Sen. Blunt: Hard to get 50 senators to pass health bill


JUDY WOODRUFF: Now to the ongoing struggle to craft a health care reform bill in the U.S. Senate.

Republican lawmakers are scrambling to draft a new version of their bill before leaving Washington for the July fourth recess.

A short time ago, I spoke with Senator Roy Blunt of Missouri, who is vice chair of the Senate Republican Conference.

I begin by asking where the efforts to find compromise stand right now.

SEN. ROY BLUNT, R-Mo.: I think it's challenging and challenged. We will see what happens, but this is a difficult topic that touches every American family. And the more members of the Senate and the House both know about it, I think the harder it is to reach that conclusion you would like to get to.

JUDY WOODRUFF: Well, there are reports, as you know, news reports that the majority leader, Mitch McConnell, is trying to come up with accommodations to appeal to both sides of this argument, to moderate Republicans.

One of the stories is that he's considering keeping the tax on high-income individuals in order to pay for more of the gaps in Medicaid coverage. And, by the way, the Congressional Budget Office is saying the cuts to Medicaid are going to be much deeper than thought in the future years.

SEN. ROY BLUNT: Well, I think what they're saying is, in the second 10 years, you have even more substantial savings.

Now, remember, there are no cuts to Medicaid. Every year in Medicaid, you spend more money than you spent the year before under this plan, but the growth is not as great as it would be if you continued to pay, for instance, 100 percent for single able-bodied adults.

We have got a plan where the states were told, OK, we will pay 100 percent for able-bodied single adults, but we're only going to pay an average of 52 percent for mothers and their young children. Now, there is something wrong with the way that system is put together.

JUDY WOODRUFF: But keeping that tax on higher-income individuals, is that being looked at?

SEN. ROY BLUNT: I think it is. I think everything is being looked at, both on the revenue side and on the expenditure side and trying to reach that point where 50 Republicans, that might include the vice president being one of the 50, is — are being added to that 50 is what it takes to get this done.

JUDY WOODRUFF: One of the other things we're seeing, a potential way of appealing to the moderates, adding $45 billion or so for opioid abuse treatment. Is that something else that's on the table?

SEN. ROY BLUNT: It's a problem that Congress has really taken on in the last couple of years. I started sharing the committee that appropriates money for health and human services two years ago.

We tripled that year the money that was being — to be spent on opioids. Legislation sort of followed that. Then we doubled that tripling. I think, at some point, there's a limit to how many times we can multiply that in a short period of time, but this is a real problem.

In Missouri, more people die from drug overdoses than car accidents. If you're a first-responder in Missouri as part of a fire department, you're three times more likely to respond to a drug overdose than you are a fire. So it's a problem.

I don't know exactly what the right number is, but certainly I think members of the Senate and House are rightly concerned about it.

JUDY WOODRUFF: And to appeal to conservatives, we're reading that the majority leader is giving more options for coverage plans, allowing people, in other words, to have a choice of some less costly, cheaper plans, in effect, that would provide less coverage, but would give them more choices.

SEN. ROY BLUNT: Give them more choices.

It might also provide some more up-front coverage. I think one of the lessons we should have learned from what's happened with the current plan is that there is insurance coverage, but there is not really, many times, access to health care. If you have these high deductibles, there is every — there is a disincentive to get the policy, because you would have to pay another — I think the average of deductible policies on the individual market is $6,000 per individual before the insurance really kicked in, and if two of you got sick, $12,000.

Makes it hard to make that decision, particularly when you think what your family needs is the first $1,000 that covers the kids getting sick with the flu or something like that.

JUDY WOODRUFF: What do you think the chances are now that you're going to be able to come up with something that passes? And I ask this because President Trump tweeted this morning, he said, "If Republican senators are unable to pass what they are working on now, they should immediately repeal and then replace at a later date."

SEN. ROY BLUNT: Well, it's pretty late to come up with a new plan.

The hypotheticals are never legislatively what you want to be talking about. You want to be talking about what you're focused on at the time. I think it's fair to say that it's hard to get 50 senators out of 52 to vote for a package this complicated.

Actually, Judy, the more that members know about this, in many ways, the harder it is to make that final decision, because you have got so much information, and you know how many other things are impacted here by one decision here that, five decisions later, has made a big difference in somebody's life.

JUDY WOODRUFF: So, if you can't get it passed in July, do you just set it aside?

SEN. ROY BLUNT: Well, I think we have had a three-step plan in mind. We pass this bill that did as much as we could to kind of clear the way for Democrats and Republicans to work together later.

The secretary of health and human services would look at the 1,400-plus rules that the law gave that person the ability to define and see how those could be better defined, so they were better for families, better for access and then, when that's done, get down to the real work of Republicans and Democrats working together to do things you can do outside the budget restraints of the way we're trying to do this first step.

And if the first step doesn't work, then you just go to, I guess, a two-step process, and it will take longer.

JUDY WOODRUFF: Where you do finally work with Democrats, Democrats and Republicans together?


JUDY WOODRUFF: Last thing …

SEN. ROY BLUNT: And that's going to happen. That has to happen to expand the way more people can get more insurance in groups, to look at things like more transparency from providers. That eventually has to happen.

But it doesn't have to happen to stabilize the moment we're in right now. The insurance markets, the individual markets are collapsing. A third of the counties in America now only have one company that's willing to offer an insurance product on the exchange. The estimate for next year is over 40 percent of the counties.

And if you only have would be choice, you really don't have any choice. You either buy that policy or pay the penalty, and all those things will happen if we don't change the current law.

JUDY WOODRUFF: Last thing I want to ask you about, Senator Blunt, and that is the president's tweets.

A lot of attention has been diverted in the last few days to the president's tweets criticizing cable news hosts Joe Scarborough, Mike Brzezinski, in her case in very harsh personal terms.

What's your reaction?

SEN. ROY BLUNT: Well, there's no doubt that cable news hosts can say things that the president of the United States shouldn't say, and people can be harsh at you. That doesn't mean you benefit by being harsh back.

I think, generally, the president's tweets are not helpful to him. At the same time, he's figured out a way to communicate with people in ways that no other president has, or he wouldn't be president.

JUDY WOODRUFF: Do those tweets help his agenda and the Republican agenda?

SEN. ROY BLUNT: They sometimes they do and they sometimes don't. I think there needs to be a much more significant filter on those tweets. It's OK to have some unspoken and untweeted thoughts.

JUDY WOODRUFF: Senator Roy Blunt of Missouri, thank you very much for joining us.

SEN. ROY BLUNT: Nice to be with you.

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