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Health Care Vote; Congressman on Health Care Vote; Opt Out for States. Aired 1-1:30p ET

Aired May 04, 2017 - 13:00   ET

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

(COMMERCIAL BREAK)

ANNOUNCER: This is CNN breaking news.

JAKE TAPPER, CNN ANCHOR: Hello, I'm Jake tapper live in Washington, D.C.

WOLF BLITZER, CNN ANCHOR: I'm Wolf Blitzer. We want to welcome our viewer here in the United States and around the world.

We're following breaking news. The political cliff-hanger hanging over health care reform that's playing out right now. The House of Representatives begins voting this hour on the latest effort to repeal and replace Obamacare.

Will they or won't they have enough votes to pass it? Republican leaders say they will.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: How are you feeling?

REP. KEVIN MCCARTHY (R), MAJORITY LEADER: I feel great.

UNIDENTIFIED FEMALE: Do you have votes?

MCCARTHY: Yes.

UNIDENTIFIED FEMALE: Absolutely?

MCCARTHY: Yes.

(END VIDEO CLIP)

BLITZER: Here's a look at some of the biggest changes under the GOP plan. High-risk pools return to cover people with pre-existing conditions. The bill repeals Obamacare subsidies and replaces them with refundable tax credits based on age and income. It drops the individual and employer mandates, overall is Medicare funding, and eliminates Obamacare taxes on wealthy Americans, insurers and others.

Our Chief Political Correspondent Dana Bash is up on Capitol Hill following the minute-by-minute developments with the very latest.

What is the very latest right now, Dana? DANA BASH, CNN CHIEF POLITICAL CORRESPONDENT: The very latest is that Republican leaders are quite a bit confident that they have the votes. What a difference from the other day when -- the last time we were here talking about what was happening, talking about the fact that they had to -- excuse me for one second. I'm going to talk back to you. We have an audio issue. I'm going to talk back you to. I'm going to get right back to you.

BLITZER: All right, Dana, stand by for a moment. You know, Jake, this is a moment, a technical moment. She's going to get her microphone fixed and we're going to get the latest from Dana up there.

But this is a critically important vote that's coming up, presumably within the next hour.

TAPPER: Two major things going on here. There's the politics of it and the policy of it. In terms of the politics of it, there is a big concern that Republicans are able to go back home during the next recess and have something to talk about to conservatives that they did.

The first step in repealing and replacing Obamacare, in their view, is something that they'll be able to do, especially after the government spending bill in which Democrats got a lot of what they wanted and Republicans got relatively very little.

Then, there's the policy of this. And the truth of the matter is there are a lot of Senate Republicans, right now, who are very concerned about the process that this has gone. A very limited debate. No amendments. Not a lot of time to understand what exactly is in the bill.

But the House Republicans sense that they will be able to have a victory. They will be able to pass this bill. Senate Republicans are very concerned. They don't know what's in it and they don't know that they're going to be able to support it.

BLITZER: And one of the most sensitive issues right now is normally before a big vote like this, the Congressional budget office, nonpartisan, they lay out what it's going to cost the American public, how many people are going to be affected. They did that six weeks ago before the -- there was no vote before the first vote was supposed to take place and it caused a lot of anguish among the Republicans. This time, they haven't had the time to do it.

TAPPER: In fact, you don't have to go back very far or search Twitter or the Internet very hard to find all sorts of quotes from all sorts of Republicans, including now Vice President Mike Pence criticizing the Democrats for rushing Obamacare to the floor of the House for a vote.

And there are all sorts of quotes, especially from then speaker now leader Pelosi saying we have to pass it to find out what's in it.

But, at the same time, there's absolutely no comparison when it comes to how much time was spent on the legislation. It's true that a lot of Democrats probably did not know everything that was in that bill. But, by the same token, that took ions compared to the process by which this is going to hit the floor of the House.

BLITZER: I think Dana Bash is ready now. Dana, update us on when we anticipate the actual roll call to take place.

BASH: That's right, we got our audio kinks worked out here. And the answer is probably within the next 15 minutes or so is when the roll call is going to begin. And we're going to see just how much this confidence that we're hearing from the Republican leadership is going to bear out.

But one of the key questions, in addition to a lot of the substantive issues with regard to this major, major vote that is going to be taken here is, what's going to happen when they walk down the steps and get in their cars and go home?

And whether or not Republicans are going to get applauded as they think they are going to be for doing what they promised to do for so many elections which is repeal Obamacare, or whether they are going to face a buzz saw that will get them back in the place that a lot of Democrats were in after the Obamacare vote which is losing their seats.

[13:05:00] I want to bring in somebody who's in a bit of a swing district, a Democrat. Congressman Josh Gottheimer, thank you so much for joining me.

REP. JOSH GOTTHEIMER (D), NEW JERSEY: (INAUDIBLE.)

BASH: You were not here during -- in Congress during the Obamacare vote. But you are in, you know, a purple district, --

GOTTHEIMER: Yes.

BASH: -- fair to say, in New Jersey.

Do you feel that your constituents are going to see this and say, you know what? I really wish that you, even though you're a Democrat, voted to repeal Obamacare because there's so many problems with it. How are you going to go home and face your constituents?

GOTTHEIMER: It's been very consistent for the last months we've been talking about this and the phones are ringing off the hook in the office today. People don't want this. Why? Because they don't like the way it's done. And it's really going to hurt my district.

It's been -- the numbers have come out; it's a $4,000 new tax on families for people in New Jersey. Seniors are particularly worried we're going to, like, throw them out of the nursing homes. There's a new senior tax.

So, the incoming I'm getting from everybody, when I talked to folks in Medina last weekend, it was pretty clear. Please stop this. Fix Obamacare. Fix the ACA which I really want to do.

There's plenty to fix. But do it in a bipartisan way. And don't just let them jam something down us that's going to hurt us in New Jersey.

BASH: OK. But to be real here, --

GOTTHEIMER: Yes.

BASH: -- there's no bipartisan way. I mean, could you see yourself working with Republicans to make some major changes to Obamacare for real? Because, from my understanding, --

GOTTHEIMER: Yes.

BASH: -- is that the Democratic base would go ballistic if you tried to do that.

GOTTHEIMER: I don't know, I talked throughout my campaign. I said, there are areas like the Cadillac tax, the Medical Device tax. And there is where we need to fix it. I'm not talking about throwing it out. I'm talking about actually making it better.

But that starts with an outreach. You can't -- you know, as a Democrat, if somebody is bipartisan, you can't just show up and say, here it is, now vote on it. You actually have to be part of the process.

BASH: OK. So, knowing that that is not going to happen. It's not the world --

GOTTHEIMER: Maybe not on this issue.

BASH: -- that you live (ph) right now on this issue.

GOTTHEIMER: Yes.

BASH: The Republicans are arguing over and over again that this whole Obamacare idea, the way it is, isn't working. That you have states, even in the last 24 hours, like Iowa where every insurance provider has pulled out of the state that is related to Obamacare. I mean, that's a -- that's a fair criticism. There are people out there who are insured but can't afford it.

GOTTHEIMER: I know. I'm focusing on my state because, obviously, that's where I represent in northern New Jersey.

BASH: Right.

GOTTHEIMER: And what I hear is pretty consistent from the hospitals. I just talked to the CEO from the largest employer hospital in New Jersey, in Hackensack. And everyone throughout the state fears the same thing in New Jersey, right, that this is very bad for us.

The Medicaid dollars, right, are going to shift a lot of costs over to the state to us and that means our tax dollars are going to go up locally. So, that's how they're looking at it from how it affects us. I can't talk about the other states.

BASH: You know, you obviously came in knowing that the potential to, you know, dry to dismantle Obamacare was going to be on the table. Did you have any inclination at all, given where you're from and given the fact that it's not exactly the most liberal place in the world, --

GOTTHEIMER: Right.

BASH: -- even though you're a Democrat, to be more aggressive? And did you try to work with Republicans to fix it?

GOTTHEIMER: I did. I -- actually, I co-chair some of the problem solvers caucus, 20 Democrats, 20 Republicans. We sit down on things like tax reform and infrastructure where we're actually finding some common ground.

On this issue from the beginning, though, we were never really brought into the circle. And I said to my colleagues on the other side, please, that there are a bunch of us who actually want to fix this if you do it in the right way.

So, I'm hoping actually, in the months ahead, that there's a chance to make this better. You're right that it's probably not very realistic but that doesn't mean we shouldn't keep trying.

BASH: Congressman, thank you so much.

GOTTHEIMER: Good to see you, Dana.

BASH: You, too.

GOTTHEIMER: Take care.

BASH: Back you to, Wolf and Jake.

BLITZER: All right, Dana, thanks very much. We'll stand by for the roll call which is about to begin on the floor of the House.

So, while we don't know how much this revised plan will cost, let's talk about what we do know about what's inside the bill. Tami is a CNN Writer for CNN MONEY who covers Obamacare and health policy for us.

Tami, let's first discuss the return of those high-risk pools. Do we know what types of pre-existing conditions would qualify someone for the pools?

TAMI LUHBY, SENIOR WRITER, CNN MONEY: They are the pricey ones. You know, the cancers, heart conditions, diabetes, kidney failure, hepatitis C. There's a lot of them but there's also conditions you might not think of. In Maryland, one accept (ph) a kid with acne.

BLITZER: What would happen next for these people?

LUHBY: Well, that remains to be seen. It'll depend on whether they live in a state that opts to waive these protections. And that waiver is actually going to be pretty easy to get.

So, it's really going to be up to the state because every state would run their own pool. Those that opted for the waiver. But, presumably, they would probably try to apply for insurance. They'd get denied. And then, they'd be able to try to apply for this high- risk pool.

BLITZER: Let's talk about the changes to essential benefits. Under Obamacare, as you know, insurers must cover certain conditions. There is a provision that allows states to be more selective in this Republican legislation.

Talk about that.

LUHBY: Well, so, states could opt out of covering the 10 essential health benefits that are in Obamacare right now. Benefits like substance abuse, mental health, maternity, prescription drugs. These are very important benefits to a lot of people and they were benefits that were very hard to get on the individual market before.

[13:10:05] But, again, these raise premiums. And that's why the Freedom Caucus and other conservatives pushed to allow states to waive out of them if they wanted to.

BLITZER: What about if you get health insurance through your employer? Could this provision affect those folks?

LUHBY: It is possible that the employer policies will change.

But remember that employers, particularly large employers, use benefits to attract and retain workers. So, if they were to start offering skimpy plans, employees would start leaving and they may not want to do that.

So, yes, it's possible that some employers, particularly smaller ones, won't off a comprehensive set of benefits. It's possible that people will have to pay more out of pocket or will find some of their benefits limited.

But, generally, particularly among larger employers that are the ones who employ most Americans, probably not too, too much is going to change.

BLITZER: Tami Luhby, thanks very much.

LUHBY: Thank you.

BLITZER: Republican leadership say they have the votes. But until lawmakers cast their vote this hour, no one really knows whether they can actually reach that magic number which, in this Congress, is 216.

Here with us to discuss all of it is CNN Chief National Correspondent John King, CNN Senior Political Reporter Nia-Malika Henderson and CNN Chief Political Analyst Gloria Borger.

Nia, let me start with you and some tweets that we recently saw just this morning from Senator Lindsey Graham, Republican of South Carolina. He's certainly no fan of Obamacare. He tweeted, I appreciate the apparent progress on health care reform in the House of Representatives. I will admit, I'm concerned with the process.

And then, he tweeted, a bill finalized yesterday, has not been scored, that means analyzed by the Congressional Budget Office, amendments not allowed. And three hours' final debate should be viewed with caution.

We should point out, this isn't just Lindsey Graham shouting this from the sidelines. He is going to now asked to be -- to vote on this in the Senate.

NIA-MALIKA HENDERSON, CNN SENIOR POLITICAL REPORTER: Yes. It is likely a bill that's dead on arrival in the Senate. And we heard that from different senators. Bob Corker, for instance, said that it's really hard to imagine that the bill, as it stands now, the sort of dicey prospect around preexisting conditions, what's happening with the Medicaid expansion, that it could -- that this bill could mean that they could cobble together enough Senators, Republican senators, who are a diverse bunch, right?

I mean, there's some moderates. There's some conservatives there as well. But that is this sentiment about this rushed process is what I'm hearing from Republican strategists as well.

I was just texting with one and he said that he can't believe that they're rushing this. There's no scoring or anything. And it's going to do real harm.

And the harm he is thinking about is what they're going to hear from Democrats. And these are basically Congress people who are putting their careers on the line. The ads write themselves.

And even if you can say this is a bill that's a work in progress. It's going to change in the Senate. You can see what the ads are going to look like in some of these House districts, particularly the one that Hillary Clinton won.

TAPPER: And, John King, yesterday, I was interviewing Senator Rob Portman, former budget chief for George W. Bush, or George H. W. Bush, rather. And he's a senator from Ohio. He's just reelected so he doesn't have to worry about this for years.

And he was on the show to talk about opioid abuse. I was asking him about the fact that in the EHBs, which are the essential health benefits, if states are no longer required -- it's no longer requiring insurance companies to have them, that means drug treatment will no longer necessary be provided.

He -- and are you not -- are you not concerned about the health care bill? He said, forget that. I'm concerned about what they're going to do with Medicaid because Medicaid is one of the main ways that people, with dependency issues, get treatment in my state.

So, Republicans are -- in the Senate are very aware of this. And I don't sense a ground swell of support, at least not right now.

JOHN KING, CNN CHIEF NATIONAL CORRESPONDENT: No. And so, what happens now is let's assume the Republican leadership triple and quadruple check the votes and they send this bill over to the Senate. Senator Portman is a serious policy guy, has legitimate concerns. Senator Corker was on television this morning on another network, saying we're going to take our time with this.

The essential benefit is a huge concern to Senator Portman and to the moderates, if you'll call them. Their conservatives right of center but like the -- like Lisa Murkowski of Alaska, Susan Collins of Maine, remember Mitch McConnell who is, again, about to become the most important man in Washington has a 52 to 48 majority. He can only lose two or three if the vice president is there in the end to break a tie.

So, you have the concerns about what I'll call the more generous benefits of Obamacare that have become popular. Republicans didn't support them when they were passed. But now, you're saying you're going to take something away.

Coverage for opioid abuse, the other essential benefits, hospitalization, maternity. There are a handful, at least, of Republicans who say, well, let's be careful about this.

Then, you have on the flipside, you know, the Mike Lees and the Rand Pauls and the Ted Cruzes who say, we promised the American people a full repeal of Obamacare and this is not that.

TAPPER: And his is not that.

KING: This is not even close to a full repeal. So, you're going to have the same dynamics at play in the Senate, where I think you have less of a political imperative to move fast.

GLORIA BORGER, CNN CHIEF POLITICAL ANALYST: And don't --

KING: So, the speaker of the House thought and the president of the United States demanded they do this in the House now because he wants a trophy.

[13:15:03] Here's the question. I don't mean to be snarky. Is it a participation trophy or do they get the final trophy?

GLORIA BORGER, CNN CHIEF POLITICAL ANALYST: Well, and that's - you know, that's obviously the big question.

KING: Yes.

BORGER: I would argue, and not to be too cynical about it, that they're trying to push this through because once they get the budget score, once they get the CBO analysis which says how many millions of people will be uninsured under this, how many more people will be - we saw the last one was 24 million over a number of years, and we have to see whether this actually adds to the deficit or doesn't, because if it adds to the deficit, by the way, they have a problem bringing it up in the Senate.

KING: Right.

NIA-MALIKA HENDERSON, CNN SENIOR POLITICAL ANALYST: Yes. BORGER: Because it's under a budget bill and it has to be - it has to be deficit neutral.

But one of the ways that health care - that people feel health care, is they look at it after it's passed and they're going to read all these stories about it and they're going to hear about it and they're going to say, how does it affect me and my family. And if I have a pre-existing condition, I have cancer, and the - you know, the American Cancer Society has come out against this because my insurance is going to go down and I'm going to pay so much more out of pocket, this is how people are going - are going to judge these things. Do I need mental health care? And my state, for example, decides to opt out. Do I need coverage for my addiction that I'm trying to break and I'm covered under Medicaid? That's a big issue that it's hard to kind of talk about now, sort of generally we say, oh, well there's going to be a roll back of Medicaid. Just wait. And, you know, Governor John Kasich also of Ohio has said that he would not support this because he took the Medicaid money under Obamacare. And this is a real problem for Republicans. They have to get out there, explain, and then wait for people to feel this.

HENDERSON: Yes.

BLITZER: We're watching as this high drama being played out in the House of Representatives right now. A long-awaited vote on health care. The White House says it's optimistic about the outcome. Is the president about to get the major legislative victory he has been seeking? Much more of our special coverage right after this.

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[13:21:02] BLITZER: You're looking at the live pictures of the House floor where they're getting ready to vote on the Obamacare repeal and replacement bill. They need 216 votes. The Republicans can afford only 21 "no's" from their own members. No Democrats will vote in favor of this legislation. We're going to bring you the vote as soon as it happens.

JAKE TAPPER, CNN ANCHOR: And joining us now from Capitol Hill is Ohio Republican Congressman Jim Renacci.

Congressman, thanks so much for joining us.

My understand is that you are planning on voting for this legislation. The Congressional Budget Office estimated that in the last bill 24 million Americans would no longer have health insurance. Some of them would opt out willingly, others not. There has not been a Congressional Budget Office study or score of this latest bill. Why not wait until there is a score before there is an analysis and you have a better idea of what this bill might actually accomplish?

REP. JIM RENACCI (R), OHIO: Well, look, this bill has been debated already two years ago in reconciliation. It was - now it's been changed by a number of amendments. The amendments are the only things we're talking about. The amendments actually make it a little better. They actually, in my mind, help those that are going to need the safety net, which I think is important.

So, again, I think what we need to do is this is process, process, process. As I've said so many times, I'm a businessman. A businessman wants to see things move forward. We need to move this forward. We need to get it over to the Senate. We're going to have plenty of time. This is not the final bill. This is the best we have today. Let's move it forward. Let's continue to work on it. Let's make it better. In the end, we're going to have a very good bill.

TAPPER: But as a businessman, don't you wait until you have a full analysis of what something will do? You say that this bill has been debated before, but this amendment, the MacArthur amendment, is new. And the Upton amendment to that amendment is new. These are new provisions. We don't know exactly what the analysis will be as to what the effect will be on potentially millions of Americans. I don't understand - so help me - help me understand, please, the rush to do this today.

RENACCI: Well, I know - I know what the effect is if we do nothing. And, again, I always compare this - so this airplane can't continue to fly. The Affordable Care Act is a problem. I've got people back home that have coverage but can't afford coverage. They have coverage but can't afford deductibles. They are complaining. They're telling me this isn't working and we have to make a change. We have to fix the problem. And I think this is the beginning of the starting point of making a difference and changing this.

Again, I've been here now for six years. We've talked about repeal, repair, repeal, replace. We're at a stage where we need to do something. We can keep waiting, but the American people can't keep waiting and we need to move this forward.

TAPPER: So one of the provisions that I understand, and correct me if I'm wrong, but one of the provisions I understand you like is the one that allows states to opt out of different Obamacare provisions, such as, for example, what's called EHBs or essential health benefits, that is a standard imposed by Obamacare that all insurance companies have to provide ten different things, including maternity care, drug treatment care, et cetera. You like that, right? You want Ohio to be able to decide whether or not it wants to opt in or opt out of EHBs, essential health benefits.

RENACCI: Well, the one thing I know is, the one size fits all mentality in Washington doesn't work. Remember, this is a waiver. This is an opportunity for states to ask for a waiver. But when they ask for a waiver, they have to meet a whole bunch of requirements and they have to make sure there's a safety net or the pool available.

So, again, do I like getting the government closer to the people? Absolutely. I believe as close as you get to people, the better the product is. And that's why I believe it's great to allow governors to have that ability to waiver. Remember, that doesn't mean they're going to take the waiver and they still have to go through a long process of getting the waiver and they have to meet certain requirements.

So, do I like it? Yes. I like any time we get some flexibility for governors to have an opportunity to make a difference for the people they serve and they're closest to.

TAPPER: Do you want Ohio to seek a waiver so that insurance companies in your state are no longer required to provide essential health benefits?

RENACCI: Well, what I want to do is make sure that the government - look, we can't continue under this basis either with - I'm on the Budget Committee. I can tell you the budget numbers don't look very bright for the future. The best way of doing this is get it back into the state's hands. Do I think -

[13:25:10] TAPPER: Right, and when it goes to Ohio's hands, do you want Ohio to opt out of the EHB requirement?

RENACCI: Well, what I would do is I would meet with the insurance industry, make sure where we're at with this. I believe that as a governor I'm going to make sure that the safety net is taken care of. That we're going to make sure that pre-existing conditions are still taken care of. That doesn't mean when you opt out you eliminate some of this stuff. But at the same time, I want to bring costs down and I want to work toward getting costs down.

TAPPER: Well, what -

RENACCI: I'm in a pretty interesting position because I'm also running for governor as well and -

TAPPER: Right, no, I know, and that's why I'm surprised why you haven't said whether or not you think Ohio should opt out of the EHBs, because you are actually running to be one of the governors you're talking about. It seems like you want this option. You think states should be able to do this. So what would you do as governor?

RENACCI: Well, I think what I would do is, look, again, I'm not governor today. I have to look at those options and those positions. I want to make sure that people are covered. I want to make sure that there's opportunity. As governor, I'm going to do that and I'm going to look and decide whether it's best to waiver. I'm concerned that the waiver up (ph) - the way to get a waiver is very difficult. I don't know if Ohio will even be able to qualify to get it done. But I would look at it and, again, the more that I can take back in Ohio and the more I can get away from the federal government, the more I'm going to want to do. The closer again we can get government to the people, the better off we're going to be.

TAPPER: Do you want Ohio to opt out of the requirement that all individuals in Ohio with pre-existing conditions have to be allowed to get insurance? That insurance companies cannot discriminate against them? Or do you want them to be able to opt out of that?

RENACCI: Well, see, that's not the - the waiver is not that. The waiver is an opportunity for states to look at costs and to better take care of the citizens of their state. If a governor decides to do that, that does not mean people lose their pre-existing condition. What that means is the governor has to make sure people continue to have continuous coverage and at the same time design a program and make sure that the people are taken care of and protected.

Again, we can continue to run down this path we're going today. The federal government cannot continue to spend the money it's spending. States are going to have to do this anyway. In the long run, I think we need to take a look at the options. And as governor, that's a - that's exactly what I would do.

TAPPER: So you think that the option should be there, but you're not willing to say one way or another, even though you're running for governor, that you want to pursue any of those options?

RENACCI: Well, no, as a governor, I would want to take as much back to the state as I can. So I'm telling you that, as a governor, I would want to pursue what's in the best interests of the people of the state of Ohio. And you're asking me a question today as, well, would you do that right now? Well, again, what I think I would do is I would try and get as much as I can back to the state. I would look at the options to, make sure we're taking care of people back in Ohio and that people aren't losing coverage and pre-existing conditions are still being met. If I can do that inside the waiver program, which I believe I can do, and still make sure I have a better product, you bet I'm going to do it.

TAPPER: All right, Congressman Jim Renacci, thank you so much. Appreciate your time, sir.

RENACCI: Thank you.

BLITZER: Coming up, moment of truth. We're showing you live pictures of Capitol Hill right now. Just a matter of minutes the House will vote on a Republican plan to repeal and replace Obamacare. Will it be a major shot in the arm for the president and his party?

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