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April 27, 2015

April 24, 2015

Return of the Reformicons | Pennsylvania Avenue

(Tom Williams/CQ Roll Call File Photo)

Rubio has identified with some of the Reformicons’ proposals.  (Tom Williams/CQ Roll Call File Photo)

Last year, a group of mainly young conservative intellectuals made a splash with a document titled “Room to Grow,” attempting to outline policies that would address the problems, anxieties and worries of the middle class. The so-called Reform Conservative Movement — “Reformicons” for short—got favorable attention from The New York Times Magazine for its attempt to make the Republican Party “the party of ideas.”

Unless you’re a reader of the lively journal National Affairs, edited by Reformicon leader Yuval Levin, you might have thought the movement had gone into hibernation, though a number of 2016 GOP presidential wannabes — notably Sen. Marco Rubio, R-Fla., and former Florida Gov. Jeb Bush — have identified with some of its proposals, especially making college more affordable and reforming K-12 education. “Room to Grow”also contained proposals for family friendly tax reform, health care affordability, safety-net and regulatory reform, and infrastructure and energy policy. We’ve yet to see much uptake of those ideas either by the Republican Congress or the presidential field. The latter group, Bush excepted, seems preoccupied with pandering to the basest instincts of the GOP base. Rubio and Wisconsin Gov. Scott Walker have reversed themselves on immigration reform. And there’s a mass rush, Bush again excepted, to denounce Common Core educational standards which were originally invented by the nation’s governors and are now seen by the Tea Party (in de facto collusion with the teachers unions) as an President Barack Obama/Bill Gates takeover of the minds of America’s children.

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100 Years Later, Time to Recognize the Armenian Genocide | Commentary

By Reps. Frank Pallone Jr. and Robert J. Dold

While ordering his military leaders to attack Poland, Adolf Hitler rationalized, “Who, after all, speaks today of the annihilation of the Armenians?” These chilling words make one thing abundantly clear: when you do not shed light on injustices, they will be repeated.

Today marks the 100th anniversary of the Armenian genocide, during which Ottoman Turkey systematically exterminated over 1.5 million Armenians and Christian minorities. The genocide is a fact that cannot be ignored — it is settled history.

Full story

April 23, 2015

The Prosperity Corps: Millions of Americans Selling Products and Services Abroad | Commentary

By John L. Habib

On Oct. 14, 1960, President John F. Kennedy made an impassioned plea to University of Michigan students, exhorting them to move abroad and assist nations struggling under the weight of underdeveloped economies. Kennedy was convinced American talent is a unique, effective export commodity.

That speech laid the foundation for the Peace Corps, officially formed in 1961 by executive order. Now, 65 years later, the Obama administration should revolutionize Kennedy’s bold stance by adopting policies that aggressively promote what should be labeled “The Prosperity Corps” — the estimated 6.3 million Americans living and working outside the United States.

This nation of expats represents a job-creation juggernaut, an export-promotion powerhouse.
Serving informally as economic ambassadors, Americans toiling in foreign markets are far from “spoiled fat cats.” Instead, they sustain and grow new and existing companies, while creating valuable business networks for Americans back home who are similarly dedicated to enhancing U.S. business presence in far-flung markets.

Statistics recently trumpeted by the U.S. Department of Commerce show that the sale of U.S. products and services is surging in foreign markets. This is occurring not just in traditional overseas industries such as oil and gas, military defense/aviation and financial services. U.S. workers are prominent and prosperous in many “new economy” sectors overseas as well, such as information technology and software development, and the rapidly evolving renewable energy and energy conservation industries.

The United States directly benefits from domestic manufacturing output that is exported to these countries. For example, United States exports are disproportionately large to the United Arab Emirates, including aircraft, vehicles and electronic and general machinery. The presence of an estimated 50,000 Americans in the UAE has no doubt directly contributed to dynamic growth in bilateral trade volume with UAE, with exports from the U.S. tripling over the past 10 years, yielding positive economic ties and benefits for U.S. workers.

Expat Americans also spur foreign direct investment back into the United States, further creating jobs and prosperity inside the homeland.

Americans abroad organize themselves in many ways to maximize their influence, particularly by their membership in the thriving AmCham business council network which spans across 100 countries. April 20 marked the launch of the annual Washington, D.C., Export Promotion Week sponsored by AmCham Abu Dhabi on behalf of the Regional Council of AmChams of the Middle East and North Africa Region.

When considering tax reform, Congress and the administration are rightfully considering provisions to make American companies more competitive overseas. Sadly, since Kennedy’s inspiring words, our tax system has fallen out of step with our competitors, and we have taxed our overseas Americans in an uneven playing field. The same tax policy approach should be applied to Americans working abroad: tax revenue where it is earned. A more competitive tax code for Americans abroad means additional benefits for our domestic economy.

Another example of U.S. tax policy making it harder for citizens working abroad is the application of inexplicably complex and overly intrusive regulations promulgated under the Foreign Account Tax Compliance Act. FATCA, signed into law in 2010 but fully effective in 2015, is designed to stop tax evasion. This is a worthwhile goal, but the regulatory net applies so broadly that personal and business accounts of law-abiding Americans simply trying to comply with the rules are caught up in its paperwork net — and drowning.

The impact is not just needless hassle. FATCA has made overseas Americans far less attractive as employees or business partners. Policymakers should recognize that if hiring an American as a key executive means subjecting a business to significant costs and intense scrutiny of a company’s accounts, reasonable foreign companies will shy away from the burdens of hiring Americans, placing our citizens at a great disadvantage in foreign employment markets. FATCA needs to be fine-tuned to be more rational and avoid some its negative impacts on honest, hard-working Americans overseas.

AmCham’s Export Promotion Week agenda renews calls for Congressional legislation and Treasury Department regulations that actually treat these hard-working Americans as The Prosperity Corps that they truly represent for the nation’s interests internationally.

John L. Habib is co-owner of a US-UAE joint venture law firm based in Abu Dhabi, and a board member of AmCham Abu Dhabi and AmCham MENA.

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Medicare’s Doctor Payments Are Fixed, Now It’s Time to Support Medicare Legislation to Keep Crucial EMS Helicopters Flying

By Rick Sherlock

What is a life worth? Bipartisan Federal Legislation (HR 822) — designed to reform Medicare payments for patients flown by medical helicopters — has been introduced in the House and its Senate companion is imminent. Without this legislation, millions of Americans could lose timely access to critical health care. HR 822 will build a payment system based upon actual cost data to ensure access to health care for 80 million Americans who can only access Level 1 or Level 2 Trauma Centers, within an hour, through the use of Emergency Medical Services helicopters.

EMS helicopters, staffed with skilled pilots and highly-trained medical professionals, who are among the best caregivers in the world, provide rapid access to health care, coupled with the highest-levels of patient care, while taking patients to the medical facility best suited to treat their specific needs. Between 1990 and 2005, 339 trauma centers in the United States closed, and between 1991 and 2011, 22 percent of America’s rural hospitals closed. Both trends are expected to continue. EMS helicopters are our nation’s health care safety net for our most serious, time-sensitive cases — trauma, traumatic brain injury, strokes, heart attacks, burns and spinal-cord injuries, as well as high-risk obstetric, neonatal/pediatric and transplant patients. A 2010 study found patients transported by helicopter were more severely injured, had longer transport times and required more hospital resources than those transported by ground. It also found patients transported by helicopter were 22 percent more likely to survive and more likely to be discharged home after treatment when compared with those transported by ground.

Air-medical transport is a highly effective medical intervention for the most critically ill and injured patients, particularly in rural areas where helicopters function as the primary access to definitive and critical care facilities for nearly one-third of America’s population. Its impact cannot be underestimated. EMS helicopters transport roughly 400,000 patients each year.

Air-medical transport can be expensive and is, effectively, a marriage of two large heavily regulated industries — aviation and health care. The cost of a flight can be high, because providers must be ready to respond to a patient, at their most critical hour, 24 hours-a-day, 365 days-a-year.

The costs of maintaining that readiness rest solely on the programs providing the services. The costs can vary based on the cost of fuel, medicine, medical supplies and distances flown. However, the major readiness costs are fixed, based on aircraft costs, the costs of maintaining teams of trained, properly-licensed, experienced professionals (pilots, physicians, nurses, paramedics, etc.), and the safety improvements that ensure the highest-quality patient care is provided in the safest environment possible. It’s all about the patient and our industry’s ability to respond, provide them with the highest quality of care, and get them to the right trauma center during the “golden hour” which can be the difference between them returning home or remaining in the hospital for extensive care.

Air-medical transport is not appropriate for every patient and is used only when requested by a Doctor or a medically-trained first responder. EMS helicopters transport every patient-in-need, without regard to their ability to pay. Today, roughly 14 percent of Americans are uninsured or underinsured, 18 percent are covered by Medicaid, 35 percent by Medicare, and 33 percent have commercial insurance. In the past, commercial insurers have paid rates that provided levels-of-coverage for uninsured, underinsured, Medicaid, and Medicare, all of which pay less than the average cost-per-transport.

“Cost shifting” is no longer sustainable. Some smaller programs and non-profit programs are already closing across America. Without reforming Medicare at the federal level and Medicaid at the state level, many more programs will close, creating gaps in access to health care for millions of Americans.

HR 822 will fix an important piece of the Medicare puzzle while providing near-term stability for the industry, reform its reimbursement structure, and require it to provide cost and quality-of-care data to Congress, the U.S. Department of Health and Human Services, and the GAO for their review and independent analysis. Those data and analysis will form the basis for future decisions on reimbursement levels, which the industry will readily accept. Doesn’t it make sense to base future decisions on verifiable data that are independently analyzed? The systems that provide access to health care in America are not something we can afford to break.

The sound of a medical helicopter is often the sound of someone’s life being saved. By the time we recognize the silence, the system will be broken.

Rick Sherlock is president of the Association of Air Medical Services.

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April 22, 2015

Invest in Our Transportation Network to Drive the Economy Forward | Commentary

By Paul Yarossi

Investing in transportation creates jobs for those hardworking Americans who build the infrastructure we rely on to live productive, fulfilling lives. These jobs are opportunities for thousands of American workers to earn a paycheck, gain skills and advance their careers in a challenging and rewarding field. Today, many folks begin on construction sites as laborers and leave as equipment operators, managers or other positions of increasing rank.

The transportation infrastructure these individuals build greases the wheel of our broader economy. Our transportation network allows us to deliver products and services to market, creating even more jobs. It’s how we get to baseball games and weekend barbecues, make it to work and respond to natural disasters.

Full story

April 21, 2015

Why China Votes ‘No’ on TPA | Commentary

By Jay Chittooran

With a deal reached on trade promotion authority (TPA, or fast track), pro-trade and anti-trade advocates are ramping up their case. But amid this ongoing battle is a surprising player who desperately wants a deal to go down: China.

Critics of TPP often warn that it will hurt blue-collar workers in the United States and weaken labor standards globally. Supporters believe TPP will create net new manufacturing and service-sector jobs while also raising global standards, particularly labor protections. They point to substantially improved U.S. trade balances in the blue collar goods sector for trade deals concluded since 2000.

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April 20, 2015

Rush to Judgment | Commentary

By Barry M. Blechman

When the U.S. and its negotiating partners surprised the world on April 2 by concluding the framework for an agreement that would prevent Iran from acquiring nuclear weapons for an absolute minimum of 10 years (and probably for much longer), one would have thought critics of the talks might have waited a few seconds to excoriate the deal. Indeed, a reasonable person might have concluded, “Well, Iran’s progress toward a bomb has been halted for the nearly two years that it took to conclude this framework agreement, let’s give the negotiators the three more months they’ve allowed themselves to write down the actual, detailed agreement and then take a look at it.”

But of course “reason” cuts no ice in Washington anymore, even when it pertains to foreign policy and crucial issues such as nuclear proliferation. What matters are political ambitions and the money required to fulfill them. Indeed, the Republicans attempted to pre-empt the framework talks before they succeeded by lending the bully pulpit of a joint congressional session to Israel’s Prime Minister Benjamin Netanyahu and then — in an unprecedented act — writing a letter to the leaders of Iran seeking to undermine the U.S. position in the talks. (Imagine the Democrats in Congress writing to Ho Chi Minh in 1972 warning him they would not support the agreement to end the Vietnam War Henry Kissinger was negotiating in Paris.) Full story

5 Years After BP Oil Spill, Focus on Restoration — Not Misinformation | Commentary

By Douglas J. Meffert, David Muth and Steve Cochran

It’s been five years since images of oil-soaked pelicans, dead turtles and contaminated shorelines along the Gulf Coast shocked our national consciousness. Half a decade after the Deepwater Horizon rig exploded, killing 11 men and unleashing the worst marine oil spill in U.S. history, BP would like you to believe that everything is back to normal along the Gulf Coast. In reality, BP has not yet truly accepted responsibility for the enormity of the damages it caused. Its recent Gulf of Mexico Environmental Recovery and Restoration report states that “most environmental impact from the accident was limited in duration and geography, and the natural resources that were affected are rebounding.” The scientific authority on the spill – the trustees of the Natural Resource Damage Assessment, said this in response: “BP misinterprets and misapplies data while ignoring published literature that doesn’t support its claims.” In this battle of PRs – public relations vs. peer-reviewed science, we side with science.

As leaders in national environmental organizations working with local partners to address Louisiana’s land loss crisis, here’s the reality. We’re still seeing persistent re-oiling of habitats like barrier islands and nesting habitats along Louisiana’s coast. The day after BP released its report, a 25,000 pound tar mat of BP oil was found on a Louisiana barrier island. Up to 10 million gallons of oil were recently discovered on the Gulf floor, creating a “bathtub ring” of oil the size of Rhode Island around the site of the disaster. Ongoing effects to wildlife persist: dolphins in badly-oiled Barataria Bay are dying at a rate four times higher than normal; fish such as mahimahi hatched in oiled areas have reduced swimming abilities; an estimated 800,000 birds died as a result of the disaster. And the spill worsened land loss in areas that received heavy oil, a continued blow as Louisiana confronts having lost 1,900 square miles of land since the 1930s — an area the size of Delaware. Full story

April 17, 2015

Iran Framework Could Yield Middle East Nuclear Proliferation | Commentary

By Rep. Charlie Dent

A robust national discussion on the recently presented framework regarding the Iranian nuclear program is critical and congressional review is essential. First, we need to be clear: There is no nuclear agreement with Iran. We are told a framework exists — although neither side apparently agrees on its details.

Consider Iranian leader Ayatollah Khamenei’s April 9 declaration that all sanctions be removed the day an agreement is signed. This demand directly and irreconcilably contradicts President Barack Obama’s interpretation of the framework. This is not a mere technical disagreement, but a fundamental one that must give us pause. Full story

You May Not Have Heard of This Dodd-Frank Provision, but It’s Saving Lives | Commentary

By Samir Goswami

Debate continues in Congress and among policymakers around changes to the Dodd-Frank Act. Last year’s budget bill included a last minute Wall Street-backed provision that rolls back a rule affecting derivatives, which some cite as a financial product that contributed to the 2008 economic crisis. Regardless of what further changes are made to Dodd-Frank, one section of the law has started to have a profound impact. This section (1502) requires companies in the United States to determine whether conflict minerals from the Democratic Republic of Congo are used in any of their products and report those findings to the U.S. Securities and Exchange Commission. In the SEC’s own words, “Congress enacted Section 1502 of the Act because of concerns that the exploitation and trade of conflict minerals by armed groups is helping to finance conflict in the DRC region and is contributing to an emerging humanitarian crisis.”

The DRC has been in a state of violent conflict for nearly two decades, is plagued by countless militias that prey on the land and other people, and has almost no functional government or rule of law. With its economy in shambles and the majority of the population living in poverty, one might question how so many militias are able to stay in business, and with seeming impunity. But the DRC is rich in a number of valuable minerals. The militias have been able to gain control of many of the mines operating in the country and sell their plunder to Western technology and jewelry companies — and then, Western consumers. Militias are thus able to amass a great amount of wealth to pay their soldiers, providing greater incentives for people to join them. Full story

April 16, 2015

This Is No Time for Partisan Politics: Vote on Loretta Lynch Now | Commentary

Sharpton is calling on the Senate to vote on Lynch's nomination immediately. (Douglas Graham/CQ Roll Call File Photo)

Sharpton is calling on the Senate to vote on Lynch’s nomination immediately. (Douglas Graham/CQ Roll Call File Photo)

By Al Sharpton

More than 150 days ago, President Barack Obama nominated Loretta Lynch as the next U.S. attorney general following Eric Holder’s decision to step down. More than 48 days ago, the Senate Judiciary Committee voted to confirm Lynch as the top law enforcement official in the nation. And yet, Senate Majority Leader Mitch McConnell, R-Ky., still refuses to schedule a vote. At a time when key issues important to the American people like protection of voting rights, law enforcement accountability/reform and oversight of numerous areas demand leadership, McConnell and many in his party are stalling.

A graduate of Harvard Law School, Lynch has spent a significant amount of her tremendous career going after corrupt politicians, mobsters and criminals that other less-capable individuals might be too afraid or hesitant to investigate and pursue. Time and time again, she has proven to possess the fortitude, insight, intelligence, courage and determination we as a nation need in a top law enforcement official. Instead of providing a speedy confirmation process for such a qualified and esteemed nominee, those wishing to hold us back are once again doing what they do best – obstructing. Full story

Changing the Political Landscape, One Race at a Time | Letter to the Editor

By Matt Walter

In last week’s Roll Call, Stuart Rothenberg waded into the critically important, yet under-reported topic of state and local elections (“RSLC Presents GOP State Level Gains Out of Context,” Roll Call, April 8). It’s exciting to see a well-respected federal elections analyst give attention to the levels of government that have the most pointed impact on people’s homes, jobs, roads and children’s education. Unfortunately, Rothenberg’s analysis of two recent local Republican victories in Democratic territory fundamentally misses current state-level trends and is simply inaccurate when it refers to these races as taking place in “competitive or even Republican-leaning districts.”

In Pennsylvania, Rothenberg misunderstood Martina White’s victory to become the second House Republican from Philadelphia when he attributed it in part to a “split in the Democratic Party.” In truth, this talented 26-year-old financial adviser ran a better campaign and won because she was the right candidate, with a clear vision for a better future for her district. White brought together an unexpected coalition of voters from both sides of the political aisle to carry her to victory in a district President Barack Obama won by nearly 15 points.

Her win was neither easy nor insignificant. A Republican has not won the 170th District seat since George W. Bush was in the White House in 2006 when Democratic voter registration outweighed Republicans 53 percent to 39 percent. Following almost 10 years of growing registration on the Democratic side and redistricting, White took the seat back for our party this year when Democratic registration now outweighs Republicans by 30 points.

In California, Rothenberg correctly noted Andrew Do’s race saw “enthusiastic support” from his former boss, current state Sen. Janet Nguyen who previously held Do’s Board of Supervisors seat. Having the support of Nguyen — who won her senate race last November by 16 points in a district Obama carried by nearly 9 points — is welcome when trying to keep a supervisors’ seat in a district where registered Democrats outweigh Republicans. Do campaigned tirelessly and fought for the votes of those in his community by sharing his message of open and innovative governing. In the end, he turned out enough voters in an extremely close race to beat a better-known, formerly-elected Democrat. The Democrat he beat even held this same supervisor seat immediately before Nguyen.

Rothenberg also missed the broad impact of Nguyen’s story: Her recent election to the state senate made her the country’s first Vietnamese-American woman state legislator and was one of the key wins that broke the Democratic super-majority in the California Senate. She won by sharing a deep commitment to delivering results on state and local issues in an era when Americans are supporting responsive local government.

These wins are significant as the latest in a trend in our party that began when Obama controlled a completely Democratic federal government in 2008, leading to unchecked growth in government, federal overreach into the states and the passage of Obamacare. Voters rejected that old top-down, one-size-fits-all Democratic approach and have since welcomed the bottom-up, innovative and open solutions being implemented by state and local Republicans. Voters embraced a new type of Republican candidate — like White, Do and Nguyen — running different kinds of races for a better type of government.

In the 2010 election cycle, Republicans flipped 21 state legislative chambers, taking control of more legislative seats than any time since 1928. In 2011 and 2012, Republicans again had a net gain in state legislative chambers. And for a third-straight cycle of expansion, Republicans in 2014 won control of more chambers than they have ever held in history — a super-majority of legislative majorities with 69 out of 99 state chambers. 23 of those majority chambers are in states Obama won twice.

Each race and each win matters and continues moving state and local governments toward effective and responsive governing that makes a tangible difference in people’s lives. Over the past three cycles, Republicans have netted more than 900 new legislative seats. New victories such as the recent wins in Philadelphia and California are a further progression of this six-year trend.

It’s easy to forget in Washington that effective politics results from the right leaders delivering the right policies that make people’s lives better. That’s how Republicans at the state level have reached historic highs across red, purple and even blue states. That’s how White, Do and Nguyen were elected. And as long as state and local Republicans continue delivering effective local leadership while the old, top-down Democratic bureaucracy reigns in Washington, Republican governing will continue to succeed and spread, one seat at a time.

Matt Walter is president of the Republican State Leadership Committee.

Related:

RSLC Presents GOP State Level Gains Out of Context

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Time for Congress to Reform Cable TV Laws | Commentary

By Matthew M. Polka

With Washington, D.C., divided on a number key policy fronts, now is perhaps the perfect time for Congress to focus on an issue that has bipartisan support: Overhauling the 1992 Cable Act and scrapping many badly outdated video regulations.

A great place to start is with the requirement called the basic tier buy-through. This regulation mandates that cable subscribers buy all local TV stations prior to accessing any other video service offered by their cable company. A real-world example shows how this particular cable statute distorts the market and drives up the price of cable by government fiat. Full story

After King v. Burwell, Republicans’ Goal Should Be Federalism on Steroids | Commentary

By Paul Howard and Yevgeniy Feyman

There are three simple numbers Republicans in Congress need to keep their eyes on in the aftermath of the Supreme Court’s forthcoming decision in King v. Burwell, no matter what the outcome: 28, 60 and 67.

28: The number of GOP governors in states with a federal health insurance exchange where a combined total of 6.5 million subsidy-eligible residents are at risk of losing those subsidies and their insurance if the plaintiffs win in King. The Department of Health and Human Service will offer these governors a quick fix: Simply deem the federal exchanges an “exchange established by the state” for the purpose of receiving federal subsidies. Without a Republicans alternative for these 28 governors, HHS’ escape hatch is going to look very attractive.

60: The number of votes Republicans must rally to overcome a Democratic filibuster of legislation that might put the president in an awkward position — such as repealing the individual mandate in exchange for allowing the subsidies to continue to flow for an interim period.

67: The number of votes Republicans need in the Senate to overcome a presidential veto — an impossible number. Republicans would have to be content to make Democrats take a hard vote on a full “repeal and replace” bill, losing the battle, but hope that it would set them up to win the war by maintaining the Senate and taking the White House in 2017.

These simple political realities make immediate goals of repeal-replace bills impossible. Instead, Republicans need a “bridge”: A solution to get them through a potential win in King that doesn’t leave Republican governors out to dry, but still allows serious health care reform.

One such bridge could come in the form of the so-called “State Innovation Waivers,” under section 1332 of the law, slated to begin in 2017. This little known element of Obamacare allows states to waive various parts of the law’s requirements including “essential health benefit” standards, requirements for exchanges, premium tax credits, and even the employer and individual mandates. In return, states receive a block grant of funding that would otherwise flow through Obamacare’s mechanisms.

States could combine these waivers and existing Medicaid waivers (so-called “section 1115 waivers”) to receive a block grant of funding that would encompass an even larger population, allowing bigger reforms. (Standardizing the combination of these waivers could appeal to both red and blue states.)
The catch is the administration’s bait-and-switch approach to the Medicaid expansion. While HHS has promised flexibility, very little has been offered so far, making governors hesitant to propose ambitious reforms.

The solution is simple: Congress should write flexibility directly into new legislation. Allow states to experiment with the flexibility of 1332 waivers, requiring “auto-approval” so long as reforms attain similar coverage and remain deficit neutral.

Similarly, Congress should standardize Medicaid’s 1115 waiver system, allowing states to experiment with standardized approaches — including cost sharing and chronic disease management programs for Medicaid recipients — that would allow states to fast-track credible reform experiments, with stringent outcome reporting requirements.

This approach lets states implement standardized Medicaid and exchange reforms, knowing that the administration can’t pull the rug out from under them.

Policymakers should also consider taking the waivers to another level — offer the ability to wrap together other streams of federal funding, like supporting housing around drug treatment or prisoner re-entry programs. These mega-block grants would allow states to test more ambitious strategies for helping high risk, low-income residents. (House Ways and Means Chairman Paul Ryan, R-Wis., has proposed a similar approach, called Opportunity grants.)

In a nutshell, Congress would call the president’s bluff. He’s said he’s in favor of state flexibility, allowing states to experiment. This would be an opportunity for the president to walk the walk on federalism.
Republicans have been hoping to replace Obamacare at a single stroke since 2010, either through one election or one Supreme Court case, only to be disappointed. The math is against them today as well. The advantage of a waiver/template approach that it works within the framework of the law, addresses conservatives’ core concerns and promotes entitlement reform along the way.

This strategy could be implemented in one large bill, or tested via a series of amendments to legislation allowing federal exchange subsidies to flow until 2017 if the plaintiff’s win in King.

Conservatives must acknowledge short-term realities while working toward long-term goals. While King won’t allow them to overturn the law, Obamacare’s own provisions allow a state-by-state repeal and replace strategy that helps set the stage for a larger health care debate in 2017.

Paul Howard is a Manhattan Institute senior fellow and director of the Manhattan Institute’s Center for Medical Progress. Yevgeniy Feyman is a Manhattan Institute fellow and deputy director of the Manhattan Institute’s Center for Medical Progress.

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Dietary Guidelines for Americans: Playing Politics With Our Health | Commentary

By Jeff Volek

Later this year, the Department of Health and Human Services and the U.S. Department of Agriculture  will release the latest edition of their dietary guidelines, which sets the agenda for what Americans should eat to maintain a healthy weight, prevent disease and sustain overall wellness. Since the guidelines were first released 35 years ago, various recommendations have come and gone. But the guidelines have been unwavering in their insistence that Americans consume the majority of their daily allowance of calories in the form of carbohydrates.

However, instead of guiding Americans toward better health, the results have been the exact opposite.

Since the dietary guidelines were first released, adult obesity rates have doubled and they’re set to increase another 50 percent by 2030. Childhood obesity and diabetes diagnoses have tripled. Two-thirds of U.S. adults are overweight, one-third are obese and roughly 25 million have diabetes. Our damaged health is also hurting our wallets: we spend $250 billion annually managing diabetes, a number expected to double by 2020.

If the current dietary guidelines are failing in their sole purpose of making American’s healthier, and there are other scientifically-proven approaches to having a healthy diet, why have they been ignored?

This is the question 30 Senators, led by Sen. John Thune and Sen. Angus King, and 70 House Members led by Rep. Vicky Hartzler, R-Mo., posed in a recent letters to Health and Human Services Secretary Sylvia Mathews Burwell and United States Department of Agriculture Secretary Tom Vilsack regarding inconsistencies found within this year’s Dietary Guidelines Advisory Committee report. Both letters state that the current DGAC report ignores peer-reviewed scientific evidence that contradict DGAC claims on what types of food — specifically red and processed meats — can constitute a healthy diet.

Because agency leaders rely on the DGAC report to develop the dietary guidelines, the senators and House members asked Burwell and Vilsack to reconsider current research and scientific literature before finalizing the guidelines, and directed them to ensure adherence to their congressional charters. But shouldn’t this have always been the case?

In the past, the rush to support DGAC recommendations and dietary guidelines without a serious discussion around the science behind them has led to negative outcomes. For instance, we recently saw the vilification and then reversal of position on various fats, including saturated fats and trans fats.

Another significant problem with trying to have an informed and reasonable discussion on the state of nutrition science and the public health benefits is that well-meaning, albeit misguided interest groups have consistently led the lobbying charge to implement what they believe to be good nutrition policy, despite consistent evidence to the contrary.

Once such group that voiced support for the most recent guidelines was the National Alliance for Nutrition and Activity, which is a subsidiary of the group Center for Science in the Public Interest. CSPI often accuses industry groups of being solely motivated by the food industry or economic self-interest. While there may be an economic benefit for industry associations, it doesn’t mean they are wrong.

As a dietitian and scientist, I have published dozens of peer-reviewed studies demonstrating the positive impact that decreased carbohydrate intake can have on performance, weight management, reducing cardiovascular risk, and overall health. And I’m not alone — dozens of my colleagues around the country have come to similar conclusions.

Advocating for the restriction of saturated fat, as the current DGAC report and previous guidelines have recommended, requires that people eat fewer full-fat animal products, including red meats, eggs and dairy. This also means people eat more sugars and processed starches, which are “highly reinforcing,” in that one can consume more calories without feeling full. The excessive consumption of carbohydrates is the primary cause of obesity and diabetes — and it’s not a stretch to implicate the dietary guidelines in these epidemics plaguing our country.

Unfortunately, advocating for lower-carbohydrate, higher-fat diets would fly in the face of everything the DGAC, HHS and the USDA have recommended over the past three decades, and it flies in the face of self-proclaimed nutrition advocacy organizations, such as CSPI. It’s time for all Americans, and especially all members of Congress, to ask why we’re sticking with an ineffective approach to deciding what is best for our nation’s health. Such an about face would be an acknowledgement that the process to date has been misguided. But if we’re serious about saving lives and money, then that is exactly what must be done.

Hartzler, Thune, King and the 97 others who expressed their concerns about scientific integrity of this year’s DGAC report to the USDA and to HHS should be applauded. Their efforts resulted in an extension of the public comment period that will give researchers, public health advocates and nutritionists a chance to openly discuss and consider all proven scientific research and options that may shift our nation in a healthier direction.

Jeff S. Volek, Ph.D., R.D., is a registered dietitian and full professor in the Department of Human Sciences at Ohio State University.

The 114th: CQ Roll Call’s Guide to the New Congress

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