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House GOP Defends Obamacare Replacement Bill; GOP Critics Blast GOP's New Plan As "Obamacare Lite" Aired 11-11:30a ET
Aired March 7, 2017 - 11:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
UNIDENTIFIED FEMALE: -- with respect to the executive order, ordering a review of regulations on the books, my recollection is that President Obama issued something quite similar during his term in office. And I haven't studied what the results of that study were.
In terms of the other executive order, again, I haven't studied it, but I think that any regulatory action taken by any agency of the government has to comply with the requirements of the Administrative Procedure Act, which require reason decision making. That statute remains in place.
But as to the interplay between the APA and the executive order, those decisions would fall in the first instance to the regulatory agencies themselves, but I would have to study it further.
UNIDENTIFIED FEMALE: Thank you very much. Thanks, Mr. Chairman.
UNIDENTIFIED MALE: Senator Hatch?
UNIDENTIFIED MALE: Thank you, Mr. Chairman. Let me first say that I --
KATE BOLDUAN, CNN ANCHOR: Hello, everyone. I'm Kate Bolduan. You have been listening to senators on the Senate Judiciary Committee questioning the nominee to be deputy under Attorney General Jeff Sessions. Rod Rosenstein would be the man in charge of the investigation into ties between the Trump campaign and Russia since Jeff Sessions recused himself last week.
You can see where the line of questioning is going already though he's saying he's not in the position yet. He doesn't know the facts and so he's saying he can't answer the question about should there be a special independent prosecutor yet.
We are going to discuss this in just a moment. But first, we're also following breaking news on the other side of the Hill. House Republicans right now defending laying out rolling out the Obamacare replacement bill. Let's listen in.
REPRESENTATIVE GREG WALDEN (R), OREGON, ARCHITECT OF NEW GOP BILL: -- promise to not pull the rug out from anyone, including those on Medicaid. We are also creating a new and innovative, patient and state stability fund to help low income Americans afford health care and to repair the damage done to state insurance markets by Obamacare and we return power back to the states. We strengthened Medicaid and we prioritize help for our nation's most vulnerable. Simply put, we believe we have a better way to deliver solutions to patients, not Washington bureaucrats first. We provide the American people what we've asked for and what they've asked for, greater choice, lower costs and flexibility to choose the plan that best suits their family's needs.
Introduction of this bill is just the first step in helping American families across the country obtain truly affordable health care and we're eager to get started. Now turn it over to my colleague, the chairman of the Ways and Means Committee, Mr. Brady.
REPRESENTATIVE KEVIN BRADY (R), CHAIRMAN, WAYS AND MEANS COMMITTEE: Greg, thank you all for joining us today. Seven years ago, Obamacare put Washington in control of Americans' health care and for seven long years this failing law has hurt more people than it's helped. Families can't afford their premiums. Patients can't visit the doctor that they like and fewer insurers are often coverage options every day.
It's getting worse. With President Trump now in office, House Republicans are taking action to deliver relief to Americans now. This week, House Republicans have introduced legislation to repeal this failing law and to help ensure Americans have access to health care that's tailored to their needs.
Not health care dictated and tailored to Washington's needs. The American Health Care Act transfers power from Washington back to the American people. We restore state control of health care so it can be designed for the families and communities in each state.
We restore the free market so Americans have a greater choice of products tailored again to what they need, what their family needs. So in the Ways and Means Committee, our role is first to act now, dismantle Obamacare's unpopular taxes and mandates that have hurt jobs and driven up health care costs.
To enhance and strengthen health saving accounts so people can spend their health care tax dollars the way they need to. And we're going to help low and middle income Americans access affordable, quality health care with a monthly tax credit. It's immediately available.
As Health and Human Services Secretary Price wrote today, this morning, our legislation aligns with the president's goal of rescuing Americans from the failures of the Affordable Care Act. Secretary Price also wrote that our bill, our bills are a necessary and important first step toward fulfilling our promises toward the American people.
I encourage you to read the bill and cover our action tomorrow. This bill is available to the American public. Contrast this to the Affordable Care Act, 2,400 pages written in the dark of night and rushed through Congress.
[11:05:00]This legislation is a little over 100 pages and every American can read and understand it. House Republicans promise to deliver a step-by-step effort to provide relief from Obamacare and give people the health care they deserve. We take that critical first step tomorrow.
WALDEN: With that, we'd be happy to take your questions.
UNIDENTIFIED FEMALE: You criticized Democrats for years for pushing through Obamacare before people had a chance to read it. But now you're holding committee votes as early as this week on a bill nobody knows how much it's going to cost. Nobody knows how many people will lose coverage. Aren't you doing the exact same thing?
WALDEN: No, not at all. In fact, the bill went online live for the entire American people, all of you, all of us to read. All of our colleagues to read at 6:00 last night. It's as my colleague said, not that much to get through. It's pretty well understood. And it's keeping in practice with reconciliation legislation.
As you know when the Democrats did reconciliation, they didn't have a CBO score before it went up to the Budget Committee. That's pretty much how it operates. We'll proceed with our mark-ups. There will be a CBO score coming and we look forward to that before it comes to the House floor so all the members of our Congress have an opportunity to see that.
UNIDENTIFIED FEMALE: Critics are already blasting this as Obamacare Lite. What's your message to your Senate colleagues who are already saying this bill will not pass?
WALDEN: Well, we had a good briefing with our Senate colleagues last week, walked through with them the various provisions. I'd encourage them to actually read the bill, find out what's in it. I've sent notes and copies over to some of the senators who are seeking the bill. So they can read through it.
We are repealing and replacing Obamacare. We start with the 2015 reconciliation legislations, the underpinning document, and we're moving forward to get health insurance where it's affordable and available to create more choices in the marketplace and to do the biggest entitlement reform since Bill Clinton signed welfare reform into law.
So these are big measures moving forward. We've certainly met the test of the president and Secretary Price who believed this is repeal and reform. We will work with them, but we need them to board to make this happen.
BRADY: I might add, too, this is Obamacare gone. This is the first and most important step to giving relief to Americans from this terrible law, and to begin the replacement principles of restoring state control and restoring the free market that conservatives, moderates, all Republicans have built consensus around.
Dr. Price's own legislation last year, which we embraced in our Republican plan had an 84 co-sponsors, including members and leaders of the freedom caucus, the roc and the Republican conference. We're following that consensus. And here is I guess my main point. As Republicans, we have a choice. We can act now or we can keep fiddling around and squander this opportunity to repeal Obamacare and begin a new chapter of freedom for the American people. House Republicans are choosing to act now.
UNIDENTIFIED MALE: Comment on the president's (inaudible) and opening negotiation. So how much of this bill are you guys willing to negotiate? On the one hand you have conservatives in your own caucus that are going to hold a press conference later today and say they don't like it. On the other hand, they're going to attack you because it covers less people and it's going to reduce the protection (inaudible) --
WALDEN: This is -- we've held a lot of listening sessions with our conference members. I've met individually with the leaders of the various groups within our conference. We had a lot of discussions over the weekend with the White House and various folks there.
It is a legislative process. We now have a bill that's available for all to read, and I encourage you to do it. I'd encourage them to do it. I'd encourage them to look against their own bills and what they've supported in the past and then let's have a thoughtful legislative discussion.
There's a process before each of our committees. There would be a process at the Budget Committee. There's a process at the Rules Committee and then it will come to the floor. So this is an important step moving forward, though, to fulfill our promise to the American people to repeal and replace Obamacare.
UNIDENTIFIED MALE: That the metric of how many people are covered is not the proper way to engage the success of the health care program?
WALDEN: Well, you know, it's interesting because if you go back to what CBO predicted would be covered on the exchanges today, they are only off by about a 2-1 ratio. So there were 21 million they projected would be covered, 10 million are actually covered and the worst part of that is we're chasing young people away from insurance coverage through the various Obamacare mandates.
So as a result, 45 percent of those people who decided not to sign up for Obamacare and pay the penalty instead or get an exclusion are people under the age of 35.
[11:10:09]We need to reform those markets to give options that are affordable and available to more people to actually come on to insurance coverage.
We also believe the reforms under Medicaid will allow states to innovate and drive more of their dollars into coverage rather than into the bureaucratic process they have to go through to get waivers.
UNIDENTIFIED FEMALE: (Inaudible ] was one of the main options they were looking at to pay for it. What was the thought process behind not putting that in the final bill and is that something you decided on (inaudible) -- BRADY: So we have been listening very carefully to House Republicans.
The entire conference, across the philosophical spectrum about how best to restore state control. How best to return -- create a free market and how to make sure we do that in a way that balances in the budget.
We looked very seriously at the option of actually providing the same health care available work to others through the exclusion. At the end of the day, our conference, the direction they gave us was that was not a provision they were comfortable today and so we decided to again go a different direction. Yes?
UNIDENTIFIED FEMALE: Will this cover more Americans or less Americans than it covers right now?
BRADY: Will it cover more Americans with affordable health care than today is probably the key question. Here's what I know in Texas in our district. More people have opted out, found a way to get out of Obamacare than are taking it, and those who have it, frankly, can't use it. The deductibles are too high. Co-payments are too high. It's just a card. It doesn't help them.
Under our approach, by returning innovation to the states and actually giving Americans a broad choice of plans they can actually use, I believe we're increasing access to affordable care for those who want it. And I think that's an important distinction here. And as I see the tax credit, I have a small business background as a Chamber of Commerce executive.
So for decades I watched small businesspeople, entrepreneurs, mom and pop companies struggle to get health care. While workers and big businesses got all the help. So under the Republican plan for the first time, look, if you work hard and play by the rules, you were treated equally.
You get that help as an entrepreneur. So those businesses frankly aren't taking the Affordable Care Act. Those small businesses, it doesn't help them.
WALDEN: Here's what we do know. That last year, 225 counties in America had one option left for people to choose from on the exchange. This year it's 1,022 and that was before Humana pulled out. This insurance market is collapsing before our eyes. The CEO of Aetna said it's in a death spiral. Those aren't our words. Those are his words, and he's in that market.
As I talk to insurers, they are looking whether they can sustain the losses that they're now enduring because the way the market is created. So the facts of the matter are not what this will or won't do going forward.
The facts are we've arrived at the scene of a pretty big wreck and we are trying to clean up the mess. If we don't intercede now, fewer will have access to insurance, period. We're not kicking anybody off Medicaid that's on it today. You can read that in the bill pretty clearly. We're going to devolve power back to the states, decision-making back to the states and hopefully expand access to affordable insurance that people can take advantage of. When you're down to one out of three counties in America, one plan and in some cases next year we're hearing there may be zero, that's the gap that we're trying to prevent.
UNIDENTIFIED MALE: (Inaudible) Candidate Trump and President Trump have been promising better coverage, lower costs and better health care. Do you think you're on the road to that, meeting that goal right now?
WALDEN: Not only do I think that, I think Secretary Price believes that and President Trump believes that based on the letter that they've sent -- the letters they've sent us, the communications they've issued.
UNIDENTIFIED FEMALE: So do you have internal numbers of how many people may lose their health care? And is there a reason you won't share that with us or the American people?
WALDEN: We're waiting for CBO to give us a score of the bill as its print.
UNIDENTIFIED FEMALE: When do you think you'll get that?
WALDEN: That's up to CBO.
UNIDENTIFIED MALE: Can you explain a little bit about this insurance cap, premium or hike or fine or whatsoever it's being called and how that's different than the current individual mandate?
WALDEN: Yes, sure. So we're looking at continuous coverage. This is not a novel concept, by the way.
[11:15:05]It's -- you'll find a similar version of this to cover pre- existing conditions in Medicare Part B, Medicare Part D and in the employer market. So we modeled it after that.
One of the issues we found is that some people were gaming the system with guarantee issue. It's not that they had a pre-existing condition necessarily. It's they pay for nine months of insurance, get 12. The other three for free, automatically come back in the market.
That was part of what's causing this spiral downward. We want to make sure if you have a pre-existing condition, you get coverage, and that the coverage is not rated based on that condition. It's just if you let it lapse, if you didn't pay the premiums.
There was a marginal penalty there going backwards. It's a little bit like you don't get to buy fire insurance for your house when the roof is on fire. You have to buy it ahead of time. It's a little different I realize when it comes to health care, but the concept is continuous coverage.
You can have a gap of 63 days, basically that's two months. That's how it is in other areas of federal law today. Our goal is to make sure that if you have a pre-existing health condition you're not denied insurance or priced out of the market because of that condition. That's what we accomplished here.
UNIDENTIFIED FEMALE: (Inaudible question).
BRADY: Yes, I disagree. You know, I look at the 20,000 jobs that have left America because of the irresponsible medical device tax. I look at the health insurance taxes and others that drove up health care costs on Americans, especially those who could least afford it.
You run down tax increase after tax increase after tax increase, they hurt the economy. They hurt health care. They achieve nothing. I don't want Americans to continue to struggle under the Obamacare taxes, which is why we are moving to repeal them, as well as the subsidies.
And at the end of the day, for this to pass the Senate, this has to balance within the budget and the window that we've been giving, and we'll make sure it does.
UNIDENTIFIED MALE: Where are the deviations between the 2015 bill and this bill this year?
BRADY: So on the side that we're focused on, very little from the standpoint of repealing the taxes, the penalties on the mandates and the subsidies, as well, making sure that we are defunding Planned Parenthood and redirecting those dollars to community health centers so women have those services where they need them.
So we use the 2015 reconciliation bill as the foundation for repeal, but we go farther with those two key principles. Returning state control so communities can get health care designed for them. Restoring the free market so people can choose health care they need.
WALDEN: Yes, and from our standpoint, I think we have crafted the biggest entitlement reform in the last 20-plus years by going to a per capita allotment back to states for the traditional Medicaid population. I don't believe that was in the 2015 reconciliation bill.
I that's really important to empower states, and to put Medicaid on a budget. So that's probably the biggest, and we have the patient stability and state stability fund in here as well because there's been all this damage done to the market itself.
We want states to be able to come in whether it's Texas or Oregon. We have vastly different decision making that's gone on in health care in our states to be able to help out.
UNIDENTIFIED MALE: (Inaudible), is that going to be an annual pay-in by Congress, or is that going to be set up as an endowment that just --
WALDEN: I think it's $100 billion fund over ten years. It will be about $10 billion a year out to the states if they could know that it's coming to their states. UNIDENTIFIED MALE: Have you talked to any states that didn't expand and determined if they will expand if this law were (inaudible) --
WALDEN: We've talked to a lot of states. As you might imagine I've heard from a lot of governors, had some very productive discussions. They can -- I don't believe they'll be allowed to expand if they haven't expanded before, but if they have the expansion they can add new people on under December 31st, 2019.
Now why do we do that? Because the states have told us, and others have informed us that you have got to have a transition period here that works for the people that are on Medicaid and that works until Mr. Brady's tax piece is up online.
And, remember, with the insurance markets, it takes them a year or so to come up with the new plans and policies and get them out there. So what we're trying to do is what we pledged we would do, not pull the rug out from anybody.
[11:20:01]Make sure there's a transition to a better way with more policies, more opportunities and a more fair health system.
UNIDENTIFIED MALE: (Inaudible).
WALDEN: You'd have to ask the individual governors.
UNIDENTIFIED MALE: On the tax policy --
UNIDENTIFIED MALE: (Inaudible) small businesses. So this is going to repeal that net investment tax. How does that fit into your broader tax vision with the rate cuts?
BRADY: Well, clearly, we have an economy that's struggling. Worst recovery in half a century. We have some young people that can't find good paying jobs. A lot of people have given up. So part of this is to remove the damaging, we think job killing taxes in the Affordable Care Act.
To lower the cost but also it fits in to our vision of the tax reform proposal that's built for growth, built for the growth of jobs and wages in the U.S. economy. I think a key element of the tax credit is that it is really targeted and tailored to the individual.
It's a credit that's immediately available to them. It grows and increases with age because your health care costs go up as you get older. Expands with your family because you have greater needs as a family. It's a credit that you can take from small business to small business.
From state to state, home if you are starting a business or raising a family, even as you are approaching retirement. This is unprecedented freedom. And I would note, too, that in this legislation, thanks to the work of Chairman Walden. That those who are on the ACA today, who are watching it slowly collapse, they'll actually be able to buy products off the exchanges, including catastrophic coverage that's very important to them as we make this transition. And so it is very carefully and deliberately thought out.
WALDEN: Thank you.
KEILAR: All right, there you have it. Chairs of -- let's just call them for the architects of the Republican replacement to Obamacare. They promised it. They campaigned on it. They won elections on it. They energized a huge swath of the country around it.
Today is the day after years of rallying against Obamacare, Republicans finally roll out their plan to replace it. And already, as you can see from the line of questioning, the fight is on. Not just with Democrats but among Republicans themselves.
President Trump, where is he on this? He tweeted this this morning, "Our wonderful new health care bill is now out for review and negotiation."
All right, let's get to this. CNN congressional correspondent, Sunlen Serfaty is on Capitol Hill. We've got the sales pitch from Kevin Brady and Greg Walden, Sunlen, but sum it up for everybody who needs to know. What stays? What goes?
SUNLEN SERFATY, CNN CORRESPONDENT: Yes, that's such an important question, Kate, especially as you noted that one of the main lines of attack and a catch phrase that's quickly catching on up here on Capitol Hill among some conservatives is that this bill boils down to, in their words, Obamacare 2.0 or Obamacare-Lite.
You heard Representative Brady trying to beat back on that criticism. Defend the bill saying this is Obamacare gone. So those semantics aside, here's what would stay and what would go according to this new plan.
What stays is this plan still allows children to stay on their parents' plan until age 26. It largely keeps the Obamacare protections of those with pre-existing conditions in place and keeps the no annual lifetime limits in place.
But there are still many notable differences. It repeals the individual and employer mandate. Repeals out-of-pocket subsidies and changes Medicaid expansion.
And as you know, Kate, you've been covering that specific point, the restructuring of Medicaid makes many conservatives very nervous especially those Republicans from the Medicaid expansion states -- Kate.
KEILAR: Yes, Medicaid expansion, there is an issue there. Tax credit, there is a real issue there. Sunlen Serfaty, great to see you. A lot more to come so let's chew through it, my panel right now, Mark Preston is here with me. Gut check. Greg Walden, Kevin Brady, they think it's great.
They think it's -- they have -- probably didn't say perfect but this is what they've got. Here is the big replacement and the big reveal. Can it get to the president's desk?
MARK PRESTON, CNN SENIOR POLITICAL ANALYST: In its current form, absolutely not. It's not even Democratic opposition. It's the Republican opposition. Not only in their own chamber, but certainly what we're seeing from United States senators across the capitol.
KEILAR: It's for various reasons. Rana, one of the big questions is how much is this going to cost? You heard from the lawmakers. They don't need that cost estimate from the CBO. That will come later. If they're working without it right now, is that telling?
RANA FOROOHAR, CNN GLOBAL ECONOMIC ANALYST: There's a lot of concerns on cost. Let's start by saying that Obamacare was unpopular in many ways because the whole U.S. system is screwed up. I mean, on either side of the aisle, you have a mishmash between public and private.
[11:25:01]The U.S. has the world's most expensive health care system about 2500 more per capita than Switzerland which is the next most expensive. We have terrible outcomes. I don't think that this plan actually moves us away from that.
I think what we need is economies of scale. I personally think that that means more government involvement in health care. That's an ideological issue between Republicans and Democrats. That's not what you'll get here.
Because when you get rid of individual mandates and employer mandates, you'll get less people signing up. That's going to drive up health care cost. You probably going to get sicker people staying on the plan and healthier people going off of it, and that's going to mean higher premium. So I don't see the economics here working.
KEILAR: There's one tough problem. The other thing is markets, too, Alex, is simply numbers. I'm talking about the vote count in the Senate. The vote count in the House. I mean, if you are losing the House Freedom Caucus, a group of conservatives, maybe even the Republican Study Committee, if they lose that, they're done.
You already have Republican senators coming out of the Senate saying they have an issue. If they can't get there, they have the Heritage Foundation coming out against it. Where are they?
ALEX CONANT, FORMER COMMUNICATIONS DIRECTOR, RUBIO FOR PRESIDENT: This is the beginning of the process. I don't expect they'd put out a bill today that every Republican would in lock step say, yes, this is the plan I support especially after seven years of all these members working on their own plans and own ideal version of what would replace Obamacare. But I do think that this is a very good first step. Not only because you have House and Senate leadership united behind this plan, but you have President Trump this morning tweeting out that this is a plan that he supports.
If he's able to put his political capital behind this plan, put some shoulder into the legislative push, they can earn those votes, but they have to earn them. That's what -- today was the start of a long campaign to win passage.
KEILAR: I think the most important thing other than everything you say is important. Alex, one of the most important things you said right there is if the president -- if he puts some skin in the game. I get the sense from Republicans so far they haven't seen it and that is a concern.
The statement coming from the White House so far. We read -- we read that tweet. I read you the tweet from the president saying our wonderful new health care bill is out for review and negotiation. The White House putting out a statement yesterday from Sean Spicer, "President Trump looks forward to working with both chambers of Congress to repeal and replace Obamacare.
When you see that, I think, how much of an endorsement is that? Is he really sticking his neck out for this?
KAYLEIGH MCENANY, CNN POLITICAL COMMENTATOR: I think he is. I think there's a lot of intentional positioning going on behind the scenes. He did call it our bill. He did call it wonderful. He is endorsing the bill. I think this bill was intentionally put out in a form that was less than appealing to the conservative hard liners to the House Freedom Caucus because what was so interesting about the president's tweet is he called it a negotiation.
What does the art of the deal tell us? It tells us you put forth the strictest, most hard line position and you negotiate and give a little. Don't put out like for instance, crossing state lines, allowing insurance companies to cross state lines.
Don't put that in now even though the president is behind it. Allow that to be something that you give to conservatives. There's a lot of conservative proposals that were not put in this because those will be the carrots given to the conservative wing of the party to ultimately get the votes needed.
KEILAR: Paul Begala, joins us here, Democratic strategist. From a communications standpoint, though, if you have conservatives calling this Obamacare Lite, how do you beat back that narrative?
PAUL BEGALA, CNN POLITICAL COMMENTATOR: As they move to the right, Kayleigh is almost certainly correct that this will move to the right. Then they'll lose votes in the middle, particularly in the Senate side. There is a lot of Senate Republicans who are worried that this will cripple the Medicaid expansion in their state.
But the fundamental thing is they still can't tell us two questions, the two most important. How much does it cost? Who does it cover? We don't know yet and we'll find that out in time. The Congressional Budget Office will score this. We shouldn't debate it until they have.
But I guarantee you this, before the Congressional Budget Office has reviewed the bill, I bet my life House Republicans keep their health care on this. Senate Republicans keep their health care on this. Congressmen and senators, believe me, they are not going to kick themselves off, but they're going to kick millions of Americans off.
And that's the political problem they will face. They will go home to their town hall meetings and people will say, wait a minute, I work for a living and you are taking away my health care, and you work about four days a month and you make me pay for yours? It's untenable politically.
KEILAR: And that is one question that is already, Nia Malika, join us here, that Republicans are already facing. How many are more or less Americans going to be covered on the plan? So far, the answer has not been an answer.
You heard Kevin Brady say they're going to be increasing access to affordable care for those who want it. That might be great for some, but on the issue of especially access to health care for low-income Americans, this is how Congressman Jason Chaffetz answered that question this morning on CNN.
(BEGIN VIDEO CLIP)
REPRESENTATIVE JASON CHAFFETZ (R), UTAH: Americans have choices and they've got to make a choice. Maybe rather than getting that new iPhone they love and want to spend hundreds of dollars on. Maybe they should invest that in their own health care. They have to make those decisions themselves.
(END VIDEO CLIP)
KEILAR: He's trying to clean up -- already trying to clean up those remarks, Nia, but remarks like that is going to come back to bite him?
NIA MALIKA HENDERSON, CNN SENIOR POLITICAL REPORTER: I think so. It might come back to bite him in terms of Donald Trump. Donald Trump has been the one thing that he wants people covered. He doesn't want to see people dying on the street and not having a health care.