Happy Monday! Congress returns from its July 4th recess tonight, and Democratic lawmakers will be coming back to a storm of questions about whether President Joe Biden should stay in the race or drop out. Biden had his own forceful answer to that question: “I’m not going anywhere,” he insisted in an unscheduled call to MSNBC’s “Morning Joe” program. Here’s the latest.
Biden Defiant: ‘I’m Not Going Anywhere’
President Joe Biden’s official schedule for Monday was light, showing only a 10:45 a.m. daily briefing. Biden was plenty busy, though, as he ramped up his efforts to salvage his troubled re-election campaign.
With lawmakers returning to Capitol Hill after their July 4th recess and questions still swirling about Biden’s fitness for another term following his disastrous debate performance 10 days ago, the president sought to quiet the panic in his party and push back strongly on suggestions that he isn’t up to the job.
In a letter to congressional Democrats, Biden said he has heard the concerns about his candidacy but that he still thinks he’s the best person to defeat former President Donald Trump. “I want you to know that despite all the speculation in the press and elsewhere, I am firmly committed to staying in this race, to running this race to the end, and to beating Donald Trump,” Biden wrote to fellow Democrats.
He also argued that Democratic primary voters have had their say and have chosen him to be their nominee. “How can we stand for democracy in our nation if we ignore it in our own party?” Biden asked. “I cannot do that. I will not do that.”
The president closed his letter by seeking to silence the Democratic discussion over his fitness for office. “The question of how to move forward has been well-aired for over a week now. And it’s time for it to end,” Biden wrote. “We have one job. And that is to beat Donald Trump. We have 42 days to the Democratic Convention and 119 days to the general election. Any weakening of resolve or lack of clarity about the task ahead only helps Trump and hurts us. It is time to come together, move forward as a unified party, and defeat Donald Trump.”
In a surprise call to MSNBC’s “Morning Joe,” Biden slammed the party “elites” who want him to withdraw and dared any Democrat to challenge him at the party convention. “I’m going to be the Democratic nominee,” Biden said, later adding, “I don’t care what those big names think. They were wrong in 2020. They were wrong in 2022 about the red wave. They’re wrong in 2024.”
Biden said he was confident that grassroots Democrats still want him to be the nominee, despite polls showing widespread concerns among voters about his abilities.
“I am running,” Biden said. “I am not going anywhere.”
Democrats remain divided: The timing of Biden’s offensive is critical, as it comes ahead of some key meeting of Democratic lawmakers and some public events for the president. Senate Democrats reportedly canceled plans to meet Monday to discuss Biden’s re-election bid, but House and Senate Democrats are still scheduled to hold meetings Tuesday that are sure to see some lively debate.
More than a handful of Democratic House members have publicly called for Biden to step aside, and several senior lawmakers reportedly did so privately Sunday afternoon on a call convened by Minority Leader Hakeem Jeffries. One of those lawmakers, Rep. Adam Smith, the top Democrat on the House Armed Services Committee, told CNN on Monday that Biden should step aside and that Vice President Kamala Harris would be a stronger candidate.
“Any candidate for the highest office in our nation has a strong burden to bear,” Smith said in a statement. “That candidate must be able to clearly, articulately, and strongly make his or her case to the American people. It is clear that President Biden is no longer able to meet this burden.”
The White House said Monday that Biden has engaged with dozens of lawmakers as he tries to shore up support, and he got two key votes of confidence, from Jeffries and Congressional Black Caucus Chairman Steven Horsford of Nevada. But The Washington Post’s Ashley Parker reported Monday that “the consensus among Democratic senators is that Biden needs to step down, according to two Democratic senators, who spoke on the condition of anonymity to candidly share a sensitive opinion.”
Monday’s White House news briefing was a testy affair, as press secretary Karine Jean-Pierre was peppered with questions over whether the administration had been fully transparent about the president’s health and pressed for answers about reports that a neurologist specializing in Parkinson’s disease had visited the White House eight times in eight months. “We’re miffed around here about how information has been shared with the press corps around here,” Ed O’Keefe of CBS News told Jean-Pierre, who told reporters that the president is not being treated for Parkinson’s and that exams had found no evidence of a neurological disease.
What’s next: Biden’s got a crucial week ahead, including what is sure to be a closely scrutinized solo press conference on Thursday after a NATO summit in Washington, D.C.
The bottom line: Biden and the White House remain on the defensive, and the president’s efforts to reassure his party, and the public, haven’t put to rest the concerns about his functioning, sometimes raising new questions instead. The president is trying to position himself as the rightful choice of the Democratic base fighting back against the party’s panicky elite. As Biden wages his battle, he continues to lose time that could otherwise be used to campaign against Trump, who continues to lead in the polls. Trump has benefitted by staying under the radar — though Democrats’ ongoing debate has complicated the timing of Trump’s announcement of a running mate.
Insurers Bilk Medicare for $50 Billion to Treat Fictitious Illnesses
Private insurance firms running Medicare Advantage programs have been overcharging the federal government billions of dollars by making patients look sicker than they really are, according to a report in The Wall Street Journal on Monday.
The excess charges are driven by the fact that insurers in the for-profit Medicare Advantage program are paid more for providing healthcare to patients who have certain complex medical conditions. A patient with a chronic condition such as diabetic cataracts or morbid obesity, for example, is worth more to the insurer, which can charge the federal government more for their care.
In an analysis of billions of diagnoses delivered to patients in Medicare Advantage plans between 2018 and 2021, Journal investigators found that insurers added hundreds of thousands of questionable diagnoses to patient charts that resulted in higher payments, even when patients received no treatment for the specific illness involved. Insurers were paid about $50 billion more because of those added diagnoses during that time, the Journal found.
“The questionable diagnoses included some for potentially deadly illnesses, such as AIDS, for which patients received no subsequent care, and for conditions people couldn’t possibly have,” the Journal’s team of investigators wrote. “Often, neither the patients nor their doctors had any idea.”
According to the Journal, the worst offender among the five major Medicare Advantage insurers was UnitedHealth, which earned $8.7 billion in payments in 2021 from “insurer-driven diagnoses” that were not treated by doctors.
The bigger picture: Medicare Advantage was created under the assumption that private, profit-driven insurers could provide healthcare more efficiently. But the system, which now costs more than $450 billion and accounts for more than half of all Medicare spending, has proven to be more expensive than the regular Medicare system it is steadily replacing.
“Instead of saving taxpayers money, Medicare Advantage has added tens of billions of dollars in costs,” the Journal investigators wrote. “One reason is that insurers can add diagnoses to ones that patients’ own doctors submit.”
Chart of the Day
According to a new analysis of health insurers’ financial performance by the nonpartisan policy research group KFF, firms offering Medicare Advantage plans recorded the highest gross margins last year. “At the end of 2023, gross margins per enrollee ranged from $753 in the Medicaid managed care market to $1,982 in the Medicare Advantage market,” KFF’s analysts said. “Gross margins per enrollee in the group and individual markets were $910 and $1,048, respectively, roughly half the level observed among Medicare Advantage plans on average.”
The analysts note that gross margins are not the same as profitability, since private firms have different levels of administrative expenses. Still, high gross margins are usually a sign of solid profitability. “Potentially spurred by the prospect of strong financial returns, the Medicare Advantage market has grown substantially in the last decade, with more than 50% of eligible beneficiaries enrolled in a Medicare Advantage plan in 2023,” the analysts said.
Fiscal News Roundup
- Biden Tells Hill Democrats He Won’t Step Aside Amid Party Drama: ‘It’s Time for It to End’ – Associated Press
- Biden Slams Dem Critics as ‘Elites’ During Surprise ‘Morning Joe’ Interview – Politico
- House Democrats Brace for a Brawl Over Biden's Future – Axios
- Democrats Long Focused on Beating Trump. Now They’re Divided on What to Do – Washington Post
- Biden Pitches Himself to Top Donors as Democrats’ Best Bet Against Trump – CNN
- 4 More Senior Dems Call on Biden to Stand Down From Reelection Bid – Politico
- Tester Says Biden Must ‘Prove’ He’s ‘Up to the Job’ – The Hill
- Biden Narrows Gap With Trump in Swing States Despite Debate Loss –Bloomberg
- RNC Platform Approved by Panel Highlights Tax Cuts, Border – Bloomberg
- Biden Slams Trump for Proposing ‘National Sales Tax’ as He Fights for Political Future – MarketWatch
- A Republican Platform That Could Read Like a Trump Rally – New York Times
- Defense Secretary Continues Sentinel Nuclear Missile Program Despite Soaring Costs – The Hill
- Former Social Security Watchdog Abused Her Authority, Investigation Finds – Washington Post
- Johns Hopkins Med School Will Be Free for Most After $1 Billion Donation – Axios
Views and Analysis
- Biden’s Defiant Delusion – David Axelrod, CNN
- Biden’s Strategy to Make the Race About Trump Is Suddenly in Doubt – Reid J. Epstein, New York Times
- Biden’s Fate Could Come Down to House Minority Leader Hakeem Jeffries – Edward-Isaac Dovere, CNN
- OK, Democrats, This Is the Week to Say What You Really Believe – Michael Tomasky, New Republic
- Behind the Curtain: Trump's Dream Regime – Jim VandeHei and Mike Allen, Axios
- The Enormous Risks a Second Trump Term Poses to Our Economy – Robert E. Rubin and Kenneth I. Chenault, New York Times
- Europe Can’t Afford the Far Right’s Fiscal Policies – Bloomberg Opinion Editorial Board
- Kash Patel Is Pushing Conspiracies and His Brand. He’s Poised to Help Lead a Trump Administration – Alan Suderman and Juliet Linderman, Associated Press
- Lessons From the French and British Elections for Bolstering U.S. Democracy – Max Boot, Washington Post
- Medicare’s Crazy Payment System Is Creating Monopolies in Health Care – Marty Makary, Washington Post
- The US Primary-Care System Can't Withstand the Next Pandemic – Bloomberg Opinion Editorial Board