WASHINGTON — After losing in Congress, President Donald Trump is counting on the courts to kill off “Obamacare.” But some cases are going against him, and time is not on his side as he tries to score a big win for his re-election campaign.
Two federal judges in Washington, D.C., this past week blocked parts of Trump’s health care agenda: work requirements for some low-income people on Medicaid, and new small business health plans that don’t have to provide full benefits required by the Affordable Care Act.
But in the biggest case, a federal judge in Texas ruled last December that the ACA is unconstitutional and should be struck down in its entirety. That ruling is now on appeal. At the urging of the White House, the Justice Department said this past week it will support the Texas judge’s position and argue that all of “Obamacare” must go.
A problem for Trump is that the litigation could take months to resolve — or longer — and there’s no guarantee he’ll get the outcomes he wants before the 2020 election.
“Was this a good week for the Trump administration? No,” said economist Gail Wilensky, who headed up Medicare under former Republican President George H.W. Bush. “But this is the beginning of a series of judicial challenges.”
It’s early innings in the court cases, and “the clock is going to run out,” said Timothy Jost, a retired law professor who has followed the Obama health law since its inception.
“By the time these cases get through the courts there simply isn’t going to be time for the administration to straighten out any messes that get created, much less get a comprehensive plan through Congress,” added Jost, who supports the ACA.
In the Texas case, Trump could lose by winning.
If former President Barack Obama’s health law is struck down entirely, Congress would face an impossible task: pass a comprehensive health overhaul to replace it that both Speaker Nancy Pelosi and Trump can agree to. The failed attempt to repeal “Obamacare” in 2017 proved to be toxic for congressional Republicans in last year’s midterm elections and they are in no mood to repeat it.
“The ACA now is nine years old and it would be incredibly disruptive to uproot the whole thing,” said Thomas Barker, an attorney with the law firm Foley Hoag, who served as a top lawyer at the federal Health and Human Services department under former Republican President George W. Bush. “It seems to me that you can resolve this issue more narrowly than by striking down the ACA.”
Trump seems unfazed by the potential risks.
“Right now, it’s losing in court,” he asserted Friday, referring to the Texas case against “Obamacare.”
The case “probably ends up in the Supreme Court,” Trump continued. “But we’re doing something that is going to be much less expensive than Obamacare for the people ... and we’re going to have (protections for) pre-existing conditions and will have a much lower deductible. So, and I’ve been saying that, the Republicans are going to end up being the party of health care.”
There’s no sign that his administration has a comprehensive health care plan, and there doesn’t seem to be a consensus among Republicans in Congress.
A common thread in the various health care cases is that they involve lower-court rulings for now, and there’s no telling how they may ultimately be decided. Here’s a status check on major lawsuits:
The challenge to the ACA was filed by officials from Texas and other GOP-led states. It’s now fully supported by the Trump administration, which earlier had argued that only the law’s protections for people with pre-existing conditions and its limits on how much insurers could charge older, sicker customers were constitutionally tainted. All sides expect the case to go to the Supreme Court, which has twice before upheld the ACA.
The Trump administration says it will continue to approve state requests for work requirements, but has not indicated if it will appeal.
The administration said it disagrees but hasn’t formally announced an appeal.
Also facing challenges in courts around the country are an administration regulation that bars federally funded family planning clinics from referring women for abortions and a rule that allows employers with religious and moral objections to opt out of offering free birth control to women workers as a preventive care service.
Most Lake Waco parks are getting back to full strength for the start of their busy season after flooding once again forced closures and caused damage late last year.
Reynolds Creek Park, with its beachfront, campsites and equestrian facilities and trails, is reopening Monday. April 1 is the regular seasonal opening day for the 51 campsites, but the day-use area would typically remain open year-round. A flooded lake in October and again in December brought debris and damage that volunteers and U.S. Army Corps of Engineers crews have been working to clear to get the full 41-acre park ready for opening day.
Continual flooding concerns caused disruptions for all Lake Waco parks in the last five months, said Courtney Heuring, a Corps natural resource specialist at Lake Waco. All but two are up and running Monday.
“A lot of our parks got hit hard with the October, November flooding. Reynolds Creek tends to get a lot of debris stacked up in it from the inflow of the North Bosque River,” Heuring said. “The day-use area had a lot of the debris that caused a lot of the clean up to be in this area.”
Work to get the area ready continued up through late last week and the weekend. On Thursday, crews made burn piles to dispose of large limbs and other debris.
Vietnam War veterans Larry Slagel and Bob Wall, among the volunteers at Reynolds, said the work leaves them with a sense of pride and ownership in the public space.
“We enjoy it and getting in here to pull this stuff out to get it ready,” Slagel said. “At the end, it really makes you proud.”
“It’s kind of like our park, because it is,” Wall added. “… After everything is done, we know how happy everyone is that we cleaned it up so everyone can use it.”
In November, volunteers with Fish On, the Group W Bench Litter Patrol and Keep Waco Beautiful worked to help clean up flood damaged Twin Bridges Park. All lake parks, excluding Koehne Park and Airport Beach Park, will be open from Monday.
Lake manager Health McLane said employees and volunteers are still cleaning up Airport Beach, and officials expect it to reopen May 1. Koehne Park suffered extensive damage and it is not likely to reopen this year, McLane said.
“We truly appreciate everyone’s work in getting all the parks reopened this year,” he said.
HERAT, Afghanistan — An impoverished teenager, Mehdi, joined the wave of Afghans who left their homeland, dreaming of reaching Europe to find work. Where he ended up was entirely different: On the battlefields of Syria’s civil war, in a militia created by Iran.
Mehdi was one of tens of thousands of Afghans recruited and trained by Iran to fight in support of Tehran’s ally, Syrian President Bashar Assad. In Syria, he was thrown into one of the war’s bloodiest battles, surrounded by the bodies of his comrades, under fire from Islamic militants so close he could hear their shouts of “Allahu akbar” before each mortar blast.
Iran created a network of militias made up of Shiites from across the region and used it to save Assad from the uprising against his rule — not only Afghans but also Pakistanis, Iraqis and Lebanese. Now with the 8-year war in Syria winding down, the question is what will Tehran do with those well-trained, well-armed forces.
Mehdi and other soldiers-for-hire from Afghanistan’s impoverished Shiite Muslim communities are returning home, where they are met with suspicion. Afghan security officials believe Iran is still organizing them, this time as a secret army to spread Tehran’s influence amid Afghanistan’s unending conflicts.
“Here in Afghanistan we are afraid. They say we are all terrorists,” said Mehdi, now 21 and back in his home city of Herat. He was terrified, speaking on condition he not be fully identified for fear of retaliation. He met The Associated in a car parked in a remote, mostly Shiite neighborhood, and even there kept his face obscured with a scarf, glancing suspiciously at every passing car.
The returning veterans are threatened from multiple sides. They face arrest by security agencies that see them as traitors. They face violence from the brutal Islamic State affiliate in Afghanistan, which views Shiites as heretics and vows to kill them. Last May, IS gunmen attacked a Shiite mosque in Herat, killing 38 people.
To back Assad, Iran sent hundreds of Revolutionary Guard troops to Syria and brought in a number of allied militias. The most well-known and most powerful was Lebanon’s Hezbollah.
But the largest was a force made up of Afghans, known as the Fatimiyoun Brigade, which experts have estimated numbered up to 15,000 fighters at any one time. Over the years, several tens of thousands of Afghans trained and fought in it, most from the ethnic Hazara minority, who are among Afghanistan’s poorest.
Roughly 10,000 veterans of the brigade have returned to Afghanistan, says a senior official in Afghanistan’s Interior Ministry, who spoke on condition of anonymity.
The Afghan government and many experts believe Iran could mobilize these ex-fighters once more, especially if the country’s many armed factions turn on each other in escalated warfare after U.S. and NATO troops withdraw. Iran could use the chaos to deploy the brigade, with the very real pretext that the vulnerable Shiite minority needs a defender.
“Expect the Iranians to reconstitute their militias inside Afghanistan at some point,” said Bill Roggio, editor of the Long War Journal, a site devoted to coverage of the U.S. war on terror. “Iran does not discard assets in which it invests time, treasure, and expertise.”
Like most of those who joined the Fatimiyoun Brigade, Mehdi was driven by poverty, not ideology or loyalty to Iran.
Too poor to afford books for school, Mehdi had just turned 17 when he left Afghanistan in 2015. He went to Iran and worked in Tehran for months, saving money for the next leg of the trip to Europe. But Europe’s borders closed, and Mehdi was stranded in Tehran.
An Afghan friend suggested they enlist for Syria. As a fighter for Iran, they could earn the equivalent of $900 a month. At the time Mehdi was making barely $150 a month.
“I thought about it and I made my heart strong, like a raging river,” Mehdi said. “I decided, ‘Live or die, I’ll go’.”
He and other Afghans underwent 27 days of training under the Revolutionary Guard at a base in Iran’s southern Yazd province. Afterward, Mehdi was flown to Damascus with around 1,600 other new recruits.
In Damascus, the recruits opened bank accounts where their salaries would be deposited. They went to the shrine of Sayeda Zeinab, a site outside Damascus revered by Shiites, for final blessings before battle. The next day, they were taken by bus to the northern city of Aleppo and sent immediately to the front.
Mehdi was thrown into one of the fiercest battles of the war — a 2016 campaign against Islamic militant factions for control of the town of Khan Toman and nearby villages on Aleppo’s edge.
It was a fight that showed the international nature of the war. Among the militants were Syrians, Iraqis, Chechens, Turkmens, Uzbeks and other foreign jihadis; on the other side were Syrian and Iranian troops, Lebanese Hezbollah fighters, Iraqi Shiites and Afghans, backed by Russian warplanes — all battling for a piece of Syrian land. The fighting went on for months, killing and wounding hundreds on both sides.
“Often in the morning I saw seven, eight dead bodies.” Mehdi said. He said in one battle, 800 Afghans were sent to the front line and all but 200 were either killed or wounded.
Mehdi returned to Afghanistan a year ago. He remains dirt poor, and unable to find a job. He spoke bitterly of his lack of options. He noted that the Fatimiyoun Brigade remains in Syria, and some Afghan veterans stayed there after their service to work.
“I don’t know what my future brings,” he said. “Maybe I become a thief — or maybe I go back to Syria.”
The fiercest battle for campaign cash is playing out between the presidential candidates who might not be on your radar.
Ahead of Sunday’s fundraising deadline for the first quarter, the underdogs of the Democratic primary were in a mad dash to coax as little as $2 from grassroots donors. It’s all part of their bid to clear a new threshold from the Democratic National Committee to earn one of 20 highly coveted spots in presidential debates that begin in June.
“I’ll be blunt,” former Obama Cabinet member Julian Castro told prospective donors in one social media ad that was running as late as Thursday. “The Democratic Party’s new debate rules mean I might not make it onto the debate stage.”
New York Sen. Kirsten Gillibrand sent multiple fundraising emails pleading her case, telling recipients in one that they could chip in $5 “to become a founding member” and “help get Kirsten on the debate stage.”
Washington Gov. Jay Inslee urges donors in a Facebook ad to “chip in ... at any amount to make sure” his call to combat climate change “is on the stage in June.”
John Delaney, a little-known former Maryland congressman, is going a step further. He promised to donate $2 to charity for every new donor who donated on his website as Sunday’s fundraising deadline approached.
At issue are the rules that DNC Chairman Tom Perez announced in February for the first two debates in June and July: The debates will take place over two back-to-back midweek evenings with 10 slots each night. Candidates have two paths to the stage: They can either achieve 1 percent support in three reputable national or early nominating state polls or they can collect contributions from at least 65,000 donors, with a minimum of 200 in at least 20 states. The amount raised doesn’t matter. It’s all about how many voters are contributing.
It’s not immediately clear how many candidates are short of the fundraising threshold and how many might be using the rules as a way to expand their fundraising base. That won’t be known until mid-April, when campaign finance disclosures are next due with the Federal Elections Commission.
Perez says he’s not concerned either way, arguing that he wanted to make the debate qualifications fairer by not relying only on polling. He also wanted to force candidates to “engage with the grassroots,” those people who have provided Democrats with energy and votes since President Donald Trump’s election in 2016.
“It’s important to empower the grassroots,” Perez said recently on C-SPAN, explaining that the DNC worked with ActBlue, the online fundraising juggernaut for Democrats, to come up with the threshold.
He characterized the requirements as “not a layup for any candidate but also not a full-court shot.”
It actually might be a layup for a few candidates. Sen. Bernie Sanders’ campaign says he has more than 760,000 donors, another eye-popping mark after hauling in more than $10 million in the first week after his official campaign launch. Former Texas Rep. Beto O’Rourke’s campaign said he raised more than $6.2 million in his first day, more than surpassing the individual donor requirements. California Sen. Kamala Harris raised more than $4 million in her first day.
But Perez says his point stands, with rul es that help candidates by relieving them of polling pressure while still requiring them to show progress among voters.
Pete Buttigieg, the 37-year-old mayor of South Bend, Indiana, said the rules forced him to tailor his fundraising efforts to the grassroots. He said he already has surpassed the requirements.
“All of us, I think, are going to be responding to the incentives that the DNC creates,” Buttigieg said in an interview, “and whether it’s intentional or whether it’s just a happy side effect, it just amplified the kind of on-the-ground quality that hopefully will be a spirit that stays in this cycle throughout.”
Delaney was less enthusiastic as he sought support in Epping, New Hampshire.
“I think it’s a weird standard because it’s a money standard and I don’t think the Democratic Party should qualify candidates based on money,” he told The Associated Press.
That’s in partial contrast to what Delaney said in December, when he praised Perez for pursuing “a debate structure that is fair and on-the-level” after the chairman first confirmed publicly that grassroots donors might figure into debate qualifications.
Despite any frustration, Delaney is among those benefiting from another side effect of the rules, with some donors spreading their money around to ensure the field doesn’t winnow before the debates. That goes for donors big and small.
Major donor Susie Buell is committed to Harris but held a fundraiser for Buttigieg anyway, telling NBC News that “Mayor Pete has a voice that must be heard.”
That was the same impetus that spurred Joe Denoncour to give Delaney’s campaign $20 before he left a recent campaign event. Looking ahead to the debates, he said, “I think everybody should get on there that wants to do it.”