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President Trump Eliminates Health Care Subsidies for Low-Income Americans; President Trump Looks to Change Iran Nuclear Deal. Aired 3- 3:30p ET

Aired October 13, 2017 - 15:00   ET



GOV. RICARDO ROSSELLO, PUERTO RICO: First of all, to thank the leadership of the speaker for acting quickly, as well as the delegation that is here, taking into consideration our people, but also coming over here, and, as the speaker said, seeing it with his own eyes, hearing it with his own ears, and recognizing that this is probably one of the biggest disasters that anybody that came on this trip has ever seen.

So, thank you for your leadership. Speaker, thank you. To the chairman, to all the congressmen and congresswoman that came over here, thank you for what you have done.

But, more importantly, on behalf of the people of Puerto Rico, thank you to your commitment to what is up ahead for our recovery of Puerto Rico, so that we can rebuild stronger than ever before.

I would like to have Mike Byrne, our FEMA coordinator, have some remarks as well, and then the congresswoman and the speaker will have some comments as well.

BRIANNA KEILAR, CNN ANCHOR: All right, House Speaker Paul Ryan is going to be speaking after his tour in Puerto Rico.

Only 9 percent of the island right now has power.

And also this, the president of Iran firing back at President Trump's decision to decertify the Iran nuclear deal. That's just hours after President Trump announced Iran was violating the -- quote -- "spirit of the deal." President Rouhani said his speech was baseless and he even encouraged President Trump to read a history book.

Here is just some of President Trump said in his speech today.


DONALD TRUMP, PRESIDENT OF THE UNITED STATES: The deal allows Iran to continue developing certain elements of its nuclear program and, importantly, in just a few years, as key restrictions disappear, Iran can sprint towards a rapid nuclear weapons breakout.

In other words, we got weak inspections, in exchange for no more than a purely short-term and temporary delay in Iran's path to nuclear weapon.


KEILAR: Joining me now from Tehran is CNN senior international correspondent Fred Pleitgen.

So, Fred, what more is Rouhani saying in reaction to this speech?

FREDERIK PLEITGEN, CNN CORRESPONDENT: Well, it was interesting, because he went on so shortly after U.S. President Trump spoke and just absolutely ripped into President Trump on pretty much every level, historically calling upon the many times that the Iranians felt that the U.S. did them wrong.

Also saying that he believed a lot of things that President Trump was saying was lies, as you noticed, also saying that he believes that President Trump needed a history lesson. Let's listen in to some more of what the President Hassan Rouhani of Iran had to say just a few minutes ago.


HASSAN ROUHANI, IRANIAN PRESIDENT (through translator): In Trump's speech, he talks about Iran's policy. Only bad-mouthing and baseless accusations were made against the Iranian nation. He had nothing else to say.


PLEITGEN: You know, one of the things that President Trump in his speech said is, he kept talking about the people of Iran suffering under the government here.

Well, President Rouhani also shot back at that, saying that President Trump's speech tonight showed that the U.S. and President Trump were -- quote -- "against the people of Iran."

But I thought the most important thing that I noted in the speech of the Iranian president was that he was defending the Revolutionary Guard here in this country. That is something that is very, very interesting, because the Revolutionary Guard was heavily criticized by Hassan Rouhani in a recent election campaign that he ran.

And to now all of a sudden see a lot of moderates like President Hassan Rouhani and others as well now come to the defense of the Revolutionary Guard, after they have been attacked by President Trump and now of course also designated a terrorist organization by the Treasury, that certainly is something that is to be noted and certainly something we will have to see where this goes in the future, but certainly seems to shot power base here in this country, even people who were at odds with each other before, now feel under attack and certainly are moving closer together than further apart, Brianna.

KEILAR: All right, Fred Pleitgen live in Tehran, thank you so much.

I want about this more now with Jim Walsh. He's an international security analyst. And also Mackenzie Eaglen, a national security analyst at the American Enterprise Institute.

Welcome to both of you.

Jim, it is important to note that some of the president's top officials, a lot of them actually, disagree with the president. Let's listen.


GEN. JOSEPH DUNFORD, JOINT CHIEFS OF STAFF CHAIRMAN: Iran is not in material breach of the agreement and I do believe the agreement to date has delayed the development of the nuclear capability by Iran.

REX TILLERSON, U.S. SECRETARY OF STATE: My view on the nuclear deal is they are in technical compliance of the nuclear arrangement.

UNIDENTIFIED MALE: Do you believe it is in our national security interest at the present time to remain in the JCPOA? That's a yes-or- no question.


UNIDENTIFIED MALE: Yes, Senator, I do.


KEILAR: And then add to that today Rex Tillerson, who said himself -- quote -- "We don't dispute that they are under technical compliance, that Iran is under technical compliance."

What do you make of that?


It's what the intel community has said. It is what the International Atomic Energy Agency said, the IAEA. And I think what we have seen play out is here a process where the president's national -- the president has -- in his mind, he wants to stop this deal, and then his national security team is trying to walk him back or find some compromise, some way to thread the needle, so that he can satisfy his own needs, but also not destroy the agreement, because if we destroy the agreement, if you break it, you own it.

And we would be isolating ourselves. And his national security team realizes that.

KEILAR: OK, so the real effect of this, Mackenzie, talk about this, he may be decertifying this, and so the optics of it are that he is out there in way dismantling the Iran deal. But that's not really what is happening.


This is really -- it would have been porridge too hot to walk away completely and it would have been porridge too cold to go to war to prevent them from obtaining a nuclear weapons. So this was his Goldilocks solution.

But all parties to the agreement will keep it going. And again we are still party to the agreement. It is not a treaty. And any changes to that would require 60 votes in the Senate. Really what he is doing is kicking this to Congress while looking, it has the appearance of taking action, but for all intents and purposes, nothing is fundamentally changing.


EAGLEN: And he is trying to really just spotlight the non-nuclear aggression of Iran, which is he is just using this as a vehicle, this nuclear agreement, to do that.

KEILAR: Jim, and that's the key point, right, 60 votes needed in the Senate. And that would mean the Republicans would rely on Democratic help, which it would be very difficult to see how they would get that. What kind of changes might they want to make? Would it just be conditions?

WALSH: Yes, there are two sets of things that they will be looking for. One is a variety measures that are aimed at Iran's behavior outside the nuclear deal, like human rights or whatever it may be. And they're within their prerogative under the deal to do that, as long as they are respecting the sanctions relief under the nuclear deal.

Now, for the nuclear deal itself, there is a bill. There's a Corker bill that is set that allegedly is reportedly going to set triggers, you know, and try to introduce new extended restrictions on ballistic missiles or on this or on that.

The Congress cannot unilaterally renegotiate an agreement negotiated by sovereign states and supported by the U.N. Security Council. So if Congress if passes a bill that says here are these trigger points, you better renegotiate the deal or we impose sanctions, and they impose sanctions, again, we will the one breaking the deal, a great gift to Iran, because then they can do whatever they want because we're the ones who broke it.

So I agree with you, though. The politics of passing any piece of legislation in this Congress are going to be exceedingly difficult.

KEILAR: Yes, and that's Republican bill that Corker is doing. Obviously, he has got some help, but it is from another Republican. So it just seems like that is kind of a no-go.

Mackenzie, I know you probably heard what the French president, Emmanuel Macron, has said. He expressed fears about withdrawing from the deal. Let's listen.


EMMANUEL MACRON, FRENCH PRESIDENT: North Korea is a very good illustration of the what-if scenario from nuclear arm deal with Iran. Why? Because we stopped everything with North Korea years and years ago. We stopped any monitoring, any discussions with them.

And what is the result? They will probably get a nuclear weapon. So my position for Iran vis-a-vis President Trump was to say, look at the situation on North Korea. I don't want to replicate the situation with Iran.


KEILAR: Mackenzie, that is a nightmare scenario where he is saying if in a way you alienate Iran so much and they become essentially a rogue nation that could ultimately have nuclear capabilities and be like a North Korea, how real is that concern?

EAGLEN: The French president shares that exact concern with our own secretary of defense, Jim Mattis.

He has expressed these same points to the president as well, and I think they are incredibly well-founded, if not scary, but true. So there is something to be said. And that really goes to the shared objective of President Obama trying to achieve the deal. All the other states are a party to it, the U.N. endorsing it and now even President Trump not backing out of it, but asking for parallel legislation.


What is the end objective? Really, all of this is a way to just buy time, buy more time to prevent Iran from continuing the nuclear program, in the hopes that further opening their economy and their culture to Western values will ultimately lead them to not want a nuclear weapon at all.

Who knows if any of that will ever be achieved, but the irony here is that President Trump shares that with the last president.

KEILAR: That is ironic.

All right, Jim and Mackenzie, thank you so much to both of you. We do appreciate it.

The other big headline today is that President Trump is undoing critical carts of Obamacare by using a maneuver taken from the Obama playbook, one that President Trump, then not President Trump, complained about, the executive order.

President Trump just announced he's going to end what is called cost- sharing subsidies. This is the money that is given to health insurers so that many lower-income Americans can afford their health insurance.

I will turn now to Julie Rovner. She's the chief Washington correspondent for Kaiser Health News. She covered every health bill in Congress since 1986.

You are the go-to expert on this, Julie. And you point out that insurers still have to give low-income Americans these subsidies, even if they are being cut off from the federal government. So it is the insurers who aren't going to receive the money. But how does this then perhaps get passed on to the consumer?

JULIE ROVNER, KAISER HEALTH NEWS: Well, that's a good question.

The insurers will have a couple of options. Of course, the law requires that they provide these discounts people with low and moderate incomes. And now the president has said, not so much by executive order -- there's been a lawsuit that's been out there lingering, but he just decided at 11:00 last night that he is not going to pay them anymore starting with this month's payment.

The insurers can do a couple of things. They can raise premiums on everybody else. And that's what most of them are doing for next year. There's an open enrollment that starts in a couple of weeks. The other things that insurers can do is they can probably sue. Most legal experts think if they sue the federal government, they will win, because the law says that they are entitled to this money.

Just because Congress didn't create a good enough appropriation doesn't mean they aren't still entitled to the money somehow. Or this is what people are concerned about, they could just leave the market entirely. That would hurt people, the low-income people and the upper-income people who are paying these premium increases. And there is a concern that there could end up being counties in the U.S. where there is no insurer on the individual market anymore, which looked like it might happen and at the moment isn't.

But there is an escape clause in most of these contracts that would let these insurers say, yes, this is just too much. We don't want to play anymore.

KEILAR: So you think there is an opening for insurers to sue? And I wonder. So I was looking on the Web site for Heritage, the think tank, and, of course, a lot of conservatives say, look, this money wasn't appropriated, so this is actually illegal. And that's one of the talking points that we're hearing from conservatives.

Heritage has pointed out that congressional health insurance subsidies that are disbursed also don't have congressional authorization or appropriation, which kind of lends to that chase, right, that insurers might make that this is legal, even though it hasn't been appropriated or authorized by Congress.

ROVNER: Well, they are two different things. The congressional coverage was something that was kind of jerry-rigged after Congress tried to apply the Affordable Care Act to itself, and did apply it to itself, but then they couldn't figure out how not to lose all of their staff by no longer providing health insurance, making them pay for their own health insurance.

So they kind of came up with a way with the Office of Personnel Management that staff could go through the D.C. exchange, which really isn't a small business, and that is a kind of a different issue. But the law is very clear about these cost-sharing reductions is that

the people who are eligible for them are entitled to them and that insurers are basically promised that that money will be paid back. It was just that the law -- as we know, the law wasn't written as well as it could have been.

We have already seen a bunch of lawsuits. And I think that's what is going on here. But the fact that Congress probably didn't appropriate the money doesn't mean that it is not still owed to the insurers.

KEILAR: All right, Julie Rovner, always taking the complicated and making it more basic for us, we really appreciate it.


KEILAR: And, next, many of those impacted by this health care change are people who voted for Donald Trump. So what is the political impact of this for the president?

And what is the likelihood that Trump can get Democrats to work with him on a health care solution?

And we have some breaking news as well, the Las Vegas sheriff holding an emotional news conference just moments ago defending his department's investigation into the mass shooting, also explaining some of the confusion around the timeline and even conspiracy theories that have percolated. We will have a live report coming up.



KEILAR: As President Trump makes good on his campaign promise to end key Obamacare subsidies, now some attorneys general plan to make good on their promise to fight this move, calling the subsidy cut -- quote -- "sabotage."

But moments ago, President Trump made it very clear that he hopes by seeing the cost-sharing subsidies go that Democrats will see it's time to make a deal on health care.


TRUMP: What would be nice, if the Democratic leaders could come over to the White House. We will negotiate somehow deal that is good for everybody. That's what I would like.

But they are always a bloc vote against everything. They are like obstructionists. I would say that the Democrats should come to me. I would even go to them, because I'm only interested in one thing, getting great health care for this country.


KEILAR: Let's take a deep dive on this now. I have with me CNN senior economic analyst Stephen Moore, who used to

advise the Trump campaign, and David Jolly, a former Republican congressman from Florida who used to be on the Appropriations Committee.

OK, so, David, do you think, when you hear the president say that, that he wants Democrats now to basically read the writing on the wall and come negotiate with him, do you really think they are more likely to come to the table now?


DAVID JOLLY (R), FORMER U.S. CONGRESSMAN: Well, I think that might suggesting the president is being more strategic than he typically is.

Look, I think legally he has footing on this, that this is a matter for the Congress, not necessarily for the White House. And there is a federal district court decision to actually back that up. He may have legal footing.

But the problem with what he has done is, there is no recognizable coherent strategy to what he has done with CSRs, either for the construct of Obamacare and what it means for repeal and repair and replace, but also politically there is no coherent strategy.

There's three constituencies that come out of Obamacare, those who saw a reduction in costs, those who saw an expansion in coverage through preexisting conditions and essential health benefits, and then those who lost. They saw increased premiums. They saw disruption of plans to their lives, the year -- if you will.

None of those three constituencies can look what the president has done in the last 124 hours and see how they are better off by that move. There's no strategy to what he has done.

KEILAR: Stephen, what do you think?


Donald Trump did something just yesterday that was amazingly positive, where he is basically allowing people, as you know, David, to get enrolled in associated health plans, trying to allow people to buy insurance across state lines, so you get more competition.

And, as we know, economists, when you have more competition, that lowers prices. And the big problem, Brianna, with Obamacare, among many others, is that there is so little competition. You have got well over a third of counties in the United States with either one or zero insurance companies left. That's no competition at all.

Look, I do agree with David that there is a risk associated with this move by Donald Trump, that when, look, Obamacare is falling apart financially. We're seeing that. I was just in Arizona a week or two ago, Brianna. That's a state where people's insurance premiums have gone up,

doubled, $5,000 or $6,000 year, and nobody can afford it. And so it's falling apart. And Democrats may seize on this move by Donald Trump and say, aha, you see, it's Donald Trump that is causing problems with Obamacare.

In fact, I have debated people on CNN who have made exactly that point. And so he is going to be -- they will say, oh, he is not providing funding for these insurance exchanges, therefore, he is responsible for the failure of it. But it is already failing.

What I hope, Brianna, is that Donald Trump can negotiate a deal with the Democrats where he basically says, look, I will fund the exchanges. You have to allow to have an off-ramp from Obamacare and buy the kind of affordable insurance plans that they want.

KEILAR: Stephen, as an economist, and you reference what he did yesterday, if he is allowing people to go on short-term plans that are not privy to these protections of preexisting conditions, but, as an economist, how do you then cover the people that essentially those folks would need to offset?


KEILAR: Isn't that just -- you are talking about something that is broken. But isn't that just the president breaking it more quickly?

MOORE: No, see, this is the exact problem with Obamacare, is that all the sick people are signing up for health insurance under Obamacare and healthy people more and more are dropping out.

It is a classic case of what is called the death spiral in insurance. And I worked at "The Wall Street Journal" for 10 years at the time when Obamacare was being debated. And we made this prediction, that you are going to put the system into a death spiral.

Look, this was great for consumers what Donald Trump did yesterday. He is going to allow literally millions and millions of Americans to buy lower-cost and truly affordable health plans.

Now, you raise a good point, Brianna. What are we going to do about those people who have preexisting conditions? Donald Trump wants to take care of those people. I want to take care of them. I have a niece who has a preexisting condition.

But you don't put them in an insurance pool with everybody else. You create a separate program that provides them with funding. And I think that would be the solution, but Democrats don't want to do that.

KEILAR: David, what do you think?

JOLLY: Yes, here is the problem we face.

Let's start first -- and I think Stephen would agree with this -- health care is not a free market industry. It simply is not. And so in the case of what the president has done, yes, he created better options, and it was the right move for those who are healthier, who are looking for more choice in their plans.

MOORE: Right.

JOLLY: But if those people leave the exchange, and now you have the high-cost individuals in the exchange, and the law requires that they still be given lower prices, the law requires that, then where do we make up the additional cost for those people?

And it is actually going to be on the mandatory side and through taxes. Somebody has to pay for it. And those very healthy families that get to leave, and now they are in these new programs, their premiums might have gone down, but their cost as taxpayers have gone up.

And so I don't -- Stephen, maybe you can make that wash. I can't.

MOORE: Well, David, you make a good point here. And, remember, Brianna, I remember this like it was yesterday.

Donald -- Barack Obama said, I promise you that this plan will not cost a dime, that it will not increase the deficit a dime.


Well, now here they are back asking for $10 billion or $12 billion this year to bail out the insurance companies. Next year, it will be $15 billion. We got to fix the system, Brianna.


KEILAR: These subsidies have to be delivered.

MOORE: They do.

KEILAR: So if the federal government isn't footing the bill, doesn't the insurance company just pass that on to middle-income Americans, and they are the ones paying for it, to considerable expense and hardship?

MOORE: But, look, you could -- a lot of people even on the exchanges, if you allowed them to buy, for example, health savings accounts, catastrophic coverage, it would cost about half of what Obama -- the problem with Obamacare is it requires people to buy really expensive insurance.

I ran into a woman the other day, Brianna, who is 55 years old. She said, look, why do I have to buy maternity benefits? I just want insurance that covers me for my protections. I don't want to buy drug abuse coverage and so on.

I want to buy the insurance package that is good for my family, that protects my children and my wife and myself. I don't want to pay higher premiums that have to cover other people.

(CROSSTALK) KEILAR: I want to ask you about executive orders, because -- I'm sorry to change the subject, but I really to get want your perspective on this, because Republicans were so mad at President Obama for using them.

And who else was? Donald Trump. Remember this tweet from 2012, or certainly this sentiment, where he said: "Why is Obama constantly issuing executive orders that are major grabs power of authority? Hypocritical?"

Well, now you have President Trump, who has taken quite a liking to this. How do you square that circle?


MOORE: Oh, go ahead, David.

KEILAR: Yes, David.

JOLLY: I was going to say, for a large part, it is complete, blatant 1000 percent hypocrisy, one side of the aisle to the other, because now Republicans and Donald Trump are using executive orders.

I would say there is one area where Donald Trump could be given a little bit leeway, and it is unwinding executive orders that the courts have said were overreach by President Obama. The courts, federal courts said his executive actions on immigration were overreach.

They actually said his executive action on CSRs in this case were overreach. So that's where the president unwinding them, I don't know in that case by executive action is extraconstitutional, if you will, because it is going back to the constitutional requirement of the Congress.


JOLLY: But I don't think the president is actually sophisticated enough to understand there are some that are OK and some that aren't.

KEILAR: Well, Steve, we just heard from the Kaiser reporter who has covered everything. She is the go-to person on this. And she says there are going to be lawsuits and they are going to have legal standing.

So what do you think about that, considering that this E.O. may be extraconstitutional?


MOORE: Well, I'm an constitutional scholar and I'm not a lawyer, thank God. So I can't give probably you a good answer for whether they can win those lawsuits or not.

But, as you know, Brianna, there were a lot of lawsuits against the executive actions that Barack Obama took. And I'm not defending it. Look, I don't like government by executive action. As a conservative

who believes in the separation of powers, it is not a good way to do business.

But, on one the hand, you know, if the Democrats come in and do everything through executive action, and then have you got a Democratic Congress that says no to everything Barack Obama wants to do -- I mean, that Trump wants to do, are we just going to unilaterally disarm ourselves as conservatives and just allow Democrats and Chuck Schumer to block everything?

I don't like this form of governance. But I'm not so sure what other choice Donald Trump has right now.

KEILAR: Yes, all right, Stephen, David, gentlemen, thank you so much for the discussion. We certainly appreciate it.

JOLLY: Good to be with you.

MOORE: Thank you.

KEILAR: The Las Vegas sheriff pushing back against accusations of incompetence in an emotionally charged news conference. We are going to take you there live to explain how they are clarifying the timeline in the Las Vegas massacre.