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A critical part of the Affordable Care Act is the setup of marketplaces or exchanges to let people without insurance buy individual health plans. Some states setup their own exchanges, and some states let the federal government step in and run them. To help the lower middle class and poor the Act provides health subsidies to buy insurance in the exchanges, and 85% of customers in the exchanges qualify for this benefit. The U.S. Supreme Court voted 6-3 in 2015, compared to a tight vote in 2012 on the Affordable Care Act, to maintain the health subsidies. Justice Roberts wrote the majority opinion, saying "Congress passed the Affordable Care Act to improve health insurance markets, not destroy them." Justice Scalia dissented calling it "interpretive jiggery-pokery." Justices Clarence Thomas and Samuel Alito Jr. dissented. Voting in favor were Justices Anthony Kennedy, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, Elena Kagan, Justice Kennedy dissented in the 2000 case. The challengers petition to the courts was based on a reading of phrases in the Affordable Act which had not occurred to the writers of the law. The reading suggests only people enrolled in state setup exchanges are eligible for subsidies. If the Supreme Court ruled in favor of the plaintiffs the 6.4 million Americans who are enrolled in the federal exchanges would lose the subsidies provided under the law and lose health insurance. And the economic foundations of the Affordable Act would be undermined with insurance companies required to provide insurance to all regardless of pre-existing conditions and subsidies removed, leaving the companies with sicker pool of customers resulting in destabilizing the exchanges and higher premiums. The court ruled in favor of an interpretation that is compatible with the whole law and the intentions of the statute to help the middle class and the poor buy health insurance. The chaos in the insurance markets that would result in going with the plaintiffs because of a careless writing of a phrase, was uppermost in the majority's mind. Chief Justice Roberts emphasized this, saying- "The statutory scheme compels us to reject petitioners' interpretation, because it would destabilize the individual insurance market in any state with a federal exchange and likely create the very 'death spirals' that Congress designed the act to avoid." This case originated with 4 plaintiffs from Virginia who challenged the IRS regulation that said subsidies were allowed regardless of whether the exchanges were run by the state or the federal government, arguing that this was at odds with the particular phrase in the law that was ambiguous about federal exchanges eligibility for health subsidies. Judge Roger Gregory of the Fourth Circuit Court of Appeals in Richmond, Virgina, ruled that the phrase was indeed ambiguous, but the IRS was owed deference in its opinion. Chief Justice Roberts made it clear that this was not a case for the IRS, saying "it is instead our task to determine the correct reading." ...

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The major provisions of the Republican House healthcare bill that passed by a vote of 217-213 are- 1. To help people buy insurance coverage the bill offers $2000 to $4000 a year, upto $14,000 a year in credits based mainly on age, reducing them for families making $150,000, individuals making $75,000. 2.  Under the Affordable Care Act insurers cannot charge older Americans more than 3 times for same coverage they offer to younger people, the new bill makes this 5 times. This would increase premiums for older Americans and reduce it for younger Americans. This is the most controversial part of the bill. Older Americans supported the Republican party in the presidential election. 3. The new bill ends Medicaid as an open ended entitlement and places this on a budget with cuts of $880 billion over 10 years. 4. To mollify conservative Republicans a provision allows state to opt out some provisions of the ACA that requires minimum benefits such as maternity care and emergency services. It retains coverage for pre-existing conditions to mollify moderate Republicans. The bill provides states with $138 billion over 10 years to subsidize premiums, provide coverage for pre-existing conditions, mental healthcare and drug addiction. 5. The bill removes the taxes imposed under the Affordable Care Act (ACA) on high income people of about $300 billion over 10 years by repealing a payroll tax increase and tax on investment income. This bill and the ACA offer 2 competing visions on healthcare, both bills passed only by a margin of 4-5 votes in the House. The ACA overlooked the impact on premiums causing discontent among middle income Americans. The new bill lets premiums rise for older Americans in order to keep premiums down for other Americans. This shows the many tradeoffs involved and choices being made, and the lack of a consensus on the issue of healthcare in the U.S., becoming a highly politicized issue instead of the way it is treated in western Europe.     ...

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Of the nine positions on China's Politburo Standing Committee, which effectively runs the country, only Xi Jinping and Li Keqiang will remain as China moves to a transition in leadership. There is considerable uncertainty about the direction in which Xi Jinping and Li Keqiang will take the country- whether continuing the status quo or making efforts to introduce democratic processes in the country and shift away from the export model for the economy.

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Paul Ryan says in May 2016 that he will not endorse Donald Trump as the nominee of the Republican party for president of the U.S.

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Senator Mitch McConnell, the U.S. Senate Majority leader, and Speaker Ryan, achieved a win in the U.S. Congress which is expected to set a new trend of bipartisan cooperation, as the House passed the bill in Dec. 2015 for $1.1 trillion spending with a vote of 316 to 113, and the Senate with vote of 65 to 33. The persuasion on the Republican side was based on giving Speaker Ryan a strong hand in negotiations with the White House in 2016. Ryan secured a lifting of the oil export ban for the Republican side in return for flexibility in spending. Ryan deftly sent the issue of Puerto Rico having access to bankruptcy laws to the committe chairmen to come up with a plan in March to get the needed votes. Democrats had pushed for aid to Puerto Rico. Also included in the bill that passed is giving more voice to emerging market countries China and India in the running of the IMF.

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This editorial in the New York Times is strongly critical of former president Barack Obama for accepting $400,000 in speaking fees from Wall Street for a single speech. It says the news is causing people to question the ideas and words presented by Obama in his books about the dangers of losing sight of the interests of ordinary people. It gives the impression says the NYT, that Obama is cashing in like everybody else, and that his talk was empty. The editorial says the millions raised by Hillary Clinton led to her defeat in the election. Obama is reported to plan a foundation with the work of training a new generation of political leaders. This NYT editorial says it would be better to stay true to vision and purpose, to walk the talk for president Obama, especially now that a recent poll shows two thirds of voters, including about half of Democrats say that the Democratic Party is out of touch with the interests of the American People. By associating this closely with wealthy donors leading Democrats contributed to this. During a period when some of the remarkable achievements of the last fifty years such as the European Union are being called into question, when ordinary working people, young people and older people are struggling, this is all the more a tone deaf approach by politicians. The idea of helping train a new generation of political leaders through a foundation sounds bizarre in this context, and seems to suggest politicians believe there is always a solution through marketing their audacity and money.   ...

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The is WSJ report points out that there were differences between the president and his defense secretary Mr. Esper, over the issue whether active duty military should be sent in to control protests in Washington D.C., Minneapolis and other cities in America. On May 25 president Trump considered firing Mr. Esper who said at a Pentagon press conference that he opposed bringing in the military to cities to quell domestic protests. Mr. Esper stated "The option to use active duty forces in a law enforcement role should only be used as a matter of last resort. And only in the most urgent and dire of situations. We are not in one of those situations now."  Military and defense officials were very much opposed to this as fundamentally contrary to military values.  Mr. Trump consulted several advisers who told the president that this was not the right thing to do. Mr. Esper for his part also was making his own preparations to resign and here again his advisers persuaded him to not do this, says this report in WSJ.  The incidents happened as protesters crowded Lafayette Square, the park across from the White House, and the president believed that violent protesters were making it difficult for National Guard troops to maintain control. Mr. Esper is a West Point graduate and former Army officer. The president's advisers from the military included Chairman of the Joint Chiefs of Staff Army Gen. Mark Milley. Milley and Esper discouraged the president from invoking the Insurrection Act of 1807 and calling in army troops to the cities. Mr.Trump later visited the area around the church near Lafayette Park. The advisers consulted by the president on May 25 were Mark Meadows, White House chief of staff, Secretary of State Mike Pompeo, David Urban, and two senators Tom Cotton of Arkansas and James Inhofe of Oklahoma. Mr. Cotton, a first term senator from Arkansas, later wrote a article in the NYT opinion pages on June 3 supporting use of the military. That article had the title "Send in the Troops- Tom Cotton" which NYT says was placed by editors, and appears baffling, considering the importance that this matter presents for the military and the nation. The NYT later stated with the article that it did not reflect "a thoughtful approach"  and lacked the "additional context" that would let readers be informed and think carefully. The essay also had a reference to the constitutional duty to the states from the federal government that could be misinterpreted, and without context. Mike Pompeo, one of the president's close advisers is Secretary of State. He is a West Point graduate, standing first in his class from the U.S. military academy in 1986, served 5 years in Germany in the 4th Infantry Division, before being elected to Congress from Kansas. The other key adviser in the decision Mr. David Urban headed the Trump campaign effort in a key state Pennsylvania. Both appear to be sensitive to public opinion and the thinking in the military.  By June 6 the White House press secretary said that Mr. Esper was instrumental in bringing calm to American cities after a week of protests following the death of Mr. Floyd in Minneapolis. For both Mr. Trump, Mr. Esper, senior White House officials, and the nation, moments for reflection and a sense of gratitude that calmer minds prevailed. ...

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If John F. Kennedy were writing Profiles of Courage in 2024 he would have James Lankford as one of these Senators who showed courage to take the right stand in the face of opposition from his fellow Republican Congressmen and people in his state and the country who support loyalty to president Trump. Lankford says in this NYT interview that in December 2023 the immigration bill would have passed Congress into law. He has always seen that no one person is the boss. Trump is not the boss even as president. He is a co-equal branch, says Lankford. He sums it up saying- I work for the people of Oklahoma not the president.  Senator Lankford of Oklahoma is interviewed by Lulu Garcia Navarro of the NYT for his role in negotiating a immigration bill with Democrats in Congress and president Biden that would fix asylum policy and close the Border with Mexico. It is a tough bill says Lankford, and the Republicans held onto their position that there would be no citizenship for the immigrants who crossed the border illegally since 2024. If it came up in December 2023 it would have fixed the Border, says Lankford. It came up in February, and by this time the election nominee was Trump who decided not to support it, as it would take away the immigration issue that he hoped to run on against Democrats. It is still alive as Kamala Harris says it is her top priority to get the Lankford immigration bill passed into law. To know Lankford is to know that he ran the largest Baptist youth camp in the Nation at Fall Creek. He believes every person has value and worth and even if he disagreed with them that person has value and worth. His faith, he says, is something important for him, and not something you take off and put on.  The title should be The Men and Women who Solved Immigration for the Nation. This includes Republican Senator James Lankford of Oklahoma, Senator Krysten Sinema of Arizona, and Democrat Senator Chris Murphy of Connecticut. Lankford for 22 years a youth Baptist minister from Oklahoma, Sinema immigration attorney from southern Arizona, and Murphy a lawyer from Connecticut. The man who selected Lankford to negotiate the immigration bill on behalf of the Republicans in Congress was Senator Mitch McConnell of Kentucky. For the Democratic party Pat Schumer helped bring Democrats in Congress and president Biden behind a tough bill that reflected the consensus view that something serious had to be done about the US Border for a lasting solution. This opportunity may come again if Kamala Harris wins as she says it will be her top priority to get the Lankford -Sinema Bill passed. ...

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NYT reports show the Republican health care bill AHCA 33 votes short of passing the House and likely to fail. Conservative Republicans were looking to whittle down the safety net in the Affordable Care Act, and moderate Republicans could not stomach the whittled down bill removing guarantees of essential benefits for instance. The basic problem- no real consensus among Americans about providing health care to all Americans, and no real solutions possible as long as there is acceptance of disproportionately high levels of medical care costs for treating each disease in the U.S. compared to Europe and other countries.

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This is an exceptionally humorous operating room story of Dr. Trump and Dr. McConnell by Kristof of the NYT. Sometimes humor tells the story- and Kristof does this using a story of a surgeon president Trump in the operating Room trying to address the concerns of the patient Janet, as he keeps telling her she needs a new heart with great benefits, great benefits, before she implodes or goes down failing. Flat out take the old heart out even if a replacement hasn't been found, believe me great benefits the surgeon tells her, just that the patient just isn't getting convinced as its happening to her. The analogy is with replacing a health care plan, not just the Obama plan, any plan without something to take its place. For a few days before this article by Kristof, the Republican effort to repeal the Affordable Care Act without having a replacement was presented as a good idea. Janet is like the three Republican women- Collins of Maine, Capito of West Virginia, and Murkowski of Alaska who wanted to keep the heart they had till a replacement was found, against the surgeon Trump's advice. In a way it is about politicians in the last decade who never had any discussions as they rushed through with their own agendas, as the Republican and Democratic health care plans were rushed through Congress with relatively little participation and debate to hear all viewpoints. ...

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Dilip Hiro's new book on the emergence of two states India and Pakistan in 1947 presents the story in terms of the two founding leaders Mohandas Gandhi and Mohammed Ali Jinnah. The division of the region into conflicting states is shown as a result of the divergent views and politics of the two leaders. Jinnah who was skeptical of the mass civil disobedience movement of Gandhi and preferred a legislative approach, and Gandhi who appealed to the masses and oppressed millions in British India. Jinnah and Gandhi's style and approach were fundamentally different. Seven decades later Pakistan has failed to build a genuine participatory democracy for most of this period with military actively involved in government, and India in the manner of Gandhi built institutions of participatory democracy under different political parties. Jinnah was an assistant to Dadabhai Naoroji, India's first nationalist leader at the turn of the century, when the two were in London. Naoroji passionately argued against the British policies that entrenched the poverty of millions of Indians in the countryside. Ironically it was Gandhi, not Jinnah, who took up Naoroji's call for bringing hope to the hundreds of millions of people on the subcontinent in "Poverty and Un-British Rule in India," first published in 1901, and showing how the draining of the country by the British was leaving India weak and oppressed. In 2015 that struggle of Naoroji for bringing hope and economic opportunity to millions of people is the task taken up by India's new government and the new government in Pakistan. Naoroji, the first Asian to be elected as a member of the British parliament, established the East India Association in 1867, the predecessor organization to the Indian National Congress which he founded with Hume, and is the leader Gandhi and Jinnah most respected in the first three decades of the twentieth century. Naoroji was elected to the British parliament for the Liberal party from Finsbury Central in 1892, and was assisted in his campaign and duties as a member of parliament by Mohammed Ali Jinnah. In the light of this common upbringing for Gandhi and Jinnah, the nineteen forties and their aftermath could be seen as a detour, not the substance of political life on the subcontinent- just as Mao and Chiang Kai Shek are a sort of detour for today's China. Particularly in a globalized world where technology continues to open up unbelievable economic opportunity, interchange and communication. ...