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Has the Health Care Ruling Upped the Ante for Election Contenders?

June 29, 2012 at 12:00 AM EST
Ray Suarez talks to Democratic Maryland Gov. Martin O'Malley and Romney campaign adviser Tevi Troy about how the election campaigns will use the Supreme Court's decision to uphold the Obama administration's health care law.
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JUDY WOODRUFF: Now to American politics.

Ray Suarez has two different takes on what yesterday’s Supreme Court ruling on health care policy will mean in the presidential contest.

RAY SUAREZ: Maryland Gov. Martin O’Malley is chairman of the Democratic Governors Association and a top surrogate for the president.

Governor, welcome.

Yesterday, during his address following the release of the decision, the president kidded about the political value of the Affordable Care Act, almost implying there wasn’t much. But looking at it now, is this a win politically for the president?

GOV. MARTIN O’MALLEY, D-Md.: Well, I think, ultimately, it will be.

What we have to do a better job of as a party is explaining the benefits and the rationale here. I mean, not only do we need to stop wasting money on a broken health care system, but we need to improve wellness and bring down costs, so that we can grow our economy, so that we can create jobs, and so that we can expand opportunity.

And that’s the golden opportunity now that we have to better explain this important step in America’s journey.

RAY SUAREZ: Well, in advance of that explanation, the public opinion research implies that the law is still pretty unpopular, even though the public says it likes parts of the overall legislation.

How is that an asset going forward to November?

GOV. MARTIN O’MALLEY: Well, again, I think we have to do a better job of explaining it than the detractors have done in attacking it.

Look, all of us, I think, have a natural inclination to be against any sort of expansion of government. And the critics of this Obamacare have tried to portray it as if it’s some sort of welfare expansion, when it’s not.

They use coded words like Medicaid or federal spending or government programs, when, in point of fact, what this allows us to do for the first time now, to join other industrialized nations. Instead of wasting money on a much more expensive system, where fewer and fewer people every year are covered, we can now use those dollars, as we bend down the cost curve, to reinvest and to allow family-owned businesses to reinvest in their own businesses and expand jobs, instead of cutting an ever larger check to insurance companies for insurance premiums.

RAY SUAREZ: The public has already started to see some changes. What is in the pipeline? If I live in Maryland and I’m watching nervously as my bills come in from time to time or if there is a check-off on my pay stub, what is going to change about acquiring health care?

GOV. MARTIN O’MALLEY: Well, for those who already have health care, I mean, they will see no perceptible change, except that, over time, those premiums will not increase, as they had been skyrocketing over the last 10 years.

But important changes are the fact that, soon, no one will be able to have their insurance denied because of a preexisting condition. Now, that could affect half of the people of Maryland under those old insurance company definitions.

Kids up to the age of 26 will be able to continue to receive health care under their parents’ plans. And, also, the preventive care, the wellness that seniors are able to receive free of charge, those things will continue.

The most important thing that this does is, it allows us, with some finality and some clarity, to finally move forward, beyond this sort of ideological campaign against Obamacare, and instead actually see that it will benefit our economy, will allow us to stop wasting money on increased health care costs, and instead start to grow our economy again.

RAY SUAREZ: More than half the governors in the United States — you were not one of them — went to court to block implementation of the law.

Do you worry that some of the mechanics of the Affordable Care Act will be undermined if some states opt out after the high court’s pronouncement on Medicaid yesterday?

GOV. MARTIN O’MALLEY: Well, those other governors will have to respond and have to be held accountable to their public for their decisions.

I can tell you that, in Maryland, we decided early on that we wanted to be an early implementer of Obamacare, because we realized that that will be a competitive advantage for our family-owned businesses, for our startups.

You know, Mr. Suarez, the U.S. Chamber of Commerce named Maryland number one in innovation and entrepreneurship. So we foresee the benefits that will come to our small businesses and our startups by being able to finally bring down those health care costs, so they can bring up the jobs that come from their talents and their hard work.

RAY SUAREZ: Are you ready for the exchanges? Are you ready to bring people who meet some of these income requirements into the system and get them a new way of buying insurance?

GOV. MARTIN O’MALLEY: We are. I mean, it’s required a lot of work. We had to bring stakeholders in from private sector, insurance companies, nurses, doctors.

But we have already passed through the Maryland General Assembly the law that sets up our health care exchange. We have already set up the I.T. infrastructure that will allow this to work. And we also have core staff in place that will be able to manage this new marketplace where family-owned businesses can obtain more affordable health care moving forward.

These are all steps that we took because we wanted Maryland to be a winner and wanted Maryland to take advantage of this opportunity. And we’re very excited about it, and we are certainly willing and able to help other states that will now see the benefits and also want to serve their people.

RAY SUAREZ: Martin O’Malley is the governor of Maryland.

Thanks for joining us.

GOV. MARTIN O’MALLEY: Thank you.

RAY SUAREZ: For the other side, we’re joined by Tevi Troy, a senior fellow at the Hudson Institute and a special adviser to Gov. Mitt Romney’s presidential campaign.

What’s your reaction to what Gov. O’Malley had to say?

TEVI TROY, Hudson Institute: Well, first of all, thanks for having me. And it’s great to sea my home state governor, Gov. O’Malley, on screen.

I do have some issues with what he had to say, especially this notion that it is a communications problem, that they haven’t communicated enough. The problem is not the communication strategy about the Affordable Care Act. The problem is the policies of the Affordable Care Act.

It is a tax-hiker. It will cost jobs. It will not bend the cost curve down. It doesn’t cover everybody. It creates an IPAB which gets between an individuals and their doctors. There are so many problems. And that is why the American people have been rebelling against it.

RAY SUAREZ: Gov. Romney promised repeal in his message yesterday. If it is not a blowout for the governor and the Republicans in November, as a practical matter, is repeal even possible?

TEVI TROY: Well, I am not sure where we are going with blowout, but if Gov. Romney. . .

RAY SUAREZ: Well, I mean, if you have more than 40 Democratic senators who are members of the United States Senate in January. . .

TEVI TROY: So you are talking about if Gov. Romney wins and there is a Republican House and there’s a Republican Senate, but not 60 votes.

In that instance, there are an enormous number of opportunities. If you remember, the Affordable Care Act in the end was passed through a reconciliation-type process. That is why they couldn’t handle things like severability in the final version of the bill.

So, I think Gov. Romney has said very clearly — in fact, his statement yesterday was a lot clearer than the Supreme Court decision which people are still trying to sort through. So Gov. Romney said country clearly in his statement yesterday that he would pursue repeal from his first day in office.

And if there is a Republican House and a Republican Senate, there is a real opportunity to do so.

RAY SUAREZ: The governor has also implied that he would try to retain the parts of the bill, eventually, that people like. But the insurers are saying, sorry, reform won’t work unless we have it all. The numbers just don’t work.

TEVI TROY: Well, look, there’s a 2,700-page bill, and it’s hugely complicated and hugely problematic.

That is why Gov. Romney says we have to repeal the whole thing and start from scratch, try and find a bipartisan way to go forward with market-based reforms that give individuals more flexibility, that give states more flexibility, and still preserve safeguards for individuals who need them.

Gov. O’Malley was talking about preexisting conditions. Well, Gov. Romney yesterday talked about preexisting conditions and making sure people who maintain continuous coverage can get coverage if they have preexisting conditions.

RAY SUAREZ: But preexisting conditions is a. . .

TEVI TROY: I don’t think there is a real disagreement there.

What I think is that you need to start from scratch with a market-based bill.

RAY SUAREZ: But that is a perfect example — 2,700 pages or not, you have to have countervailing money coming in if you are going to make a promise that you’re going to cover people that you didn’t used to cover because they were expensive. Money has to come from somewhere else now.

Can you do that?

TEVI TROY: Yes, absolutely. That’s a really good question.

And I found it interesting how Gov. O’Malley talked about code words like federal spending. Well, federal spending is not a code word. If the Affordable Care Act spends $2 trillion, well, that is not a code word. That is $2 trillion that the American people are going to have to pay for.

And I think the Affordable Care Act is so expensive and so outlandish that there are opportunities to find better, cheaper ways of doing this, especially if you use market mechanisms, if you let people purchase across state lines. If you have tort reform, that would save $50 billion over 10 years, that one reform alone. So, Gov. Romney has a whole host of ideas, a whole host of reforms.

He has specific ideas, but also general principles that would govern how he would go forward.

RAY SUAREZ: The governor has promised to cut taxes and balance the budget. The Congressional Budget Office says repeal would cost the government $300 billion. Can you do all of that?

TEVI TROY: Well, you know, the question of repeal is a question of how much it spends based on the CBO score at the time.

So I think we are going to look at the CBO scores if and when Gov. Romney becomes president and figure out the best way to do that. But it is quite clear that the $2 trillion that the Affordable Care Act is going to spend, and originally seemed to be $1 trillion, that number keeps going.

And as the cost estimates for the Affordable Care Act get worse and worse, I think is less and less of a saver to — less and less of a coster to repeal it.

RAY SUAREZ: Does it remain a difficulty that the first elected official in the United States to sign a health care bill with a mandate is criticizing the second one for doing the same thing?

TEVI TROY: Look, they’re very — I know you are talking about Gov. Romney’s plan in Massachusetts. It was very different from what President Obama has done.

RAY SUAREZ: How so?

TEVI TROY: Gov. Romney didn’t impose something on all 50 states of the nation. Massachusetts, as we know, is a more liberal state and wanted a different type of approach.

Gov. Romney wouldn’t have imposed that on all 50 states. Also, President Obama’s plan cut $500 billion from Medicare without doing anything to shore up Medicare financing. Gov. Romney didn’t do anything along those lines, nor did Gov. Romney create an IPAB, an independent payment advisory board, which is very unpopular and will also lead to getting — bureaucrats getting in between patients and their doctors.

RAY SUAREZ: Tevi Troy, we will keep watching the numbers and we will keep talk. Thanks for joining us.

TEVI TROY: Thanks for having me.

JEFFREY BROWN: On our website, we continue our coverage of the Supreme Court’s ruling with a blog from Gwen Ifill on how the momentous day’s events unfolded and how many in the news media initially got things all wrong.