GOP Sen. Cassidy on addressing rising health care costs and expiring subsidies

Geoff Bennett:

Tomorrow, our Lisa Desjardins will break down the main alternative plan many Republicans prefer. That's an expansion of health savings accounts.

We're joined now by the author of one such GOP plan, Louisiana Republican Senator Bill Cassidy, chair of the Senate Health Committee, who also happens to be a physician.

Welcome to the "News Hour."

Sen. Bill Cassidy (R-LA):

Thank you.

Geoff Bennett:

I know you said there's a deal to be had on health care, and I understand a bipartisan group of senators met last night to hash out an agreement. At this point, what does a compromise look like?

Sen. Bill Cassidy:

First, let me just say what is important to me. We have to make these policies affordable to the enrollee, to our fellow American.

And so it's not just about containing premiums, although that's important, but also about making sure that somebody has the money in their pocket to pay the out-of-pocket for the policy, if you will, giving power to the patient, not profits to the insurance company. There's your deal.

We will do something to address the high cost of premiums for some, and do something else to address that need to have money for the out-of-pocket for as many as possible. That could be a deal.

Geoff Bennett:

In the meantime, though, health care premiums for more than 20 million people in those marketplace plans are set to spike in the new year, with the House speaker, Mike Johnson, saying he's not going to call for a vote on extending the enhanced subsidies.

So what can be done in the here and now to help people keep their coverage?

Sen. Bill Cassidy:

So people are opting for the lower-cost plans on the Affordable Care Act, so-called Affordable Care Act exchange.

They're going from a silver plan to a bronze plan, and they're trying to make it affordable. What our plan does, by the way, which I think we could maybe not implement for next year, but for the following year, is to give them that money in an account, their pocket, their purse, if you will, that would help address that higher deductible.

It may be that the deductible turns out to be the same between the bronze and the silver plan, but the premium on the bronze plan is lower. You get more affordability. You get money up front to pay for those out-of-pocket costs. That's really making things more affordable.

Geoff Bennett:

So the only option for Americans, absent action from Congress, is to reduce their level of coverage right now?

Sen. Bill Cassidy:

So you're speaking only of that 7 percent of Americans who are on the exchange and you're speaking about a minority of those. Let's first be clear.

For those less than 400 percent of federal poverty level, they still have a lot of subsidies going towards it. For those who are above, it depends. But I can tell you what the alternative is just to have people continue to subsidize premiums, so they still have a $6,000 deductible, is not really an option.

Most people are living paycheck to paycheck. They don't have money for a $500 medical bill, much less a $5,000 medical bill. So what we have to do is help Americans where they are. And that is yes, make the premiums affordable for those for whom it's not, but also help all folks on the exchange with their out-of-pocket. And that's, I think, the better way forward.

Geoff Bennett:

Critics on both sides argue that the current options either maintain an expensive status quo, ACA, or shift burdens onto patients.

So how does your proposal strike the right balance without reducing coverage or increasing uncompensated care?

Sen. Bill Cassidy:

The plan I am proposing takes financial burden off the patient. Consider the alternative.

Democrats are advocating we give $26 billion to insurance companies for next year and they take 20 percent for profit and overhead. But if you give money to the patient, she's going to use 100 percent of that money for the care that she needs. Now, she may choose a less expensive bronze plan. It's less expensive because it has a higher deductible.

But we're putting in some cases up to $5,000 into an account for her to pay that deductible. That actually could lower her net deductible, if you will, lower cost premium, lower net deductible. That's how my plan is a sweet spot. Maybe we can't get it for this coming year. We absolutely should get it for the next year because the Obamacare exchanges have become unaffordable for too many.

Geoff Bennett:

Where's the White House on all of this?

Sen. Bill Cassidy:

The president has made it clear he will not sign a law giving all the money to insurance companies. He wants money to go to the patient. And the president's intuition is correct.

I said it earlier. I will say it again. If you give the money to the insurance companies, they take 20 percent for profit and overhead. They have to give you permission to get the care you know you need. If you give the money to the patient, she gets 100 — she uses 100 percent of the money for the care she knows she needs. She doesn't have to ask permission. She's got the power, power to the patient, not profit to the insurance company.

Geoff Bennett:

Beyond the matter of health care coverage and costs, there's also the question of public health and public health leadership.

You explicitly said that you would support RFK Jr.'s nomination as health secretary, you delivered that decisive confirmation vote, in exchange for serious commitments, that he would meet with you on a regular basis, consult with you before making changes to vaccine safety monitoring, not remove language from the CDC Web site saying vaccines don't cause autism.

He's made all of those changes. Have you actually received any consultations from him?

Sen. Bill Cassidy:

We — he and I have spoken. And in part of our agreement, he will come back to speak to the Health, Education and Labor and Pension Committee on a periodic basis.

We're right now in the process of when that next time would be. So, to answer your question directly, yes.

Geoff Bennett:

Well, do you believe the actions at the CDC reflect the agreement that was struck before you voted in favor of him?

Sen. Bill Cassidy:

I think you can look at the agreement and you can look at what has been done. There's clearly a difference between the two.

Geoff Bennett:

Would you vote to confirm him again if you were presented with the opportunity?

Sen. Bill Cassidy:

Reporters love to ask that question. But, right now, it is what it is. We have to live life going forward. And so let's live life going forward.

Geoff Bennett:

Well, you called the federal panel of vaccine advisers handpicked by him, you said it was totally discredited. So does he still have your support?

Sen. Bill Cassidy:

You know, there's things we agree on, ultra-processed. I just have to hand it to the secretary. He's made an issue of something that has, frankly, never been an issue before.

But we clearly differ on things like immunizations. On immunizations, they are safe. They do not cause autism. It is clear that we're having an outbreak of vaccine-preventable diseases and even death from people who have chosen not to vaccine — vaccinate their child or themselves.

We have a flu season which is kind of one of our worst in a while. And the end and flu immunization is at a low point. We have got a measles outbreak in South Carolina, and we had two that died in West Texas. Clearly, the safety, the effectiveness of vaccines should be emphasized now. There should not be spurious claims made about their safety.

And I think that kind of says it all.

Geoff Bennett:

So what can be done now? I mean, for Americans who look to the CDC for clear science-based guidance, what assurance can you give them under RFK Jr.'s leadership?

Sen. Bill Cassidy:

I think most Americans talk more with their personal physician than they do look at the CDC Web site.

Indeed, I have never seen anybody look up on the CDC Web site unless the mother is a pediatrician. And so speak with your physician. Your physician will reassure that vaccines are safe, that the benefit from them far outweighs the risk. They are not associated with autism in any credible study.

And so — and, by the way, if you don't get vaccinated, unfortunately, you're at risk of vaccine-preventable diseases and even death. I say that as a physician, as a doctor who has seen patients die from vaccine-preventable diseases or disease get transmitted and that transmission could have been stopped if the person had been vaccinated, either one of the two.

So do yourself a favor. Speak to your physician, get your vaccines, and your life — that's how you make yourself healthy.

Geoff Bennett:

Senator Bill Cassidy, Republican from Louisiana, thanks again for your time this evening.

Sen. Bill Cassidy:

Thank you.