News, Straight to the Point

Thursday will be a deja vu moment on the Senate-side of the Capitol. Senate Republicans will gather in a private room off the Senate chamber to go over a freshly unveiled health care bill they hope they can pass to fulfill their years’ long promise of dismantling the Affordable Care Act.

Just like they did in June.

But, like the morning they went through this exercise a few weeks ago, deep disagreements remain among the conference over how to replace Obamacare and whether that effort should include a gutting of Medicaid. There’s been no sign yet that Majority Leader Mitch McConnell (R-KY) has hit the sweet spot. He needs to win 50 out of 52 Republican votes to pass the legislation. Yet he has previewed a quick turnaround time between unveiling his revisions to the Better Care Reconciliation Act and a vote on the bill, with a Congressional Budget Office score coming as early as Monday, and an initial procedural vote also next week.

Here are the five big unknowns going forward:

Did McConnell change enough to get rid of the old bill’s stench?

It was obvious that McConnell didn’t want to send members home for the July 4 recess without taking a vote on the legislation, and last week, while they were home, it became clear why. Very few Republicans aggressively promoted the legislation—many spent their recess in hiding—and those who did make public appearances distanced themselves from the effort.

Rank-and-file Republicans like Sen. Jerry Moran (R-KS) and John Hoeven (R-ND) came out against the old draft, and high-profile defectors like Sens. Shelley Moore Capito (R-WV) and Susan Collins (R-ME) defended their opposition.

Now, whether they can come back around will depend on if the revised bill at least looks different enough for them to justify supporting it. So far though, the sense is there hasn’t been a major overhaul—beyond Obamacare taxes for high-earners being preserved and extra funding for opioid programs.

“I don’t think there’s going to be that many dramatic changes,” Sen. Ron Johnson (R-WI) admitted to reporters Wednesday, after a Senate GOP lunch.

What the hell is going on with the Cruz amendment?

Perhaps the most substantive change to the legislation on the table is a proposal by Sen. Ted Cruz (R-TX) to let insurers sell unregulated plans as long as they offer an Obamacare-compliant plan as well. Cruz, however, could not tell reporters Wednesday when the CBO would be done scoring the provision, if it would be included with the legislation being unveiled Thursday or even when the text of his proposal will be made public.

Nonetheless, he indicated that he’d vote against advancing the bill, including on the first procedural vote, if it wasn’t part of the base legislation.

Other Republicans have raised concerns about Cruz’s idea, because it would likely to gut pre-existing protections many GOP lawmakers vowed to protect. The insurance industry agreed with their sentiments, in a statement bashing the Cruz proposal Wednesday.

Thus, other Republicans like Sen. Mike Rounds (R-SD) and Sen. Bill Cassidy (R-LA)  have been suggesting tweaks to Cruz’s proposal to make it more workable. Here again, the details are sparse. It’s unclear how far along they are in writing adjustments to Cruz’s amendment, whether those tweaks would solve the major policy problems, or how making those adjustments would fit in the aggressive timeline McConnell has laid out for passing the legislation.

Will moderates swallow big Medicaid cuts?

Enough Republicans opposed the draft bill’s deep Medicaid cuts to kill it. Yet, it’s expected that those provisions — which both scale back the ACA’s Medicaid expansion and gut the traditional program — will remain largely unchanged in the latest version.

Its passage, thus depends at least three of the following—Sens. Capito, Collins,  Dean Heller (R-NV), or Lisa Murkowski (R-AK)— flip-flopping on their previous requests that the cuts be softened.  Rounds suggested that tweaks to the Medicaid formulas could be made in the amendments process known as vote-a-rama that will occur on the Senate floor some time after next week’s expected procedural vote on the bill. There’s some skepticism, however, as to whether that would really result in substantive changes to the bill, since McConnell will still tightly control the process. (Hence, Cruz’s insistence that his proposal be included in the base text.)

“A fully amendable bill after the motion to proceed should give everyone a sense that they’ll have an opportunity to make whatever point they want to make,” Sen. Roy Blunt (R-MO), a member of the GOP leadership team, said.

Can they get the bill past the first hurdle?

We could know as soon as Tuesday whether the GOP repeal effort is doomed. McConnell has been insistent that a vote on the motion to proceed—which advances it procedurally to consideration, before a final vote—will come some time next week.

Some Republicans are arguing that, despite their or other GOP lawmakers’ reservations, they should at least vote for this initial step.

“I just can’t imagine not voting to proceed to a bill when you’ve got an open amendment process and you can offer any amendment you wish and you still have a vote at the end of the process,” Sen. Bob Corker (R-TN) said Tuesday.

Already one Republican, Sen. Rand Paul (R-KY), has said he’ll vote against it there, so it would only take two more GOP members to kill next week’s motion, perhaps if they see no point in taking politically tough votes during the vote-a-rama. The prospect of a failed motion to proceed was what McConnell was facing when he delayed a vote last time.

Is the timeline just too fast?

Which brings us to the next unknown: what happens if the votes aren’t there next week, but there’s a path to securing them in the future. McConnell has already delayed the August recess by an extra two weeks. Though he has said health care is still an agenda item for next week, there still is that extra time as a fallback. And by keeping some of Obamacare’s taxes on high-earners, McConnell has some money to work with to try to make things work. Will an extra two weeks be enough to settle on a version of the Cruz amendment that the broader GOP conference is willing to swallow? Or to make some adjustments to Medicaid provisions that expansion state senators can claim as their victory?

Or will McConnell decide that if he can’t draft a deal on health care now, a deal on health care is just not possible?

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The Senate returns to D.C. Monday evening after a week-long recess, and on the surface they appear to be even further from a deal to pass a health care bill than when they canceled a planned vote in late June.

Existing ideological divisions were exacerbated over the break as lawmakers were hit from all sides—hounded by constituents at town halls, hammered with attack ads, and pressured by GOP leaders and President Donald Trump to pass something in the few short weeks before their August recess.

But despite some Republicans declaring the effort “dead,” a flurry of activity—including backroom negotiations and new data from the Congressional Budget Office—could bring the bill back to life. Some GOP leaders are even saying that a vote could happen as early as next week.

Here are the things to watch as the debate unfolds:

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The CBO score released Monday on the Senate health care bill rained down what must have been the worst nightmare—or close to it—for the GOP senators squeamish about the bill: blockbuster coverage losses just about as bad as the House version’s, Medicaid provisions that kick off even more people from the program than the House bill and average premium reductions that come at the cost of making insurance inaccessible for many low income people.

Already, it appears Senate Republicans don’t have enough votes to advance the legislation, and it will be a scramble to get that number up to 50 for Senate Republicans to pass the bill, the Better Care Reconciliation Act, this week, as planned.

Lawmakers will only have a day, maybe two, to analyze the report before GOP leaders are expected to move forward with a procedural vote to advance the legislation Tuesday or Wednesday, with the goal of a final vote by the end of the week. Before the score was released, a handful of conservatives and two moderate Republicans had signaled opposition to the draft legislation, though the conservatives said they were mostly open to negotiations. About a half dozen more moderate Republicans, and particularly those from Medicaid expansion states, are in the hot seat to make up their mind about supporting the bill, and the CBO score only turns up the temperature.

Here are 5 points on how Monday’s score affects GOP leaders’ ability to find 50 votes in favor of the legislation:

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Ousted FBI Director James Comey’s riveting testimony before the Senate Intelligence Committee last week characterized President Donald Trump as a habitual liar who made wildly inappropriate demands, but the President and his allies immediately seized on what they saw as a victory: Comey confirmed publicly that Trump personally had not been under investigation as long as he was at the bureau.

Trump declared “complete vindication” following the hearing, despite Comey stressing that the question of whether the President was under investigation could change in the future, and dropping several telling hints that special counsel Bob Mueller was likely examining Trump’s conversations and actions since taking office. That victory cry sounds even more ridiculous in light of the Washington Post’s revelation Wednesday night that Mueller is, in fact, looking into whether Trump tried to obstruct justice—a criminal inquiry triggered by the President’s very decision to fire Comey.

Here are five people who beclowned themselves by triumphantly boasting too soon that the President was out of the legal woods:

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On Thursday, former FBI Director James Comey will testify publicly for the first time since President Trump fired him in early May and threatened to release tapes of their conversations. Unless the President invokes a claim of executive privilege to block Comey from testifying, Comey will take questions from the Senate Intelligence Committee—first in a public hearing and later in a closed session.

As a wave after wave of leaked information and wild claims about the fraught few months Comey spent as both Trump’s FBI director and the leader of the Russia investigation has inundated Washington, both the senators and the public are anxious to hear from the man himself.

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In the weeks since the unwieldy and politically unpopular task of dismantling the Affordable Care Act fell to the GOP Senate, Republican senators have been able to punt on some of the tough decisions in writing their repeal legislation until after they saw what the CBO said about the House Obamacare repeal bill.

That CBO report has now landed, and it doesn’t make GOP senators’ lives any easier. Wednesday’s report reinforced the many problems and ugly trade-offs in the House bill that Senate Republicans have been struggling with for months. It also dropped in their laps a new problem that was a result of an amendment added to the House bill that was scored for the first time in Wednesday’s CBO report: What to do about people with pre-existing conditions, whose protections under the ACA are significantly rolled back in a provision that allow states to opt out of Obamacare’s insurer mandates?

Here are five points on how the CBO score puts the big squeeze on Senate Republicans:

The waivers make pre-existing conditions protections very messy, if not impossible.

The big question for the CBO was the impact of a major, last-minute addition of a waiver provision to the House bill, which stands to violate GOP promises to protect those with pre-existing conditions.

The CBO found that one-sixth of Americans would live in states that would seek waivers so aggressive that it would create a wide variation in premiums for which the CBO did not even provide an estimate average. In those places, the individual market would grow increasingly unstable over time, as healthy people flocked to less generous plans that were allowed to medically underwrite based on health status. People with pre-existing conditions would in turn see premiums rise until some were priced out of coverage entirely. The extra $8 billion funding added to the House bill to subsidize them would not be “sufficient to substantially reduce” their “large increases” in premiums, the CBO said.

Senate Republicans have been generally open to a waiver idea, but many have insisted they want people with pre-existing conditions protected. So cleaning up that mess will be a top priority.

There’s no escaping 23 million people losing coverage.

The CBO’s top line coverage number was bad the first time the AHCA was scored and it hasn’t budged much since. Twenty-three million fewer Americans will have insurance by 2026 under the House-approved bill, which is hardly better than the 24 million in coverage losses predicted under the initial version. That downward tick in coverage losses comes in part, the CBO said, because the individual marketplace will be less attractive and more employers will thus continue to offer coverage than was projected in the March version of the legislation.

The first time around some Republicans cast doubt on the CBO’s predictive abilities and that strategy is already in play now. Nevertheless, some GOP senators have recognized those coverages numbers are far from ideal and floated more robust tax credits or a softer cushion to the Medicaid cuts as a way to improve them. The problem there, however, is that those tweaks will likely require more funding, and the Senate’s bill will still have to reduce the deficit by $119 billion over 10 years.

Medicaid remains the elephant in the room.

One of the biggest challenges in the Senate is an aspect of the House bill that hasn’t changed since the March CBO score: its massive cuts to Medicaid, which is at the heart of the legislation.

Of the 23 million fewer covered Americans under the GOP House plan, 14 million lose coverage due to the House bill’s phaseout of the Medicaid expansion and its overhaul of the larger program from an unlimited match rate to a capped system that limits funding on a per enrollee basis.

This gutting of Medicaid saves the government $834 billion, which in turn finances the $664 billion in tax cuts to industry and high earners under the House bill. But the Medicaid cuts also pits expansion state senators against non-expansion state senators. And the formula used to cap the traditional program hits different states in different ways, also complicating the bill’s path to 51 votes for Senate passage.

Older people and poor people lose out under the GOP’s tax credits.

Wednesday’s CBO report reinforced a point made in its analysis of the original version. AHCA’s tax credit scheme severely shortchanges lower income consumers and older people, the latter a key GOP constituency. That constituency is hit a second time by a provision in the bill that allows insurers to charge older consumers more than young people, when compared to the ratio allowed under current law.

A 64-year-old at 175 percent of the poverty level who lives in a non-waiver state will pay eight times more in net premiums than under the current law.

Senate Republicans, led by the conference’s No. 3 Sen. John Thune (R-SD) have promised that they will rework the tax credits so the burden on older and lower-income people is less pronounced. But doing so may require shifting some of the tax benefit away from young and healthy people, who Republicans want to incentivize into buying insurance to make the risk pool less expensive.

Premiums in some places drop, but the costs are picked up elsewhere.

There was one number in the CBO report Republicans are likely to tout. The CBO predicted that about one-in-three Americans will live in states that seek waivers for “moderate” changes to the ACA’s insurer rules that would bring average premiums down by 20 percent by 2026 while maintaining relatively stable marketplace.

But those tweaks come with their downsides.

“Although premiums would decline, on average, in states that chose to narrow the scope of EHBs, some people enrolled in nongroup insurance would experience substantial increases in what they would spend on health care,” the CBO said, referring to the ACA’s 10 Essential Health Benefits, that states would be able to opt out of or rewrite under the GOP plan.

For years, Republicans have bashed Obamacare for how deductibles have increased under its implementation. Senators will now be contemplating a plan that will even further raise out-of-pocket costs.

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Just in time to serve as a prebuttal to a much-anticipated CBO House GOP Obamacare repeal bill score, the U.S. Health and Human Services Department released a study showing, in the words of its spokesperson, that under the Affordable Care Act, “the status quo is unsustainable”

The study, conducted by the Office of the Assistant Secretary for Planning and Evaluation, found that average premiums in the 2017 HealthCare.gov exchanges used by 39 states were about double the average premiums in the entire, pre-ACA 2013 individual market.

Not surprisingly, the study made its way onto the Twitter feeds and into the floors speeches of the GOP lawmakers currently seeking to dismantle the Affordable Care Act.

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National Security Adviser H.R. McMaster on Tuesday morning marched in lockstep with the larger Trump administration narrative on reports that the President disclosed highly classified information to Russian officials, insisting during a press briefing that nothing inappropriate was shared and that the “real issue” was leaks to the press.

Yet even as he defended the White House, McMaster revealed some telling details.

He did not deny that Trump shared classified information with senior Russian diplomats, and he divulged that Trump spontaneously shared details about an Islamic State threat with a country that the U.S. intelligence community agrees intervened in the 2016 presidential election to Trump’s benefit.

These are the key takeaways from McMaster’s turn at the briefing podium.

Trump made snap decision to share info

McMaster said that President Donald Trump made a spontaneous decision to share “code-word” information, the highest level of classification, during his conversation with Russian Foreign Minister Sergey Lavrov and Russian Ambassador Sergey Kislyak.

“When was the decision made to share that information with the Russians?” a reporter asked McMaster. “Did the President spontaneously, on the spot, decide to give that information over?”

“He made the decision in the context of the conversation,” McMaster said during the White House daily briefing, which he took over from Press Secretary Sean Spicer.

He called Trump’s remarks “wholly appropriate.”

“In the moment then, during the context of that conversation?” the reporter pressed.

McMaster declined to clarify further.

He also would not confirm or deny whether the information Trump shared with the Russian diplomats was classified, saying, “I will not be the one to confirm that information that could jeopardize our security.”

The CIA and NSA were warned about what Trump divulged

McMaster confirmed the Washington Post’s reporting that the CIA and NSA were contacted following the meeting, although he would not comment on why.

“If there was nothing the President shared that he shouldn’t have shared, why did they contact the NSA and CIA?” a reporter asked.

“I would say an overabundance of caution but I’m not sure,” McMaster said. “I’ve not talked to him about that. About why he reached out.”

The Post reported that Thomas Bossert, assistant to the President for homeland security and counterterrorism, called those agencies to try to contain the damage of Trump’s revelations. Bossert’s aide also requested that section of their conversation be stricken from internal memos, and that the full transcript of the meeting be shown only to a small circle of senior staffers, according to the Post.

Asked again why the NSA or CIA would be contacted, McMaster told reporters that he, Secretary of State Rex Tillerson and Deputy Adviser for National Security Dina Powell were in the room and did not feel that the conversation “was inappropriate.”

Trump was never briefed on where the info came from

The White House has repeatedly insisted that no “intelligence sources or methods” were divulged during the Oval Office meeting, offering a defense that goes beyond what the Post, CNN, New York Times and other outlets have reported. The stories instead allege that Trump’s disclosure of highly classified information, apparently without permission from the ally that provided it, could jeopardize a key source on the Islamic State and provide Russia insight into U.S. intelligence capabilities.

McMaster argued Tuesday that Trump could not have divulged such information even if he wanted to—because the President was never briefed on the sourcing.

“The President wasn’t even aware where this information came from,” McMaster told reporters. “He wasn’t briefed on the source or method of the information either.”

McMaster stands by his statement that WaPo’s story is “false”

The national security adviser has mostly avoided the spotlight since assuming his role, working behind the scenes to bring discipline to the administration’s unruly foreign policy apparatus. This came to an end Monday night, when he was sent out to give an on-camera statement in the White House driveway calling the Post story “false” and defending the President’s right to discuss terrorist threats with foreign countries.

When a reporter offered him the chance to clarify or correct that statement after Trump said on Twitter early Tuesday morning that he did indeed share “facts” with his Russian visitors, McMaster didn’t change course.

“I stand by my statement,” he replied. “The premise of that article is false.”

Leaks are the ‘real issue’ here!

In the clearest indication that McMaster had subsumed himself into the White House communications machine, the highly-respected general argued that the leaking of classified information to the press posed a graver danger to national security than whatever Trump discussed with Russian diplomats.

“The real issue, what I would like to see debated more, is national security has been put at risk by those violating confidentiality and those releasing information to the press that can be used connected with other information available to make American citizens and others more vulnerable,” McMaster told reporters.

In response to months of damaging stories about turmoil amid White House staff, Trump’s conversations with foreign leaders, and the ongoing investigation into whether Trump campaign staffers colluded with Russian officials who interfered in the U.S. election, the President has insisted that those leaks themselves are the “real news.”

As Trump infamously put it in February, “The leaks are real; the news is fake.”

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The people who professionally study election protocols are very worried about the commission President Trump has created to ostensibly study election protocols. The so-called “Presidential Commission on Election Integrity,” which was unveiled in an executive order last week, is being viewed with deep skepticism in the voting rights community.

That is in no small part due to Trump’s outlandish and unsubstantiated claims that millions of people voted illegally in the 2016 election; the commission appears to be the result of Trump’s promises of a “major investigation” into voter fraud.

But there are also other hints, tells and coded language signaling that the aims of the commission are less concerned with nonpartisan study of election protocols and more likely to be seeking to trumpet allegations of voter fraud, which has historically been used as an excuse to enact restrictive voting laws.

Here are five points on what Trump’s bogus ‘Elections Integrity’ commission is really about:

Beware the heavy emphasis on voter fraud.

Voter “fraud” or “fraudulent” voting is mentioned five times in the executive order, which goes on to define four types of alleged illegal voting that will be within the purview of the commission. Prospective commissioners floated for the commission—and especially its vice chair, Kansas Secretary of State Kris Kobach—have made careers out of fanning the flames around flimsy fears of voter fraud and advocating for stricter voter laws.

Study after study has found voter fraud—and particularly the types of fraud prevented by a voter ID—to be extremely rare. Yet Kobach said that it was “a very large number” that was “ probably in excess of a million,” when defending Trump’s baseless allegation that millions of illegal voters where the reason he lost the popular vote.

What these stricter laws end up doing is making it harder for certain groups, particularly low income voters and minorities, to vote. One of the two Democrats reportedly tapped for the commission, Maine Secretary of State told TPM last week he would “walk away” if the commission was used as a “trojan horse” to impede access to the ballot box.

The who is as important as the what.

The Trump administration is stressing that commission will be bipartisan, but the lack of participation to this point by any moderate, widely-respected Republican election officials is notable. Instead the GOPers tapped so far for the commission are on the fringe when it comes to voting issues.

Vice President Mike Pence is chairing the commission and joining him in serving on it is Indiana’s Secretary of State Connie Lawson (R). Indiana authorities, under both their watch, launched a sketchy raid of a voter registration drive last fall, and the two Republicans have been accused of overhyping the results. Lawson has since purged Indiana’s voter rolls of nearly half-million names ahead of the next election. Previously, as a state legislator, Lawson was an original sponsor of the state’s 2005 voter ID law, which was upheld in a seminal Supreme Court case.

Former Ohio Secretary of State Ken Blackwell has also been tapped for Trump’s commission. Blackwell was at the forefront of the initial push to implement voter ID laws in the mid-aughts. As Ohio’s top elections official, he was investigated by Democrats on the House Judiciary Committee for his handling of the 2004 elections in the state. He imposed stringent requirements on voter registration drives, including a directive to ignore registrations not printed out on 80-pound stock paper.

Maine Secretary of State Matt Dunlap (D) stands out among the group, for being skeptical of voter restrictions and instead, as he described himself to TPM last week, as a “strong advocate for voter access” who was skeptical of restrictive laws. The other Democrat so far named, New Hampshire Secretary of State Bill Gardner has some—let’s say—unique views on administering elections and once said that early voting, which is used disproportionately by minority voters, “cheapens the value” of election day. He is also supportive of a Republican bill in the state that adds new requirements for certain voters to prove they live in the state, a move critics say is to make it harder for students to vote.

Red flag: No mention in the order of voter suppression.

Reports leading up to the formal unveiling of the commission suggested looking at voter suppression would also be among its charges, as a way to get Democrats to sign on.

The executive order makes no such reference in the commission’s mission, suggesting that the study of voter suppression is not actually a priority of the commission.

Kobach has continued to claim that voter suppression will also be studied. But it’s hard to take that seriously, given that voter suppression is not defined, nor even mentioned in the entire executive order text and many of the people floated to be on the commission have played it down as an issue.

Telltale sign: A peculiar focus on “confidence” in the election system.

The main focus of commission, the order says, is to study whether the public’s “confidence’ is being “undermined” or “enhanced” by certain election protocols. The emphasis on confidence reflects a broader shift in the legal defense of restrictive voting laws: in the absence of legitimate cases of voter fraud to justify the new laws, proponents have argued that because people believe there is a prevalence of voter fraud, the laws are necessary.

“All of us who work in this area know that measuring confidence in electoral rules is something that is both easy to do and amenable to gross manipulation,” Nate Persily, who served as a senior research director for President Obama’s Presidential Commission on Election Administration, told TPM over email.

Persily, an election law expert at Stanford Law, has worked on studies that showed factors like partisanship, education and one’s trust in government influence confidence in an election, beyond actual instances of fraud or restrictions placed on voting ostensibly meant to prevent fraud.

The order is fixated on voter registration issues.

The order mentions time and again the commission’s interest in instances of “fraudulent” or “improper” voter registration. This is no coincidence. Overblown concern about non-citizens being registered to vote is the latest frontier in the campaign to enact stricter laws.

Kobach has been seeking to implement a proof-of-citizenship registration requirement, while elsewhere organizations that conduct voter registration have been targeted by GOP lawmakers.

Election experts and voting rights advocates acknowledge that yes, occasionally mistakes are made and people such as felons or non-citizens are accidentally registered to vote, for instance, while getting a driver’s license. But oftentimes, the ineligible voter never casts a ballot, and doesn’t even realize he or she was registered, and thus prosecutions have been rare.

Furthermore, the order disregards the importance of intent in the commission’s investigation of irregularities.

The commission will study acts conducted “regardless of the state of mind or intent of that individual,” the order says in its definition of “improper voting” and “improper voter registration.”

“They seem to want to reach even those individuals and elections administrators who make an honest mistake or in the course of administering an election to hundreds of millions of Americans,” said Janai Nelson, Associate Director-Counsel of the NAACP-LDF.

Nelson worried that those instances “may be manipulated to paint a picture of voter fraud that really is not existent.”

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In the wake of their razor-thin vote to repeal the Affordable Care Act, House Republicans and President Trump have trotted out a number of misleading and outright false claims about their bill’s provisions and its potential impact on millions of Americans.

These talking points are aimed at obscuring the bill’s most unpopular provisions, including massive cuts to Medicaid, the shrinking of tax credits for low-income and older Americans, and the waiver of some insurance market reforms designed to protect people with pre-existing conditions.

Here are five of the biggest whoppers Republicans are telling about the American Health Care Act:

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