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Soon: Trump Signs Executive Order Dismantling Obamacare; Rumors Intensify Over Chief Of Staff's Future In White House; Vanity Fair: White House Insiders Fear Trump Is "Unraveling"; San Juan Mayor Calls Trump "Hater In Chief". Aired 11-11:30a ET

Aired October 12, 2017 - 11:00   ET




KATE BOLDUAN, CNN ANCHOR: Hello, everyone. I'm Kate Bolduan. Just minutes from now, we will go live to the White House where President Trump is about to make the first and most significant change to health care in this country since he took office.

Of course, you remember, the promise to repeal and replace Obamacare on day one, that didn't happen, but this is what is happening today. He is taking matters into his own hands and through executive action the president -- that the president railed so much against, he is changing the way insurance can be purchased and what it will cover. Standby for that.

And this -- what else is going on in the White House right now? New reports today from "Vanity Fair" that White House is once again in chaos and insiders are saying that the president is, quote/unquote, "unraveling." Even his former chief strategist voicing concern according to the report that the president has a 30 percent chance of finishing out his first term.

And, then there's this -- while most of Puerto Rico is still without power and clean water, three weeks after Hurricane Maria, the president had this message today, "We cannot keep FEMA, the military and the first responders who have been amazing under the most difficult circumstances in Puerto Rico forever." There's that message.

The White House press secretary quickly playing cleanup, quickly after, saying don't read too much into that effectively.

We've got a lot to cover here today so let's get to it. Let's begin with CNN's Kaitlan Collins at the White House. Kaitlan, we are just moments away now from President Trump signing this executive order. Tell us what this is about?

KAITLAN COLLINS, CNN WHITE HOUSE REPORTER: So he's going to sign this executive order that relaxes the rules on these small companies that ban together to buy insurance in order to free them up from these regulations, and he's going to sign it in about 15 minutes in the White House in front of some small business owners, Kate. But what this really is a larger effort is, is the president's first step in dismantling Obamacare. Despite multiple efforts, Congress has not been able to replace the Affordable Care Act, to repeal the Affordable Care Act.

And the president has not hid his frustration over that, repeatedly calling out Senator John McCain of Arizona who famously voted no on a bill to do just that back in the summer, and the president even as recently as last night in an interview said that he sees this executive order as a way for him to take matters into his own hands frankly, since Congress hasn't been able to do so -- Kate.

BOLDUAN: Yes. But taking matters into his own hands is also tough when there are so many examples we'll get into them of the president railing against the president doing just that, taking matters into their own hands and using executive orders.

So, there's also this, more and more reports coming out of White House in chaos, effectively. "Vanity Fair" is the latest pointing a pretty dark picture of what things are like in the west wing. What are you hearing?

COLLINS: Yes. Things have definitely been tense. They've been tense essentially the entire time the president has been in office, but we've really seen it ramped up lately with the fight between him and his Secretary of State Rex Tillerson, after reports surfaced last week that Tillerson had referred to the president as a moron.

We're actually learning more, that that came after a particularly tense meeting with the president at the Pentagon that one official described to CNN as a, quote, "rough day." Now the president denies that there's any rift between him and the secretary of state.

He says that the press just doesn't understand their relationship, but some of those public disagreements have really spilled out into the public eye and then all of this comes as John Kelly, the new chief of staff, his deputy, is leaving the White House.

The president is going to announce this afternoon in a ceremony here at the White House that they're going to nominate her to be the Department of Homeland Security secretary. That's a position that's been left open and filled by Acting Secretary Elaine Duke since John Kelly came over to the White House in July to replace Reince Priebus as chief of staff.

But some are wondering what this could mean for John Kelly's future here in the west wing because this is someone she's worked at DHS before, has a long background in cyber security, and Kristen Nielsen (ph) has been John Kelly's eyes and ears here as he came in to quiet this really chaotic west wing.

And some people are speculating that it could mean that John Kelly is not long for the job here because they don't see how he stays in this west wing without her by his side -- Kate.

BOLDUAN: The intrigue. Kaitlan, thank you so much. We're there. We're keeping our eye on the White House as I said for when the announcement comes and the president takes to make his executive order, sign this executive order. We have a lot of coverage on that coming up.

With me now to discuss everything, Josh Holmes, former chief of staff to Senator Mitch McConnell, Angela Rye, former executive director of the Congressional Black Caucus, and Mark Preston, CNN senior political analyst.

All right. Mark, I think we've gone over this one before, but let's just start here, more talk of a White House influx, more talk of a president that can't be controlled.

[11:05:02] Gabe Sherman in "Vanity Fair" sources saying unstable, losing a step, unraveling. Remind me, when things are going well in a White House, do leaks like this happen?

MARK PRESTON, CNN SENIOR POLITICAL ANALYST: They do, but not at this propensity and not as vicious as we're seeing right now. You will always have some kind of disagreement in the White House about direction and policy and what have you, but this has gotten very, very personal right now and for good reason.

You know, when Donald Trump, President Trump, took office, he was lauded for someone who likes to bring chaos in, he likes to create rivals in order to get the best results. However, let me just go over a list right now, Kate, this is why we're in chaos right now.

A national security adviser, chief of staff, senior adviser, two communications director, a press secretary, and your director of advance have all left the White House. Those are all your top aides.

They are integral to trying to get things done and they have all left -- well, not all of them, because the NSA director left for other reasons, but the other ones left because they couldn't get along with Donald Trump.

BOLDUAN: Josh, Sharon also citing Bannon citing sources that Bannon's biggest concern wasn't impeachment of the president, but the 25th Amendment where the VP and the cabinet could determine that the president is unfit for office. Just let's be real, would the Trump cabinet ever invoke, go through this process of the 25th Amendment and try to get him removed?

JOSH HOLMES, FORMER CHIEF OF STAFF, SENATOR MITCH MCCONNELL: No, no. No, there's no chance of that ever happening. These are Trump loyalists. They're in the job for a reason. You know, the consistency here is that drama follows wherever Steve Bannon is. The funny thing about this whole story in "Vanity Fair" is actually has been a little while since we've had a whole lot of palace intrigue. That first eight months --

BOLDUAN: Calling it intrigue is the most important news here. Keep going. I love it.

HOLMES: No. I mean for the first eight months while Steve Bannon was there, it was nothing but naval gazing and who did what within the White House and accusing each other of everything under the sun and now for the last two months basically they've been on the same page here. This is, obviously, a disruption in that, but I think by and large General Kelly has done a lot to straighten that out.

BOLDUAN: I think that's a very fair point there, my friend, Josh. Angela, today, as Kaitlan was laying out, you got a new DHS secretary to be nominated. She's John Kelly's deputy, well respected, all across the board.

But give me your take on this? Do you see this as a move that, A, an outgoing Kelly is trying to give a top staffer a soft landing that some speculation or do you think it's B, a show of how powerful he is now and he is in the White House to stay?

ANGELA RYE, CNN POLITICAL COMMENTATOR: No, I think it may be that Donald Trump may have been fresh out of options as to who to put there. There's a lot of backlash about a Sheriff David Clarke going there and I think since then, we haven't really heard many ideas coming from Donald Trump about DHS, although he did kind of swipe at what their whole mission is with the FEMA tweet earlier.

I would also say, that there are a lot of concerns from Democrats, particularly, the top-ranking Democrat on the Homeland Security Committee, Benny (ph) Thompson, who put out a statement about her nomination yesterday calling into question the job she did and how accomplished she was under the Bush administration.

So, there is a little bit of challenge there, but I would say she is consistent with traditional Republican picks and while you may be giving Kelly some credit here, I think that it may just be he was fresh out of options.

BOLDUAN: Either way, he has this option right now. OK, this just in, guys, so I mentioned and you mentioned talking about FEMA, Angela, Mark, we got this in, so the president tweeted this morning about Puerto Rico.

We cannot keep FEMA, the military, first responders who have been amazing under the most difficult circumstances in Puerto Rico, forever. The White House says basically don't read too much into that, reaffirming their commitment today to Puerto Rico.

But the mayor of San Juan, where there's been a lot of back and forth and tension with the president, just tweeted a couple things, "POTUS, your comments about Puerto Rico are becoming -- are unbecoming of a commander-in-chief. They seemed more to come from a hater in chief."

And also, "It is not that you do not get it, you are incapable of fulfilling the moral imperative to help the people of Puerto Rico. Shame on you." Is this just -- I don't know, tell me, talk to me.

PRESTON: Right. Well, a couple things. One is, let's just compare his response to Puerto Rico this morning to what he said about Texas and the days following the hurricane that hit Texas. We'll be with you today. We'll be with you tomorrow. We'll be with you until the end, basically paraphrasing it. We can go back --

BOLDUAN: And we heard essentially that from the vice president --


BOLDUAN: -- about Puerto Rico as well but --

PRESTON: But when it comes from the president's mouth, whether he knows it or not and by the way, I do think he knows it. I think we've been giving him too much leeway in saying, he's just putting out statements here and there.

The fact of the matter is he knows what he's doing, when he likes the wick of a firecracker it is going to blow up and what's even more disturbing than what we saw from President Trump tweeting that this morning is that the last time I looked at it over 30,000 people liked it.

[11:10:06] Are you kidding me, 30,000 people liked the idea of pulling out of Puerto Rico right now where about 90 percent of the people are still without electricity and for everybody out there that doesn't understand this, Puerto Rico is part of the United States.

RYE: Right.

BOLDUAN: Josh, and it's not -- there is -- there are two separate things here, I think, right.


BOLDUAN: One is the president's statement, FEMA and first responders can't stay there forever, that's correct. They can't stay there forever. That's a true statement. It's maybe that the statement was made now.

HOLMES: Yes. You know, look, I think that the reality is, is what the president is talking about here, is a real infrastructure problem that they had in Puerto Rico long before they got hit by two hurricanes.

I mean, we've had an economy down there that has been mismanaged to the hill for generations and they've gotten to a point where their infrastructure is just flat broke. And these hurricanes have just devastated the island and I think the president and this administration have had a real commitment with FEMA and first responders to go down there.

To this mayor, look, I think we've proven over the last week to ten days that this mayor sees a real political opportunity in attacking Donald Trump and they've got 76 mayors that are on large part on the long side of the administration and one who is consistently taking the opportunity to make headlines whenever she gets a chance.

So, I'm not saying that she doesn't have a legitimate gripe. There are clearly people that are suffering, but I think FEMA has proven that they've got a real commitment to try to make sure that we get everything back up and running in Puerto Rico.

BOLDUAN: Angela?

RYE: Yes. So, let me first say, that that is remarkable.

HOLMES: I don't know how that's remarkable.

RYE: This is a mayor -- yes. Just let me finish. This is a mayor who was wading in water waist deep to save her constituents, to save people in Puerto Rico while Donald Trump was doing whatever on Twitter.

And so, to me this is interesting that at a time when this -- this place is in crisis, he is continuing to nudge and to prod. It is a very, very delicate situation. People are suffering trauma right now and for him to take this opportunity to tell them that the resources, the only resources they have left to rely on, could be taken away from them at any moment's notice is very, very scary and it's unfortunate.

That is the sign of a bully. That is a sign of someone who is unraveling. That is the sign of someone who need a psychological evaluation to begin with, to be sworn into office and should still get one now. That is wrong.

Like at -- there shouldn't be any partisanship attached to this. One other thing, the crisis in Puerto Rico could have been solved by these united states if we really cared about them to Mark's point, they are a part of the United States, and we turned a blind eye to that.

That is the Republican-led Congress that refused to give them any type of debt relief when they've been asking for it for several months before the crisis hit them --


RYE: Wait a minute. Go ahead.

HOLMES: Are you of that? I mean, are you aware that they passed a huge relief package within the last two years?

RYE: Are you aware that it wasn't sufficient? Are you aware that it wasn't sufficient?

HOLMES: OK. Nothing ever is.

BOLDUAN: But I -- but I think where we are right now is, I don't know, it's time and place and tone and that's one of the things we can talk about because factually, factually, FEMA can't stay there forever.

But there's a thing called empathy that comes with being -- empathy that comes with being the president. Where I'm trying not to read into a presidential tweet too much because we read into them too much all the time.

When it comes to this issue, you did have the press secretary who then had to come out and say we reaffirm our commitment to Puerto Rico and be there for the long haul, there's something to that right, maybe it can't be summed up in 140 characters.

Guys, standby, a lot more to come. Thank you. We're standing by for this, the president of the United States, at the White House at the Roosevelt Room, expected to make a major move to dismantle Obamacare. Taking matters into his own hands. Folks are gathering there for the big moment the announcement President Trump set to speak any minute. We'll take you there live.



BOLDUAN: Any minute now, President Trump will begin unwinding Obamacare with the stroke of his pen. He is set to sign an executive order very shortly that will help trigger the biggest change to the nation's health care system since he took office.

Under the new rules that he will be putting in place through an executive action, small businesses, some individuals will have expanded access to cheaper plans that offer fewer protections. Groups will be able to purchase health care across state lines.

This undermining though the protections that people -- some people like about Obamacare. This, of course, comes after Republicans in Congress, they failed to make good on their promise for seven years to repeal and replace Obamacare.

Joining me now is one person who helped craft Obamacare, Dr. Zeke Emanuel, CNN contributor and former Obama White House health policy adviser. Doctor, thanks for coming in.


BOLDUAN: Thank you. So, you helped craft Obamacare. You also have been very consistent in saying that the law needs fixing. Is what we're going to see today, is this the fix?

EMANUEL: No, this is terrible, actually. So, there are three parts to the executive order as we understand it. One allows these so- called association health plans to operate across state borders, a second expands the opportunity for short-term health insurance the Obama administration had three months as the limit.

That doesn't have to fully comply with the essential health benefits and other aspects of Obamacare and the third is to change the health care reimbursement processes. All of the -- what the executive order does is tell the Departments of Health and Human Services, Treasury, and Labor to relook at these regulations.

The real worry is that, especially under these association health plans is fraud. The association health plans have had a very checkered history almost every time we permit them, hundreds of thousands of people end up being affected. [11:20:12] Because their bills are not paid, a lot of scam artists go into this because there's less oversight, and as you point out, some people will win. There's definitely some people who will get lower rates.


EMANUEL: In small businesses that have younger, healthier workers. That means that some businesses will be adversely affected and they will be -- have their rates go up tremendously because remember, what we're trying to do is create a big pool of people.

And if you siphon off healthy people into another pool, you actually create a smaller pool, increase the risk that any one single person who gets sick will affect the rates for everyone and leaves older people --

BOLDUAN: In the interim, right, nothing -- Congress has done nothing to try to fix the problems with Obamacare, but are you saying that this move is terrible, doing something here is worse than doing nothing?

EMANUEL: Yes. This is a case where doing something is worse than doing nothing. There's many things -- look, we all want to get health care more affordable, premiums to actually decline. There's a lot of things we could do. The president talked about drug pricing.

There are other pieces of legislation changing how we pay doctors so they have an incentive to conserve money and not spend as much money when you can get to the same result. That's very important.

Those will keep prices down much more effectively than this because while this will lower prices for some healthy people, it will raise prices for older workers and people in small businesses that tend to be riskier businesses.

It's not going to solve the problem at all and remember, it effects a very small number of people. What the president is going to do today will affect maybe a few million people. It won't do anything for the 178 million Americans who get health insurance through their employers already.

It won't do anything for a lot of the people on the exchange who are not members of franchises or trade associations. So, this is more show than actual reality in terms of making health care affordable for Americans.

And it undermines parts of the exchanges and Donald Trump will own that if the exchanges see a big exit of healthy people and no longer can function. Donald Trump did it.

BOLDUAN: That is an important question going forward when you put your finger on it and hand on it, is it yours? You have also, though --

EMANUEL: Well, he can no longer blame -- he will no longer be able to blame Obama. This will adversely affect the exchanges and it's Donald Trump who decided to do it and explicitly did it.

BOLDUAN: You have talked to President Trump more than once, though, about health policy and we know he obviously wants a legislative win that didn't work. But what does he really want when it comes to health care policy in the country? Have you gathered that from your conversations with him?

EMANUEL: Well, I think for political reasons, he wants something he can call repeal and replace. I think his real heart is he wants to make it more affordable and I have suggested to him, as I did to you, a number of policies that will make it more affordable and that would be historic.

Remember, bringing health care costs down would be a first time in history and that would be pretty wonderful for the country and for Americans, not just in this small group of small businesses, but Americans writ large in Medicare, Medicaid and those of us Americans who get our insurance through our employer.

That is a much bigger challenge, but it's ironically something where there's bipartisan agreement and what I think the president should focus his attention on and what I've said over and over, is focus on where there's agreement. That's where we can push forward.

What he's doing today is totally partisan, very fringe, it's opposed by not just liberal health policy experts like myself, but most conservative health policy experts think this is a bad idea and it really doesn't solve the problem at all.

And as I said, it may make it worse by siphoning off healthy people and this is an area that's going to be right for a lot of fraud and small businesses to be affected by scam artists.

BOLDUAN: Dr. Zeke Emanuel, thanks for coming in. Let's listen to the president and see what he says any minute now. Appreciate your time.

Also, though, joining me right now Republican Congressman Ryan Costello of Pennsylvania. Congressman, thank you so much for coming in.

REP. RYAN COSTELLO (R), PENNSYLVANIA: Nice to be with you.

BOLDUAN: So, you heard my conversation with Zeke Emanuel. I want to ask you about what the president is about to sign. You don't like Obamacare. You also, though, voted against the House health care bill in May because it didn't do enough to protect people with preexisting conditions. Folks, a big issue for folks in your district. Are you happy about the move the president is making then today?

COSTELLO: Well, I, obviously, won't know what is done until he issues an executive order. I did hear what Dr. Emanuel said.

[11:25:06] One thing I would add, though, that I do think is good, as I understand it to be, which is looking at the consolidation of health care systems across this country and how it may adversely impact patient access and patient protections, is something that's going to be looked at a little bit closer.

I think all Americans agree that we need to be concerned about that and need to get to the bottom line. Some of the other things Dr. Emanuel spoke to were sort of foreshadowing or forecasting why it might be bad.

Obviously, I think I want to look closer at that, but the desire to reduce the costs of health care for Americans is a good thing. Obviously, in doing so, one of the reasons I did vote against the health care bill, was the concern that if we do rogue patient protections that's not a good thing.

BOLDUAN: What the president is signing is doing today the regulation, what he's changing is one thing, but what the president -- how the president is going about it is another thing, by doing it through executive action.

Here's a few times, few of the times, that the president himself has railed against executive power. Listen to this.


DONALD TRUMP, PRESIDENT OF THE UNITED STATES OF AMERICA: Obama goes around signing executive orders. He can't get along with the Democrats and he goes around signing all these executive orders. It's a basic disaster. You can't do it. I don't think he tries anymore. I think he signs executive actions.

Nobody wants to listen to him, including the Democrats, so he goes around signing executive orders.


BOLDUAN: How is this any different?

COSTELLO: Some good splices there. It's not different. Obviously, the president will issue an executive order which he feels will enable him to study and get to some policy reforms that would be good. Every president issues executive orders.

The question, obviously, and you're probing it, is will this executive order be a good thing or not. That remains to be seen. Obviously, as a House member these are the sort of things you to look at much deeper and get input from a number of different constituencies and stakeholders.

That hasn't been done because we just received word of this. But my objective I think is the same as the president's and Dr. Emanuel -- make sure we provide patient protections but also reduce health care costs. The devil is in the details.

BOLDUAN: It always is. That's the tough fit. You have to make decisions.

COSTELLO: That's right.

BOLDUAN: That is the fact of the matter. You are co-sponsoring the House bill that bans bump stocks.


BOLDUAN: In the aftermath of the Las Vegas shooting. Paul Ryan just said yesterday about the whole issue that a regulatory fix is the smartest fix. Do you agree?

COSTELLO: I agree with both. Let me explain. Number one, the quickest, most efficient, easiest way to get to the finish line on preventing bump stocks to be purchased the way they are right now is a regulatory fix through ATF.

I also think, though, that if we're going to rely on a regulatory agency to make a fix that regulatory agency in the future, as it did in 2010 here, could exempt it or could roll it back.


COSTELLO: So, legislation would be the final, full, most effective way of addressing this long term. That will take a little bit longer to do, which is why I think an intermittent ATF fix as the speaker suggested is the right approach, but I still co-sponsored this bill.

And I actually may introduce legislation myself which would basically require that bump stock, if there is any legitimate reason for it, I remain -- I need to be convinced of that. But if someone can convince one of that, that would at least have to go through the same process that an automatic weapon purchase would require.

And right now, that's not required and that equivalency between taking a semiautomatic and making it automatic by purchasing something off the shelf doesn't make sense and I think every American can agree with that approach.

BOLDUAN: You are also in a tough district for re-election. You said --


BOLDUAN: -- this week that you are not afraid of what made a lot of news which was Steve Bannon's threats from the right. That everyone was under the microscope. What are you more concerned about, a challenge from the right or the Democrats?

COSTELLO: Well, look, I work hard. Any time someone wants to challenge you, you have to evaluate that within the context of what you're doing and making sure you get your message out.

To be perfectly blunt with you, I would imagine that a general election matchup would be more so, but look, if this is a time where a lot of stridently pro-Trump voters want to see every member of Congress back fully the president's agenda and candidly leave their own evaluation and judgment at the doorstep.

I won't do that. I was elected by 705,000 constituents and I need to look at everything issue by issue, speak my mind when I disagree, speak out, when I agree, speak out, but explain why throughout the entire process.

I think a lot of members in districts like mine have to be more vocal. I'm starting to go on more television because I think my constituents need to hear weekly if not daily what I'm working on, why I think --