Tillerson says new sanctions to test Kim Jong Un – The Hill

Secretary of State Rex TillersonRex Wayne TillersonOvernight Regulation: Trump adviser affirms plans to leave climate deal | FDA to study new cigarette warning labels | DOJ investigating Equifax stock salesTop US security official targeted in Cuba Embassy covert attacks: reportTrump adviser tells foreign officials no change on Paris climate dealMORE on Friday said that North Korean leader Kim Jong Un will be “tested” by the new sanctions announced this week.

“Our diplomatic efforts continue unabated. We have put in place the strongest economic sanctions ever to have been assembled against Kim Jong Un, so he is being tested with these sanctions,” Tillerson said on ABC’s “Good Morning America.”

“Voices from every corner of the world are calling on him to cease his program, come to the table and let’s talk about the future of North Korea and the North Korean people,” he added.

The Trump administration announced its latest round of sanctions on Thursday, which take aim at countries, businesses and individuals that choose to do business with North Korea by cutting them off from the U.S. financial system. 

The United Nations Security Council also voted unanimously earlier this month to impose new penalties on Pyongyang. 

The sanctions came as North Korea continues to escalate its nuclear weapon and ballistic missile development. 

Trump administration officials have also insisted that the U.S. has military options in place for dealing with North Korea should such measures become necessary. 

“We will continue our efforts in the diplomatic arena, but all of our military options — as the president has said — is on the table,” Tillerson said Friday. “And once we can assess the nature of this threat the president will make a decision regarding the appropriate actions.”

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The Health 202: Cassidy-Graham’s abortion ban workaround – Washington Post

THE PROGNOSIS

Tony Perkins is president of the Family Research Council, a group that has pushed for antiabortion language in the Republican health-care bills. (Mary Altaffer/AP)

Want the inside scoop on health care? Get more stories like this.

Abortion opponents believe they’ve built an impenetrable firewall between taxpayer dollars and abortion coverage in the latest Obamacare overhaul plan known as Cassidy-Graham.

The trick: Funnel the money through an existing health-care program, the Children’s Health Insurance Program.

Now, they just have to make sure the Senate parliamentarian agrees with them.

Bear with me, as this gets a little wonky and complicated. The issue is a major pressure point for antiabortion groups, who have long insisted that no government funds should be used to cover elective abortions. And those groups have a big influence on how conservatives vote — especially in the House. 

Antiabortion groups like the Family Research Council and Susan B. Anthony List care about a few things in revamping the Affordable Care Act. A big one is ensuring the Hyde amendment — which prohibits taxpayer funds from paying for abortions except in cases of rape, incest or if the woman’s life is at stake — is now part of the legislation. That means that federally subsidized plans on ACA marketplaces could no longer cover the procedure.

The current language in Cassidy-Graham — which the Senate may vote on next week — complies with conservatives’ litmus test. But activists acknowledge the Senate parliamentarian will probably strip the Hyde language from the measure altogether, meaning that federally subsidized plans could keep covering abortions.

In the last go-round, that’s exactly what conservatives were worried about, too: that the Hyde amendment would be eliminated from the (now defeated) Better Care Reconciliation Act pushed by Senate Republicans under special rules governing the budget process.(That’s the vehicle Republicans are using to try to overturn much of the ACA because it doesn’t require Democratic votes.) Democrats believed that the parliamentarian agreed with them in that the Hyde language had to go, though Republicans said that guidance wasn’t final.

This is important because had Hyde been eliminated from BCRA, antiabortion groups might have turned against that bill altogether because it would have maintained marketplace subsidies (albeit reshaping them) that go toward plans that cover abortions.

The same problem exists for Cassidy-Graham. Democrats and Republicans on the Senate Budget Committee are expected to meet early next week with the parliamentarian, who rules on which provisions can go into a budget bill (that process is known as a “Byrd bath”). The Hyde language could get eliminated if the parliamentarian says it’s not closely enough tied to spending.

But these activists will probably just shrug their shoulders if those subsidies are given the green light this time.

That’s because that measure eventually phases out the marketplace subsidies anyway. Starting in 2021, it would funnel them through CHIP, which already contains the Hyde restrictions. States could use the money mostly as they wish – but they would be barred from paying for elective abortions or plans that cover them.

Senate parliamentarian Elizabeth MacDonough. (Photo by Jakub Mosur)

In short, abortion foes feel their goals will be achieved no matter what, as long as parliamentarian Elizabeth MacDonough gives the OK to Cassidy-Graham’s overall structure of turning subsidy money over to states.

“If Elizabeth MacDonough buys that whole structure, then we’re golden,” Family Research Council lobbyist David Christensen told me.

Of course, if the Hyde language somehow stays in Cassidy-Graham and the whole bill becomes law, insurers would face an immediate, pressing question: What to do about dozens of health plans that cover abortions? The prohibition would go into effect immediately, applying to 2018 plans that are up for sale starting in just a few weeks, on Nov. 1.

This wouldn’t be an issue in about half the states, which have passed their own restrictions on abortion coverage in the ACA marketplaces. Insurers already had to exclude coverage from the plans they’re selling in those states, so they wouldn’t need to scramble to change anything at the last minute.

But it could complicate the situation in the other states — particularly in California, New York and Oregon — that actually require most plans to cover abortions. Even if the Senate passes Cassidy-Graham next week, the House likely couldn’t consider it until October, after the point at which states are supposed to have their marketplace offerings all firmed up for next year.

Of course, that’s not all abortion-rights advocates have to be worried about.

Planned Parenthood president Cecile Richards. (Zach Gibson/AP)

As with previous repeal bills, Cassidy-Graham essentially bans Planned Parenthood from getting Medicaid reimbursements for one year. Medicaid dollars already can’t be spent on abortions (barring the exceptions laid out under Hyde), but conservatives say the women’s health organization shouldn’t get any taxpayer dollars, period, as long as they continue to provide the procedure.

That’s left Planned Parenthood, which relies on federal reimbursements and grants for about 43 percent of its budget, in a defensive posture as it tries to protect itself from deep funding cuts. The group’s president, Cecile Richards, stressed to Marie Claire magazine this week that its clinics use Medicaid dollars for a variety of health-care services including cancer screenings and birth control.

Planned Parenthood said this week its supporters have organized more than 2,200 events across the country, made more than 300,000 phone calls and delivered more than 1 million signatures to members of Congress opposing the defunding effort.

“These next 12 days are make-or-break for the health care millions of people rely on,” said Erica Sackin, a spokeswoman for Planned Parenthood Action Fund. “Graham-Cassidy is the worst version of Trumpcare we’ve seen yet.”

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PRICE CHECK

Health and Human Services Secretary Tom Price speaks in the Roosevelt Room of the White House in June. (Photo by Jabin Botsford/The Washington Post)

–Jetting around the country by private plane has become the norm for Health and Human Services Secretary Tom Price, who has taken at least 24 flights on private charter planes at taxpayers’ expense since early May, according to the latest report by Politico. The trips cost more than $300,000 in total, according to a review of federal contracts and similar trip itineraries, write Dan Diamond and Rachana Pradhan.

“Price’s use of private jets represents a sharp departure from his two immediate predecessors, Sylvia Mathews Burwell and Kathleen Sebelius, who flew commercially in the continental United States,” they write.

“Many of the flights are between large cities with frequent, low-cost airline traffic, such as a trip from Washington to Nashville that the secretary took on June 6 to make a morning event at a medication distributor and an afternoon speech. There are four regular nonstop flights that leave Washington-area airports between 6:59 a.m. and 8:50 a.m. and arrive in Nashville by 9:46 a.m. CT. Sample round-trip fares for those flights were as low as $202, when booked in advance on Orbitz.com. Price’s charter, according to HHS’ contract with Classic Air Charter, cost $17,760.”

One of the private flights occurred after Politico had first reported on the practice earlier this week, Dan said:

STILL FLYING — The day after POLITICO’s investigation broke, Price took another charter jet. https://t.co/fYCWgyxU67

— Dan Diamond (@ddiamond) September 21, 2017

Dan tweeted a picture of the ride:

THE PLANE — Here’s the 30-seat charter that Tom Price, Kellyanne Conway took for their ~$25,000 DC-Philly roundtrip. https://t.co/LXUYelPqwupic.twitter.com/RCdbZUWYiB

— Dan Diamond (@ddiamond) September 20, 2017

–Price’s office sought to justify the practice by saying staff has routinely evaluated the most effective way for him to travel and has turned to chartered flights when necessary for Price to manage one of the largest executive branch agencies while also staying grounded with voters.

“This is Secretary Price, getting outside of D.C., making sure he is connected with the real American people,” said Charmaine Yoest, his assistant secretary for public affairs. “Wasting four hours in an airport and having the secretary cancel his event is not a good use of taxpayer money.”

“Revelations of Price’s luxury travel, however, have drawn swift criticism from Democratic members of Congress,” The Post’s Aaron C. Davis reports, adding the decision to use charters was made after the HHS secretary was forced to wait in an airport for hours after a flight was delayed, missing an event organized by his department (incidentally, something that happens to millions of us who fly).

“Late Wednesday, the ranking members of the House committees on Energy and Commerce and Ways and Means wrote to the inspector general of Price’s agency saying the reported flights appear to violate federal rules and policies, and they demanded an immediate investigation,” Aaron reports.

“The flights aboard private jets — including one Price took last week in a cabin with high-backed leather chairs and a kitchen — have even led some senior administration officials to distance the White House from Price’s travel practices,” he adds. “A senior administration official who spoke on condition of anonymity said Thursday that the White House did not approve Price’s travel on chartered planes.”

AHH, OOF and OUCH

Sen. Bill Cassidy (R-La.) speaks on Capitol Hill. (AP Photo/Alex Brandon)

AHH: An internal analysis by the Trump administration concludes that 31 states would lose federal money for health coverage under the Cassidy-Graham health-care bill, with the politically critical state of Alaska facing a 38 percent cut in 2026, The Post’s Amy Goldstein and Juliet Eilperin report.

“The report, produced by the federal Centers for Medicare and Medicaid Services, focuses on the final year of a block grant that states would receive under the Cassidy-Graham legislation,” Amy and Juliet write. “It shows that government funding for such health insurance would be 9 percent lower overall in 2026 under the plan than under current law.”

“The predicted loss is less than that forecast by three independent analyses of the bill’s impact in recent days, but the internal numbers show a similar checkerboard of states that would be big winners and equally big losers. The states that expanded their Medicaid programs under the ACA would be hit with the greatest reversals of federal aid…the greatest winners in 2026 would be Mississippi and Kansas, where federal health-care funding would more than triple and double, respectively. On the other hand, Connecticut’s aid would be cut by just over half.”

Rep. Matt Cartwright (D-Pa.) responds to the protesters in May after the House passed its health-care bill. (AP Photo/Susan Walsh)

OOF: Sen. John McCain (R-Ariz.) won’t vote for the Cassidy-Graham bill because “he’s staring death in the face right now,” according to Pennsylvania Democratic Rep. Matt Cartwright. Cartwright was back in his district during the House’s week away from Washington and was caught on video making the comment about McCain, who had surgery for a serious form of brain cancer earlier this summer.

“McCain I’m worried about,” Cartwright said on Tuesday at a town hall meeting. “Also because the governor of Arizona came out in favor of the Lindsey Graham-Bill Cassidy bill so that puts pressure on McCain…But, man, something tells me McCain, he’s staring death in the face right now, so he’s probably going to make good choices and he’s not going to bend to political pressure.”

Watch the remark below:

[embedded content]

A water tower is seen in Flint, Mich. (Shannon Millard/The Flint Journal-MLive.com via AP)

OUCH: A new working paper shows the fertility rate in Flint, Mich., dropped precipitously after the city decided to switch to lead-poisoned Flint River water in 2014, The Post’s Christopher Ingraham reports.

That decline was primarily driven by what the authors call a “culling of the least healthy fetuses” resulting in a “horrifyingly large” increase in fetal deaths and miscarriages. Among the babies conceived from November 2013 through March 2015, “between 198 and 276 more children would have been born had Flint not enacted the switch in water,” write health economists Daniel Grossman of West Virginia University and David Slusky of Kansas University.

Grossman and Slusky compared birth and fetal death rates in Flint with those in other Michigan cities, including Lansing, Grand Rapids, Dearborn and Detroit. “These areas provide a natural control group for Flint in that they are economically similar areas and, with the exception of the change in water supply, followed similar trends in fertility and birth outcomes over this time period,” the authors wrote.

What they found was “a substantial decrease in fertility rates in Flint for births conceived around October 2013, which persisted through the end of 2015. Flint switched its water source in April 2014, meaning these births would have been exposed to this new water for a substantial period in utero (i.e., at least one trimester).”

TRUMP TEMPERATURE

President Trump. (AP Photo/Evan Vucci)

–Senate Republicans have made a calculated decision: Better to fail again trying to repeal the ACA than not to try at all, The Post’s Paul Kane writes. 

“That bet, made out of fear rather than a sense that victory is any nearer than it has been all year, can be traced to this year’s August recess — the five-week stretch back home that immediately followed the Senate’s previous, failed attempt to overhaul the nation’s health-care laws,” Paul writes. “The late-summer break, distant as it already feels to many of us, remains fresh in some lawmakers’ minds.”

“That’s the driving reason behind Senate Majority Leader Mitch McConnell’s decision to at least ‘consider’ holding votes next week on new legislation to repeal the ACA. Stuck in what might become the greatest damned-if-he-does, damned-if-he-doesn’t moment of his political career, McConnell is, for now, siding with those clamoring for another vote to repeal the health law.”

“All the more remarkable is the lack of evidence that the bill’s chances are any better this time around than they were in July,” Paul continues. “In fact, some Republicans openly expect another defeat. Yet they still believe that trying again is the only option.”

— Win or lose, President Trump appears to be all in. He’s been dispatching top officials to Congress. And, of course, tweeting about Cassidy-Graham. The president tweeted a warning this morning to Sen. Rand Paul, the Kentucky Republican who says he opposes the measure:

Rand Paul, or whoever votes against Hcare Bill, will forever (future political campaigns) be known as “the Republican who saved ObamaCare.”

— Donald J. Trump (@realDonaldTrump) September 22, 2017

HEALTH ON THE HILL

Sen. Lisa Murkowski (R-Alaska) is a key Republican holdout on the Cassidy-Graham bill. Photographer: Andrew Harrer/Bloomberg

–Alaska, Alaska, Alaska. Wither goes its GOP Sen. Lisa Murkowski, there goes Cassidy-Graham? Many people sure think so. Murkowski has been negotiating behind closed doors with GOP leaders on the measure, which she has said must not hurt her state if she’s going to embrace it. If Sens. Paul and Susan Collins (R-Maine) oppose the bill, Murkowski’s vote would be essential or the whole thing would crumble.

Interestingly, there’s a provision buried deep in the 140-page bill that would benefit Alaska, The Post’s Juliet Eilperin reports. Beginning on page 95, the bill has a provision that exempts low-density states whose block grants either decrease or stay flat between 2020 and 2026 from the Medicaid per capita cap. Under that scenario, both Alaska and Montana would be exempted from the funding cap that applies to all other states during that period.

Alaska Gov. Bill Walker speaks to reporters in June. (AP Photo/Becky Bohrer)

–Yet Alaska Gov. Bill Walker, an independent, has signed onto a letter with other governors indicating opposition to Cassidy-Graham. Yesterday, Walker told Juliet he was still looking for the kind of assurances that would allow him to support the bill but had not yet received them.

“I’m concerned about protecting Alaskans, and my comfort level is just not there yet,” he said, adding that the bill has to be written “in such a way that Alaska does not get hurt in the process.”

Walker said he’s especially worried about constraining federal health-care dollars through a fixed block grant because Alaska has so many remote communities and that, in turn, drives up the cost of health-care delivery.

“You can’t drive to 82 percent of our communities. That’s a concern,” he said. “When it comes to our health-care costs, they’re clearly the highest in the nation.”

You better believe Democrats will be jumping all over the provision benefiting Alaska. From Sen. Chris Murphy (D-Conn.):

The outright purchasing of votes. Everyone involved in this moral and intellectual monstrosity should be ashamed of themselves. https://t.co/A5ylD4CFhZ

— Chris Murphy (@ChrisMurphyCT) September 21, 2017

What we know about where Republican senators stand on Cassidy-Graham:

–1 opposes the bill (Rand Paul)

–3 have concerns (Murkowski, Collins and Arizona Sen. John McCain)

–22 haven’t said how they feel about it

–26 support it

–Keep up with The Post’s whip count, right here.

And here are a few more good reads from The Post and beyond:

MALPRACTICE

STATE SCAN

DAYBOOK

Today

  • The National Institute for Health Care Management Foundation holds a webinar on navigating care choices.

Coming Up

  • The American Enterprise Institute holds an event on “Innovative rethinking of health care delivery and competition” on September 29.

SUGAR RUSH

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Facebook, Google and Twitter face proposed bill targeting shadowy political ads – Washington Post


Facebook chief executive Mark Zuckerberg. (Eric Risberg/AP)

Democratic lawmakers are pushing for new legislation that would require greater disclosure of political ads that run on Internet platforms, despite a pledge by Facebook chief executive Mark Zuckerberg that the company will voluntarily pull back the curtain on political advertising on the social network.

Sens. Amy Klobuchar (Minn.) and Mark R. Warner (Va.) urged colleagues Thursday to support a bill that would create new transparency requirements for platforms that run political ads online akin to those already in place for TV stations, according to a letter obtained by The Washington Post.

The senators said that the Federal Election Commission, the independent agency that regulates political spending, “has failed to take sufficient action to address online political advertisements and our current laws do not adequately currently address online political advertisements published on platforms like Google, Facebook, and Twitter.”

While the senators suggested they were pleased that Zuckerberg promised to improve how Facebook reviews political ads and to enhance public visibility about who is purchasing them, they told colleagues, “This legislation would formalize, and expand, the transparency requirements Facebook has made.”

“This is an iconic company in many ways, but they really rely on the trust of their users. I think the steps they took today were important and necessary,” Warner said Thursday. “But there are still a lot of questions.”

A spokeswoman for Klobuchar did not immediately respond to a request for comment.

The bill would require digital platforms with more than 1 million users to create a public database of all “electioneering communications” purchased by a person or group who spends more than $10,000 on political ads online. In addition to storing a digital copy of the ad, the database would include a description of the targeted audience, the ad’s view count, the date and time the ad ran, its price, and contract information for the purchaser.

The measure would create a reporting system similar to the one required of television stations by the Federal Communications Commission, which collects public information about political ads aired on TV and the names of the groups that sponsor them.

There are disclosure rules for online political spending. Under FEC rules, all political committees, individuals and groups that pay to run ads on an Internet platform must report their spending in public filings and include disclaimers on the ads themselves that state the ads’ sponsors — just as they do for television ads.

However, as social media has played a growing role in campaigns, the commission has not drawn clear lines on what is required of small, character-limited political ads online. As recently as 2011, Facebook argued to the FEC that such ads should not require the usual disclaimer that runs with political messages because it would be inconvenient and impractical.

The revelations that Russian-financed ads ran on Facebook during the 2016 campaign prompted the usually divided FEC last week to reopen a long-delayed assessment of whether it should require more robust disclosure in online ads. The panel voted unanimously to seek public comments on whether it should update its Internet rules — drafted back in 2006 — when it comes to small, online messages. Ellen Weintraub, the Democratic commissioner who is calling for the new rulemaking, has said she plans to invite representatives from tech companies such as Facebook, Twitter and Google to attend a public hearing to discuss potential new regulations.

Read more:

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Uber Loses Its License to Operate in London – New York Times

LONDON — London’s transportation agency dealt a huge blow to Uber on Friday, announcing that it would not renew the ride-hailing service’s license to operate in the British capital, the company’s largest market in Europe.

“Uber’s approach and conduct demonstrate a lack of corporate responsibility in relation to a number of issues which have potential public safety and security implications,” the agency, Transport for London, said in a statement.

The license will expire on Sept. 30, but Uber has been given 21 days to appeal, during which it may continue operating in London. The company immediately vowed to appeal.

The decision is the latest problem to confront a company that has upended public transportation across much of the world by using smartphones to connect drivers with waiting passengers. That success has helped it grow into a behemoth worth around $70 billion, operating in major cities across the globe.

But along the way, Uber has faced an array of controversies, from allegations of sexual discrimination to its use of software to evade the gaze of authorities. Those and other issues contributed to the removal of its founder, Travis Kalanick, as chief executive this year, leading to a search that culminated in the appointment in August of Dara Khosrowshahi, the former head of the online travel site Expedia, as its new leader.

Uber had hoped that new leadership would help it turn the corner on a turbulent period.

The decision by Transport for London, which is responsible for the city’s subways and buses, as well as regulating its taxicabs, illustrates the gravity and severity of the issues confronting Uber. And a ban on operating in one of its largest markets — a global city where it has 40,000 drivers and 3.5 million customers use its app at least once every three months — would hit the company’s bottom line.

Transport for London said it had concluded that Uber was “not fit and proper to hold a private hire operator license.”

Among the issues it raised: how Uber deals with serious criminal offenses; how it conducts background checks on drivers; and its explanation for its use of a software program called Greyball that “could be used to block regulatory bodies from gaining full access to the app.”

Tom Elvidge, Uber’s general manager in London, said that the agency and London’s mayor, Sadiq Khan, had “caved in to a small number of people who want to restrict consumer choice.”

Uber conducted background checks using the same methods as those used for black-cab drivers, he said.

“Our pioneering technology has gone further to enhance safety with every trip tracked and recorded by GPS,” he said, adding that the company “have a dedicated team who work closely with the Metropolitan Police.”

He added that Greyball “has never been used or considered in the U.K. for the purposes cited by TfL,” or Transport for London.

Uber is used in more than 600 cities around the world, and in more than 40 cities and towns in Britain. According to the company, by 2015 it had driven Londoners almost 100 million miles, and taken them on 20 million trips.

“This ban would show the world that, far from being open, London is closed to innovative companies who bring choice to consumers,” Mr. Elvidge said.

John Colley, a professor at Warwick Business School, said the decision was the latest sign of an erosion in Uber’s corporate image.

“There is a very long list of businesses who have suffered for failing to uphold the level of values necessary,” he said. “Until Uber gets this message, then it will suffer lost trade as a result of its deteriorating reputation.”

Uber arrived in London in 2012, just ahead of the Summer Olympics, initially with a luxury service, adding UberX, which competes more directly with London’s storied black taxis, a year later.

Its debut here created a clash almost immediately with those black cabs, which trace their roots to 1634. To earn their licenses, black-cab drivers must memorize some 25,000 streets and 100,000 landmarks across the capital for an exam known as The Knowledge, considered among the world’s toughest.

Black-cab drivers complain that Uber drivers are under-regulated and that they don’t have to satisfy the same exacting standards. Moreover, Uber fares are about 30 percent lower than those of black cabs, whose drivers fear that Uber will put them out of business.

The conflict also involves tensions over ethnicity and class — most black-cab drivers are white native-born Britons, while many Uber drivers are immigrants who see the service as a means of seeking a better life.

Uber has said that it receives hundreds of complaints a month from its drivers about remarks from black-cab drivers. Among the insults hurled are “Uber slave!” and “Go back to your country!”

Many black-cab drivers have now signed up with competing apps like Gett and MyTaxi, which like Uber allow passengers to hail rides via their smartphones. Londoners can also choose from a wide variety of private-hire services, known as minicabs.

The GMB, a trade union that has challenged Uber in court in Britain, described the ruling as a victory.

“No company can be behave like it’s above the law, and that includes Uber,” Maria Ludkin, the union’s legal director, said on Friday. “No doubt other major cities will be looking at this decision and considering Uber’s future on their own streets.”

Ahmad Shoaib, an Uber driver, said the service was being unfairly targeted.

”I know there have been some problems with drivers, but most of us are good and reliable and play by the rules,” he said. “It is not fair to punish everyone because of the mistakes of one or two people.”

Mr. Shoaib switched to Uber from a minicab company in Croydon, in South London, after he saw how much work friends were getting from the ride-hailing service. He described Uber as “like our family business,” and added, “London needs Uber, it’s cheap and easy.”

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North Korea Hits New Level of Brinkmanship in Reacting to Trump – New York Times

SEOUL, South Korea — North Korea has long cultivated an image of defiant belligerence, punctuating its propaganda and diplomacy with colorful threats, insults and bluffs. But Kim Jong-un’s unprecedented personal statement released on Friday, and his foreign minister’s threat to test a nuclear weapon over the Pacific Ocean, represent a new level of brinkmanship by the government.

Speaking in the first person in his statement, Mr. Kim called Mr. Trump a “frightened dog” and a “mentally deranged U.S. dotard.” Saying he was personally insulted by Mr. Trump’s United Nations General Assembly speech threatening to “totally destroy” North Korea, Mr. Kim vowed to take the “highest level of hard-line countermeasure in history.”

Shortly after the North’s state-run news agency KCNA carried Mr. Kim’s statement, his foreign minister, Ri Yong-ho, delivered prepared remarks to reporters outside his hotel in New York, saying it was up to Mr. Kim to decide what to do, but that North Korea might conduct the “biggest ever hydrogen bomb test in the Pacific.”

Mr. Ri could not have made such an alarming comment without approval from Mr. Kim, although analysts doubt whether North Korea has the technology or political daring to conduct an atmospheric nuclear test, which the world has not seen for decades.

Mr. Trump on Friday responded with some name-calling of his own. On Twitter, the president referred to Mr. Kim as “obviously a madman.”

North Korea has often issued statements in the names of its government and its People’s Army, and since taking power in late 2011, Mr. Kim has delivered an annual New Year’s Day speech. But the comment on Friday was the first open statement ever issued toward a foreign head of state by a top North Korean leader.

By issuing a statement in his own name, Mr. Kim, whose cultlike leadership rests upon his perceived daring toward North Korea’s external enemies, has turned his standoff with the United States into a personal duel with Mr. Trump, analysts said, further raising the risks of the already volatile relationship between Washington and Pyongyang.

North Korean media carried photos of Mr. Kim sitting in his office and reading his statement. But his voice was not broadcast. On the country’s state-run Central TV, a female announcer read his statement.

”This is totally unprecedented,” said Paik Hak-soon, a longtime North Korea analyst at the Sejong Institute, a research think tank outside Seoul, referring to Mr. Kim’s statement. “The way North Korea’s supreme leadership works, Kim Jong-un has to respond more assertively as its enemy gets more confrontational, like Trump has.

”There is no backing down in the North Korean rule book,” Mr. Paik said. “It’s the very core of their leadership identity and motive.”

Until now, Mr. Kim himself has appeared to refrain from personal attacks on the American president, even as Mr. Trump has called him a “maniac,” a “madman” and a “total nut job.”

On Friday, Mr. Kim said he took Mr. Trump’s latest assault personally.

“Trump has denied the existence of and insulted me and my country in front of the eyes of the world and made the most ferocious declaration of a war in history,” he said.

Koh Yu-hwan, a professor of North Korean studies at Dongguk University in Seoul, said that Mr. Kim, faced with Mr. Trump’s threat of annihilation, could only respond equally forcefully.

“When Trump stood before the United Nations General Assembly and threatened to totally destroy his country, Kim Jong-un had to take that as the United States telling the world of its intention for possible military action,” Mr. Koh said. “He had to respond in kind, launching the same kind of verbal bombs.”

Analysts said that by putting his personal reputation on the line with his statement, Mr. Kim was now far more unlikely to stand down. Instead, his government would use the escalating standoff as an excuse to conduct more nuclear and missile tests, they said.

”Trump shot himself in the foot with his unabashedly undiplomatic United Nations General Assembly speech,” said Lee Sung-yoon, a Korea expert at the Fletcher School of Law and Diplomacy at Tufts University. “By threatening to totally destroy North Korea, he created the impression around the world that it is actually the United States — instead of North Korea — that’s motivated by aggression. In effect, Trump gave Kim Jong-un a freebie for another major provocation. Kim will oblige, and claim that it was in ‘self-defense’ against Trump’s unnerving threats.”

Daryl G. Kimball, executive director of the Arms Control Association, compared the Korean standoff to the October 1962 crisis over Soviet missiles in Cuba, urging the United Nations’ secretary general, António Guterres, to convene the six parties that were previously involved in talks on denuclearizing the Korean Peninsula — China, Japan, North Korea, Russia, South Korea and the United States — to discuss reducing fever-pitch tensions.

”We are in a cycle of escalation that leads to a very bad end,” Mr. Kimball said.

North Korea has conducted all of its six nuclear tests within deep underground tunnels to diminish the spread of radioactive materials, and has stepped up the pace of its missile tests. Some analysts fear that the next step might be for North Korea to try to prove that it can deliver a nuclear warhead on a long-range missile, no matter how dangerous and provocative that might be.

It has been 37 years since any nation tested a nuclear weapon in the planet’s atmosphere, reflecting the nearly universal opposition to such tests over fears of the effects of radioactive fallout on human health and the environment. The last atmospheric test took place in 1980, when China fired what experts believed to be a nuclear-tipped ballistic missile into a desert salt flat more than 1,300 miles west of Beijing.

Shin Beom-chul, a security expert at the government-run Korea National Diplomatic Academy in Seoul, said that even if North Korea wanted to conduct an atmospheric nuclear test in the Pacific, it did not have the ability to dispatch test-monitoring ships to the open ocean while the United States military was on the prowl.

Mr. Shin said North Korea probably would not risk the radioactive fallout and other grave dangers involved in a nuclear missile test. The country has yet to master the technologies needed to prevent the warhead at the tip of its long-range ballistic missile from burning up while re-entering Earth’s atmosphere from space, South Korean officials said.

”What if the nuclear missile goes wrong mid-flight and detonates over Japan? It would mean a nuclear war,” Mr. Shin said. “More likely, North Korea will graduate its provocations, as if moving on steppingstones.”

Analysts said North Korea had been escalating tensions in stages in what they called a “salami tactic,” as in slice by slice.

Kim Dong-yub, a defense analyst at the Seoul-based Institute for Far Eastern Studies of Kyungnam University, said that North Korea would probably try to disprove skeptics in the West over its ability to strike long-range targets by firing its Hwasong-14 intercontinental ballistic missile over Japan and father into the Pacific — but without a nuclear payload.

Some analysts said North Korea’s Mr. Kim was acting more defensively than offensively, with his threats aimed at forcing the Trump administration to ease sanctions. On Thursday, Mr. Trump issued an executive order empowering his government to punish international banks and other entities that trade with North Korea.

But other analysts warned that North Korea’s determination to improve its nuclear capabilities — and act offensively — had long been underestimated.

“If we follow what North Korea has been doing, it will be almost certain that it will fire its missile sooner or later to demonstrate an ICBM range,” Mr. Kim, the Kyungnam University analyst, said. “I don’t think the missile will carry a nuclear warhead, but I can’t shake off the fear that it might, because North Korea has time and again carried things beyond my expectation.”

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