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Obama, Pence Visit Hill for Obamacare Fight; GOP Leaders Comment on Obamacare Showdown; Pence: Trump to Sign Executive Orders on Obamacare 1st Day. Aired 10-10:30a ET

Aired January 4, 2017 - 10:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


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[10:00:34] CAROL COSTELLO, CNN ANCHOR: And good morning. I'm Carol Costello. Thank you so much for joining me. A showdown on Capitol Hill like we've never seen before, moments from now, at this podium, we are expecting to see Vice President-elect Mike Pence and the House Speaker Paul Ryan. Right now, the two are in a closed-door meeting with Republican lawmakers on the top priority of this new Congress, repealing Obamacare. President Obama, taking the extraordinary step of holding his own meeting on Capitol Hill, that's happening right now. He's talking strategy with Democrats on how to salvage the health care overhaul that's a big part of his legacy. Democratic leaders also due to speak later this hour. Let's begin though with our senior political reporter, Manu Raju. He's in the middle of the action. Good morning.

MANU RAJU, CNN SENIOR POLITICAL REPORTER: Good morning, Carol. In fact, President Obama just walked into this meeting about 20 minutes ago to meet with House and Senate Democrats in trying to urge them to stand firm against any efforts to repeal his law. This is expected to be a pep rally of sorts, a meeting of the minds. Democrats here are largely united behind this approach to try to stand against any efforts to dismantle this law and presumably to block any efforts to replace the law. Democratic leaders do not want to work with Republicans in replacing the law.

And there's Obama walking in. We had a chance to ask him, "Do you think that this party should work with Republicans to replace the law after the repeal takes effect?" He heard the question, but he didn't answer it, and he said "Happy New Year" instead and walked into this meeting. Now, not all Democrats agree with this hard line approach. Joe Manchin, the West Virginia Democrat announcing today that he was not going to attend this meeting because of his concerns about being too partisan, him of course, coming from a conservative state and up for re-election in two years.

But just steps across the Capitol, there is a meeting going on right now with Mike Pence, urging Republicans to work with them on trying to figure out how to repeal and replace the law. Repeal effort happening right now beginning in the Senate. This month, question about how to replace it, there is -- some talk among Republicans about how to deal with this administratively, move regulations, other things that they could do to try to ease some of the burden in finding a quick legislative replacement to the law. Those are all things that they're trying to work through in this closed-door session with Mike Pence and Republicans on Capitol Hill, all coming to ahead today in these dueling meetings right now, Carol.

COSTELLO: All right. Manu Raju, will need to do some fine reporting. Thank you so much. So, the question this morning, will this last ditch effort by President Obama help Democrats save his marquee legislation and what exactly are Republicans planning as far as a repeal goes. Let's talk about this. I'm joined now by CNN's chief political correspondent Dana Bash and CNN presidential historian Douglas Brinkley, national correspondent for "The Hill" Reid Wilson is also with me. Dana, I want to start with you because I would love to be a fly on the wall in either of these meetings. How do you suppose those meetings are going?

DANA BASH, CNN CHIEF POLITICAL CORRESPONDENT: You know, we'll hopefully find out from talking to our sources afterwards. Luckily there are a lot of people in these private meetings. But one thing we can say is that as much as publicly the Republicans and they've even shown it over the years in the House through their votes, say that they want to repeal Obamacare. The reality is that they know that it is not so easy to take a benefit away from an American citizen, even if it's not a perfect benefit.

So, the way that they go about this is going to be very tricky for them, even though they have the votes and they can do it. On the flip side, Democrats who are meeting right now with the president in this extraordinary moment, where he should be taking a victory lap, not a, you know, "please help me save my primary legacy" issue, are trying to figure out a way to drive a wedge between Republicans and their constituents who have Obamacare, or even maybe if they don't, who can be convinced that repealing, even to do so without a replacement mechanism for a couple of years or even sooner, could shake the insurance markets so that everybody's premiums could go up. That's just one of the message points that I'm told Democrats are talking about in this meeting and will be soon saying to the public.

So, as much as it looks like they're all going into their partisan corners, and it really is remarkable to see those visuals, there is not entirely a certain path for both sides on how to do what they want to do.

COSTELLO: And of course Donald Trump I suspect is watching this because, Reid, he's been tweeting about it. So, what role will he play in what happens today?

REID WILSON, NATIONAL CORRESPONDENT "THE HILL": Well, we've already seen the president-elect playing a pretty significant role in the 115th Congress, tweeting yesterday

[10:05:16] about the House Republican plan to roll back or dramatically alter the Office of Congressional Ethics. Republicans dropped that plan right after his tweet. So, he could play a significant role here but you showed an interesting interview that he gave to "60 Minutes" in the last hour -- well, the interview was last year, where he talked about the need to cover everyone. And Dana raises a good point here, this is a huge political mine field for Republicans, because whatever they come up with, has got to cover as many people as possible, so that they don't run this sort of gauntlet of taking a benefit away from voters who are going to show up to the polls next year, or in 2018, and then in 2020. So, in the long run, you know, I kind of think that Republicans might end up coming up with a replacement that looks an awful lot like Obamacare. You know, there are a number of Republican lead states that accepted Medicaid expansion under a different name, and one of those states that did was Indiana, under governor and now Vice President-elect Mike Pence.

COSTELLO: You're absolutely right about that. From a historical standpoint, Douglas, this has got to be something for you because here is President Obama. He's talking about a piece of historical legislation, right? He's now fighting to save his legacy, kind of history-making, on his last days in office, right? You have a president-elect unlike any other president-elect we've had before, who is sort of like overseeing this. So, this kind of is a bonanza day for you, isn't it?

DOUGLAS BRINKLEY, CNN PRESIDENTIAL HISTORIAN: Well, for President Obama, this is just where he doesn't want to be. He didn't envision in January, days before his farewell, he's got to kind of rally the troops to defend the Affordable Care Act. However, something else is going on with President Obama coming there. He's also rallying Democrats to be a party that is for something. You know, Hillary Clinton was against Donald Trump. He's unacceptable as president. The Democrats, I think, are going to start this year saying we are for affordable health care for all Americans. That's what the Democratic Party brand stands for. If you guys want to mess with it, we'll tell you stories of people that you're putting out on the street by doing away or repealing the system.

So, I agree. I think, it's not really get repealed in the real sense. It's going to be nibbled at, fixed, might be called a neutered Obamacare, but you're going to get something very similar staying in there. Because otherwise you're going to have 20 million people wondering where their health care disappeared and blaming Republicans.

COSTELLO: And you know, the Kaiser Foundation which has followed Obamacare religiously since it was passed, right? They did a study on how many people actually want to keep Obamacare, or tweak it or expand it, that number is 66%. So, that makes it very difficult for Republicans in Congress too, Dana.

BASH: Sure, exactly. And that's the point that we've been making. That you can say repeal Obamacare, because for Republicans, just on the political side of this, the term "Obamacare" is just anathema, but also for people out there who are seeing their premiums go up, never mind that there are, you know, 20 million people who now have insurance who didn't before, you know, it's difficult.

My understanding is that Obama, although this legislation is certainly his legacy, the message he's been trying to send to Donald Trump is, you know, I don't care what you call it, call it Trump care, but just preserve the key elements like the pre-existing conditions element, like making sure that people who are 26 years old can stay on their parents' health care, like making sure that women don't have to pay more for their health care than men. Things like that. So, you know, -- a lot of it is in the substance and it's a very tricky kind of matrix, that is Obamacare. But a lot of it also is in the marketing.

COSTELLO: Yes, marketing and that's really important, Reid, because I think that many of Donald Trump's own constituents in states like West Virginia and Kentucky, some of them really like Obamacare. And some of them also believe that when Donald Trump says something, he doesn't really mean it in the moment, right? So, they're not really sure what he wants to do, because you mentioned before, what he said in December on "60 Minutes," he said he wanted to cover everybody, right? He wanted everybody to have health insurance and he didn't mind using the government to do that, right? The government would pay for it. But this morning -- he's been tweeting he's going to repeal Obamacare outright. So, what is he --

WILSON: And one of the ironies of the Affordable Care Act is that a lot of those 20 million people that we've been talking about who are receiving health care through the ACA are the constituents who elected Donald Trump in places like rural Kentucky, rural West Virginia, places that historically voted Democratic but had now flipping in voting Republican because they're so hungry for a change.

[10:10:16] So, Trump risks taking health care away from his own constituents unless he fashions some kind of alternative, like Dana was talking about, that doesn't take away a benefit from the millions of people who are suddenly on it. So, this is, you know, the delicate tightrope that Republicans walk. Will the replacement plan that they now have a few years to come up with or they plan to have a few years to come up with? Will it cover all these people? Will it do the things that Jim DeMint was talking about in the last hour, covering people across state lines are allowing interstate competition? Whatever that plan looks like we haven't seen it. And Republicans are now putting themselves on the clock for a certain number of years until they phase out what exists today -- and replace it with whatever they plan to come up with.

COSTELLO: All right. I have to leave it there. Dana Bash, Douglas Brinkley, Reid Wilson, thanks to all of you. Right now, 20 million people in the United States are using Obamacare and they want know what happens if Obamacare is entirely repealed. So, let's explore that now, shall we? With me now is Dr. Sanjay Gupta, CNN's chief medical correspondent and J.B. Silvers, health finance professor at Case Western Reserve University. Welcome to both of you.

J.B., I'd like to start with you because you're an expert in the insurance industry. I talked to Jim DeMint in the last hour. And he said that, you know, they would kind of leave in place parts of Obamacare for a year, and the insurance industry will not fear that because they're going to make it more competitive for them. And the insurance companies will stay on board even though the insurance companies know that Obamacare is being chipped away. In your mind, is that reasonable?

J.B. SILVERS, HEALTH FINANCE PROFESSOR CASE WESTERN RESERVE UNIVERSITY: I think it's totally naive. Insurance companies are there to bear a risk and pay claims. And if the risks go up, they're going to run away. They'll just run away, out of the private insurance market. And we've decided we want to use private insurance companies. So, we've got to have them in the game.

COSTELLO: So we've got to have them in the game. So Sanjay, we often hear, and we've heard it from President-elect Trump too, that he wants to open state lines, right? So, you can buy insurance in Missouri if you live in Ohio, and he says that would create this competition and that would make insurance cheaper for Americans. Would that work?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, it could work, conceivably, but not right away, as I think J.B. -- Silvers is talking about, this notion that the individual marketplace has always been a difficult place. It's never worked really, really well. People who have their insurance through their corporations or their companies, they don't think about this issue as much but people who are in the individual marketplace think about this issue all the time.

And you have the president-elect say he's going to get rid of the existing Affordable Care Act. Then he goes on and does an interview with "60 Minutes" that you played earlier, Carol, where he says he's going to have health care insurance for everyone. And one thing he had stated consistent on though is this notion that by increasing competition among insurance companies, making them compete across state lines, you're using free market principles as opposed to the government to try and drive down the premiums for the people in the individual marketplace and possibly for everyone else as well. That's what he's saying. Whether it works or not, I don't know, I don't think it happens right away.

COSTELLO: So, J.B., what do you think? Could it work?

SILVERS: Well, you've got to attract -- to make a market work, you've got to attract both buyers and sellers. And in this case, you have to have insurance companies in the game. -- They will run away from excess risk and low profits. And in fact, losses were what they've had. If you upset the market, and it's already been upset the last few years because we've changed the rules several times and gotten rid of the some of the risk reduction methods that were built into the Affordable Care Act. When you take that away, they will leave the market. They will leave the private insurance market, because they -- can't make it. That's what happens with insurance companies and we've already seen that in a number of cases, where they've withdrawn from areas where the market is really difficult.

COSTELLO: Interesting. I'm just reading some incoming information from our reporters on Capitol Hill about what Mr. Trump is planning to do in his first days in office. And I'll just tell you, Sanjay, Mike Pence, you know, he's meeting with House Republicans right now. He says, "President-elect Trump is planning to sign Executive Orders related to Obamacare on his first day in office." Now, it's unclear what those Executive Orders will entail. But they will demonstrate immediate action. So what could they be, Sanjay?

GUPTA: We don't know. And obviously, there have been things that went to President Obama's desk in the past that he vetoed that had primarily to do with basically, you know, taking away the funding source, if you will, taking away the money for paying for the Affordable Care Act. So, in terms of repealing it, it's a longer process,

[10:15:16] not something he could do certainly on day one. He could start the process, I guess, but he couldn't do it on day one. But in terms of actually -- starting to chip away at the funding of it, so you're taking away the guts of it, if you will, that may be what he's talking about.

But look, it's worth saying, and all the viewers know this, you know this, Carol, we don't know. I mean, we've heard wildly divergent things in terms of what's going to happen with the Affordable Care Act. We've heard from the president-elect that he's going to repeal it, absolutely came down it (ph), repeated it over and over again, and then, said he's going to have health care insurance for all, when asked who would pay for it, he said the government. That - you know, to many that would suggest a universal health plan of some sort that is very highly government involved, if not government sponsored. So, what exactly this shakes out to be, I don't know. I don't think - I don't think anybody, frankly, knows.

COSTELLO: OK. So, we see Republicans gathering. The House leadership there gathering and they're going to talk about what happened with Mike Pence in that big meeting. Should we pause and listen?

(BEGIN VIDEO CLIP)

REP. KEVIN MCCARTHY, (R) MAJORITY LEADER: The heart and the responsibilities. We have a special guest with us today, someone who had been here many times before in the service. I want to congratulate the Trump/Pence team. They had the wisdom to listen and now they have the courage to lead America. When you walk around the floor today, we're going to start with that courage.

We've watched what has happened to the jobs across this country, the regulation that has been impounded for the last eight years. You'll see this week that we will bring up the REINS Act. Many of you know about that legislation. It simply says give the people a voice when it comes to regulation in America. The REINS Act only deals with those bills of regulation that get imposed upon that cost more than $100 million on business. Do you think there would have been a few of those? But if you look in just the last six years, there were 82 of those presented and put in place every single year in this administration. We have to get that burden off and start working. So, the REINS Act will say no new major rulings will be imposed without a vote of the House and the Senate where the people have a voice.

We'll also be dealing with Obamacare. So many of you know of what these failed policies have done to Americans. If you look at those families that have employer based insurance, their premiums have increased by more than $4300. Of the 23 co-ops that were created in Obamacare, 18 of them have already failed. But what's most concerning to so many, more than 1,022 counties across America, that's more than one-third, have only one choice inside the exchanges. Everything President Obama promised about health care has failed. We are so thankful that we have a new administration coming that had the wisdom to listen and the courage to lead.

REP. STEVE SCALISE (R) MAJORITY WHIP: Good morning, everybody. It was an exciting day yesterday to see all the new members get sworn in, to see this new majority excited about getting the work for the American people. There's a lot that we want to do. There's a lot we're going to do working in tandem with our new president and new vice president. It's great to welcome our friend and former colleague Mike Pence back, not as a member of Congress but as the soon to be Vice President of the United States, as a great partner in working to get our country back on track. And there's a lot that we need to do. There's a lot we're going to do.

But you also know that there's somebody else that's going to be here at the Capitol today, and that's Barack Obama. And I think, when the president comes back here today maybe for the last time as president, it's important to remember the first time that Barack Obama came here as president. Barack Obama came here and made very specific promises to the American people about Obamacare. He came here and said if you like what you have, you can keep it. How did that work out? Today, millions of Americans lost the good health care plans that they liked and expected to keep and are not able to today because of the broken promises of his law.

Barack Obama came here to this Capitol and said that if his bill passes, health insurance costs will drop dramatically for families. And instead, what have we seen? The reverse. Dramatic increases in health care costs. In my state of the Louisiana, over 25 percent increases that families are paying in higher costs for health care because of those broken promises of his law. I hope he comes here to apologize for those broken promises. But I don't think that's what's going to be the case. I think he's going to be here more concerned about preserving his legacy than about fulfilling those promises.

The good news is we are here to fulfill those promises to the American people. We told the American people that if you give us this great opportunity, that we're going to work hard

[10:20:16] every day not just to repeal Obamacare but to replace it with reforms that actually put patients back in charge of their health care decisions, that actually focus on lowering costs and increasing access to health care, and to bringing doctors back in the practice of medicine who are getting out of the practice because they don't want unelected bureaucrats in Washington telling them how to deliver the health care that they were trained to provide.

So, it's an exciting time for the country. We're really excited about getting to work to restoring those promises that were made to the American people and to get our economy back on track and to "Make America Great Again."

REP. CATHY MCMORRIS RODGERS, REPUBLICAN CONFERENCE CHAIRWOMAN: Happy New Year, everyone. I'm very excited, energized by the New Year, the new opportunities that it brings. This really is a moment that we've been given by the people, the moment to think big. It's a moment to reimagine the federal government and to put people back at the center of it.

You know, just down the road is the Washington monument. And right now it's closed to visitors. We think about families, individuals that travel from all around the country, from eastern Washington it's a long trip, maybe a once in a lifetime opportunity to visit the Washington monument. And yet, they'll be met with a closed sign because the federal government is going to take more than two years to fix an elevator. Now, this is just one example.

The people are dealing with these kinds of roadblocks every day at the VA, at the doctor's office, when they're just trying to do the right things, provide for their families, get a job, this is how the government has come to operate, one person, one agency at the top deciding for everyone. It's why it's our responsibility as the people's voice and the people's representatives in their government, to protect the Constitution and the balance of power, representative government, the rule of law, equal opportunity for all is protected here in the House by the people and for the people.

I want to thank Vice President-elect Mike Pence for joining us today. It is so exciting for us as we start this unified Republican government. 2017 and all that it has in store for the people of this country, creating opportunities for everyone.

REP. PAUL RYAN, (R) HOUSE SPEAKER: Happy New Year, everybody. Throughout this transition, we have been working hand in hand with the vice president-elect with one goal in mind, and that is to make sure that President-elect Trump can hit the ground running when he takes office on the 20th.

So, we're getting right down to business. We are starting today on our work to deliver relief to Americans struggling under Obamacare. We must remember this. This law has failed. Americans are struggling. The law is failing while we speak. We need to reverse the damage that has been done. Then once we repeal this law, we need to make sure that there is a stable transition to a truly patient-centered system. We want every American to have access to quality, affordable health coverage. All of the things that Obamacare has kept from the American people, more choices, more control, more freedom, we want to put them back in their hands.

We know that things are only getting worse under Obamacare. This is about people paying higher premiums every year and feeling powerless to stop it. It's about families paying deductibles that are so high, it doesn't even feel like you have health insurance in the first place. And in so many parts of the country, as you've always heard, even if you want to look for better coverage, you're stuck with one option. One choice is not a choice. It is a monopoly. The health care system has been ruined, dismantled, under Obamacare. The answer here is not to ignore the problem. The answer here is not to ignore the problem to keep some failed legacy. The answer here is bold action. Solve problems. Bring relief to Americans. We will help Americans crying out for relief from Obamacare. And we will keep our promise to the people.

As you can see, we'll be working with the new administration on every step of this law, every step of the way, even before day one. With that, I want to hand it over to somebody that we all know very well because he served here with us. We're so proud of him and we're so pleased about this new working relationship with our new vice president, Vice President-elect Mike Pence.

(LAUGHTER)

GOV. MIKE PENCE, (R) VICE PRESIDENT-ELECT: Thank you, Mr. Speaker. Thank you to the Speaker and to the leadership for the warm welcome today at the House Republican Conference. I'll be meeting later today with members of the Senate at their weekly luncheon. And this is a day that our message is very simple.

[10:25:16] On behalf of the president-elect and on behalf of all the leadership, that we are 16 days away from the end of business as usual in Washington, D.C. Today, our message is very simple, working with the leadership here in the House and in the Senate. We're going to be in the promise-keeping business. The president-elect campaigned all across this country. He gave voice to the frustrations and the aspirations of the American people. He laid out an agenda to "Make America Great Again." And my message, on his behalf today, before this conference and before members of the Senate, is that we intend to keep those promises.

Now, that begins with assembling a government. And the energetic effort through the course of this transition to build a cabinet that will be able to implement that agenda speaks for itself. It will literally begin on day one. Before the end of the day, we do anticipate that the president-elect will be in the Oval Office, taking action to both repeal Executive Orders and also set into motion through executive action policies to implement promises that were made on the campaign trail.

Working with the Congress, we're going to have that classic three-part agenda that the president-elect talked about so often on the campaign trail, jobs, jobs, jobs. The focus is going to be from day one. And to work with the Congress and you heard about the efforts this week, to begin to roll back the onerous regulations that have been stifling growth in the American economy and stifling jobs and opportunities. We're going to be working with the Congress over the course of the first several months to construct the kind of tax reform for businesses and individuals that will unleash the bound-up energy in the American economy. We're going to keep our promises to end illegal immigration, build a wall. We'll have an infrastructure built. We'll invest in rebuilding our military, as our commander in chief marshals strategies with our military commanders to hunt down and destroy ISIS.

But the first order of business is to repeal and replace Obamacare. And that was our message today, and it will be our message on Capitol Hill. And it needs to be done. Not just as a promise kept, but because in the course of this election, the American people had a choice. And what appeared too many as against all odds, oftentimes with overwhelming opposition, our president-elect took his case to the American people to repeal and replace Obamacare, and the American people voted decisively for a better future for health care in this country. And we are determined to give them that. The reality is I was here in March of 2010, in another capacity when Obamacare was signed into law. I remember all those promises. We were told that if you like your doctor, you can keep them. Not true. We were told if you like your health insurance, you can keep it. Not true. We were told that the cost of health insurance was going to go down. Not true. The reality is today premiums this year are increasing by an average of 25 percent in some states. In Arizona, premiums went up this year 116 percent, 63 percent in Tennessee, 53 percent in Pennsylvania, 40 percent in North Carolina.

Obamacare has worked a hardship on American families, on American businesses, and in a very simple conclusion. The American people have sent new leadership here, because Obamacare has failed, and it has been rejected by the American people. But now is the time for us to keep our promises. Step one will be to repeal Obamacare. But as the president-elect said today, and I admonished members of the House Republican Conference today, it's important that we remind the American people of what they already know about Obamacare, that the promises that were made were all broken.

And I expect you'll see an effort in the days ahead to talk about the facts around Obamacare. And secondly, of course, is to begin that orderly transition to something better. The truth is that the commitment that the president-elect made was to repeal and replace Obamacare. And as he said this morning, in a tweet, it will be important that we be careful as we do that. That we do that in a way that doesn't work a hardship on American families who gained insurance through this program, doesn't work a hardship on our economy.