JUDY WOODRUFF: The effort by Senate Republicans to replace the Affordable Care Act picked up steam today, as their leader promised a first look at their bill before the end of the week.
So far, Democrats remain unable to stop it on their own. But they mounted a public relations attack as Republicans counted votes.
The word came from Majority Leader Mitch McConnell that a draft of the Senate GOP’s health care package was on its way.
SEN. MITCH MCCONNELL, R-Ky., Majority Leader: Well, we’re going to lay out a discussion draft Thursday morning. And I wouldn’t want to compare it to the House bill. It will speak for itself. It’ll be different, and take a different approach based upon these endless discussions we have had with the only people interested in changing the law, which is Republican senators.
JUDY WOODRUFF: He spoke as Democrats, in the minority, were making their own symbolic stand on health care on the Senate floor. Minority Leader Chuck Schumer quoted what the president reportedly said about the House health care bill to attack Republican efforts broadly.
SEN. CHUCK SCHUMER, D-N.Y., Minority Leader: For once, on the topic of health care, I find myself agreeing with the president. His health care bill is mean. Cutting Medicaid to the bone is mean.
WOMAN: This is an insult to the American people.
JUDY WOODRUFF: Democrats and their allies held the Senate floor yesterday well into the night, and took Republicans to task for keeping their work behind closed doors.
SEN. BERNIE SANDERS, I-Vt.: So, I say to the Republican leadership, what are you afraid of?
JUDY WOODRUFF: Today, the number two Republican in the Senate, Texas’ John Cornyn, turned the focus back to the Democrats, charging that their speeches were just that, talk.
SEN. JOHN CORNYN, R-Texas: Unfortunately, they’re spending their time and energy giving speeches to each other on the Senate floor, and absolutely contributing nothing toward a solution to this problem.
JUDY WOODRUFF: No details from the Republican discussions have been publicly released. But The Washington Post and others reported that the Senate version would make deeper Medicaid cuts than those passed in the House. They also would be phased in more slowly. The House bill calls for cutting $800 billion over 10 years.
At the same time, senators are also reportedly considering offering more generous insurance subsidies, especially for older Americans, as well as eliminating some, but not all, of the taxes put in place by Obamacare.
Whatever the eventual bill looks like, Republicans don’t expect any Democrats to support it. Thus, they cannot afford to lose more than two of their own members. Yet, some GOP senators, like Tennessee’s Bob Corker, have said that, even up to now, they remain out of the loop.
QUESTION: Have you seen the Republican health care bill?
SEN. BOB CORKER, R-Tenn.: I have not. Have you? Have you?
QUESTION: I have not.
SEN. BOB CORKER: I would have liked, as you already know, for this to be a more open process and have committee hearings. But that’s not what we’re doing.
JUDY WOODRUFF: Making sure that Corker and other Republicans not in on the drafting process are on board is a priority for the Republican leadership, especially McConnell, as they prepare for a possible vote next week.
And just a short while ago, I spoke with two key voices in the Senate about this health care debate.
John Barrasso is an orthopedic surgeon from Wyoming and chairman of the Senate Republican Policy Committee. And senator Chris Van Hollen, a Democrat from Maryland, he played a key role in the House leadership when Obamacare was passed in 2009.
Senator Barrasso, Senator Van Hollen, thank you both for joining us.
Senator Barrasso, we just heard the majority leader say that this bill takes a different approach than the bill that came out of the House. What makes it better?
SEN. JOHN BARRASSO, R-Wyo.: Well, look, the pain of Obamacare is getting worse every day. We’re seeing it all across the country, as premiums continue to go up and choices continue to go down.
We’re looking at ways to make sure that anyone with a preexisting condition is protected. We’re looking for ways to stabilize the market and also lower the skyrocketing cost of insurance and then stabilize Medicaid for the long run, because we need a safe and secure program there. It has to be strong, and it’s not strong now.
JUDY WOODRUFF: Senator Van Hollen, is there any part of that the Democrats can support?
SEN. CHRIS VAN HOLLEN, D-Md.: Well, Judy, of course, we don’t know what’s in the Senate Republican bill, because it’s been kept in deep secret from the American public, no hearings, no amendments in committee
But Senator Cornyn, one of the members of the Republican leadership, said it was going to be 80 percent like the House bill. The House bill is a bill that President Trump celebrated in the Rose Garden, but then, behind closed doors, said was mean.
And it is mean because it will mean 23 million Americans who will not have access to affordable care who would otherwise have it. People with preexisting conditions will go back to being able to be victims of discrimination by insurance companies. It is why virtually every patient advocacy organization, in fact, I think 100 percent, are against that legislation, and every provider group I have heard from is also against it.
It will provide huge tax cuts to the wealthiest Americans. If you’re a millionaire, you are going to get a $50,000, on average, annual tax cut — tell me how that helps health care — and cuts Medicaid by $830 billion. This is going to wreak havoc on our health care system.
JUDY WOODRUFF: Well, let’s just take a part of that.
SEN. JOHN BARRASSO: Sure.
JUDY WOODRUFF: Senator Barrasso, what about the Medicaid cuts? Again, we haven’t seen what the Senate is coming up with, but the reporting is that it is going to be deeper Medicaid cuts than what the House bill had.
SEN. JOHN BARRASSO: Well, first of all, it’s hard to stand here and hear Chris talk about a bill he hasn’t seen — he will see it Thursday — and make a number of attacks against it, when, in his own state of Maryland, insurance rates asked for, for next are going up 58 percent.
I don’t know how somebody with a straight face can call that affordable. And they went up 24 percent last year. And the president of the Maryland care — the care — insurance company has said we’re in the beginning of the throes of a death spiral of insurance.
They have lost $600 million. Obamacare has failed in Maryland. It’s failing all across the country. And for people with preexisting conditions, Judy, when you see all of these counties across the country where no one is even willing to sell Obamacare insurance, if you have a preexisting condition and nobody is going to be willing to sell you insurance, even with a subsidy, your preexisting condition is not covered, and you have been deceived by Obamacare.
SEN. CHRIS VAN HOLLEN: I’m glad John brought that up.
Yes, Blue Cross/Blue Shield, the largest insurer in the state of Maryland, asked for a whopping 50 percent increase. Here’s what the president of Blue Cross/Blue Shield told us, that well over half of that increase is due to deliberate sabotage by the Trump administration and cuts Republicans made to Obamacare/Affordable Care Act payments.
A full 20 percent of the increase they’re asking for is because the president issued an executive order on the first day of his administration saying that they wouldn’t enforce the individual mandate provision.
You tell people they don’t have to join, including healthier people, it means sicker people will pay a lot more. And, by the way, that’s why AARP is on the warpath against this health care bill, because they’re going to see dramatic increases.
And, yes, John, I have not seen the Senate bill. Neither has the country, which is a shame on the democratic process.
And, finally, John didn’t answer your specific question about Medicaid, which has nothing to do with the exchanges. It’s a whopping cut. I know his state of Wyoming didn’t take the Medicaid expansion, but this will wreak havoc on tens of millions of Americans.
JUDY WOODRUFF: Senator Barrasso, what about the point he made about the criticism that it’s what Republicans have done that have undermined Obamacare, but also the Medicaid question?
SEN. JOHN BARRASSO: Well, you know, insurance company executives prior to the election, prior to the November election were saying they’re thinking of pulling out in 2018, so this is nothing new.
Had Hillary Clinton gotten elected president of the United States, we’d be having to make major changes to Obamacare, trying to clean up the mess that has been created by the Obama health care law. That’s where we are right now. The current status is not sustainable.
JUDY WOODRUFF: What about the Republican bill, though, Senator?
SEN. JOHN BARRASSO: We’re working on it in the Senate is a different way to deal with Medicaid to make sure that states that did expand, because there are a number of states that did and states that didn’t, that states that did will have a smoother glide path to getting to the point where, for anyone on Medicaid in those states, they’re reimbursed the same way as was set up initially for people who are disabled, blind, the elderly and children.
That’s who Medicaid was set up for originally. Plus, I was in the state Senate in Wyoming, and I will tell you, Judy, we always felt, if we had more control of that money, rather than the one-size-fits-all that comes out of Washington, we could have helped a lot more people in a lot better ways with — given some of the flexibility and the freedom of choice that a state has, instead of having to listen to the mandates of Washington.
And as to Chris’ point of the individual mandate, it is the most hated part of Obamacare. And the judges that say, how do they count the numbers, they say, if you get rid of the individual mandate, which I am committed to do and the Republicans did, they say millions and millions of people will not buy a mandated government product they don’t think is worth the money.
SEN. CHRIS VAN HOLLEN: The whole idea of insurance, as John knows, is everybody has got to be part of the pool. That’s the whole idea of social insurance and health insurance.
The core of the Republican bill in the House, and we suspect in the Senate, is rotten. And here’s why: It cuts Medicaid by $830 billion. That’s huge. It provides tax cuts of about $900 billion.
You tell me how cutting taxes to millionaires and giving them an average tax break of $50,000 has anything to do with making health care better. In fact, it takes two years off of the Medicare Trust Fund, because, as part of the Affordable Care Act, we asked wealthier Americans to put some of their unearned income into shoring up Medicare.
The Republicans give them a big tax break. They hurt millions of Americans in the process. And it is a bad deal.
JUDY WOODRUFF: Senator Barrasso, what about those tax cuts for wealthier Americans that would be realized under — presumably, under the Senate plan?
SEN. JOHN BARRASSO: That’s still part of the debate we’re having, and the bill will come out Friday.
We want to eliminate all the taxes that raise premiums for people, the medical device tax, the health insurance tax, the tax on prescription medication.
But getting back to Medicaid, Judy, a third of the doctors — and I practiced medicine for 25 years — a third of the doctors in this country will not take new Medicaid patients, and major hospitals around the country have said, look, if you have to make an appointment for somebody either with Medicaid or who has traditional insurance, don’t give that appointment to somebody with Medicaid — this is what the Mayo Clinic said — because we have reached a tipping point where we can’t continue even paying the salaries at the rate that Medicaid reimburses.
Medicaid is failing. We need to strengthen it for the long term.
SEN. CHRIS VAN HOLLEN: So, their answer is, it’s failing, so cut it by another $180 billion.
It’s not sufficient to completely reimburse doctors now, so give them even less, while you’re giving tax breaks to the very wealthy. That’s nuts. And I think the American people know it. I think that’s why this has been kept in secret in the Senate for so long.
I hope that, at long last, we will have a chance to have a debate on this.
JUDY WOODRUFF: So, just finally, to both of you, when the public is told that the Senate version is going to stabilize the health care coverage in this country, quickly, Senator Barrasso, how does it do that?
SEN. JOHN BARRASSO: Well, there are a number of different provisions to do exactly that, to help people at a significant high risk of high medical costs.
It’s worked successfully around the country. And part of it is to just give more flexibility to the states, so they can make decisions about what insurance can be bought and sold in those states to allow people to get what they want and they need and is right for their family, not what the Democrats who voted for Obamacare said they have to have.
SEN. CHRIS VAN HOLLEN: Well, listen, Judy, there are issues with some of the exchanges. We can fix them. There are commonsense things you can do about that, rather than blow them up.
And with respect to Medicaid — and, in Maryland, I can tell you, of the people who are directly benefiting from the Affordable Care Act, more than half are from Medicaid. And John hasn’t said anything that’s going to explain how those people are going to be better off when they cut $830 billion or whatever amount they’re going to cut from the Medicaid program.
Medicaid already has lots of waivers. It already has lots of flexibility. We’re using it in the state of Maryland. His state of Wyoming did not take the expansion, so maybe, you know, that’s something he doesn’t feel strongly about.
But I can tell you we’re hearing from Republican governors in states that have, and they’re saying do not do that kind of damage to the Medicaid program.
SEN. JOHN BARRASSO: Somebody may have a Medicaid card, but it doesn’t mean they get to see a doctor.
SEN. CHRIS VAN HOLLEN: Yes, I can tell you, when they take $830 million away from them and give it to wealthier Americans, they are not going to be better off. They are going to be a lot worse off.
JUDY WOODRUFF: Gentlemen, thank you very much. We’re going to get our first peek at the bill on Thursday.
Senator Chris Van Hollen, Senator John Barrasso, we thank you both.
SEN. JOHN BARRASSO: Thank you for having us.
SEN. CHRIS VAN HOLLEN: Thank you.