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      Why Stacey Abrams Is Rejecting Her Democratic Stardom

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      On the campaign trail for Georgia governor, she is talking more about Medicaid expansion than voting rights, betting that a hyperlocal strategy and the state’s leftward tilt can lift her to victory.CUTHBERT, Ga. — As Stacey Abrams began her second campaign for Georgia governor with a speech this week about Medicaid expansion in front of a shuttered rural hospital, the crowd of about 50 peppered her with questions on issues like paving new roads.But Sandra Willis, the mayor pro tem of this town of roughly 3,500 people, had a broader point to make. “Once you get elected, you won’t forget us, will you?” she asked.The question reflected Ms. Abrams’s status as a national Democratic celebrity, who was widely credited with helping to deliver Georgia for her party in the 2020 elections and has made her name synonymous with the fight for voting rights.But she has shown little desire to put ballot access at the center of her bid. Her first days on the campaign trail have been spent largely in small, rural towns like Cuthbert, where she is more interested in discussing Medicaid expansion and aid to small businesses than the flagship issue that helped catapult her to national fame.Ms. Abrams’s strategy amounts to a major bet that her campaign can survive a bleak election year for Democrats by capitalizing on Georgia’s fast-changing demographics and winning over on-the-fence voters who want their governor to largely stay above the fray of national political battles.“I am a Georgian first,” she said in an interview. “And my job is to spend especially these first few months anchoring the conversation about Georgia.”In Cuthbert, where Ms. Abrams was pressed on Monday by Ms. Willis on her commitment to Georgia’s small communities, she reminded onlookers that this was not her first visit to town — and she promised it would not be her last. The town sits in Randolph County, one of a handful of rural, predominantly Black counties that were crucial to Democrats’ victories in Georgia in the last cycle. Upward of 96 percent of Black voters who cast ballots here in the 2020 presidential election voted in the 2021 Senate runoff elections.Randolph has also been held up as an example of the state’s neglect of its low-income, rural residents: The county’s only hospital shut down in October 2020.“I’m here to help,” Ms. Abrams said in her Monday speech in front of the closed hospital. Listing the names of seven counties surrounding Randolph, she promised to be a “governor for all of Georgia, especially southwest Georgia.”Georgia’s population continues to grow younger and more racially diverse, trends that have historically benefited Democrats.Nicole Craine for The New York TimesMs. Abrams’s focus on state and hyperlocal issues reflects an understanding that to win Georgia, any Democrat must capture votes in all corners of the state. That also means knowing the issues closest to voters in every corner.“Everything either happens in Atlanta, or outside of Atlanta in the suburbs,” said Bobby Jenkins, the mayor of Cuthbert and a Democrat. “But as the election in November showed, you’ve got a lot of Democrats, a lot of people in these rural areas, and you cannot overlook them. There aren’t many in this county. But when you band all of these counties together in southwest Georgia, then you can create some impact.”Ms. Abrams has also used visits like the one to Cuthbert and a later meet-and-greet in the central Georgia town of Warner Robins to criticize Gov. Brian Kemp, a Republican who beat her in the same race in 2018, over what she called his weakening of the state’s public health infrastructure during the pandemic and his underinvestment in rural communities.“If we do not have a governor who sees and focuses on how Georgia can mitigate these harms, how Georgia can bolster opportunity, then the national environment is less relevant, because the deepest pain comes from closer to home,” Ms. Abrams said in the interview.Still, that national environment remains unfriendly to Democrats. Less than eight months before the November midterm elections, the party is staring down a record number of House retirements, a failure to pass the bulk of President Biden’s agenda and a pessimistic electorate that is driving his low approval ratings.Yet Democrats see reasons for hope in Georgia. The state continues to grow younger and more racially diverse, in a boon to the network of organizations that helped turn out the voters who flipped Georgia blue in 2020. Many of those groups remain well-staffed and well-funded. And while Ms. Abrams is running unopposed in the Democratic primary, Mr. Kemp faces four challengers, including a Trump-backed candidate, former Senator David Perdue.All of this is why, while Ms. Abrams’s public image has expanded, she has not deviated much from the campaign strategy she employed in 2018. During her first run for governor, she visited all 159 of Georgia’s counties and aimed for surges in turnout in deep-blue metro Atlanta counties even as she sought to turn out new voters in rural areas that Democrats had historically ceded to Republicans. Several of her 2022 campaign staff members formed her 2018 brain trust.Voting rights activists in the state — many of whom say their relationship with Ms. Abrams and her campaign remains warm — hesitate to question Ms. Abrams’s reduced focus on ballot access, especially since it is so early in the campaign and her strategy could yet shift.“She has a certain star, national spotlight quality that you rarely see with Southern candidates,” said LaTosha Brown, a co-founder of the group Black Voters Matter in Georgia. She expressed confidence that Ms. Abrams’s candidacy would “continue to keep the voting rights issue from dying.”In 2021, after Georgia Republicans passed a major law of voting restrictions, Ms. Abrams spoke out against the measure to legislators in Congress.Nicole Craine for The New York TimesStudent supporters danced onstage after a rally for Ms. Abrams in Atlanta on Monday.Nicole Craine for The New York TimesMs. Abrams’s organizing for voting rights has its roots in her years as the minority leader in the Georgia Statehouse. She founded the voter enfranchisement group New Georgia Project in 2013 to turn out more young and infrequent voters — a strategy she pitched to national Democrats ahead of the 2020 election amid efforts to persuade white moderate voters.Then, a year ago, after Georgia’s Republican-led legislature passed a sweeping bill of voting restrictions, ballot access again became a central issue for national Democrats. Amid the party’s uproar about the bill and others like it, Ms. Abrams focused on the policy implications of the legislation over the political. During testimony to Republican senators in Washington shortly after the law’s passage, she laid out a laundry list of criticisms of the measure, denouncing its limits on drop boxes and a reduction in election precincts that could deter working people from voting.Understand the Battle Over U.S. Voting RightsCard 1 of 5Why are voting rights an issue now? More

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      Vulnerable Democrats, Seeking Distance From the Left, Offer a Midterm Agenda

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      The plan aims to inoculate Democrats in conservative-leaning states from Republican attacks on cultural issues, underscoring how successful the G.O.P. has been at weaponizing them.WASHINGTON — A cluster of House Democrats from conservative-leaning districts is circulating a reworked legislative agenda for the coming election season that would embrace some of President Biden’s most popular initiatives and tackle rising prices while distancing lawmakers from the left’s most divisive ideas.The plan, obtained by The New York Times, seeks to inoculate the most vulnerable Democrats from the culture wars pursued by Republicans trying to win back the congressional majority. Its existence underscores how successful Republicans have been at weaponizing issues like pandemic-related school closures and “defund the police” efforts against Democrats in politically competitive districts.The draft agenda was written by Representatives Abigail Spanberger of Virginia, Steven Horsford of Nevada, Josh Gottheimer of New Jersey, Dean Phillips of Minnesota and Elissa Slotkin of Michigan. It includes almost 75 bipartisan bills already drafted and broader bullet points such as “Combat Rising Costs for Food, Gas, Housing and Utilities,” “Reduce Prescription Drug Prices, Co-Pays and Deductibles” and “Fight Crime & Invest in Law Enforcement.”Rather than proposing cuts to funding for police departments, for example, it suggests financing the hiring of additional officers, especially in rural and small-town departments — though it would also fund body cameras and training, demands from liberal critics of law enforcement. Taking on Republican efforts to end mask mandates and school closures, the agenda includes legislation to “re-establish faith in America’s public health system and ensure preparedness for future pandemics, so that our economy and schools can remain open.”The plan avoids other items popular with progressives, such as a $15 minimum wage and a universal, single-payer “Medicare for all” insurance system, but it embraces some of the most broadly popular health care initiatives in Mr. Biden’s now-moribund Build Back Better Act: an agreement to allow Medicare to negotiate the prices of some of the most expensive drugs on the market and an expansion of Medicare to cover vision, dental and hearing care.Representative Steven Horsford of Nevada, one of the authors of the draft agenda.Chip Somodevilla/Getty ImagesWith their wafer-thin congressional majority and a president whose approval ratings are mired around 42 percent, Democrats are facing formidable headwinds in November’s midterm elections. The document, though stuffed with actual legislation, is more notable for its political message than for its policy details — in part because it omits any mention of how to pay for its initiatives.Some of its headline initiatives are not backed by the legislation below those programs. The plan promotes “Combating the Climate Crisis,” for instance, but the bills listed on that topic address the reliability and resilience of the electricity grid, top concerns for climate change deniers.But the agenda’s authors hope to at least revive a sense of momentum in a Democratic Congress that has entered the doldrums since enactment of a $1.2 trillion infrastructure law in November, followed by the Senate’s stymying of House-passed climate and social safety net legislation and a far-reaching voting rights bill.It is no accident that the document is circulating just before Mr. Biden’s State of the Union address on March 1, and the following week’s House Democratic “issues” retreat.The dozens of bills listed in the agenda all have Democratic and Republican authors, many of them endangered either by anti-Democratic momentum or by challengers endorsed by former President Donald J. Trump.One such bill, written by Representatives Debbie Dingell, Democrat of Michigan, and Liz Cheney, Republican of Wyoming, would make permanent Medicare tele-health expansions undertaken during the pandemic. There is a diabetes prevention bill by Representatives Diana DeGette, Democrat of Colorado, and Tom Rice of South Carolina, a Republican who, like Ms. Cheney, voted to impeach Mr. Trump. An expansion of tax-favored education savings accounts is co-sponsored by Ms. Spanberger and Representative Fred Upton of Michigan, another Republican who voted to impeach. Also included is a significant expansion of eligibility for child and adult nutrition programs, drafted by Representatives Suzanne Bonamici, Democrat of Oregon, and Jaime Herrera Beutler, a Washington Republican facing a serious Trump-backed challenge for her impeachment vote.There are even incentives for utilities to invest in cybersecurity written by Senator Joe Manchin III of West Virginia, the Democrat who has raised the contempt of the left by blocking the social policy and climate change bill in the Senate, and refusing to join his party in changing the filibuster rule to pass voter protection legislation over Republican opposition.But most striking is how the draft agenda takes on issues that appear to be dominating the campaign trail, even if they have not generated much debate on the floors of the House and the Senate.To beat back inflation, one bill the group is pushing would “prohibit” foreign governments from participating in cartel-like activities, a hit at OPEC that would have no real impact. The Federal Energy Regulatory Commission would be granted the authority to order refunds for natural gas bills “that are unjust, unreasonable, unduly discriminatory or preferential.” And assistance would be given to new and small meat processors to combat monopoly pricing from the few dominant meat processors, an effort already underway by the Biden administration.Rising crime rates across the country would also receive attention, through an expansion of existing grants to local law enforcement, new safety requirements for ride-hailing companies, stronger reporting requirements for electronic communication service providers to help track child predators and a new federal crime designation for “porch pirates” who steal packages from home stoops.One measure included in the agenda appears to accept the Republican talking point that the coronavirus was created in a laboratory in China, then covered up by the World Health Organization — assertions that have been challenged repeatedly by scientific researchers.The Never Again International Outbreak Prevention Act, by Representatives Brian Fitzpatrick, Republican of Pennsylvania, and Conor Lamb, a centrist Democrat running for the Senate in Pennsylvania, “would provide accountability with respect to international reporting and monitoring of outbreaks of novel viruses and diseases, sanction bad actors and review the actions of the World Health Organization.” More

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      Left and Center-Left Both Claim Stacey Abrams. Who’s Right?

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      Ms. Abrams, the Georgia Democrat running for governor, has admirers in both wings of her party — and Republicans eager to defeat her. Her carefully calibrated strategy faces a test in 2022.To left-leaning Democrats, Stacey Abrams, who is making her second run for Georgia governor, is a superstar: a nationally recognized voting-rights champion, a symbol of her state’s changing demographics, and a political visionary who registered and mobilized tens of thousands of new voters — the kind of grass-roots organizing that progressives have long preached.“I don’t think anyone could call Stacey Abrams a moderate,” said Aimee Allison, the founder of She the People, a progressive advocacy group for women of color.Moderates would beg to differ. They see Ms. Abrams as an ally for rejecting left-wing policies that center-left Democrats have spurned, like “Medicare for all,” the Green New Deal to combat climate change and the defunding of law enforcement in response to police violence.“I don’t know that anybody in the party can say, ‘She’s one of us,’” said Matt Bennett, a founder of Third Way, the center-left group. “We can’t pretend she’s a moderate,” he added. “But the progressives can’t say she’s a progressive and not a moderate. We’re both kind of right.”The question of how to define Ms. Abrams, 48, the presumptive Democratic standard-bearer in one of the most high-profile races of 2022, takes on new urgency amid the current landscape of the party.Moderates and progressives sparred in Washington throughout 2021, frustrating a White House struggling to achieve consensus on its priorities and continuing an ideological debate that has raged in the party for years. There is also thirst for new blood across the party, considering the advanced ages of President Biden, congressional leaders, and leading progressives like Senator Bernie Sanders of Vermont and Senator Elizabeth Warren of Massachusetts.On a local level, whether Ms. Abrams maintains credibility with both Democratic wings may determine how well she can withstand Republican attacks. Those close to her campaign say they expect an extremely close race, and that the key is holding the suburban moderates who supported her in 2018 while exciting enough of the new Georgia voters who have registered since that election.Republicans in Georgia — who await Ms. Abrams in the general election — are eager to denounce her as a left-wing radical out of place in a state that was a G.O.P. stronghold until it narrowly tipped into the Democratic column in 2020. Gov. Brian Kemp, who faces a fierce primary challenge in May from former Senator David Perdue, who has the support of former President Donald J. Trump, has released five digital advertisements attacking Ms. Abrams since she announced her campaign on Dec. 1.“Stacey Abrams’ far left agenda has no place in Georgia,” one warns ominously.But a review of Ms. Abrams’s policy statements and television advertisements, and interviews with political figures who have known her for years, reveal a leader who has carefully calibrated her positions, making a point to avoid drifting into one Democratic lane or another.Her allies say the fluidity is an asset, and highlights how policy is only one way that voters choose which candidate to rally behind. Racial representation and the unique political context of the American South are also factors in whether a candidate can credibly claim progressive bona fides, they argue..css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-3btd0c{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:1rem;line-height:1.375rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-3btd0c{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-3btd0c strong{font-weight:600;}.css-3btd0c em{font-style:italic;}.css-1kpebx{margin:0 auto;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}#NYT_BELOW_MAIN_CONTENT_REGION .css-1kpebx{font-family:nyt-cheltenham,georgia,’times new roman’,times,serif;font-weight:700;font-size:1.375rem;line-height:1.625rem;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-1kpebx{font-size:1.6875rem;line-height:1.875rem;}}@media (min-width:740px){.css-1kpebx{font-size:1.25rem;line-height:1.4375rem;}}.css-1gtxqqv{margin-bottom:0;}.css-1g3vlj0{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:1rem;line-height:1.375rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-1g3vlj0{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-1g3vlj0 strong{font-weight:600;}.css-1g3vlj0 em{font-style:italic;}.css-1g3vlj0{margin-bottom:0;margin-top:0.25rem;}.css-19zsuqr{display:block;margin-bottom:0.9375rem;}.css-12vbvwq{background-color:white;border:1px solid #e2e2e2;width:calc(100% – 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-12vbvwq{padding:20px;width:100%;}}.css-12vbvwq:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-12vbvwq{border:none;padding:10px 0 0;border-top:2px solid #121212;}.css-12vbvwq[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-12vbvwq[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-12vbvwq[data-truncated] .css-5gimkt:after{content:’See more’;}.css-12vbvwq[data-truncated] .css-6mllg9{opacity:1;}.css-qjk116{margin:0 auto;overflow:hidden;}.css-qjk116 strong{font-weight:700;}.css-qjk116 em{font-style:italic;}.css-qjk116 a{color:#326891;-webkit-text-decoration:underline;text-decoration:underline;text-underline-offset:1px;-webkit-text-decoration-thickness:1px;text-decoration-thickness:1px;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:visited{color:#326891;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:hover{-webkit-text-decoration:none;text-decoration:none;}Steve Phillips, an early supporter and prominent progressive Democratic donor, said Ms. Abrams’s political strategy was progressive, even if her policy positions were more moderate.“It’s hard for white progressives to be too critical of someone who is so strongly and fiercely unapologetically Black and female,” he said. “Her authenticity comes from the sectors that are the core parts of the progressive base.”Ms. Abrams’s approach does carry risks. In the 2020 Democratic presidential primary race, several candidates who sought to straddle the line between moderate and progressive policies lost the trust of significant numbers of voters in both camps, as activists pushed for firm commitments on issues like health care, climate change, expanding the Supreme Court and reparations for descendants of enslaved people.At times, Ms. Abrams has used her perch to speak out against progressive causes and defend the Democratic establishment. She said attempts to defund police departments after the murder of George Floyd were creating a “false choice” and said departments should be reformed instead.On health care, she has focused on expanding Medicaid rather than supporting a single-payer system. And in 2020, a think tank founded by Ms. Abrams released a climate plan focused on the South that embraced efforts to incentivize renewable energy but stopped short of the ambitious goals pushed by progressive activists and lawmakers like Representative Alexandria Ocasio-Cortez of New York.But Ben Jealous, a former Democratic candidate for governor of Maryland who leads the progressive group People for the American Way, said progressives should trust Ms. Abrams just the same. “The Green New Deal is designed for the industrialized unionized North,” he said. “And you’ve got to translate that into Southern.” He added, “She does that.”Several of Ms. Abrams’s allies welcomed an examination of her policy record, arguing that characterizing her as a progressive only fueled Republican attacks.Ms. Abrams declined to be interviewed for this article. Asked how she defined herself ideologically, a spokesman, Seth Bringman, said she “defines herself by her values and her ability to deliver results for the common good by navigating disparate groups and ideologies.”“She’s unwavering in her support for unions, and she worked with anti-union corporations to stop discrimination against the L.G.B.T.Q. community,” he added. “She’s unapologetically pro-choice, and she coordinated with anti-choice legislators to pass criminal justice reform. She’s a capitalist who supports regulation and believes we can fight poverty while praising success.”Such pragmatism has encouraged some moderates — including Georgians who served with Ms. Abrams in the State Capitol — to compare her to other center-left national figures who had credibility among the grass-roots base, like Presidents Barack Obama and Bill Clinton. Mr. Bennett, a co-founder of Third Way, said Ms. Abrams had demonstrated that she “wasn’t going to be pushed around by anybody in the party, from the center or from the left.”Some moderates see Ms. Abrams as a center-left leader in the mold of former Presidents Barack Obama, right, and Bill Clinton.Ruth Fremson/The New York TimesHe added, “That independence has made her a very viable candidate.”Carolyn Hugley, a Georgia state representative who has known Ms. Abrams since 2011, said she had always sought to be seen as a “doer” and an organizer. As minority leader, Ms. Abrams, a budget wonk, aligned with Tea Party members and some religious groups to oppose a Republican tax reform bill.“If you had asked me 10 years ago if voting rights was what she was going to be known for, I would probably say no,” Ms. Hugley said. In Georgia, Ms. Abrams became known for her willingness to work with anyone, even if it led to a backlash. In 2011, she lent bipartisan credibility to an effort by Gov. Nathan Deal, a Republican, to restructure the state’s scholarship program for low-income students. Several Democrats criticized her decision to stand with him at a news conference, saying it gave a gift to an incumbent who had sought to shrink the program and was an example of Ms. Abrams’s putting her own ambitions above the party’s long-term interests.“It got misinterpreted,” said DuBose Porter, a former chairman of the Georgia Democratic Party. “But the real Stacey Abrams will always come through. And that real Stacey Abrams is somebody that cares about the issues.”Mr. Jealous, of People for the American Way, said he recalled Ms. Abrams encouraging him to reach out to Newt Gingrich, the Georgia Republican and former House speaker, to build cross-aisle support for reforming the state’s prisons.This campaign cycle, even Ms. Abrams’s supporters concede that the intensifying spotlight could test her political talent anew. The prospect that she could become the first Black woman in the country to be elected governor has already renewed whispers about her possible presidential ambitions.Unlike in 2018, when Ms. Abrams was not yet a national figure, or during Mr. Biden’s vice-presidential search, in which she was considered a long shot, she enters the 2022 race as a marquee name on the Democratic roster — and a prime target for Republicans.The Virginia governor’s race offered a preview of what Ms. Abrams could face, with Democrats on the defensive and Republicans pummeling them over Mr. Biden’s vaccine mandates, how schools teach about racism and the removal of Confederate statues.Ms. Abrams rallied Virginia Democrats behind the Democratic candidate, former Gov. Terry McAuliffe, in the days before the election — a testament to her standing in the party. By contrast, Ms. Ocasio-Cortez said she and other progressives were told to stay away.When announcing her candidacy in December, Ms. Abrams stuck to local themes, highlighting her work during the pandemic and her efforts to expand Medicaid access in Georgia. In the 2018 governor’s race, she did not run an ad about race or voting rights, according to a list her aides provided.Last month, during an online campaign event with more than 350 supporters on the theme of “One Georgia,” Ms. Abrams steered clear of policy specifics and hot-button cultural conversations, focusing instead on issues like the coronavirus and education — and on her Republican opponents.“When people ask what’s the biggest difference between me and the current governor, it’s that I like Georgians,” Ms. Abrams said. “I like all of them. The ones who agree with me and the ones who do not.”As much as Democrats may want to label her, Mr. Jealous advised against it, citing two lessons he learned about Ms. Abrams when they first met as 19-year-old college activists. The first: She would not be pushed to go anywhere she was not comfortable. The second: “Never speak after her,” he said.Mr. Phillips, the Democratic donor, said he was confident that the war between moderates and progressives would not affect Ms. Abrams in 2022.When, then, would it matter?“If and when she runs for president,” he said. More

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      The Mike Pence Saga Tells Us More Than We Want to Know

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      Bret Stephens: Hi, Gail. I was hoping to pick up where we left off last week, with the New York City mayoral primary and our new ranked-choice voting system. Assuming Eric Adams holds on to his lead, what do you think his win says about the state of the city — and of the Democratic Party?Gail Collins: Bret, this is why I love conversing with you. I’ve been hearing Republicans howl about the negotiations with Joe Biden on spending, and I was dreading a discussion on that subject.Bret: Biden gets out a little over his skis with a dumb remark, publicly admits he screwed up, pledges to keep his word on a bipartisan bill. Imagine that.Gail: Well, the city election is definitely a more interesting topic and I can see why Eric Adams intrigues you. He’s a Black former police officer who ran on his crime-fighting skills. Politically he’s a moderate — by New York standards, anyway. And talking with his supporters after the vote, I did get the impression that some were most concerned with blocking off Maya Wiley, the only real leftie with a chance of winning.Of course while the left was getting bad news in New York City, regular Buffalo Democrats were discovering their longtime mayor had lost the primary to a Black female socialist. Hoping to hear a lot more discussion about India Walton as we slowly make our way through this political year.Nothing is for sure yet in the city — thanks to our new preferential voting system New Yorkers may not get the final word on who won the primary for ages. But if it’s Adams, it could send a cheerful message to people like Chuck Schumer, who’s up for re-election next year. There’s been speculation about whether Schumer might be challenged by a progressive.Bret: New system or not, I still don’t understand why it should take forever to know the results of a municipal election. But I’ll be happy if Adams holds on to his lead, for lots of reasons.One good reason to cheer an Adams victory is that it would demonstrate yet again that the Alexandria Ocasio-Cortez left doesn’t represent the Democratic base. “Defund the police” is not a working-class interest.Gail: Yeah, but having unarmed, trained mediators who could respond to complaints like family fighting might get a good response.Bret: I used to think that was a good idea. Then several of our readers explained to me that family altercations are often violent and require more than a social worker.Getting back to working-class interests: Blocking Amazon and the thousands of jobs it would have brought to Queens was not pro-worker. Nor does it help the working class to deny parents who can’t afford to send their kids to Dalton the school choice they need, when it comes to getting a better education for their children.Gail: The public school issue is so important and so complicated. You want to make sure it’s always open to reform and improvement. Still, you don’t want to create a system that allows canny parents to get terrific options for their own kids while reducing public pressure for all-around quality education.But go on.Bret: My bottom line is that “democratic socialism” might be cool with pampered N.Y.U. undergrads, but it isn’t going to help people who aren’t partying in Washington Square Park. So hooray for Adams and all middle-of-the-road Democrats. In the meantime, our mutual friend Donald Trump is on the rally circuit again.Gail: Wow, I watched his speech over the weekend. I guess it was a sort of return to national politics — Trump’s been off the trail since January when his attempt to convince the world he didn’t lose the election led to a bloody riot.No violence this time. In fact, the whole thing was one big snooze.Hard to imagine him really making a comeback. But also hard to imagine who’d be coming next. Can’t really picture a President Pence.Bret: You know, I probably spend more time thinking about Mike Pence than I ought to, given my high blood pressure. He reminds me of Mr. Collins, the unctuous clergyman in “Pride and Prejudice,” who’s always bowing and scraping to the overbearing, tasteless, talentless Lady Catherine de Bourgh, while he also lords it over the Bennet family because he stands to inherit their estate. Alternatively, Pence could be a character out of Dickens, with some ridiculous name like Wackford Squeers or Mr. Pumblechook.Gail: Wow, great analogies. Plus, it is indeed possible you spend more time thinking about Mike Pence than you ought to.Bret: Here’s a guy who makes his career on the Moral Majority wing of the Republican Party, until he hitches his wagon to the most immoral man ever to win a big-ticket presidential nomination. Phyllis Schlafly deciding to elope with Larry Flynt would have made more sense. Then Pence spends four years as the most servile, toadying, obsequious, fawning, head-nodding, yes-siring, anything-you-say-boss vice president in history. He’ll do anything for Trump’s love — but not, as the singer Meat Loaf might have said, attempt to steal the presidential election in broad daylight.For this, Trump rewards Pence by throwing him to a mob, who tried to hunt him down and hang him. But even now Pence can’t get crosswise with his dark lord, so the idea of him ever taking the party in an anti-Trump direction seems like a fantasy.Gail: You have convinced me that Pence is too much of a wimp to rebel. But you can never tell — look what happened to Mitt Romney.Bret: Unlike Pence, Romney is a true Christian, with actual principles. As for Nikki Haley, I just don’t see her winning the Republican nomination. She’s just not Trumpy enough. My bet is on the governor of Florida, Ron DeSantis, with Senator Tim Scott of South Carolina as his vice-presidential nominee. Crazy?Gail: Oh God. What a combo. l hear there’s a “Ron Be Gone” movement in Florida. Maybe they can combine it with a “Tim, Don’t Get In.” Or just: “Not Scott.”Bret: DeSantis is a very shrewd guy. He’s made a point of staying close to Trump, personally, and he’s also been very good at baiting the media. His handling of the pandemic was better than most liberals will ever give him credit for, because, unlike Andrew “I’m-still-standing” Cuomo, he made a point of protecting nursing homes. With Scott on the ticket he could also peel off some of the Black vote, or at least make white suburban voters feel comfortable about voting for a G.O.P. ticket that progressives will inevitably attack as racist.Of course none of that will stop Trump from turning on DeSantis if he decides to run again in 2024, and I have to assume there are skeletons in the governor’s closet. In the words of the immortal Beatles song, “Everybody’s got something to hide except me and my monkey.”Gail: Right now the only thing we’re thinking about in DeSantis’s state is the terrible condo collapse near Miami. There are going to be lots of questions about how that disaster came to be, and the government’s role in ensuring public safety.Bret: It’s so heartbreaking. I have my own memories of what it’s like, from having lived through the Mexico City earthquake in 1985, which killed thousands of people and flattened a lot of buildings in the vicinity of my dad’s office. It’s hard to think of a more awful way to go.But I’d hate to see the issue politicized. Buildings collapse in cities and states run by Democrats, too, like the Hard Rock Hotel in New Orleans a couple of years ago.Gail: Good point. But you will remember DeSantis is also the guy who’s been fighting against vaccine requirements on cruise ships.Bret: Sounds like an unreasonable government restriction on private enterprise trying to make the rules for what’s allowed on their premises.By the way, I’m increasingly of the view that Medicare and health insurance companies should refuse to underwrite treatment for any non-vaccinated people who wind up getting sick. People who take unreasonable private risks shouldn’t be allowed to socialize the cost of the consequences. What do you think?Gail: When said unvaccinated people get sick they’re going to need medical care. Which, if they’re uninsured and of low income, is going to have to be taken care of by the taxpayer unless the hospitals are directed to refuse to admit the unvaccinated critically ill.Bret: True, though my scheme would only apply to anti-vaxxers who refused to get a vaccine, not those who just didn’t have access to it. It’s never going to happen, for the same reason that we’re probably not going to deny coverage for lung cancer patients because they happen to be ex-smokers. But I just wish we lived in a country where being willfully dumb was a little more costly.Gail: Make being willfully dumb a little more costly — I think you’ve got a campaign slogan, Bret. Don’t let Mike Pence get his hands on it.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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      Covid-19 Relief Bill Fulfills Biden’s Promise to Expand Obamacare, for Two Years

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      #masthead-section-label, #masthead-bar-one { display: none }The Coronavirus OutbreakliveLatest UpdatesMaps and CasesRisk Near YouVaccine RolloutGuidelines After VaccinationAdvertisementContinue reading the main storySupported byContinue reading the main storyPandemic Relief Bill Fulfills Biden’s Promise to Expand Obamacare, for Two YearsWith its expanded subsidies for health plans under the Affordable Care Act, the coronavirus relief bill makes insurance more affordable, and puts health care on the ballot in 2022.President Biden after delivering remarks on the Affordable Care Act in November. The changes to the health law would cover 1.3 million more Americans.Credit…Amr Alfiky/The New York TimesMarch 8, 2021WASHINGTON — President Biden’s $1.9 trillion coronavirus relief bill will fulfill one of his central campaign promises, to fill the holes in the Affordable Care Act and make health insurance affordable for more than a million middle-class Americans who could not afford insurance under the original law.The bill, which will most likely go to the House for a final vote on Wednesday, includes a significant, albeit temporary, expansion of subsidies for health insurance purchased under the act. Under the changes, the signature domestic achievement of the Obama administration will reach middle-income families who have been discouraged from buying health plans on the federal marketplace because they come with high premiums and little or no help from the government.The changes will last only for two years. But for some, they will be considerable: The Congressional Budget Office estimated that a 64-year-old earning $58,000 would see monthly payments decline from $1,075 under current law to $412 because the federal government would take up much of the cost. The rescue plan also includes rich new incentives to entice the few holdout states — including Texas, Georgia and Florida — to finally expand Medicaid to those with too much money to qualify for the federal health program for the poor, but too little to afford private coverage.“For people that are eligible but not buying insurance it’s a financial issue, and so upping the subsidies is going to make the price point come down,” said Ezekiel Emanuel, a health policy expert and professor at the University of Pennsylvania who advised Mr. Biden during his transition. The bill, he said, would “make a big dent in the number of the uninsured.”But because those provisions last only two years, the relief bill almost guarantees that health care will be front and center in the 2022 midterm elections, when Republicans will attack the measure as a wasteful expansion of a health law they have long hated. Meantime, some liberal Democrats may complain that the changes only prove that a patchwork approach to health care coverage will never work.“Obviously it’s an improvement, but I think that it is inadequate given the health care crisis that we’re in,” said Representative Ro Khanna, a progressive Democrat from California who favors the single-payer, government-run system called Medicare for All that has been embraced by Senator Bernie Sanders, independent of Vermont, and the Democratic left.“We’re in a national health care crisis,” Mr. Khanna said. “Fifteen million people just lost private health insurance. This would be the time for the government to say, at the very least, for those 15 million that we ought to put them on Medicare.”Mr. Biden made clear when he was running for the White House that he did not favor Medicare for All, but instead wanted to strengthen and expand the Affordable Care Act. The bill that is expected to reach his desk in time for a prime-time Oval Office address on Thursday night would do that. The changes to the health law would cover 1.3 million more Americans and cost about $34 billion, according to the Congressional Budget Office.Representative Frank Pallone Jr. of New Jersey, who helped draft the health law more than a decade ago and leads the House Energy and Commerce Committee, has called it “the biggest expansion that we’ve had since the A.C.A. was passed.”But as a candidate, Mr. Biden promised more, a “public option” — a government-run plan that Americans could choose on the health law’s online marketplaces, which now include only private insurance.“Biden promised voters a public option, and it is a promise he has to keep,” said Waleed Shahid, a spokesman for Justice Democrats, the liberal group that helped elect Representative Alexandria Ocasio-Cortez and other progressive Democrats. Of the stimulus bill, he said, “I don’t think anyone thinks this is Biden’s health care plan.”Just when Mr. Biden or Democrats would put forth such a plan remains unclear, and passage in an evenly divided Senate would be an uphill struggle. White House officials have said Mr. Biden wants to get past the coronavirus relief bill before laying out a more comprehensive domestic policy agenda.Senators Bill Hagerty and Chris Coons at the Capitol on Saturday during a series of votes on amendments to the relief bill.Credit…Anna Moneymaker for The New York TimesThe Affordable Care Act is near and dear to Mr. Biden, who memorably used an expletive to describe it as a big deal when he was vice president and President Barack Obama signed it into law in 2010. It has expanded coverage to more than 20 million Americans, cutting the uninsured rate to 10.9 percent in 2019 from 17.8 percent in 2010.The Coronavirus Outbreak More

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      Pandemic Relief Bill Fulfills Biden’s Promise to Expand Obamacare, for Two Years

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      #masthead-section-label, #masthead-bar-one { display: none }The Coronavirus OutbreakliveLatest UpdatesMaps and CasesRisk Near YouVaccine RolloutNew Variants TrackerAdvertisementContinue reading the main storySupported byContinue reading the main storyPandemic Relief Bill Fulfills Biden’s Promise to Expand Obamacare, for Two YearsWith its expanded subsidies for health plans under the Affordable Care Act, the coronavirus relief bill makes insurance more affordable, and puts health care on the ballot in 2022.President Biden after delivering remarks on the Affordable Care Actin November. The changes to the health law would cover 1.3 million more Americans.Credit…Amr Alfiky/The New York TimesMarch 8, 2021Updated 8:30 p.m. ETWASHINGTON — President Biden’s $1.9 trillion coronavirus relief bill will fulfill one of his central campaign promises, to fill the holes in the Affordable Care Act and make health insurance affordable for more than a million middle-class Americans who could not afford insurance under the original law.The bill, which will most likely go to the House for a final vote on Wednesday, includes a significant, albeit temporary, expansion of subsidies for health insurance purchased under the act. Under the changes, the signature domestic achievement of the Obama administration will reach middle-income families who have been discouraged from buying health plans on the federal marketplace because they come with high premiums and little or no help from the government.The changes will last only for two years. But for some, they will be considerable: The Congressional Budget Office estimated that a 64-year-old earning $58,000 would see monthly payments decline from $1,075 under current law to $412 because the federal government would take up much of the cost. The rescue plan also includes rich new incentives to entice the few holdout states — including Texas, Georgia and Florida — to finally expand Medicaid to those with too much money to qualify for the federal health program for the poor, but too little to afford private coverage.“For people that are eligible but not buying insurance it’s a financial issue, and so upping the subsidies is going to make the price point come down,” said Ezekiel Emanuel, a health policy expert and professor at the University of Pennsylvania who advised Mr. Biden during his transition. The bill, he said, would “make a big dent in the number of the uninsured.”But because those provisions last only two years, the relief bill almost guarantees that health care will be front and center in the 2022 midterm elections, when Republicans will attack the measure as a wasteful expansion of a health law they have long hated. Meantime, some liberal Democrats may complain that the changes only prove that a patchwork approach to health care coverage will never work.“Obviously it’s an improvement, but I think that it is inadequate given the health care crisis that we’re in,” said Representative Ro Khanna, a progressive Democrat from California who favors the single-payer, government-run system called Medicare for All that has been embraced by Senator Bernie Sanders, independent of Vermont, and the Democratic left.“We’re in a national health care crisis,” Mr. Khanna said. “Fifteen million people just lost private health insurance. This would be the time for the government to say, at the very least, for those 15 million that we ought to put them on Medicare.”Mr. Biden made clear when he was running for the White House that he did not favor Medicare for All, but instead wanted to strengthen and expand the Affordable Care Act. The bill that is expected to reach his desk in time for a prime-time Oval Office address on Thursday night would do that. The changes to the health law would cover 1.3 million more Americans and cost about $34 billion, according to the Congressional Budget Office.Representative Frank Pallone Jr. of New Jersey, who helped draft the health law more than a decade ago and leads the House Energy and Commerce Committee, has called it “the biggest expansion that we’ve had since the A.C.A. was passed.”But as a candidate, Mr. Biden promised more, a “public option” — a government-run plan that Americans could choose on the health law’s online marketplaces, which now include only private insurance.“Biden promised voters a public option, and it is a promise he has to keep,” said Waleed Shahid, a spokesman for Justice Democrats, the liberal group that helped elect Representative Alexandria Ocasio-Cortez and other progressive Democrats. Of the stimulus bill, he said, “I don’t think anyone thinks this is Biden’s health care plan.”Just when Mr. Biden or Democrats would put forth such a plan remains unclear, and passage in an evenly divided Senate would be an uphill struggle. White House officials have said Mr. Biden wants to get past the coronavirus relief bill before laying out a more comprehensive domestic policy agenda.Senators Bill Hagerty and Chris Coons at the Capitol on Saturday during a series of votes on amendments to the relief bill.Credit…Anna Moneymaker for The New York TimesThe Affordable Care Act is near and dear to Mr. Biden, who memorably used an expletive to describe it as a big deal when he was vice president and President Barack Obama signed it into law in 2010. It has expanded coverage to more than 20 million Americans, cutting the uninsured rate to 10.9 percent in 2019 from 17.8 percent in 2010.The Coronavirus Outbreak More

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      After 4 Years of Trump, Medicare and Medicaid Badly Need Attention

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      President-elect Joe Biden has pledged to “marshal the forces of science” in his administration. Undoubtedly he needs to start by bolstering the credibility of the Food and Drug Administration and the Centers for Disease Control and Prevention.But a third health agency, central to the lives of older Americans, low-income families and the disabled, is sorely in need of his attention. Science has also been under assault at the Centers for Medicare & Medicaid Services, which provides federal health insurance to more than 130 million Americans at a cost of more than $1 trillion, nearly twice the Pentagon’s budget.C.M.S. does more than just write checks for medical care. Its scientists and analysts determine which treatments should be offered — I am the chairman of the committee that advises Medicare on those decisions — and how best to care for the patients it serves.Unfortunately, the Trump White House has steadily eviscerated the agency’s dispassionate approaches to making those determinations.Recently, for instance, the Trump administration set in motion a plan to strip C.M.S. of its ability to assess for itself whether new medical devices approved by the F.D.A. are appropriate for the older patients it covers. This is important because the benefits and risks of such devices and procedures, which range from implantable hips and cardiac stents to digital apps and laboratory tests, can vary widely based on patient age and disability.The proposed rule requires Medicare to pay for any new device so long as the F.D.A. labels it a “breakthrough.” And that word does not mean what you think it does.The F.D.A. calls a device a “breakthrough” when it is expected — though not yet proved — to be helpful to patients with serious conditions. The designation has nothing to do with how the device works in older patients, or even if it was studied in that population at all. The proposed rule would also require Medicare to cover any new drug or device if at least one commercial insurer covers it for its members, even if its members are young and healthy.Already, companies seldom generate enough data on their products for C.M.S. to assess their value for its patients. In 2019, for instance, data was insufficient in just under half of new F.D.A. drug approvals to assess benefits or side effects in older patients. The proposed rule would drain the last remaining motivation that companies have to study their treatments in the patients who are likely to ultimately receive them.C.M.S. scientists and analysts do more than evaluate new treatments. They also test alternative ways to organize and pay for patient care. The agency has found, for example, that enrolling people at risk of diabetes in gym sessions reduced how often they were hospitalized. But some seemingly obvious ways to improve health care don’t work: C.M.S. also found it could not reduce hospitalizations for cancer patients by paying their doctors to actively manage their patients’ care.The fact that so many promising ideas don’t work as expected is the reason C.M.S. needs to double down on evaluations of how medical care is delivered to its patients.This administration has gone in the other direction. Just before the election, the White House conjured up a plan to send older people a $200 prescription drug discount card in the mail. Research has already demonstrated that if you give people money to buy prescription drugs, they will buy more of them. The pharmaceutical industry knows this, too. That’s why it hands out coupons worth billions of dollars.These same studies also show that when people are indiscriminately given cash for medicines — instead of only those who need that money the most — it costs much more overall than it saves. No wonder the discount card giveaway would have cost around $8 billion. Fortunately, the president has yet to follow through with it.In another troubling development, the administration announced on Nov. 20 that it would run an experiment in which reimbursements to physicians will be cut for dozens of high-cost drugs they administer in the office, such as chemotherapies and treatments for inflammatory diseases.C.M.S. financial analysts warned that the cuts will lead many Medicare patients to lose access to these important treatments. Scientists should evaluate this prediction by including a comparison group of patients whose doctors would not receive a cut in payment. But the agency administrator made it clear that she didn’t believe the warning. No comparison group is planned. That is no way to evaluate whether our nation’s vulnerable would be helped or hurt by this significant policy change.Another example of a poorly designed experiment involved taking Medicaid coverage away from able-bodied people who are not working or going to school, under an ill-founded theory that doing so would inspire them to seek employment. Such a study is best done narrowly, so that any harms are minimized. Instead, the administration invited multiple states in 2018 to test the outcome.A Harvard study found that a work requirement in Arkansas led to a rise in the number of uninsured people and no significant changes in employment. Thousands of Medicaid beneficiaries in Michigan and New Hampshire were set to lose their coverage before work requirements in those states were ended. Given those results, the overall program should have been canceled. The administration broadened it.Through its reliance on scientific evaluation of what it should pay for, and how, C.M.S. has remained financially viable for more than half a century. As the new president plans to fix the damage done by the current president, this vital agency demands his attention.Peter B. Bach is a physician at Memorial Sloan Kettering Cancer Center. He served as a senior adviser to the administrator of the Centers for Medicare and Medicaid Services in 2005 and 2006.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