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Health Care Bill Passes House, Faces Uphill Battle in Senate. Aired 6-6:30a ET
Aired May 5, 2017 - 06:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DONALD TRUMP (R), PRESIDENT OF THE UNITED STATES: We will have great, great health care for everyone in our nation.
[05:58:33] UNIDENTIFIED MALE: The bill is passed and without objection, the motion to reconsider is laid upon the table.
UNIDENTIFIED MALE: If the American people could sue Congress for malpractice, my Republican friends would be in deep trouble.
UNIDENTIFIED MALE: I'm confident that we just made a vote to stop this death spiral.
REP. ADAM SCHIFF (D), CALIFORNIA: If you have a pre-existing condition. You may have just lost your health care.
MIKE PENCE (R), VICE PRESIDENT OF THE UNITED STATES: Welcome to the beginning of the end of Obamacare.
UNIDENTIFIED MALE: This is a fraud bill, and we're going to fight it with all we have.
We will get this passed through the Senate. I feel confident.
UNIDENTIFIED MALE: ... Hey, hey, good-bye.
ANNOUNCER: This is NEW DAY with Chris Cuomo and Alisyn Camerota.
CHRIS CUOMO, CNN ANCHOR: All right. We want to welcome our viewers from the United States and around the world. This is NEW DAY. It is Friday, May 5, 6 a.m. here in New York. And up first, the battle to repeal and replace Obamacare now shifting to the Senate. Believe it or not, this House battle was the easy part. This is an uphill fight in the Senate, to say the least. Some Senate Republicans reject this House bill outright, saying they're going to write their own version.
ALISYN CAMEROTA, CNN ANCHOR: But that is not stopping President Trump from celebrating his first legislative win. So how are lawmakers going to answer constituents who may be angry about their vote.
We have it all covered for you. So let's begin with Suzanne Malveaux. She is live on Capitol Hill. What's the latest, Suzanne.
SUZANNE MALVEAUX, CNN CORRESPONDENT: Good morning, Alisyn.
The House Republicans really taking the first key step towards fulfilling a promise to the American people by passing their health care plan, at least in the House. But this really is far from over. It is really the first step to turning this legislation into law.
TRUMP: I think we'll get it through. Mitch McConnell knows how to do things.
MALVEAUX (voice-over): The Republican effort to repeal and replace Obamacare. Now in the hands of the Senate with a controversial bill that narrowly passed in the House...
UNIDENTIFIED MALE: The bill is passed.
MALVEAUX: ... faces an uphill battle.
TRUMP: It could change a little bit. It could get maybe even better.
MALVEAUX: Senators on both sides of the aisle aren't in any hurry, vowing to do things their way.
SEN. BERNIE SANDERS (I), VERMONT: Mr. President, I'm sorry to disappoint you. This bill in its current form is not getting through the Senate. No way. No way.
UNIDENTIFIED MALE: The Senate will write its own bill. I don't think that the House bill necessarily predicts what is in the Senate bill.
MALVEAUX: The legislation passed in the House eliminates the tax penalty for Americans who choose not to buy insurance, replaces the generous subsidies offered under Obamacare with tax credits and rolls back Medicaid expansion starting in 2020. It also increases the limit on what insurers can charge older enrollees and allows insurers to charge customers more if they have a pre-existing condition.
Among those who lose the most in this plan, those with pre-existing conditions, the elderly and low-income Americans. While younger Americans, the healthy, the middle and upper class, and the insurance companies stand to benefit.
UNIDENTIFIED MALE (singing): Hey, hey, hey, good-bye.
UNIDENTIFIED MALE (singing): Hey, hey, hey, good-bye.
UNIDENTIFIED MALE (singing): Hey, hey, hey, good-bye.
MALVEAUX: Democrats voted unanimously against the bill, taunting Republicans after the vote, which they say will be a political liability in 2018. REP. NANCY PELOSI (D-CA), MINORITY LEADER: Some of you have said,
"Well, they'll fix it in the Senate. But you have every provision of this bill tattooed on your forehead. You will glow in the dark on this one.
MALVEAUX: Republican Senator Lindsey Graham stressing that the bill should be viewed with caution, because it was rushed through the House without a cost and impact estimate.
SEN. JOHN MCCAIN (R), ARIZONA: We should have had a CBO estimate. I don't always agree with CBO. In fact, quite frequently I disagree. But we should still have assessment from them.
MALVEAUX: Some House Republicans admitting they haven't even read the legislation before voting yes.
REP. CHRIS COLLINS (R), NEW YORK: I will fully admit, Wolf, I did not. But I can also assure you my staff did.
UNIDENTIFIED MALE: I would be dishonest if I said I individually read it all. That's why we have a legislative staff.
MALVEAUX: Something then-Congressman Paul Ryan blasted Democrats for back in 2009.
RYAN: I don't think we should pass bills that we haven't read.
We shouldn't rush this thing through.
MALVEAUX: The Congressional Budget Office is expected to come up with that score in two weeks or so. And then the Senate process will take several weeks after that. They say specifically that their process is not going to be rushed, that they will go ahead and it will be deliberative, and they will look for areas of compromise. Once that's done, that bill will go back to the House where the debate will start all over again -- Chris.
CUOMO: All right, Suzanne. It's so nice they're going to do it twice.
President Trump taking a victory lap, nonetheless, riding high off what is perceived as a legislative victory and again declaring Obamacare is dead. But he has a lot of people scratching their heads over comments he made after the vote. What were those?
CNN's Jeff Zeleny has that for us right now.
JEFF ZELENY, CNN CORRESPONDENT: Hey, good morning, Chris. Good morning, guys.
President Trump is waking up this morning at his golf course in Bedminster, New Jersey, after spending a little more than four hours in New York City last night. It was his first visit back to his home town since taking office. But he didn't stop in at home at all, and he was welcomed by some protesters.
But he did arrive with the sense of satisfaction. One of his biggest campaign promises is closer to becoming reality.
ZELENY (voice-over): President Trump savoring a victory, the first major legislative win of his presidency. Visiting New York last night for the first time as president, a new era of confidence after House Republicans united to repeal and replace Obamacare.
TRUMP: Republicans came together all of a sudden two days ago, and it was like magic. They just came together. They're very, very united.
ZELENY: The president meeting with Australian Prime Minister Malcolm Turnbull, making new promises to voters.
TRUMP: Premiums are going to come down very substantially. The deductibles are going to come down. It's going to be fantastic health care.
ZELENY: The president also making this off-handed remark.
TRUMP: I shouldn't say this to our great gentleman and my friend from Australia, because you have better health care than we do.
ZELENY: Democrats quick to point out Australia has universal health care.
SANDERS: Well, Mr. President, you're right. In Australia and every other major country on earth, they guarantee health care for all people. They don't throw 24 million people off of health insurance.
ZELENY: The president delaying his first face-to-face meeting with the Australian prime minister after taking an impromptu victory lap in the Rose Garden, surrounded by House Republicans who helped deliver a much-needed win on his 105th day in office.
[06:05:05] TRUMP: We're going to get this passed through the Senate. I feel so confident.
ZELENY: Presidential promises on health care can be hard to keep. Just ask President Obama.
BARACK OBAMA, PRESIDENT OF THE UNITED STATES: If you like your doctor, you can keep your doctor under the reform proposals that we put forward. If you like your private health insurance plan, you can keep it.
UNIDENTIFIED MALE: Kill the bill! Kill the bill!
UNIDENTIFIED MALE: Kill the bill! Kill the bill!
UNIDENTIFIED MALE: Kill the bill! Kill the bill! ZELENY: Under his watch, Democrats lost control of the House and
Senate, largely over health care. The question voters will ultimate decide: is Trumpcare better than Obamacare?
TRUMP: We suffered with Obamacare. I went through two years of campaigning, and I'm telling you, no matter where I went, people were suffering.
ZELENY: The president basking in the moment. Vindication from failing to pass the bill more than a month earlier.
TRUMP: How am I doing? Am I doing OK? I'm president. Hey, I'm president! Can you believe it? Right?
ZELENY: Now the president has no public events on his schedule today as he breathes a sigh of relief at the biggest win of his young presidency. But there is an uphill battle in the Senate on health care.
A White House official tells me this morning the president learned a lesson from this whole process and plans to be more personally involved in this next phase of this.
But the reality is now he owns the reshaping of the American health care system. It's on him, the policy and the politics -- Chris, Alisyn.
CAMEROTA: Jeff, thank you very much for all that.
We obviously have a lot to discuss, so let's bring in our panel to help us make sense of this. We have CNN senior political analyst Ron Brownstein; CNN political analysts Maggie Haberman and April Ryan. Great to see all of you.
Maggie, so after all the consternation in the House, and you know, all of the last-minute arm twisting, now the battle begins for the Senate. So now what happens?
MAGGIE HABERMAN, CNN POLITICAL ANALYST: The Senate indicated it's paying no mind to what -- or very little mind to what the House passed yesterday. They are essentially starting over. And they have been holding a number of meetings the last couple weeks, largely led by Senator Ted Cruz to try to come up with a bill they way they think is acceptable.
But they have already said that they are very unhappy with what has come before. And so when you are essentially starting from scratch. After this process that we saw over the last month and a half or so in the House, this isn't even -- this is not reconciliation. This is not the normal process we are used to. This is basically two separate tracks on health care. And it's a reminder why so much of Washington has expectations and how you set them.
And so watching the president take this victory lap yesterday, I understand why he wanted to. This is a president who loves winning; this was important to the White House, psychically, as a victory. But really, that's all it was. A psychic victory.
CUOMO: Right. It's a "win" in quotes.
CUOMO: That's what it is. And now, you know, the politics are going to be less relevant, Ron Brownstein, in the Senate. It's going to be much more policy driven. One, just because the absolute numbers. For every Ted Cruz, you have, like, ten Ted Cruzes in the House versus one in the Senate. And the policy approach is almost completely opposite. The senators seem much more concerned about what happens to the needy and what happens to those voters who made up the Trump base than we saw in the House. True?
RON BROWNSTEIN, CNN SENIOR POLITICAL ANALYST: Right. Absolutely. There's a whole set of different considerations.
First of all, it was a win in the House only in the sense that an alternative was a clear loss, right? I mean, if you would have -- if this bill would have failed, the image of dysfunction would have been very harmful. Now the "victory," in quotes, is that they get to continue debating a bill for weeks that had a 17 percent approval rating in the public before they eliminated the nationwide guarantee to -- for people with pre-existing conditions.
Look, I think there are two key issues in the Senate. The first is that idea of allowing states to opt out of the nationwide assurance for people with pre-existing conditions. Very hard to see that getting through, which means the people in the House voted for a deeply controversial idea that is highly unlikely to see the light of day.
And the other, perhaps even bigger, is the question of the Medicaid expansion. Because you have in the end, after initial resistance, a number of states with Republican governors that did expand Medicaid. And in many cases, the beneficiaries of that expansion, a state like Ohio, for example, are concentrated among those older, lower-income whites who are the modern Republican base, especially in rural areas, especially in places dealing with the opioid addiction problem.
And it will be very difficult for Republican senators from states like Ohio or Nevada or even Arkansas to vote for anything like the $880 billion in Medicaid cuts in the House bill.
CAMEROTA: Here's what is it in, April, I mean, as far as we know. So let's just put this up here for our viewers so that we can try to understand it.
We'll start with what's out. OK? The individual mandate. The employer mandate. These obviously were not popular ever with Republicans. The subsidies for out-of-pocket money. Here's what's changing medication ex-expansion. The essential benefits. All the things that -- you know, we've talked so much about mental health, addiction services. And the pre-existing conditions policy will be up to the states.
[06:10:04] And then what's in is the wildly popular kids staying on your parents' coverage until 26.
CUOMO: And one thing we haven't been capturing in this is that, by taking away the subsidies, they're replacing it with a tax credit. OK? It's about 2,000 to 4,000. Families can get up to $14,000, then they start hitting you for income levels. But it is decidedly less money and less absolute than what was there now.
For instance, a lot of individuals work as a group at -- at their place of work. And they are not allowed to take this tax credit with them. So they have to go and get a policy individually. They can't pool all their credits together at the employer base. That was something that a lot of lawmakers wanted, but they wanted to show as much savings as possible. And so they -- people have less money to use for their health care. g
CAMEROTA: How do you see it, April?
APRIL RYAN, CNN POLITICAL ANALYST: You know, the question is, is it really a savings? We are waiting for the CBO report, and we're going to find out an estimate of what's going on.
But I talked to several senators and well as House members last night. And they were saying look, this is borne on the backs of the most vulnerable and elderly and poor and the most vulnerable. People with pre-existing conditions.
And originally, when they first started, when President Trump was campaigning, you know, talking about the problems and the ills of the Affordable Care Act, better known as Obamacare. You know, the White House did acknowledge, yes, at that time, the Obama administration did acknowledge that yes, you know, there needs to be some tweaks. Preferable, one of the key pieces was the issue of the high deductibles. Now it's more so other things that are being changed.
People are now dealing with the fact that, as you said, mental health, substance abuse and maternity issues, also pre-existing conditions are now possibly going to be opted out of some states getting waivers, and then they're going to possibly have to pay more. And it just does not marry.
You go from one issue to the next and then you still do not have a CBO score.
We just have to wait and see how this plays out. But it looks like the Senate will definitely start from scratch and then will rebuild this, because right now, as you see, the lawmakers are on recess. They're going to hear "yeas" or "nays" from the community, and it's going to be loud, one way or the other.
CUOMO: Well, look, you have -- this is a very clear case of competing interests, Maggie. You know, the CBO score. We know one thing in advance: it's going to show a big cost savings. There's no question about that. They took the taxes off certain businesses, off high-end individuals.
CAMEROTA: Adding, then, to the deficit or debt.
CUOMO: Well, it depends. It depends on...
CAMEROTA: If it follows what it did -- what the CBO did last time.
CUOMO: But it depends on how you want to play with the numbers. Because what they'll say is "We're reducing all the benefits. So we're going to keep our costs down. We're going to use that number to motivate tax policy.
But then you get what April just said, which is at whose expense? And that's when these senators are going to have to make a decision. When I go back home in my district. Even someone like a Joe Manchin, OK, they he need Medicaid money there. And what are you going to tell them? "Well, I saved a lot of money, just not for you."
HABERMAN: Look, there's a reason why you saw Tom Cotton of Arkansas up on stage at town halls, getting screamed at by a lot of his constituents about the need to maintain the President Obama's version of this health care law.
And there is a reason that you have not seen Tom Cotton, who's been an ally of this administration, really pushing this through. Take that as a case study. And you look at these House members, many of them who are moderates and even who are in swing districts who are worried about the mid-terms who have now walked the plank for a vote on a bill that likely -- again, likely -- will not end up looking much like this by the time it's done if it gets reconciled at all into something.
And you are now going to have months of Republicans arguing over this. This is important, as I said before, psychically, because you have had the Republican Party looking as if it could not move from being the opposition party to being the governing party. And so this was a hurdle in the minds of both Congress and the GOP and at the White House. But this is coming at a potential cost.
CAMEROTA: Go ahead, Ron.
BROWNSTEIN: Can I add two points to Maggie's point? First, if you look at who benefitted under the Affordable Care Act, over 20 million gained -- 21 million people gained coverage. Guess what? They were not all Democrats. If you -- if you look at the -- if you look at many of these interior Republican states, states that were critical to Donald Trump's victory and where there are Republican senators -- places like Ohio and Iowa and Wisconsin and Arkansas and West Virginia and Indiana -- a majority of the people who gained coverage under the law were non-college whites, who are the core of the modern Republican coalition. So that's the first point.
The second point that, if you look at who voted for this bill, many Republicans in competitive swing seats in the House were forced to vote for it in the end. There are 23 House Republicans in districts that Clinton carried. Twenty -- nine -- excuse me, nine of them voted -- 14 of them voted for the bill; only nine voted against the bill. In California, all seven of the House Republicans in districts that
Clinton carried voted for the bill in the end. And strangely enough, in a state that is so reliably Democratic, that probably makes California now ground zero in the battle for the House in 2018.
[06:15:15] So there is a -- there is a lot -- there's a big gamble put down on the table by a lot of House Republicans. Broader measure: 61 House Republicans are in districts that voted either for Clinton in 2016 or Obama once; 46 of them voted for the bill. All of them moved up on the Democratic target list.
CAMEROTA: All right. We will be talking more about that shortly. Panel, please stick around.
CUOMO: And April Ryan's point. When we come back, 50 percent of you out there are like us. You get your health care through work. So you don't really care about what just happened. Right? Wrong. We're going to take you through who wins and who loses here and what it will mean for the politicians next.
CUOMO: President Trump and Republicans are a step closer to getting rid of Obamacare, touting the American Health Care Act. Passing in the House was a major victory. So who are the winners and who are the losers under what just happened?
[06:20:07] Let's bring back our panel: Ron Brownstein, Maggie Haberman and April Ryan. Let's put up a graphic that shows winners and losers. We'll go from there.
Winners: younger Americans. Why? No mandate. Middle and upper class. Why? Well, the tax structure that has changed in this program. A lot of the taxes went away for the upper class. And healthy people. Why? Because if you don't have mandated coverage, you will get some salon effect where you can get a cheap plan that doesn't cover as many things.
So Maggie, when you look at the winners, let's just talk about them first. We have the losers. We'll get to them in a second. But how powerful is that base of winners in terms negotiating the next step of this in the Senate?
HABERMAN: It's not as powerful as the losers list. Right? I mean, the losers list -- I don't mean to swing to the other side too quickly. The winners list is going to comprise of states that are wealthier, places like New York and California, where there are big cities with lots of wealthy people.
When you are talking about people who are the drivers of the president's base and a lot of these swing districts in the House and some of these, as Ron was saying before, some of these purple and red states, those are poorer folks; those are working-class folks. Those are the people for whom Obamacare was designed to help.
And essentially, this bill, which the president keeps saying is going to be a huge improvement over Obamacare, does basically the opposite.
You had an interesting moment last night when he was meeting with the prime minister of Australia and he sort of let slip -- he was glowing about the health care bill passage, and he said, you know, "Of course, in Australia, you have better health care than we do." Well, what they have is something closer to Obamacare.
CUOMO: They have universal health care.
HABERMAN: Exactly, right. And Obamacare is not universal health care, but it was closer to it than this is.
CAMEROTA: Right. He was touting that as what the model should be. I mean, not model but something that was great.
HABERMAN: I think that this is basically a bill that has made several people have to make statements on the record, among them the president. But he won't be reelected -- up for reelection for another couple years if he does run for reelection. But it is going to put a lot of members of Congress in the next year and a half in a difficult spot for the reasons we just said.
CAMEROTA: OK. So now let's look at the losers. April just said that we can spell this out. So low-income people. Older Americans. To Maggie's point, these are some of the folks who voted for President Trump. People with pre-existing conditions, as we've discussed, and Planned Parenthood. This is interesting. Because April, as you know, there was just -- the Democrats were just sort of claiming a victory in the budget resolution, because Planned Parenthood wasn't touched there. Here funds for Planned Parenthood are cut.
CUOMO: For a year.
CAMEROTA: At the moment for the year. So what do you think in terms of the political calculus of why the president and Republicans would take this risk when much of that -- not the Planned Parenthood but the rest -- is their base? April.
A. RYAN: You know, yes, well, Chris -- I mean, Chris and Alisyn...
CUOMO: We're the same person.
A. RYAN: Politics early in the morning. No, you're not. You know the saying, all politics are local? Well, for this, politics is personal. You know, as one of your guests said, it's not just about Democrats or Republicans. It's everyone.
People are affected and to include a large portion of the president's base. He's got everyday people who were on the fringe for a long time. And a lot of these people have pre-existing conditions. A lot of these people are older. A lot of these people need this.
And I believe -- and then when you when you look at Planned Parenthood, they're going to be a loser, as well.
I think the American people who need Trumpcare will be losers. If this comes to pass -- and it doesn't look like it's going to come to pass in the Senate -- but on the face of this, the American public who would use Trumpcare would lose.
CUOMO: You know what's interesting, Ron Brownstein, just as one indicator of how this is being absorbed by the markets? You would think that health care company stocks would pop on this news. Right? Because this was just -- this would be a banner day for them. But if you look at the futures markets, it's not really going that way just yet, which means they probably priced in "We have to see what happens in the Senate." Because that's where the battle is going to be won or lost.
BROWNSTEIN: Well, also, Chris, if it did go through, you'd have 24 million fewer people with coverage buying -- you know, purchasing health care. So, you know, what you had in this, actually, is this extraordinary convergence of opposition from all of the varied interests in the health care industry, which are usually at odds with each other.
I mean, we had everyone from the AMA, the American Medical Association, the doctors to the hospitals to the AARP representing older Americans to even the insurance industry at the end, all coming out against different aspects of this bill but ultimately opposing it.
You know, and look, the Senate is not likely to pass anything exactly like this. On the other hand, you know, the question really will be how much do they roll back Obamacare, if they can find, you know, 50 votes at all?
I mean, for example, if they -- if they don't cut Medicaid by nearly as much as the House does, which is talking about an $880 billion reduction and 14 million people -- fewer people on the program, they may still, you know, come together around rolling some of this back.
[06:25:08] So I don't think people who have supported the Obamacare should view the fight is over for sailed into safe waters here. Because there is still the possibility of significant changes in this law.
CAMEROTA: But Maggie, it can't be all bad. That doesn't make political sense. The 2018, you know, midterms are just around the corner, may I remind you? So it doesn't make political sense.
Are you saying that they're just hanging their hat on "We kept a campaign promise," regardless of sort of the fallout?
HABERMAN: Not "just," but I would say that's a major piece of it. Look, during the campaign, I spoke to a lot of voters, a lot of people in poorer areas, in working-class areas and rural areas. There were some who relied very happily on Obamacare. And then there were others who said that their premiums had skyrocketed because of Obamacare. And they were very angry about it, and it was a huge driver. That is the flip side of this coin.
There is a reason why Republicans campaigned against this for three consecutive cycles. So yes, part of this is "We are going to stick to this." The other piece of this, though, however is that if that is the only reason you are doing something, you have to take all the equities into consideration. And there are a lot of equities on both sides in this case.
I think the other thing -- and I can't state this enough. It was important in the minds of some in the White House to get this through the House, because it was basically creating a log jam for other legislative priorities. Once the president had decided he was not going to drop it for a variety of reasons, he was going to move forward with it, they felt like they had to get this done.
CUOMO: April Ryan, you know, as we said during the tease, people are sitting at home saying, "Thank God I get my insurance through my employer. I don't have to worry about this." But -- but what this House bill would do if it stays consistent in the Senate is free the individual employers from the mandates, as well, in terms of what they have to cover. And they could pick any states' coverage, even if they're not headquartered there, even if they don't have business in that state and mimic those offerings. Which means they could reduce what they cover and how much contributions their employees have to make. Right?
A. RYAN: Yes. Most definitely. What happens federally sends a rip the effect throughout private sectors.
So Trumpcare recipients, Obamacare recipients, once it becomes Trumpcare, they wind up being the example for private industry and insurance. And many of us who are not on Obamacare or ACA or it could possibly be Trumpcare, are worried, as well.
I mean, you know, think about this. Many Americans have pre-existing conditions. We've talked about this before. Many Americans are -- we are a nation that has numbers that are getting higher in age. And people are living longer. And that's something we have to worry about as you get older. Am I going to be paying more when I'm trying to pull back?
So I mean, this has a ripple effect on private insurance industries, as well. Those who are not -- those who are not involved in Trumpcare. But again, this is very personal for a lot of people.
CAMEROTA: April, Ron, Maggie, thank you all very much. Have a great weekend.
CUOMO: All right. So we have to discuss the different aspects of effect here. And coming up on NEW DAY, we're going to talk about it with governors. All right? Because they've been left out of this conversation. All this idea about choice, this is what the governors wanted, and we're going to help them with the Medicaid thing, giving them what they wanted. Is that true? You've got one from each side of the aisle. Both have been very active. Terry McAuliffe and Asa Hutchinson. We also have senators Tim Kaine and Congressman Mark Sanford on to kind of round out how people are reacting to this and how we move forward.
CAMEROTA: And meanwhile, another story: historic flooding in America's heartland. Rivers are rising, levees failing. The threat is not over today, so we have a live report for you next.