TRUMPadelphia: Vegas and beyond, and what you missed in the Obamacare debate

Good morning, friends. I'm back from Las Vegas, where I wrote about the aftermath of the mass shooting at a concert on the strip a week ago (you can read some of my coverage here).

I keep thinking about something Steve Sisolak, the Clark County committeeman who raised millions for the shooting victims, told me a few days after the attack. This is what he can't stop thinking about: how he toured the crime scene the morning after, when there were still bodies on the grounds of the concert venue, and purses and jackets and chairs and cell phones scattered all over. And how, as he stood there, trying to take all of it in, one of those phones started to ring.

I don't know whose phone it was, or who was trying to find them, or whether they made it out. You hear so many stories like this when you're covering a tragedy — the kind that chill you for a moment and stay with the people who lived it forever.

Las Vegas is a good city with good people in it, whose outpouring of love and support was truly inspiring to watch, and they'll pull through. Everyone always pulls through. I'm reminded, though, that this December it'll be five years since I drove to Newtown, Connecticut to cover a shooting at an elementary school there — a horror so great that your naive correspondent, then 24, thought it might represent some kind of line in the sand for this country and the destruction we allow our people to wreak. I wonder how many more lines we'll draw.

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» READ MORE: Aubrey Whelan

What's at stake

A few pretty crucial deadlines sailed by us amid the last-ditch effort to repeal Obamacare (again) a few weeks back. The deadline expired for Congress to renew funding the Children's Health Insurance Program — which, generally speaking, covers kids whose families can't afford private insurance but whose incomes are too high for Medicaid. And unless Congress acts, $2 billion in funding cuts at Disproportionate Share Hospitals, which see a higher number of uninsured patients and who use funds from the federal government to help make up the difference, are set to go into effect next year. (Temple University and several other hospitals in Philadelphia get DSH funds.)

Healthcare advocates have been sounding the alarm about these deadlines for some time. But the delay in funding these programs — combined with the Trump administration's apparent attempts to undermine Obamacare enrollment in the wake of repeated repeal failures — mean that this year has been marked by uncertainty and upheaval for healthcare advocates and providers and many patients, too.

The local angle

Cuts to DSH funding are actually an Obama-era plan — with the thinking being that every state would accept the Medicaid expansion, more people would get insured under the Affordable Care Act, and hospitals like Temple wouldn't have to see so many uninsured patients and wouldn't need the extra cash. But that didn't go quite as planned, and Congress has continued to delay the cuts — until now. Pennsylvania got $616 million in DSH funds this year; the Hospital and Health System Association of Pennsylvania reported that several Pennsylvania congressmen on both sides of the aisle signed a letter against the cuts.

Kids who get CHIP in Pennsylvania and New Jersey will likely not be affected immediately — funding exists through the spring in Jersey, and probably until February in Pennsylvania. But elsewhere in the country, the situation is becoming increasingly dire.

What's ahead

There are bills in Congress to address both programs, and CHIP, especially, is such a political no-brainer ("Senator So-And-So Took Insurance Away From Children In Particular" is not an attack ad anyone wants) that it will likely eventually get funded. (Still, the fallout is real: "Congress can't even handle healthcare for kids," the Baltimore Sun scoffed last week.) But it's the uncertainty that gets you in these times: not knowing whether to plan for funding cuts, health advocates say, is dangerous enough.

"It's not doing anything good for us and families in PA to have this continual uncertainty about what the future looks like," Teresa Miller, the state secretary of health and human services, told me today. Trump-instituted cutbacks on the Obamacare enrollment period have her worried fewer Pennsylvanians will sign up for health insurance this year — and repeated repeal attempts destabilize insurance markets, she said.

As for CHIP: "There's bipartisan support for this program," Miller said, "so for the life of me I don't understand why it's taking so long."

"I think it's fake news, but if he did that, I guess we'll have to compare IQ tests. And I can tell you who is going to win." — Donald Trump in Forbes, on Secretary of State Rex Tillerson reportedly calling him a "moron."

"The dirty money must be returned immediately, not funneled to liberal special interest groups." — PA GOP spokesman Greg Manz, on Sen. Bob Casey and other local Democrats sending campaign donations from Harvey Weinstein to women's groups after explosive reports on years of sexual harassment and assault allegations against the powerful Hollywood producer.

"It's a shame the White House has become an adult day care center." — Sen. Bob Corker, taking a Sunday afternoon Twitter feud with the president to the next level.

My colleague Allison Steele has a lovely story on a beloved North Philly bakery bouncing back after a fire.