New York Gov. Andrew Cuomo was in Manhattan on Thursday to declare a “state of emergency” at the Metropolitan Transportation Authority, the beleaguered agency that moves millions, some of them to the office and some of them to tears, every workday.

The event in question was the launch of the MTA Genius Transit Challenge, a yearlong quest to figure out how to run a big city subway system. Three $1 million prizes will be distributed. (Nobody tell Tokyo, Beijing, Moscow, London, or Paris—we want to keep this a fair fight.)

It’s part of Gov. Cuomo’s campaign to show the world he really does run the MTA, at least when he feels like it. This new effort to disrupt the status quo might have a little more credibility had he not, three years ago this week, established a commission of 22 experts to reinvent the MTA. (Reader, they didn’t.) This year’s task is reimagining. It is at once an odd diversion, since managing a subway system is not rocket science, and a welcome one, since it reinforces a sense of political accountability at a time when it feels like the system has reached a crisis point.

It’s also an interesting turn for Cuomo, who came into office with a transit system functioning in high gear, with annual record ridership on shiny new trains. He inherited credit for finally completing the Second Avenue Subway, adding the most new track mileage to the subway system in decades. His relationship with the unions was good. He made cheap, cosmetic improvements like installing Wi-Fi in stations as service steadily languished.

It all left him free to focus on his true love: cars. (Or so he thought …) In an effort to brand himself a modern-day Robert Moses, Cuomo built new bridges—one of which, the State Assembly decided today, will be named after his late father, Gov. Mario Cuomo—invested half a billion in tolling technology, and spent billions on highway construction in upstate New York while shorting the city’s own infrastructural needs.

As a result, Cuomo now finds himself celebrating two new bridges whose predecessors together carried 320,000 cars a day, while a derailment snarls the A and C trains, which clock 800,000 rides per day. (Oh, and the city bus system is in terminal decline, which has helped contribute to subway crowding problems.)

It’s déjà vu all over again, as Cuomo follows in the footsteps of his counterpart across the Hudson River, New Jersey Gov. Chris Christie. When Christie took office, the state’s commuter rail system, New Jersey Transit, was a model. Now it’s a mockery. When he took office, the state had billions in federal money ready to build a second trans-Hudson rail tunnel. Now it has one, deteriorating tunnel whose imminent failure will irreparably damage the state’s economy.

That Gov. Christie is now the least-popular governor in the long, misruled history of the Garden State has much to do with his alleged involvement in a scheme to punish a political rival with a traffic jam. But Christie also did his part to punish the state’s transit commuters.

First, in 2010, he canceled that tunnel, then the nation’s largest public works project. Whatever its faults, Access to the Region’s Core, as it was known, would have provided a back-up to the 107-year-old North River Tunnels to Penn Station. Christie spent the state’s own contribution on roads. Decried as shortsighted then, the decision has looked even more dumb since 2012, when the existing, ancient tunnel was flooded by Superstorm Sandy. Amtrak subsequently announced the tunnel must be shut down for repairs. Senators from both New York and New Jersey are desperately trying to procure federal support for a new tunnel before that happens.

Confronted with the delays caused by the aging tunnel, the two governors spent a while trying to dodge that problem as well, though they eventually came around, as I wrote last year:

In July [of 2015], Christie had called on his attorney general to investigate Amtrak. In August, Cuomo had said the tunnel was not his problem. “It’s not my tunnel!” he told reporters. “Why don’t you pay for it?” But by September, the men agreed their states would pay for half the new project. “Our shovels are ready,” a joint letter proclaimed.

Meanwhile, New Jersey Transit—the commuter rail system that shares the tunnel with Amtrak—underwent its own decline. NJT was been the country’s fastest-growing commuter railroad between 1980 and 2016, a period during which rail passengers crossing under the Hudson to New York more than tripled. In 1980, 9 percent of New Jersey travelers bound for Manhattan used commuter rail. By 2014, that figure was 16 percent.

It has since become, the Newark Star-Ledger wrote in a scathing May editorial, a “dystopian nightmare”:

In the past year, the agency had a $45 million shortfall, the director's office was empty, its board hid from the public, it had a fatal crash and several derailments, and its grim safety records were marked by federal fines, an alarming breakdown rate, and slow installation of an automatic braking system.

Over the past 12 years, even as ridership has risen 20 percent, capital expenditures have gone down 19 percent. “The agency has been starved,” its co-founder and former director Martin Robins said last year, after a commuter train came screaming into Hoboken and half-destroyed the station. State subsidy to NJT has fallen 90 percent on Christie’s watch.

Now, it’s hard to know how much of Christie’s decline can be attributed to this—his approval rating has been volatile, spiking with Sandy and plummetting with Bridgegate. But it has continued to slide since. According to a Quinnipiac poll released last month, the percentage of New Jerseyans who approve of Christie’s handling of trans-Hudson mass transit is 18—the same percent that think he’s handling his job well. Just 18 months earlier, he was at a more respectable 39 percent, according to a Rutgers poll. Meanwhile, transit has been a big issue in the current gubernatorial race—a subject of real debate in a way that would surprise anyone accustomed to transit’s quiet political profile. Crashing trains look bad even if they don’t personally snarl your commute.

Cuomo doesn’t need me telling him he doesn’t want to end up like the guy who fetches President Trump’s chicken nuggets. He had a 41 percent approval rating in June, according to Marist, and it’s up to 51 percent in heavily Democratic (and subway-dependent) New York City. He isn’t embroiled in a federal conspiracy trial.

But it’s hard to avoid the sense that New York, under Cuomo, is living a delayed version of New Jersey under Christie. Christie took office in 2010, Cuomo in 2011. Two governors, each of whom saw himself as a moderate capable of bridging the political divide, each had presidential ambitions, each mistook “infrastructure” to just mean “roads,” and each failed to make the trains run on time.

Christie has paid the price. Can Cuomo learn from his example?

One of the key reasons Senate Republicans have not been able to reach a health care compromise is that they can't agree about what to do with Obamacare's insurance market regulations. Conservatives, like Sen. Mike Lee of Utah, want to let states junk all of them in order to make coverage cheaper for healthy adults. Moderates, meanwhile, don't want to be blamed for eliminating highly popular consumer protections, such as the rules that prevent insurers from discriminating against Americans with pre-existing conditions.

Into this divide steps Ted Cruz, who has proposed a compromise that might let Republicans finally bridge their differences. As Vox's Dylan Scott describes it: “As long as a health [insurer] offered at least one Obamacare-compliant plan in a state, [the insurer] would also be allowed to offer non-Obamacare-compliant plans in that state.” The political logic of this approach is elegant. If you're sick, you'll be able to buy a policy with all of the Affordable Care Acts safeguards. If you're young and hale or just have a high tolerance for risk, you can get something cheaper.

As Kang and Kodos might put it: Obamacare for some, miniature American flags for others!

While the Cruz plan may be politically appealing, it would also be a messy policy with the potential to disadvantage and infuriate many middle-class families.

Under Cruz's scheme, the individual insurance market would almost certainly split in two. Healthy Americans would flock to inexpensive, unregulated insurance while sicker individuals would choose the Obamacare-compliant plans, likely causing the premiums on those policies to skyrocket. The Obamacare exchanges would effectively turn into expensive high-risk pools.

This would not necessarily be a problem for everybody. Like Obamacare, the Senate proposal offers insurance subsidies to poor and working-class households that cap their monthly premiums as a portion of their income. If you are 40 years old and earn 250 percent of the poverty line, you will owe no more than 8.05 percent of your paycheck toward your coverage; the government picks up the rest.

But that leaves a big question: What happens to people who don't receive subsidies? In the Senate's current draft bill, households are only eligible for federal help if they make less than 350 percent of the poverty line. That comes out to $86,400 for a family of four—or barely above the median for a married couple. Many middle-class households don't qualify and would be stuck paying the full, potentially unaffordably high price for an Obamacare-compliant plan if they ever, say, got cancer. Cruz, for his part, seems to think states will be able to deal with this issue using an insurance market stabilization fund the Senate plans to set aside. “The exchanges have very significant federal subsidies, whether under the tax credits or under the stabilization funds,” he told Scott. But under the GOP's bill, that pool of money shrinks over time. Maybe it will be enough to make Obamacare-style plans affordable for everybody. Maybe not.

If it failed to do so, though, the Cruz plan would create a rather perverse outcome. Sick Americans would only be guaranteed remotely affordable health coverage if they earned less than 350 percent of the poverty line. Everybody else on the individual market? Tough luck.

There would also be some irony here. Republicans have long complained that Obamacare discourages people from working, because its insurance subsidies cut off sharply at 400 percent of the poverty line. Cruz's plan creates an even stronger incentive against work, since fewer people would be eligible for subsidies, and those without them could pay steeply higher prices for insurance coverage should they ever become ill. His idea looks a lot like the Obamacare cliff—except the people who tumble off it will fall about 5,000 feet further.

To New York Gov. Andrew Cuomo, who so loves his fancy car and flashing lights but is unfortunately saddled with the extremely grown-up responsibility of running the busiest subway system in the Western world, I recommend a child’s lesson: When you get in trouble, tell the truth.

Fessing up would be a necessary tonic for Cuomo’s dissembling act about who controls the Metropolitan Transportation Authority, the very wobbly backbone behind the 8 percent of U.S. GDP also known as the New York City metropolitan area. Last week, Cuomo moved to “take control” of the MTA, a bit like a groggy sea captain might bellow that he was taking control after waking from slumber to seize the wheel in a gale.

The truth is, Cuomo has always had control. His Captain Haddock act is duplicitous in light of both the organization’s governance, of which he is and has been the functional head, and the authority’s public relations branch, which has long made clear who takes credit. When a snowstorm loomed in January 2015, it was Cuomo who initiated the system’s first snow-induced shutdown in 111 years, contradicting the agency head and surprising the internal command center, where officials learned the news on television. (The snowstorm was a bust.) When the trains ran on time, when the Second Avenue Subway opened, when there were countdown clocks in the stations and new buses on the streets, every MTA press release began Gov. Cuomo this, Gov. Cuomo that, like anaphoric stanzas of a heroic epic.

Lately, however, “the Engineer on the Second Floor,” as the governor was known when this train set was still fun to play with, has lost interest. He did not appear at the scene on Tuesday morning, when an A train derailed in Harlem, sending 37 people to the hospital. New Yorkers behaved with aplomb, of course, filing through the beached train with calm and kindness. Two hundred firefighters, 100 police officers, and dozens of MTA workers helped hundreds of commuters through the smoky tunnel. It was a very New York display of cool behavior in crazy circumstances.

If Cuomo does the big-picture hedging, the MTA does it daily in its communication with riders. Tuesday’s disaster was no exception. Passengers in the derailed train were told after 10 minutes what had transpired. But as scores of trains halted in tunnels from Brooklyn to the Bronx, and thousands more commuters collected on platforms, it took the agency a full hour to confirm that the delays were caused by a derailment. First, it was an “inspection.” Then, it was a “power failure.” Finally, the agency broadcast the truth.

We've come to expect that kind of obfuscation from subway announcements. But on Tuesday it was particularly galling. Because one of the governor’s high-profile subway initiatives was installing Wi-Fi and cell service in stations (lipstick on this big old steel pig), passengers on the derailed train began broadcasting footage of the train’s busted door long before the MTA had moved beyond saying it was conducting an “inspection.”

Fixing the agency’s structural problems is going to be a long, hard haul—but fixing its communications problems needn’t be. On-time performance has fallen for the sixth straight year, down to 63 percent from 85 percent in 2011. The less reliable the system becomes, the more we depend on accurate warnings about delays. Making them better could start tomorrow.

“Train Traffic Ahead,” the eternal MTA delay announcement, is always a punchline. Inside the great subway sauna of June 6—a sweltering, stalled F train that compelled at least one passenger to strip to her underwear—commuters were told there was “train traffic,” though crews had reported a power problem. “Most of the time, they don’t even tell us the true cause,” Richard Richards, a longtime train conductor, told the Daily News on that occasion. “They’ll relay that message to us, to tell the customers that there’s train traffic.” Service changes come with no more clarity.

The cumulative effect of all this noise pollution, as Second Avenue Subways blogger Ben Kabak has observed, is an beat-by-beat dissolution of credibility that mirrors the governor’s own. It makes it hard to plan the day, but it’s also dangerous: Twice in the past week riders have left stalled trains on their own, because they don’t believe what they’re hearing from conductors—if they're hearing anything at all. That means straphangers wandering through dark, electrified tunnels where trains run at 30 miles per hour.

Last week it was two renegade commuters who “self-evacuated.” Today it was 500. Tomorrow, who knows?

Meanwhile, three hours after the derailment had—as often happens—prompted the MTA to draw an entirely new subway map to send trains around the bottleneck, the agency alerted commuters with a quiet “Service Change” notice. The new routes weren't front and center until midafternoon.

It wasn’t good enough to prevent scenes like this on Tuesday night:

Who among hasn’t let a (metaphorical) train go off the rails? How you talk about it counts.

On Monday, the Congressional Budget Office reported that the Senate's Obamacare repeal legislation would leave 22 million Americans uninsured within a decade. Most people in Washington, both Democrats and Republicans, seem to have accepted that this forecast is, in fact, not flattering to the bill (which is one reason why a vote on the thing has been postponed). But a few stalwart conservatives have tried to frame it as a positive. Most notable among them: House Speaker Paul Ryan, who spent an interview on Fox & Friends trying to spin the CBO's estimate like a dreidel.

"What they're basically saying at the Congressional Budget Office is that, if you're not going to force people to buy Obamacare, if you're not going to force people to buy something they don't want, then they won't buy it,” said our nation's foremost P90X enthusiast. "It's not that people are getting pushed off a plan. It's that people will choose not to buy something that they don't like or want."

It's the smile that makes it so eerie, right?

In an extremely narrow, technical sense, Ryan is almost right: The CBO does say that under the Republican plan, Americans would choose not to buy insurance, in part because they'd no longer be required to by law. But that's a bit like saying a poor single mother of three is choosing to skip meals so her kids can eat. It's not really a choice. It's a sacrifice. Likewise, many people (though, to be fair, not all) would choose not to buy insurance under the Republican plan because the premiums and deductibles would no longer be affordable.

I am not performing some esoteric reading of the CBO's footnotes here. It's right there in the report:

In the nongroup market, some people would choose not to have insurance because they choose to be covered by insurance under current law to avoid paying the penalties. And, under this legislation, without the mandate penalties, some people would forgo insurance in response to the higher premiums that CBO and JCT project would be charged.

In other words, some young and healthy adults would drop their insurance because they only purchase it today due to Obamacare's individual mandate. Some low-income and older adults would drop their insurance because it would become unaffordable—especially if they were previously eligible for Medicaid, which the bill would significantly curb. As the CBO notes, a 40-year-old making $11,400 in 2026 could choose to buy a plan with a $300 premium and a deductible equal to more than half their income. Or they could choose to buy a plan with a $1,700 premium and a deductible equal to more than one-third of their income. “Many people in that situation would not purchase any plan,” the CBO notes. You know, that would just be their decision.

“Many of the people who are projected be eligible for Medicaid under current law but not eligible under this bill would face a similar choice,” the CBO continues. “Those people would instead be eligible for a premium tax credit under this legislation. But because of the expense for premiums and the high deductibles, most of them would not purchase insurance.”

I am sure these Americans will be grateful to Paul Ryan for giving them the opportunity to make such a liberating choice.

The Congressional Budget Office confirmed on Monday that Republicans are incapable of writing a humane health care bill. The Senate's Better Care Reconciliation Act, which it revealed to the public on Friday and may vote on this week, would leave 22 million additional Americans uninsured within a decade, according to the CBO, largely by cutting both Medicaid and subsidies for private insurance in order to fund extravagant tax cuts for the wealthy ($536 billion of them, in fact).

Technically, that number is a slight improvement over the GOP's previous efforts. The CBO forecast that the American Health Care Act, which the House passed last month after crafting it in a shambolic rush, would eventually leave 23 million uninsured in order to provide tax relief to investors and medical device–makers.

That is pretty much all anybody needs to know about the Republican Party's push to repeal Obamacare—every piece of legislation the party produces amounts to a wealth transfer from the vulnerable to the rich that lowers premiums, though just slightly, for some younger and healthier Americans.

But it's worth lingering on one specific portion of the Senate bill: the cruel bait and switch it pulls on America's poor.

Reading extremely charitably, one could make the case that the Senate bill is designed to move low-income Americans off of government insurance and into highly subsidized private coverage. It unwinds Obamcare's expansion of Medicaid, which allowed adults to qualify for the program if they earned up to 138 percent of the poverty line. But it also imitates Obamacare by providing tax credits to help low- and middle-income households buy private insurance, capping their premiums as a percentage of their earnings. A woman in poverty would have to pay no more than 2 percent of her paycheck toward her health insurance, for instance. A woman making 133 percent of the poverty line would pay 2.5 percent. It's a worse deal than Medicaid, which is generally free, but it's something.

Except there's a catch. Obamacare's tax credits were designed to cover the cost of midpriced health coverage; meanwhile, the law provided additional subsidies that drastically lowered out-of-pocket expenses like co-pays and deductibles for poorer households. The Senate bill spends $424 billion less on subsidies and designs its tax credits to cover the price of a low-end health plan with high deductibles—similar to one of Obamacare's bronze plans—while doing nothing to keep down out-of-pocket costs for the needy.

As a result, poor would be unable to use the coverage they could actually afford and unable to afford the coverage they could actually use. For example, a single adult making $11,400 in 2026 would only have to pay $300 per year in premiums for a benchmark health plan. But their deductible would amount to more than half their income. "Despite being eligible for premium tax credits, few low-income people would purchase any plan," the CBO concludes.

Ironically, this is exactly the same complaint middle-class families who currently don't qualify for subsidies have had about Obamacare. The Senate bill does relatively little to help them while putting poor households in exactly the same predicament. It takes the worst pain some unlucky families have experienced under Obamacare and replicates it, over and over.

Some Senate Republicans clearly want to at least look as if they have compassion. Otherwise, they wouldn't have bothered aiming the BCRA's tax credits at the poor. After all, the House bill didn't; instead, it provided mostly flat subsidies based on age. But just like their colleagues in the lower chamber, Senate Republicans are too wedded to the dogma of tax cuts to properly fund a health care bill that provides for the vulnerable. Their legislation is just a variation on the same heartless theme we've been listening to for months.

On Monday, Trump party planner Lynne Patton assumed her role at the top of the Department of Housing and Urban Development's Region II, HUD's largest bureau, where she will oversee HUD operations in New York and New Jersey.

Patton's experience in government and housing amounts to a six-month stint as the department's director of public engagement, during which she organized director Ben Carson's speaking tour, on which he got stuck in an elevator.

Her appointment indicates the Trump administration's determination to distribute jobs to well-connected friends and relatives, regardless of their qualifications. The Israeli-Palestinian peace process, for example, is being handled by the president's son-in-law, a New York real estate developer. Affordable housing in New York, in turn, will be handled by the president's son's party planner. (We can only assume the ghost of Richard Holbrooke will be planning the president's parties, to complete the circle.)

Prior to her arrival in Washington, Patton helped plan Eric Trump's wedding and served as a vice president at his foundation, which is being investigated by New York State Attorney General Eric Schneiderman. Her purview there, she writes on her LinkedIn profile, included overseeing "all foundation outreach & operations, high-net worth fundraising, event planning, social media and vendor/corporate partnerships."

The profile lists a "J.D. (N/A)" from Quinnipiac School of Law, which she attended but did not graduate, and Yale University, which she did not attend. However, her father did get a medical degree at Yale, a fact she noted in a speech at the Republican National Convention last summer.

The confirmation follows a little back and forth: Patton's promotion was announced on Wednesday, June 14. Two days later, following outraged statements from politicians in the region, HUD claimed the position was unfilled. Now, Patton is back in charge of HUD's largest regional office, Politico reports. Most previous appointees to the office have had a background in housing, and all have had experience in government.

Patton will be at the head of an organization that functions as a liaison between Washington and the New York City Housing Authority, or NYCHA, in addition to supervising the region's block grants and housing vouchers.

Last week, I wrote a little about the promise and problems of NYCHA:

NYCHA is widely considered a paragon of public housing, an enclave for service workers and the elderly in a very expensive city. The system also has an $18 billion backlog of repairs in addition to an operating deficit. “Housing conditions at NYCHA remain a tenant’s nightmare, with moldy units, holes in floors, and broken walls,” New York City Comptroller Scott Stringer said in April, announcing a brief on the maintenance concerns of NYCHA residents. The waiting list is still a quarter-million people long.

Let's get this party started!

The U.S. Conference of Mayors is meeting this week in Miami Beach, a perfect locale for a group that, following President Trump’s withdrawal of the United States from the Paris Agreement, sees itself as the heir to America’s global leadership on climate change.

And then some: U.S. cities (and states) have also recently supplanted the federal government in negotiating with Canada. They have crafted their own immigration policies at odds with federal wishes. They are increasingly responsible for the provision of the safety net, especially as it relates to housing, as Washington and some statehouses have disclaimed responsibility for anti-poverty programs.

The enthusiasm of mayors for that role—as D.C. Mayor Muriel Bowser led the chant at January’s Women’s March, “Leave us alone!”—is matched only by their unsuitability for it. Constitutional power limits and meddling legislatures in both red and blue states have curtailed municipal initiatives from the minimum wage to plastic bag bans. Any effort to effect a greater redistribution of wealth is severely hamstrung by suburban separatism. We may have new stereotypes about urbanites, and need new ones about suburbanites, but one thing remains true: Most American metropolitan areas are still doughnuts, poverty surrounded by wealth.

Former New York City Mayor Michael Bloomberg is here to help, he told the conference on Monday, with a new grant-making program called the American Cities Initiative. Over the next three years, Bloomberg Philanthropies will distribute $200 million to U.S. cities, beginning with a “Mayor’s Challenge” to grant $5 million to an urban project on any issue and millions more to runners-up.

The return of Bloomberg’s urbanist philanthropy, which has more recently focused on Latin America and Europe, to the American city is in response to two things, the billionaire told the New York Times. First, the recognition that cities now "replace Washington and, in some cases, state governments, to provide services.” And second, the more abstract concept that innovative urban governance is a way of restoring America’s image and influence in spite of Trump's anti-urban agenda.

First: This is a very small amount of money for Bloomberg to dangle, especially for the big-city mayors who conduct foreign state visits and so on. The $100,000 grants dedicated to runner-up proposals in the new Mayor’s Challenge, which reprises a Bloomberg project from 2013, wouldn’t buy a public toilet. The grand prize is small potatoes relative to billion-dollar big-city budgets, and the entire dedication of $200 million is pocket change against the billions the Trump budget cuts from the transit grants, housing voucher programs, and other federal outlays on which cities depend.

Still, small grants give mayors the political capital to try new things, or go out on a limb with endeavors that might not seem like an obvious use of public money. The development of 911, for example, was spurred largely by small local grants from the Robert Wood Johnson Foundation. Urban resilience efforts in the U.S. (to say nothing of city-focused journalism, including much of my own work at, say, Next City or the Guardian) have been fostered by the Rockefeller Foundation. The last time Bloomberg Philanthropies tried its challenge here, in 2013, big cities like Houston and Chicago won grants—and plenty more applied. These little gifts spur matching investments from cities and states, functioning as affirmations that something is a good idea and worthy of investment.

Since then, Bloomberg has turned his focus in the U.S. toward politics, via the quietly effective Everytown for Gun Safety project, started in the spring of 2014, and donations to candidates who support gun control or others that Bloomberg likes. In 2016, he threw $65 million into races and referenda, especially those supporting charter schools and soda taxes.

But maybe Bloomberg, a Clinton supporter who spoke at the Democratic National Convention in Philadelphia, has come to the conclusion that money in politics is a little less effective than money with no politics. Why bother spending money on getting a candidate elected who supports your project when you can just pay for it yourself? This is a philosophy that is, on a superficial level, perfectly tailored for American mayors, whose political aims have coalesced so closely that one administration is almost indistinguishable from the next. The question is less who to elect but which of an array of competing but favored projects to pay for; Bloomberg has an answer.

Listen to the technocratic veneer that Mitch Landrieu, the mayor of New Orleans and the current head of the USCM, applied to mayoral control in the New York Times: “We’re moving to a different model in this country, and it’s really going to be nonideological,” he told the paper. “It’s going to be problem-solving driven.” Technocracy is its own ideology, of course. But what Landrieu really means is that Bloomberg is going to focus on the easy stuff in cities: free money for good projects, the type that we would all fund if we could.

The more daunting, underlying problems—like regressive tax regimes, no annexation power, and political independence—will have to wait for some other benevolent billionaire.

After spending seven years attacking Obamacare's unpopular individual mandate for requiring Americans to buy insurance, Senate Republicans have decided to replace it with a rule that could be even more politically toxic.

Under the proposal, Americans who let their health insurance lapse for 63 days over the previous year will have to wait at least six months before they can get coverage again—even if they're deeply ill and in need of medical attention. The rule is designed to prevent people from waiting until they are sick to buy insurance and is essentially a more stringent version of restrictions already in place thanks to the Affordable Care Act. It was included in a new, revamped draft of the Senate GOP's health care repeal bill released on Monday morning, and—at the risk of speculating—I am guessing it will poll about as well as lighting leukemia patients on fire.

After the Senate released its draft legislation last week, both fans and critics pointed out a glaring flaw: The bill kept Obamacare's regulations guaranteeing coverage to Americans with pre-existing conditions—but didn't include any rules to make young, healthy people buy insurance in order to balance out the market. Obamacare, of course, tries to accomplish this with the individual mandate, which makes people get covered or pay a small tax penalty. But after railing against this weak nudge as a tyrannical imposition on personal liberty for the better part of a decade, Republicans had to junk it. If they didn't do anything to make young people get coverage, however, their legislation risked sending the insurance market into a death spiral—not the imaginary death spiral Republicans accuse the law of having set off, but a real one.

And as the GOP is obviously learning, it's really hard to come up with a solution to this problem that both works and is politically palatable. Threatening the uninsured by locking them out of the market for six months may get a few more twentysomethings to sign up for coverage, since they won't be able to get it in an emergency. But this solution is now generating headlines like “Trumpcare's Newest Provision Might Be Its Most Odious.” As New York's Eric Levitz puts it: “Instead of coercing Americans into buying insurance through a small financial penalty, the GOP would do so by locking some cancer patients out of access to insurance for a potentially fatal amount of time.”

This is ever-so-slightly unfair. Under current law, uninsured Americans who get cancer still have to wait until the next open-enrollment period to buy insurance coverage unless they qualify for an exception (for instance, if they lose their previous insurance because they got fired). The main difference with the new Republican approach is that even people who try to sign up for a health plan during open enrollment will have to wait six months before their insurance takes effect if they didn't have continuous coverage over the past year.

Another way to put: Under Obamacare, you're better off getting sick closer to open enrollment. Under Trumpcare, you're waiting at least six months to get insurance no matter what. The policy approach is more vicious by increments. But by making some desperately sick people wait even longer than they would have to now for coverage, the optics seem orders of magnitude worse.

Health care: Nobody knew it could be so complicated.

One of the expressed intentions of Republicans’ efforts to repeal and replace Obamacare is to undo some of the age-related distribution inherent in the system. Today, healthy young people pay more so that older, less-healthy people don’t have to pay quite as much.

The Republican plan unveiled in the Senate on Thursday sharply scales back the distributional nature of the system—on an income basis, and on an age basis. The tax credits that help people afford policies on the exchanges will be sharply scaled back. So let’s say you and your spouse are 60, your kids are grown, and you’re insured on the individual market. Poverty level for a family of two is $20,420. If you make $80,000 a year between you, you’ll have to pay as much as 16 percent of your income for a high-deductible plan under the Senate’s Better Care Act as its currently written. (CNN found that, if the House plan passed last month were to become law, a 64-year-old earning $24,600 in 2026 would pay a premium of about $14,600—about 60 percent of total income.)

Asking older people to pay so much for health care is particularly devastating given the ongoing structural changes in our economy. Most Americans don’t make that much money. The median household income in the U.S. is about $55,000. But the median household income for those in the 55–64 cohort is markedly below the median for those in the 45–54 and 35–44 cohorts. Most Americans don’t have much savings. The median retirement savings for people between the ages of 50 and 55 in 2013 was $8,000.

Now, the best way to avoid paying a large chunk of your income and savings for insurance for a few years until Medicare kicks in at 65 is to keep a payroll job with health insurance. But increasingly, American employers don’t want to keep people in their 50s on their payrolls. The closer Americans get to Medicare eligibility, they more likely they are to be pushed out of their jobs—and out of the workforce entirely. The data from the Bureau of Labor Statistics tells the tale. In 2014, 79.6 percent of Americans between the ages of 45 and 54 were in the workforce. But of those between the ages of 55 and 59, 71.4 percent were in the workforce, while 67 percent of those aged 60–61 were and just 53 percent of those between 62 and 64 were.

In virtually every industry, at virtually every level of the income ladder, employees are explicitly seeking to move people off the payroll as they age into their 50s. Which means more of those Americans must buy insurance on the market the Republicans are currently trying to remake.

After the financial crisis, the big autoworkers worked out two-tier wage systems with unions which protected existing wages and benefits for older workers while allowing them to add new people to the payroll at lower rates and with less extravagant promises. So, of course, these large employers have lots of incentives to hasten the retirement of older workers.

Earlier this year, Fidelity Investments offered voluntary buyout packages to employees over the age of 55. In April, Brigham and Women’s Hospital in Boston offered buyouts to employees over the age of 60. Last year the Museum of Modern Art in New York offered buyouts to, you guessed it, employees over the age of 55. In education, some states are trying to get rid of tenure, and Wisconsin has already taken steps in that direction.

You see it at the high end, too. Many professional services companies, like consulting and accounting firms, require partners to retire at the age of 60. Law firms routinely push older partners to go off counsel. At Goldman Sachs, it’s hard to find people working in senior positions past their mid-50s (unless they’re in the C-suite).

As for the media, I defy you to go into a television newsroom, digital media company, or newspaper and find more than a handful of people over the age of 50, let alone 60.

Given the relentless global competition and pressure continually to boost profits, it is likely that this dynamic will intensify in coming years. Which should push reasonable policymakers to make it easier for older people to afford health insurance on their own, either by maintaining existing premium support, or by, say, opening up Medicare to people over the age of 50. But of course, the Republican plans are going in precisely in the opposite direction.

There is one area where employees who enjoy generous payroll benefits, including health insurance, can age in place. The average age in the 115^th Congress is 58.