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Health Care Vote Is Trump's First Big Legislative Win; House Narrowly Passes Bill To Replace Obamacare; Republicans Visit White House For Victory Lap; House Democrats Sing To Mock Republicans; Trump: I'm So Confident Health Care Bill Passes Senate. Aired 3-4p ET

Aired May 4, 2017 - 15:00   ET




ZAIN ASHER, CNN INTERNATIONAL GUEST ANCHOR: Hello and a warm welcome to all of you at home. Welcome to THE WORLD RIGHT NOW. I'm Zain Asher

sitting in for Hala Gorani in New York.

I want to begin today with some very important breaking news out of Washington, in fact, President Trump, is no doubt taking a victory lap,

because one of his biggest campaign promises is now his very first major legislative achievements.

I will explain why. Just minutes ago, the House of Representatives passed a bill to repeal and replace Obamacare. It was very narrow with just few

votes to spare.

Republicans have been trying for years to overhaul health care and President Trump made it a personal mission to get this bill passed. As I

mentioned, no doubt, he is taking a victory lap.

House leaders from both parties made their final arguments just before votes were cast. Take a listen.


REPRESENTATIVE NANCY PELOSI, MINORITY LEADER: Our responsibility to the sick and the hurt is biblical. It is fundamental to who we are. As Pope

Francis said, health is not a consumer good, but a universal right. So access to health services cannot be a privilege. Today, let us declare

once again that the affordable health care must be the right of every American, and not the privileged few.

REPRESENTATIVE PAUL RYAN (R), HOUSE SPEAKER: In this failed experiment, let's make it easier for people to afford their health insurance. Let's

give people more choices and more control over their care. Let's make insurance companies come in and compete for your business. Let's return

power from Washington to the states. Let's help get people peace of mind.


ZAIN: Speaker Paul Ryan speaking earlier, and even though bill has passed in the House, it is certainly not over yet, because the bill now heads for

the Senate where they could certainly face a lot of stiff challenges.

I want to bring in Sunlen Serfaty who is joining us live now. So Sunlen, this is certainly an important win for President Trump, but are they

actually prepared, are Republicans actually prepared for the political fallout especially in swing districts?

SUNLEN SERFATY, CNN CONGRESSIONAL CORRESPONDENT: Well, they are certainly, Zain, as you noted before, a long way for legislation to go, although we

will see of course, House Republicans and President Trump take a victory lap today, it is going to be a temporary victory lap, a short termed

victory lap, because the hard work still does remain.

It certainly is a significant legislative victory. The fact that the House of Representatives today passed their bill to repeal and replace Obamacare,

but that is just one step in the process. This now heads over to the Senate where already here in the Senate, we are hearing from Senate

Republicans that they are not happy not only with the process of how this went down.

The fact that the bill was passed without a CBO score, which give us the cost estimate, and the coverage estimate of the bill, but the fact that

they are not happy with the policy of the bill, and that they intend to make significant and potentially drastic changes to this bill.

And then from there, even if and when it gets through the Senate, then it has to going to something called the Conference Committee where those

changes would have to be OKed by the House.

So certainly it is a legislative victory today in part by House Republicans, but there is many, many steps to go, but to your question,

this certainly does give House Republicans who are about to head out of Washington for a week-long recess some deliverable to take home to their

home states.

To say, look, we campaigned on this and we have been promising that we will do this for seven years, and that gives them a talking point to take home

to their constituents.

ZAIN: But Sunlen, as you mentioned, the CBO has not scored this. I mean, nobody really knows the damage in terms of a concrete number of people who

might end up losing health care. So just explain, what was the point in trying to ram this through today? Why not wait?

SERFATY: A lot of the Democrats are asking that question -- those questions for sure, Zain, and I think that the feeling was that this is all

about momentum. House Speaker Paul Ryan knew that they were operating under this deadline.

Where if they leave Washington tonight, he did not want to send his team of House Republicans back to their home districts to in essence get beat up

like we saw in the aftermath of the failed attempt about 40 days ago.

So there is a sense that there was momentum here, a small window of opportunity to get it done, and that this is the best bill at this

particular time for them to do that.

And that is why we have these 11th-hour negotiations, 11th-hour modification, and added amendments to the bill happen overnight where it

was able to win one or two additional vote.

[11:05:11]And as we saw in the very, very close breakdown today, 217 to 213 votes, those last-minute negotiations really made the difference here in

getting this through the House.

ZAIN: Yes, certainly very narrow. OK. Sunlen Serfaty live for us on Capitol Hill, thank you so much. Appreciate that.

I want to show you some live pictures now. House Republicans certainly found out the thought that they felt about the passing of the bill the

moment they actually stepped outside of the building.

And you can actually hear protesters who have gathered there -- there was protests rather gathered outside of the White House basically chanting


Those voices that you are hearing there are protesters chanting the words "shame." A lot of people are not happy about this bill so lawmakers

actually got to hear people chanting, "shame."

House Republicans, though, as I mentioned, are taking a victory lap. They are, meantime, arriving now at the White House where they will soon be

greeted by President Trump.

I want to bring in Stephen Collinson for the very latest on this. So Steven, you know, was this bill -- did lawmakers actually care about the

details in this bill or was it just simply about getting rid of Obamacare and getting something that was different but not necessarily better?

STEPHEN COLLINSON, CNN POLITICS SENIOR REPORTER: Yes, I think what happened today was that the price for not passing the bill for many of

these lawmakers began to outweigh the uncertain and somewhat distant consequences of passing it.

You have talked about how people say this is a flawed bill, it could cost millions of people their health insurance, but for a lot of these lawmakers

in the safe Republican districts, they are not worried about whether they'll lose to a Democrat in the 2018 midterm elections.

They are worried that they are going to get a challenge from their right from even more conservative challengers so in that sense, it was a case of

political self-preservation.

The reason it was so close is because there are also a number of Republicans who are in more moderate districts, districts won by Hillary

Clinton in the presidential election. It is a much tougher vote for them.

They don't want to be portrayed as they already are by Democrats of taking away people's health insurance, of effectively condemning people to getting

sick and possibly even dying because they don't have health insurance.

So it is a political issue here rather than the details of the bill. As Sunlen was saying, we also know that the bill that comes back from the

Senate is going to be very different.

So I think there are a number of lawmakers who are hoping that the bill will be a much more functional piece of legislation in the future than it

is already.

ZAIN: Stephen, as you are speaking, we were looking at the live pictures outside the White House as lawmakers gathered there and President Trump is

set to speak in about 20 minutes from now. What do you expect him to say on this? No doubt, he is very proud that this bill passed like he said it


COLLINSON: Yes, I think the president has been waiting for a major legislative victory for his entire presidency. Remember last week, we were

all talking about the first 100 days and how he did not have a victory, that raised all sorts of questions about his ability to manipulate the

Republican majority in Washington to enact the rest of his agenda.

And I think this is a moment of great psychological importance for the president and the Republican majority. A moment where they can actually

come together, because you'll remember back in March when this bill first founded in the House, there were a lot of recrimination between the White

House and Republicans on Capitol Hill.

This will give Republicans confidence that on other issues of the Trump agenda, things like tax reform for example, that they can actually get

together and pass something. It is not too long ago that we were talking about the dawn of a new conservative era in Washington.

The fact that it took so long to do something that is so many thought would be so easy after all when President Obama was president, Republicans voted

to repeal Obamacare multiple times.

But now, when you are in power, it is a lot more difficult when you are being blamed for the consequences of people's lives, it is a much tougher

vote. So I think this is a good moment for the Republican Party, but I think it is a short lived moment of celebration.

This is just the end of the beginning of this effort to repeal Obamacare, much more complicated sort of politicking remains.

ZAIN: Right. So there is certainly about this, but this is just the first step is basically what you are saying. Obviously, it still has to go

to the Senate, and lot of senators have been very skeptical about this particular bill. OK, Stephen Collinson live for us there, thank you so


[15:10:03]I want to bring you the very moment in the House, just after this bill passed. Republicans certainly had reason to celebrate. The House

Democrats actually began singing. Take a listen.


ZAIN: These are the lyrics from "Nah, Nah, Hey, Hey, Kiss Him Goodbye" made famous by bands like the (inaudible). Democrats sang that to warn

Republican lawmakers, they will lose their seats over the vote.

I want to bring in Tim Miller who is a former communications director for Jeb Bush's presidential campaign. So Tim, thank you so much for being with


You know, we heard Nancy Pelosi basically saying, listen, this is actually an opportunity for Democrats because we will make sure that voters know who

exactly took away their health care. What do you have to say to that?

TIM MILLER, FORMER COMMUNICATIONS DIRECTOR, JEB BUSH PRESIDENTIAL CAMPAIGN: I think that she is right on the merits, but I don't know about the

childish taunts, but health care is going to be really tough, just ask the Democrats who have had to defend Obamacare.

When people see in their lives the result of health care, you know, their premiums going up, and their deductibles are going up, and they took it out

on the Democratic politicians. We won in a huge landslide in 2010.

I think that is a big risk for us in 2018. So I was skeptical that Republicans should take on health care first because I think that this is

going the galvanize Democrats, and if people do begin to start losing their health insurance, Republicans are going to be the ones to blame.

And the health care system is always messy, and so by taking the political ownership of it, I think the Republicans are putting ourselves at risk for

the midterms no doubt.

ZAIN: And you know, Donald Trump watched the vote. He congratulated everybody around him, but the fact is this is now have to go to the Senate,

where it is going to be a tall order to get this through the way it is. And then even if senators end up proposing changes, and the House has to

agree on those changes or at least come to some kind of compromise.

MILLER: Yes, as a moderate Republican, I am encouraged that this bill has to go to the Senate, because I think that there will be a lot of influences

in the Senate that move the bill more towards the center.

Senators from states that have a lot of people on Medicaid are going to demand that their increasing Medicaid protections such as the low income

health care system in this country.

So I think that the big question then is, if the senators are able to push through a more centrist version of this health care bill when it goes back

to the House, will the more conservative representatives swallow their pride and vote it through or will it get stuck?

That remains to be seen, and I think that final hurdle is going to be the biggest one for Donald Trump.

ZAIN: And we are looking at live pictures outside the White House, where Donald Trump is expected to address lawmakers, and address television

cameras after this initial victory. Tim, do you think that the Democrats should have been, I guess, more aggressive in proposing fixes or the

changes to Obamacare?

MILLER: Going back a few years, sure. I think that potency of the Republican message against Obamacare was that the Democrats, you know,

essentially rushed it through on the party line vote like we have now done this time, but they did not make any fixes over the course of six, seven

years, very, very little was done to change it.

And so that left the Democrats extremely vulnerable on this. Now what I don't expect is any sense of where somebody as polarizing as Donald Trump

in the White House, there is going to be bipartisan solutions over the next two to four years.

I think you will see a repeat of the Obamacares, but inverted where the bases of each party are so galvanized against their opponents, that nobody

wants to compromise, because of threats within their own party.

And, so you know, I don't think that the Democrats are going to look to work with Republicans to make this bill better. I think their strategy

will be rather to let us hang ourselves with it, if we are not smart about changes before it is signed.

ZAIN: But in terms of, you know, being sort of smart about proposing changes, the fact remains that we showed some pictures earlier of

protesters screaming "shame, shame." People are just extremely angry about the prospect of the health care being taken away from them or higher

premiums. How do the Republicans at this point win over skeptical voters?

MILLER: Look. We are an extremely polarized country right now, and so I think if you are look at what Donald Trump, his strategy is, how did he

win, how did he get elected president, it was by really energizing the 47, 46 percent of the country that is Republican and conservative that

responded to Donald Trump.

[15:15:07]He is not like many of our past recent presidents who wants to reach across the aisle and broaden his base. What his strategy is to

continue to motivate and excite that 46, 47 percent in order to jam through very close narrow victories.

So that is going to be the Republican strategy. The Democrats then on the flipside have to do the exact same, which is to galvanize their supporters,

the people out there protesting and shouting in front of the capital today. The question is where will the energy be --

ZAIN: Where is the country divided?

MILLER: It is not just that much to flip because it is a small percentage in the middle right now in this country and people who go back and forth

between the two parties, and so it is really galvanizing your supporters to show up is the key strategic play at this point.

ZAIN: And we are looking at live pictures, there is Paul Ryan coming up on stage. Guys, do we is he's going to address -- is he going to go up to the

podium and speak to people or not? Are we waiting at this point because we don't know whether he is going to speak?

But we are waiting for President Trump to come out any moment now. In fact, I have been given a 2:00 warning in my ear. So Tim, do you think at

least the Republicans at this point waited for the CBO to at least score this before trying to jam this through?

MILLER: Politically speaking, long term, yes. Short-the term, I think they are worried that they would lose the votes. If you have seen, they

had 217 votes. They needed 216 to pass. It was a very tight vote, and if the CBO score does not come out in our favor, you can easily have seen them

lose a couple more votes.

ZAIN: And overall, how do you think -- it is look as though we have President Trump making his way on to the stage as he is addresses

lawmakers. Let's listen in.

MIKE PENCE, VICE PRESIDENT OF THE UNITED STATES: Speaker Ryan, Majority Leader McCarthy, Majority Whip Scalese, Chairwoman McMorris Rogers, and

Chairman Brady, Chairman Walden And Chairwoman Black, and Congressman MacArthur, Congressman Meadows, and all the principled members of Congress,

who are standing with us here today on behalf of President Donald Trump and the first family, welcome to the White House. Thanks to the leadership of

President Donald Trump, welcome to the beginning of the end of Obamacare.

It was March 2010, seven years ago, Democrats passed a government takeover of health care. And at that time, the Republicans in Congress promised the

American people that law would not stand.

Today, thanks to the perseverance, the determination and the leadership of President Donald Trump, and all the support of those gathered here, we have

taken a historic first step to repeal and replace Obamacare and finally give the American people the kind of health care they deserve.

So, today, with heartfelt gratitude for all he has done to keep his word to the American people, and for all that he will do to continue to make

America great again, it is my high honor, and distinct privilege to introduce the you the president of the United States of America, President

Donald Trump.

DONALD TRUMP, PRESIDENT OF THE UNITED STATES OF AMERICA: Thank you. Thank you. Thank you, Mike. That's the group. Thank you. Thank you. This is

really the group.

And this is the great group of people and they are not doing for it party, but they are doing it for the country because we suffered with Obamacare.

[15:20:04]And I went through two years of campaigning, and I am telling you no matter where I went people were suffering so badly with the ravage of

Obamacare and I will say this that as far as I'm concerned, your premiums are going to start to come down.

We will get this passed through the Senate, I feel so confident. Your deductibles when it comes to the deductibles that were so ridiculous that

nobody got to use their current plan, this non-existent plan that I heard so many wonderful things about over the last three or four days and after


I mean, it is -- I don't think that you will be hearing so much right now, the insurance companies are fleeing. It is been a catastrophe and this is

a great plan. I actually think it will get even better, and this is, make no mistake, a repeal and a replace of Obamacare. Make no mistake about it.

Make no mistake.

And I think that most importantly, yes, premiums will be coming down, yes, deductibles will be coming down, but very importantly it is a great plan.

Ultimately, that is what it is all about. We knew that wasn't going to work.

I predicted it a long time ago and I said it is failing, and now, it is obvious that it is failing. It is dead. It is essentially dead. If we

don't pay lots of ransom money over to the insurance companies, it would die immediately.

So what we have is something very, very incredibly well crafted. I will tell you what, there is a lot of talent standing behind me, an unbelievable

amount of talent. That I can tell you. I mean it.

And you know, coming from a different world and only being a politician for a short period of time, and how am I doing? Am I doing OK? I am

president. Hey, I'm president. Can you believe it, right? I don't know.

It is -- I thought that you needed a little bit more time, they always told me, more time, but we didn't. But we have an amazing group of people

standing behind me. They worked so hard, and they worked so long, and what I said, let's do this.

Let's go out just short little shots for each one of us, and say how good this plan is. We don't have to talk about this unbelievable victory, and

it was unbelievable so we don't have to say it again.

But it is going to be unbelievable victory actually when we get it through the Senate, and there is so much spirit there, but I said, let's go out,

and we have a little list of the some of the people.

And I think after that list goes, if they don't talk too long, our first list, we will let some of the other folks come up and say whatever you

want, but we want to brag about the plan because this plan, really?

UNIDENTIFIED MALE: We don't want that.

PRESIDENT TRUMP: Well, we may. But we are going to talk about the plan, how good it is and some of the great features. I want to thank Paul Ryan,

he has worked so hard. And I was joking, I said, you know, Paul, for the last week, I have been hearing Paul Ryan doesn't have it. It is not

working with Paul Ryan, and he is going to get rid of Paul Ryan and then today I heard Paul Ryan is a genius, and he has come a long way.

UNIDENTIFIED MALE: I will take whatever.

PRESIDENT TRUMP: You know, the groups have all come together, and we have the Tuesday Group. We have so many groups, and we have the Freedom Caucus,

and -- they are all great people, and we have a lot of group, but they all came together, and really, Paul, I'd say in the last three or four days,

especially in the last day.

You can see Mark and Kevin and so many people, and Jim, we just have developed a bond. This has really brought the Republican Party together,

and as much as we have come up with a really an incredible health care plan, and this has brought the Republican Party together.

We are going to the get this finish and then we are going -- as you know, we put our tax plan in, it is a massive tax cut, the biggest tax cut in

the history of the country.

I used to say the biggest since Ronald Reagan, and now it is bigger than that. And also, pure tax reform. So we are going to get that done next

and this really helps. And a lot of people said, how come you kept pushing health care knowing how tough it is.

Don't forget Obamacare took 17 months, Hillary Clinton tried so hard, really valiantly in all fairness to get health care through, and it didn't

happen. We have really been doing this for eight weeks if you think about it, and this is a real plan and great plan, and we had no support from the

other party.

So I just wanted to introduce somebody to say a few words who really has been I think treated unfairly, but in no longer matters, because we won,

and we are going to finish it off and go on to a lot of other things.

[15:25:05]And we are going to have a tremendous four years and maybe even more importantly, we will have a tremendous eight years, but we will start

off with just a great first year, and Paul Ryan, come up to say a few words, congratulations on a job well done.

RYAN: Thank you. Thank you, guys. Thank you. First, thank you, Mr. President. Thank you. Thank you, for your leadership. There are too many

people to name who played such an important role in helping to us get to this part, but I want to thank a few people in particular.

I want to thank Chairman Greg Walden, Kevin Brady, Diane Black and Pete Sessions and the members of the committee who put in all of the hard work

to get us to this point.

I want to thank the other members who contributed to making this the best bill possible. It really was a collaborative, consensus-driven effort. I

also want to thank the team here at the White House. I want to thank Tom Price.

I want to thank Mick Mulvaney and I especially want to thank Reince Priebus. We could not have done this without you, Gentlemen. You guys are

the best.

Of course, this would not have been possible if it weren't for the two gentlemen behind me. This is the fourth presidency I've served with. I

have never ever seen any kind of engagement like this.

I want to thank Mike Pence and President Donald Trump for their personal involvement in working with our members and working to get this right and

for getting this done and getting us to where we are. Thank you, Gentlemen.

Today was a big day, but it is just one step in the process, an important step. We still have a lot of work to do to get this signed into law, and I

know that our friends over in the Senate are eager to get to work.

They are. We are going to be see that work through. You know why we are going to see this work through? Because the issues are just too important,

and the stakes are just too high.

The problems facing American families are real and the problems facing American families as a result of Obamacare are just too dire, and too


Just this week, just this week, we learned of another state, Iowa where the last remaining health care plan is pulling out of 94 of their 99 counties.

Leaving most of their citizens with no plans on the Obama market at all.

What kind of protection is Obamacare if there are no plans to choose from? This is a trend that we are seeing all across the country. The truth is,

this law has failed and is collapsing.

Premiums are skyrocketing and the choices are disappearing and it is only getting worse spiraling out of control. And that is why, we have to repeal

this law and put in place a real vibrant marketplace with competition and lower premiums for families.

That is what the American health care act is all about. It makes health care more affordable, and it takes care of the most vulnerable, and it

shifts power from Washington back to the states, and most importantly, back to you, the patient.

Like I said, we have a lot of work to do, but one thing is now clear, Republicans are committed to keeping our promise to lift the burden of

Obamacare from the American people, and put in place, a better more patient-centered system.

It is my pleasure at this time to thank and welcome to the stage someone who helped to make this so possible, our very talented Majority Leader

Kevin McCarthy.

REPRESENTATIVE KEVIN MCCARTHY (R), MAJORITY LEADER: I remember the very first time I came down here to see the new president, President Trump. We

talked about health care. You know what the president said? He said, let's not make this partisan.

Don't do what you think is right for the Republican Party, do what is right for the American country and today, that is exactly what we did.

You see, if you simply reading the papers from this week, you take politics out of it, and you put people before politics, how do you look in the faces

of 94 counties in Iowa out of 99?

Not that they won't have very many choices, they'll have no choice. How do you care for pre-existing conditions when there is no care at all or you

read the paper yesterday and you look at Aetna pulling out of Virginia or Tennessee next year with 16 counties with no care?

[15:30:00] What about those families that paid into those 23 co-ops that Obamacare created with more than $2 billion? Eighteen of them has

collapsed. And the only answer that this American government gives them is a penalty.

If you simply look at the facts, more people took the penalty or the exemption than actually signed up for Obamacare. I did not run to this

office to promote a party. I ran for this office to make this country better.

Yes, it would be easy to say no. It would be easy to watch it collapse, but I can't look at those families. I don't think that is right. And that

is the exact message I got from this administration.

So, Mr. President, I want to thank you. I want to thank you for your leadership. I want to thank the Vice President. You know, I have only

been through a few presidents, but I've never seen someone so hand's on. I walked into my office yesterday morning, they say the President is calling

again. I pick up the phone --


MCCARTHY: I happen to be the majority leader of the former whip. I know my members well. The President gives me a list of who he thinks I would be

best to talk to on the list.


MCCARTHY: And he was right.


MCCARTHY: And, Mr. President, they all voted for the bill.


MCCARTHY: Today is a start. Today is a start of a new beginning. Yes, it is about providing better health care, but I happen to have been a small

business owner. I listened to my district. You know how many families no longer have a 40-hour job and now have to take two part-time jobs, or how

many small businesses told me that they couldn't expand anymore because they were afraid of what Obamacare would do for them?

We are going to unshackle, build an economy, let people have greater choice in their health care, and protect the pre-existing conditions. And I thank

you for that work.

I want to call up --


MCCARTHY: I was this job before being majority whip. I never had to go through a bill like this. And I will tell you, being the whip really isn't

one person. The deputy whip should get a lot of credit as well.


MCCARTHY: Patrick McHenry. But whip Steve Scalise never gave up, answered every question. And the team between Scalise and McHenry, I'd put beyond

any team we've ever had. I give you the Majority Whip Steve Scalise.


REP. STEVE SCALISE (R), MAJORITY WHIP, UNITED STATES HOUSE OF REPRESENTATIVES: Today, we took the first step toward rescuing families

from the failures of Obamacare. We've been seeing it play out all across the country. This isn't some hypothetical discussion.

You can see the families struggling in every part of our country. I hear from families all the time in my district in southeast Louisiana sharing

with me stories of double-digit premium increases every single year. When we had the 27 1/2 hour mark-up before the House Energy and Commerce

Committee, the longest they said in the history of Congress, to pass this bill out of committee, we had a long and important discussion about health

care policy in America and how this isn't about achieving some kind of political goal.

It's about families. Families who are struggling under the weight of this law that doesn't work. And so I reached out to my own constituents, and I

said, share with me some of the stories in how this law, Obamacare, is affecting you personally. And, unfortunately, I got a lot of horror


You know, we talked a lot about protecting people with pre-existing conditions in the context to this bill, and there are so many things,

multiple, multiple layers in our bill that we passed today that not only protect people with pre-existing conditions, but actually focus real

targeted money on lowering premiums for families with pre-existing conditions.

And so during the committee hearing, it might have been around 3:00 in the morning, I shared a story of one of those constituents, Chris from Slidell,

who sent me a letter and talked about their family having pre-existing conditions. They have a family member with pre-existing conditions, and

how because of the problems of Obamacare, they're paying double-digit increases. But this is the real story for families that have pre-existing

conditions that are truly being hurt by Obamacare.

One of the untold stories are the dramatic increases in deductibles. So there are a lot of families across the country that have over $10,000

deductibles. Now, for most people, that means they really can't even use the health care that they have in Obamacare.

[15:35:02] And so what Chris told me was, not only when we go to the doctor do we have to pay so much for our premium, but almost everything we do,

we're paying out of pocket because we've got such a large deductible. So basically, I'm paying a lot of money for a health care plan that doesn't

work for me. Please provide relief for my family. We hear these stories over and over.

And what's been so encouraging about this debate is that, from the very beginning, every member of Congress that's been involved in trying to get

this bill passed has been focused on two main things. And the first one is lowering premiums for families that are struggling, and the second is

making sure that patients and doctors are the ones that make their own health care decisions.

Unelected bureaucrats in Washington should not have anything to do with the health care decisions made between a patient and their doctor, and that

ends with this bill.


SCALISE: And so as we went through this process, and it took weeks. Some people wanted it to take a couple of days, but we said we're going to take

the time to get it right because it affects every person in this country. And every change that was made along the way made this bill better. Almost

every change that was made along the way was focused on lowering premiums.

Of course, you had a lot of other things we wanted to do. We reformed the Medicaid program. One of the most broken parts of health care, anybody

will tell you, is Medicaid. And so we actually give governors and states the flexibility to go and be innovative and do things that will, in a much

more targeted way, help low-income families in a way that Medicare is failing them today. That is another important aspect of this bill.

But we wouldn't be here today without the work and the help of the President and the Vice President of the United States directly getting

involved. Because every meeting we had with members that wanted to get additional components added to the bill, President Trump said, "Bring them

into the White House. I want to meet with them. I want to talk to them about how we can actually lower premiums," because President Trump's focus

from the beginning was the same thing.

He knows that Obamacare fails, but it's failing because it's hurting families. And he said, how can we lower premiums? How can we give

patients more control of their health care? And ultimately, all of the meetings that we had along the way that made this bill better were focused

on those objectives. And that's why it's so important that we get this first step done today there.

There's a lot of work left to be done. And I look forward to the Senate taking the action that they need to take, but ultimately getting a bill to

President Trump's desk that he'll sign that actually rescue families from this incredibly failed law and put patients back in charge of their health

care decisions and lower premiums. And the man that led the charge in starting this process in the committee was the House Energy and Commerce

Committee Chairman Greg Walden. I want to bring him up.



Mr. Vice President. It has been a pleasure and an honor to work with you hand in hand to get this bill to this point. And I want to tell you what a

great team you have and what a great team, I think, we have in the Congress and on the Energy and Commerce Committee and our Subcommittee Chair Mike


Mike, come out here for a second. Dr. Mike Burgess has done incredible work on this as well.


WALDEN: You've heard a lot about our goal to get this back to a patient- doctor relationship, to make insurance affordable to every American and available where they have choices and lower costs and competition in that


It is collapsing around us state by state, county by county. Last year, there were 225 counties in America where you only had one choice on the

Obamacare exchange. This year, it's 1,022. And you've heard now there are some counties where you'll have no choice. That's not affordability.

That's not access. That's not patient care.

That is what we're trying to reform in this legislation. You heard about Medicaid reform. I started on Medicaid reform in the 1989 session of the

Oregon legislature. I helped out there and we became the majority in '90. I was majority leader in '91. We continued these reforms to achieve this

same goal of trying to get people care that they needed when they didn't have it, and I continue that battle today.

We reached out to governors, and we reached out to insurance commissioners. We reached out to innovators in this space. I think of Governor Herbert

out of Utah who told us the story of having to petition CMS -- the old CMS, not Seema Verma and Tom Price's CMS -- to see if he could use a modern new

innovative --


WOLF BLITZER, CNN ANCHOR: Congressman Greg Walden speaking right now. We're going to continue to monitor the celebration going on in the Rose

Garden over at the White House. A big, big win for the Republicans in the House of Representatives, 217 to 213. That's the final vote passing the

repeal and replacement of Obamacare.

But there's still a long, long way to go in the United States Senate. Senate will take up this legislation, presumably make several significant


John King, you see the President. He was very, very happy. And he deserves a lot of credit because he worked very hard over these past

several days to get those final votes to reach 217.

[15:40:05] JOHN KING, CNN CHIEF NATIONAL CORRESPONDENT: And the smile on his face and the nodding as he receives praise and as the other Republicans

praise the parties involved in this shows how happy he is, shows that this is the first time -- very rare, this has passed one chamber of Congress,

and we're having a Rose Garden ceremony. We used to have a Rose Garden ceremony when you're signing legislation.

But this was so important to the President to try to say and to righty say that we passed out of the House a key Republican and a key Trump campaign

promise. Now, his emphasis was trying to put pressure on the Senate to act as quickly as possible.

That is the giant question. Not to be the skunk at the Rose Garden party, but, you know, passing something in the House changes the optics in

Washington and changes the conversation in Washington. It changes absolutely nothing in the health care of Americans who are watching this

debate. Whether they are for Obamacare or against Obamacare, it changes nothing today. It is a step in the direction.

And now, the question is, can the President get to the finish line? And what he is hoping is that this gives him a boost, that this gives him some

momentum, that this gives him also some experience at the rough business of this. They failed 42 days ago, they succeeded today. Can the President

get this through the Senate in a way that then you get back to the House and make a compromise? That is a giant question. It's a giant, unknown


I will say this about the Senate. Senator Orrin Hatch, a key influential veteran Republican, says we need to manage expectations, focus on the art

of the doable. The Majority Leader Mitch McConnell said thank you to the House for passing this, did not comment at all on the specifics of the

bill, just said he wanted to repeal and replace Obamacare.

And the guidance from the Senate leadership is we need that CBO score first. We need some other budget numbers first. Because of the rules of

the Senate, they can't take this bill up as it is until they know more about it and how it's going to be. So this is a big achievement for the

President today. He needed this.

If you look at the disgust among the conservative base at the spending bill, all the backlash against the White House and the Republicans for the

spending bill they just passed, the President needed to really look his base in the eye and say, I'm making progress. Now, we'll see where we're


BLITZER: And they are making progress and he deserves a lot of credit for this initial step.

NIA-MALIKA HENDERSON, CNN SENIOR POLITICAL REPORTER: That's right. I mean, huge, huge defeat that he suffered 42 days ago, and now he is

celebrating. And this is, in some ways, a sendoff party for those folks who are going to go back to their districts and have to talk to their

constituents about that. You imagine that Democrats will try to flood some of those town halls.

KING: Right.

HENDERSON: Particularly if they have town halls. Some of these Republicans might not want to have town halls.

KING: That's right.

HENDERSON: But the President, today, sounding optimistic, sounding bullish on whatever comes out of the Senate, the sort of final product. He

promised premiums are going to start to come down. I'm not sure when means they're going to start to come down. And he also said the deductibles will

be going down as well.

I mean, today, you could see the places where Democrats can make ads out of this event, sort of them laughing and joking and the celebration. And you

imagine that that will end up happening from Democrats, but Democrats still, you know, have a lot of work to do in terms of their messaging and

what they should do.

BLITZER: Yes. And, Gloria, the President was very, very specific. He said we're going to get this passed in the United States Senate. The

ravages of Obamacare, he says, will be gone. What a great group of people. He thanked all Republicans who have gathered. And the Vice President said

this is the beginning of the end of Obamacare.

GLORIA BORGER, CNN CHIEF POLITICAL ANALYST: Right, and they made promises. They did make promises. Remember, President Obama said if you like your

health care, you can keep it. Well, we've heard a lot of promises from Republicans, such as premiums are going to come down, that there aren't

going to be any changes in your pre-existing conditions, that this is going to benefit you in every single way. We're going to have to see that.

I want to point out one thing, that there are 23 Republicans we know who won in districts that Hillary Clinton won. And 14 of them voted for this

bill, nine of them voted against this bill. You can be sure that the 14 of those Republicans -- and John, you know this better than anybody -- 14 of

those the Republicans who voted for this bill have now a big target on their back from the Democratic Party.

HENDERSON: Unless --

KING: Or as Nancy Pelosi called it, a tattoo.


BORGER: A tattoo on their front, not a target on their back.

KING: On their forehead.

BORGER: On their forehead, not a tattoo on their back.

HENDERSON: Unless some of those folks decide to retire, right? I mean, that is one of the things to look for over the next weeks as well, to see

if, you know, they walked the plank and they walked off to retirement.

BORGER: But, again, you know, we can't emphasize the importance of this, two people watching this, about what is going to happen to their health

care. The uncertainty out there is a little frightening, I think, for people, particularly people with pre-existing conditions that cost an awful

lot of money. And they don't know what their state might do.


BORGER: They don't know what the Senate might do. They don't know what is going to happen to their states if Medicaid is block granted. And so

people have to watch this very closely as we finally get the text of this legislation, which we don't have yet, so they can find out, well, wait a

minute, how is this going to affect my state? How is this going to affect me? And people need to start asking lots of questions about this, as you

go into the Senate debate on this bill.

[15:45:04] BLITZER: The victory celebration continues in the Rose Garden. Over at the White House, the Republican members of Congress, they are

speaking, celebrating this victory in the House of Representatives.

I want to bring in our Senior Political Commentator David Axelrod. Very quickly, David, do you remember after Obamacare, the Affordable Care Act,

was passed in the House and then went on to the Senate, was there a celebration in the Rose Garden similar to this one?

DAVID AXELROD, FORMER SENIOR ADVISOR TO PRESIDENT BARACK OBAMA: No, there was no celebration. I remember a long laborious process. And, you know,

there was no love lost between the House and Senate, and there was real tension between them. And even when it became apparent after Democrats

lost Ted Kennedy's Senate seat, that the House would have to swallow the Senate version of the bill because it couldn't go back there and get 60


The House was very resentful. It took a long time to and a lot of negotiations to get the House to accept it. So it's appropriate that

they're having this celebration in the Rose Garden because this is a thorny issue for Republicans from this point on. It's going to be very hard to

get it through the Senate.

And if they do, they have made some promises here that they will have to keep. The Congressional Budget Office painted a much different picture of

the impact of the bill that they just passed than you heard depicted by the President and members of Congress, at least the version before this one.

And everyone there says, well, that's largely the same bill.

The only thing that's been added is that people with pre-existing conditions are going to be a little less secure. You know, you've seen a

lot of Senators already tweeting, Republican senators, that they aren't for the bill -- Senator Portman, Senator Heller. Senator Alexander who is a

key committee chairman said, thanks a lot, we're going to take our time now and consider this.

So they have a long way to go on this, but nobody relishes and hungered for a win more than Donald Trump. And he got at least a short-term win today,

hence the premature Rose Garden celebration.

BLITZER: And it was an important win for the President of the United States. He's standing there. Republican members of Congress, they're

still speaking in the Rose Garden. The President invited them to come up and say a few words, and that's exactly what they are all doing,

celebrating this win of the House of Representatives.

I want to bring in Lanhee Chen. He was the public policy director for the Romney presidential campaign. Former New York Democratic congressman,

Steve Israel is with us as well. Our Senior Economics Analyst Stephen Moore. Former White House Communications Director Jen Psaki.

So, Lanhee Chen, what's your reaction?

LANHEE CHEN, FORMER PUBLIC POLICY DIRECTOR FOR MITT ROMNEY: Well, this is a significant accomplishment for the President, a significant accomplishment

for Paul Ryan and House Republicans. I do think it's the case, as many of your commentators have noted, the bill is going to change substantially in

the Senate.

You're going to see more provisions around Medicaid to, perhaps, equalize the treatment of states that did the Medicaid expansion and states that did

not. You're going to see potentially more generous support for lower income Americans to help them purchase health insurance. The bill that you

see today leaving the House is going to look very different than the bill that will return from the Senate weeks, perhaps months, from now.

So this process does have a long way to go. But we shouldn't take away from the fact that this is a significant accomplishment for the President

and for House Republicans.

BLITZER: Stephen Moore, whatever emerges from the Senate, it's going to have a struggle in the House of Representatives, right, because presumably

the Senate is going to ease up on some of the more conservative elements.

STEPHEN MOORE, CNN SENIOR ECONOMIC ANALYST: Wolf, good point. I mean, here we go again, right? You know, we could have another, you know, a more

kind of moderate bill that comes back to the House outside of the Senate, and then you get the same debate, you know, within the Republican Party and

the Republican caucus that you've just seen that got resolved.

So this is a heavy lift. I agree with Gloria and others that getting this over the goal line is going to be a tough thing, but I do feel confident

they're going to get this done. And then, Wolf, we turn to my favorite issue, which is tax reform, and we can't get that done until we get this


BLITZER: That's going to be a big struggle, too, tax reform, tax cuts. As the President just said, these will be the greatest, the largest tax cuts

in American history, even bigger than what passed during the Ronald Reagan administration.

I think, Steve Israel, and you were a Democratic leader in the House of Representatives, you have to admit the President of the United States, he

got personally involved. He worked really hard in squeezing a lot of these Republican lawmakers to vote in favor of this legislation. I assume you'll

give him some credit for that?

STEVE ISRAEL, FORMER UNITED STATES REPRESENTATIVE: Oh, absolutely. He deserves the credit for the fact that the House passed this bill, and he

deserves this photo-op. They are capturing a moment right now at the White House.

But you know who else is capturing the moment, Wolf? The Democratic Congressional Campaign Committee and Democratic media consultants. I

watched that ceremony and I heard the President of the United States say, and I quote, "premiums will be coming down and deductibles will be coming


[15:50:07] And my former colleagues with the DCCC heard it and captured it, taped it, and you will see those words over and over and over. And so I

believe that the midterm election effectively began on this day despite the fact that they have not passed and signed into law any kind of replacement

for the Affordable Care Act.

BLITZER: Jen Psaki, and you worked in the Obama White House, how worried are you though that the President's legacy achievement, the Affordable Care

Act, Obamacare, as the Vice President just said, this is the beginning of the end of Obamacare? How worried are you that Obamacare, the Affordable

Care Act, could go away?

JEN PSAKI, FORMER WHITE HOUSE COMMUNICATIONS DIRECTOR: Well, he also said that premiums will go down, and this bill will be better for people with

pre-existing conditions. And I don't think you can find a single health care expert who agrees with that.

Look, I think, Wolf, you know, the day after the election in November, if you would've told me that the Obamacare was still alive in May, I wouldn't

have believed you. I think there is a lot more steps to go here, which your panel has been talking about. It's not just the Senate.

Members are going to go home to their districts tonight, and they are going be met by a fierce and motivated opposition to their vote on this bill.

And senators who are going to be considering this for the next couple of months are going to be met with the same thing. So people are watching

this very closely. I'm not too worried yet, but I think that this is a time where people are really going to need to be out there and active and

showing up at town halls. And I expect that is what will happen.

BLITZER: Yes, I --

MOORE: Can I add one thing to that, Wolf, if I may, just a quick point?

BLITZER: Go ahead.

MOORE: You know, the historic nature of this vote in the House today is that, you know, I've been in politics for 30-some years. This is the first

time I can remember when a major entitlement program was actually rolled back. I mean, Congress loves to play Santa Claus, but rolling back some of

those benefits is a difficult thing. But, you know, we always talked about the fact that the entitlements are what's bankrupting our country, so this

was a courageous vote for a lot of these Republicans.

BLITZER: Well, it hasn't been rolled back yet.

PSAKI: It's courageous to make the movement --


BLITZER: It's the initial vote in the House. It still got to be --

ISRAEL: This supported $8 billion new program.

BLITZER: Hold on a second. It still got to be rolled back in the Senate. Steve Israel, go ahead, make your point.

ISRAEL: Well, you know, the hypocrisy to me is often stunning. These deficit hawks in the Freedom Caucus who want to cut spending across the

board in order to punt this bill to the Senate, they just supported an $8 billion additional expenditure for a social program. It's a program I

would support. I believe pre-existing conditions should be covered, but I don't want to hear these Freedom Caucus members anymore talk about being

deficit hawks.

BLITZER: Lanhee Chen, go ahead.

CHEN: Well, look, I mean, on net, this bill is going to cut the deficit, so, obviously, the bill is responsive to the desire of deficit hawks to get

some control over spending. I think it's the case, by the way, that this bill does provide a number of protections for people with pre-existing

conditions. We talk about the $8 billion, we forget the underlying bill offers a hundred billions over 10 years to states --

BLITZER: All right.

CHEN: -- to help them cover people with pre-existing conditions itself.

BLITZER: Lanhee, hold on. The President is speaking again.


DONALD TRUMP, PRESIDENT OF THE UNITED STATES: I even want to thank the media.


TRUMP: Thank you all very much, everybody. Thank you. Thank you very much. Thank you.



BLITZER: Well, even thanking the media, John King. We don't hear that often from this President.

HENDERSON: And we may never hear it again.

KING: Exactly. If you need any proof the President is in a good mood today, you just got it right there.



KING: But it's interesting. To the point that the excellent was just talking about. Look, this issue, since the Affordable Care Act, Obamacare,

was passed, it has been a Republican friend in three of the four elections since. Two midterm elections, two presidential years.

2012, President Obama, of course, was re-elected. But in 2010, 2014, and 2016, Republicans used this issue to their advantage. I think the question

on the table today, even though we don't know the finish line, does this become a law, or did they just pass something through the House?

Now that they voted on this under a Republican President, now that they had this big event -- and Steve Israel is exactly right -- it's going to be a

lot Democratic ads against Republicans pretty quickly. Does the dynamic flip?


KING: Obamacare has been a Republican asset in electoral politics. Does this TrumpCare or this vote now become a Democratic asset?

BLITZER: All right. I'm going to be back in an hour in "THE SITUATION ROOM." In the meantime, I want to throw it over to Brooke Baldwin.


BROOKE BALDWIN, CNN ANCHOR: All right. Wolf, thank you so much. I've got my panel sitting with me.

And so, Jeff Zeleny, just to you on this, we were all sitting here and listening to the President and him allowing all these other people to speak

in the Rose Garden. I don't know if I had ever heard the word "deductible" come out of President Trump's mouth?

JEFF ZELENY, CNN SENIOR WHITE HOUSE CORRESPONDENT: Certainly not and certainly not in the run up to this. He's been working the phones

privately and talking privately about this. But even at his so-called health care rallies in Louisville, and that's where I was at, he rarely

talked about it.

But what he said today, he said premiums will start to go down. He made a promise in that sound bite, those words, will be played back again and

again and again. He'll be measured by those words, politically speaking, going forward here.

[15:55:07] So I think that it was akin to President Obama saying, if you like your doctor, you can keep it. It's a promise that the President might

like to make, I'm not sure if he actually can make it.

BALDWIN: He did say, Tami. He talked about deductibles going down and premiums going down. You are in the weeds in all of this. Fact check all

that for me.

TAMI LUHBY, CNN MONEY SENIOR WRITER: Well, premiums will go down for some people, probably younger people, people who have more income. But there

are a lot of people who they're going to go up for, low-income people, older Americans. The insurers lobbying group just sent out an e-mail with

their reaction. And they said that the bill needs important improvements to better protect low and moderate-income families.

So there is a lot that needs to be done. Plus I have spoken to a lot of insurers, usually premiums and deductibles don't go both down at the same

time. It is going to be very difficult for insurers to do this, so we will see what happens.

BALDWIN: That's Jeff's point about cut the soundbite and play it over and over and over again.

To you, sir, on how the Democrats are salivating over how they want to cut these ads to swing through in the midterms.

DAVID CHALIAN, CNN POLITICAL DIRECTOR: Well, it's just like we're watching the mirror image of where we were in the fall of 2009, when this vote was

taken on the House floor and Nancy Pelosi, with the Democratic-controlled House and the Democrats had the Senate and the Democrats the presidency,

and they got this through by the skin of their teeth, a two of-vote margin, and the Republicans started immediately plotting their path back on this


Now, it's' just happening and switching. You can take Paul Ryan's floor speech today and substitute Nancy Pelosi in 2009. I mean, it's just

astonishing to see the role reversal. We are 550 days from the November 2018 midterm elections, and it begins today. This is the starting gun to

what is going to be yet another election cycle where health care is going to be front and center, the politics of health care. But this time, the

roles are going to be reversed.

ZELENY: One thing the President was telling people, I'm told, if you vote for this, I will have your back. So I do think now he'll be out there

campaigning for them. So it's a test for him. And is he going to lose the House like President Obama did in the midterms back in 2010 and then in

2014? You know, if they lose this.

LUHBY: But there are two things that come up before that election.


LUHBY: The premium prices for 2018 plans, and the premium prices for 2019 plans. Those are all going to be available in early November.

CHALIAN: Unaffected by what we saw just today. The premium price is based on the existing law, right?

LUHBY: It depends on what happens in the bill. There's a lot of uncertainty still and the insurers are very concerned. So --

ZELENY: Like, what's the effective? If this is signed into law, which is also a huge ship.

LUHBY: Right.


ZELENY: We should pause and be all, OK. The Senate also needs to weigh in, and there is no sense of urgency, I think.


BALDWIN: On that note, have you ever seen a Rose Garden ceremony for a bill that passed one chamber?

CHALIAN: We were talking about that. I can't think of one. I don't know if you can think of anything.

ZELENY: I can't either.

CHALIAN: I can't think of one. And yet, I think it was a really smart political thing for the Trump White House to do


CHALIAN: Because they needed a win so badly, and so they got one. This failed six weeks ago. They turned it around. And they needed to put a

very powerful exclamation point on it.

ZELENY: It is a messaging battle now, and Republicans now just got on the board with their messaging on this.

BALDWIN: It's about promises kept, right?


BALDWIN: Even more than -- I know you were sitting there and listening at all, but we're trying to figure out which Republican members and how they

voted, if they were incoming from districts that Hillary Clinton won in November of last year. And it's been this sort of, you know, quandary of

how do you vote.

Do you, you know, make good on the promise that the Republicans have been saying they would do, you know, since 2009? Or do you risk being booted

out of your eat because your constituents love their Obamacare?

CHALIAN: And it's different when you want to measure the primary politics against that versus the general election politics against that. So they

have to make a calculation here about not demoralizing their base by coming through and delivering this promise, versus having your name attached now.

Nancy Pelosi promised she's going to put it up in neon to a bill that may be unpopular. So that's the conundrum that a lot of these competitive

districts Republicans find themselves in.

BALDWIN: So quickly, in 60 seconds, now that this moves over to the Senate, what are the key pieces of this bill that really could start

changing around?

LUHBY: Well, we're going to have to see what they do with Medicaid. These are pretty draconian changes that they want to make to Medicaid. Already,

Lamar Alexander has said that he wants to probably have a softer landing.

There's going to have to be more protections for older enrollees, those in their 50s and the 60s, because, right now, this bill would really raise

premiums on them. And I don't think anybody wants that, particularly not the AARP. And there are going to be a lot of other changes. I think

that's what we're going to have to wait and see.

BALDWIN: What about women? We've talked so much about essential benefits, maternity --

LUHBY: Right.

BALDWIN: Go ahead.

LUHBY: True. Except that, at least for the premium prices, they're maintaining the protections against gender rating.


LUHBY: So they can't charge women more, but women may not get maternity in their policy.

BALDWIN: Which is a really big deal.

LUHBY: Sure.

BALDWIN: Especially if you're a woman and you're thinking about that as you are heading into 2018.

ZELENY: That's right.

BALDWIN: Tami and Jeff, David, thank you all so very much.

[16:00:00] I'm Brooke Baldwin. Thank you for being with me. We're going to send it back to Washington. "THE LEAD WITH JAKE TAPPER" starts right