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CNN Live Event/Special

Live Coverage of Health Care Showdown Continues

Aired March 21, 2010 - 20:00   ET


REP. DEVIN NUNES (R), CALIFORNIA: My friends, that is what this debate is really about.

Today Democrats in this House will finally lay the cornerstone of their socialist utopia on the backs of the American people.

Say no to socialism. Say no to totalitarianism. Say no to this bill.

UNIDENTIFIED MALE: Time is expired. Gentleman from Michigan.

WOLF BLITZER, CNN ANCHOR: All right. He's got some -- he's very, very forceful. You heard that Republican congressman from California, Congressman Nunes.

You know what? There was a very, very different assessment from John Lewis, the Democratic congressman from Georgia, one of the great civil rights pioneers.

Listen to what he said.


REP. JOHN LEWIS (D), GEORGIA: We have a moral obligation today -- tonight -- to make health care a right and not a privilege. There are those who have told us to start over. There are those who have told us to wait. They have told us to be patient.

We cannot wait. We cannot be patient. The American people need health care and they need it now.


BLITZER: All right, very different than Congressman Nunes of California.

Sanjay, I wanted you to weigh in on what we're about to see within the next hour or so. The passage of the same piece of legislation by the House and the Senate.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes, I was going to get Kevin to weigh in on what Nunes said but I guess I won't put him on a spot like that.

You know, it's interesting. From a purely medical standpoint, I mean, I work in a county hospital in Atlanta. Something I've chosen to do. And you know, it's -- you see people who are uninsured or underinsured all the time. And it is -- it's one of those incredible thing because people come in with later stages of disease. They come in having not received any preventive care.

And it's very striking as a physician to sort of -- to know that these people could have been helped. A lot of preventable diseases occurring and preventable deaths as a result. Some -- you heard Congressman Dingell say 18,000 people die a year because they don't have health care insurance.

So -- you know, think it's a huge day. You know I've been following this along since 1992. And I worked at the White House in the mid '90s and discussed a lot of these issues. So I think for a lot of docs out there, while they may disagree on some of the specifics which I've been researching in great deal, I think this idea that people should have access to health care insurance which they're going to get over the next several years, granted not tomorrow, but over the next several years, it's very monumental.

BLITZER: You were a White House fellow in those years and you worked very closely on many of these issues when the Clinton administration tried to get health care reform passed.

It failed at that time. It is about to succeed now.

Sanjay, give us your analysis. What -- why will it succeed now as it failed then?

GUPTA: Well, you know, it's interesting. It was a little bit of an example in leadership style differences. You know clearly President Clinton and the first lady then, Hillary Clinton, absorbed a lot of the work themselves, or herself, primarily, and then put something out for the legislative body to look at.

And I think one thing, you know, is interesting is when you're the one crafting it, a lot of people can throw darts at it. No question. And I think this time, it was almost the exact opposite. You know we'll draw the broad brush strokes in the White House and let the legislative body sort of really craft this.

I think that was one big difference. I also think, you know, it was a much larger overhaul of health care back in '93-'94. What was being proposed. It wasn't sort of just keeping the employer-based system the way it is and making more tweaks around the edges. It was a larger sort of overhaul.

And there were some similarities. But I think they didn't have this sort of broad support from the AMA, from the pharmaceutical industry, from the nurses, from AARP, lots of different organizations back then than they do have now.

BLITZER: Yes. And remember, President Clinton was elected with about 42 percent of the popular vote. Barack Obama was elected with about 53 percent of the popular vote. I think that's a significant difference.

GUPTA: That's right. BLITZER: Kevin Madden, Sanjay Gupta is a much nicer guy than I am. So I'm going to ask you to comment on what we just heard from that Congressman Nunes from California when he said this Democratic plan, this version of health care that President Obama wants is nothing short -- and I'm paraphrasing a little bit -- of a Soviet-style failed socialist program.




MADDEN: Look, Republicans always run a risk, I think, when we start to think about our, you know, dislike of government institutions and in creeping size of government into our lives.

I think that -- that the congressman from California has a point, but it was inartfully framed. One of the most important things we can do out there is talk to the American people's anxiety about the size and the scope of this bill and how radically it would change 1/6 of our economy without leading -- and you can do that without leaving a lot of these labels that seem to be like, you know, nails on a chalk board aside.

You know every single Republican up on Capitol Hill -- and I want to emphasize this. Every single Republican up on Capitol Hill believes in health care reform. The difference is in the fundamentals.

Republicans believe that we can incentivize the states to start pile the programs. They're the laboratories of democracy to help get unique health care populations the health care that they need. The access and to help lower the costs.

Democrats believe that we ought to have a one-size-fits-all federalized mandate from Washington that says we know better than the states. That is the fundamental difference. It's not getting into socialism or totalitarianism, but instead that is a fundamental difference.

And I think we're more closely aligned right now with public sentiment when we make that up.

BLITZER: And let me bring Roland Martin in because, Roland, you know, this argument that this is socialized medicine which the Democrats are about to enact into law -- and you heard this congressman from California basically say it's Soviet style socialism.

It -- you know, they don't have a public option. They don't have a single-payer system. It's far from socialism, isn't it?

ROLAND MARTIN, CNN POLITICAL ANALYST: That's just stuck on stupid. I mean to sit there on the House floor and all of a sudden you're talking about, oh, this is communism and you're sitting here and reaching -- that's just dumb, OK? You know what? If Republicans truly cared about health care, why in the world didn't they do anything for eight years? So don't stand here now when the Democrats have been pushing the issue and now say, oh, no, Republicans -- we really care about health care when you had the opportunity to make changes to our system.

The fact of the matter is, when you have Republicans who want to sit here and throw all these kind of nonsensical names out there, it does nothing but stir up the nutcases who are frankly calling Democrats the kind of names on yesterday.

And so if you want to make an argument that there are core differences, there are no doubt between Democrats and Republicans on this issue. And you know what? You sometimes have to make tough issues -- tough decisions.

And so I just don't believe in these ridiculous names, what's communism and what's socialism. People probably can't even spell communism and socialism, much less identify it.

MADDEN: Well, you know, first of all, I think that's unfortunate that you would make an ad hominem attack like that. I think that there's very important principles --

MARTIN: But that's what he did on the House floor.

MADDEN: But I think what you're doing is making a personal attack and I don't think that helps the decor rum of the debate either. But I think what you have to remember --

MARTIN: OK. Got you. So --

MADDEN: The Republicans have been very -- been very -- we've been very, I think, good at putting forward ideas on health care. If you look at the 2000 elections, 2004 elections, we closed the gap with Democrats on health care because we put forward very progressive ideas, I think, when you look at health savings accounts, when you look at association health plans.

Those are all -- core Republican principles to get more access to bring down costs. So, you know, I would disagree that we haven't been putting out any ideas. I think that the -- the health care forum that the president held down at the White House obliterated the argument that Republicans are the party of no and the Republicans don't have health care ideas.

BLITZER: Let me let Roland respond, but before I do.

Kevin, Medicare, which is very popular for seniors right now. That is much closer to some sort of socialism than what the president and the Democrats are now about to enact into law because that, in effect, is the single-payer system that the government runs.

MADDEN: Well, that's right. And Medicare was designed as a safety net for those who were a specific population of older Americans. I think what happens is when you start to try and expand Medicaid and you start to try and expand Medicare, you see a growing reliance on government versus looking for the private sector and a more free market oriented approach to helping drive down costs.

BLITZER: Roland, go ahead.

MARTIN: Look, Wolf, one of the reasons why I might view this a little bit differently than Kevin, because in 2000, when my appendix ruptured and spent five days in a hospital in Los Angeles, had no health care, almost $100,000 in bills, had to file for bankruptcy, so maybe my whole view in terms of how do you insure the uninsured is a little bit different.

But the point there is, when you are a member of Congress, and when you stand on the floor and you throw out these ridiculous terms like communism, it makes no sense. And, yes, I laugh at these people who go to town hall meetings who say, I don't want government health care but don't you touch my Medicare.

I'm sorry, do you even know what you're talking about? OK? That's what you have here.

You have everybody who wants to protect their own interest. And I'd still go back to it. Republicans may have said, here's a piece here, a piece there. But when you talk about health care reform, they did not do anything in a significant way where they had the power and now when Democrats say we'll touch it, then they say, hey, we've got some ideas here.

You had the power, you could have made a difference. The difference here is, the Democrats had the power and they're making a difference.

BLITZER: All right. Guys, stand by because we're getting closer and closer to that actual roll call. They're getting ready to -- I'm guessing at about half an hour, 45 minutes or so wind up the debate on the House floor. They'll have 15 minutes then to vote. We think the Democrats have the 216-vote margin to go ahead and pass health care reform.

Our coverage will continue after this.


BLITZER: I think we're only about a half an hour or so away from a roll call on the Senate version of health care reform on the floor of the House of Representatives.

I think it's fair to say it will pass. It will get to 216 votes. The health care reform will then be passed and the president eventually -- whether tonight, tomorrow, we don't know -- will sign it in to law.

There's a lot still going on, John King, as we watch all of this unfold. But I want to get back to this whole issue of some of the rhetoric that we're hearing. A lot of it is pretty poisonous out there.

KING: And it has been throughout the debate. This debate has divided the parties. It has divided many of the interest groups, the Catholic nuns against the Catholic bishops. The anti-abortion Democrats against the anti-abortion Republicans. It is an election year.

In Congressman Nunes's case he said communism and socialism, he gets 45 seconds to speak on the floor. He's also from a very safe district back in California. So he doesn't have a swing district back there that he might be offending a key base.

But it's part of, Wolf, the next phase of this debate which begins tonight. The Republicans know this bill is going to pass. The Democrats now have the vote, they know it's going to pass. Now we're in the next phase which is selling it to the American people, which is divided.

Some of the components of the bill are very popular. Others are not very popular, and some others are sort of in the middle. So the president will try tonight to reframe the debate. And Sanjay touched on a key point a bit earlier.

This was health care reform at the beginning of the debate. Then it was health insurance reform when the White House rebranded it because people don't like their insurance companies so you find a villain or you find somebody who's even less popular than you when you're in trouble.

The next phase is -- you've now heard the Democrats in the last 48 hours say we're doing this for the American people. You can run from those polls that say a significant segment of the population doesn't like some of this. Some politicians do run from the polls. Others try to grab them and shape them.

That's what the Democrats are trying to do now, saying we fought for you, we're on your side. We got in the way of your insurance company. They can't do that to you again.

That is the challenge. Does the president still have the political power to reshape a political argument? He did it my times during the presidential campaign, in the primaries and in the general election.

Does he have the power to shape it now or can Republicans sell, we can't afford this, it gives the government too much power to reach into your life, and it's -- and you should not trust any big institution?

Because since Katrina and the bank bailouts and GM failing, the public is predisposed right now to think if it's big, it's not going to work.

GLORIA BORGER, CNN SENIOR POLITICAL ANALYST: And you know, when the White House is looking for a villain -- as you say -- in this debate, something happened towards the end of the debate that really worked for them which was Anthem, for example, raising its rates in California.

And suddenly, the villain was crystallized. You know, there it was, your rates went up 39, 40 percent for these people. And the White House which had been talking about health insurance reform suddenly had a very good example that it could use.

It started out by the way, this debate, I remember talking about it as a deficit reducer, remember? Early on in this debate, President Obama said we've got to do this because in the long term, it's going to reduce the deficit.

Well, that was an argument that didn't really click with the American people because while it may be or may turn out to be right, it's hard to understand how you're going to spend $1 trillion and in the end reduce the deficits.

So then you move to the insurance companies and that clearly worked better for them particularly late in the game.

BLITZER: Sanjay is getting a lot of questions on Twitter and elsewhere. How all of this will affect people out there.

We're going to get to you in a moment, Sanjay. I want you to answer some of these questions because I'm getting bombarded on Twitter and elsewhere as well with what does this means for me and we have -- we want to take a look at what's inside this legislation that is about to become the law of the land.

I also want to remind our viewers, tomorrow, 7:00 p.m. Eastern, and every weeknight, "JOHN KING USA." It premieres tomorrow night, 7:00 p.m. Eastern, "JOHN KING USA" right after THE SITUATION ROOM.

Our coverage will continue right after this.


BLITZER: Want to go to the floor of the House of Representatives. Listen in a little bit on this debate as it begins to wrap up.

UNIDENTIFIED MALE: -- insurance in a breast cancer illness that she faced. We are -- we're done.

UNIDENTIFIED MALE: Without objection, the gentleman from Michigan will be charged time consumed.

Gentleman from Michigan?

UNIDENTIFIED MALE: I yield 45 seconds, I wish I could yield more to our distinguished colleague from Maryland, Mr. Van Hollen.

UNIDENTIFIED MALE: The gentleman is recognized for 45 seconds.

REP. CHRIS VAN HOLLEN (D), MARYLAND: Thank you, Mr. Speaker. They called it a dangerous device invented in Nazi Germany, and a method for imposing Stalinism. Those were the statements made by the opponents of Medicare -- Medicare that now provides health coverage to 45 million Americans.

This legislation will insure that 32 million more Americans have access to affordable health care and that no American is held hostage to the abuse of practices of the insurance industry. As in 1965, we have the rhetoric of mass distortions. This morning Republican leader Boehner even said this bill means Armageddon.

The day after this legislation is signed by President Obama, the world will see the world is not coming to an end. That there are no death panels. They will being to see a system that works for them, not the insurance industry that is spending millions of dollars to kill the bill.

UNIDENTIFIED MALE: At this time, Mr. Speaker, I yield 45 seconds to the distinguished member of the Ways and Means Committee, Dr. Boustany of Louisiana.


UNIDENTIFIED MALE: The gentleman is recognized for 45 seconds.

BOUSTANY: Thank you, Mr. Speaker.

We all have compassion for families struggling. Those who've lost jobs, those who lack access to health care. We all want to do what's right for our country. We all want to solve these problems. But as I look at this massive, complex, and partisan bill, I see premiums continuing to rise for families, an abject failure to control health care costs for families and businesses.

I see huge tax increases coupled with irresponsible cuts to Medicare services. All to expand new coverage entitlements where physician access will worsen, continuing to burden our strapped emergency rooms.

Mr. Speaker, frankly, I see a sequel to the modern Greek fiscal strategy unfolding before us with the potential for default. We have a duty. We have a duty --

UNIDENTIFIED MALE: Time is expired.

BOUSTANY: -- to reform health care but an obligation to get it right.

UNIDENTIFIED MALE: Time has expired. Gentleman from Michigan.

UNIDENTIFIED MALE: I now yield 45 seconds to a very senior member of our committee, Mr. McDermott of Washington.

UNIDENTIFIED MALE: The gentleman is recognized for 45 seconds. Without objection so ordered.

REP. JIM MCDERMOTT (D), WASHINGTON: Mr. Speaker, there are times in history that action is demanded. In 1935, we needed Social Security and unemployment insurance, the Democrats answered. In 1965, we needed health care for senior citizens, the Democrats answered.

In 2010, the country needs health care reform and the Democrats will answer tonight. It was never in doubt. Business wanted to change. The medical profession wanted a change. And labor wanted a change.

And the Republicans brought an economic collapse to make it clear to everybody that we all are in danger if we don't change the health care system in this country.

I yield back the balance of my time.

UNIDENTIFIED MALE: Time is expired. Gentleman from Michigan?

UNIDENTIFIED MALE: At this time, I yield 45 seconds to a distinguished member of the Ways and Means Committee, the gentleman from Nevada, Mr. Heller.

UNIDENTIFIED MALE: Gentleman is recognized for 45 seconds.

REP. DEAN HELLER (R), NEVADA: I thank the gentleman for it.

Mr. Speaker, thousands -- thousands of Nevadans have been surveyed and an overwhelming number oppose the government takeover of health care. Yet 2/3 of Nevada's delegation will defy their constituents and vote with their leadership instead.

This $2.6 trillion legislation will raise Nevada taxes, kill Nevada jobs, remove Nevada seniors from Medicare, and -- and saddle the state of Nevada with budget-busting mandates.

I urge my colleagues from Nevada to speak for Nevada, not their beltway benefactors, when casting their vote today.

I yield back.

UNIDENTIFIED MALE: The time is expired.

BLITZER: They're going back and forth, 45 seconds each, Democrat, Republican. They're making their respective cases.

We're only a little bit away, maybe 20, 25 minutes, from the final roll call on the Senate version of health care reform. Our coverage will continue after this.


BLITZER: They're going to get ready to wrap up this debate on the floor. The leaders -- the Democratic leaders, the Republican leaders -- will be speaking. We're going to want to hear what they have to say as they get ready for the roll call of the Senate version of health care reform which we expect the House to pass with more than 216 votes.

What's in this legislation? What will it mean for you? We're getting flooded with questions from viewers out there on Twitter and elsewhere.

Dr. Sanjay Gupta is here.

Sanjay, I want you to answer some of those questions.


BLITZER: Because they're pretty good. GUPTA: Yes, it's fascinating to see where people's heads are on this.

FCarloSantana (ph), writes this, "Does any part of the reform take effect before 2014?"

We've been talking about this obviously all day. But it's -- people getting just chunks of information. There is significant amounts of things happening this year, probably. But as far as getting the 32 million number insured -- you know a lot of that probably won't happen for a few years once these exchanges open up and the mandate to people to have health care insurance actually takes place.

That's four years from now. But short of that, now, they're going to talk about these high-risk pools. So people who are sick and uninsured are probably the most -- they're going to benefit the most, at least initially.

What you're looking there on the screen is what happens in 2014. But in initially people who are sick and uninsured are going to benefit the most probably from these high-risk pools. They are going to fund these incidentally with about $5 billion of the total cost to try and get these people insurance right now.

There's also not going to be rescissions of health care anymore which means this idea that, you know, you're clicking along, doing fine, all of a sudden you get sick, and the insurance company decides to drop you. That's it.

BLITZER: And this year that will go into effect --

GUPTA: That's right. That'll go on --

BLITZER: In other words once the president signs this legislation into law, let's say a week later, someone gets really, really and the insurance company used to be able to say there's a cap on how much we're willing to spend -- after this that's not going to happen.

GUPTA: Well, they say within six months to be fair. They talk about these pools being set up sooner than that, maybe within 90 days. The rescissions ending in about six months and also this idea of not being able to cap how much the insurance company pays either annually or over a lifetime, that should also take place this year.

BLITZER: You got another question.

GUPTA: Yes, we have time for -- another one, "Being a recent college grad who's employed but uninsured, what can I expect if this health reform passes?" This is Omar Bogdrun, 37.

This is a big deal. I mean this is a group of people who could benefit, again, sooner rather than later. College grads who haven't gotten their first job and they're not coming into some sort of employer-based coverage, that coverage for them could be under their parents' policy now up until the age of 26.

So that's an extension. And that's probably a pretty big deal. I was in that situation myself. For a period of time, I know a lot of my friends were as well. So this is going to cover someone like him.

BLITZER: All right, Sanjay, I know you're getting more. We're going to get back, because I want our viewers to understand better how this will impact them.

We'll take another quick break.

We expect the leaders, the Democratic and the House leaders, to make their summation statements in the next few minutes. And then the roll call. All that coming up right after this.


BLITZER: They started the two-hour clock at 6:42 p.m. Eastern. It's approaching 8:42 p.m. Eastern. So that two-hour debate should be wrapping up right now pretty soon at least. And then they will have the roll call.

You know what? Let's listen in to the final minutes of this historic debate on the House floor.

REP. JOHN KLINE (R), MINNESOTA: -- sustain jobs and create jobs. Instead, this bill will destroy jobs at a time when we need them the most. Our job is to ensure freedom, security, and prosperity for future generations.

Instead, this bill will be paid for by our children and our grandchildren and our great grandchildren.

Our job is to legislate openly with integrity and fairness. Instead, this bill is full of backroom deals negotiated behind closed doors.

This bill is not what the American people want. They're imploring us to start over with reforms to bring down health care costs while preserving the relationship between patients and their doctors.

This is our last chance to stand up to the people who sent us here and display the courage to prove that we can do better.

I reserve the balance of my time.

UNIDENTIFIED MALE: Gentleman reserves. Gentleman from California?

UNIDENTIFIED MALE: I yield one minute to the gentleman from Connecticut, Mr. Courtney, a member of the committee.

UNIDENTIFIED MALE: The gentleman is recognized for one minute.

REP. JOE COURTNEY (D), CONNECTICUT: Thank you, Mr. Speaker. Mr. Speaker, tonight we are going to answer a question which the tea party on the right, the reformers on the left ask constantly, which is why can't the American people have access to the same type of benefits that members of Congress have?

It's a good question. Some of the most hysterical voices in opposition have access to a purchasing exchange through the Federal Employee Benefits plan that has comprehensive benefits. Choice. No rescissions, no lifetime caps.

And this bill is going to give the American people exactly what members of Congress have. And in case there's any question about that, Section 1312 will make sure that starting in 2014, members of Congress have to use exactly the same purchasing exchange that the American people will have to use.

No more haves and have-nots. No more tax-paying Americans who don't have health insurance underwriting the health benefits of members of Congress who would deny them access to quality, affordable health care.

It is time to answer that question tonight in the affirmative by passing this legislation.

I yield back the balance of my time.

UNIDENTIFIED MALE: Time is expired. Gentleman from Minnesota.

UNIDENTIFIED MALE: Thank you, Mr. Speaker. At this time, I'm pleased to yield two minutes to the gentleman from Georgia, the ranking member of the Health, Employment, Labor and Pension subcommittee, Dr. Price.

UNIDENTIFIED MALE: The gentleman is recognized for two minutes.

REP. TOM PRICE (R), GEORGIA: Thank you, Mr. Speaker.

Health care decisions that we make for ourselves and for our families are some of the most important and personal in our lives.

As a physician, early in my career of caring for tens of thousands of patients, I recognized that there were more folks in Washington who affected what I could do for and with my patients than anybody I ever met in residency or in medical school. And that that was wrong.

Health care, taking care of people, is a moral endeavor and should be grounded in principle. And if the principles that we hold dear for health care are applied to this debate and into this bill, the picture is not pretty.

Accessibility, being able to receive care, affordability, being able to afford care. Quality, receiving the best care availability. Responsiveness, having a system that works for patients. And innovation, being certain that we have the newest and the best treatments. And choices, patients being able to choose their physicians and how and where they're treated.

All of these are harmed by this bill. All of these principles are violated. None of these principles are improved by the further intervention of the federal government.

So you see, Mr. Speaker, mostly this is bad for patients, for all Americans. But trust that is necessary between care giver and care receiver, between patients and their doctors, to believe that your health is not being undermined by the system will be permanently eroded. Permanently damaged. And it is that trust that is in the foundation of the morality of health care.

So this is a sad day, yes, because there are so many wonderful and positive and patient-centered solutions that could be enacted. You see we trust patients and families. They trust government.

As a physician, I know when patients and their families and their doctors are not allowed to decide what care they receive. We lose more than our health care system, we lose our morality, we lose our freedom.

The positive vote, the patient-centered vote, the bipartisan vote on this bill is a no.

UNIDENTIFIED MALE: Gentleman from California.

UNIDENTIFIED MALE: I yield one -- one minute to the gentlewoman from California, Miss Woolsey, a member of the committee.

UNIDENTIFIED MALE: Gentlewoman is recognized for one minute.

REP. LYNN WOOLSEY (D), CALIFORNIA: Mr. Speaker, the whole nation desperately needs health care reform. But no group of Americans needs it more than women who face discrimination and insult at the hand of the broken status quo every single day.

We all know that the current system allows insurance companies to deny coverage based on preexisting conditions. But I wonder how many of my colleagues realize that essentially being a woman is a preexisting condition.

Pregnancy, for example, or C-sections can be deemed pre-existing conditions. And most almost unbelievable of all, insurance companies can legally turn their backs on women who suffered injuries due to domestic violence. Because that, too, can be defined as a preexisting condition.

We should all be ashamed of a system that puts healthy insurance company profits ahead of healthy American women.

This weekend we will -- today, tonight, we will make history by passing a health care bill that will correct these injustices. And no longer --

UNIDENTIFIED MALE: Time is expired.

WOOLSEY: -- will female be considered a preexisting condition.

UNIDENTIFIED MALE: Time is expired. Gentleman from Minnesota.

UNIDENTIFIED MALE: Thank you, Mr. Speaker. At this time, it is my great pleasure to yield two minutes to the gentleman from Kentucky, the ranking member of the Higher Education Lifelong Learning and Competitive subcommittee, Mr. Guthrie. Two minutes.

UNIDENTIFIED MALE: Gentleman is recognized for two minutes.

REP. BRETT GUTHRIE (R), KENTUCKY: Thank you, Mr. Speaker. I've always liked to describe the process I've seen in the last two weeks trying to put a bill together like putting the puzzle together, but for some pieces together and trying to make them fit. And in the end, the puzzle doesn't have a complete picture.

And one of the pieces they're trying to make fit to make -- keep this bill under $1 trillion is what the score is, but what we're not mentioning is the incredible unfunded mandate that we're placing on our states.

Just a couple of years ago, I was a state senator, and tonight, state senators in Kentucky, my former colleagues, are meeting together to try to close a $1 million budget gap.

And what does this bill do? This bill puts a $30 billion unfunded mandate by CBO estimates on to our states.

To the south of Kentucky, Phil Bredesen, a very respected Democratic governor of Tennessee, says this is the mother of all unfunded mandates. And just to the north of me in Indiana, Governor Mitch Daniel said half a million more Hoosiers will be on Medicare costs and the state taxpayers billions of dollars.

It's going to cost my state according to the Heritage Foundation $303 million from 2014 to 2019. So that's when our next budget session meets will be budgeting for 2014. So the state legislators tonight, hoping the economy will turn around, maybe there'll be light at the end of the tunnel, are now having to deal with the $303 million freight train that's the light at the end of that tunnel.

But on the top of that, this proposed bill also take student loan money to finance this bill. The government has taken over the student loan business. They have lowered interest rates. Instead of lowering the rate our students are going to be paying back on their interest rates, we're going to take part of that money and fund this back on the backs of our students.

Mr. Speaker, it's unfair to put these burdens on our states and our students. I yield back.

BLITZER: Congressman Bret Guthrie, Republican of Kentucky, making the Republican case. We're going back and forth. They each have a minute, two minutes. We expect the debate to wrap up within the next 10 to 15, maybe 20, minutes. And then there will be the roll call. And at that point, we expect the Democrats to win, to get more than 216 votes.

Remember later tonight, the president of the United States will be addressing the American people from the east room at the White House. We'll have live coverage of that. We'll have live coverage of all of this history unfolding.

Don't go away. Our coverage continues after this.


BLITZER: They are still considering this issue on the floor of the House of Representatives. The debate continues. At that point, once the debate is over, they'll have the roll call. It could be another 10 or 15 minutes away.

Sanjay Gupta is here. Our chief medical correspondent.

I'm getting a lot of e-mails and tweets from our viewers. They really appreciate what you're doing, Sanjay. Not just doing the politics, not just doing the little process that's going on, but explaining in clear, concise, precise terms how this will affect our viewers out there.

You've got some more questions --


BLITZER: -- that have been tweeted.

GUPTA: It's interesting. People have a lot of specific questions about the plans. But here's something a little bit different. This is from KAKTalk. Question is where is incentive for everyone to try and be healthy? That will eventually reduce the need for priced -- high-priced drugs and tests.

It's an interesting question, Wolf, and you and I have talked about this as well. You know, I know people who have health care insurance, have lots of resources, and aren't necessarily the healthiest either.

So it's hard to draw the line between having health care insurance and all of a sudden creating a healthier population.

I think it's safe to say that people will get more preventive screening, trying and get the tests and the preventive procedures that may keep them from getting as sick later on. But whether or not we're going to become a healthier society as a result for this increased access to health care insurance, I don't know about that.

BLITZER: If you diagnose somebody earlier in the process, it's a lot cheaper when all is said and done than if you wait until there's -- the disease is fully blown up.

GUPTA: That's no question. And I think that's part of -- at least medically -- what was meant by when people said we're going to bend the cost curve downward by insuring more people, first of all, you don't -- people who are uninsured right now are utilizing the health care system, just at much later stages of disease.

So now, you know, you get people in earlier, get people blood pressure check, prevention, screening, all that earlier in life. And that would probably save money down the road. So that was, I think, in part at least medically, how you'd save some costs.

You get another question here. This is from M-4-Z-Damon. It says, "How does a free government plan compete with private health insurance plans? Won't it eventually eliminate them?"

You know this has obviously changed. The plan has changed several times. They may still be talking about when a public option was part of this bill. It is not anymore. So there's not per see a free government plan out there.

There is a national health exchange that will be implemented in about four years that will be sort of government overseen and people will have subsidized health care insurance to that plan. But that's much more of a supermarket type of thing where you go out there, find an insurance plan for you, and let them sort of compete for your business. So it was how managed care was supposed to work in the mid '90s.

BLITZER: There is a free government public option out there. It's called Medicaid for very poor people who don't have any health insurance or don't have any other capabilities to deal with these issues. They're eligible for Medicaid.

GUPTA: That's right. And under this as well, that would be expanded to some degree as well. So for childless couples living near the poverty line, they would also be eligible to get some subsidies for their health care insurance. So you're right that we do have examples of this type of thing.

BLITZER: Kevin Madden, you're watching all of this. And you're a Republican strategist. Right now, you realize, of course, the Democrats are going to win.

MADDEN: Right. Yes.

BLITZER: So then what?

MADDEN: Are you asking me or telling me?

BLITZER: On this issue of health care reform, the Democrats will win.

MADDEN: They're going to win the vote.

BLITZER: The president -- they will win the vote and the president will sign it into law. The Senate version. And they'll fool around with tweaking it. Making some fixes. The Republicans will still have a chance to slow that process down.

But fundamentally, the president will sign health care reform into law maybe within the next 24 hours?

MADDEN: Right. And I think what you'll see very quickly is Republicans across the country, whether they're there running for office or they're currently in office right now running for re- election, they're going to start to -- you're going to hear the mantra which is repeal and replace.

I think that's something that the Republicans feel very confident that they can go out and find this big middle of the electorate right now that's very unhappy with the size of the cost of this bill and very unhappy with the size and scope of it. And that it's going to dramatically change the way people's health care is given to them today. And that's not for the better, not for -- that's not a good thing.

So they're going to go out there and they're going to try to find that main coalition which really has abandoned the Democrats over this last year, which is independent voters. Independent voters are not happy with this bill. They are not happy with the process that brought this bill to the floor today.

So that I think is where Republicans are going to concentrate their efforts.

BORGER: But who will benefit? In other words, if you give people -- if you fix the so-called doughnut hole in Medicare prescription drugs, which means you help seniors pay for more of their prescription drugs, how do you repeal a positive benefit?

How do you say to parents whose kids maybe 23 years old now that they, OK, now you can't stay on your insurance policy if they're not insured.

How do you take things away from people politically? Because there are things in this bill that people are going to like.

MADDEN: There are two tracks. There's the legislative track and then there's the political track. The legislative track, that's a good question. And that's going to be --

BORGER: I always thought they were the same track.

MADDEN: No, they're not. They're not. Trust me, as a political hack, I can tell you that for sure.

But the legislative track, that's going to be something that's going to be a question if the Republicans were to gain power. The political track right now is repeal and replace is the message. That's going to be something they're going to take to voters now in the midterms and try and force a debate on with -- against Democrats.

BRAZILE: Sixty-two percent of people who filed bankruptcy last year did so because they were trying to stay healthy. We know tonight that for every minute that we debate health care, someone is losing their health care, someone has found out that their premiums will go up, or someone will, perhaps, die because we don't -- they don't have health care.

So the Republicans are sitting around making a political calculation that they can go out there and sell this as some, you know, bad bill when most Americans will look at this next month, the month after, the next month and say, OK, is this going to reduce my cost? Will this help my family? Will this allow me to --

MADDEN: Again, I cannot emphasize enough --

BRAZILE: -- continue to provide coverage for my children. MADDEN: I'm with you, and you have your point and I have mine. But I cannot emphasize enough that every Republican wants health care reform. Every Republican believes that we need to bring down costs and we need to expand access.

But we don't need to do it by growing the size of government and that there are ways to do it outside of the way this plan has been crafted.

BRAZILE: But the Republicans had eight years to do that and they didn't do it because they didn't believe to provide health care.

BLITZER: All right, hold on one second.

BRAZILE: So we can just keep going round and round on this.

BLITZER: I want to go right to Dana Bash up on Capitol Hill. She's got a developing story.

What's going on, Dana?

BASH: There goes the speaker. I don't know if you just saw her. She just walked by here. She's on her way to the House floor. She came from her office which is right back there. And sort of signals the beginning of the end of the debate.

I believe that there's a little bit more time on the House floor for the various committees who had jurisdiction over this legislation to continue their debate. But she is going to be one of the final if not the final speakers during leader's time.

So she's clearly going on to the floor to hear the end of the debate and prepare for her remarks.

BLITZER: That was not nice of her, Dana, to just walk right by you. She must be the only person --

BASH: That's OK.

BLITZER: I can't imagine anyone else not stopping and answering your questions as they walk by.

BASH: I hate to tell you but that's happened before.

BLITZER: Really?


BLITZER: I'm shocked. How could anyone not be nice to Dana Bash, one of the nicest people in Washington, D.C.? I'm going to have to have a talk with the speaker about this.

BASH: You do that.

BLITZER: Well, maybe on her back to her office you'll grab her, Dana. Thanks very much. We'll listen to all the leaders, the Democratic leaders, the Republican leaders. They're wrapping this debate. They'll have the roll call and our coverage will continue after this.


BLITZER: Only a few minutes away from the leaders, the Democratic leaders and the Republicans leaders, making their summation statements before the roll call on health care reform.

This is it. This is the vote they've been waiting now for more than a year. The health care reform bill is about to be passed by both chambers. This legislation passed the Senate on Christmas Eve.

It is about to go through the House of Representatives and then be signed into law by the president.

Dana Bash, you've got some information on the speaker. She just ran by you as she was going out to the floor. But she's invited some special guests to be on hand for this historic moment.

BASH: That's right. It's just one more indication of, as you said, how historic this is from the perspective of Democrats and the way they're treating this moment. You know during the State of the Union every year, both the president and the speaker invite people to sit in their box up in the gallery to watch the -- what -- the goings on.

Well, the same thing has happened tonight, formally. The speaker's office sent out a list of people that they have invited. And it's actually an interesting list because it has a lot of the biggest supporters and interest groups -- heads of interest groups that have supported this legislation throughout this.

H-CAN, which is one of the biggest interest groups for the head -- the head of that group for the passage of this. The American Academy of Pediatrics, AFL-CIO, the head of the National Medical Association, and also several members of the president's staff, including Sikh Emanuel. He is the brother of Rahm Emanuel who happens to work on the -- as health care policy advisor. And several members of the National Economic Counsel.

So that kind of gives you a sense of the import from the perspective of the Democrats the fact that they wanted to formally let the public know that they invited key constituencies to watch this.

And another few people who are in this -- on this list, Wolf, members of Nancy Pelosi's family who I can tell you they have been back and forth -- especially a couple of her daughters, have been back and forth to the floor and they've been in the room, in her office including her husband.

And I can tell you, it wasn't just the House floor that was on in that office, there was March Madness going on. Just a little inside scoop that I got from one Paul Pelosi.

BLITZER: When we hear about March Madness, we think about Capitol Hill March Madness because it's been a lot of madness going on here in Washington as well.

Dana, thanks very much.

It would have been something, wouldn't it, John, if the president and/or the first lady would have come over to watch this vote unfold and sit up in the gallery?

KING: That would be, I believe, unprecedented at least in my time here in Washington 22 years. But it is wonderful that her family is there because however you feel about this legislation, and they're going to have a big vote tonight, and then this debate will continue through the election year, this is a victory for the speaker.