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Puerto Rico in Crisis; Latest Republican Obamacare Repeal Effort Nearing Collapse. Aired 3-3:30p ET

Aired September 22, 2017 - 3:00   ET



PAMELA BROWN, CNN ANCHOR: I'm Pamela Brown, in for Brooke Baldwin, on this Friday.

Senator John McCain says he will vote no on the new effort to replace Obamacare.

In a statement McCain says in part: "I cannot in good conscience vote for the Graham-Cassidy proposal. I believe we could do better working together, Republicans and Democrats, and have not yet really tried, nor could I support it without knowing how much it will cost, how it will affect insurance premiums and how many people will be helped or hurt by it without a full CBO score, which won't be available by the end of the month.

"We won't have reliable answers to any of those questions. I take no pleasure in announcing my opposition. Far from it. The bill's authors are my dear friends. And I think the world of them. I know they are acting consistently with their beliefs and sense of what is best for the country. So am I."

And with that, Republicans only have one vote left to lose. And with several senators expressing a wide range of concerns, their chances are looking bleak.

Let's go straight to CNN congressional correspondent Phil Mattingly on Capitol Hill.

What has the reaction been so far, Phil?


And I can tell you that a lot of Republicans that I have been speaking to, those that are actually text messages, e-mails and phone calls right now, were absolutely taken aback by that. They didn't know it was coming.

I'm not speaking for leadership for senator Lindsey Graham, obviously a close friend of Senator McCain, co-author of the bill. Their offices haven't responded yet on this. But a lot of people didn't know it was coming today.

And I think it's the timing that people are most struck by. If you talk to them about what they expected going forward, they knew it was a jump ball at best, Pamela, because they remember what Senator McCain was saying on the Senate floor just a little bit more than a month ago, really talking about process, really kind of castigating the chamber for not working in a bipartisan manner.

Senator McCain is essentially sticking to exactly what he said over the past couple of months on this issue in particular. I want to talk about what this actually means going forward.

As you noted, this is two official out no votes right now. Senator Rand Paul is a no for reasons that he feels the bill doesn't go far to repeal and replace Obamacare, Senator McCain obviously because of the process, because of the way this has all come about.

You look at Susan Collins, she is leaning no. That is what she told "The Portland Press-Herald" today," a hometown paper for her up in Maine. I can tell you I have been talking to leadership officials since this kind of came back from the dead about five or six days ago.

Nobody has ever considered her as a possible yes vote. That in and of itself win, those three senators, when or if Susan Collins comes out as a no would give Democrats the votes with their caucus to block this.

This would essentially sink the health care plan altogether. And, as you can imagine, Pam, Democrats are seizing on this. Senator Chuck Schumer, the leader of the Democratic Party in the U.S. Senate, putting out a statement saying: "John McCain shows the same courage in Congress that he showed when he was a Naval aviator. I have assured Senator McCain that as soon as repeal is off the table, we Democrats are intent on resuming the bipartisan process."

It is worth noting Senator McCain discussed that bipartisan process, that bipartisan work that had been taking place between Senator Patty Murray, a Democrat, the top Democrat on the Senate Health Committee, and Lamar Alexander, the top Republican, until the repeal effort came back.

Democrats ready to go on that. The big question now is what do Republicans do? Do you still hold the vote even though you know where this is going? One other thing to keep a very close eye on. It wasn't just those three senators, Collins, McCain and Paul, that were in the no or likely no column.

There are a handful of others, most notably Lisa Murkowski, a couple senators from Medicaid expansion states that hadn't come out publicly in support of this. We were kind of waiting the see what was going to happen.

It's a very real possibility that Senator McCain is providing cover for everybody right now who was considering voting no.


BROWN: I was just going to say, was he trying to sort of alleviate the pressure in a sense on Senators Murkowski and Collins, given the amount of heat they are facing if they vote no? MATTINGLY: Yes, look, in speaking with Senator Murkowski, I think she

was going to be pretty independent on her decision on this no matter what.

And I think there was a lot of trepidation amongst Republican leaders that she would ever come around as well. But if you look and down the conference, it wasn't like there was a mad rush to support this bill. They were seeing the same things a lot of other people were, outside groups, advocacy groups, everybody kind of coming out against this.

And some were very wary of taking this vote. But I do want to note that until Senator Collins comes out as a no, and even if she comes out as a no, it doesn't foreclose the possibility that they still hold a vote, put everybody on record, tell them this was their last chance to repeal and replace.

One senior GOP aide I spoke to said right now they are evaluating options. They don't exactly know which way they are going to go. But he also noted, I'm not breaking news, Pam, in telling that this is not good.

BROWN: Absolutely not for Republicans, for sure.

Still, tonight, the president is a Republican senator at risk of losing his seat. What should we expect? How do you think this will play into everything?

MATTINGLY: Look, a rally in the evening down South, for those of us who cover the president on the campaign, you know that that opens the door to all sorts of things.


They are entertaining and they are a little bit wild. And they are very rarely scripted. And I think when you get in a situation like this, you look at all of the news that's been happening over the last week, there are no shortage of topics for the president to discuss.

But if you look back to the failure at the end of July of this repeal and replace effort, you look at the effort to revive it in such a short, compressed timetable, this is obviously going to be top of mind. The president said repeatedly on Twitter and public comments this is something Republicans promised campaign cycle after campaign cycle.

He thought there was going to be a repeal and replace bill on his desk the first day, he said, whether or not that was possible legislatively. So the idea he would just ignore this, that he would avoid this, that he is going to dodge this tonight, I think you're probably going to hear a little bit of his thoughts, perhaps on Senator McCain.

Obviously, they have an interesting past and history. But most certainly on if Republicans can't move forward on this -- and right now it looks like they can't -- his feelings on their failures, Pam, I think you know quite well the kind of anger inside the White House, particularly in the Oval Office, with how Senate Republicans have operated over the course of the last nine months.

Whether merited or not, there's a lot of fingers to be pointed here, but the president clearly believes Senate Republicans have been incapable of moving his agenda forward. And it's almost a certainty, at least based on past impression here, that you're going to hear about that tonight.

BROWN: Certainly. He has not held back when it comes to Senator Mitch McConnell, John McCain. Previously, he was outspoken about him when he -- the last no vote.

You're right. I think we will be hearing more from him, his thoughts tonight.

Thanks so much, Phil Mattingly.

I want to bring in Republican and CNN political commentator Doug Heye, "RELIABLE SOURCES" host Brian Stelter, and CNN political commentator Ana Navarro, who is also a friend of John McCain.

Brian Stelter, to you.

Take a look at this tweet from Jimmy Kimmel, Where he profusely thanks John McCain for being a -- quote -- "a hero again and again and now again."

Just curious what your view is in terms of his impact, his role in all of this?

BRIAN STELTER, CNN SENIOR MEDIA CORRESPONDENT: We are talking about a late-night host who really has had a big impact on the health care discussion in the United States.

He has been talking about this bill on television all week long, reaching millions of people. And then because it is so unusual to see a comedian railing against a health care bill, his comments have been picked up and covered all around the country, reaching tens of millions of people, including a lot of United States senators.

So, I think Kimmel definitely has had influence in this conversation. He is on Twitter, as you just showed a few minutes ago, thanking McCain, referring I think to the earlier moment where McCain came down to the floor and voted no with that thumbs down and now with this decision this afternoon.

You see Kimmel praising McCain for that decision. Kimmel is not going to be on tonight. So, Twitter was his way of expressing support. But this is deeply personal for this late-night host. He has had a son with a heart problem. He has talked about that openly on the show.

We see sort of in this weird moment of media, where news and entertainment continue to blur, a late-night host being an influential voice in this health care conversation.

BROWN: Yes. I saw you retweeted his wife, who was saying, look, people who are telling us stay in our lane, the lanes are merging. We have something to say here. This is personal for us.

Doug Heye, your reaction to John McCain once again becoming a thorn in his party's side?

DOUG HEYE, CNN POLITICAL COMMENTATOR: Well, that's the role John McCain has played for a long time.

But I don't want to overemphasize John McCain's decision today on what his status as a hero is. Last night, I didn't watch "Jimmy Kimmel." I was actually watching the PBS documentary on the Vietnam War, which showed the footage of John McCain.

He was a hero in the Vietnam War for us. He's not a hero because he votes yes. He's not a hero because he votes no. John McCain is a hero. Whatever problems Republicans have with health care, and they go back years and years, ever since Obamacare was enacted, even before -- that's not -- that's got nothing to do with John McCain.

Republican struggles with health care are a real party creation. The bigger challenge for Republicans is, what is Donald Trump's role going to be now? He has suggested this month and shown us this month that he is quite willing to go around congressional Republicans and work with Democrats.

If that's the move the president makes in the further, whether or not the Republicans have a governing majority, I think is in serious question.

BROWN: Ana, are you surprised that his friend Senator Lindsey Graham couldn't convince him on this? Is she there with us?


BROWN: Well, I was told she is with us.

OK. OK. Go ahead, Ana.

ANA NAVARRO, CNN CONTRIBUTOR: No, actually, I'm not.

Look, if you no anything about the relationship between Lindsey Graham and John McCain, it is a true friendship. It is the type of friendship, Pam, that we should all be blessed with, where they can deliberate about issues, they can argue about issues.

They can agree and they can disagree. And they understand and respect each other's individuality and each other's conscience.


And I have no doubt that Lindsey Graham has no problem. He may be disappointed. But he has no problem in respecting the fact that his friend, his mentor (INAUDIBLE) as well is today exercising his convictions, his principles, and his conscience.

That what true friendship is all about. Too often, in today's political world, we expect friends to align themselves 100 percent with what we believe. That's not what John McCain and Lindsey Graham do.

They are individuals. They respect each other. They love each other. They love each other endlessly. The friendship between these two is -- it's a joy to watch in action.

But at the same time, they respect each other. I am not surprised that Lindsey couldn't convince him. I think that Lindsey would not want to convince John McCain to do something that's against his convictions.

And, frankly, I could not imagine, after the speech John McCain gave, with such drama, such poignancy, such a powerful speech when he returned to the Senate and spoke for 15, 20 minutes about regular process, making a plea for bipartisanship when it came to health care and other issues, I could not imagine him, having give than speech a month ago, and then turning around and voting for something where there has been no regular order, which has not been fully debated.

That was just unimaginable to me. So, I think today what we saw was John McCain acting consistent with his conscience.

BROWN: And let me ask you this, Doug Heye, because he did hint that he wanted that process.

He wanted this go to through the normal order, and that that isn't happening. In some sense, it's not a surprise he is voting no. But how much do you think the timing of this, announcing this today, was also an effort by John McCain to take the pressure off, you know, Susan Collins and Lisa Murkowski, those senators who were under a lot of pressure and were likely going to vote no anyway?

HEYE: Yes, certainly a lot of pressure, especially towards Lisa Murkowski and talks about whether or not deals were being cut, say, a bridge to somewhere for Lisa Murkowski if she voted yes.

I think part of this was to help his colleagues. But, to Ana's point, the United States Senate is not a buddy system. People have to represent their states and work in their state's best interest, regardless of what that vote may be, whether it's yes or no.

The problem that Republicans faced with this is, part of it was process. There's no CBO score. Part of it was policy, the question about preexisting conditions, which was very difficult for Republicans to answer, the question about block grants, which was very difficult for Republicans to answer.

And, again, Republicans have struggled with health care for years and years now. I can take you back to 2014, when I worked in the House of Representatives. We spent six months working specifically on a replacement bill. We not only weren't able to put a white paper together. We weren't even able to get past the meeting phase.

So, it's no surprise that yet again we see Republicans struggling. The real question now is, with the September 30 deadline, is this the Republicans' Elvis Presley moment? Is this now or never?

BROWN: All right, stand by, everyone.

I'm about to speak with one of the people behind this bill, former Senator Rick Santorum, who has been pushing it behind the scenes all week. We will get his reaction to Senator John McCain putting it on the brink.

We will be right back.



BROWN: More on our breaking news right now.

Senator John McCain saying he will vote against the new Republican health care bill, putting it on the brink. Republicans cannot afford to lose one more vote.

My next guest was one of the chief collaborators of the Graham-Cassidy bill. He was instrumental in crafting some of its more nuanced policies. And he has been in the thick of negotiations all week, CNN senior political commentator and former Senator Rick Santorum.

Rick, Senator, this is clearly personal for you. Let me first just get your reaction to this news.

RICK SANTORUM, CNN COMMENTATOR: I was surprised by it.

Senator McCain has said repeatedly that he actually likes the bill, that he actually likes the structure of the bill, he likes the idea of federalism, he likes the idea of giving the power back to the states.

His governor, Doug Ducey, who we have worked with very closely on the bill, came out in favor of the bill last week. And John has always said throughout the process that he didn't like the fact that this didn't go through what was termed regular order in the United States Senate.

And John is a big regular order guy. You got through the committee and the markups and all these things. And so that's always been a concern to John. We knew it was always a concern and you know, disappointed, obviously that he decided on that reason alone to vote against the bill that is about federalism and does help the state of Arizona, and, by the way, all other states, in my opinion, because we are going to get much more effective health care than what we're getting under Obamacare.

But I think I can tell you that having talked to the group here just before I came on air, the commitment is still very strong to move forward. We feel no vote is decided until it's cast. There is still an opportunity for us to get there.

And even though I know people have said they are not for the bill, there is a week or so to go. There will be a hearing on Monday in the Senate Finance Committee. I will be testifying at that committee hearing on Monday and explaining the bill.

The bill hasn't even been filed yet. There have been drafts circulated around, but the final bill hasn't even been filed. I think there's still some room, and we will continue fighting on. We think we have a bill that can get to 50.

BROWN: So, you say you're surprised by his announcement today, Senator McCain's announcement that he will vote no.

But he has been hinting at this. He has been very clear of what he is not comfortable with. And he listed them. And you pointed out one of them. But he listed them in his announcement today.


He said no CBO score. And this is something that will impact the economy in a huge way and the health of every American family, and yet no CBO score, no bipartisanship. And it is not going through the normal process.

In light of his arguments he makes here, his list of reasons, does he make a fair argument, in your view? Can you see where he's coming from here?

SANTORUM: Well, number one, there will be a CBO score.

BROWN: But before September 30?

SANTORUM: Yes. Oh, yes. There will be a CBO score before September 30.

BROWN: And before the vote, there will be a CBO score?

SANTORUM: Absolutely. I was on the phone today with CBO a couple of times.

And so the answer is, CBO is working very, very hard. I give them a lot of credit. They have been really diligent in taking this on and focusing on this. We've had to make -- as the bill gets out and people react to it, you make a tweak here and there to address issues that maybe we didn't see.

And it is an iterative process. And CBO has really been great in working with us so far. And I can tell you without a doubt there will be a CBO score before there's any vote.

So, that's one of the things that John mentioned. And again there will be a hearing on Monday, which is part of the regular order, if you will.

As far as bipartisanship, that's a pretty high hurdle. Lamar Alexander worked with -- tried to work with Patty Murray on the Health Committee for several months now and got basically nowhere.

The Democrats have basically decided that the only thing wrong with Obamacare is putting more federal dollars into a system that's failing and it's growing. Premiums are going up by double digits. Your projections for the growth in the spending, the federal spending on it is in some areas 13 or 14 percent increase per year.

This is a system that is failing. And it's a system that Democrats don't want to change, except a whole bunch of Democrats want to offer a new system which is called Berniecare or Medicare for all.

So, even Democrats are admitting that Obamacare is failing. Otherwise, they wouldn't introduce a new health plan. I think John McCain hopefully throughout the week will see what's going on, will get a chance to look at the bill and hopefully take a second look at it.

BROWN: So you think you might be able to convince him to get back on board?

SANTORUM: There's over a week. I would say there's about a week or so until the final vote on this package.

And there is a lot that's going to happen in between now and then. Again, the bill hasn't been seen. The bill hasn't been scored. There hasn't been a hearing yet. And we are going to continue on this path and try to convince not just John McCain, but Rand Paul and others to join this effort.

BROWN: And it really does seem at this point, given where we stand right now, at this time on Friday, it seems like Senator Murkowski is your last best hope.

Is there anything you're doing behind the scenes, anything that's being done in an attempt to convince her to vote yes?

SANTORUM: Well, I will tell you we are talking to a lot of different senators.

You have four senators up there. But I can tell you I have talked to more than those four senators over the last 24 hours. And Senator Graham and Senator Cassidy have probably talked to many more than that.

This is a bill that, you know, with all of the opposition that's rolling out against it and the claims that are being made, we are getting a lot of phone calls. What does it do here? Is this right? Is this what happens to my state? Is this what happens to people with preexisting conditions?

BROWN: Any sweetheart deals?


Every -- one of the things that I think everyone in the group decided to do is that we would do things that are good policy. We are not doing any deals that are bad deals, in the sense that we are treating some state differently than others.

Every state has unique needs. And you mentioned Alaska. Alaska is six times the size of France and has six hospitals in the entire state. The cost of care in Alaska is 50 percent higher than the national average.

Are we going to treat Alaska differently? Well, of course you do, because you can't treat Alaska like Delaware. There are things that you do, but they are driven by the policy needs and the unique needs of a particular state. And so we are doing that not just for Alaska, which has very unique needs because of the nature of their population, but there are other states too that are very rural states.

There are states where cost of care is exceptionally high, far above the average. We are looking at all of those states, by the way, Democratic and Republican states, because we want this to be something that's fair and that looks at the actual problems that confronted the states.

So, we give them enough money in the block grant so the states can do the job.

BROWN: Let's talk about policy. Let's dive into a little bit more, because, as you well know, a big sticking point here is preexisting conditions.


BROWN: I was on with David Axelrod earlier. He wrote that op-ed saying he cried when Obamacare was passed. He was so relieved because he had a daughter with epilepsy.


And he said he had a hard time paying for her medical bills before Obamacare. Under your bill, will every single American be able to afford health insurance if they have preexisting conditions?

Because you well know the argument is being made that if states get a waiver, that basically Americans won't be able -- some Americans won't be able to afford their health insurance because they can skyrocket for those with preexisting conditions.


Let me make a couple of points here. First, I have a child with a preexisting condition. I have a disabled daughter. And this is a concern for me. I am on the Obamacare exchanges.

And I am not buying affordable health insurance right now. My health insurance premiums are over $30,000 a year for a silver plan, not a gold plan, not the top-of-the-line plan, but for a silver plan.

And my deductibles are about $10,000 a year. I don't know how -- and they are not allowed to "discriminate" against me. That's what everybody pays.

I buy insurance because I have a daughter with a preexisting condition. So, I need it. But if I had four healthy kids, I might decide to pay the tax and maybe buy an off-label type of product that is a lot cheaper than what's on the Obamacare exchanges.

And that's what's happening. Folks like me who have children who need that kind of care, we are buying insurance, even though it's really high-cost. But people who don't have those problems aren't going to spend that kind of money, in most cases because they don't have that kind of money to spend.

And so they go off. And so what happens? The people in the Obamacare exchanges have a lot of higher health care bills. And so what happens to that? The insurance premiums go up.

I don't think that a $30,000 insurance policy is an affordable insurance for someone with a preexisting condition. That's today. What we do in the bill is we say to the states, you have to cover people with preexisting condition, but we are going to give you flexibility on how to do it.

They are completely mischaracterizing what the bill does. It says every state shall provide affordable and accessible health insurance for people with preexisting condition. It's just not the way Obama does it, because that's not the best way to do it.


BROWN: Because it's not defined. What is affordable? What is adequate?


SANTORUM: It's not defined in Obamacare, because I can tell you what I'm buying is not affordable. It is not affordable for the vast, vast majority of people.

BROWN: But the concern is that, without a well-defined definition of affordable...

SANTORUM: It's not defined in Obamacare.


BROWN: OK, but does that make it OK for your bill that, just because it's not defined, in your view, in Obamacare, it is OK for it not to be defined in this bill?

Because the concern is that it leaves it open to interpretation, that adequate and affordable, well, what does that mean? OK, a state can get a waiver, and then insurance companies can raise the cost tremendously for those with preexisting conditions.

What are the parameters here?


SANTORUM: I would the argument that we are actually in better shape than what is under Obamacare, because under Obamacare says that you have to cover people with preexisting condition. That's it. It doesn't say anything about affordable. It doesn't say anything about accessible. Well, it says accessible. You have to cover people -- you can't exclude people with preexisting condition. But it doesn't say anything about providing affordable coverage, because, I can tell you, they're not.


BROWN: But what does affordable mean?

What may be to affordable to one person won't be affordable to another. What does that mean exactly?

SANTORUM: The state has to show to the secretary that this is affordable coverage.

So you will have someone looking at the state and saying, no, I don't think you're doing a very good job on this and you have got to do better. And, by the way, a bone of contention even among Republicans in debating this bill.

I would make the argument that the Graham-Cassidy proposal actually does a better job in guaranteeing, because there's no guarantee of affordability under Obamacare. It just says you have got to cover it.

But it doesn't say you have to -- and, you know, it limits how much you can charge and things like that. But what happens is, because so many people are dropping out of Obamacare, and you're seeing coverages are going down -- the new CBO reports are showing fewer and fewer people enrolling in these exchanges, premiums going up and up.

This is because you don't have affordable insurance. So, yes, someone has to have coverage, if you have come there and say, I have a preexisting condition, you have to cover me, but there's no guarantee.

And, in fact, the reality is, there isn't any real good coverage, affordable coverage under Obamacare. At least in our bill, the state has to provide that affordability. And they can do it through high- risk pools. They can do it through other types of subsidies. That's not what is going on in Obamacare.

BROWN: All right, Senator Rick Santorum, thank you very much.

SANTORUM: My pleasure.

BROWN: Clearly, this is an issue we are very passionate about.

SANTORUM: Thank you. I am. It's personal.

BROWN: I know it is.

Meantime, there is some breaking news coming out of hurricane- devastated Puerto Rico. The National Weather Service just tweeted that a dam is failing, causing massive flash flooding.

This is happening along the river there in the northwest part of the island. People are being evacuated as we speak by bus. And officials are calling this a -- quote -- "extremely dangerous situation."

Meantime, Maria also slammed the U.S. Virgin Islands.