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Week In Politics: Trump And Kim, Health Care


The effort to repeal and replace the Affordable Care Act may be in its final hours after Senator John McCain said he'll vote no. And a week in which the president and Kim Jong Un went back and forth - rocket man, mentally deranged, frightened dog. And you ought to hear what the president called Colin Kaepernick last night in Alabama. That's quite an introduction for NPR's Ron Elving. Ron, thanks for being with us.

RON ELVING, BYLINE: Good to be with you, Scott.

SIMON: If this latest effort does not go to the floor, did Senator McCain upset his party or save it with his no on the Graham-Cassidy bill?

ELVING: It may turn out to be both. He surely did upset the latest attempt to deliver on the Republicans' clear and salient promise to repeal and replace Obamacare. And that has terribly upset the president and party leaders and activists, including major donors and many small donors to the party as well. But in the long run, if this really does stop this latest effort, it's probably better to upset your base than to upend the whole country's health care and health insurance system, and this bill looks likely to have done both.

SIMON: Were Republicans ever really enthusiastic about this bill?

ELVING: What they really like about the bill was erasing the failures of the summer on repeal and replace. Some really do like the substance of the bill. Of course, they do like turning over all the decisions to the states. But a lot of Republicans also were afraid that this bill would cost some people their coverage.

The only estimates we have so far because we don't have one from the Congressional Budget Office, but the ones we have from the Brookings Institution say more than 20 million people would lose their coverage. And they knew, of course - the Republicans knew - that media coverage of the bill was probably going to be pretty critical. And they also feared that it might cost them, to at least some degree, at the polls in 2018.

SIMON: Do you see more political damage to the president or the Senate?

ELVING: You know, it hurts them both because many of the voters just don't understand how this can be happening. They know the president wants it. They know the Senate majority wants it or says it wants it. But the Senate just can't muster even half its votes to do it, and they can't bring all the Republicans to bear on it. So something is not right. Either the mojo of the president isn't working or the mechanism of the Senate is not working, and to some degree, both are true.

SIMON: Is there any reason why Democrats now might want to sign on to any kind of bipartisan health care effort when their own plan has been saved?

ELVING: Yes, absolutely. The Democrats need to go forward with some kind of bipartisan solution because there are many real problems with the execution and the administration of Obamacare. Now, Patty Murray, the senator from Washington state, has been working with Tennessee's Lamar Alexander in the Senate. And he's a Republican. He's the chairman of one of the committees that's relevant here.

And, of course, a lot of the Democrats are aware of these shortfalls. And there are counties with only one insurance company and counties where it's not clear there are going to be any insurance companies. And some of that's been overblown, but there are real problems. And, of course, any bill, any large program, any law needs to be revisited and amended, and the parties need to get together to do that.

SIMON: These insults this week flying back and forth between the president and Kim Jong Un - lunatic, frightened dog, dotard. I don't know about you, I had to look that one up.

ELVING: We all did.

SIMON: This is this just scenery chewing or are people in official Washington worried it could encourage something more destructive?

ELVING: Winston Churchill, we always have to quote him once in a while, right? He said that jaw-jaw was better than war-war. And no matter how awful the war of words may get, it's only serious, really, if it leads to real war. And if North Korea is truly a nuclear power now, any thought of a military solution is somewhere between horrific and unthinkable.

SIMON: And the Mueller investigation's widening?

ELVING: We do see more evidence that the Mueller investigation thinks it has some kind of goods on Paul Manafort, former campaign chairman for Donald Trump. He also seems to think he can use whatever he has on Manafort to pry loose more stuff on other campaign figures. Is this going to reach the president himself? At this point, that does not seem to be indicated. But this probe is going to continue and get a lot more uncomfortable for the president before it's over.

SIMON: NPR's Ron Elving. Thanks so much.

ELVING: Thank you, Scott. Transcript provided by NPR, Copyright NPR.