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Health Care Bill Passes House, Faces Uphill Battle in Senate. Aired 7-7:30a ET
Aired May 5, 2017 - 07:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
GOV. TERRY MCAULIFFE (D), VIRGINIA: Build a strong economy. Keep our folks healthy. We have a very lean system. And in fact, we have one of the leanest systems in all of America, if you look at our system. I don't have any room to cut, and that's the problem with a per cap. I can't go back and cut. Do I tell the single woman, "I'm going to take that away from you and take it down to $5,000 -- you have to make $5,000 a year"? These are real people and real numbers and, unfortunately, the rhetoric of a political campaign has come in and it's going to do grave danger to our brave country.
[07:00:29] CHRIS CUOMO, CNN ANCHOR: Governor Terry McAuliffe, thank you for calling in. Be safe down there. Appreciate your perspective as a governor of a major state.
MCAULIFFE: Thank you, Chris.
CUOMO: All right. Thank you, sir.
"Per cap," he says. That means "per capita."
They have choices now. You can get money on an individual basis or you can get a block grant. But as the governor said, either way, you're going to get less.
All right. Thanks to you, our international viewers, for watching. For you "CNN TALK" is next. For our U.S. viewers, what does this health care bill mean to you? We've got the answers. Let's get after it.
DONALD TRUMP, PRESIDENT OF THE UNITED STATES: We're going to take care of a lot of people with their health care needs.
SEN. BERNIE SANDERS (I), VERMONT: If the bill became law, thousands of Americans would die, because they no longer have access to health care.
UNIDENTIFIED MALE: I don't think this bill is going to go anywhere in the Senate.
REP. PAUL RYAN (R-WI), SPEAKER OF THE HOUSE: We have a lot of work to do.
One thing is now clear. Republicans are committed to keeping our promise.
REP. ELIJAH CUMMINGS (D), MARYLAND: I didn't come here to take away people's rights. And I'm not going to.
TRUMP: This is a repeal and a replace of Obamacare. Make no mistake about it.
UNIDENTIFIED MALE: The "ayes" are 217. The "nays" are 213.
REP. NANCY PELOSI (D-CA), MINORITY LEADER: They have this vote tattooed on them. This is a scar they will carry.
ANNOUNCER: This is NEW DAY with Chris Cuomo and Alisyn Camerota.
ALISYN CAMEROTA, CNN ANCHOR: Everyone, welcome to your NEW DAY. President Donald Trump celebrating his first legislative win in the House, but the fight to repeal and replace Obamacare now shifts to the Senate, where it faces an uphill battle. Some Senate Republicans are already rejecting the House bill. They want to write their own.
CUOMO: All right. The president, though, taking a victory lap from the White House to New York. Democrats are vowing that Republican lawmakers are going to pay when people head to the polls next year. They were literally doing that "Na, na, na, na, hey, hey, bye-bye." That was the Democrats doing it to the Republicans.
CAMEROTA: Why didn't you sing that? It's better sung.
CUOMO: I felt it would be too influential. My voice can literally change your entire day for the worse.
CAMEROTA: I know that.
CUOMO: We have it all covered. Let's begin with Suzanne Malveaux live on Capitol Hill -- Suzanne.
SUZANNE MALVEAUX, CNN SENIOR WASHINGTON CORRESPONDENT: No more singing there, Chris.
Well, House Republicans took a significant step, of course, into fulfilling a promise to the American people in passing their health care plan on the House side. But there is a significant way to go before it becomes law. Senate Republicans already rejecting some key provisions of this bill. Some even vowing to start from scratch.
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.
SANDERS: Mr. President, I'm sorry to disappoint you. This bill in its current form is not getting through the Senate. No way. No way.
SEN. BILL CASSIDY (R), LOUISIANA: 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, who 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.
[07:05:07] RYAN: I don't think we should pass bills that we haven't read.
We shouldn't rush this thing through.
MALVEAUX: The CBO score is expected to take several weeks. And then, of course, Senate Republicans saying that it will take several weeks for them to go through their deliberative process. They say it's going to be a process that is not going to be rushed and that will also consider compromise, and that bill will go back to the House where the debate will start all over again -- Alisyn.
CAMEROTA: And you'll be covering all of it for us. Suzanne, thank you very much for all of that.
So President Trump, though, is taking a victory lap. He is riding high on his first legislative win in the House and again declaring Obamacare dead. But he also made some head-scratching comments after the vote. CNN's Jeff Zeleny joins us now with more on that.
JEFF ZELENY, CNN SENIOR WHITE HOUSE CORRESPONDENT: Hey, good morning, guys.
President Trump is waking up this morning at his golf course in Bedminster, New Jersey, after spending just a little more than four hours in New York City last night. It was his first visit back to his hometown since taking office. And was welcomed by some protesters, which is why he didn't stay longer.
But he did arrive with a sense of satisfaction that one of his biggest campaign promises is one step 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 air 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 to 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.
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 (D), FORMER 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: 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. There is an uphill battle in the Senate. A White House official tells me the president learned a lesson from this whole process and plans to be more personally involved in the next phase of this.
The reality now: he owns the reshaping of the American health care system. It's on him. The policy, the politics of Trumpcare.
CAMEROTA: OK, Jeff, thank you very much for all that.
Let's bring in our political panel to discuss it all. We have CNN political analysts Abby Phillip and Maggie Haberman; and reporter and editor at large for CNN Politics, Chris Cillizza.
Maggie, so everything that just happened over the past couple of weeks in the House, that was fun. Now the real work begins in the Senate. I mean, is that fair to say? For all intents and purposes, they're starting from scratch?
MAGGIE HABERMAN, CNN POLITICAL ANALYST: Literally starting from scratch. You heard them essentially say, "We are not going to pay much attention to this. You're not seeing the normal process that we're used to of reconciliation where you have essentially dual tracks that are going in the same general direction. I mean, there is a lot that is, I think, going to be tossed out. And then we will see what it ends up looking like when they try to marry these bills.
But make no mistake. You have a lot of senators who are from purple states or from red states where President Trump did well who have a lot of working-class or rural voters who do like Obamacare. Obamacare is not a slam dunk for a lot of voters. I heard plenty of voters complain about it during the 2016 campaign and had their premiums had gone up.
But enough of President Trump's base of support and enough sort of swing voters favor it that it is not the easiest thing in the world to just take it and get rid of it. And the thing, the provisions that those voters liked in many cases are not in the House version.
CUOMO: And even if they didn't like Obamacare, it is hard to argue they are better served under what just passed as Trumpcare in the House.
CHRIS CILLIZZA, CORRESPONDENT AND EDITOR AT LARGE, CNN POLITICS: Sure.
CUOMO: -- the idea of the president looking at the Australian leader and saying, "You have better health care than we do. You have universal health care," you know, which is what the implication was from that.
Do we dismiss this as complimentary and not knowing what he was talking about in term of Australian health care? Or was this an admission on its face that he prefers, you know, the Democrats' version of what they want on health care?
CILLIZZA: I think we -- well, I shouldn't -- dismiss may not be the right word, because I do think this is a sort of a larger pattern of anytime he goes off script, he does stuff like this.
But I do not think he knew what he was endorsing there. I think he has a tendency to sort of tell people what they want to hear, particularly in a public setting like that. And that's what he was doing here.
I don't think he's -- my guess is he did not study up on the Australian health care system before doing that sit-down.
So again, the more he talks, I think his 100-week -- 100-day mark was a bad one because he gave so many interviews. I counted 12 or 13 interviews he gave. He just talks and talks and talks. And it's almost always -- Maggie and Abby can attest to this better than I can -- it's almost always off script. He starts on-script, but then it goes in this -- it's like reading Jack Kerouac. It just goes in this sort of stream-of-consciousness all over the place.
And he says stuff that he just sort of heard. And that is not good -- first of all, it's not good as a statesman, generally. When you're the most powerful person in the country, maybe the world. But it's not good politically, because you say and do stuff like this.
Even the thing with the House Republicans yesterday: "Am I president? Huh, huh, huh?" You know, I'm not sure that that's the best thing to be doing when you are trying to reform a health care system lots of people are worried about.
CAMEROTA: Well, by the way, this is not the first time that he has endorsed universal health care. In his 2000 book, he was all for it. Let me just read a passage for you: "I'm a conservative on most issues but a liberal on this one. We should not hear so many stories of families ruined by health care expenses. We must take care of our own. We must have universal health care."
So he liked it then. Obviously, there's been many years, but he seemed to like it again yesterday. And, you know, in terms of what -- what Republicans are thinking with this bill, it would be political suicide if they -- if it was all bad. So clearly, they see some advantages in what they just passed in the House.
PHILLIP: Yes, I mean, you're right. The universal health care thing is one of the things that Trump has held onto, really perplexingly over many, many years. As recently as a few months ago, he was saying he wanted everyone to have insurance. This plan clearly does not accomplish that.
And -- but there's a disconnect here between Trump wanting that, wanting people to have everything that he thinks is good for them. He wants them to be covered. He wants pre-existing conditions to be covered. And the political reality that that's not really possible in a Republican House.
I think if Trump is going to move forward here, it's going to be with a bill that is going to be substantially changed in the Senate, and Republicans are actually -- you heard Mark Meadows saying, "I actually think the bill is going to get so much better in the Senate, because they don't think that the substance of this bill is doing what they need to accomplish. The tax credits are not high enough. The Medicaid expansion, that process does not work for the states. There's a lot that they have to fix, and Republicans in the House are actually hoping for that.
CUOMO: It will be interesting if this gets exposed through the Senate process as a naked political play by those in the House and whether they get punished for it.
Another piece of sound to evaluate. Ryan hanging this as his big victory as speaker: "We did it. We got it done. This is the right way to do it."
Here's what he said about Obamacare.
(BEGIN VIDEO CLIP)
P. RYAN: Last week, in a stunning and revealing statement, Speaker Pelosi said, in quote, "We have to pass the bill so that you can find out what's in it," end quote. This is the vaunted transparency that the president promised? The arrogance, the paternalism, the condescension to the American people is just breathtaking. This is not just a simple fixer bill either. This is the lynch pin for health care.
(END VIDEO CLIP)
CUOMO: He went on to say in another interview, and many times, "We shouldn't have done this before we knew its impact." He just did. And obviously hypocritical move. And yet, he's being celebrated for it. Maggie, explain.
HABERMAN: Well, I think it depends on who you see doing the celebrating. Right? I mean, I think we saw the White House celebrating and members of his conference. You saw Democrats waving and saying, you know, "Na, na, na. Na, na, na, good-bye." Because they do remember what happened.
[07:15:06] I mean, look, Republicans are looking at a mirror version of what they complained about Democrats doing.
And remember, Obamacare was debated over many, many months. And this was not rushed through in a couple of weeks. There was a much longer process. To be clear, you can have lots of complaints about how that bill went down, but it was done in a much more thorough way.
This is not -- there has been no CBO scoring yon this yet. You had Chris Collins acknowledge he wasn't familiar in the bill, that he hadn't read it. Those kinds of bits of sound you just played, I think, is the type of campaign commercial that you can expect to see in another year or so. Obviously not against Paul Ryan, necessarily, as effective, but against a lot of these moderates in swing districts who are vulnerable with voters who do prefer what exists.
PHILLIP: And when you take things away from people, it's harder. You have to explain it to them. You cannot just say, "Oh, your pre- existing conditions were here yesterday, but they're going to be gone tomorrow. We won't tell you exactly how that process is going to work."
This is the huge political gamble that they are playing here. That's why the Republicans were so opposed to Obamacare in the first place. You give people entitlements. Taking them away is hard, almost impossible, and it's very, very unpopular.
CUOMO: So you have a slice, Chris Cillizza, that the Republicans have zeroed in on on everything that's about Trumpcare. And it is about one and a half to two million individuals in the individual market who got hit with spiking premiums and high deductibles for various different reasons. That's their gamble here. How big a stakes are -- how big are the stakes?
CILLIZZA: Well, they're huge, because one and a half or two million people, Chris. We don't -- Maggie noted this -- we don't have a CBO score. So we don't know how much it's going to cost, and we don't know how many people are -- are going to be missing coverage as a result of it.
The problem for Republicans is we're going to find that out. The CBO will score this, almost certainly before the Senate does anything with it. And my guess is you're going to have more than one and a half or two million people who are not covered. There were 24 million people when the CBO first scored this that had coverage under Obamacare that would not have coverage under the House plan. That's the issue.
I think Abby makes a really important point. When you take something from someone that, even if they didn't like it, they had it, that it's very hard, politically speaking.
Because the explanation for Democrats now is, "You had this. They took it from you. You don't have it anymore."
The explanation for Republicans is "Well, you don't have it anymore, but let me explain." That explanation usually goes longer than a 30- second television commercial. And the Democrats' explanation takes about five seconds in a television commercial. And then you play a clip of Chris Collins saying, "I didn't even read the bill." End -- end scene. Right?
So that to me is the problem. I don't to make -- there are real policy impacts here, obviously, for people with pre-existing conditions. If the Medicaid funding freeze goes through ultimately. But from a political perspective, this is a much easier sell if you are a Democrat running against a Republican who just voted for it.
CAMEROTA: You make such a good point. Hands off my stuff. Even my bad stuff.
CAMEROTA: Thank you, panel. Great to talk to you.
CUOMO: All right. So the House bill promises to give states more control of health care. You've been hearing a lot of people talking about what governors want. You have not been hearing from governors. We gave you a Democrat in Virginia, Governor Terry McAuliffe.
Now we have a Republican, the governor of Arkansas. What do they say they wanted and what they're getting with this bill? Next.
(BEGIN VIDEO CLIP)
[07:22:36] UNIDENTIFIED FEMALE: I could tell you three members of my family, including me, that would be dead -- dead! -- and homeless if it was not for ACA. I am an angry constituent. You work for us!
(END VIDEO CLIP)
CUOMO: All right. That was in February. One angry Arkansas voter taking on Senator Tom Cotton at a town hall. Now the Republican controlled House voted to dismantle key parts of Obamacare. Governors are often used as a reason for many of these changes, that "This is what the governors asked us for."
Now, what does that really mean? We haven't really been hearing from governors. We're going to hear from one right now, Arkansas's governor, Asa Hutchinson, joins us right now.
Governor, thank you for joining us. I do not want to ignore a very pressing situation going on with flooding in your state right now. We know especially in certain northeastern regions there's a problem. How are you guys doing? How great is the need?
GOV. ASA HUTCHINSON (R), ARKANSAS: Well, it's very dramatic. I did a flyover yesterday and saw much of the flooding region. And the water, thank goodness, is receding in many parts, but we've had broken levees. It's going to impact our farm lands, and we're going to have significant damage. We're going to be asking for a natural -- national declaration down the road. But right now, it's all about recovery and saving property and lives. Thank you.
CUOMO: Now, look, the concern is real. And we are here to get out the information as needed for what will be done to help those being victimized in Arkansas and elsewhere in the flood region.
So look, let's use that as a pivot point to what your job is all about. You know, being a governor is about taking care of those in need. What do you say to your constituents in your state about what Trumpcare, this bill that just passed, means for them?
HUTCHINSON: Well, whenever we passed the bill in the House, we need to understand that's not a completion of the process. It's a good first step, but we don't want it to be the final step. And there needs to be more changes in the Senate.
But what we have right now, from a governor's standpoint in Arkansas, is really not manageable over the long term. We can't afford the system. And for example, in Arkansas, in the Medicaid expansion, we estimated 250,000 would be on the program. It's dramatically increased to over 320,000. That's one of the things that we started doing in our own reform in Arkansas, asking for waivers from the federal government that we could not get under President Obama's administration.
[07:25:27] And so there needs to be change. It started in the House yesterday. It gives us more flexibility to manage our health care systems. But it still results in a cost shift to the states that needs to be rectified when it gets to the Senate.
CUOMO: You know, now I want -- I want you to explain that to our audience, please. Because I've had so many Congressmen on. And I know, you know, governors are busy. It's hard to get you on. But now that I have you.
They say, "Hey, this is what the governors asked us for. They wanted flexibility. I can give it per capita, based on how many individuals you have in the program. I can give you a block grant. That's what they wanted." And what they ignore is that they are cutting how much you're going to get, period. And they're going to shift that cost to the state as if you guys had bottomless pockets. What is the reality?
HUTCHINSON: Well, the reality is that we need that flexibility. And a good example is that we want to put a simple work requirement in those -- for those that are on Medicaid when they're able-bodied and don't have dependent children.
The Obama administration or Obamacare refused to give that to us.
HUTCHINSON: We need that work requirement in place so we can get people trained, we can move them into the work force. We don't want this to be a permanent entitlement program.
Secondly, we want to concentrate our limited state resources on those who are at the poverty level or before. The Obama administration insisted that we cover up to 138 percent of the poverty level. We need to concentrate our resources, and that's why we're limiting it, asking the federal government if we can limit it to 100 percent and those that are greatest in need.
And when it comes to flexibility, sure, we've got to look at the per capita cost to make sure there's sufficient money there to cover the program needs. I'm also worried about those that are moving toward the exchange that the subsidies on the exchange continue in a fashion that gives people a solution that, whenever they are in that mid-range above poverty level, but not making enough to afford health insurance.
CUOMO: Right. But I'm not -- I'm not hearing you on that aspect. They're cutting the amount of money that you're going to get from the federal side. They're going to ask you to chip in more. You know, looking at your fiscal numbers, I don't see where that money is going to come from.
Is that a real issue that needs to be addressed in the Senate? How much money states like yours will get to take care of people who can't take care of themselves?
HUTCHINSON: I think the federal government can save money on the Medicaid side of it, on the Medicaid expansion. If you give us more flexibility, more ability to control the costs, and we'll save money for the federal government and to the states.
Where the issue, I think, most dramatic is, whenever you're looking at the subsidy on the exchange, we have to have the federal resources focused on those that are moving off the exchange, moving up the economic ladder, trying to get a better job. That's where we need to concentrate the federal resources. And right now, it's strung out too much on the higher income levels.
HUTCHINSON: We want to make sure that we don't absorb the burden on that in the states in terms of uncompensated care. That's what needs to be looked at in the Senate.
CUOMO: So what do you say to the Senate as they take up this bill? What do you want to see as change from what is being put on their desk?
HUTCHINSON: I would like to see a closer examination of that cost shift to the states and how that could be remedied. This is a partnership with us and them. What everybody wants is that we want more in the private insurance market so markets control more on the cost of insurance. And we believe that competition will drive those costs down and increase availability.
And so that is something that we need to look at those cost shifts to make sure they're sufficient when we move them off of the Medicaid expansion, move them off of Medicaid that they have somewhere to go.
And let's focus our -- our attention in the Senate on that option, and we'll partner with them to save both the federal government money as well as the states. If we can have flexibility in our programs and to make sure they're sufficient for that subsidy that they currently have on the exchange. But we're concerned about that being more limited under what came out of the House.
CUOMO: Governor Asa Hutchinson, thank you very much. And again, many wishes for safety and a quick, quick duration to the flooding that's going on down there.
HUTCHINSON: Chris, thank you very much.
CUOMO: All right. Be well.
Coming up in just minutes, Virginia Senator Tim Kaine joins us live. Remember, we heard from the governor of his state. Now the senator is taking up the bill. What is he going to say about what the Senate will do with your health care? Alisyn.
CAMEROTA: So Chris, how will the GOP's health care bill impact all of us? We have experts from both sides to break it down next. (COMMERCIAL BREAK)