partly out of what they claimed was concern about his incivility and coarseness, are now pursuing a debate about health care legislation in Washington by characterizing the Republicans who disagree with them about policy details as mass murderers.

Think that’s an exaggeration?

Hillary Clinton, the Democratic Party’s 2016 presidential candidate who remains among its most prominent and mainstream voices, tweeted Friday: “If Republicans pass this bill, they’re the death party.”

Sen. Elizabeth Warren (D-Massachusetts) tweeted, “I’ve read the Republican ‘health care’ bill. This is blood money. They’re paying for tax cuts with American lives.”

Ezra Levin, an influential Washington organizer of the resistance to Trump, tweeted Sunday, “TrumpCare will kill tens of thousands of working class people, and with the savings it cuts taxes for billionaires.”

This line of argument carries a powerful emotional charge. It isn’t, though, a particularly useful, constructive, or clear-minded way to think or talk about writing laws.

To start with, there’s the Washington-centric misconception that the killers are the congressmen. Disregarded are any other actors who play roles in our health care system. If federal politicians are murderers for adjusting health care laws, what about all the state-level politicians who failed to enact Mitt Romney-style comprehensive coverage in their own states before Obamacare? Were they also murderers for failing to act? What about doctors and hospitals who refuse to treat non-emergency patients who are uninsured and can’t pay? The system could probably treat more people if doctors, nurses, and medical-device and drug-company executives earned less money. Does that make every BMW-driving surgeon a murderer? Is every individual American a murderer who spends any discretionary income on movies or trips to Disney World rather than charitable donations earmarked for uncompensated care to his local hospital?

It may well be that as a moral matter, voluntarily paying for a poor person’s health care is a superior use of money than driving a fancy car or taking an expensive vacation. But an individual’s choice to consume rather than donate doesn’t make that individual a murderer, or even a killer. Neither does a congressman’s decision not to compel the individual, by taxing him, to do so. The failure of Democrats to recognize this signals a fundamental confusion.

There’s also a false certainty in the claim that higher taxes for more health insurance will translate into extended lives. Some of the more honest Democrats acknowledge this if one listens to them carefully. Even Sen. Bernie Sanders, for example, in repeating an exaggerated claim that TrumpCare would cause 28,000 unnecessary deaths, conceded, “Nobody, obviously, knows exactly what would happen.”

Obviously.

The “Harvard” study—really more of a blog post by one Harvard professor, two non-Harvard medical students, and two scholars at a liberal think-tank—that Sanders and Clinton cite is more nuanced than they claim. It mentions two studies—”outlier results”—raising doubts about whether insurance coverage translated into better health. It concedes, accurately, “insurance is a necessary but not sufficient factor to receive quality health care.” Ironically, its model for projecting what it calls “excess deaths” is based entirely on extrapolation from “analyses of the Massachusetts health reform.” Again, that is a state-level reform of the sort that might have spread organically and successfully if President Obama and the Democrats in Congress hadn’t decided to impose it nationally.

Democratic accusations about additional deaths are often made without any price tag attached. Assume, for the moment, that Democrats are right that money should be taken away from higher earners and redistributed instead for the purpose of extending life-years or improving health.

There’s a whole universe of possible interventions other than subsidizing heath insurance or Medicaid. Auto-ignition breathalyzers to prevent drunk-driving accidents, a nationwide 55-mile-an-hour speed limit with aggressive enforcement, disabling texting from cellphones in moving cars, some sort of intervention in Syria—all might, at least potentially, save more lives at a lower cost.

Failing to enact these measures doesn’t make politicians murderers, or even the moral equivalent of murderers. It’s just a political difference of opinion.

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More Americans Support Same-Sex Marriage Than Ever

Gay marriageAs Gay Pride month draws toward a close, a new poll by the Pew Research Center suggests the fight over same-sex marriage in the United States is over. This is not Roe v. Wade 2.0.

Sixty-two percent of Americans support legal recognition for married gay couples, while only 32 percent opposed, according to the latest poll numbers gathered earlier in June. Gay marriage and homosexuality itself does not represent the cultural divide it used to and is becoming “normalized” in the eyes of most Americans.

It’s worth remembering majority support for same-sex marriage recognition surpassed opposition for the first time in 2011. This shift has taken place over just six years.

Pew notes that demographic groups historically more opposed to same-sex marriage have shifted significantly. For the first time a majority of baby boomers support legal recognition. Over the past two years, support for recognition among African Americans has increased from 39 percent to 51 percent. Support from younger white evangelical Christians has jumped from 29 percent to 47 percent in just a year.

In terms of the political fight over who “owns” the LGBT vote, it’s worth noting what’s going on with Republicans. For the first time, opposition to legal recognition among Republicans and Republican leaners has dropped below the majority. It’s nearly split now—47 percent favor recognition while 48 percent oppose it.

That shift in the political winds is very important in terms of how elements of the LGBT movement are attempting to tie it to “The Resistance” and reinforce the idea that the real LGBT political movement leans to the left.

The end result this year has been a purging of actual LGBT people from pride marches for not holding the right views or for being—interestingly enough—members of disfavored groups. A gay supporter of President Donald Trump became a national news story because a pride parade in Charlotte, North Carolina, is refusing to let him participate.

In cities like Minneapolis and Washington, D.C., protesters attempted to block police participation in the parade, in some sort of attempt to draw attention to police abuse. In Chicago, people said they were told they could not wave flags displaying the Star of David and express their Jewish heritage within the parade because it made others uncomfortable.

In each of these cases, people are trying to purge other LGBT participants for reasons that have little to do directly with the gay community. Trying to ban the police was particularly loathsome (and you could tell from responses to the behavior in the media coverage), given that gay people have both been fighting for years to get police to treat them with respect and to serve as openly gay police officers. The political roots of gay pride are deeply embedded in stopping police violence targeting gay people. That’s what the Stonewall Riots were about!

There’s something particularly narcissistic about trying to purge your adversaries from your sight by denying them participation in these events and thinking that this is a useful response. There is nothing about purging police from a march that’s going to improve the relationship between police and minority communities. Purging Jewish flags is not going to do a single thing to improve the relationship between Israel and Palestine.

That support for gay marriage has so dramatically increased is a direct reflection of the value of participation, not of purging and segregation. LGBT people are increasingly visible in all communities (not just urban enclaves), and the realization that gay marriage helps strengthen families and social stability has undoubtedly contributed to the dramatic drop in resistance to gay relationships.

Activists might want to keep that in mind before trying to deliberately boot people out of the movement.

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The Republican Health Care Dud, Harry Potter, and Supreme Court Shakeup [Reason Podcast]

“Were trying to extend twentieth century or even nineteenth century entitlement spending into the twenty-first century,” says Reason’s Nick Gillespie about the Senate Republicans’ health care legislation. “The demographics don’t work, the economics don’t work, and nobody will talk about just increasing the supply and variety of health care. It’s maddening!”

Peter Suderman joins Nick Gillespie and Katherine Mangu-Ward in a discussion moderated by Andrew Heaton. In addition to making sense of the unimaginative Republican bill and suggesting more radical reforms in place of it, they discuss a new CATO piece about the true number of libertarians in America; the cultural impact of Harry Potter two decades in (and which house Gillespie and Mangu-Ward would would fall into); and who should replace Justice Kennedy on the Supreme Court if he retires.

Audio production by Ian Keyser.

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Why I Microdose Acid: Silicon Valley Entrepreneur Speaks Out: New at Reason

Tech entrepreneur George Burke consumes a tiny amount of LSD (about a tenth of a typical dose) every morning before he goes to work.

He says “microdosing” subtly improves his cognitive functioning.

“I notice that my brain seems to be able to solve problems a little bit better than…before,” says Burke, who runs a startup called Fuel that helps its clients custom tailor their diets to their unique genetic makeups.

The use of psychedelics as productivity and creativity hacks is deeply rooted in Silicon Valley culture. Burke was partly inspired to go public about his drug use by the late Steve Jobs, who told his biographer Walter Isaacson, “[t]aking LSD was a profound experience, one of the most important things in my life.”

“People have to actually have to step up and state what they’ve been doing,” says Burke.

Reason spoke with Burke and with James Fadiman, a scientist researching the effects of microdosing.

Watch the full video above.

Produced by Zach Weissmueller. Camera Alex Manning. Additional graphics by Meredith Bragg. Music by Kai Engel and Broke for Free.

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LSD Microdosing: The New Silicon Valley Productivity Hack

Tech entrepreneur George Burke consumes a tiny amount of LSD (about a tenth of a typical dose) every morning before he goes to work.

He says “microdosing” subtly improves his cognitive functioning.

“I notice that my brain seems to be able to solve problems a little bit better than…before,” says Burke, who runs a startup called Fuel that helps its clients custom tailor their diets to their unique genetic makeups.

The use of psychedelics as productivity and creativity hacks is deeply rooted in Silicon Valley culture. Burke was partly inspired to go public about his drug use by the late Steve Jobs, who told his biographer Walter Isaacson, “[t]aking LSD was a profound experience, one of the most important things in my life.”

“People have to actually have to step up and state what they’ve been doing,” says Burke.

Reason spoke with Burke and with James Fadiman, a scientist researching the effects of microdosing.

Watch the full video above.

Produced by Zach Weissmueller. Camera Alex Manning. Additional graphics by Meredith Bragg. Music by Kai Engel and Broke for Free.

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LSD Microdosing: The New Silicon Valley Productivity Hack

Tech entrepreneur George Burke consumes a tiny amount of LSD (about a tenth of a typical dose) every morning before he goes to work.

He says “microdosing” subtly improves his cognitive functioning.

“I notice that my brain seems to be able to solve problems a little bit better than…before,” says Burke, who runs a startup called Fuel that helps its clients custom tailor their diets to their unique genetic makeups.

The use of psychedelics as productivity and creativity hacks is deeply rooted in Silicon Valley culture. Burke was partly inspired to go public about his drug use by the late Steve Jobs, who told his biographer Walter Isaacson, “[t]aking LSD was a profound experience, one of the most important things in my life.”

“People have to actually have to step up and state what they’ve been doing,” says Burke.

Reason spoke with Burke and with James Fadiman, a scientist researching the effects of microdosing.

Watch the full video above.

Produced by Zach Weissmueller. Camera Alex Manning. Additional graphics by Meredith Bragg. Music by Kai Engel and Broke for Free.

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Senate Republicans Add Individual Mandate Workaround to Health care Bill

Despite being billed as an Obamacare repeal plan, the health care bill released last week by Senate Republicans kept many of Obamacare’s core elements in place, including federal regulations restricting health insurers from charging based on preexisting conditions and income-based subsidies for individuals purchasing health coverage on the individual market. But it lacked one of Obamacare’s notable features—the individual mandate to purchase health insurance.

From a political perspective, this was not surprising. Republicans have spent the last seven years criticizing the health law’s mandate. But as a matter of policy, it was an unusual decision: Over the last several decades, several states have attempted to implement preexisting conditions regulations without a mandate.

Every single one has seen their individual insurance market melt down in the space of a few years. With regulations but no mandate, people wait until they are sick to buy coverage, meaning that health insurers end up covering a smaller group of sicker people. This raises premiums, which pushes healthier people out of the market, which raises premiums further, and the cycle continues until premiums are unaffordable and insurers, unable to make money, leave the market: in other words, a death spiral.

This afternoon, Senate Republicans updated their health care bill, the Better Care Reconciliation Act (BCRA), to include a provision that is not a mandate, but is intended to act as a substitute for it. It’s a backdoor mandate—a workaround designed to fulfill the same function. It’s another sign of how much of Obamacare’s individual market design Republicans have borrowed for their own bill.

Instead of a fine for going uncovered, as in Obamacare, the Senate GOP bill now includes a continuous coverage provision: Anyone who goes without coverage for more than 63 days must wait six months before getting coverage again. The goal, as with the mandate, is to create an incentive for health people to buy coverage and maintain it, by penalizing if they don’t.

It doesn’t take too much work to imagine how a provision like this might end up being weakly enforced, if only for political reasons. Obamacare already includes an open enrollment period, outside of which people are not allowed to buy coverage—at least in theory. In practice, there are numerous exceptions, and insurers have complained that those exceptions have allowed large numbers of people to jump on and off health plans throughout the year, obtaining coverage only when sick. In turn, insurers respond by raising premiums. If the six month waiting period goes into effect, it’s likely to lock some sick people out of coverage, and the result could be the creation of loopholes that weaken the provision’s effectiveness.

It’s one of the many flaws inherent in the design of both Obamacare and the Senate bill: The political unpopularity of the mandate, and of mandate alternatives like this, makes it difficult to maintain the regulatory balance that is supposed to make the whole system work. In any case, it’s one more way in which the health care bill put forward by Senate Republicans resembles a skimpier version of the bill it is supposed to repeal, and further evidence that Republicans aren’t repealing the health law so much as putting their own awkward stamp on it.

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Senate Republicans Add Individual Mandate Workaround to Health care Bill

Despite being billed as an Obamacare repeal plan, the health care bill released last week by Senate Republicans kept many of Obamacare’s core elements in place, including federal regulations restricting health insurers from charging based on preexisting conditions and income-based subsidies for individuals purchasing health coverage on the individual market. But it lacked one of Obamacare’s notable features—the individual mandate to purchase health insurance.

From a political perspective, this was not surprising. Republicans have spent the last seven years criticizing the health law’s mandate. But as a matter of policy, it was an unusual decision: Over the last several decades, several states have attempted to implement preexisting conditions regulations without a mandate.

Every single one has seen their individual insurance market melt down in the space of a few years. With regulations but no mandate, people wait until they are sick to buy coverage, meaning that health insurers end up covering a smaller group of sicker people. This raises premiums, which pushes healthier people out of the market, which raises premiums further, and the cycle continues until premiums are unaffordable and insurers, unable to make money, leave the market: in other words, a death spiral.

This afternoon, Senate Republicans updated their health care bill, the Better Care Reconciliation Act (BCRA), to include a provision that is not a mandate, but is intended to act as a substitute for it. It’s a backdoor mandate—a workaround designed to fulfill the same function.

Instead of a fine for going uncovered, as in Obamacare, the Senate GOP bill now includes a continuous coverage provision: Anyone who goes without coverage for more than 63 days must wait six months before getting coverage again. The goal, as with the mandate, is to create an incentive for health people to buy coverage and maintain it, by penalizing if they don’t.

It’s not too hard to imagine that a provision like this will end up being weakly enforced, if only for political reasons. Obamacare already includes an open enrollment period, outside of which people are not allowed to buy coverage—at least in theory. In practice, there are numerous exceptions, and insurers have complained that those exceptions have allowed large numbers of people to jump on and off health plans throughout the year, obtaining coverage only when sick. In turn, insurers respond by raising premiums. If the six month waiting period goes into effect, it’s likely to lock some sick people out of coverage, and the result could be the creation of loopholes that weaken the provision’s effectiveness.

It’s one of the many flaws inherent in the design of both Obamacare and the Senate bill: The political unpopularity of the mandate, and of mandate alternatives like this, makes it difficult to maintain the regulatory balance that is supposed to make the whole system work. In any case, it’s one more way in which the health care bill put forward by Senate Republicans resembles the bill it is supposed to repeal, and further evidence that Republicans aren’t repealing the health law so much as putting their own awkward stamp on it.

Read More on Reason

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What Are The Benefits of Lyft Shuttle? Listen to Ed Krayewski on AirTalk

Lyft’s roll out of a pilot program called Lyft Shuttle, where vehicles follow set routes, picking up and dropping off people at pre-designated stops, was panned by some critics as an unnecessary re-invention of the city bus. But it’s not—instead, LyftShuttle offers another choice than the city bus. When it heads to areas not currently served by city buses, it’ll offer a service that didn’t exist before. Either way, it can exert competitive pressures that could prompt public transit agencies to do better in order to keep up. It could even lead to a regulatory environment where more competitors can enter the market, benefiting many people.

I’ll be on AirTalk on 89.3 KPCC in Los Angeles at 11:30 a.m. Pacific Time (2:30 p.m. ET) to talk about this with guest host Libby Denkmann and Slate‘s Henry Grabar, who will voice criticisms of the Shuttle to which I’ll respond. You’ll even be able to call in to ask questions! Tune in if you’re in Southern California, maybe stuck in late morning traffic, or listen live online.

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Trump’s Travel Ban Is Headed to the Supreme Court

Today the U.S. Supreme Court agreed to hear consolidated oral arguments in the cases of Trump v. International Refugee Assistance Program (IRAP) and Trump v. Hawaii. At issue is whether President Donald Trump’s controversial executive order banning travelers from six majority-Muslim countries violates the Establishment Clause of the First Amendment and/or exceeds the president’s lawful powers under federal immigration law.

The Supreme Court says it will schedule oral arguments “during the first session of the October Term 2017.”

These cases raise fundamental questions about the reach of executive power, the meaning of federal immigration law, the scope of the Establishment Clause, and about the role of the courts in policing the boundaries.

According to the Trump administration, not only did Congress give the president vast leeway to control what happens at the border, the executive branch is entitled to overwhelming judicial deference in all matters dealing with national security. According to the state of Hawaii and to the International Refugee Assistance Program, Congress did not authorize Trump’s approach and Trump should get no deference from the courts because he is using government power to heap disfavor on Muslims.

Until now, the Trump administration has mostly lost on this matter in federal court. In May, the U.S. Court of Appeals for the 4th Circuit, in IRAP, issued an injunction blocking enforcement of the executive order on the grounds that the legal challengers were likely to prevail in their Establishment Clause challenge. Then in June, the U.S. Court of Appeals for the 9th Circuit, in Hawaii, issued an injunction blocking enforcement of the executive order on the grounds that Trump was exercising powers that federal law did not properly delegate to him.

But today the Supreme Court partially lifted those injunctions, allowing the executive order to go into effect in certain limited circumstances. Specifically, in an unsigned per curiam opinion, the Court lifted the injunctions “with respect to foreign nationals who lack any bona fide relationship with a person or entity in the United States.” That is a small victory for the Trump administration.

However, the Court left the injunctions in place with respect to foreign nationals “who have a credible claim of a bona fide relationship with a person or entity in the United States.” The Court explained, “a foreign national who wishes to enter the United States to live with or visit a family member…clearly has such a relationship…. So too would a worker who has accepted an offer of employment from an American company or a lecturer invited to address an American audience.” That is a sizable loss for the Trump administration.

Notably, Justice Clarence Thomas, joined by Justice Samuel Alito and Justice Neil Gorsuch, wrote separately to argue that the injunctions should be lifted “in full.” This suggests those three justices may be inclined to ultimately rule in favor of the Trump administration. After all, if they think they might rule against the executive order in October, why would they want to let the order go into full effect right now? It also raises the interesting possibility that Chief Justice John Roberts and Justice Anthony Kennedy may be more inclined to ultimately rule against Trump.

One thing is certain: This fall Donald Trump will face the first major test of his presidency before the U.S. Supreme Court.

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