Lankford: Obamacare repeal vote is not the final step on health care reform

Republicans have not yet been able to muster enough support among their ranks to pass what's being called a "skinny repeal" of the Affordable Care Act. Sen. James Lankford, R-Okla., joined Judy Woodruff to discuss what he sees as the best way forward for health care reform, as well as his reaction to President Trump’s public attacks on Jeff Sessions and more.

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    Back to health care now.

    At this hour, its fate remains uncertain. Republicans have not been able to muster enough support among their own ranks.

    I spoke to one of them, Senator James Lankford of Oklahoma, just shortly before four of his colleagues said that they'd vote no without assurances from the House of Representatives.

    I began by asking the senator if he thinks any version of the health care bill will pass.


    I do actually, but I don't think it's the final version.

    What we have is the House will have version, the Senate will have a version. Neither of us want it to be the final version at this point. It will go to a conference committee, and we will work out the differences, and there will be significant differences between the House and Senate, and then bring a final version out after CBO can score it sometime in September.

    So, CBO has taken about four weeks to score just about everything we put out, so we have got to be able to give them a lot more time again to be able to run through scoring, and then we will be able to have that final vote.

    So, this week and the next 24 hours is a step again, but definitely not the final step.


    Well, in terms that voters, that a layman could understand, what is mainly this legislation going to consist of as it comes out of the Senate, do you think?


    So, this version that will come out, as I mentioned, is just a step that's coming out. It will deal with some basic things, like the individual mandate, the employer mandate, state flexibility in allowing states to have greater options.

    When the Affordable Care Act was passed, it took all the control of health care to Washington, D.C., away from all the states. And so we want to be able to return some of that control back, when prices were much cheaper in the time before, when the Affordable Care Act was passed.

    So those will be the basic elements. There will be some other smaller parts to it. It's basically the employer mandate, individual mandate, and state control vs. federal control.


    Well, as you know, Senator, Democrats and even a number of Republicans are saying what's being called skinny repeal, which is, I gather, what you're referring to…




    … would leave, what, more than 15 million Americans without coverage. Other versions would leave many more millions without coverage.

    Any one of these versions, we're told, would raise the cost of premiums. How do you explain a vote to support that?


    So, again, today's vote is not the final vote. I understand that.

    They're trying to score something that's not finished by any means. So, that's one big piece of it. The other one is to be able to look at how CBO scores this. CBO scores — they basically assume that if there is not a mandate to buy it, most people won't buy the insurance products that are put out there under the Affordable Care Act.

    So, literally, there's nine million people right now on the exchanges. They assume 22 million people won't have insurance in the days ahead based on them changing this. Now, this may seem odd, and it only works in an economist's mind, that only nine million people have it, 22 million people lose it in that sense.

    But here's what's really going on. Of the mine million people that are having it, CBO says, if they're given the choice to be able to buy it, many of the individuals don't want to buy that product, and they only buy it because they're forced to buy that product. So that's the number that's sitting out there.

    I would also say, in my state, CBO never saw in their original estimates when the Affordable Care Act passed that in my state the insurance rates would go up over 200 percent for the individuals that were buying their insurance.

    So CBO is making their best guess, but I can assure you they don't always guess correctly. No one can really see into the future on that. So they're laying out an economist's view vs. practically what's actually happening on the ground.


    Well, we know that hospital officials in Oklahoma have said if one of the versions of this were to pass, that they thought it would be devastating on their ability to take care of low-income individuals, whether on Medicaid or otherwise.

    What do you say to them, the folks in your own state?


    Yes, same thing, Judy.

    Obviously, they're looking at just part of a plan. And I know that my Democratic colleagues have been very good for distributing bits and pieces of plans and saying here is the whole plan, without actually putting the full picture out there for individuals to be able to see how the stability works, how aspects of it work.

    They will just put out and say, this is going to be a cut that happens to this particular area. What will happen? Immediately, they respond back, well, that will be dramatic.

    Let me give you a for instance on Medicaid. I hear a lot of talk about how Medicaid goes down in one of the earlier proposals. Medicaid actually increases every year for the next eight years in that proposal by twice the rate of inflation, and then nine years from now it increases at only the rate of inflation.

    That's put out by my Democratic colleagues as a big cut in Medicaid because nine years from now it doesn't increase as fast, but every single year it's increasing, and for the next eight years it increases twice as fast as inflation.


    Senator, I want to change the subject and ask you about the attorney general, Jeff Sessions.

    As you know, President Trump has been publicly criticizing him for the last several days, mainly because the attorney general recused himself from the Russia investigation.

    What do you make of the president's public campaign against him?


    Yes, it's something I would never do. Obviously, the president is the president. He can lead his staff however he chooses. But I would never say to my staff in a public setting that there is a problem.

    If I have a problem with a staff member, they will sit down with me in my office and we will sit down and work it out. And if we can't work it out, then they will leave.

    But that's something we are going to work out in private, not in a public setting. And, quite frankly, Jeff Sessions had to recuse himself. That's something all the legal counsel in the Department of Justice, once he joined as the attorney general, sat down with him, laid out the law of the statute.

    Everyone looked at it's. Everyone read it exactly the same way, that Jeff needed to recuse himself. Now, did Jeff understand that before he got there? No, I don't think he did, but once he was in that spot, sitting down with all the attorneys, he understand full well that he had to do that.

    I understand that frustrates the president, but it was the right thing to do.


    What would it mean if the president were to fire the attorney general or if Jeff Sessions were to step down because of this pressure from the president?


    Well, there would be — obviously, the president — doesn't have to be just pressure from the president. The president chooses who his staff is, and they all serve at the pleasure of the president.

    So, if any point the president is uncomfortable with Jeff Sessions and his leadership, he can choose to remove him. That's what the president does for that. So, that's not the issue. The issue is then going through the process, going through all of the nomination. Getting through all that aspect again starting all over again and getting someone in will take months and months.

    Right now, the attorney general is getting a good stride and dealing with U.S. attorneys around the country, getting with his staff, getting on board with different investigations that need to be done. So, I hate to be able to lose that progress that is happening right now.


    What would it mean for the Russia investigation if that were to happen?


    It wouldn't change the Russia investigation at all.

    Jeff is completely disconnected from what is happening in the Russia investigation. He's recused himself. We have had numerous interactions with people in the DOJ. He's not tried to interfere in that in any way. That's already in the special counsel's responsibility. So, it doesn't change that investigation at all.


    And, finally, Senator, the president's announcement by Twitter yesterday that he wants to ban individuals who are transgender from serving in the military?


    Yes, we're trying to get additional details on what he means by that, the implementation.

    Obviously, the Pentagon was unaware of an announcement like that. The Pentagon was already in a six-month review dealing with transgenders in the military, what that means as far as costs, unit cohesion, deployment capabilities, what that means.


    Would you support the ban?


    Well, again, I'm waiting for that six-month review to come back from the military officials.

    We open up our military to all aspects for any individual that comes into the military that wants to be able to serve. There are unique issues, not just with a gay soldier or member of the military, but of someone who is in transition. You deal with medical issues. You deal with a lot of additional costs and implementation, what happens in a unit based on that, because that's — as you know, that's not a single surgery. That's a series of surgeries that happens.

    And it's a long time for them to be away from their unit. So, there are additional questions that are there that are unique to that, whether that individual should go through transition before they come into the military or after. All of those things are still up in the air, and the military is walking through that right now.


    Senator James Lankford of Oklahoma, we thank you.


    Great. Thank you.


    And you can continue watching the Senate as it votes on the health care measures. We will be live-streaming throughout this night on our Web site. That's

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