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THE LEAD WITH JAKE TAPPER
Interview With Louisiana Congressman Steve Scalise; House Passes Health Care Plan; House Passes Bill to Replace Obamacare; Interview with Republican Congressman Leonard Lance of New Jersey. Aired 4-4:30p ET
Aired May 4, 2017 - 16:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
ANNOUNCER: This is CNN breaking news.
JAKE TAPPER, CNN ANCHOR: Thanks, Brooke.
And welcome to THE LEAD.
We are going to begin with breaking news in the politics lead.
Of course, after seven years of campaigning, and promising and false- starting, today, Republicans actually did it. The House voted to repeal and replace the Affordable Care Act, otherwise known as Obamacare. They needed 216 votes. They got 217.
(BEGIN VIDEO CLIP)
UNIDENTIFIED CONGRESS MEMBERS (singing): Nah, nah, nah, hey, hey, hey, goodbye.
(END VIDEO CLIP)
TAPPER: If you can make that out, that rendition of, nah, nah, nah, hey, hey, hey, goodbye originally by the band Steam is, according to Dana Bash on the Hill, House Democrats singing goodbye to Republicans whom they believe will lose their seats over this vote.
The bill still faces major hurdles in getting through Senate, of course, but let's take a look at some of the biggest changes under this plan.
First of all, states will have the option to allow insurers to deny coverage to people with preexisting conditions as long as those states establish high-risk pools or other programs for those vulnerable people. States will also have the option whether insurers have to provide so-called EHBs, or essential health benefits, such as maternity care or mental health care, in their insurance plans.
The bill will repeal Obamacare subsidies and replace them with refundable tax credits, will be based on age and income. It will drop the government requirement or mandate on individuals or companies to buy insurance. But it will require insurance companies to charge you more if you don't have continuous coverage. It turns Medicaid over to the states with a fixed amount funded by the
federal government and will eliminate Obamacare taxes on wealthy Americans, insurers and others.
Here is what President Trump just moments ago in a Rose Garden ceremony promised that this bill will accomplish for you.
(BEGIN VIDEO CLIP)
DONALD TRUMP, PRESIDENT OF THE UNITED STATES: Yes, premiums will be coming down. Yes, deductibles will be coming down.
But, very importantly, it's a great plan. And, ultimately, that's what it's all about.
(END VIDEO CLIP)
TAPPER: We will see if premiums and deductibles go down. So much remains unknown because, frankly, this bill was passed before the Congressional Budget Office could analyze it and weigh in and share it with the public.
We don't know how much this will cost or how many people will be affected and in what way.
So, yes, a political victory for President Trump and House Republicans today. TBD on the policy and whether it will be a win for you.
President Trump is applauding House Republicans after today's vote, of course. Some were bussed over to the White House to be by his side. He spoke moments ago, saying this is a good first step.
Let's go to Jim Acosta at the White House for us.
And, Jim, now it is time for the president to make deals with the Senate to get something passed through the Senate. What is the president's message, as we all watch this bill move forward into that process?
JIM ACOSTA, CNN SENIOR WHITE HOUSE CORRESPONDENT: I think the message from this president is to trust him.
You know, he worked the phones mightily throughout this process, Jake, and, you know, I think, at this point, you know, this was a victory lap here in the Rose Garden, but perhaps a half a victory lap, because, as you have been saying, this not only has to go through the Senate, it has to perhaps, after the changes are made there, go back to the House and satisfy all of these Republicans and even some Democrats who are going to have to vote in favor of making these changes to Obamacare.
And so we're well, well short of the finish line for the White House and for Republicans in Congress to repeal and replace Obamacare. But you heard the president here in the Rose Garden try to make the case that this is going to lower premiums for Americans, lower deductibles for Americans. You heard Republican lawmaker after Republican lawmaker vow to the American people here in the Rose Garden of the White House that people with preexisting conditions will still be protected under Trumpcare.
Obviously, there are a lot of critics out there who say, no, that is just not going to be the case. And we're going to have a Congressional Budget Office score coming out here in the next couple of weeks that will talk about that.
But you heard the president here in the Rose Garden just within the last hour talk about his prospects in the Senate, essentially almost guaranteeing that it is going to make its way through the Senate and eventually get to his desk. Here is what he had to say.
(BEGIN VIDEO CLIP)
TRUMP: It's dead. It's essentially dead.
If we don't pay lots of ransom money over to the insurance companies, it would die immediately.
Coming from a different world and only be a politician for a short period of time, how am I doing? Am I doing OK? I'm president. Hey, I'm president.
TRUMP: Can you believe it? Right? I don't know. I thought you needed a little bit more time, they always told me. More time. But we didn't.
(END VIDEO CLIP)
ACOSTA: Now, you heard during the president's remarks there, Jake, talk about how Obamacare is dead. That's something that you're be hearing time and again.
And it is really a prebuttal to this debate that is going to be taking place over the next weeks and really months as this tries to make its way through the Senate. And that is because of this concern about what is going to happen with people with preexisting conditions.
We heard one official over at the White House earlier today saying it is impossible to score just how many people are going to lose their insurance because of the different protections for people with preexisting conditions in Trumpcare.
That is a preview of coming attractions, Jake, when it comes to this debate. It is not over yet -- Jake.
TAPPER: All right, Jim Acosta for us at the White House, thank you so much.
Joining me to now talk about this more is House Majority Whip Congressman Steve Scalise.
Congressman, thanks so much. Congratulations on the victory.
What do you think finally brought your -- you guys over the top?
REP. STEVE SCALISE (R-LA), HOUSE MAJORITY WHIP: Well, good to be with you, Jake.
And really what it was is a lot of members coming together, focused on how we lower premiums for families that are struggling under Obamacare. And then, of course, in the last few days, some of our members that weren't quite there yet wanted to do even more. And we already do a lot to protect people with preexisting conditions, but wanted to do more to actually focus on lowering the premiums even lower than where they are today, because a lot of people with preexisting conditions today are paying very high premiums and they actually have massive deductibles, in many cases over $10,000, that really makes their insurance meaningless, if they're not able to -- have to pay so much money out of pocket.
So, we put additional money in place to lower premiums even more for people with preexisting conditions. And that was one of the final pieces that got it over the top.
TAPPER: Right. You put in $8 billion over five years to help with those high-risk pools, so states can put individuals, if they allow insurance companies to not provide insurance, to discriminate against people with preexisting conditions, the high-risk pools will cover them.
But $8 dollars, even conservative think tanks say that that's not going to be enough to help pay for these individuals. As you know, that's one of the big expenses is paying for sick people, paying for people who have preexisting conditions.
So, why was $8 billion a selling point, if not even the Heritage Foundation or the American Enterprise Institute think that is going to be enough to help with the high-risk pools?
SCALISE: Well, first of all, the premise of your argument is inaccurate.
There is no discrimination against people with preexisting conditions. In fact, in our bill, we actually have a protection that says nobody can be denied coverage with preexisting conditions. And we also have a provision that says if you have continuous coverage, meaning as long as you keep insurance, even with a preexisting condition, then a state can't even request a waiver to deny you coverage.
So, everybody is protected already. The real concern was the cost. And so the experts were telling us about $5 billion in those states that sought a waiver from certain provisions of the law would be enough to make sure that you could truly buy down premiums, so people with preexisting conditions could actually see their rates go down from where they are today. Our members wanted to make sure we did even more, and so ultimately we
bumped that up. Instead of $5 billion, we bumped it up to $8 billion, which, again, only applies in the states that would seek a waiver from some of the provisions of this bill.
But, ultimately everybody, even in a waiver state, has full protection if they have a preexisting condition already. Now we are focused on lowering their premiums even more, so, in many cases they won't have these massive $10,000 deductibles that they have under Obamacare.
TAPPER: I'm afraid I don't understand, so maybe you could help me out.
I thought that your bill would allow states to allow insurers to not be required to provide insurance for people with preexisting conditions, as long as those states made sure that there was something to take care of those people. What am I getting wrong?
SCALISE: No, there is a specific provision in our bill with the MacArthur amendment, one of the final changes, that makes it very clear that everybody, including people with preexisting conditions, have what's called guaranteed -- guaranteed issue, meaning no matter what your health status is, you can buy insurance policies.
And then with something called -- with something called continuous coverage, you're always in what's a community rating pool, meaning you buy insurance at the same rate as everybody else.
TAPPER: So, what do the states need waivers for?
SCALISE: States might want waivers for certainly -- what are called the 10 essential health benefits, some of the additional mandates that were put in place in Obamacare that you used to -- you used to have state-by-state regulation of insurance. Obamacare came in with a whole large number of other mandates...
SCALISE: ... that jack up the cost of health care.
So, if states want to go back to the previous laws that they used to have on their books before Obamacare, they will be able to do that if they want.
TAPPER: So, I want you to take a listen to House Speaker Paul Ryan criticizing Democratic efforts to pass Obamacare back in 2009 before he was speaker.
(BEGIN VIDEO CLIP)
REP. PAUL RYAN (R-WI), SPEAKER OF THE HOUSE: I don't think we should pass bills that we haven't read, that we don't know what they cost. And if you rush this thing through before anybody even knows what it is, that's not good democracy. That's not doing our work for our constituents.
We shouldn't rush this thing through just to rush it through for some artificial deadline. Let's get this thing done right.
(END VIDEO CLIP)
TAPPER: So, as you know, this bill was passed without sufficient time for the Congressional Budget Office to do an analysis of it.
Many members of the Senate, Republicans, are criticizing the process by which not enough people had enough time to read this legislation before voting on it.
How is that any different from what Speaker Ryan was criticizing the Obama team and the Democrats for in 2009?
SCALISE: Well, first of all, every member that voted on this bill had more than enough time to read every aspect of it.
In fact, the total bill, which most of it had been online for weeks, even the changes that we made today were about three pages' worth of changes. The whole bill is less than 200 pages, so everybody has had more than enough opportunity.
In fact, there were some people criticizing us that wanted us to bring it up weeks ago. Some people wanted it brought up in the first 100 days, which we would like to have done, but the bill was not ready. The bill hadn't been completed. There were more members that wanted to make additional changes, and so we took that extra time.
In each step that we took, each amendment that we added in was online for days, if not weeks. So everybody has had more than enough time to read the bill.
Obviously, some people that want Obamacare to stay in law don't like this bill because they like Obamacare. But Obamacare is failing. Iowa yesterday, almost the entire state of Iowa is about to lose every insurance carrier, meaning if you have a preexisting condition in Iowa and you're in Obamacare, you literally will have zero choices to buy health care, nowhere to go.
That's not health care. That's not what people were promised. There is a better way. Our bill actually fixes those problems and lowers premiums for families all across the board, including with preexisting conditions.
TAPPER: House Majority Whip Steve Scalise, thank you so much for your time. Appreciate it.
SCALISE: Thanks, Jake. Good to be with you.
TAPPER: One of the few Republicans who voted against this bill will join me coming up next. Stay with us.
[16:15:07] JAKE TAPPER, CNN ANCHOR: Welcome back. We're sticking with politics lead. House Republicans passing a bill
to repeal and replace Obamacare after seven years of promising to do so.
Lots to talk about with my political roundtable.
Bill, let me start with you. President Trump came out in the Rose Garden and said deductibles are going to go down, premiums are going to go down. Do you think that's going to happen?
BILL KRISTOL, EDITOR AT LARGE, THE WEEKLY STANDARD: Hard to know. I mean, probably because the bill kicks a lot to the states. So, a lot will depend on what states decide to waive what. And -- I mean, this is a very complicated policy area. Hard to know.
I mean, I think the Republican president and Congress had to repeal Obamacare and replace it or begin replacing it. This isn't the way I would have done it either in substance or, more importantly perhaps, in process. But all things considered from -- the Republicans, it is better to have won this victory than to have lost it.
RUTH MARCUS, COLUMNIST, THE WASHINGTON POST: It seems likely if you are young and healthy your premiums and deductibles are likely to go down. But if you are not, then there's only a debate about how big a problem you have really, how effective -- if you're really unhealthy, that is, if you have a preexisting condition, how effective these risk pools will be, whether there's anywhere near enough money, which most of the experts suggest not.
And even if you're not in that preexisting condition situation, the -- a plan that was deemed to be so difficult for seniors and for older people and for rural people earlier that lead to the original version of this not passing is still essentially in place.
TAPPER: And, Olivier, help me clear up for the viewers the disagreement that I had with Steve Scalise about whether or not states have the option of seeking a waiver so that they don't have to require insurance companies to cover people with preexisting conditions.
Where is the -- I suspect I was getting a little congressional soft shoe there. Explain the difference.
OLIVIER KNOX, CHIEF WASHINGTON CORRESPONDENT, YAHOO! NEWS: Well, the challenge here has to do with the money. It has to do -- one of the reasons you got this eight billion dollar sop to the states is that, right, so you can't deny insurance to people with preexisting conditions but you also can charge them kind of whatever you want. And so, what Congress had to do was make a way to make it so if you had a preexisting condition and your coverage lapsed, for example, you didn't suddenly face, you know, a $37,000 monthly premium, or at least not anesthetic.
And so, I think that's where --
TAPPER: It was capped under Obamacare, you couldn't -- you couldn't charge them that. KNOX: Right. And so, there were limits that are now -- that now are
gone, but they had to find a way to bring in some of the moderates who said, well, hold a second, you're really going to make this a real problem for me, because a lot of people in my state are suddenly going to find that they're actually being charged a lot more.
DANA BASH, CNN CHIEF POLITICAL CORRESPONDENT: And I have to tell you, I had a moderate Republican who voted yes today admit to me privately that eight billion was -- it was completely symbolic and it was just a fig leaf to get people on board who were on the fence because it was very hard for them to go home to their district and say, look, you know, potentially I'm leaving a lot of you with preexisting conditions high and dry.
And this moderate Republican again who voted yes said, but even so, even knowing that to him, politically, it was better to kind of accept that as political cover because what was worse, he felt for him, is going home and thinking that, you know, in the next month perhaps, some major insurance carriers are going to raise premiums even more and he's going to have to face them and say, sorry, I failed once again to repeal Obamacare.
KNOX: And there's a good moment in the Rose Garden --
KNOX: -- when Paul Ryan said, you know, we know our Senate colleagues are eager to get down to business, and basically, everyone chuckled, right? So, the way forward matters, too, because they can go back and say, as we've been saying off line, well, let's see what changes the Senate makes.
TAPPER: Yes. Bill?
KRISTOL: No, I think that's right. I mean, I think the degree to which Obamacare did look like it was collapsing, at least in some states -- I mean Iowa, Virginia, the major insurers pulling out -- I think gave the moderates some comfort to be able to say, hey, look, we're going to fix this, we may have to come back and fix it next year, it's complicated.
The states have a lot of leeway, incidentally. It's not as if -- you know, if your state thinks that people who are 58 years old with preexisting conditions not only shouldn't be denied insurance, which they can't be, but also should have a cap on what they can pay, I assume the state can legislate that. The states did it in old days. You know, that's why different states had different insurers, different insurance markets.
I'd say it's a policy matter. This is a big move towards federalism. That's been undercovered. If you talk privately to some of the conservative health policy wonks, they'll say this is extremely complicated, the swapping out of the Obamacare exchange for this complex set of regulations. It may not be as good or bad as people think either way. The biggest policy change is in it probably is block granting Medicaid to the states. BASH: No question.
KRISTOL: Which really is a big deal. That was a federal program. Everyone signed up and now, every state decides how to treat poor people in terms of providing healthcare.
TAPPER: All right. Everyone, stay right here. Stick around.
We're going to come back to the panel, but also, one of the few House Republicans who voted no on the healthcare bill is here next. What bothered him about the bill, should it bother you too?
Stay with us.
[16:24:24] TAPPER: Welcome back to THELEAD. I'm Jake Tapper.
We have breaking news this hour: House Republicans have finally, after years of promising, passed a bill to replace and repeal Obamacare.
CNN's Sunlen Serfaty is on Capitol Hill with more on this extraordinarily close vote and what this bill would actually mean for your health insurance.
Sunlen, this is something that House Republicans have been pledging to do for almost a decade now.
SUNLEN SERFATY, CNN CONGRESSIONAL CORRESPONDENT: That's absolutely right, Jake. For seven years, we've heard this promise that they will repeal and replace Obamacare. So, certainly, this is something that House Republicans can head home to next week for their week-long recess and hold up as progress being made.
And while certainly this is a significant win for them right now, it is a short-term one, just one step in a long process to actually get this done.
[16:25:11] SERFATY (voice-over): After seven years of campaigning and promising --
UNIDENTIFIED MALE: The bill is passed --
SERFATY: And Republicans today taking the first step to deliver on their pledge to repeal and replace Obamacare.
REP. PAUL RYAN (R-WI), SPEAKER OF THE HOUSE: Today was a big day, but it is just one step in this process.
SERFATY: House Speaker Ryan declaring victory --
UNIDENTIFIED MALE: You know, there wasn't a single --
SERFATY: -- after a flurry of frenetic negotiating and last minute changes to win over enough members to save the bill.
UNIDENTIFIED MALE: I feel great. It's going to be a good day.
SERFATY: Republicans moving forward without an answer on how many people would be covered by the bill and at what price.
REP. STENY HOYER (D-MD), MINORITY WHIP: They're rushing to judgment because they think the facts are going to be against them and the facts are going to undermine their ability to pass this bill. We don't have a CBO score.
SERFATY: The original bill as analyzed by the non-partisan Congressional Budget Office estimated it would leave 24 million fewer people insured in the next decade than under Obamacare. But the new version with the 11th hour modifications to the bill has not been scored by the CBO.
Even some Republicans who support the proposal say it is being rushed.
REP. MARK SANFORD (R), SOUTH CAROLINA: It has been a truncated process. I think it is not what a lot of us would have like to have seen from the standpoint of a more robust debate, but we are where we are.
SERFATY: The bill passed by the House today would provide refundable tax credits based mainly on age, revamp Medicaid funding and reducing federal support by capping funding, and would repeal Obamacare subsidies for lower income Americans, eliminate individual and employer mandates and Medicaid expansion money starting in 2020, eliminate Obamacare taxes on the wealthy and insurers, and weaken guaranteed protections for people with preexisting conditions.
The bill passed without a single vote from the Democrats --
REP. NANCY PELOSI (D-CA), MINORITY LEADER: Republicans again are fraudulently claiming the Upton Amendment covers Americans with preexisting conditions. It does not.
SERFATY: -- who are already putting Republicans on notice, readying to use this vote as ammunition to win back the House in 2018.
PELOSI: They have this vote tattooed on them. This is a scar they will carry.
SERFATY: The bill now moves to the Senate where it faces another daunting path ahead with Republicans holding a slim majority.
SEN. MITCH MCCONNELL (R-KY), MAJORITY LEADER: It will be a real big challenge on the Senate side as well.
SERFATY: Senate Republicans openly questioning the process pursued by their House colleagues. Senator Lindsey Graham tweeting the bill has not been scored, amendments not allowed and three hours of final debate should be viewed with caution.
While other Republicans say the House version will undergo significant changes in the Senate.
SEN. BOB CORKER (R), TENNESSEE: People are going to want to improve it. I don't see anyway that it goes back in the form that it comes.
SERFATY: So, certainly, a big battle ahead in the Senate, and even if they are able to pass something in the Senate, there's absolutely no assurance that the House would be OK with the dramatically altered bill when it goes to conference committee. So, certainly, a very long and likely very rocky road ahead -- Jake.
TAPPER: All right. Sunlen Serfaty on Capitol Hill for us -- thank you so much.
The final vote was 217-213, with 20 Republicans and all Democrats opposing the bill. One of those Republican noes was Congressman Leonard Lance from the Garden State of New Jersey.
Congressman, thanks so much for joining us.
Tell us why you voted no?
REP. LEONARD LANCE (R), NEW JERSEY: I don't think this bill will lower premiums on the American people and I would prefer to see a bill that has purchase of policies across state lines and tort reform, and I think and hope that the Republicans should work with the Democrats and the Democrats should work with the Republicans. This needs a bipartisan solution, Jake, and I hope the Democrats will come to the table.
TAPPER: There were a lot of Republicans that were concerned about whether or not this bill would be bad for people with preexisting conditions. Do you think it will?
LANCE: I certainly favor and have campaigned on making sure that nobody is denied coverage based upon a preexisting condition. I'm not sure this bill goes far enough in that direction.
TAPPER: Steve Scalise was on the show earlier basically saying that the law prevents discrimination against people with preexisting conditions. Of course, it has been pointed out that what it does though is it doesn't require that insurance companies have a reasonable cost of insurance for those individuals. Is that your concern?
LANCE: Insurance has to be accessible and it has to be affordable, and we in New Jersey have long had a provision in our state law regarding no denial of coverage based upon preexisting conditions and community ratings. I would have preferred that that stay in the underlying legislation.
TAPPER: Fourteen Republicans who represent districts that Hillary Clinton won last November voted for this bill. Are you worried that this vote will cost them jobs come November 2018? LANCE: I certainly think by that time there will be a host of issues,
and I will campaign vigorously for Republican colleagues. I think it's important that we retain control of the House.