Hundreds of miles from the health care debate that will begin again this week in Congress, lobstermen here are out in force, bees are furiously pollinating the state’s famous blueberries and part-time workers are preparing for another summer tourist season.

As a result of their short-term spike in income, many of Maine’s working class will likely lose some or all of their health insurance subsidy, a feature of the federal health care law, which has been a complicated blessing for the citizens of Maine.

Senator Susan Collins, Republican of Maine, has spent a lot of time thinking about how to deal with these “subsidy cliffs,” even as her party’s leaders press for the wholesale repeal of the Affordable Care Act, President Barack Obama’s signature domestic achievement.

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Sen. Bill Cassidy got cheers on late-night television for calling for an Obamacare replacement plan that would pass what he calls “the Jimmy Kimmel test” — that is, cover children like the comedian’s son recently born with a congenital heart defect.

To hear him tell it, he’s the one in Congress fighting to keep President Donald Trump’s promises to his base. On the campaign trail, Cassidy argues that Trump consistently promised a health care plan that would reduce premiums, eliminate mandates, ensure continuous coverage and protect people with pre-existing conditions. Any GOP plan, he says, needs to meet that bar.

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President Trump’s recent 2018 budget proposal, which includes roughly $800 billion in cuts to Medicaid over the next decade, has led to howls of outrage from Democrats.

Senate Minority Leader Chuck Schumer, D-N.Y., said last week that the cuts would “carry a staggering human cost.” Sen. Bernie Sanders, I-Vt. has called them “just cruel.”

Medicaid’s defenders claim that it’s a bargain for patients and taxpayers alike. As Sen. Schumer put it, “Medicaid has always benefitted the poor. That’s a good thing.” A recent issue brief from the Kaiser Family Foundation, meanwhile, concludes, “Medicaid is cost-effective.”

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Republicans should be on the lookout. While the GOP tries to repeal and replace Obamacare, Democrats are sharpening their message on health care. In their race to the left, Democrats are increasingly calling for a full-fledged single-payer system. The momentum is shifting, and the stakes are getting higher for Republicans. As we all know, in politics, a bumper sticker beats an essay. With the “single-payer, universal health care” catchphrase, Democrats are beginning to use their simple “bumper stickers” more frequently.

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A new Lancet study adds to the growing mountain of evidence that market-oriented health care systems outperform the single-payer systems that have captivated the imagination of progressives for more than a century. Yet despite their claims of believing in evidence-based policy, far too many progressives persist in disparage efforts by Republicans to move the U.S. health system in a more market-oriented direction even while working feverishly on a misguided quest to put California on the path to single-payer health care.

The Lancet study focuses on the extent to which countries are able to avert “amenable mortality.” “Amenable mortality” refers to “unnecessary, untimely deaths,” i.e., deaths that hypothetically would not occur with timely and effective medical care. The idea is that it makes no sense to fault a country’s health system for deaths that never could have been averted even if the system was organized to be as efficient and effective as possible. Market-driven systems have shown to be superior at averting avoidable deaths.

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Senate Republicans may be all over the map on an Obamacare repeal plan, but on one fundamental point — reducing insurance premiums — they are in danger of overpromising and underdelivering.

The reality is they have only a few ways to reduce Americans’ premiums: Offer consumers bigger subsidies. Allow insurers to offer skimpier coverage. Or permit insurers to charge more — usually much more — to those with pre-existing illnesses and who are older and tend to rack up the biggest bills.

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Republican senators return on Monday from a 10-day recess with immediate decisions to make on their quest to overhaul the 2010 health care law.

While Senate leaders have largely avoided putting any artificial timelines on their endeavor, the GOP is under an extreme time crunch to produce and advance their own legislation to match the House bill that narrowly passed the chamber last month.

Some members, however, are now openly doubting whether Republicans can follow through on their seven-year effort to repeal and replace President Barack Obama’s signature domestic achievement.

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For years, Republicans savaged Democrats for supporting the Affordable Care Act, branding the law — with some rhetorical license — as a government takeover of health care.

Now, cast out of power in Washington and most state capitals, Democrats and activist leaders seeking political redemption have embraced an unlikely-seeming cause: an actual government takeover of health care.

At rallies and in town hall meetings, and in a collection of blue-state legislatures, liberal Democrats have pressed lawmakers, with growing impatience, to support the creation of a single-payer system, in which the state or federal government would supplant private health insurance with a program of public coverage. And in California on Thursday, the Democrat-controlled State Senate approved a preliminary plan for enacting single-payer system, the first serious attempt to do so there since then-Gov. Arnold Schwarzenegger, a Republican, vetoed legislation in 2006 and 2008.

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Senate Republicans reworking Obamacare are considering taxing employer-sponsored health insurance plans, a move that would meet stiff resistance but which would help make the tax preferences for health insurance more equal. The move could raise billions in revenue that could be used to help stabilize the fragile individual insurance market. But it could be politically risky, since it could expand the impact of GOP health proposals from Medicaid recipients and those who buy insurance on their own to the roughly 177 million people who get coverage through their employers.

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The Kaiser Family Foundation asked Americans about replacing the Affordable Care Act, and 55 percent of those surveyed want the Senate to reject a bill that passed the House unless the Senate makes major changes. Joe Antos says, “Not only do Democratic respondents think that the things that are going wrong are really on President Trump’s watch and he’s responsible but most Republicans believe that, too.”