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Senators Mike Lee of Utah and Jerry Moran of Kansas declare their opposition to the Republican Health Care bill proposed by Senator McConnell. This decision by the two senators makes it impossible to begin debate on the bill. Earlier two other senators, Susan Collins of Maine and Rand Paul of Kentucky announced their opposition. This means the Republican health care bill has no chance in the Senate even after changes to the bill passed by the House of Representatives. Republicans have a thin majority in the Senate make it difficult to pass legislation. Collins met with residents in Maine and Moran with people in his home state of Kansas, and both senators heard a lot about the negative effects of the Republican bill on people in their state. The bill is seen as hurting people in rural areas, elderly, and not likely to do enough to bring down premiums. Its plan to slash Medicaid spending has drawn strong opposition from all Democrats.

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Bernie Sanders tells his supporters at the Democratic National Convention in Philadelphia that "immediately right now, we have got to defeat Donald Trump, and we have got to elect Hillary Clinton and Tim Kaine." He says this campaign was not about just electing a president but about transforming the country. And for this he was planning to back about 100 candidates with similiar thinking across the U.S. He called on supporters to continue the campaign for social, economic, racial and environmental justice. Voters for Sanders were offended by the information shown in DNC email leaks of the bias against Sanders shown by DNC chair Debbie Wasserman Schultz, who has since resigned.

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Martin points to some opinion in the Republican Party that sees the Supreme Court decisions as a way to move beyond social and cultural issues to issues relating to national security and the economy.

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Progressive caucus in the US House of Representatives led by Pramila Jaypal, a first time Indian American Congresswoman defeats an attempt by Josh Gottheimer of the Problem Solvers caucus to separate much of the president Biden's agenda in health, education and social policy and risk it being defeated by Senators Manchin and Sinema in the US Senate. Without the efforts on child care, education and health, climate change and social services part of the Biden Workers and Families Plan much of the Biden agenda would remain unfinished and Democratic party promises not kept. This also means that Manchin a Senator from West Virginia with a population of 1.8 million and Arizona with a population of 7.2 million, both conservative leaning Democrats could sink the entire agenda of president Biden to support American families and workers for a population of 331 million people. That two states with a population of less than 3% of the American population could sink the entire agenda of president Biden shows how fragile a situation has been created within the Democratic party to support workers and families even during the pandemic following the leadership of Carter, Clinton, and Obama Ms. Jaypal, a three term Congresswoman from Seattle, Washington state, was first elected in 2016 with an endorsement from Bernie Sanders who was the Democratic Party's leading candidate for president till the late stages of the 2020 US presidential primaries. Bernie Sanders says of Jaypal- "I think she is doing an extraordinary job. And I think the Progressive Caucus is doing an extraordinary job." Sanders founded the Progressive caucus after getting elected to the Senate from Vermont 30 years ago. Even though it is hard to imagine the Democratic party being the Democratic party without bold policies in climate change, affordable housing, reducing income disparities,  investing big in childcare, education and healthcare, attempts were being made to sink the entire Democratic party and national agenda going back to Franklin Roosevelt. Jaypal is described in the WSJ as diplomatic and firm, saying "I am so proud of our caucus; I have never seen our caucus so strong. And I am a very good vote counter also." Fifty members of the 100 member Progressive Caucus held firm in support of president Biden's original agenda without which the president would have little to show in keeping promises he made to the American people in the election and little to differentiate him from Mr. Trump who also supported infrastructure spending. Separating the infrastructure bill would have risked sinking Mr. Biden's plan for recovery of America from the pandemic and the devastating policies pursued by American presidents in the last two decades. Policies by previous presidents that have impoverished the country, created huge income disparities, weakened America in the world in trade and technological leadership, and wasted resources in foreign wars. There are no centrists or far left- these are just labels. When Ms Japal said "Let's just remember the Speaker (Nancy Pelosi) is a great champion of this agenda. I think she was trying to do as much as she could to get this done," she could have said it is Mr. Biden's own agenda pushed forward with conviction to help workers and families during the pandemic, and build a solid American recovery, restore American leadership in the world. Pramila Japypal is the first Indian American woman in the US Congress, and one of only two dozen naturalized American citizens in the US Congress. That she could play such a critical role for good in the US Congress shows that with the right convictions, determination, experience, much can be done for the common good in America and the world.   ...

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Health insurance premiums for family plans increased by 9% in 2011 according to a survey by Kaiser Family Foundation. A similiar survey by Mercer showed premium increases around 6%. Another change is that health insurance plans are becoming less comprehensive and deductibles are higher, with higher copays and employees contributing more to premiums.

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Elizabeth Rosenthal looks at Obamacare's contribution to cost containment in 2013-2014. Rosenthal says its is a kind of delicate maneuvring at the edges, because serious work needs to be done. The fee-for-service and many of the drivers for increases in medical costs, the old system of pricing, are still in place. In 20 years at the current rate and after Obamacare health care will still take 25% of the U.S. budget if nothing is done. Healthcare costs are about half that of the U.S. in some of the advanced European countries. She calls Obamacare a trickle down theory of cost containment becaue it leaves most of the drivers for cost increase in place and works at the margins. Princeton economist Uwe Reinhardt calls it an ugly patch on a somewhat ugly system. Rosenthal cites the armies of consultants anticipating every move to reduce prices, and working on "strategic billing'' to increase revenues for hospitals and doctors. For those who say the prices are now up more slowly than in the past, Michael Chernew of the Harvard Medical School, has this to say- its like a diet, reminding us that that we haven't even lost weight, just gaining weight slower than before. ...

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Lobbying by the American pharmaceutical industry and the Obama administration. Emails showing the negotiations between the administration and the pharmaceutical companies.

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The U.S. Senate passes a motion that allows the chamber to proceed with a debate on a health care bill. The motion passed 51-50 with Vice President Mike Pence casting the deciding vote. Republican Senators Collins and Murkowski voted against the motion. This report in the WSJ says this sets in motion a process in which debate will take place and amendments will be made. It is not clear what shape the bill will take. Under the process used only a simple majority is needed in the Senate, yet this allows for many amendments to be made.  Only hours after this motion passed by one vote, a bill replacing major parts of the Affordable Care Act failed to pass 57 votes against and 43 in favor. Senator John McCain who arrived in Washington from Arizona following brain tumor surgery, delivered strong criticism of the way the Republican healthcare bill was rushed through allowing very little debate. Experts have commented on the way the bill was rushed through with a thin majority for passage, with very little debate, first by Democrats in 2009 and now in the House by Republicans. With the same pattern now followed in the Senate by Mitch McConnell, the Republican leader in the Senate. A backup bill would remove just the individual and employer mandates and a tax on medical devices- the elements Republicans agree on, if no majority can be put together for the healthcare bill. ...

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A Pew Research poll shows Democratic voters now favor a bold ambitious agenda by large margins. Voters seeking compromise swung sharply going downwards from 69% to 46%. Many are calling for Medicare for All. In the Republican Party the shift is slight from 46% to 44%.

In the House the Congressional Progressive Caucus now has about 90 members. Of the 50 newly elected members who are House Democrats 20 are part of this Caucus pushing for bold action.

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The NYT Editorial Board on efforts in the U.S. Senate by lobbying groups to have the 2.3% tax on medical devices- to pay for medical coverage of the uninsured in the Obama health Care law- repealed.