Thursday, May 4, 2017

Washington Apple Growers Sink Their Teeth Into The New Cosmic Crisp

A worker takes a break after planting young Cosmic Crisp trees in an orchard near Wenatchee, Wash. Dan Charles/NPR hide caption

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Dan Charles/NPR

Get ready for a new kind of apple. It's called Cosmic Crisp, and farmers in Washington state, who grow 70 percent of the country's apples, are planting these trees by the millions. The apples themselves, dark red in color with tiny yellow freckles, will start showing up in stores in the fall of 2019.

Scott McDougall is one of the farmers who's making a big bet on Cosmic Crisp.

"It goes back to believing in the apple," he says.

"You believe?" I ask.

Sweet. Tart. Crunchy: How To Engineer A Better Apple

The Salt

Sweet. Tart. Crunchy: How To Engineer A Better Apple

"I believe!" he says, and chuckles.

Planting has begun at one of his company's orchards near the city of Wenatchee. It's a spectacular site — a giant natural amphitheater in the hills above the Columbia River.

As we watch, a slow-moving tractor slices open the bare earth, and two men carefully lower delicate tree roots into the opening, one tree every three feet. These are among the first of about 400,000 Cosmic Crisp trees that McDougall and Sons expects to plant over the next few years. Across the state, 12 million of the trees have been ordered. That first wave of plantings will deliver about 5 million 40-pound boxes of Cosmic Crisp apples to grocery stores.

"Hitting 5 million boxes right away, that's never happened with any other variety that we've ever planted in Washington state," McDougall says.

For comparison, it took the popular variety Honeycrisp 20 years after it was introduced to reach that level of production.

These apples put out for a taste test are Honeycrisp (from left), Jazz, Gala, Red Delicious and Cosmic Crisp. Dan Charles/NPR hide caption

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Dan Charles/NPR

Why this phenomenal success? First of all, the apple tastes great, even after months in storage, McDougall says. But that's not the only reason.

A lot of apple farmers in Washington have been looking to switch from the varieties that they've grown for decades — in particular, Red Delicious. That variety is still the single most widely grown apple in the state, but it's fallen out of favor with American consumers. Prices have sometimes fallen so low that growers simply discarded part of their harvest.

Inside The Life Of An Apple Picker

The Salt

Inside The Life Of An Apple Picker

Many potential alternatives, though, have problems of their own. Honeycrisp is loved by consumers but is difficult to grow. Many other hot new apples, like Opal or Jazz, are only available to small clubs of growers.

Cosmic Crisp, though, is open to every farmer in Washington state. The tree is vigorous and produces lots of fruit. Also, it's ready for harvest at that same time as Red Delicious, which is a crucial consideration for big-time apple growers who are trying to coordinate the harvest of several different varieties.

"You've kind of got the best of all worlds," McDougall says.

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Patent holder Bruce Barritt stops by the mother of all Cosmic Crisp trees. Cosmic Crisp was the result of breeding project at Washington State University in the 1990s. Dan Charles/NPR hide caption

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Dan Charles/NPR

Patent holder Bruce Barritt stops by the mother of all Cosmic Crisp trees. Cosmic Crisp was the result of breeding project at Washington State University in the 1990s.

Dan Charles/NPR

The man who's listed on a patent as the inventor of Cosmic Crisp, Bruce Barritt, drove five hours from Canada to see these trees go into the ground.

Barritt is 74 years old now. He takes pictures of the newly planted trees like a proud parent.

"They are my children," he says. "Just like your kids who are 18 years old, we don't know a lot about them yet. Four years from now, we'll know whether they're the real thing."

Washington state hired a private company to handle the commercial launch of the new apple. They named it Cosmic Crisp because the apple's flecks of yellow reminded someone of stars in the sky. Courtesy of Bruce Barritt hide caption

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Courtesy of Bruce Barritt

Two decades ago, when Barritt was working for Washington State University, he persuaded the university and the state's apple industry to pay for an effort to create new and tastier apple varieties.

"We knew that it would be about 20 years before we had anything of significance — if we were lucky!" he says.

He started the work of apple breeding — first taking pollen from blossoms of some trees and fertilizing the blossoms of others, creating thousands of new genetic combinations. Then he collected the apples that resulted from this cross-fertilization and grew new little trees from their seeds. He watched those trees produce their own apples, all different from one another. "Some green ones, some yellow ones, some red ones. Some little ones, some big ones," Barritt recalls.

Barritt says he'd spend days walking those rows, searching for a superior apple. Hundreds of times each day, he'd take a bite. "Your taste sensors, sugar and acid, kick in, and you'll either enjoy it or you won't. And then you spit it out," he says.

He doesn't remember the day in 1997 when he took a bite of an apple from the tree that was labeled WA 38. But it must have made a good impression because he and his colleagues kept it around.

Want To Grow These Apples? You

The Salt

Want To Grow These Apples? You'll Have To Join The Club

It's still there, in a research orchard near Wenatchee. Most of the orchard is filled with rows of young seedlings, the latest products of Washington state's breeding program. At the far end of the orchard, though, stands the original WA 38 "mother tree."

Every one of the millions of Cosmic Crisp trees now growing in orchards and nurseries is a clone of this tree.

Barritt and his colleagues duplicated it the old-fashioned way, cutting buds from its branches and splicing, or grafting, those buds onto existing apple tree roots. The buds grew into new WA 38 trees.

The Salt

'Paradise Lost': How The Apple Became The Forbidden Fruit

For almost two decades, people in the apple industry studied those trees, tasting the apples. The more they learned, the more they liked it.

Tom Auvil, who worked for the Washington Tree Fruit Research Commission, says that when they took boxes of different varieties to events with apple growers, it was the box of WA 38 that got cleaned out. "This happened every year," he says. "We never bring any WA 38 home."

Auvil says the apple has that sought-after crisp, cracking sensation when you bite into it. It has sweetness and acid; almost a sensory overload for your tongue.

Washington state hired a private company to handle the commercial launch of the new apple. They named it Cosmic Crisp because the apple's flecks of yellow reminded someone of stars in the sky. Farmers finally got a chance to plant these trees in their own orchards this spring. For now, it's only available to farmers in Washington, since they helped support the breeding program that created it.

There

The Salt

There's Much More To Apples Than What Meets The Eye

The flood of orders has astonished almost everybody in the industry. In fact, it's provoking some anxiety. After all, consumers haven't even seen Cosmic Crisp yet. Nobody really knows if they'll like it.

Tom Auvil, who's been a Cosmic Crisp booster, calls the wave of orders "just an amazing level of investment. I just hope somebody doesn't drive up my driveway and say, 'You got me into this, now get me out of it!' "

A few years from now, when stores are full of Cosmic Crisp apples, those farmers will find out whether this was a smart bet.

Trump Set To Relax Rules On Political Activity By Religious Groups

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President Trump flashes a thumbs up at the National Prayer Breakfast in February. Win McNamee/Getty Images hide caption

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Win McNamee/Getty Images

President Trump flashes a thumbs up at the National Prayer Breakfast in February.

Win McNamee/Getty Images

President Trump is set to sign an executive order on Thursday that aims to relax restrictions on political activity by religious groups without threatening their tax-exempt status.

According to a senior White House official, the order will reiterate the White House's commitment to religious liberty; will direct the IRS to use "maximum enforcement discretion" to ease the burdens of the Johnson Amendment, which regulates political activity of non-profits such as churches; and will call for "regulatory relief" from the Affordable Care Act mandate that employer-provided health care plans provide free birth control and other reproductive health services.

Trump will sign the executive order Thursday morning on the National Day of Prayer. The White House has not yet released the full text of the executive order.

The Johnson Amendment In 5 Questions And Answers

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The Johnson Amendment In 5 Questions And Answers

Inside Trump

Politics

Inside Trump's Closed-Door Meeting, Held To Reassure 'The Evangelicals'

The directives are among the promises Trump made on the campaign trail that would blur government lines dividing church and state. In meetings with religious leaders last year, Trump pledged to "get rid" of IRS rules that prohibited tax-exempt groups like churches from engaging in political advocacy, NPR's Sarah McCammon reported. However, such rules, established by the 1954 Johnson Amendment, are rarely enforced.

Trump repeated the pledge as president at the National Prayer Breakfast in February, saying that he "will get rid of and totally destroy" the restrictions in order to "allow our representatives of faith to speak freely and without fear of retribution."

However, there are limits to what this executive order can do, and Trump himself is not able to repeal the Johnson Amendment, which would take an act of Congress.

While some evangelical voters — who comprised a significant portion of Trump's base during the election — are sure to champion the new rules on political advocacy, it is not clear whether the religious liberty language will satisfy social conservatives. The language does not appear to go as far as one reported draft that leaked in February, just after Trump spoke at the National Prayer Breakfast. Such an order would radically redefine what constitutes a religious organization, and reports of its consideration raised widespread backlash and predictions that the rules would not hold up in court. That initial order never materialized.

Why White Evangelicals Are

Politics

Why White Evangelicals Are 'Splintering' Politically

The new executive order does give some religious groups, such as the Little Sisters of the Poor, one of the things they had hoped for from Trump — allowing religious entities to stop providing contraception in their employee health care plans if they have religious objections. In 2014, the Supreme Court ruled that closely-held private corporations such as Hobby Lobby, which brought the challenge, did not have to comply with the contraception mandate if it violated their religious beliefs.

The order also comes after the White House and Republicans made concessions, such as continuing to fund Planned Parenthood, in the latest spending bill, that many religious conservatives wanted undone.

Even what the order does call for will not be met with universal acclaim by evangelical groups. The National Association of Evangelicals, or NAE, released a survey in March that showed that pastors overwhelmingly opposed endorsing candidates from the pulpit. The directives from the White House could give pastors the comfort to do that with the assurance that the IRS will not come after them and challenge their church's tax-exempt status.

"Evangelicals emphasize evangelism, and pastors often avoid controversies that might take priority over the gospel message," said NAE President Leith Anderson in a statement about the poll. "Most pastors I know don't want to endorse politicians. They want to focus on teaching the Bible."

But other fervent Trump backers, such as Liberty University president Jerry Falwell, Jr., have championed Trump's push to do away with the political restrictions.

"It's used as a club, by the [Internal Revenue Service] and the left, to silence conservatives," Falwell told the Lynchburg, Va., __news & Advance in February.

Tom Gjelten contributed.

Spit Test May Reveal The Severity Of A Child's Concussion

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A saliva test allowed scientists to accurately predict how long concussion symptoms would last in children. technotr/Getty Images hide caption

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technotr/Getty Images

A saliva test allowed scientists to accurately predict how long concussion symptoms would last in children.

technotr/Getty Images

A little spit may help predict whether a child's concussion symptoms will subside in days or persist for weeks.

A test that measures fragments of genetic material in saliva was nearly 90 percent accurate in identifying children and adolescents whose symptoms persisted for at least a month, a Penn State team told the Pediatric Academic Societies Meeting in San Francisco, Calif. In contrast, a concussion survey commonly used by doctors was right less than 70 percent of the time.

If the experimental test pans out, "a pediatrician could collect saliva with a swab, send it off to the lab and then be able to call the family the next day," says Steven Hicks, an assistant professor of pediatrics at Penn State Hershey. Hicks helped develop the test and consults for a company that hopes to market concussion tests.

A reliable test would help overcome a major obstacle in assessing and treating concussions, which affect more than one million children and adolescents in the U.S. each year. Many of the injuries are related to sports.

In most cases, concussion symptoms last only a few days. But up to 25 percent of young patients "go on to have these prolonged headaches, fatigue, nausea, and those symptoms can last sometimes one to four months," Hicks says.

And, right now, there's no way to know which kids are going to have long-term problems, he says.

"Parents often say that their biggest concern is, 'When is my child going to be back to normal again?' " Hicks says. "And that's something we have a very difficult time predicting."

Hicks and a team of researchers have been looking for an objective test that might help.

They knew that, after a concussion, injured brain cells try to heal themselves. As a part of this process, brain cells release tiny fragments of genetic material called microRNAs. Some of these fragments eventually turn up in blood and even in saliva.

The team did an experiment that involved 50 concussion patients between the ages of 7 and 18.

Poll: Nearly 1 In 4 Americans Reports Having Had A Concussion

Shots - Health __news

Poll: Nearly 1 In 4 Americans Reports Having Had A Concussion

"When they came to our medical center and received the diagnosis of concussion, we evaluated them with some standard survey-based tools and then we also got a sample of their saliva," Hicks says. Most samples were collected about a week after the injury.

The team measured levels of many different microRNAs in the samples, and eventually they identified a handful that let them predict how long symptoms would last. They also identified one microRNA that predicted which children would have a specific concussion symptom: difficulties with memory and problem solving, Hicks says.

A saliva test could greatly improve care for young people who don't have obvious symptoms of a concussion, says Manish Bhomia, an adjunct assistant professor at the Uniformed Services University of the Health Sciences in Bethesda, Md.

"A lot of children get mild concussion and oftentimes it goes ignored," he says.

A reliable lab test would help ensure that children who have a head injury don't go back to school, or to the soccer field, before their brain has healed, Bhomia says.

And microRNAs offer a promising way to assess concussions in adults as well as children, says Bhomia, whose research involves a range of "biomarkers" for traumatic brain injury.

But saliva may not be the best place to measure microRNAs, Bhomia says. A better option, he says, might be blood samples, which tend to contain greater numbers of the genetic fragments.

Obama Presidential Center Design Unveiled

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A rendering of the Obama Presidential Center. Courtesy of the Obama Foundation hide caption

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Courtesy of the Obama Foundation

A rendering of the Obama Presidential Center.

Courtesy of the Obama Foundation

The design for the Obama Presidential Center was unveiled Wednesday at an event attended by former President Obama and Michelle Obama.

The Center, slated to be completed in 2021, will be located in the Jackson Park neighborhood of Chicago's South side and it will include three buildings — a museum, forum and library that surround a public plaza.

The buildings will be made up of variegated stone with glass openings to allow for natural light and be certified at LEED v4 Platinum for resource efficiency and sustainability.

The Obamas are in Chicago Wednesday to unveil the library and host a roundtable discussion on the future of the Center.

By planning more than one building, the Obama Foundation says it hopes the Center will be a "living, working center for engagement — an ongoing project for the community and world to shape what it means to be an active citizen in the 21st century."

"The Obamas want to create a safe, warm, inviting place that brings people in, teaches them something new, and inspires them to create change in their own communities," said Obama Foundation Chair Marty Nesbitt. "The Center will be a place for doing, not just looking or listening, "

The Foundation also says the Center will "strengthen the economic climate of the community by bringing hundreds of thousands of visitors to the South Side every year, creating new jobs and opportunities on the South Side, and revitalizing historic Jackson Park," according to a release.

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A three-dimensional model of the proposed Obama Presidential Center in Chicago. Courtesy of the Obama Foundation hide caption

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Courtesy of the Obama Foundation

A three-dimensional model of the proposed Obama Presidential Center in Chicago.

Courtesy of the Obama Foundation

Obama reportedly called early versions of the design "too quiet."

"He said it was too unflashy," one of the Center's architects Billie Tsien told ArchDaily. "He looked at what we did and he said, 'I said you could be sort of quiet, but I think you're a little too quiet.'"

Parade Floats And Altered K-Pop Songs Mark South Korea's Coming Election

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Amateur K-pop dancers perform at a presidential campaign rally for Moon Jae-in, the candidate for Korea's Democratic Party, in Seoul on Saturday. Courtesy of Moon Jae-in Campaign hide caption

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Courtesy of Moon Jae-in Campaign

Amateur K-pop dancers perform at a presidential campaign rally for Moon Jae-in, the candidate for Korea's Democratic Party, in Seoul on Saturday.

Courtesy of Moon Jae-in Campaign

With tensions rising over North Korea's nuclear program, you might expect panic in South Korea — air raid drills or schoolchildren climbing under their desks, Cold-War-style.

But I found an altogether different scene in the capital, Seoul, when I arrived last week: parade floats and pop music.

Ahead of Tuesday's presidential election, dancers have been riding around on huge parade floats, belting out Korean pop songs, with lyrics changed to support one candidate or another. They wear their candidate's signature color, with matching hats, umbrellas and even clown wigs and fake animal ears. There are signature dance moves to go with the songs, and even YouTube videos to help voters learn them.

In South Korea

Parallels

In South Korea's Presidential Election, A Referendum On U.S. Relations

The campaigns have altered the lyrics to popular Korean songs — K-pop, as it's known globally — to mention the candidates. The K-pop song "Cheer Up," by the girl band Twice, is now an anthem for the front-runner Moon Jae-in — a 64-year-old lawyer in a gray suit who may be the antithesis of a K-pop star.

"I changed the lyrics to mention political issues of interest to youth, and also older people," says Jeong Min-hong, 27, fresh from the South Korean army and volunteering for Moon's campaign. Jeong is unemployed and considering going back to school.

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Moon supporters wear matching outfits for their K-pop performance in Seoul. The signature colors and dance moves are part of an unusual kind of campaigning in South Korea. Courtesy of Moon Jae-in Campaign hide caption

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Courtesy of Moon Jae-in Campaign

Moon supporters wear matching outfits for their K-pop performance in Seoul. The signature colors and dance moves are part of an unusual kind of campaigning in South Korea.

Courtesy of Moon Jae-in Campaign

"About North Korea, the provocations are so frequent that people have grown numb to it," he says. "Youth unemployment is a bigger issue for me and my peers."

During this election season, morning commutes mean ducking past rival campaign floats blasting K-pop at one another.

"It's part of Korean culture and community spirit," says commuter Hong Young-rae. At 60, even he knows most of these teen beat songs, though he says he's able to tune them out when he needs to.

Easy for him to say. Covering an election in South Korea has given me a pretty acute case of earworm.

Come Wednesday, this country will have a new president. But the streets of Seoul may seem eerily quiet.

Police Close Investigation Into New York Judge's Death, Saying It Was Likely Suicide

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Court of Appeals Judge Sheila Abdus-Salaam speaks to family and friends after a swearing-in ceremony at the New York Court of Appeals in Albany, N.Y., in 2013. Hans Pennink/AP hide caption

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Hans Pennink/AP

Court of Appeals Judge Sheila Abdus-Salaam speaks to family and friends after a swearing-in ceremony at the New York Court of Appeals in Albany, N.Y., in 2013.

Hans Pennink/AP

Judge Sheila Abdus-Salaam, 65, the first African-American woman on the New York Court of Appeals — the state's highest court — was found dead last month in the Hudson River.

On Wednesday, Chief of Detectives Robert Boyce said the New York Police Department had completed its investigation into her death.

He said investigators had tracked down all leads and found no criminality, and that her death likely was a suicide.

Evidence gathered by the police has been turned over to the city's medical examiner, who will make a final determination, Boyce said.

A previous autopsy was inconclusive.

When police found Abdus-Salaam's fully clothed body in the river on April 12, there were no visible signs of trauma or foul play, law-enforcement officials said.

At the time, police said initial evidence indicated she probably had committed suicide. But the judge's husband and other family members disputed the idea that she would take her own life.

GOP Expected To Pass Its Health Care Bill At Long Last, But Still A Long Way To Go

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The U.S. Capitol dome seen at sunrise in Washington. The House GOP believes it has the votes to pass a repeal-and-replace health care bill, but this likely won't be the final version of the law. J. Scott Applewhite/AP hide caption

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J. Scott Applewhite/AP

The U.S. Capitol dome seen at sunrise in Washington. The House GOP believes it has the votes to pass a repeal-and-replace health care bill, but this likely won't be the final version of the law.

J. Scott Applewhite/AP

Republicans appear to have finally gotten their health care bill.

After seven years of repeal-and-replace rhetoric against the Affordable Care Act, two presidential campaigns waged for and against it and a recent high-profile failure, GOP House leaders say they have the votes for their bill.

The trouble is this bill is likely never to become law — at least in its current iteration.

House Set To Vote On GOP Health Care Bill

Politics

House Set To Vote On GOP Health Care Bill

Here's why: While the bill is expected to pass the House (narrowly) Thursday afternoon, it still has to go to the Senate. It's being done with a wink and a promise that the Senate will overhaul substantial portions of the bill.

Politics

Republican Rep. Tom Cole On GOP Health Care Bill

Republican Rep. Tom Cole On GOP Health Care Bill

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"This thing is going to the United States Senate. It's going to change in my view in the United States Senate in some way," Rep. Tom Cole of Oklahoma, a deputy whip in the House, told NPR's Morning Edition. (He's one of the people in charge of making sure Republicans have the votes.) "Then we have to have a conference to work out the differences. If we can do that, then it has to still pass the House and the Senate again before it ever gets to the president. So at some point, you just have to move."

Sure, the Senate is controlled by Republicans, too, but they have an even slimmer majority there with equally fractious divisions.

Sen. Tom Cotton of Arkansas has been doing a delicate dance on Medicaid expansion. He's called Medicaid a "welfare program" and said "able-bodied adults" shouldn't be on it.

But after an angry town hall, he's seemed to back away, saying the House bill was "moving too fast; I didn't think it got it right." He also has indicated he's against it in its current form because, "I simply think that it's not going to work to bring down premiums for working Arkansans or working Americans around the country."

Up First

Up First

Other senators, like Sens. Lisa Murkowski of Alaska, Susan Collins of Maine, Bob Corker of Tennessee, Rob Portman of Ohio and Bill Cassidy of Louisiana, are in favor of repeal, but want something "stable" to replace it. They have indicated that affordability, coverage and rural access (like what the bill means for rural hospitals) are key.

Senate Majority Leader Mitch McConnell is going to allow amendments. That means the bill will change. And if even a comma is inserted, it has to pass the House — again.

And that is inevitably going to bring back this whole game of whack-a-mole in the House.

Exhausted yet?

Wait, there's more. Because Democrats aren't going to sign onto something that guts the coverage mandates of the Affordable Care Act, Republicans can't get 60 votes to advance the legislation.

So in order to pass it, they're going to have to use the process known as reconciliation. That allows legislation to pass with just a majority (plus one). But there's a catch — it has to be tied to the budget.

Get ready to hear a whole lot more about the "Byrd Rule." What's that? The Committee for a Responsible Federal Budget explains it this way:

"Although reconciliation bills are granted many privileges that are not available to most other legislation (see Reconciliation 101), they remain bound by several conditions. Some of these restrictions championed by former Senator Robert Byrd (D-WV) and established in Section 313 of the Budget Act are jointly referred to as the 'Byrd Rule.' The Byrd Rule disallows "extraneous matter" from being included in a reconciliation bill, extraneous matter being defined in three major categories of restrictions.

"First, reconciliation legislation must only involve budget-related changes and cannot include policies that have no fiscal impact, that have 'merely incidental' fiscal impacts, or that increase the deficit if the committee did not follow its reconciliation instructions (including proposals outside of a committee's proper jurisdiction—more on this below). Second, reconciliation bills cannot change Social Security spending or dedicated revenue, which are considered 'off-budget.' And finally, provisions in a reconciliation bill cannot increase the deficit in any fiscal year after the window of the reconciliation bill (usually ten years in the future) unless the costs outside the budget window are offset by other savings in the bill."

The umpire of what qualifies under the Byrd Rule is the Senate parliamentarian. Her name is Elizabeth MacDonough. Politico wrote of her in 2015:

"[S]he may very well be the most powerful person in Washington in determining how far Republicans can go in trying to repeal Obamacare. As the Senate parliamentarian, MacDonough will make the decisions on which pieces of the law qualify to be repealed using a complicated budget procedure called reconciliation. Her decisions would allow Senate Republicans to vote to kill major provisions of the health care law under a simple 51-vote majority without giving Democrats a chance to filibuster."

MacDonough was appointed in 2012, and even though she's liked on Capitol Hill by both sides, past parliamentarians (known colloquially on the Hill as "parls") have come under fire because the majority party didn't like how they ruled. More from Politico:

"Republicans protested decisions by then-parliamentarian Alan Frumin in the 2010 health care reform fight, when Democrats used the budget fast-track tool to pass a small part of the Affordable Care Act. In 2001, Republicans fired Robert Dove as parliamentarian after he ruled against them on how many reconciliation bills could be used. That was actually his second stint in the job: Democrats had fired Dove when they took the majority in 1987."

Reconciliation — and what fits and doesn't fit into it — isn't the GOP's only complication. Their biggest one is the policy itself. It has a lot of shortcomings.

The nonpartisan Congressional Budget Office said of the last iteration of the House bill that it would save money but would leave some 24 million without insurance.

So the GOP bill would be less generous in terms of benefits and cover fewer. And the only reason it would save money is because the repeal bill would cut $880 billion from Medicaid.

That would break President Trump's promises of "insurance for everybody" and "no cuts to Social Security, Medicare & Medicaid."

The CBO won't get out an analysis of the bill before Republicans are planning to vote. Politically, that gives them a chance to wipe their brows and not have to defend something that could be difficult to defend.

House To Vote On GOP Health Care Bill Thursday With Leadership Sure Of Support

Shots - Health __news

House To Vote On GOP Health Care Bill Thursday With Leadership Sure Of Support

It's morally questionable, though, to vote on something without knowing its cost or consequences. And what happens when the CBO score does come out — and they've already voted for it without the opportunity to make changes?

And there's the issue of the popular preexisting conditions provision in Obamacare — that requires insurance companies to cover people with preexisting conditions.

Trump claimed as late as this week that this bill would guarantee people with preexisting conditions would continue to be covered. But Republicans' attempts at doing that are very different than how Obamacare achieves it.

The GOP plan would essentially allow states to take sicker people out of the broader pool of people buying coverage and put them into a "high-risk pool." That in theory would bring down the cost insurance for healthier people, but drive up the cost for the sick. Depending upon how much costs increase, that could shut some or many of the people who definitely need health care out of the insurance market.

High-risk pools haven't shown great results where they have been currently implemented. Part of the problem has been funding. That's why Trump picked up two more votes with a proposal for $8 billion more for those pools, but experts say that's not even likely enough.

For The Deal-Making Trump, Compromise Seems To Be A Dirty Word

Analysis

For The Deal-Making Trump, Compromise Seems To Be A Dirty Word

The U.S. government already has very high-profile high-risk pools, Medicare and Medicaid. Medicare, health care for the elderly, is popular but expensive.

A big point of Obamacare was to not go down that potentially problematic funding lane. Healthier people might pay a little more, but if you got sick, it wouldn't bankrupt you.

So why the rush to get this through if it has all these holes and it may not be what eventually becomes law anyway? Politics. The House finally has a chance to tell its base it did something, it passed something to repeal-and-replace Obamacare.

The House goes on recess next week, and Republicans want to get this done and hand President Trump a win before then.

It's a huge relief for House Speaker Paul Ryan, who was feeling the heat of not being able to govern House Republicans.

It's a huge relief for President Trump, who has been made to look ineffectual with no legislative wins to speak of in his first 100 days and little other major accomplishments in that time — despite Republicans being in charge of the White House, the House and Senate.

But remember, the GOP plan that failed previously had just a 17 percent approval rating. And, policy-wise, it hasn't changed all that much.

President Obama ran into a similar problem — health care is very difficult to message about but very easy to poke holes in. And Democrats lost control of the House in 2010 because of health care.

Now, the Affordable Care Act, Obama's signature legislative achievement, has had a resurgence in public opinion. Gallup found approval of the ACA at 55 percent this month, the first time its ever reached a majority in the poll.

You can't compare anything to ObamaCare because ObamaCare is dead. Dems want billions to go to Insurance Companies to bail out donors....New

— Donald J. Trump (@realDonaldTrump) April 30, 2017

President Trump says the GOP bill can't be compared to the ACA "because Obamacare is dead."

First of all, that's not true. The last CBO analysis of the ACA said it's not in a death spiral.

Second, anything that comes after Obamacare has to be compared to it.

What's that you say, health care and legislating are complicated? Yes, they are, and there's still a long way to go.