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      DeSantis Says He Would Pass a Bill to ‘Supersede’ Obamacare

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      The comments from Florida’s governor on Sunday followed a similar statement by former President Donald J. Trump; Democrats have denounced their stances.Gov. Ron DeSantis of Florida said on Sunday that, if elected president, he would pursue legislation that would “supersede” the Affordable Care Act, echoing former President Donald J. Trump’s comments, which Democrats seized upon last week.“What I think they’re going to need to do is have a plan that will supersede Obamacare, that will lower prices for people so that they can afford health care, while also making sure that people with pre-existing conditions are protected,” Mr. DeSantis said on NBC’s “Meet the Press.” He went on to say that repealing and replacing the Affordable Care Act was a broken promise from Mr. Trump’s 2016 campaign.“We’re going to look at the big institutions that are causing prices to be high — big pharma, big insurance and big government — but it’s going to need to be where you have a reform package that’s going to be put in place,” he said. “Obamacare promised lower premiums. It didn’t deliver that,” he added. “We know we need to go in a different direction, but it’s going to be done by having a plan that’s going to be able to supersede it.”Mr. Trump called for the same thing last week, writing on his social media platform that he was “seriously looking at alternatives” to the Affordable Care Act. After President Biden’s campaign denounced the statement, Mr. Trump wrote: “I don’t want to terminate Obamacare, I want to REPLACE IT with MUCH BETTER HEALTHCARE. Obamacare Sucks!!!”Mr. DeSantis named two specific policies he would address: making health care costs publicly available so that consumers can compare prices, and lowering insurance premiums for people who choose lower-cost providers. He called coverage for pre-existing conditions, a key component of the Affordable Care Act, “an easy thing that we’ll agree on.”Beyond that and a list of principles — “more transparency, more consumer choice, more affordable options, less red tape” — he did not go deep on his plan. Of the more than 40 million Americans covered by A.C.A. plans, he said, “We’ll have a plan that will offer them coverage, so the coverage will be different and better, but they’re still going to be able to be covered.”He said he would release a full proposal “probably in the spring,” which would be after a majority of states have held their primaries or caucuses.While opposition to the Affordable Care Act was initially a vote driver for Republicans, the law has become much more popular over the years, and Republicans’ failed effort to repeal the law in 2017 helped Democrats in the 2018 elections.A KFF poll in May found that 59 percent of Americans supported the A.C.A. Mr. DeSantis’s and Mr. Trump’s calls to replace it could play well in the Republican primary — only 26 percent of Republicans support the health law, according to the poll — but could become a liability in the general election because 89 percent of Democrats and 62 percent of independents support the health law.The Democratic National Committee condemned Mr. DeSantis’s comments.“DeSantis is hellbent on taking his failed ‘Florida Blueprint’ nationwide, even though it has contributed to some of the highest health care costs in America and left hundreds of thousands of hardworking Floridians without insurance,” Sarafina Chitika, a D.N.C. spokeswoman, said. “If Ron DeSantis, Donald Trump and MAGA Republicans have their way, they’d send premiums skyrocketing to line the pockets of greedy health care executives and their wealthy buddies.”Florida is one of 10 states that have not expanded Medicaid under the Affordable Care Act and had one of the nation’s highest percentages of uninsured people last year, according to the Census Bureau. More

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      Biden Campaign Aims to Weaponize Trump’s Threat to Obamacare

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      The president’s aides quickly jumped on a statement by Donald Trump that he was “seriously looking at alternatives” to the health law.Very few events bring aides on President Biden’s re-election campaign more joy than when former President Donald J. Trump threatens to repeal popular Democratic policies.So when Mr. Trump, the Republican presidential front-runner, wrote on social media over the holiday weekend that he was “seriously looking at alternatives” to the 13-year-old Affordable Care Act, and that his fellow Republicans should “never give up” seeking its repeal, Mr. Biden’s campaign was happy to cede its programming decisions to Mr. Trump.The president’s campaign altered its previous plans and instead will spend much of this week amplifying Mr. Trump’s threat, which was less a substantive policy proposal he had considered thoughtfully than it was a reaction to an editorial he had read in The Wall Street Journal.Still, Mr. Biden’s aides intend to once again push to make Mr. Trump and his proposals the news. That strategy has become a key cog for the campaign, as Mr. Biden struggles with low approval ratings and increasingly focuses on foreign policy rather than his re-election bid. The campaign will air TV ads this week in Las Vegas and on national cable that contrast legislation passed by Mr. Biden that lowered prices on some prescription drugs with Mr. Trump’s proposal to repeal the Affordable Care Act, said Michael Tyler, the campaign’s communications director.The president himself weighed in on Monday.“My predecessor once again called for cuts that could rip away health insurance for tens of millions of Americans,” Mr. Biden said. “They just don’t give up.”Mr. Biden’s campaign is in the process of arranging surrogates for the 2024 race — particularly in North Carolina, a presidential battleground that on Friday will become the 40th state to expand Medicaid under the Affordable Care Act.Gov. Roy Cooper of North Carolina, a Democrat, is expected to be a key Biden surrogate promoting the health care law, which is widely known as Obamacare. Mr. Cooper signed his state’s Medicaid expansion bill in March after it was passed by the Republican-controlled legislature. Mr. Cooper and Representative Nancy Pelosi of California, the former House speaker, are scheduled to hold a press call for the Biden campaign on Tuesday.“Donald Trump and G.O.P. extremists continue to try and rip away health care from millions of Americans without any serious alternative,” Mr. Cooper said on Monday. “If this country lets Donald Trump anywhere near decision making on health care, it would be a disaster for millions of people.”Mr. Trump’s social media post surprised even his own aides, who have not developed a plan to alter the country’s health care law, according to a person close to him.A spokesman for Mr. Trump’s campaign did not respond to requests for comment.Republicans successfully ran against the health law in the 2010 and 2014 midterm elections, and Mr. Trump used his call for “a full repeal” as an applause line at campaign rallies in 2016, even though he also said “everybody’s got to be covered” by health insurance. But Republicans have not made a serious effort at rescinding the health care law since Senator John McCain of Arizona cast the deciding vote against G.O.P. legislation to repeal the law in July 2017.In his social media post, Mr. Trump called that moment “a low point for the Republican Party.”Mr. Tyler said, “We’ve got Donald Trump every single day providing the American people a window into how harmful he would be if he were able to regain power.” He added, “He is making this easy for us.”The Biden campaign referred reporters to surveys illustrating the popularity of key elements of the health care law. Polling from KFF, the health care policy organization, found that as of May, 59 percent of Americans had a favorable opinion of Obamacare, up from 43 percent at the end of President Barack Obama’s term in office. Democrats in 2018 won sweeping victories by campaigning against Republican efforts to upend the health care law.Republicans remain broadly opposed to the law. KFF’s polling found that 73 percent held an unfavorable view of it in May.The Biden administration said in January that 16.3 million Americans had enrolled in health insurance plans through the Affordable Care Act’s marketplaces during the open enrollment period, more than had ever signed up before.Last week, the Department of Health and Human Services said that 4.6 million people had selected an Affordable Care Act plan in the first three weeks of the new open enrollment period, which began Nov. 1 and runs through January.Ruth Igielnik More

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      With Poll Results Favoring Trump, Should Biden Step Aside?

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      More from our inbox:Reducing I.R.S. FundingHealth Insurance, SimplifiedPoll results show President Biden losing to Donald J. Trump by margins of four to 10 percentage points in key battleground states.Doug Mills/The New York TimesTo the Editor:Re “Voters in 5 Battlegrounds Favor Trump Over Biden” (front page, Nov. 6):When will the Democratic Party stop sitting on its hands and do something about the dire reality of the coming presidential election?The most recent New York Times/Siena College poll has President Biden behind Donald Trump in five of six swing states while his approval ratings among youth and minorities — two essential demographics for the party — continue to plummet.There comes a time when we have to say, “Dad, you’ve been a wonderful father and we love you dearly, but we are taking away the car keys.”We can all see it: the shuffle, the drifting focus, the mental confusion during a news conference in Vietnam. Mr. Biden’s handlers keep him under close wraps now, but the gasps among the electorate are going to be frequent when he gets out on the campaign trail debate circuit.This is no time to nominate an octogenarian who refuses to acknowledge his visibly dwindling abilities. The fact that Mr. Trump is only three years younger is irrelevant. Facts, logic and even multiple criminal proceedings are nonfactors when your opponent is a cult figure whose worshipers are willing to follow him blindly into authoritarianism.What the Democrats need to win is vigor, freshness and the hope of positive change. This is no time to cling to gentlemanly traditions of incumbency.Mr. Biden should go down in history as the president who led us out of our darkest hours, but if he refuses to pass the torch to a younger generation, he will be remembered as just another aging politician who refused to let go.If the Democratic Party sits back idly, pleading helplessness in our moment of need, it will prove that this country has not one but two dysfunctional parties.Bill IbelleProvidence, R.I.To the Editor:I read this headline, “Voters in 5 Battlegrounds Favor Trump Over Biden,” and was shocked; then I looked at the charts and graphs in the paper, and was depressed, and turned to my application for Canadian citizenship. Then finally, on Page A13 (they will have to pry the print paper out of my dying hands), I see in large print: “Polls have often failed to predict results of elections this far out.”I really hate polls, but believe they have the power to sway people significantly. So, why publish them this far out if they are lousy predictors at this stage?Betsy ShackelfordDecatur, Ga.To the Editor:The media’s coverage of President Biden is the principal reason the latest poll shows him behind Donald Trump in five of six critical states.Mr. Biden inherited the worst economic crisis since the Great Depression and the gravest public health crisis in a century. He got off to the fastest start of any president since F.D.R., creating over six million jobs in his first year and reaching his goal of the vaccination of over 200 million Americans in fewer than 100 days. Yet the bulk of the reporting for most of his presidency since then has involved inflation and his age.Underreported is the impact of Mr. Biden’s other achievements: the largest investment in green energy in American history; a $1 trillion investment in infrastructure; the first federal gun safety legislation in nearly three decades; and the biggest expansion of veterans’ benefits in over three decades.Michael K. CantwellDelray Beach, Fla.To the Editor:The latest polls showing President Biden losing support from minority and youth voters should prompt leading Democrats to urge him not to seek a second term. It’s time for a high-level delegation, including Barack Obama and Bill Clinton, to visit the White House for a reality check.Yes, Joe Biden is a patriotic American and a good president. But the specter of Donald Trump back in the Oval Office demands that he step aside and pass the torch to preserve our democracy.Judith BishopMiami BeachTo the Editor:Your article about the latest poll was frightening but not surprising. How many times and in how many ways does the leadership of the Democratic Party have to be told that President Biden is unpopular?Are they backing him because, according to the book, an incumbent is more electable than a challenger? Are they relying on the fact that Mr. Biden defeated Donald Trump in 2020? If so, they need to take another look at that election.I am a lifelong Democrat surrounded by the same, but neither I nor any of my friends voted for Mr. Biden; we all voted against Mr. Trump. That may not be enough in 2024.It’s entirely possible that many of the people I know — and large sections of the electorate — won’t vote at all. And very few of us have the energy and enthusiasm it takes to campaign effectively.Claudia Miriam ReedMcMinnville, Ore.To the Editor:“Why Biden Is Behind, and How He Could Come Back,” by Nate Cohn (The Upshot, nytimes.com, Nov. 5), misses a critical point.It seemingly assumes that any Biden loss of voter support from 2020 will only move to the Donald Trump column. I believe there is an increasing possibility that a significant portion of any Biden losses will instead go to a third party. Not since Ross Perot in the 1992 election have I perceived such support for a viable third-party candidate.The No Labels movement seems to be making genuine progress and gaining increasing public awareness, if not outright support.While the Democrats are panicking that any gain in No Labels support will come from their candidate, I’m not so sure, as there is evidence that Mr. Trump’s numbers may be just as affected, if not more.Mr. Cohn should start digging deeper into the third-party movements and their likely impact on the election outcome.Kenneth GlennLangley, Wash.Reducing I.R.S. Funding Kenny Holston/The New York TimesTo the Editor:Re “Holding National Security Hostage to Help Tax Cheats,” by Paul Krugman (column, Nov. 3):As usual, Mr. Krugman provides a valuable perspective on an important initiative with serious policy as well as economic implications. I believe that there is a longer-term goal that the Republicans are serving by a proposed reduction in funding for the I.R.S. in addition to protecting tax cheats and suspect enterprises.Part of the funding for the I.R.S. is also scheduled to be used for major upgrades in equipment and staffing so that the I.R.S. operates more efficiently and effectively, including being available to answer questions and assist ordinary taxpayers.By reducing the funding for the I.R.S., the Republicans are deliberately undermining improved, consumer-helpful government services so that ordinary taxpayers (and voters) become increasingly frustrated with, and resentful or angry at, the I.R.S.Sowing and fertilizing dissatisfaction with government services among the voting populace appear to be a “growth industry” for the Republicans in Congress.David E. JoseIndianapolisHealth Insurance, Simplified Haik AvanianTo the Editor:Re “It’s Just This Easy to Lose Your Health Insurance,” by Danielle Ofri (Opinion guest essay, Oct. 31):Dr. Ofri rightly condemns the “illogical patchwork of plans and regulations” of the American health care system.The solution, as Dr. Ofri suggests, is to make fundamental health insurance automatic for all Americans, allowing them to opt out but not requiring them (as happened to Dr. Ofri) to opt in.Paul SorumJamaica Plain, Mass.The writer is professor emeritus of internal medicine and pediatrics, Albany Medical College. More

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      A Democratic Governor in Mississippi? He Thinks It’s Possible.

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      With a promise to expand Medicaid and a focus on turning out Black voters, Brandon Presley is confident he can do what no Democrat has done in 20 years. After stopping by a meet-and-greet in Ridgeland, a porch festival in Vicksburg, the Great Delta Bear Affair in Rolling Fork and an event on a baseball diamond in Yazoo City, Brandon Presley entered a packed room in McComb, launching into the message he believes can get a Democrat — namely, himself — elected governor of Mississippi. He would immediately move to expand Medicaid, which would help resuscitate rural hospitals and provide largely free government health insurance to most low-income adults. He would slash a hated tax on groceries. Above all, he assured the crowd, he would be a very different governor than Tate Reeves, the Republican incumbent, whom he denounced as ensconced in privilege and dented by scandal.“The fight in politics in Mississippi is not right versus left,” Mr. Presley, an elected public utilities commissioner and a former mayor of Nettleton, his tiny hometown in northern Mississippi, said in McComb. “And sometimes, it’s not even Democrat versus Republican. It’s those of us on the outside versus those of them on the inside.” Mr. Presley’s campaign has been a built on a bet that his human touch and populist platform can forge a coalition of Black and liberal-to-centrist white voters, some disaffected Republicans among them, that is robust enough for him to win. It is a test of a blueprint that Democrats have long relied on, but to diminishing effect in recent decades, as Republicans have tightened their grip on power in Mississippi and most of the South.Mr. Presley, left, and Tate Reeves, the Republican incumbent, during a debate on Wednesday.Brett Kenyon/WAPT, via Associated PressYet Mr. Presley has gained decent momentum — and with it, the attention of Democrats outside Mississippi. He has raised more than $11 million since January, far outpacing Mr. Reeves, and has used the money to flood television and radio stations with campaign advertisements. The nonpartisan Cook Political Report recently found that the election had “morphed into a competitive fight.” But it also classified the race as “likely to lean Republican” — a splash of cold water underscoring that, no matter how much ground Mr. Presley gains or optimism he has inspired in Southern Democrats, he still faces difficult odds in a state that has not elected a Democratic governor in 24 years.In the race for governor four years ago, Jim Hood, then the state attorney general and the last Democrat elected to statewide office, was seen as the most viable candidate the party had fielded in Mississippi in more than a decade. Yet he lost to Mr. Reeves by about five percentage points.Still, Mr. Presley sensed an opening. He believed that Mr. Reeves’s shaky popularity ratings, fury over a sprawling scandal involving welfare funds being directed to the pet projects of wealthy and connected Republicans, and dissatisfaction over the state’s eternal struggle for prosperity could allow him to accomplish what previous Democratic candidates could not. If neither candidate wins a majority of the popular vote on Tuesday, the race will go to a runoff on Nov. 28. Mr. Presley has invested enormous effort in mobilizing Black voters, a crucial bloc in a state where nearly 40 percent of the population is Black. But turning out the rest of the coalition that Mr. Presley needs — for example, white working-class voters who might have voted for Mr. Reeves last time — will be instrumental.“You can’t win if you don’t win white crossover votes,” said Byron D’Andra Orey, a political science professor at Jackson State University. For months, Mr. Presley has had marathon days ping-ponging across Mississippi, stopping in all 82 counties. He has become a frequent presence at football games on historically Black college campuses, as well as at festivals and small gatherings in community centers. In each place, he has made the same case: He is not a liberal — he opposes abortion rights — and he is certainly no elite. True, Elvis Presley was his second cousin, but a distant relative’s fame did nothing to boost his family’s fortunes. His mother was left to raise him and his siblings on her own after his father was killed when he was 8. Mr. Presley has become a frequent presence at football games on historically Black college campuses, as well as at festivals and small gatherings in community centers.Emily Kask for The New York Times“I’m white, and I’m country — it ain’t nothing I can do about it,” Mr. Presley told a mostly Black audience at one campaign stop. “But I get up every day and go to bed every night trying to pull Mississippi together.”The state fractures along racial and regional lines, creating a landscape that is anything but homogeneous, even as it tilts heavily in the Republican Party’s favor. The western flank, including the flat expanse of farmland in the Delta, votes for Democrats. Mr. Presley has wagered that one of his goals in particular can unify Democrats and Republicans, Black and many white voters: joining the 40 other states that have expanded Medicaid under the Affordable Care Act. Researchers have forecast that doing so would make the coverage available to roughly 230,000 lower-income adults over six years. Polls in Mississippi — where death rates are among the nation’s highest for heart disease, stroke, diabetes and cancer — have indicated overwhelming support.Mr. Reeves has been adamant in his opposition to expanding Medicaid, pointing to the cost (most of which would be a federal responsibility) and dismissing it as “welfare.” In September, he proposed an alternative that, if approved by federal officials, would increase funding for some hospitals but would not provide coverage for the uninsured. Mr. Presley with a supporter in Fulton, Miss.Houston Cofield for The New York TimesGrant Dowdy, a dentist in Greenville who came to the festival in Rolling Fork, said he was prepared to break a consistent streak of voting for Republicans precisely because of Mr. Presley’s support for Medicaid expansion. Mississippi, he said, “needs to be like every other sensible state in the nation.”But in such a polarized political climate, where party allegiance often outweighs all else, recruiting enough Republicans to tip the scale toward Mr. Presley may prove impossible. In 2001, he became the youngest mayor in Mississippi when was elected to lead Nettleton, a city of some 1,900 people in the state’s northeast. Since then, Mr. Presley, 46, has been elected four times to represent a vast swath of northern Mississippi on the state’s Public Service Commission, which regulates telecommunications, electric, gas, water and sewer utilities. Colleagues and supporters said the position — in a district filled with heavily conservative areas — helped him hone the solicitous approach he is bringing to the governor’s race. Mr. Reeves has cast Mr. Presley as a liberal aligned with President Biden, and his campaign as orchestrated by the national Democratic Party. He has pointed out that most of Mr. Presley’s fund-raising haul has come from outside Mississippi. “Ask yourself: Why are they dropping historic money on Mississippi to flip it blue?” Mr. Reeves said on social media in October. “It’s because they know Brandon Presley will govern like a liberal Democrat.”Mr. Reeves is also emphasizing his conservative bona fides, including tax cuts he has signed and a promise to keep pursuing his ambition of eliminating the state income tax. Mr. Presley has been elected four times to represent a swath of northern Mississippi on the state’s Public Services Commission.Houston Cofield for The New York TimesHe has touted the state’s unemployment rate, which has fallen to just over 3 percent — the lowest it has been in decades. He has also campaigned on raises he approved last year for public schoolteachers that were among the largest in state history, amounting to average increase of about $5,100 a year. Mr. Reeves has also said that his administration is trying to claw back money misspent in the welfare scandal, in which more than $77 million was siphoned from the state’s poorest residents to fund projects like one championed by Brett Favre, the former N.F.L. player, to build a volleyball stadium at the University of Southern Mississippi. Mr. Reeves was the state’s lieutenant governor at the time. Mr. Presley knows how to rouse a crowd, evoking a pastor in one moment and insult comic the next. He skewered Mr. Reeves at the candidate forum in McComb to cheers of approval and howling laughter, offering an almost cartoonish depiction of the governor as unfamiliar with and unsympathetic to the hardships facing the working poor.“Like the pharaoh of old, his heart has turned to stone,” Mr. Presley said. He also took particular delight in roasting upgrades reportedly made to the governor’s mansion, like a special shelter for lemon trees and a pricey ice maker (“It better make that good Sonic ice!”).At various stops, he has told crowds about a promise to his wife, Katelyn, whom he married just three months ago: If he wins, they will feed the homeless out of the governor’s mansion. His concern for the needy, he says, grew out his own experience enduring the turmoil and indignities of poverty. Some who came out to hear him speak recently said they were drawn to Mr. Presley because his early struggles sounded familiar — and simply because he was there, reaching out to them.“Look where he is,” said Joseph M. Daughtry Sr., the police chief in Columbus, where Mr. Presley had navigated a maze of country highways to speak to a few dozen people at a community center in a poor, largely Black neighborhood. “We have somebody who understands us,” Chief Daughtry said. “Somebody who cares about us. And somebody who is not ashamed of us.”Mr. Presley walked over to shake his hand. More

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      The G.O.P. Goes Full-on Extremist

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      There are no moderate Republicans in the House of Representatives.Oh, no doubt some members are privately appalled by the views of Mike Johnson, the new speaker. But what they think in the privacy of their own minds isn’t important. What matters is what they do — and every single one of them went along with the selection of a radical extremist.In fact, Johnson is more extreme than most people, I think even political reporters, fully realize.Much of the reporting on Johnson has, understandably, focused on his role in the efforts to overturn the 2020 election. Let me say, by the way, that the widely used term “election denial” is a euphemism that softens and blurs what we’re really talking about. Trying to keep your party in power after it lost a free and fair election, without a shred of evidence of significant fraud, isn’t just denial; it’s a betrayal of democracy.There has also been considerable coverage of Johnson’s right-wing social views, but I’m not sure how many people grasp the depth of his intolerance. Johnson isn’t just someone who wants to legalize discrimination against L.G.B.T.Q. Americans and ban gay marriage; he’s on record as defending the criminalization of gay sex.But Johnson’s extremism, and that of the party that chose him, goes beyond rejecting democracy and trying to turn back the clock on decades of social progress. He has also espoused a startlingly reactionary economic agenda.Until his sudden elevation to speaker, Johnson was a relatively little-known figure. But he did serve for a time as chairman of the Republican Study Committee, a group that devises policy proposals. And now that Johnson has become the face of his party, people really should look at the budget proposal the committee released for 2020 under his chairmanship.For if you read that proposal carefully, getting past the often mealy-mouthed language, you realize that it calls for the evisceration of the U.S. social safety net — not just programs for the poor, but also policies that form the bedrock of financial stability for the American middle class.Start with Social Security, where the budget calls for raising the retirement age — already set to rise to 67 — to 69 or 70, with possible further increases as life expectancy rises.On the surface, this might sound plausible. Until Covid produced a huge drop, average U.S. life expectancy at age 65 was steadily rising over time. But there is a huge and growing gap between the number of years affluent Americans can expect to live and life expectancy for lower-income groups, including not just the poor but also much of the working class. So raising the retirement age would fall hard on less fortunate Americans — precisely the people who depend most on Social Security.Then there’s Medicare, for which the budget proposes increasing the eligibility age “so it is aligned with the normal retirement age for Social Security and then indexing this age to life expectancy.” Translation: Raise the Medicare age from 65 to 70, then keep raising it.Wait, there’s more. Most nonelderly Americans receive health insurance through their employers. But this system depends greatly on policies that the study committee proposed eliminating. You see, benefits don’t count as taxable income — but in order to maintain this tax advantage, companies (roughly speaking) must cover all their employees, as opposed to offering benefits only to highly compensated individuals.The committee budget would eliminate this incentive for broad coverage by limiting the tax deduction for employer benefits and offering the same deduction for insurance purchased by individuals. As a result, some employers would probably just give their top earners cash, which they could use to buy expensive individual plans, while dropping coverage for the rest of their workers.Oh, and it goes almost without saying that the budget would impose savage cuts — $3 trillion over a decade — on Medicaid, children’s health coverage and subsidies that help lower-income Americans afford insurance under the Affordable Care Act.How many Americans would lose health insurance under these proposals? Back in 2017 the Congressional Budget Office estimated that Donald Trump’s attempt to repeal Obamacare would cause 23 million Americans to lose coverage. The Republican Study Committee’s proposals are far more draconian and far-reaching, so the losses would presumably be much bigger.So Mike Johnson is on record advocating policies on retirement, health care and other areas I don’t have space to get into, like food stamps, that would basically end American society as we know it. We would become a vastly crueler and less secure nation, with far more sheer misery.I think it’s safe to say that these proposals would be hugely unpopular — if voters knew about them. But will they?Actually, I’d like to see some focus groups asking what Americans think of Johnson’s policy positions. Here’s my guess, based on previous experience: Many voters will simply refuse to believe that prominent Republicans, let alone the speaker of the House, are really advocating such terrible things.But they are and he is. The G.O.P. has gone full-on extremist, on economic as well as social issues. The question now is whether the American public will notice.The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram. More

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      Fixing America’s Health Care System

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      More from our inbox:Trump’s Trial Dates and the Odds of ConvictionDoes Barbie Really Need Ken?September Dawn Bottoms for The New York TimesTo the Editor: Re “How Do We Fix the Scandal That Is American Health Care?,” by Nicholas Kristof, with photographs by September Dawn Bottoms (column, Aug. 20):Nicholas Kristof scratches the surface of the failures of the health care system in this country. I have been in practice for 28 years as a cardiologist and internist and have seen firsthand the miraculous breakthroughs in cardiac care as well as the appalling level of care typical in treatment of chronic diseases, especially among minority populations.Most care in this country is delivered by large for-profit and nonprofit entities (which function largely as for-profit entities but avoid taxes). These systems are incentivized to invest in high-end tertiary care, typically cardiac, orthopedic, neurosurgical and oncologic care, as they have the highest reimbursement.Chronic care for conditions such as obesity, diabetes and high blood pressure are not sexy areas of medicine and for the most part offer low compensation from Medicare, Medicaid and commercial payers.Our health care system needs to incentivize primary care and force nonprofit entities to allocate larger portions of their budgets to primary care or lose their nonprofit status.Daniel ZangerBrooklynTo the Editor:Nicholas Kristof has written a cogent and damning column. One piece of the health care crisis we must also address is physician education and remuneration.New physicians have delayed earning potential in order to attend medical school and have endured at least three years of paltry pay and extremely demanding schedules as medical interns and residents. By the time they are able to practice medicine after at least seven years of post-college training, they are unlikely to set up practice in rural areas with the lowest pay, fewest colleagues for support, professional isolation and limited call coverage. They are also less likely to practice in pediatrics or family medicine than in a medical specialty.Indeed, no one can blame them for wanting to work in a place conducive to comfortably repaying student loans as well as paying for malpractice insurance.Bright, hardworking young people can find myriad other fields of work and skip the stress that is modern U.S. medicine.If we are serious about improving health outcomes and reducing infant mortality, depression and skyrocketing rates of diabetes and other illnesses, then we need to completely revamp physician education.Nurses, doctors and hospital staff are heroes. Let’s treat them as such. Pay for their education, and incentivize work in underserved and high-risk locales.Susan BaloghBostonTo the Editor:Only last month the Department of Health and Human Services found that some of the country’s largest for-profit insurance companies, which together manage Medicaid programs that cover the majority of the 87 million individuals on Medicaid, denied more than one of every four requests for doctor-ordered treatments or medications for patients enrolled in their Medicaid plans. Medicaid serves many who live with the disadvantages that often lead to higher rates of diabetes and other chronic illnesses for which timely and consistent care is essential to better outcomes. Providing the services that doctors prescribe for these patients would go a long way to fixing the scandal described by Mr. Kristof.Ted HermanProvidence, R.I.The writer is a former health insurance executive.Trump’s Trial Dates and the Odds of ConvictionDoug Mills/The New York TimesTo the Editor: Re “This Indictment Does Something Ingenious,” by Norman Eisen and Amy Lee Copeland (Opinion guest essay, Aug. 16): The Georgia indictment might be ingenious, but the fact remains that Donald Trump won Georgia in 2016 and missed by a whisker winning again in 2020. So there is an overwhelming likelihood that some of his base of supporters will be on his jury and will not vote for his conviction no matter the strength of the evidence.Harold J. SmithWhite Plains, N.Y.To the Editor:There are many legitimate factors to take into account in determining when any criminal trial might begin, but one factor not to take into account is the defendant’s job. At the moment, Donald Trump is looking for a job (president) and in essence interviewing to get the job (campaigning).So let’s hope that the one factor that none of the judges consider in setting Mr. Trump’s trial date is his “interviewing schedule.”The judges might consider that at least some of Mr. Trump’s potential “employers” might want to know before hiring him whether or not he is a felon and set to spend many years in prison.Eugene D. CohenPhoenixDoes Barbie Really Need Ken?Iris Schneider/Los Angeles Times, via Getty ImagesTo the Editor: Re “Why Barbie and Ken Need Each Other,” by Ross Douthat (column, nytimes.com, Aug. 9):As a young woman, I agree with Mr. Douthat that “Barbie” contains some real, not-talked-about ambivalence concerning what female empowerment truly means.However, the core failing of “Barbie” is not, as he suggests, its failure to unite Barbie and Ken romantically, but a failure to imagine a world in which people of all genders can successfully lead together. Mr. Douthat’s insinuation that romance and reproduction must be the basis of any kind of productive union between men and women is archaic and troubling.This being said, the assertion of the “Barbie” movie that Ken is “superfluous” is also concerning. It is not, of course, that women have a need for men, but that humanity requires all of its members’ collaboration to achieve its highest potential. And yet, at the end of the movie, when Ken is relegated to a status equal to that of women in the real world (read: oppressed), any hope for a world in which people — or dolls — of all genders can live fulfilled, empowered lives remains elusive.Mary ElliotLenox, Mass.To the Editor:Certainly, there is evidence that married people tend to be happier than the unmarried. But that largely applies to people who are happily married. Unhappily married people are not only less happy than the happily married, but also less happy than those who are divorced, and less healthy than those who are single, divorced or widowed.There are some important factors that suggest Barbie and Ken’s union might not be a happy one. Barbie never expressed any interest in a relationship with Ken or with anyone else. As Barbie was being ushered into a black S.U.V. and taken to the Mattel headquarters, Ken high-tailed it back to Barbieland solo. While there, as Gloria (played by America Ferrera) so clearly summarized, he took Barbie’s house, he brainwashed her friends, and he tried to control the government.No one needs 40 years of General Social Survey data to know that they would be miserable. Stop trying to convince women that the key to their happiness is committing to emotionally damaged men against their self-interest and better judgment.Theresa HastertAnn Arbor, Mich. More

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      The Trump Indictment: A Changed Landscape

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      More from our inbox:Our Failure to Support New Parents and BabiesThe indictment followed criminal charges against former President Donald J. Trump in a hush-money case brought by local prosecutors in New York.Doug Mills/The New York TimesTo the Editor:Re “Trump Is Indicted Over Classified Files” (front page, June 9):The indictment of Donald Trump heralds a new chapter in American history. His trial could come sometime next year during the Republican primary season. He will continue to tell his followers that he has done nothing wrong and that this is all part of a vendetta by the Washington elite.His followers will continue to support him. If he is found guilty in any of his trials, he will appeal. If he is nominated, the appeals process will play out during the election campaign. He could be elected and then have a guilty verdict upheld as he is about to be sworn into office.Mr. Trump and the special counsel Jack Smith serve as the protagonists in the first act of a Shakespearean tragedy. The full effects on America of Mr. Smith’s essential action will not be known until the final act.Sidney WeissmanHighland Park, Ill.To the Editor:Is no one above the law? We are about to find out. The stakes couldn’t be higher if the country hopes to remain a legitimate democracy.Tom McGrawGrand Rapids, Mich.To the Editor:The indictment of Donald Trump on federal criminal charges might improve his odds of receiving the Republican nomination, but it almost certainly means that if nominated, he would lose the general election.It may increase the sympathy and anger of millions of his hard-core supporters. They will give him even more money to run and turn out in even greater numbers in the primaries, but it will not persuade many, if any, supporters of President Biden to vote against him in November 2024.This is not yet a banana republic. The greater number of Americans who voted for Mr. Biden in 2020 will continue to believe that this and future indictments are legitimate.Even if Mr. Trump manages to beat all the charges against him, he has been further disgraced by all these legal battles. And the effect of the indictments after the lessons of the Jan. 6 hearings will bring new voters, particularly first-time voters, to Mr. Biden.If he remains healthy, President Biden wins again.Allen SmithSalisbury, Md.To the Editor:Journalists need to get to the meat of the Republicans’ support of Donald Trump’s behavior in the classified documents case and ask them the following questions:Are you saying you do not trust the Florida grand jury, made up of ordinary citizens from a state that twice voted for Mr. Trump? The prosecutor presents the facts, but the grand jurors vote on whether to indict. Do you really think all of them are on an anti-Trump witch hunt?Why are you making judgments about this case when you don’t know the charges or the facts? It sounds as if you are advocating for Mr. Trump to be able to break the law at will with no consequences; do you deny that?Stop allowing Republican politicians to hide behind specious arguments bereft of facts or even common sense. They are spouting anti-democratic nonsense, and the press should be exposing them for what they are.Jean PhillipsFlorence, Ore.To the Editor:In all the discussions, among all the various talking heads, about the various aspects of this new criminal indictment, one significant factor has been overlooked.At no time, during any judicial proceedings, will Donald Trump ever take the witness stand. It will never happen.Stuart AltshulerNew YorkTo the Editor:It is vital that Donald Trump’s trial be scheduled to start no later than four months after his arraignment, so that the trial can be finished well before the Iowa caucuses. This can be done by actions of the judge assigned to the case immediately after the arraignment, setting strict time limits for all pretrial matters.Both parties have experienced attorneys who can promptly complete pretrial matters, including discovery and pretrial motions, within that four-month period so that the trial can end well before the voters have to make their decisions.Robert LernerMilwaukeeThe writer is a retired lawyer who tried many cases in federal courts as a prosecutor or as a defense attorney.To the Editor:Jack Smith, all I can say is thank you. Thank you for believing in our country. Thank you for trying to uphold our democracy. Thank you for your courage.I have tears in my eyes. You have restored my hope. Grateful. Stay well.Dody Osborne CoxGuilford, Conn.Our Failure to Support New Parents and Babies Shuran Huang for The New York TimesTo the Editor:Re “Risk to Mothers Lasts a Full Year After Childbirth” (front page, May 28) and “A 3-Month-Old Baby Was Found Dead Near a Bronx Expressway” (nytimes.com, May 29):As a midwife working with pregnant people and new parents, I found these articles — about increasing rates of maternal mortality from hypertension, mental illness and other causes and about parents charged with murder or reckless endangerment — heartbreaking.This represents the total failure of our society to support pregnant people and new parents. After receiving only rudimentary maternity services with limited access to care, new parents are turned out of the medical system without proper follow-up and support. Our health care system has not responded to the increasing challenges of parenting in the modern world, leaving parents and children to face preventable dangers.Patient-centered care in pregnancy and improved postpartum services could prevent the suffering and deaths through early identification of risks and swift intervention. Access to care is far too limited.There has been enough hand-wringing about our horrible statistics. We need immediate investment in maternity services, expanded access to obstetric and midwifery care, mental health services, postpartum care and support for new parents.How many more deaths will it take for us to invest in the well-being and safety of our parents and children?Laura WeilSan FranciscoThe writer is an assistant clinical professor at the University of California, San Francisco School of Medicine.To the Editor:Our nation’s failure to properly care for expectant and new mothers and their babies speaks to a larger problem: Our health care system is siloed and focused on delivering urgent services. We treat pregnancy as an event, focused on a safe delivery and a healthy baby and mother, and our systems respond to problems only when they arise.There is a pressing need to address increasing maternal and infant morbidity and mortality — and the many other health issues across the country that are rapidly getting worse — by considering the entirety of factors that make up a person’s health and well-being. We need to spend more time upstream, creating the vital conditions that are key to good health and well-being, like a healthy environment, humane housing, meaningful work and sufficient wealth.If we increase our investments in order to create the conditions people need to thrive, we can build the long-lasting change that is needed to prevent many serious health problems. This is much harder than treating a single person presenting in the emergency room, but it is a much smarter investment for our long-term health and well-being.Alan LieberMorristown, N.J.The writer is chief operating officer and chief health care strategist for the Rippel Foundation, which is working to rethink systems that have an impact on health and well-being. More

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      Can Brandon Presley Help Mississippi Break from the Past?

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      It’s been 23 years since a Democrat was elected governor of Mississippi and 41 years since a Democrat was elected one of the state’s U.S. senators. The Republican lock on the state — along with the policies and noxious traditions that have kept it in the basement among U.S. states for most indicators of social health — sometimes seems impenetrable.Mike Espy, the former Democratic congressman from Mississippi and U.S. agriculture secretary, tried twice to become senator, in 2018 and 2020, but never got more than 46 percent of the vote. Jim Hood, then state attorney general, did a little better in the 2019 governor’s race, getting nearly 47 percent of the vote, but the current Republican governor, Tate Reeves, prevailed.This year, with Mr. Reeves up for re-election in November, there are once again hopes that Mississippi could take a few steps up from the bottom and elect a governor willing to make a break from the past. And even though Donald Trump won the state by more than 16 percentage points in 2020, there are reasons to think it could happen.For one thing, thanks to a significant scandal involving the misappropriation of welfare funds, Mr. Reeves is extraordinarily unpopular for an incumbent Republican, with 60 percent of voters saying they would prefer another candidate, according to a Mississippi Today/Siena College poll that came out last week. For another, he has a promising and energetic Democratic opponent named Brandon Presley who has been polling fairly well and is making a strong case that the state desperately needs a change, advocating a series of popular policies that could make a real difference in the lives of Mississippians, particularly those on the lower economic rungs. The contest is already turning into one of the most interesting races of 2023.Mr. Presley, 45, is one of three elected members of the state Public Service Commission, which regulates utilities, and is the former mayor of Nettleton, a small town in the bright-red northeast section of Mississippi. He talks energetically about the need to expand Medicaid and save rural hospitals, and why it’s important to eliminate the extremely regressive state grocery tax, and would rather discuss the lives of poor families than his own family ties to a certain popular singer of the same last name from Tupelo, up the road from Nettleton. (Elvis was his second cousin.)His most effective tactic is his unrelenting attack on Mr. Reeves and the welfare scandal that has swirled around him and the previous Republican governor, Phil Bryant. A 2020 state audit found that as much as $94 million in federal anti-poverty money was improperly diverted to two nonprofit groups that used it for favors to lobbyists, celebrities and some lawmakers. The celebrities included Brett Favre, the former N.F.L. quarterback, who, according to text messages uncovered by the nonprofit news site Mississippi Today, arranged to spend $5 million in welfare funds for a volleyball stadium at the University of Southern Mississippi, his alma mater. At the same time, the state was rejecting a large majority of requests from families for Mississippi’s meager $170 a month in welfare payments.Mr. Reeves was lieutenant governor when all this was going on, and several people at the center of the scandal have been his friends and supporters. Last summer, his administration fired the lawyer who had been officially assigned to investigate the scandal and recoup the money, after the lawyer issued a subpoena to the university’s athletic foundation regarding the volleyball money. Though Mr. Reeves hasn’t been implicated in the diversion of most of the money, Mississippi Today published text messages in August showing that the former state welfare director, who pleaded guilty to federal and state fraud and theft charges last fall, said he was acting on behalf of Mr. Reeves when he siphoned $1.3 million of the welfare money to a fitness program run by the governor’s longtime personal trainer, Paul LaCoste.That was all Mr. Presley needed.“I got in this when I saw, as all Mississippi did, millions of dollars aimed at working families got diverted by Tate Reeves and his cronies,” he told me last week. “His own personal trainer, who taught Tate Reeves how to do jumping jacks, got a $70,000 vehicle and was paid $11,000 a month, while we’ve got children going hungry in Mississippi. Well, it made me want to puke.”Mr. Presley is funny and garrulous and is often described as the best natural politician in the state, with an easygoing manner that appeals to voters of all types. He grew up as the son of a low-income single mother and speaks with real empathy about the tens of thousands of poor families, Black and white, who can’t get clean drinking water, proper health care or broadband internet after decades of largely racist neglect by the state.His most significant plan is to fully expand Medicaid in Mississippi, which Mr. Reeves — along with Republicans in nine other states, mostly in the South — refuses to do. As The New York Times recently reported, health care is in a serious crisis in the state, where five hospitals have closed since 2005 and 36 percent of the remaining rural hospitals are at risk of closing from lack of funds. Mississippi’s stubbornness has cost it about $1.35 billion a year in federal funds to hospitals and health care providers, money that could be used for 100,000 poor adults who now have no guaranteed health coverage.“This will go down in history one of the dumbest decisions ever made in this state,” Mr. Presley said. “Our health care system is on fire because Tate Reeves is not willing to help working Mississippians, just because of some petty, cheap, childish politics.”The state has a $3.9 billion budget surplus and could easily afford its 10 percent share of the expansion cost, but Mr. Reeves would rather use the money to help prosperous earners by getting rid of the income tax, which most low-income people do not pay. Mr. Presley, on the other hand, is campaigning to eliminate the grocery tax, which at 7 percent is the highest in the nation and hurts poor people the most. Though he is too politic to say so, the grocery tax is yet another legacy of Mississippi’s structural racism, which helps explain why there is more hunger in the state than in any other.Polling shows that nearly 60 percent of state voters say they will support only a candidate for governor who wants to get rid of the grocery tax, and 55 percent will support only a candidate who wants to expand Medicaid. But that same poll shows Mr. Reeves ahead of Mr. Presley by 11 points. (The Presley campaign says its internal polling shows the race to be within the margin of error.) To a large degree, that contradiction can be explained by rote party identification in the state, but it’s also because nearly two-thirds of voters don’t know enough about Mr. Presley yet, particularly in African American areas.“In those neighborhoods, he’s still a white guy that nobody knows,” said State Representative Robert L. Johnson III, the House Democratic leader, who is Black and has been supportive of Mr. Presley. “But he’s not afraid to embrace the African American vote in this state. He’s made commitments to do things that other candidates don’t do. It’s early yet, but the governor has been so bad that I think this time might be different.”Mr. Presley has won the endorsement of Bennie Thompson, the Democratic congressman from Jackson who carries a lot of weight among Black voters, and he has one new advantage: In 2020, voters abolished the Jim Crow-era requirement that candidates for governor have to win not only the popular vote but also the most votes in a majority of the 122 state House districts, a law intended to keep Black candidates out of statewide offices. (Mr. Reeves did not support the repeal.)“I think he can win,” Mr. Espy told me. “He’s very likable, a good retail politician, and Tate Reeves is so very, very unpopular. But he’s got a big job. He needs to raise the money and do more Black outreach.”Mr. Presley said his campaign would do everything possible to get a high turnout among Black voters, noting that the issues he cares about, particularly Medicaid and the grocery tax, resonate well in those precincts.One thing that he doesn’t bring up that much, unless asked, is his support for Mississippi’s extremely restrictive abortion law, which bans abortion unless the mother’s life is in danger or the pregnancy was caused by rape. That law has an outsize effect on low-income women who can’t afford to travel outside the state for an abortion.Mr. Presley described himself as “pro-life and Christian.” But he quickly said that to him, being “pro-life” means being pro-hospital, pro-doctor and pro-emergency room, supporting full funding of the state education budget and ending the scams that have prevented federal and state welfare money from going to the families who need it.His position on abortion and his support for gun rights will not win him many friends in the national Democratic Party, but Mississippi is not like the rest of the nation. Winning there and finally beginning to reverse the detestable policies of the past — an enormously difficult task — will require a candidate who can bring together an unusual coalition of voters with very different interests, and Mr. Presley may be the one to do it. It’s been done next door in Louisiana, where Gov. John Bel Edwards is a Democrat in a similar mold, and if it can happen in Mississippi, it might bring hope to thousands of other voters who have ceaselessly struggled for better lives in the Deep South.The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram. More