THURSDAY, AUGUST 1 , 2019. THE WASHINGTON POST EZ RE A
DEFENSE DEPARTMENT
Senate panel advances
Trump’s military pick
The Senate Armed Services
Committee voted Wednesday to
recommend that President
Trump’s pick to be the military’s
second-highest officer be
confirmed by the full Senate,
despite an Army colonel’s
allegations that he repeatedly
sexually assaulted her while she
served under him.
The vote was 20 to 7, reflecting
bipartisan support for Gen. John
E. Hyten, now in charge of the
national’s nuclear arsenal as the
head of U.S. Strategic Command.
He was nominated in April to
serve as vice chairman of the
Joint Chiefs of Staff.
The vote also reflected
bipartisan opposition, after Sen.
Joni Ernst (R-Iowa) decided to
vote against recommending the
confirmation.
Hyten appeared before the
committee Tuesday, where he
flatly denied Col. Kathryn
Spletstoser’s charges that during
2017, he attempted to kiss or
have sex with her while the two
were on work trips.
The Air Force Office of Special
Investigations’ probe produced a
report that did not substantiate
Spletstoser’s claims, according to
the military and senators on the
panel. Most of them backed up
Hyten this week, including Sen.
Martha McSally (R-Ariz.), who
was raped by a superior officer
while she served in the Air Force,
and who said she was sure Hyten
had been “falsely accused.”
— Karoun DemirjianTEXASFire at ExxonMobil
refinery injures 37An explosion and fire at anExxon Mobil oil refinery in Texas
on Wednesday left 37 people
with minor injuries, in the latest
of a series of petrochemical
industry blazes this year in the
Houston area.
The fire began with an
explosion just after 11 a.m. at an
ExxonMobil plant in Baytown,
about 25 miles east of Houston.The facility processes light
hydrocarbons including propane
and propylene, materials used to
make plastic and industrial
products.
Jason Duncan, the plant
manager, said many of those
hurt suffered minor burns and
all were being treated at a clinic.
The fire sent large plumes ofblack smoke into the sky. By
Wednesday afternoon, Duncan
said the flames had been isolated
and contained but had not yet
been extinguished.
ExxonMobil, as well as
officials with Baytown and
Harris County, had monitored
the air quality of the area but
had not found anything to raise
health concerns.
The fire Wednesday is the
latest at a Houston-area
petrochemical facility this year,
including one at another facility
on the Exxon Mobil Baytown
complex.
On March 16, a fire erupted at
a refinery at the complex. It was
extinguished hours later, but
Harris County officials say it
continued to release toxic
pollutants for eight more days.
The county has sued Exxon
Mobil, accusing it of violating
the federal Clean Air Act.
— Associated PressNavy jet crashes in Mojave
Desert: A U.S. Navy fighter jet
crashed Wednesday in Death
Valley National Park, injuring
seven people who were at a
scenic overlook where aviation
enthusiasts watch military pilots
speeding low through a chasm
dubbed Star Wars Canyon,
officials said. A search was
underway for the pilot of the
single-seat F/A-18 Super Hornet
who was on a training mission,
said a spokeswoman for Naval
Air Station Lemoore in
California’s Central Valley.
— Associated PressDIGESTSPENCER PLATT/GETTY IMAGES
Beachgoers enjoy a quiet morning at New York City’s Coney Island on the last day of July. Much of the
East Coast has been experiencing a perfect summer week of warm temperatures and blue skies. Aside from
a severe thunderstorm watch that was in effect Wednesday, the good weather should continue through the
weekend, with temperatures hitting the mid- to upper 80s and no more rain expected until Tuesday.Politics & the Nation
BY KAROUN DEMIRJIANThe Senate confirmed Kelly
Knight Craft on Wednesday to
serve as President Trump’s ambas-
sador to the United Nations, in a
vote largely along party lines with
leading Democrats saying she
lacks the necessary qualifications.
Craft succeeds Nikki Haley,
who left the administration at the
end of December. She served pre-
viously as ambassador to Canada.
Throughout her confirmation
process, Craft struggled to allay
Democrats’ concerns about her
family’s significant investments in
the fossil fuel industry, though
notably she separated herself
from the president on climate
change. During her confirmation
hearing in June, Craft declared
that she believes fossil fuels and
human behavior contribute to the
planet’s shifting weather phenom-
ena.
She also pushed back against
Democrats’ accusations that she
had spent too much time away
from her post in Ottawa, Canada’s
capital, arguing that her travel
throughout the country and else-
where had been approved and
that many of her trips were to
negotiate and promote Trump’s
new North American trade deal.
Senate Majority Leader Mitch
McConnell (R-Ky.) praised Craft
on the Senate floor before
Wednesday’s vote, calling her an
“impressive nominee” who had
represented the United States by
“skillfully and effectively advocat-
ing” for its interests, even during
challenges that threatened trade
negotiations.
“By all accounts,” he said, “Am-
bassador Craft’s involvement led
to greater cooperation.”
The vote’s final count was 56 to- Only five Democrats — Sens.
Maggie Hassan (N.H.), Joe Man-
chin III (W.Va.), Chris Murphy
(Conn.), Jeanne Shaheen (N.H.)
and Kyrsten Sinema (Ariz.) — en-
dorsed Craft’s confirmation. Eight
other Democrats, including the
seven participating in this week’s
2020 presidential primary de-
bates in Detroit, missed the vote
along with two Republicans.
The vote to confirm Craft re-
flects far deeper partisan divisions
over her appointment than exist-
ed in the Senate for Haley, who
was confirmed in January 2017 by
a vote of 96 to 4.
Trump’s initial choice to suc-
ceed Haley, former Fox News jour-
nalist Heather Nauert, withdrew
in February amid reports that she
and her husband, years prior, em-
ployed a nanny who was not ap-
proved to work in the United
States. Jonathan Cohen has served
as acting ambassador since Ha-
ley’s departure.
In the hours before the vote, the
Senate Foreign Relations Commit-
tee’s top Democrat, Robert Me-
nendez (N.J.), released a report on
Craft stating that her “qualifica-
tions fall short: she does not have
the knowledge, skills, qualifica-
tions, or experience to successfully
lead the United States’ efforts at
the United Nations.”
Complaints in the report mirror
many of the issues over which
Craft and Democrats clashed at
her confirmation hearing. Among
them are that she “displayed a lack
of depth on basic foreign policy
issues,” such as the two-state solu-
tion for Israel and the Palestinian
territories, and that “she merely
repeated talking points” on devel-
oping crises such as Iran.
The Democrats’ report also re-
peated concerns about Craft’s
travel while ambassador to Cana-
da, pointing out that she spent
about seven months of her two-
year stint in Kentucky or Okla-
homa, where she and her husband
have homes. They also com-
plained that she did not seem to
have a full understanding of her
husband’s investments, and said
her promise to recuse herself from
negotiations and meetings related
to coal — while agreeing only to
look into doing the same for other
fossil fuels — was unsatisfactory.
Spokesmen for the State De-
partment and National Security
Council did not respond to a re-
quest for comment Wednesday af-
ternoon.
Generally speaking, Craft is ex-
pected to uphold most of the pol-
icy positions Trump has espoused,
even when it puts her into conflict
with senators, Republican or
Democrat.
During her confirmation hear-
ing, she defended Trump’s deci-
sion to reduce payments to the
U.N. and pull out of bodies such as
the U.N. Human Rights Council.
[email protected]
Senate
confirms
Craft as
U.N. envoy
BY YASMEEN ABUTALEB
AND JOSH DAWSEYWhite House advisers, scram-
bling to create a health-care agen-
da for President Trump to pro-
mote on the campaign trail, are
meeting at least daily with the
aim of rolling out a measure
every two to three weeks until the
2020 election.
One of the initiatives would
allow states to import lower-
priced drugs from Canada and
other countries and another
would bar Medicare from paying
more than any other country for
prescription drugs, according to
two senior administration offi-
cials and lobbyists — controver-
sial ideas in line with Democratic
proposals. Yet it remains unclear
whether the administration has
the legal authority to execute
some of these policies without
Congress’s approval.
The White House is already
facing fierce pushback on some
proposals from Republicans on
Capitol Hill and the pharmaceu-
tical industry, which will prob-
ably go to court to challenge any
measure it opposes.
The furious push reflects the
administration’s sense of vulner-
ability on an issue that Demo-
crats successfully used in 2018 to
win control of the House of Rep-
resentatives. White House offi-
cials are eager to inoculate the
president against a repeat of that
strategy in 2020 — and reduce the
GOP disadvantage on an issue
that pollsters say plays to Demo-
cratic strengths. Health care is
already playing a starring role in
the Democratic presidential de-
bates, with most of the candi-
dates making proposals, includ-
ing Medicare-for-all plans, key to
their campaigns.
“While the radical left has
sweeping proposals for a total
government takeover of the
health system that will hurt sen-
iors and eliminate private insur-
ance for 180 million Americans,
the Trump administration is
working on real solutions that
will provide Americans with the
options and control they want
and the affordability they need,”
White House spokesman Judd
Deere said in a statement.
Some doubt a flurry of execu-
tive orders and new regulations
would have any immediate effect
on consumers’ pocketbooks.
What is clear is that the ap-
proach, which includes White
House support for a bipartisan
Senate bill to cap Medicare drug
price increases, is putting con-
gressional Republicans in a tough
spot: Embrace Trump’s agenda
and abandon conservative pre-
cepts about interference in the
marketplace, or buck the presi-
dent on one of his top priorities.
While Republicans have large-
ly fallen in line with Trump on
free trade and immigration even
when he has blown up GOP
orthodoxy, many rely heavily on
donations from the pharmaceuti-
cal industry and are reluctant to
sour those relationships.
One lobbyist, who spoke on the
condition of anonymity, de-
scribed being stunned at a recent
White House meeting when Do-
mestic Policy Council Director
Joe Grogan said the administra-
tion would not let Democrats run
to the president’s left on lowering
prescription medicine prices.
In another tense meeting, top
pharmaceutical executives were
told bluntly “it wasn’t in the
industry’s best interests” to block
the bipartisan Senate bill backed
by Trump. If it failed, they were
told, they’d see “the president of
the United States negotiating
with Nancy Pelosi [on allowing
the government to negotiate drug
prices in Medicare],” said a per-
son familiar with the meeting.
On Wednesday, as if on cue
after the first of two Democratic
debates in Detroit, Health and
Human Services Secretary Alex
Azar held a call with reporters,
outlining steps that might even-
tually lead to the importation of
some lower-cost drugs from Can-
ada — an idea supported by
Trump but opposed by many
Republicans.
Those drugs could potentially
include insulin — whose price
rose about 300 percent from 2002
to 2013 — as well as drugs for
rheumatoid arthritis, cancer and
cardiovascular conditions.
“For the first time in HHS’s
history, we are open to importa-
tion,” Azar said. “There is a path-
way. We can be convinced.”
The plan would allow state
governments, pharmacies and
drug manufacturers to submit
importation proposals for federal
approval. However, Food and
Drug Administration experts saidit could take two to three years for
the administration to issue a final
rule. While some rules may be
done faster, this one will probably
be especially complicated — and
the administration is months
from formally proposing it.
Drug industry groups panned
the idea, as did the Canadian
government, which warned of
shortages for its 37 million resi-
dents if the United States imports
its medicines on a large scale.
White House officials are also
weighing an Obamacare replace-
ment that Congress would take
up after the election, a Medicareplan to contrast with Democratic
Medicare-for-all proposals, help
for beleaguered rural hospitals
and steps to reduce maternal
death rates, according to two
senior administration officials.
The health-care effort is being
driven by Grogan, acting chief of
staff Mick Mulvaney and the Of-
fice of Management and Budget’s
acting director, Russell T. Vought.
Other participants in the some-
times contentious daily meetings
include Azar, the president’s son-
in-law and senior adviser Jared
Kushner, White House counselor
Kellyanne Conway and represen-
tatives from the vice president’s
office.
One senior administration offi-
cial, who spoke on the condition
of anonymity to discuss internal
deliberations, said the White
House thinks it has “tremendous
authority” to write executive or-ders under food, drug and cos-
metics laws, as well as through
the Affordable Care Act, which
gives the government broad pow-
er to test ways to improve health
care and reduce costs in govern-
ment programs.
“We think the [ACA] authority
is pretty tremendous,” the official
said. The administration is argu-
ing in federal court to overturn
the law, however, with a decision
expected in late summer or fall.
But many health policy and
legal experts disagree and are
also skeptical that the steps the
administration is talking about
would have a tangible effect on
consumers before the election.
“It’s unlikely the administra-
tion is going to be able to use an
executive order that Americans
are going to be able to notice
before the election,” said Benedic
Ippolito, a health economist at
the American Enterprise Insti-
tute. “It’s an incredibly ambitious
timeline.”
Others see court challenges as
inevitable, noting that the drug
industry has been willing to sue
the administration over policies
it opposes; it recently won a lower
court victory against an HHS
regulation that would have re-
quired drugmakers to include the
list prices of their medications in
television ads.
“I’m not sure they can get
anything done and survive a
court challenge before the elec-
tion,” said Chris Meekins, a for-
mer HHS official who is now a
health-care policy research ana-
lyst at Raymond James, a finan-
cial services firm.
The White House is also at-
tempting to build support for the
Senate bill written by Finance
Committee Chairman Charles E.
Grassley (R-Iowa) and the panel’s
ranking Democrat, Sen. Ron
Wyden of Oregon, that for the
first time would require drug-
makers to pay back the federalgovernment if they raised the
prices of medications in the
Medicare program in excess of
the rate of inflation. It would also
limit out-of-pocket costs for ben-
eficiaries.
The pharmaceutical industry
opposes the bill, and some Re-
publicans have derided the legis-
lation as tantamount to negotiat-
ing drug prices or imposing
“price controls” — a line in the
sand for many who oppose what
they see as government interfer-
ence in the market. Senate Major-
ity Leader Mitch McConnell
(R-Ky.) has not said whether he
will bring a drug-pricing legisla-
tive package up for a vote, but he
is generally opposed to voting on
health-care legislation ahead of
the election.
Against the advice of many
congressional Republicans,
White House advisers are also
working to craft an Obamacare
replacement plan that Trump
could campaign on, especially if
the U.S. Court of Appeals for the
5th Circuit should declare the law
unconstitutional this fall and cat-
apult the issue to the forefront of
the 2020 races.
Some GOP lawmakers and
strategists worry about rolling
out a plan that has no chance of
passage in the current Congress
and that Democrats could pick to
pieces during a long campaign.
Many also have little appetite to
return to the debate over repeal-
ing Obamacare.
Nonetheless, the White House
is considering a plan, put togeth-
er by conservative think tanks,
that would eliminate the ACA’s
subsidies for low-income con-
sumers and replace the open-
ended federal commitment to
Medicaid with a lump-sum pay-
ment for each state in the form of
a block grant, according to a copy
posted online. The proposal
largely follows the outlines of a
2017 Republican bill, which the
Senate never voted on because it
did not garner enough support.
“We don’t have a lot of buy-in
on the Hill,” acknowledged the
senior administration official,
“but we’re figuring it out.”
Some of the other health-care
proposals under review also ap-
pear largely aspirational, for in-
stance, a draft executive order
that instructs agencies to speed
development of a universal flu
vaccine, first reported by Politico,
but that proposes no new fund-
ing. Other efforts, such as the
initiatives to reduce HIV infec-
tions and end-stage kidney dis-
ease, and double the number of
transplants, contain new funding
and have been widely heralded.
“Every chance we have to set or
tweak a rule we are doing it,” said
the senior official. “This adminis-
tration has been more creative
and accomplished more when it
comes to health care and health
than anybody has given us credit
for.”
[email protected]
[email protected]Laurie McGinley contributed to this
report.White House races to find health-care wins
Republican and industry
opposition limits options
in pre-election windowJABIN BOTSFORD/THE WASHINGTON POST
Health and Human Services Secretary Alex Azar has outlined steps that could lead to the importation
of lower-cost drugs from Canada — an idea backed by the president but opposed by many Republicans.“I’m not sure they can
get anything done and
survive a court challenge
before the election.”
Chris Meekins, research analyst