Reflect on those numbers for a moment. Republicans have managed to make tax cuts less popular than Obamacare. It’s impressive.
And yet last week, given an opportunity to tweak their bill before final passage, to make it something the American people might like a little better, the main change Republicans made was to lower the top tax rate — the rate paid by the richest Americans — even more.” (A)

“Doctors, hospitals, patient advocates and others who work in the nation’s healthcare system are growing increasingly alarmed at the Republican tax bill, warning that it threatens care for millions of sick Americans.
The legislation – which GOP leaders are rushing to pass this week – will eliminate beginning in 2019 the Affordable Care Act penalty on consumers without health coverage, a move many experts warn will weaken insurance markets in parts of the country.
The tax bill, which includes huge tax cuts for corporations, may also force tens of millions of dollars in cuts to the Medicare program under federal budget rules, though congressional leaders say they are confident they can waive the rules as they have in the past.
Most worrisome to many, the bill will open a $1.5-trillion hole in the federal deficit over the next decade. That will put substantial new pressure on government healthcare programs such as Medicare and Medicaid and has already ignited a renewed Republican campaign to cut them back.” (B)

“House Democrats are threatening to allow automatic spending cuts triggered by the Republican tax bill to take effect next year unless Speaker Paul Ryan ends an attempt to cripple Obamacare.
Under a 2010 law known as PAYGO, the $1.5 trillion reduction in government revenue caused by the Republican tax cut legislation would trigger years of across-the-board cuts to programs including Medicare starting next year. Ryan and Senate Majority Leader Mitch McConnell have vowed the cuts won’t be imposed, but they would need Democratic votes to waive the law.
Part of the price the Democrats want to extract is keeping the Obamacare mandate that individuals buy health insurance, which would be eliminated in the Republican tax bill heading toward final passage next week.
“Should you enact a tax bill by the end of the year that adds $1.5 trillion to the deficit and, as a result, triggers PAYGO cuts next month, any effort to mitigate those cuts must also remove these other catalysts of uncertainty,” the Democrats’ letter to Ryan said Friday. “At a minimum, that must include rejecting the elimination of the individual mandate as well as the use of reconciliation procedures next year for Medicare benefit cuts in order to fill the fiscal gap left by your tax bill.”” (C)

“Sen. Lamar Alexander acknowledges that the final tax bill set to pass this week will increase health insurance costs for those who use the federal exchanges. But he says his bipartisan bill to stabilize the insurance marketplace will offset the cost increase.
The tax bill ends the individual mandate for everyone to buy insurance, which would likely mean many healthy people would drop their coverage, making marketplace customers a sicker bunch more costly to insure.
Still, the Republican chair of the Senate’s health committee is glad to see the mandate go.
“That’s good news for most Tennesseans because it means you don’t have to pay a penalty for insurance you don’t want to buy. But it will also slightly create upward pressure on premiums,” Alexander said Friday after speaking to the Brentwood Rotary Club. “But the Alexander-Murray legislation will push rates down a lot further than repeal of the individual mandate will push them up.
According to Alexander, Senate Majority Leader Mitch McConnell has “pledged” to put the Alexander-Murray compromise into the spending bill that should be voted on later this week. Alexander believes he also now has support from President Trump, even though the president has previously called it a “bailout” for insurance companies.” (D)

“In other words, Senator Collins plans to vote for the Tax Cuts and Jobs Act when it reaches the Senate floor, probably tomorrow. But Collins is no dupe. Her support for the legislation is clearly the right position for any member of Congress purporting to represent the best interests of Maine’s 1.3 million residents. That the bill repeals Obamacare’s individual mandate is not a betrayal of her constituents, as some have suggested. It will instead remove a significant tax burden that falls disproportionately on the shoulders of Maine voters. As the Bangor Daily News reports, Mainers pay a larger than average share of the individual mandate’s tax penalty:Maine tax filers paid nearly $15.5 million in the ACA tax penalty in 2015, the most recent year for which the data are available. That’s about 5.25 percent of all tax filers in the state that year, a high share compared to other states. Nationwide, 4.5 percent of all tax filers paid the penalty in 2015.”….
This is why Senator Collins insisted on an amendment to the tax bill that would permit taxpayers to itemize deductions up to $10,000. The Wall Street Journal outlines the deal thus, “The House and Senate bills each allowed only property taxes to be used toward that cap. But under the agreement … that total could be used for property taxes and for either income or sales taxes.” Collins also extracted an amendment that would reduce the threshold for medical expense deductions from 10 percent to 7.5 percent of gross adjusted income, and a commitment from the Republican leadership to forestall any cuts to Medicare that would be automatically triggered by deficits.” (E)

“The expected repeal of the ObamaCare mandate to buy health insurance means that states will soon have to step in and decide whether to create their own mandates….
Outside experts and supporters of ObamaCare predict chaos in the insurance markets if the tax bill passes and the mandate is repealed.
Premiums are expected to rise significantly and insurers could leave the marketplace. The Congressional Budget Office estimated that about 13 million more people would be without insurance in 10 years.
States have the power to potentially blunt the damage if they choose to enact their own mandate penalties, but even officials in the most liberal states could face a bruising political battle.” (F)

“New rules from the Donald Trump administration that would allow cheaper, less regulated health plans into the individual insurance market have alarmed healthcare providers, insurance companies and consumer groups….
In addition, Trump wants “short-term, limited duration health plans” that may be cheaper but will cover less and attract healthy, younger purchasers away from individual health plans with richer benefits. By siphoning off healthier Americans to cheap plans Trump wants, those sold on public exchanges under the Affordable Care Act could become more expensive if a higher concentration of older and sick patients are enrolled.
“Expanding and extending short-term, limited-duration health plans, increasing enrollment in association health plans (AHPs), and relaxing rules for employer health reimbursement arrangements (HRAs) all increase adverse selection in insurance markets that serve millions of individuals and employers,” the health groups wrote to insurance regulators.
Given such concerns, it’s unclear if there will be any insurance carriers that want to sell Trump’s plans , which likely wouldn’t be available to buy until late next year for 2019 at the earliest. And analysts worry those policies that do reach the market won’t provide adequate benefits.” (G)

(A) The Republican tax bill is an American betrayal, by Ezra Klein, The Republican tax bill is an American betrayal, https://www.vox.com/policy-and-politics/2017/12/18/16782484/gop-tax-bill-cuts-reform-republican
(B) Republican tax bill fuels anxiety across the nation’s healthcare system by Noam N. Levey, http://www.latimes.com/politics/la-na-pol-tax-bill-healthcare-20171218-story.html
(C) Democrats Threaten to Allow Medicare Cuts to Save Obamacare, by Erik Wasson, https://www.bloomberg.com/news/articles/2017-12-16/democrats-threaten-to-allow-medicare-cuts-to-save-obamacare
(D) Alexander Expects His Bipartisan Obamacare Fix Will Be Passed This Week, by BLAKE FARMER, http://nashvillepublicradio.org/post/alexander-expects-his-bipartisan-obamacare-fix-will-be-passed-week#stream/0
(E) Why Susan Collins Will Vote to Kill Obamacare’s Insurance Mandate, by DAVID CATRON, https://spectator.org/we-interrupt-this-broadcast-who-speaks-for-america/
(F) ObamaCare mandate repeal would put pressure on states, by NATHANIEL WEIXEL, http://thehill.com/policy/healthcare/365182-obamacare-mandate-repeal-would-put-pressure-on-states
(G) Concerns Grow About Cheaper Trumpcare Plans, by Bruce Japsen, https://www.forbes.com/sites/brucejapsen/2017/12/17/concerns-grow-about-cheaper-trumpcare-plans/#135bc13557e4

“With the bill finally headed to a vote this coming week, taxpayers are scrambling to determine whether the legislation renders them winners or losers.
WINNERS
PRESIDENT TRUMP AND HIS FAMILY. Numerous industries will benefit from the Republican tax overhaul, but perhaps none as dramatically as the industry where Mr. Trump earned his riches: commercial real estate. Mr. Trump, along with his son-in-law Jared Kushner, who is part owner of his own real estate firm, will benefit from lower taxes on so-called “pass through” income, which is money earned by partnerships and other types of businesses whose income is passed through to its owner and taxed at the individual tax rate. Mr. Trump and Mr. Kushner benefit since they own properties through limited liability companies and other similar vehicles.
LOSERS
PEOPLE BUYING HEALTH INSURANCE. With the repeal of the individual mandate, some people who currently buy health insurance because they are required by law to do so are expected to go without coverage. According to the Congressional Budget Office, healthier people are more likely to drop their insurance, leaving insurers stuck with more people who are older and ailing. This is expected to make average insurance premiums on the individual market go up by about 10 percent. All told, 13 million fewer Americans are projected to have health coverage, according to the Congressional Budget Office.” (A)

“The tax bill barreling toward a final vote in Congress guts the most unpopular “Obamacare” provision, its requirement that virtually all Americans carry health insurance or face fines.
Politically, the move is a winner for Republicans, who otherwise would have little to show for seven years of rhetoric and repeated legislative efforts to kill the Affordable Care Act.
But if estimates by the nonpartisan Congressional Budget Office are right, it will lead to more uninsured people and higher premiums for those buying individual health insurance policies.
Congress may then find itself considering other ways to nudge people to get health insurance.
Other popular parts of the Affordable Care Act would remain in place, including subsidized premiums, “essential” benefits and protections for people with pre-existing medical conditions.” (B)

“The severity of the impact is a matter of debate among health policy experts.
The Congressional Budget Office predicts that four million fewer people would be covered in the first year the repeal would take effect. That number would rise to 13 million by 2027, as compared to current law. Meanwhile, premiums would rise by about 10% in most years of the decade.
But the agency also said it is reviewing its methodology. Others say fewer people would be left uninsured. S&P Global Ratings, for instance, projects that only three to five million more consumers would lack coverage over a decade because the mandate is not a key driver for obtaining insurance.
Still, many experts feel that removing the mandate would cause the individual market to tilt even more towards sicker and older consumers. That’s because the mandate serves as a stick to prod some younger and healthier Americans to sign up for coverage.
That shift may prompt some insurers to drop out of the market, especially since they would still be required to cover those with pre-existing conditions but would not be able to charge them more based on their medical history.
If a wave of insurers exit Obamacare, some consumers could be left without any providers on their exchanges in 2019. Already, 29% of current enrollees on the federal exchange have only one option in 2018, according to federal data. Residents in eight states — Alaska, Delaware, Iowa, Mississippi, Nebraska, Oklahoma, South Carolina and Wyoming — have only one insurer next year.” (C)

“The nongroup market refers to people who buy their own health insurance. Most Americans are covered by an employer. Many are covered by Medicare or Medicaid, a few get military health benefits and the so-called Obamacare markets were meant to help the rest get “nongroup” health insurance.
Health insurance premiums in this nongroup market will go up by 10 percent, the CBO predicted.
This will hit one group in particular, according to the Commonwealth Fund, which conducts studies in health policy and released a report Thursday on the Affordable Care Act.
“People who buy their own coverage on the individual market and who have incomes above 400 percent of the federal poverty level (about $48,200 for an individual and $98,400 for a family of four) — the threshold for ACA premium subsidies — would face the brunt of the premium increase,” it said.
A 40-year-old customer buying health insurance on one of the federal exchanges would pay $556 more in premiums in North Dakota and $1,264 more in Nebraska, the group calculated.” (D)

“The election of Doug Jones as the first Democratic senator from Alabama in a generation did many things: It opened a realistic, although still difficult, path for Democrats to capture a Senate majority in 2018, it deepened the divide between the GOP establishment and the self-styled insurgents led by Stephen K. Bannon, the former White House strategist.
And it probably ended GOP hopes of repealing the Affordable Care Act…
Throughout the past year, the Trump administration has taken one swing after another at the healthcare law, and seemingly each one has generated a chorus of predictions about the “death of Obamacare.”
That hasn’t happened….
The latest data on sign-ups came as a new study from the Commonwealth Fund, comparing data across states, showed that the law has, indeed, helped patients get to the doctor and pay their medical bills, contrary to the assertions from President Trump and others in his administration that the law was providing coverage that didn’t actually help people….
The only way to truly undo what the law has accomplished would be to cut off the billions of dollars that currently go to help more than 20 million people pay medical bills. Republicans tried repeatedly this year to cut back on that flow of funds with their various efforts to repeal Obamacare. They were poised to repeat that effort in 2018. But Jones’ upset victory now will likely put that prospect out of reach in the Senate.
Jones made healthcare a top issue in his campaign and explicitly told voters he would oppose repeal. “Repeal and replace is a political slogan,” he would say. “It’s not something that’s workable.” (E)

“But won’t the entire Obamacare system collapse without the mandate? Not if the states step into the breach. They’ve got the power to patch the hole that repeal of the mandate would leave in the ACA. The most ambitious states could even take steps to strengthen the law.
Massachusetts had an individual mandate well before the US did.
For starters, the states can adopt their own individual mandates to replace the one that Congress repeals. There’s nothing stopping them. Before the ACA existed, Massachusetts had a mandate; it’s still on the books. And, as Vox’s Sarah Kliff reported last week, a number of states — including California, Maryland, and Washington, as well as the District of Columbia— are toying with creating their own mandates.
Adopting mandates at the state level would help stabilize insurance markets, thereby keeping premiums in check and forestalling coverage losses. It would also provide a welcome source of revenue: Some people will still prefer to pay a penalty than buy insurance. Plus, the states don’t need to stick with the precise terms of the federal mandate, which has been reviled (from different quarters) both for heavy-handedness and its ineffectuality. Stiffer state-level penalties would still be unpopular, but at least they’d work better.” (F)

“Health economist Gail Wilensky said repealing the mandate might take some of the political steam out of the health care debate. It may even point to a path for lawmakers of both major parties to consider measures that would help stabilize insurance markets for people who don’t get coverage on the job.
It “may be enough to take away what has been the single most hated part of the ACA for both Republicans and Democrats,” said Wilensky, who served in a previous Republican administration.
But that won’t solve the problem of providing affordable coverage for people who don’t qualify for subsidies through “Obamacare.”
President Donald Trump’s administration is working on another track: regulations that would allow broader sale of lower-cost plans with limited benefits.
How much consumer appeal that alternative will have remains to be seen.” (G)

“Sen. Susan Collins said Thursday she isn’t concerned that House Republicans didn’t include Obamacare stabilization bills in its short-term funding bill, saying GOP leadership will add them to the Senate version.
The House GOP released a short-term continuing resolution Wednesday that funds the government until Jan. 19. It does not include two bills that the centrist Maine Republican has been pushing to stabilize Obamacare’s exchanges in return for her vote for tax legislation that includes a repeal of Obamacare’s individual mandate penalties.
Collins shrugged off the House snub, saying it didn’t matter if the House passes a spending bill that doesn’t include the legislation.
“That has never been the plan,” she told reporters. “The plan is for the majority leader to add [the bills] in the Senate.”…
Collins said Thursday that the plan is still to pass the bills by the end of the year, and the new continuing resolution would be the only opportunity left.” (H)

(A) The Winners and Losers in the Tax Bill, By JESSE DRUCKER and ALAN RAPPEPORT, https://www.nytimes.com/2017/12/16/business/the-winners-and-losers-in-the-tax-bill.html
(B) Tax Bill Guts Unpopular ‘Obamacare’ Insurance Mandate, https://www.nytimes.com/aponline/2017/12/16/us/politics/ap-us-taxes-health-care.html
(C) Will Obamacare survive the tax bill?, by Tami Luhby, http://money.cnn.com/2017/12/15/news/economy/obamacare-individual-mandate-tax/index.html
(D) Tax bill kills health insurance mandate. Who will pay more?, by MAGGIE FOX, https://www.nbcnews.com/health/health-care/tax-bill-kills-health-insurance-mandate-who-will-pay-more-n829846
(E) How Alabama saved Obamacare and other effects of an upset, by David Lauter, http://www.latimes.com/politics/la-pol-essential-politics-20171215-story.html
(F) The tax bill destroys an important part of Obamacare. The states can save it., by Nicholas Bagley, https://www.vox.com/the-big-idea/2017/12/14/16773294/obamacare-aca-states-protect-coverage-after-tax-bill
(G) Tax Bill Guts Unpopular ‘Obamacare’ Insurance Mandate, by RICARDO ALONSO-ZALDIVAR, https://www.usnews.com/news/politics/articles/2017-12-16/tax-bill-guts-unpopular-obamacare-insurance-mandate
(H) Susan Collins: Senate eyes adding Obamacare bills to short-term funding deal, by Robert King, http://www.washingtonexaminer.com/susan-collins-senate-eyes-adding-obamacare-bills-to-short-term-funding-deal/article/2643551

Doing so could jeopardize Obamacare’s already-shaky marketplaces, by reducing the number of healthier people who sign up for insurance.
The bill will “repeal Obamacare’s individual mandate tax, delivering relief to low- and middle-income Americans who have struggled under an unpopular and unworkable law,” the Kentucky Republican said in an emailed statement.” (A)

“Susan Collins believes, or claims to believe, that Paul Ryan can be trusted to protect Medicare. She thinks that seniors and Americans with disabilities who rely on the program’s benefits should trust him too. That requires ignoring everything that Ryan has ever said about Medicare…
Not only is Collins insisting that Ryan is to be trusted, and can deliver the votes, when it comes to protecting Medicare. She is showing the same gullibility — or hypocrisy — with respect to the health care of those not yet of Medicare age. The tax bill she voted for would repeal the individual mandate, an essential provision of the Affordable Care Act. That would result in 13 million people losing their insurance coverage. For those who still remain in the ACA marketplaces, premiums would go up by an average of ten percent.
But Collins claims that these harms will be mitigated because Congress will separately pass the Alexander-Murray agreement to stabilize the marketplaces. Why is she so sure they will pass it? McConnell and Ryan promised…and of course, they would never go back on their word. If they are so willing to pass it, why didn’t they do so already as part of the just-passed extension of the continuing resolution? A different vehicle will make passage even harder” (B)

“To assume that Collins was “duped” into voting for the tax bill requires thinking that she is profoundly stupid. She might be, but I don’t think she is. An alternate analysis is that Collins is not naive; that she knew all along that McConnell’s promises were worthless; and that she simply wanted a reason to justify (to constituents or to herself) voting for the tax bill. Vote for the bill, then perform disappointment when McConnell pulls the rug out from under you or the House refuses to even consider the “deal” you claim you were promised. Bada-bing, bada-boom….
Susan Collins is not an innocent bystander to the country’s destruction by her party, and it’s time for political commentators to stop treating her as such. Susan Collins is a centrist in today’s Republican Party, which is to say she surpasses the lowest possible bar for basic human decency that exists. Susan Collins is a moderate Republican in the same way that your Aunt Sue is your favorite aunt by default, because at least Aunt Sue doesn’t drink too much chardonnay and tell you the HPV vaccine is going to kill you.
If I had to bet, I’d say Susan Collins will vote for the final version of the tax bill, knowing full well that most of her constituents in Maine would detest it if they knew all its grisly details. I hope she proves me wrong.” (C)

“What happens if the Obamacare death spiral occurs?
The future of the health insurance market, and of President Obama’s signature legislation, is decidedly uncertain. If Republicans make no further changes during the remaining three years of President Trump’s term, the exchanges may limp along, and the Obamacare market may essentially become an expensive, high-risk pool in which insurers offer costly coverage and the government pays ever-increasing subsidies to cover rising premiums.
Or the death spiral may be used as a pretext to repeal the law entirely, throwing the insurance market into further chaos unless a replacement plan is put in place.
Those buying policies on the open market may wish to consider investing in a health savings account so they at least have pre-tax funds available to pay for healthcare expenditures in case the insurance market is upended and the disruption causes a temporary gap in coverage.” (D)

“A group of insurance experts is warning Congress against repealing ObamaCare’s individual mandate, saying the move would raise premiums and could cause insurers to drop out of the market.
The American Academy of Actuaries wrote to congressional leaders on Tuesday saying that “eliminating the individual mandate would lead to premium increases…
The insurance experts also say that a measure pushed by Sen. Susan Collins (R-Maine), intended to help offset the premium increases from repealing the mandate, would not be enough to make up the difference.
That bill, sponsored by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), would fund key ObamaCare payments known as cost-sharing reductions. The actuaries say the payments “would not offset premium increases due to an elimination of the mandate…”
“Insurers would likely reconsider their future participation in the market,” the actuaries write. “This could lead to severe market disruption and loss of coverage among individual market enrollees.” (E)

“House conservatives are launching a full-court press to preserve a key provision rolling back ObamaCare in the final tax-reform bill being crafted behind closed doors by congressional negotiators…
“ObamaCare’s coercive individual mandate represents perhaps the worst example of the federal government violating individual freedom and liberty — which is why we have repeatedly promised to repeal it,” Walker and 70 other committee members said in letter to lead negotiators Texas Rep. Kevin Brady and Utah Sen. Orrin Hatch. “We urge you to help fulfill our promise to the American people and include this language in a final conference package.”
Repealing the mandate would at least give Republicans a significant victory toward the larger goal of a full repeal-and-replace….
The president wants a final GOP tax plan on his desk before Christmas.” (F)

“Ms. Collins remained respectful and strained to convince the room of about a dozen skeptics that the promises that had been made to her were ironclad.
She defended her decision in the face of the group’s challenges that previous Republican promises for the tax bill had been broken, including a commitment to not add to the deficit and to not benefit the rich, and that written agreements are not law.
“I do not believe that I’ve given up leverage,” Ms. Collins said. “I’ve used my leverage to negotiate agreements that are promises to me.”” (G)

(A) GOP Tax Compromise Would Repeal Obamacare’s Individual Mandate, by Zachary Tracer, https://www.bloomberg.com/news/articles/2017-12-13/obamacare-coverage-requirement-undone-in-gop-tax-compromise
(B) Will Susan Collins Save Medicare?, https://www.huffingtonpost.com/entry/will-susan-collins-save-medicare_us_5a317543e4b06a512dd69cdf
(C) Susan Collins Isn’t Being Duped Into Anything, by Emma Roller, https://splinternews.com/susan-collins-isnt-being-duped-into-anything-1821188722
(D) What Is the Obamacare “Death Spiral” — and Can It Be Stopped?, http://www.foxbusiness.com/markets/2017/12/10/what-is-obamacare-death-spiral-and-can-it-be-stopped.html
(E) Actuaries warn of premium increases from repealing ObamaCare mandate, by PETER SULLIVAN, http://thehill.com/policy/healthcare/364514-actuaries-warn-of-premium-increases-from-repealing-obamacare-mandate
(F) Conservatives fight to keep ObamaCare mandate repeal in tax bill, by Joseph Weber, http://www.foxnews.com/politics/2017/12/12/conservatives-fight-to-keep-obamacare-mandate-repeal-in-tax-bill.html
(G) Last-Ditch Effort to Sway Senator on Tax Bill Involves Personal Pleas, by ALAN RAPPEPORT, https://www.nytimes.com/2017/12/14/us/politics/susan-collins-tax-bill.html?_r=0

Before she voted for the Senate version of the Republican tax bill, Sen. Susan Collins saw that Congress would soon be passing separate spending deals, and she had demands.
The Maine Republican laid out a series of conditions for her to support the final “conference committee” version of the tax proposal. Most notably, she wants Congress to pass two separate health care bills first….
It’s unclear how the separate health bills would become law before a final tax vote. Though Collins secured support from both President Donald Trump and Senate Majority Leader Mitch McConnell (R-Ky.), neither man controls the House of Representatives.
House Speaker Paul Ryan (R-Wis.) has suggested he doesn’t support the Collins demands, saying he wasn’t a party to her deal with McConnell. And Rep. Mark Walker (R-N.C.), leader of a group of lawmakers called the Republican Study Committee, said the conservative bloc had been promised by GOP leaders that the health bills would not be part of a must-pass spending package this month.
Collins wants Congress to pass the so-called Alexander-Murray deal — an agreement worked out between Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) that would provide for “Cost Sharing Reductions” for Obamacare insurers — and another bill providing $2.25 billion annually for states to offset the high insurance costs of some individuals.
Without those measures signed into law, McConnell could just invite Collins to become the one remaining “no” vote Senate Republicans can afford, since their tax bill passed with 51 votes last Saturday….
It would be difficult for Republican leaders to appease Collins without betraying House conservatives.
On Thursday, they went along with a stopgap spending bill under the conditions that there would be no Alexander-Murray provisions in any of the other upcoming measures to fund the government. Ryan and House Republicans could very well pass another short-term appropriations bill in two weeks, have the Senate change the bill — because, after all, McConnell needs Democratic votes to pass that bill in his chamber — and then force Ryan and House Republicans to pass the Senate version or shut down government.
But no matter the ultimate conclusion, Collins is already being asked to accept more things on faith than she was supposed to. Earlier in the week, the House Freedom Caucus nearly derailed a vote to begin merging the separate versions of the tax legislation until leaders agreed to “decouple” the tax bill from the other spending bills, with Freedom Caucus Chairman Mark Meadows (R-N.C.) telling reporters that the final tax bill would now likely come next week, days before Senators vote again on a spending bill.
If that’s the case, Collins will once again be asked to vote for legislation she believes is harmful to Americans with the promise that Congress will mitigate their actions in the future.
If Collins objects, any one other Republican senator — with Bob Corker (R-Tenn.) continuing to oppose the bill — could sink the tax legislation. And other senators may hold up the process until Collins receivers firmer commitments. Sen. John McCain (R-Ariz.), for example, could have a problem with McConnell going back on his word.” (A)

“But it should be clear at this point, to Collins and to House conservatives, that someone is going to get hoodwinked. At least one GOP leader is going to have to go back on his word. And it should be clear at this point that these commitments Republicans are making are a lot looser than members of Congress think…
Republican Sen. Susan Collins of Maine says she would consider removing her support from GOP tax plans, saying in an interview she could change her vote if her proposed amendments don’t make it in the final version.
“I would (consider changing my vote),” she told CNN affiliate CBS WABI5 on Thursday. “I’m going to look at what comes out of the conference committee meeting to reconcile the differences between the Senate and House bill. So I won’t make a final decision until I see what that package is.”…
Collins, a moderate Republican, voted for the GOP’s tax plan last week despite having helped kill the GOP’s Obamacare repeal efforts earlier this year. Several aides told CNN that Collins made clear to Senate Majority Leader Mitch McConnell that she wanted to get to “yes” on the tax legislation, unlike with health care.
“There’s a real fear that the tax bill is going to trigger a 4% cut in Medicare,” she told CBS WABI5 in the interview. “I am absolutely certain that 4% cut in Medicare that I mentioned will not occur. I have it in writing from both the speaker of the House, Paul Ryan, and also Senator Mitch McConnell.” (B)

Meanwhile, it looks as though funding for another cost-sharing reduction (CSR) payments won’t make it into the next spending bill, according to The Hill. Republican Study Committee chairman Rep. Mark Walker said House leaders made that promise during a meeting Tuesday.
That is likely unwelcome news for Sen. Susan Collins, R-Maine. She agreed to vote for the Senate’s tax bill—which repeals the ACA’s individual mandate—after striking a deal with Senate Majority Leader Mitch McConnell to pass a bill funding CSR payments and her reinsurance proposal. The idea is that those bills might mitigate the negative effects of repealing the individual mandate—though some analyses have disputed that notion.
Collins said Friday that she might change her vote on the GOP’s tax overhaul if party leaders don’t include her amendments to that measure, which are related property tax and medical expense deductions, the Associated Press reported. Collins also noted that House and Senate leaders promised her they would remove the threat of a 4% cut to Medicare. (C)

“Sen. Lisa Murkowski (R-Alaska) is pushing back on Democratic attacks that she is undercutting ObamaCare, saying opponents are simply using “scare tactics.”
In a question-and-answer video posted on her YouTube page, Murkowski defended her vote for tax reform this month. Murkowski backed a bill that includes language repealing ObamaCare’s individual mandate.
“I think it’s important that people really look to what is included in this bill when it relates to the Affordable Care Act and to get beyond the scare tactics and the rhetoric that is designed to just instill fear and paranoia in people,” Murkowski said.
She notes that the only provision in the tax bill related to ObamaCare is the repeal of the requirement to have coverage or pay a fine.
“What this bill does is says if you can’t afford health-care coverage, or if you don’t see that value in it, we’re not going to fine you,” she said. “It doesn’t impact the ACA in any other way. If you receive a subsidy for your health-care insurance before this tax bill passes you will still be able to receive a subsidy after.”
Murkowski was one of three Republican senators who voted down a Republican ObamaCare repeal attempt over the summer, which included repeal of the mandate. She has drawn sharp criticism from Democrats this time for voting for the repeal of the mandate.
Opponents of her move argue that eliminating the mandate will have wider impacts, and that it could lead to a spike in premiums or insurers dropping out of the market once an incentive for healthy people to enroll is removed.
The Congressional Budget Office finds that premiums will increase 10 percent and 13 million fewer people will have coverage over a decade if the mandate is repealed.
Murkowski argued that subsidies available under the health-care law will encourage many people to remain enrolled in ObamaCare.
She also touted a bipartisan bill from Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) as one that would help stabilize the market by providing funds for key insurer payments.
“It is my understanding that as part of the negotiation, not only has the Senate leadership committed that we will advance Alexander-Murray, but the president has indicated that support as well, so prior to the end of this year, I think we can anticipate that we will see that piece inserted as well,” Murkowski said.
Many House Republicans, though, are opposed to the bill, raising questions on if it can pass that chamber.
Experts say that Alexander-Murray alone is also not enough to counteract the premium increases from repealing the mandate, and that additional funding would be needed to bring down premiums.” (D)

“Marc Short, the White House director of legislative affairs, said the change for state and local tax deductions is “certainly being discussed.” But he said “the biggest challenge is the pay-fors” — that is, how to cover the revenue that would be lost by offering a larger deduction….
By Monday, Cohn added, “we’ll have a pretty final tax bill here, and we’ll know where we’re going to be.”
Short predicted that two GOP senators who have cited specific concerns about the legislation — Marco Rubio of Florida and Susan Collins of Maine are “going to be fine” in the end….
Collins has said she wants to see separate legislation passed to shore up health-insurance marketplaces if the ultimate tax bill repeals the individual mandate that’s part of Obamacare. The measures will almost surely face rough sledding in the House, however.
On Thursday, the White House didn’t commit to supporting the health-care bills Collins wants. Short said Friday that “if those reach the president’s desk he will sign them, but there’s some elements of that as far as the lobbying and whipping of votes that is out of our control.”” (E)

“Sen. Susan Collins, the Maine Republican whose vote was pivotal in pushing the GOP tax bill forward last week, thought she had a deal to bolster health care protections in exchange for her support.
But it’s now unclear whether her strategy to shore up part of the Affordable Care Act will prevail or that it would produce the results she anticipates.
The tax bill repeals the ACA’s fines for the individual mandate, which requires most people to have health insurance or pay a fine. Collins says she would vote for it if Senate Republicans promised to allow a vote on two other health bills….
The tax bill is now the subject of final negotiations between the House and the Senate. First, even if the bills pass the Senate, there is little to suggest that the House Republicans would go along. On Tuesday, House Speaker Paul Ryan, R-Wis., reportedly told other House leaders he was not a party to Collins’ health care deal with McConnell. Ryan had previously expressed opposition to restoring the cost-sharing payments.
In response to Ryan, Collins on Thursday signaled that she might not vote for the tax bill’s final passage.
But would Collins’ changes offset the elimination of the mandate? Some analysts question whether the bill restoring the federal cost-sharing subsidy payments could actually do more harm than good.
“It’s a mess,” says insurance industry consultant Robert Laszewski. Many states allowed insurers to raise premiums to make up for the loss of the federal cost-sharing reduction payments. So passing the law now, at least for 2018, would require insurers to make refunds to individuals and the federal government for those overpayments….
The elimination of the mandate penalties is permanent, but Collins’ bill would fund the cost-sharing and reinsurance programs for only two years. Because of that, says Timothy Jost, a former law professor and expert on the health law, “I don’t think it’s going to be much of a carrot” to encourage insurers to stay in the individual market…..” (F)

Health insurance companies know that an insurance market without the requirement that everyone get coverage will be worse for them and their customers. They just aren’t sure how much worse.
HuffPost contacted dozens of health insurance companies to ask them to assess the impact that removing the so-called individual mandate ― which Republicans in Congress are on the verge of doing as part of their tax bill ― would have on their businesses and their customers.

Fifteen companies responded ― and all warned that eliminating the mandate would force them to further raise prices, and could drive some insurers to leave the market altogether. Both of those outcomes would lead to fewer Americans having health insurance and destabilize an insurance market already plagued with problems.
Let’s assume for a second that you eliminate the mandate and so those healthy people decide to sit out, whether they need a subsidy or not, the pool shrinks,” said Jim Havens, senior vice president of individual and senior markets for Mountlake Terrace, Washington-based Premera Blue Cross.
“That means that the people left are people who either intend to use it or think they will be using it, which is going to make it more expensive,” Havens said. Premera is the sole insurer offering individual policies in Alaska and also operates in Washington state.
The biggest losers would be middle-class people who don’t get health benefits from their employers and make too much money to receive subsidies for private insurance from a health insurance exchange. They will see fewer choices and higher prices in the future.
People who live in sparsely populated regions are at the greatest risk of extremely high premiums, and of having no insurers doing business where they live because rural areas already are the toughest locations to make a profit.” (G)

*Quote attributed to Warren Buffet

(A) Susan Collins Never Had An Actual Deal On Taxes, by Arthur Delaney and Matt Fuller, https://www.huffingtonpost.com/entry/collins-tax-vote_us_5a2ac0d1e4b0a290f050378a
(B) GOP Sen. Susan Collins says she would consider changing her tax plan vote over amendments, by Daniella Diaz, http://www.cnn.com/2017/12/08/politics/susan-collins-republican-gop-tax-plan-amendments/index.html
(C) GOP lawmakers mull health insurance tax delay, by Leslie Small, https://www.fiercehealthcare.com/regulatory/gop-lawmakers-mull-health-insurance-tax-delay
(D) Murkowski pushes back on ObamaCare ‘scare tactics’, by Peter Sullivan, http://thehill.com/policy/healthcare/363975-murkowski-pushes-back-on-obamacare-scare-tactics
(E) Trump Backs Keeping State Income Tax Break With Cap, Cohn Says, by Toluse Olorunnipa and Jonathan Ferro, https://www.bloomberg.com/news/articles/2017-12-08/trump-backs-keeping-state-income-tax-break-with-cap-cohn-says
(F) Doubts Rise About Sen. Collins’ Strategy To Shore Up Insurance Market, by Julie Rovner, http://www.wbur.org/npr/569421827/doubts-rise-about-sen-collins-strategy-to-shore-up-insurance-market
(G) Health Insurers See Higher Prices And A Big Mess Ahead Without The Obamacare Mandate, by Jeffrey Young, https://www.huffingtonpost.com/entry/health-insurers-higher-prices-obamacare-mandate-repeal_us_5a272277e4b0c2117626a077

“We’re going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit,” Ryan said during an appearance on Ross Kaminsky’s talk radio show. “… Frankly, it’s the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements — because that’s really where the problem lies, fiscally speaking.”…
Ryan’s remarks add to the growing signs that top Republicans aim to cut government spending next year. Republicans are close to passing a tax bill nonpartisan analysts say would increase the deficit by at least $1 trillion over a decade. Trump recently called on Congress to move to cut welfare spending after the tax bill, and Senate Republicans have cited the need to reduce the national deficit while growing the economy.” (A)

“Healthcare lobbyists are scrambling to win changes in congressional Republican tax legislation, as Senate and House GOP leaders race to merge their separate bills into something both chambers can pass on a party-line vote this month.
But provider, insurer and patient advocacy groups doubt they can convince Republicans to remove or soften the provisions they find most objectionable. They say GOP leaders are moving too fast and providing too little opportunity for healthcare stakeholders to provide input….
Some lobbyists hold out a faint hope that the Republicans’ tax cut effort could collapse as a result of intra-party differences, as did their drive to repeal and replace the Affordable Care Act.
One possibility is that Maine Sen. Susan Collins flips and votes no on the tax cut bill emerging from the conference committee if congressional Republicans fail to pass two bipartisan bills she favors to stabilize the individual insurance market….
Collins conceivably could be joined by Alaska Sen. Lisa Murkowski, who also said she wants to see the market stabilization bills passed. If Tennessee Sen. Bob Corker, who voted no on the tax cut bill over deficit concerns, remains opposed, those three GOP senators could sink the tax bill. “We’d all like to see Collins pull her vote,” Hobson said. “It was always clear that the deal she cut with McConnell won’t fly on the House side.”” (“It appears virtually certain that repeal of the law’s individual mandate to buy coverage will be included in a final tax bill. Two of the moderate senators most likely to defect over that issue — Collins and Lisa Murkowski of Alaska — are okay with getting rid of the mandate, arguing it has been less effective than expected and its associated penalty is paid chiefly by lower-income Americans.
The question is whether Republicans will also manage to pass the two bipartisan measures essentially infusing cash into marketplace plans — a move that analysts say will help insurers lower premiums, which have been spiking across the country.” (B)

“A measure from Alexander and Sen. Patty Murray (D-Wash.) would fund $7 billion in extra cost-sharing discounts; another one from Collins and Sen. Bill Nelson (D-Fla.) would provide $4.5 billion in reinsurance funding. If either one passes, it probably would be as part of a big spending measure.” (C)

“So how’s that working out for you, Senator Collins?
The latest bit of bad news for Collins comes from Avalere Health. According to an analysis the healthcare consulting company released this morning, the reforms sought by Collins, while helpful, are possibly “overshadowed” when the Senate tax bill’s repeal of the individual mandate is taken into account.
The basic problem is that according to the Congressional Budget Office, mandate repeal will cause premiums to spike. The two pieces of legislation that Collins is supporting would try to make up for this. One bill would give insurers $4.5 billion over the next two years to help compensate for the costs of covering sick – read expensive – patients, something known as reinsurance. The other bill would restore payments to insurers — which Trump had stopped — and which would cover the cost of insuring low income people, otherwise known as cost-sharing reductions, or CSRs.
Together, they are supposed to keep down premiums. Caroline Pearson, a senior vice president at Avalere, told The Hill that their study concludes that “From a premium point of view, we do think reinsurance and CSRs probably covers the mandate.”
But this remains unclear. Topher Spiro, a health policy analyst at the liberal Center for American Progress, points out that the analysis actually doesn’t support that conclusion, once you take account of the fact that Trump has already halted the CSRs; restoring them will merely return us to the previous status quo.
What’s more, a number of healthcare wonks recently told Vox that the second of these two bills will not do nearly enough to fix the spiking premium problem.
And finally, the actions sought by Collins only cover a two-year period, and Avalere’s own experts conclude that once they expire, they would do little to deal with spiking premiums. As Elizabeth Carpenter, a senior vice president at Avalere, put it: “Eliminating the requirement to purchase coverage would create additional uncertainty in the market. It is important not to overlook the negative impact of repealing the individual mandate on long-term market stability.” (D)

“Ed Kilgore, writing in New York magazine, said Collins “is an experienced, savvy legislator. She knew when she cut her deals with Trump and McConnell that they would be worthless if the House didn’t go along.”
“She could have demanded assurances from Ryan and conservative leaders, too — certainly she could have demanded the moon at the point where it appeared she might be the decisive vote in the tax bill.
“What this series of events shows is that Collins, like the other alleged ‘holdouts,’ really wanted to ‘get to yes,’ as we kept hearing last week. If that meant securing a promise written in vanishing ink, so be it,” Kilgore said.
Collins’ office released a copy of the agreement reached between McConnell and Collins. Both had signed it. On its face, the ink looks pretty permanent.
In any case, whether Collins got played will be clear within weeks as Congress moves to adopt both the tax bill and a budget measure that Collins expects to include the health care measures she wants.” (E)

“Ms. Collins has released a copy of her agreement with Mr. McConnell in which he pledged to support passage of the two measures before the end of the year. His signature was displayed prominently at the top of the first page. But the deal has landed with a thud in the House, where Republicans appear loath to support legislation that they view as propping up a health law that they have pledged to repeal.
“Our members wince at voting to sustain a system that none of them supported,” said Representative Tom Cole, Republican of Oklahoma.
The Senate could attach the Alexander-Murray legislation to a government funding measure, hoping that Republicans in the House would be willing to swallow it as part of a measure to avoid a government shutdown. But Mr. Cole said House Republicans would be “very offended” at such an approach.
“I don’t think we’re in the mood to be blackmailed by anybody,” he said.
Mr. Brat, a member of the conservative Freedom Caucus, assailed the deal with Ms. Collins as an example of horse trading that is characteristic of the Washington swamp that he said voters had repudiated.
Likewise, Representative Mark Walker of North Carolina, the chairman of the conservative Republican Study Committee, said of the Alexander-Murray bill, “There’s no appetite for that over here.”
Ms. Collins said on Wednesday that she believed the House would “take a serious look” at the two bills intended to hold down insurance premiums and that Mr. Trump, in several recent meetings, had assured her that he also supported those bills.
“I don’t think this effort is over by any means,” Ms. Collins said.” (F)

“…The open enrollment period for 2017 is significantly shorter this year compared to last. The Trump administration shrunk the sign-up stretch to six weeks instead of three months.
With the December 15 deadline fast approaching, the number of plan selections is well short of the more than 9 million people who signed up on the federal exchange last year….
Matthew Fiedler, a fellow at the Brookings Institution’s Center for Health Policy, said there are a lot of reasons for the enrollment drop-off — but not one that stands out above others.
“My view is that various administration actions — including the shorter enrollment period, the reduction in outreach funding, higher premiums for unsubsidized consumers due to policy uncertainty, and consumer confusion about the ACA’s future — have weighed on enrollment, but the size of each of those effects is uncertain,” Fiedler told Business Insider.
Fiedler said that the decrease in enrollment will likely be detrimental to people enrolled on the exchanges.
“In terms of what the effects of lower enrollment will be, a lower uninsured population will be damaging. The additional uninsured will have worse access to care and be less financially secure,” Fiedler told Business Insider. “Similarly, other individual market enrollees will face higher premiums since the lost enrollees are likely healthier than average, and health care providers will face higher uncompensated care costs.”…
Fiedler said that the Obamacare markets could still “muddle through” even with lower enrollment.
“While bad, enrollment declines are not an existential threat to the individual market,” he said. “The impact of enrollment declines on the risk pool are smaller than sometimes thought. Furthermore, the rate increases insurers implemented for 2018 appear to be large enough to accommodate the deterioration in the risk pool we are likely to see.”” (G)

“A reinsurance program funded with $10 billion or even $15 billion in annual spending could actually offset the price hikes expected to result from individual mandate repeal. But that, of course, costs more money. And again, it doesn’t address what happens after 2020 at all.
This is what experts predicted about the Collins bill. “The Collins-Nelson bill would help mitigate premium increases resulting from repeal of the individual mandate, but it would fall short of completely offsetting the hikes,” Larry Levitt at the Kaiser Family Foundation told Dylan last week.
And at the end of the day, a lot of this debate may be moot. The Collins plan needs 60 votes to move through the Senate (unlike the tax bill, which is being run through the reconciliation process and thus only requires 50 votes). Whether Democrats would want to work with Republicans to pass a bill like this — whether more conservative senators would even get on board — is a big open question.
My takeaway from the Avalere analysis is this: Repealing the individual mandate will cause uncertainty and confusion in the individual market. That much is certain. The Collins plan is a Band-Aid on a much larger problem caused by the Senate bill — one that it just can’t fix.” (H)

“After taking a beating for three years, health plans jacked up their rates for 2017, with the average premium on the most popular products rising more than 20 percent. That created sticker shock for many Obamacare customers while putting many insurers on pace to record profits this year for the first time, according to a POLITICO analysis of 31 regional Blue Cross Blue Shield plans, many of which dominate Obamacare markets in their states.
But the turnaround comes just as Republican efforts to dismantle the health care law are creating new threats to the viability of the marketplaces. That leaves the plans in a bewildering situation, trying to improve their margins while the GOP declares Obamacare a failure and mounts another push to dismantle the system, starting with rolling back the health care law’s individual mandate.
“The political narrative is over a market in crisis, and that’s just not how the market actually looks right now,” said Larry Levitt, senior vice president for special initiatives at the Kaiser Family Foundation, a nonpartisan research group. “At this moment, the individual insurance market looks quite stable and most insurers have achieved profitability.” (I)

“The two core pieces of Obamacare are the subsidies that help middle-class families afford private insurance and the expansion of Medicaid for working-class families. The tax bill doesn’t get rid of either. Instead, it will likely repeal the individual mandate — the requirement that people buy health insurance. As a result, health-insurance markets will suffer some turmoil, and costs for some families will rise.
Most people who want health insurance will still be able to get it, though. And health care advocates can reduce the impact of the mandate’s repeal through public-information campaigns that encourage people to sign up. The elimination of the insurance subsidies and Medicaid expansion would be qualitatively worse.
Many big fights remain. The tax bill’s supporters have a clear vision, and they’ve been surprisingly up front about that vision. The first step is to cut taxes. The second is to cut government programs like Medicare, Social Security, Medicaid and much else.
But this tax bill itself doesn’t accomplish the second step (with the exception of some modest automatic cuts). Republicans will have to pass other bills to shrink programs that benefit the middle class. Democrats are already gearing up to have those debates, as they should be. A McClatchy news headline yesterday: “Dems warn GOP: We’re prepared for class war.” Debates over spending cuts are easier for Democrats to win than debates over tax policy.” (J)

“Sen. Susan Collins (R-Maine) said Thursday that she may change her vote on the final version of the GOP tax-reform bill if her proposed amendments are not included in its final version.
“I would. I’m going to look at what comes out of the conference committee meeting to reconcile the differences between the Senate and House Bill. So I won’t make a final decision until I see what that package is,” Collins told CBS WABI 5 when asked if she would consider changing her vote…
“There’s a real fear that the tax bill is going to trigger a 4 percent cut in Medicare,” Collins added. “I am absolutely certain that 4 percent cut in Medicare that I mentioned will not occur. I have it in writing from both the Speaker of the House Paul Ryan [R-Wis.] and also Sen. Mitch McConnell [R-Ky.].”
Collin expressed optimism that the final bill will adopt her amendments.” (K)

“For the moment, none of this appears to have shaken Collins’s support for the bill. But it has ensured that her second vote for the Trump tax cuts will be more politically painful than her first one. Beyond the collapse of her health-care “deal,” the Republican bill isn’t getting any less (historically) unpopular. And progressive activists in Maine are mobilizing in opposition.
If Collins were to lose her nerve — and Tennessee senator Bob Corker were to retain his opposition to the bill on deficit grounds — then McConnell would only have one vote to spare. Should one of the multiple elderly, Republican senators with ongoing medical problems fall ill — or, should Doug Jones win Alabama’s special Senate election next week — the Trump tax cuts could conceivably fall into jeopardy.” (L)

(A) Ryan says Republicans to target welfare, Medicare, Medicaid spending in 2018, by Jeff Stein, https://www.washingtonpost.com/news/wonk/wp/2017/12/01/gop-eyes-post-tax-cut-changes-to-welfare-medicare-and-social-security/?utm_term=.5b3ab0175186
(B) Healthcare lobbyists not optimistic on changing GOP tax bill, By Harris Meyer, http://www.modernhealthcare.com/article/20171206/NEWS/171209899
(C) The Health 202: Senate GOP intensifies push to send more cash to Obamacare marketplaces, By Paige Winfield Cunningham, https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2017/12/07/the-health-202-senate-gop-intensifies-push-to-send-more-cash-to-obamacare-marketplaces/5a28164030fb0469e883fa53/?utm_term=.228c5c6f8672
(D) Susan Collins is getting played. Will she really vote for the tax bill in the end?, by Helaine Olen, https://www.washingtonpost.com/blogs/plum-line/wp/2017/12/06/susan-collins-is-getting-played-will-she-really-vote-for-the-tax-bill-in-the-end/?utm_term=.cb71725eaf59
(E) Despite criticism, Susan Collins is confident that GOP leaders will stand by their word, by Steve Collins, http://www.sunjournal.com/despite-criticism-susan-collins-is-confident-that-gop-leaders-will-stand-by-their-word/
(F) Tax Bill Is Likely to Undo Health Insurance Mandate, Republicans Say, By ROBERT PEAR and THOMAS KAPLAN, https://www.nytimes.com/2017/12/06/us/politics/tax-bill-obamacare-mandate-collins.html?_r=0
(G) It’s looking like Trump’s Obamacare meddling could cause serious problems for the healthcare market, by Bob Bryan, http://www.businessinsider.com/trump-obamacare-enrollment-insurance-market-2017-12
(H) Sen. Collins’s health proposal isn’t going to save Obamacare, by Sarah Kliff, vox.com. Dec 6, 2017
(I) POLITICO survey: Insurers finally making money on Obamacare, by PAUL DEMKO, https://www.politico.com/story/2017/12/07/obamacare-profits-health-care-285258
(J) The Republic Will Survive the Tax Bill, by David Leonhardt, https://www.nytimes.com/2017/12/06/opinion/republican-tax-bill.html
(K) Collins considers changing vote on tax bill over amendments, by JOSH DELK, http://thehill.com/blogs/blog-briefing-room/363891-collins-considers-changing-vote-on-tax-bill-over-amendments
(L) Senate Republicans Made a $300 Billion Mistake in Their Tax Bill, by Eric Levitz, http://nymag.com/daily/intelligencer/2017/12/the-senate-gop-made-a-usd300-billion-mistake-in-their-tax-bill.html