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Will Republicans’ health care plan bring political fallout?

May 6, 2017 at 5:18 PM EDT
The debate over the American Health Care Act now moves to the Senate following the House’s passage of the bill on Thursday. It would allow insurance companies to charge higher premiums for the elderly and those with pre-existing conditions and limit Medicaid coverage, among other changes. NewsHour Weekend Special Correspondent Jeff Greenfield joins Hari Sreenivasan with more.
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HARI SREENIVASAN, PBS NEWSHOUR WEEKEND ANCHOR: The debate over replacing the seven-year-old Affordable Care Act is now in the hands of the United States Senate. This follows Thursday’s passage of a revamped bill from the House that would end the employer mandate to provide insurance and the individual mandate to have it.

The Republican plan would replace government subsidies to buy health insurance with tax credits. Among other things, it would allow insurance companies to charge higher premiums for elderly Americans and people with pre-existing conditions while it would limit Medicaid coverage for low income Americans. The nonpartisan Congressional Budget Office has yet to offer its analysis, but the CBO predicted the previous version of the House bill could knock 24 million Americans unto the rolls of uninsured in the next few years.

For more on this debate, I’m joined from Santa Barbara, California, by “NewsHour Weekend” special correspondent Jeff Greenfield.

Jeff, it’s hard to get into too much of a policy discussion, because we know that this is going to change in some significant form by the time it gets to the Senate, but let’s talk a little bit about the politics of this here.

What are the risks for the Republicans who decided to get this through the House?

JEFF GREENFIELD, PBS NEWSHOUR WEEKEND SPECIAL CORRESPONDENT: Well, you can see the risks that have already emerged. If you look at the people who take the political temperature, the “Cook Political Report,” which is a non-partisan site, has just in the day or two since that bill passed moved 20 seats in the House toward the Democrats. The other thing we know is that the Democratic Congressional Campaign Committee, granted that’s not non-partisan, says they now contend to contest not 45 or 50 seats but well over 100.

And one thing I would definitely keep watching is whether or not formidable Democratic contenders agree to challenge entrenched Republican incumbents as the midterms get nearer. That’s a real — that would be a real sign that Democrats think they’ve got the Republicans because of health care in a vulnerable position.

SREENIVASAN: What happens in the Senate going forward? What kind of resistance is there going to be to some of the underpinnings of what is in this legislation now?

GREENFIELD: Well, this is where if you’re trying to measure (ph) where the Republicans stand (ph), you — like they say in the ballpark, you can’t tell the players without a scorecard. This passed the House because the hard right Freedom Caucus got significant concessions, which, in turn, really worried moderates. And in the Senate, there are enough moderate Republicans to derail this.

The Republicans in the Senate have already said to the House, look, thank you very much. We’re going to write our own — our own bill.

And then you add to this, the fact that in many states, Republican governors have expanded Medicaid, and part of this bill, at least the House version, would severely limit how much is available to these states to keep expanding or even keep Medicaid where it is. So, these Republican governors may be putting pressure on Republican senators to reject what the Republican House did. It’s a byzantine picture.

SREENIVASAN: All right. Let’s also look back at how Obamacare passed. A lot of people point out that that was along party lines. That was a different vision for the country. And then, are the consequences of what happened after that going to be similar in this case?

GREENFIELD: There is no question when Obamacare finally got through — I believe the president signed the bill in March 2010 — it was very unpopular. The benefits didn’t begin to kick in for a couple more years. So, by the time the mid-terms happened in 2010, the unpopularity of that bill, which was not mitigated by any benefits by then, produced a 62-seat loss in the House for the Democrats.

If you measure public opinion polls, Trumpcare, if that’s what we want the call this, is even more unpopular now than Obamacare was then.

SREENIVASAN: One of the things that’s a little different is that Obamacare passed in the same year as an election. We have quite a bit of time between now and November of 2018. This is just one piece of legislation, one part of the history. Will voters remember this when they go to the polls?

GREENFIELD: If we’ve learned anything from the last election is trying to project a year and a half out is a fool’s errand. But one thing we should remember, or maybe two things, one is any attempt to radically change healthcare comes with a political cost. Look back to 1993 and ’94 when Hillary Clinton was in charge of developing Bill Clinton’s health care plan. That crashed and burns, never even got to a vote, and the Democrats lost both the House and the Senate that year.

There’s another thing that I think is worth nothing. Conservatives have always worried about entitlements. But once they are in place, the public doesn’t want to give them up. And it’s interesting. Now as Obamacare is threatened with repeal and replace, it is more popular than it ever has been. And I think for a lot of conservatives, their concern, once you pass entitlement, you can’t undo it, is going to be tested assuming the Republicans ever get a bill between the House and the Senate and the president that is enacted into law.

SREENIVASAN: All right. Jeff Greenfield, thanks so much.

GREENFIELD: OK, thank you.

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