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Battle Over Obamacare. Aired 10:30-11a ET

Aired January 4, 2017 - 10:30   ET


[10:30:00] GOV. MIKE PENCE, VICE PRESIDENT-ELECT: As I told the House Republican Conference today, we're working on a strategy in concert with the leadership of the House and the Senate for both a legislative and executive action agenda to ensure that an orderly and smooth transition to a market-based health care reform system is achieved.

The speaker of the House used the word stable, and we will do that. In his famous speech in Philadelphia, the president-elect spoke about an orderly transition. And it will be that. But make no mistake about it, we're going to keep our promise to the American people. And we're going to repeal Obamacare and replace it with solutions that lower the cost of health insurance without growing the size of government.

Now there is a broad range of ideas about how we do this. And Republicans have been offering those ideas again and again, literally every year since Obamacare was first signed into law. We're going to be working with Dr. Price on both before and after his confirmation, when he steps into the role at HHS, working with the Republican leadership in the House and the Senate to bring forward those solutions and to take the case for those solutions to the American people.

That being said, I couldn't be more humbled and more excited to be back in the Capitol today. I'm -- I was encouraged by the president- elect to come here to Capitol Hill, the first full day of work for members of Congress, because it's time to get back to work. While others are visiting the Capitol today talking about defending the failed policies of the past, we are here today speaking to Republican majorities in the House and Senate to advance policies that will make America great again and have a more prosperous future for all the people of this nation.


REP. PAUL RYAN (R), HOUSE SPEAKER: No shouting out. It's all good, but no shouting out.


PENCE: The president-elect and I will receive a briefing from the leadership of our intelligence agencies this coming Friday. And we'll be listening in. Look, I think that the president-elect has expressed his very sincere and healthy American skepticism about intelligence conclusions. We're going to sit down later this week. The president and I have been receiving since the election regular intelligence briefings, received a presidential daily brief with the president yesterday. And we'll be looking -- we'll be looking at the facts and the information. But I think given some of the intelligence failures of recent years, the president-elect has made it clear to the American people that he's skeptical about conclusions from the bureaucracy, and I think the American people hear him loud and clear.

UNIDENTIFIED REPORTER: Mr. Speaker, as mentioned, the president-elect is warning you should be careful here. Is there a danger here? Why move forward with the repeal of Obamacare when you still don't have a plan to --

RYAN: The president-elect is making an important point that we're trying to emphasize right here today and that is, so much damage has already been done to the country. Obamacare is a story of broken promise after broken promise after broken promise followed by a failing program, higher premiums, higher deductibles. So we want to make sure as we give relief to Obamacare, we do it in a transition that doesn't pull the rug up from anybody during that transition period. That's the point that we're all trying to make.

This law has failed, it's getting worse, families are hurting, no one has choices. We've got to fix this by replacing it with something better. And in that transition we want to make sure we don't pull the rug out from anybody during that transition. That's the point we're all trying to make.

UNIDENTIFIED REPORTER: So why still no plan to replace it?

RYAN: We have a plan to replace it. We have plenty of ideas to replace it. And you'll see, as the weeks and months unfold, what we're talking about replacing it, how we can get better choices with lower prices by not having across the government take over health care, which is causing all these problems in the first place. Sherman?

UNIDENTIFIED REPORTER: For the vice president-elect or both of you. You're talking about transition that's going to happen (INAUDIBLE). I think people want to know what it's going to look like. (INAUDIBLE).

PENCE: Well, Jake, I think it's -- I want to be very clear.

[10:35:02] And I would commend you and anyone looking on to look into -- no, I was commending you to do something, not commending you --


RYAN: Nice try. That's nice.

PENCE: That's nice. It's good to be back, it really is. I would just -- I would commend all of your attention to the president-elect's speech in Philadelphia during the waning weeks of the campaign, where he laid out a plan to repeal and replace Obamacare. He laid out the principles of harnessing the power of health savings accounts, allowing Americans to purchase health insurance across state lines. But his commitment was very clear in that, that we will insist upon and implement, working with the Congress but also using executive authority to ensure that that is an orderly transition. And we're working right now, the White House staff is, on a series of executive orders that will enable that orderly transition to take place even as the Congress appropriately debates alternatives to and replacement of Obamacare.

UNIDENTIFIED REPORTER: It sounds like it might stay in place until there's a new full plan.

RYAN: Jake, we've been saying all along, we don't want to pull the rug out from people while we're replacing this law. The point is, in 2017 we don't want people to be caught with nothing. We want to be sure that there's an orderly transition so that the rug is not pulled out from under the families who are currently struggling under Obamacare while we're bringing relief. Yes.

UNIDENTIFIED REPORTER: On the ACA repeal and replace, can you give detail on the executive actions that are planned? And how does that square with the complex budgetary process that's also involved?

RYAN: They're hand in glove. So we're working on the legislative process right now. As you know, the Senate is going to be acting first next week, then the Congress will follow, which gives us the budget resolution we need to bring the legislation through while the administration works on the executive orders that they're talking about to deliver the kind of transition relief that we've been talking about.

The problem is, just remember, Obamacare has failed, families are hurting, they broke the healthcare system. It's a string of broken promises. So we're going to make sure that we have an orderly transition to a better system so we can get back to what we all want which is lower cost health care, more choices, so that families can actually get affordable health care at a decent price with more choices, more competition, and not a costly government takeover that has really bankrupted this health care system and left families struggling.


PENCE: If I can respond to that. I'd be happy to. We're working out right now with the White House staff and in concert with legislative leadership, a two-track approach to ensuring that it is an orderly transition as the president-elect has -- you read his tweet this morning that he has admonished the Congress to be careful and I reiterated that before the Republican conference today.

Look, we're talking about people's lives. We're talking about families. But we are also talking about a policy that has been a failure virtually since its inception. And we intend to, over the course of the coming days and weeks, to be speaking directly to the American people about that failure, but about a better future we can have in health care, a future that is built not on growing government, not on mandates, not on taxes, but also -- but rather a future that's built on giving the American people more choices in health care, allowing the power of the free marketplace to flow in. But the transition to that, we will work out in a way that reflects

the compassion of the president-elect and the compassion of every member of Congress to see to it that we do that in a way that serves the best interests of the American people. But look, I think what's clear here is the American people have spoken. They want to see us repeal and replace Obamacare. And today, my message to members of Congress is that we are going to be in the promise-keeping business. And the first order of business is to keep our promise to repeal Obamacare and replace it with the kind of health care reform that will lower the cost of insurance without growing the size of government.

RYAN: Thanks, everybody. Appreciate it.


UNIDENTIFIED REPORTER: How are you going to prevent private insurers from pulling out?

UNIDENTIFIED MALE: House or Senate gym?


CAROL COSTELLO, CNN ANCHOR: All right. We're going to step away. You see John Lewis approaching the microphone. That's on the Democratic side. President Obama has just met with House and Senate Democrats. I'm sorry, that's Elijah Cummings. I'm sorry, I apologize for that. But let's listen in to see what he's saying.

REP. ELIJAH CUMMINGS (D), MARYLAND: -- and nothing to replace it with. They've had seven years to do it. They haven't done it yet.

[10:40:06] President-elect Trump made it clear that we would not have people dying in the streets. And we are going to hold him to that. And I think the -- again, the question that has to be asked of the Republican Party is, are you making things worse for the American people or better? And do you have a replacement?

They want to keep the provisions with regard to preexisting conditions. They want to keep the young people on their parents' policies until they're 26 years old. But at the same time they don't have a decent replacement. So that's going to be the question.

The politics -- the president made it clear, the politics are on our side. And that when you look at most surveys, it shows that the American people do not want it repealed. They don't mind it being improved but they do not want it repealed. The other thing that he pointed out is that it brings quite a bit of -- the actions of the Republicans bring quite a bit of uncertainty to the health care system and a lot of rural hospitals will be in trouble.

And there will be quite a bit of problems. So he has encouraged us to fight, which we had already made it clear we were going to do anyway. That's it.

COSTELLO: All right. That's Congressman Elijah Cummings, a Democrat from Maryland, looking a little dispirited, I must say. Manu Raju has been covering the Democratic side of this. Is President

Obama still in the auditorium, Manu?

MANU RAJU, CNN SENIOR POLITICAL CORRESPONDENT: He still is. We're actually expecting him to leave any moment right behind me, Carol. But he actually -- actually it was a pep rally of sorts in this meeting and actually told Democrats to, quote, "Don't rescue them," referring to Republicans, saying they should not -- the Democrats should not do anything to help Republicans replace the Obamacare law if it is in fact repealed.

He said, quote, "Don't rescue," and this according to sources in the room. And he also said that, don't give them a few votes in the Senate to make a -- pass a worse plan than the Affordable Care Act. So he wanted -- he was really telling his members, the Democrats here, to draw a pretty firm line against working on any sort of replacement.

Now interestingly, I am told that he also said that Democrats and liberal activists should employ the tactics of the Tea Party in 2009, when the Tea Party activists stormed town halls, expressed their outrage at the passage of the Affordable Care Act, and do the same thing with the repeal of the Affordable Care Act, and let members of Congress know that they should not go that route.

His argument is that it's going to be politically painful for Republicans to go this route, to do this, because he thinks that this law, its provisions are very popular, even if the name isn't popular, the provisions are, and he laid out all those benefits. So a really aggressive case that the president made behind closed doors to his members saying we should defend this, we shouldn't work with them to replace the law, if it is in fact repealed. And that Republicans should pay for this politically. So all those messages being voiced right now behind closed doors from President Obama to Democrats. And interestingly, I'm told that he also said, anything to replace it with, you can call it Trumpcare, not just -- it's no longer Obamacare. So a lot of talk about politics and strategy and messaging in this pretty fired-up room.

COSTELLO: Interesting. So is it possible -- since President Obama, once he leaves office, is going to stay around Washington for a while, right? They've got a house and everything, they're renting a house. So is it possible that President Obama will still be involved after he leaves office in protecting Obamacare?

RAJU: It's possible. It's not clear exactly what role that he's going to play. He obviously commands a major audience and certainly could. But a lot of past presidents tend to take a lower profile after they leave office. But this is -- this could be different. This is his signature legacy item. This is something that Democrats need some big voices to push back on and perhaps they'll lean on him to do that. But it's unclear exactly the role that he said he would play. We'll see if he gave any more details behind closed doors.

COSTELLO: Well, that was my next question. Who was that big passionate voice on the Democratic side that can incite passion in people like Tea Party leaders did? [10:45:04] RAJU: You know, the -- I think it's going to take a lot of

grassroots organization, that was his point that I was told he made in this in the room, that the party should be organized on the grassroots level to ensure that activist types go and they let Republican congressmen or Republican senators know that if they do try to repeal the law, they'll get a major backlash in their midterm election in 2018.

So they want the Republicans to feel pressure back home, they want this to come from the grassroots, they want this to come from the activists. But of course folks in Washington would organize that outrage and that opposition. So that was part of the key message that they were trying to voice in this meeting just now, Carol.

COSTELLO: Well, you know, it's really interesting, because I was just listening to the Republicans and Vice President-elect Mike Pence talk about Obamacare, and also Paul Ryan, calling it an abject failure that's destroyed the country. So again, we're going to hear, you know, the extremes on both sides, where Obamacare is kind of great on the Democratic side, and on the Republican side it's been an abject failure, and the truth is somewhere in the middle.

RAJU: Yes, in this meeting just now, I'm told that -- actually the president laid out all of his successes over the last eight years, in his view, and also all of the successes in his view of Obamacare, saying that he's gotten letters from members, from voters, from constituents, saying thank you for all the things in the law that have helped them. So definitely both sides of the argument are being laid out here today and right in front of our eyes. It just shows how difficult it will be for the two sides to come together on this very divisive issue, Carol.

COSTELLO: So do you think, Manu, that Senator Elizabeth Warren and perhaps Bernie Sanders might lead the effort to save Obamacare?

RAJU: I think they'll play a big role in trying to fight the efforts to repeal the law. I think they'll be -- they will also be part of that effort to mobilize folks on the grassroots level. There are very few progressives like them who can actually instill a lot of passion among particularly younger voters. So I think you probably will see their voices. They do play prominent roles on the Senate Health Committee which will have at least some say over the Health and Human Services secretary nominee, Tom Price, they'll have a confirmation hearing for him so you'll hear their voices in that regard.

But a lot of what President Obama said is that it's not a foregone conclusion that this is -- this law is going to be repealed, we can fight this until the end, and we should not work with them on a replace, do not rescue them. That was his argument.

COSTELLO: Interesting.

RAJU: If Republicans break this law, they own it. That's according to the Democrats.

COSTELLO: OK. I want to stay on this picture and I want -- Manu, you to stay in the background.

Can we bring Phil Mattingly in, his audio at least?

Phil Mattingly, can you hear me?


COSTELLO: OK. You got me. So I just wanted to ask you about one thing because Manu was talking about the Democrats not be involved in any sort of replacement proposal. But you have information that the GOP is eyeing the goal of having some sort of replacement in, what, like six months?

MATTINGLY: Yes. That's at least according to one of Donald Trump's closest allies in the House, Chris Collins, New York congressman, coming out telling reporters that his view of the meeting, of the conversation that Mike Pence was having behind closed doors with members was six months was around the timeline for a replace plan.

I think what's really interesting, when you listen to what Manu is hearing inside the room and then kind of compare it to what I've heard from sources inside the Republican meeting is trying to watch the two sides position themselves. Mike Pence making very clear, Carol, throughout the course of this meeting that Republicans have to make sure that the American people who voted for President-elect Donald Trump or at least gave him enough electoral votes to win, won't forget that Obamacare and the reason for the need to repeal and replace that law is because of Democrats.

In other words, what President Obama is asking Democrats to do is take Tea Party tactics and make it Trumpcare. Mike Pence is clearly aware that that is going to be a strategy there and he's trying to make Republicans really kind of attack that issue, try and make sure Democrats stay on defense on that but also on an action item, Carol. I'm told from somebody in the room that Mike Pence said on his first day in office, president-elect, then-President Donald Trump will be signing executive orders to help move forward the plan of repeal.

And obviously he can't repeal anything via executive order. But what you're seeing from the Trump administration is -- or soon to be Trump administration, Carol, at least according to Mike Pence in this closed door meeting, is they're ready to take action immediately, kind of underscoring what they've said publicly that this is the first item on their agenda, as difficult as it is --

COSTELLO: Yes, but --

MATTINGLY: -- almost certainly going to be, they want to move on it now.

COSTELLO: Just cutting through this, so President-elect Trump once he takes office will issue some sort of executive order which essentially pays lip service to all of those voters that he promised to repeal Obamacare, because you're right, he can't just repeal Obamacare through executive order. On the other hand, congressional Republicans, from what I heard, they want to repeal Obamacare but they want it to take maybe a year so everybody can get ready including the people who are currently enrolled in Obamacare and also the insurance companies.

[10:50:11] So how is that immediate action, exactly?

MATTINGLY: I think they want to start the process. Right? They want to say that they're starting to keep promises. And look, executive orders, as they're signed, and President Obama did the same thing in 2009, not all of them have kind of large scam implications, some of them are largely procedural or largely for show.

But I do think what you're seeing here, and why Republicans feel the impetus or the onus to move on this quickly is look, House Republicans voted I think 86, 87, 88 times to repeal the law, and nothing actually came of it. Why they want to move now? Something can actually come of it so long as they actually start to agree on that process.

But, Carol, you have a key point, there's going to need to be a transition. And what Mike Pence said behind closed doors and what you heard Speaker Paul Ryan reiterate today, they need to make sure stability is maintained. Right now the big question is, what will be the timeline? What will be the transition process? How do you keep the market from flying into chaos if you repeal first and then replace? That's one of the big questions they're going to have to answer over the next coming weeks and months -- Carol.

COSTELLO: OK. So in light of that, I want to bring back in Dr. Sanjay Gupta, a working doctor. You work in a hospital. So as medical professionals are watching all of this unfold, how are they feeling right now?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, I think that, you know, it's hard to paint all of the medical professionals with one brush, but I think if you look at the major medical organizations that represent hundreds of thousands of doctors, they reflect I think what you showed in your polling, that, you know, what, two thirds of Americans don't want to see this repealed, although maybe some tweaks, some more minor changes, but keeping the most popular provisions of the Affordable Care Act is sort of reflective of what doctors are thinking about this as well.

But they also remind, I think as Phil was just reminding as well that, look, any time you disrupt the system, any time you do something, it's like changing the parts on a fast-moving train, and what happens when you do that is that people go without for a period of time. So, you know, what you didn't hear in the meeting with Vice President-elect Pence and Speaker Ryan was about the 20 million people who now have health insurance as a result of Obamacare, and what exactly is going to happen to them.

The one constant that you seem to hear is that look, and it's a profound one I think in some ways is that they want to move from more of a government, you know, based or inspired system to a market-based system that is stable. That was the word that Vice President-elect Pence used, a stable market system, and that there will be a smooth transition, stable transition between those two. And it's a profound point, I think. Will a free market system work?

Have we seen the free market system work with regard to health care in the past? Or does it run into the system that people were trying to address, a system that costs way more than other developed countries around the world and delivered less in terms of quality, in terms of essence?

COSTELLO: Well, let me ask you about that. Free markets, isn't that what we had before? Anybody could buy insurance through a private insurance company.


COSTELLO: And you know, it was your choice which to choose, and, you know, I remember costs being sort of out of control during that time. So how are they going to solve that problem?

GUPTA: No question. And you know, it's important to keep in mind, I guess most people probably know this, but we are still talking about a private-based system here, private insurance system here. This isn't government-sponsored health care. It's a private insurance system under the Affordable Care Act. What I think you're hearing a little bit, and again, it will take months to really understand what this plan, the new plan is going to be, but the idea that it's going to be a more deregulated insurance industry that will be allowed to compete across state lines, that because of that deregulation they anticipate insurance companies, instead of fleeing, will stay in, because look, insurance companies may say, look, we're not getting the money from people mandated to buy into the system.

We're not getting subsidies from the government. Why are we still in this business, is what insurance companies may say. And that's after costs go way up. That's after premiums go way up, Carol, to your point. So we have sort of seen this before. Will the sort of deregulation that has been suggested help solve those problems? We just don't know.

COSTELLO: Just don't know. So Phil, a question for you, is anybody in the Trump team talking with the insurance industry?

MATTINGLY: Pretty much all players that are -- I think this is also an interesting element. Not just talking to industry participants, which on the policy side in Trump Tower is happening, I'm told. But also what we saw behind the scenes today. Who walked in with Mike Pence? Reince Priebus, obviously the looming chief or the incoming chief of staff, Kellyanne Conway, obviously senior adviser, but also the legislative affairs team for the next administration, the Trump administration.

All of whom are very close with Vice President-elect Mike Pence and also Speaker Ryan behind closed doors announcing today that Mike Pence will get office space on Capitol Hill.

[10:55:01] So while they will certainly be talking with industry participants, the involvement of Vice President-elect Mike Pence in how things are going to work and happen on Capitol Hill is going to be a fascinating thing to watch because much of the legislative affairs team is tied to Mike Pence.

Mike Pence getting his own office space on the Hill. So in terms of how things are going to operate here in the very complicated, complex process, Mike Pence is going to be somebody you need to watch very closely, Carol.

COSTELLO: OK. So when all is said and done, Phil, what -- how will Congress work? Will they get things done? Because the Senate is controlled by Republicans and the House. And you have a Republican in the White House. Will it work like a top now? Or because of all of this turmoil that's going on right now, will we get the same old-same old?

MATTINGLY: Yes. I think if you -- if anybody had a sure answer to that, they could probably make a lot of money on K Street. I think that the wild card obviously is you don't necessarily know how the president-elect is going to operate, where he's going to come down ideologically on certain things. He's certainly not a traditional conservative Republican.

I also think it's important to note, Carol, that while they hold a four-seat majority in the U.S. Senate and have 247 Republicans in the U.S. House, these majorities have actually slimmed down since the 2016 election. So while maybe you can move a repeal process through the U.S. Senate with just 51 senators, you can't move a replace process through without 60 because of the way the rules go. So you need Democratic support.

This idea that all of the President-elect Trump's top agenda items, all of the Speaker Paul Ryan's top agenda items, and all Senate Majority Leader Mitch McConnell's top agenda items, are just going to fly through because Republicans control Washington? You haven't been paying attention to Congress or the U.S. Senate over the courses of the last couple hundred years.

COSTELLO: All right. Phil Mattingly, many thanks. Sanjay Gupta. And thanks to all of my colleagues who participated in the NEWSROOM today. I do appreciate it.

And thank you for joining me today. I'm Carol Costello. "AT THIS HOUR WITH BERMAN AND BOLDUAN" after a break.


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