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CNN Live Event/Special
Health ?Care DEbate in Town Hall Meeting. Aired 9-10:30p ET
Aired September 25, 2017 - 21:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
TAPPER: Live from Washington, I'm Jake Tapper.
BASH: And I'm Dana Bash. And we have breaking news from Congress tonight as the state of Obamacare hangs in the balance.
TAPPER: Support for the Republicans' last best hope for repeal, the Graham-Cassidy bill, now appears to be disintegrating. A key vote, Maine Senator Susan Collins, has just announced she will vote against it. Kentucky Senator Rand Paul told me just hours ago here on CNN that he is also a firm no.
BASH: And of course, Arizona Senator John McCain, who cast the deciding vote against the last Republican effort, has pledged to vote against this one, as well. At this hour, it appears the bill will almost certainly fail.
TAPPER: The question now: Can Republicans find a way to keep their promise to repeal Obamacare with the clock ticking towards the deadline on Saturday? And if not, will they work with Democrats to fix what many Americans say remains a broken system?
We've gathered four senators at the heart of the debate. We have the authors of this latest bill, Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, physician for nearly three decades. On the other side, independent Senator from Vermont, Bernie Sanders, and Democratic Senator from Minnesota Amy Klobuchar.
BASH: And, Senators, you will get 1 minute and 15 seconds to answer questions from us or the audience, 30 seconds for responses and rebuttals, and timing lights will guide you.
TAPPER: We have an audience made up of Americans on all sides of this issue tonight. With the Congress at a crossroads once again, their questions may be more important than ever. Where should we go from here? Let's begin with an opening statement from Senator Lindsey Graham.
GRAHAM: Well, thank you for coming tonight. Where do we go from here determines a little bit about who we want to be as a -- as a nation. I want to provide high-quality health care for every American, including my family and yours, but we've got to find a way to make it so without bankrupting the country.
A little bit about me. When I was 21, my mom died of Hodgkin's disease. Fifteen months later, my dad died. My sister was 13, and moved in with an aunt and uncle worked in a textile plant. And thank God they helped me. We're all one car wreck away from needing somebody's help.
I'm here tonight because Obamacare is failing. We wouldn't be having this show if it was working. In my state, we had a 31 percent premium increase Friday. We had five insurers in 2014. We're down to one. It's not working in South Carolina, and I don't think it's ever going to work anywhere. It's time to look for a replacement. It's not enough to repeal it; you've got to replace it. I think we've got a damn good idea.
TAPPER: Senator Bernie Sanders?
SANDERS: Well, since President Trump was elected, these gentlemen and the Republican leadership have on five occasions tried to repeal the Affordable Care Act, thrown tens and tens of millions of Americans off of the health insurance they currently have, and make it impossible or very difficult for people with pre-existing conditions to get the health care that they can afford.
What these guys want to do is force older workers to see a very significant increase in their premiums, which is why the AARP is vigorously opposed to their legislation. They want to tell 2.5 million women in the United States of America who today choose Planned Parenthood to get their health care they can't do that, because they want to defund Planned Parenthood.
But here is the most important point. We're going to have a debate. It'll be a good debate. We like each other. But -- yeah, we really do.
But here's the point. Every major health organization in this country, whether it is the American Medical Association, the American Hospital Association, the American Cancer Society, the Alzheimer's Society, every single major medical organization in this country thinks that their proposal is a disaster.
So our job now is to defeat this disastrous proposal, get back to the drawing board, see if we can work together for some short-term fixes. Long term, in my view -- I speak only for myself -- this country has got to join the rest of the industrialized world, guarantee health care as a right of all people.
TAPPER: OK, Senator, thank you.
GRAHAM: Take longer than a minute and 15.
CASSIDY: For 25 years, I worked in the public hospital system of Louisiana trying to bring health care to those who did not have. And I learned in those 25 years that when the patient has the power, the system lines up to serve her. And when the bureaucrat has the power, it first serves the bureaucrat. Now, this is a debate about who has the power. Is it you, the
patient, or is it the federal government? The narrative on the other side is that you don't have the capability to care for yourself, that your governor is corrupt, scheming to take away your protections if you have a pre-existing condition. And they think the federal government taking control of your life is a better way to go.
The logical extension of that, unfortunately, is the Charlie Gard case, the Charlie Gard case in which the single payer of England said the decide -- the life -- the decision of the life of your child is too important for the parents to make, and then the child died. I will tell you, if it's a decision about you versus the federal government, we side with you. Those who oppose us and those who want single payer, they choose otherwise. Thank you.
TAPPER: Senator Klobuchar?
KLOBUCHAR: I'm up here on this stage because 20 years ago my daughter was born, and she was really sick. And she couldn't swallow, and she was in intensive care. And I was kicked out of the hospital in 24 hours. That was a rule back then.
And I went to the legislature as a private citizen and got one of the first bills passed in the country guaranteeing new moms and their babies a 48-hour hospital stay. Our story ends well. My daughter got better and better. We fed her with tubes. My husband, who's here, and I did for about a year-and-a-half. But she graduated from college this year.
And I think every mom and dad should be able to take care of their kids that way and be able to have insurance. I believe politics is about making people's lives better. But this bill, it doesn't do that. It kicks millions of people off insurance. It raises the premiums. It basically passes the buck to the states, but doesn't give them the bucks to cover people. So that's why I think we need to work together on the plans that are already underway to fix the Affordable Care Act and put the politics aside and focus on people first.
TAPPER: Thank you, Senator.
KLOBUCHAR: Thank you.
TAPPER: Let's go to our audience now. I want to bring in Warren Hudak. He's a Republican from Pennsylvania. His wife was diagnosed with multiple sclerosis several years ago, and their current policy does not cover the $6,000 a month needed for his wife's medication. And he has a question for Senator Graham. Warren?
QUESTION: Actually, Senator Cassidy, the deadline for Senate action on repeal is September 30th. The Senate failed to pass repeal and replace, full repeal, skinny repeal, and now, it appears that the votes aren't there for the Graham-Cassidy proposal that would shift decisions to the states.
The whole health care system is collapsing. Premiums are skyrocketing. Choices are dwindling in and out of the exchange. What can the Senate do before open enrollment to reduce the cost of premiums, not just subsidize them, reduce the cost of premiums? People are hurting. We need action.
TAPPER: We're going to -- I'm sorry, we're going to have that for Senator Graham. We're equally dispersing them. So, Senator Graham, if you -- if you want to handle that one. What can the Senate do before open enrollment to lower the cost of premiums, not just further subsidizing?
GRAHAM: Being honest with ourselves that what our Democratic friends did is not working. Now, we can talk about how to go forward, but I don't think you're going to find many people up on this stage saying that what happened with Obamacare is working for you and your family.
So what we want to do is repeal the individual mandate and the employer mandate, take the rest of the Obamacare taxes and block grant it back to each state in a formula that I think is fair to give people in your state control over the money so they can design a health care system good for Pennsylvania that may be different than South Carolina.
The only thing I can tell you for sure, if you keep doing what we're doing, it's going to fail not just in South Carolina, but everywhere, so that we have a replacement idea that takes the money that would have been spent by bureaucrats that you have no idea who they are and put it in the hands of people you actually can vote for.
And my good friend from Pennsylvania, under this idea, your governor and your state house member will be accountable for your health care. And if you don't like what they're doing, you can say, "Please, change it or else." Under this system, who do you complain to? Does anybody in here know who runs Obamacare in your state? Do you know your governor? Do you know your state house member? Do you know your state senator? This is the biggest change in health care in my lifetime, is giving a people a chance to complain to somebody who cares.
TAPPER: Senator Sanders, would you like to respond?
SANDERS: It's not giving people a choice. It's cutting Medicaid by a trillion dollars over 10 years and throwing millions of people off of health insurance who have no money. And let us be clear. These are wonderful gentlemen, and I know nobody up here wants to see anybody die. But you tell me what happens when somebody who has cancer, somebody who has a serious heart condition, somebody who has a life- threatening disease suddenly loses the health insurance that they have.
And the experts and studies tell us that under their type of proposal, thousands of people every single year will die. What should we do short term? For a start, what they didn't manage to do is to take on the pharmaceutical industry and lower the cost of prescription drugs. We pay by far the highest prices in the world for prescription drugs.
Sir, from Pennsylvania, it might help you if you had a public option, a choice of a Medicaid or a Medicare type plan to compete with the private insurance program.
Thirdly, what we can do short term with their cooperation is lower the age of Medicare eligibility to 55 years of age. That would help a heck of a lot of people.
TAPPER: Senator Graham, could I just ask you a question? With the news tonight of Senator Collins saying that she's a no vote, that's three no votes.
GRAHAM: Right. Right.
TAPPER: You can't afford to lose more than two. What are you doing at this late hour to get the 50 votes you need to pass the bill?
GRAHAM: Well, we're talking to Alaska. Alaska has 750,000 people, twice the size of Texas. By the way, I've learned a lot about health care in other states because I'm sort of focusing on your problems versus, you know, relying on somebody in Washington to tell me about Alaska. So we're going to press on.
And it's OK to vote. It's OK to fall short if you do for an idea you believe in. And all I can say to my good friend, Bernie Sanders, Medicare, Medicaid, interest on the debt are going to consume all the money you send in taxes by 2040. If we don't turn this around now, we're going to leave a country that's completely and utterly bankrupt.
Can you control the cost of Medicaid and still be humane? I think you can, and you better, because Medicare and Medicaid are on the path to just collapse. And I'm proud of the fact that we saved a trillion dollars. And you know how we did it? We took the Medicaid growth rates and brought them down to medical inflation. We didn't cut year to year. We just changed the inflation rate and saved a trillion dollars that can go into securing the nation. Education. We can't just be a country running two health care programs. We've got to be a country taking care of a lot of problems.
TAPPER: Thank you, Senator. Senator Klobuchar?
KLOBUCHAR: Well, two things. One, the independent governor from Alaska has already come out against this proposal, because he believes it's going to increase premiums.
But to your point exactly is that you asked about what would happen immediately. What could we do immediately? And that is the work that's being led by Republican Senator Alexander, Democratic Senator Patty Murray to come together to say, look what they did just now in Minnesota. Republican legislature, my state, Democratic governor came together and said let's do something called reinsurance, which makes it so the most expensive person in a pool who's had some major catastrophic health event, they get siphoned off and paid for by the government so that everyone else's rates don't go up. This is the kind of proposal they're working on for the nation, along
with other ways to help with co-pays and to allow states to design some of their own insurance without -- without -- making the drastic cuts that we see in the bill that my colleagues have proposed.
BASH: Senator, thank you. I want to bring in Matt DeCample from Arkansas who previously worked as the press secretary for Democratic Governor Mike Beebe. Matt was diagnosed with stage 4 cancer last year and is currently hoping for scientific advancement that will extend his life. And, Matt, you have a question for Senator Sanders?
QUESTION: I do. Senator Sanders, it feels like all of the ideas getting traction right now are extreme measures. You've got Graham- Cassidy, which would kind of strip the system down to the nubs and rebuild systems in 50 different states, and you've got Medicare for all, which I understand the ethic behind, but also would take an entire population currently involved with the ACA and move it to another system.
Why don't you think we see more in the Senate and the House gravitating toward the middle and looking for these type of consensus solutions, instead of staying on the sides and just letting the current administration chip away and destabilize the system that a lot of us are depending on to live right now?
SANDERS: Well, Matt, I know I speak for everyone here that we wish you the best in your health struggles.
Let me just be very honest. I don't think Medicare for all is an extreme idea. Every other major country on Earth guarantees health care to all people as a right. We end up spending, because of the dysfunctional and complicated system that we have right now designed to make insurance company profits, we spend twice as much per capita as any other country on Earth. We pay by far the highest prices in the world for prescription drugs.
So to do it, every other major country on Earth is doing it. I live 50 miles away from Canada. I don't think that that is a radical idea.
But clearly, Medicare for all is not going to pass so long as my Republican colleagues control the Senate and the House. So what do we do? How do we work together?
Well, here's one idea. One idea is to take on the pharmaceutical industry. You'll remember that Trump talked a whole lot during his campaign about how the pharmaceutical industry was ripping us off. He was right. Let us work together. Let us have Medicare negotiate prescription drug prices. Let us have re-importation so that pharmacists and distributors can purchase lower cost medicine abroad. That is one way that we can work together, help the American people, and save taxpayers' dollars.
BASH: Senator Cassidy, what about that? And just a broader question of the extremes and the people who want to work in the middle not getting very far. CASSIDY: A couple things. First, everybody on this stage thinks that
the current system is broken. They would like single payer, the federal government has the power, and we want to return power to the states.
This gentleman is from Arkansas. Arkansas has done so many innovative things on health care. For the Medicaid expansion, instead of putting them on Medicaid, they put them into Blue Cross Blue Shield. Now they have something for those patients who are very costly, they're doing kind of a wraparound that would kind of do care management to lower their cost.
Amy spoke about what a great story. She went to her state legislature and got a law changed. That would never happen coming to the United States Congress. I would say that we continue to allow Arkansas to do what Arkansas is doing. That's not extreme. It's what you are already doing.
Let Minnesota do what Minnesota is doing. We've heard Amy say how successful they are. And we think by doing that, it's not extreme, it's a way to bring health care to you, to you and to your state, in a way which uniquely meets your needs. We are about you getting care, you being covered, you having the power.
BASH: Senator Klobuchar, I want to let you respond, but as you do, I want to ask about President Trump, because he has shown a willingness to work with Democrats, with the Democratic leaders in the House and the Senate. Would you support Democrats working with President Trump to cut a deal to try to fix problems with Obamacare?
KLOBUCHAR: Well, of course we would. We just want to make sure it helps people, like I laid out at the beginning. And the problem for me with the proposal that the Republicans, the umpteenth proposal we've seen on repeal, is that it actually hurts my state. And people can innovate in states, but not if you're going to cut the funds and don't help these governors that want to help the state.
Now, one example of where President Trump could work with us, I'm leading the bill for the negotiation of Medicare drugs. Our seniors, 41 million of them, boy, they could really get a better deal than they're getting now, but they are banned to do that by law.
Senator Grassley and I have a bill to stop pharmaceutical companies from paying off their competitors, the generic companies, from keeping their products off the market. That would save $2.9 billion in just 10 years. These are bipartisan bills. Yes, President Trump should work with us and, more than that, he should lead the way on taking on the pharmaceutical companies to show them that they don't own Washington, D.C.
BASH: Senator Graham, you've worked with Democrats on lots of issues. Do you support the notion of the president just sitting down with Democratic leaders and finding a compromise on this?
GRAHAM: I'll sit down with anybody to talk about anything that matters as long as I think I've got a chance to deliver. I believe climate change is real. Let's don't talk about it; let's fix it. I think the DREAM Act kids deserve a place to stay and we secure our border. I'm even willing to do the minimum wage, Bernie, if we can find the tax cut that works.
But what I'm not going to do is continue the same old crap and tell you everything is fine. Let me tell you what's happened since Obamacare passed. Anybody have stock in Anthem? These are the big blues, 270 percent increase. Humana, 420 percent increase. Aetna, 470 percent increase. Cigna, 480 percent increase.
Where's the money going? It's going to insurance companies who are not delivering for you. We had five insurance companies in South Carolina. We're down to one.
And, Amy, what I'm not going to do is take more taxpayer dollars and give it to a bunch of insurance companies. Here's what I want to do. Take basically the same amount of money, flow it back to the states in a fair way, and give South Carolina a chance to come up with a better health care system for South Carolina. Give Alaska a chance to do what makes sense for Alaska.
If that's radical, God help us all. Because here's what I believe. People in South Carolina actually care about each other. Pre-existing conditions, they're going to be covered in every state and there's going to be different ways to get there. But if you send the money and power back to the states, and we have to do this same, old thing under Obamacare, how do you expect a different outcome? The biggest winner under Obamacare is insurance companies, not patients. And I intend to change that.
SANDERS: Whoa, whoa, whoa.
I like that.
GRAHAM: All right, good.
SANDERS: All right.
GRAHAM: But I'm not going to Medicare for nobody.
GRAHAM: Because that's what you'll have with Medicare for nobody.
TAPPER: Let's let Senator Sanders have the floor.
SANDERS: See, Lindsey, there it is. You actually said something that was right. I knew it would happen.
GRAHAM: I was due, Bernie.
SANDERS: What he pointed out -- I'm extrapolating a little bit, Lindsey -- but what he pointed out is, why do we have -- why do we end up spending twice as much per capita on health care as any other country? And Lindsey is right.
This system is designed to make billions of dollars in profits for the insurance industry. We spend 12 percent to 18 percent to administer the incredibly complex hundreds of plans that we currently have. And with these guys, if they got their way, there would even be more plans, more bureaucracy, more complexity, more money going to the insurance companies.
Medicare, the administration of Medicare costs approximately 2 percent. So if we are serious about moving to a cost-effective universal health care, yeah, we do have to take on the insurance companies. They do not play a role in providing health care. Our money should be going to doctors, to nurses, to hospitals, not to the insurance industry or, in fact, the drug industry, which is charging us by far the highest prices in the world.
BASH: Senator Graham, you were shaking your head. Is the bromance over already?
GRAHAM: Oh, no, no. No, Bernie is the most honest person in the Senate because he believes in government running health care from cradle to grave. All I would say is that Medicare is coming unraveled. By 2038, the trust fund is going to run out of money. And if you're 62 like me and you've worked all your life, and you're about to get on Medicare, I think it's a bad idea to have 200 of your closest friends join you, because that's Medicare for nobody.
TAPPER: All right. We're going to turn to another audience question. One of the main sticking points in this debate, as you all know, is over the issue of pre-existing conditions. Obamacare prevents insurers from charging more to people who have pre-existing conditions, but there are questions about whether that would continue under any Republican replacement, including Graham-Cassidy.
I want to bring in Kevin Potter from Ohio. He's here with his 13- year-old daughter, Erin. She's battled leukemia since the age of 3. That has required treatment, costing millions of dollars. And he has a question for Senator Cassidy. Kevin?
QUESTION: Senator Cassidy, can you tell my daughter tonight how you plan to absolutely guarantee her that she will never be subject to exorbitant premiums that would make coverage for her impossible? So far as I can tell, and based on every analysis, your proposal strips that essential guarantee from her and millions like her with pre- existing conditions.
CASSIDY: First, I admire your courage. Oh, my gosh, so young with so dealing with so much. Again, I've treated folks like you, and my hat's off.
I can't -- the way I'm trying to keep you from having to pay exorbitant premiums is to try and replace Obamacare. Because the problem with Obamacare, right now, there's a guy back home who's paying $39,000 a year for he and his wife. Put it on my Facebook page, people do not believe. Another couple, $32,000, $35,000, with a -- with a co-pay, $35,000, $38,000. That's exorbitant.
But we have in our proposal, people are shaking their head. It's on my Facebook page. Check it out. On the other hand, what we hope to do is to get the states the resources which Amy just spoke of. If the state sets up a reinsurance pool, they can actually keep you in the main insurance pool but otherwise lower the premiums. That was done in Maine. It was said to lower premiums by as much as 20 percent for everybody, while at the same time making sure that those that have the same conditions actually had lower rates.
But you got to give power to the patient. By the way, that experiment in Maine, the Affordable Care Act squashed, even though now that is what we speak of as the solution to the problem. We shouldn't squash state innovation. We should improve it so folks like you, Amy, can have those affordable premiums. Thank you.
TAPPER: Senator Klobuchar?
KLOBUCHAR: Yeah. Thank you, Erin, for your story and, Kevin, for being such a great dad. You know, there's a difference here. The process I've been talking about are the two senators working together, Lamar Alexander and Patty Murray and all the people that's been involved in that, a bunch of governors, Democrat and Republican. That would actually make the change that Senator Cassidy just mentioned on the reinsurance and do some other things.
But the bill that's before us today, that bill just today a preliminary analysis found it would actually increase the rates for people with pre-existing conditions. That's from the Congressional Budget Office. Just today, it came out.
And why is that? Well, you know, you can have things available to you like treatment, right, but if it's too expensive, is it really available to you? And if you see a Ferrari in a car lot, well, it's available to you, but you can't really buy it. And that is the problem if the prices skyrocket.
So it's doing something immediately to stabilize these prices, but then in the long term making sure we can make health care more affordable. Bernie has one idea; I have some others. And we can talk about them later.
TAPPER: Senator Cassidy, in addition to the Congressional Budget Office, you've been talking about the Jimmy Kimmel test and whether or not somebody with pre-existing conditions like his son, Billy, will be protected under your bill. We talked to a health care expert with the Kaiser Family Foundation, looking at your bill, who said that -- we think the best reading is that states could still allow insurers to charge higher premiums to people with pre-existing conditions. Do you think the current standards that protect people with pre-existing conditions like Erin should remain in place under any new legislation?
CASSIDY: We think we have those standards in our bill. By the way, those premiums I was saying, I'm not making those up, $39,000 for a couple for one year. But let me speak of what our bill does say. Our bill says that, one,
you can't deny people insurance because of their health status, and, two, we say that if a state wishes to do something different, for the state to get the approval to do something different, they shall show that those with pre-existing conditions have access to affordable and adequate coverage.
Now, someone says, how do you define affordable? Well, it's certainly not $39,000 a year. But if you look it up in the dictionary, affordable means able to be afforded.
The subtext of what you're saying, Jake, is that some governor is going to be out there saying let me scheme, let me get it so that the folks in my state with pre-existing conditions don't have access to coverage. Now, again, we reject that. I trust governors. I actually think that governors respond to the people that elected them. If they don't, they don't win next time. And, again, Amy's story is a great example of just a person going to the legislature and getting a law changed for the benefit not just of her, but for others. When you bring power to the person and to the state, good things happen, and that's the goal of our plan.
TAPPER: Senator Sanders?
SANDERS: Let me just not give you my view. Let me tell you what the American Medical Association says. It says, quote, "This bill will cause patients and consumers to lose important protections as well as undermine safeguards for those with pre-existing conditions," end of quote.
So what will happen is, yeah, insurance companies will not be able to deny you health insurance if you have a pre-existing condition, but they can charge you anything you want, which for all intents and purposes for most people will mean that they're not going to get that insurance.
KLOBUCHAR: And, by the way, this is why the Republican governor of Ohio opposes this proposal.
TAPPER: Senator Cassidy?
CASSIDY: First, let me say that 15 governors do support our bill. They actually think that they can do better in their state than the Obamacare law is currently doing. It's not hard to imagine, again, if people are paying $20,000 to $40,000 a year for premiums.
And, again, our legislation specifically says that if a state wishes to do something different, they shall show that those with pre- existing conditions have access to adequate and affordable coverage.
Now, we can decide that language does not mean something, but indeed, language does. And adequate and affordable means something. And I'll go back to what I'm saying. If you're going to compare us to status quo, status quo is $39,000 a year. Is that adequate and affordable? I would say not.
TAPPER: Senator Sanders, and then Senator Graham.
SANDERS: No, I...
TAPPER: Senator Graham, you want to say something?
GRAHAM: Yeah, I think this is really an important discussion to have. Number one, to your daughter, I promise you that in South Carolina we're not going to throw you off insurance and charge your father more than he can afford to pay, because it wouldn't be right.
Number two, somebody's got to decide this issue of adequate and affordable. There seems to be three choices. Insurance companies, anybody for that? The reason we have Obamacare is because insurance companies made this very difficult on people. So Obamacare came along and said, no, you can't stop charging so much for people with pre- existing conditions.
Here's what I would say to your family. There are a bunch of people in my state who might as well not have any insurance. The deductibles are so high and the premiums have gone up so much you're just basically insurance in name only.
So I want to take care of you and your daughter, but I want to do it in a way not to kick everybody into a situation where insurance really doesn't mean a lot. The guy in Obamacare who's deciding adequate and affordable is doing a miserable job, or I wouldn't be here.
The third option is the state governor, the state legislature working with the federal government and find a way to do better than Obamacare, maybe a different way in South Carolina versus California. But if we don't find a different way to do this, Obamacare is collapsing, folks.
The reason we're here tonight is it didn't work. In many ways, I wish I were wrong about Obamacare, but I'm right. And here's what I do think about you and your family. The best chance you have of having a say about what happens to your family is to talk to somebody that you can vote for, that actually has to be accountable to you, not somebody you'll never meet and never know.
BASH: You're talking a lot about -- go ahead, Senator.
SANDERS: Yeah, just a couple of points. We all recognize that the Affordable Care Act leaves a lot to be done. But let's not forget that 20 million Americans today have health insurance who previously did not.
Now, these guys say, well, the governors, they're not going to do the wrong thing. Before the Affordable Care Act in South Carolina, I suspect, and in 42 other states, guess what rules there were with regard to pre-existing conditions? There were none. There were none.
GRAHAM: Sure, all over the country.
SANDERS: And 43 states had no rules. Seven states did.
GRAHAM: All over the country.
SANDERS: OK. So don't let -- that's what the governors and the state legislatures did. The truth of the matter is, the Affordable Care Act has done some very important things. Let's not throw the baby out with the bath water. What the American people want is not their proposal. Poll came out today, 20 percent of the American people think your idea is a good idea. What the American people want is us to work together to build on and improve the Affordable Care Act, not repeal it.
CASSIDY: Going -- going to a single-payer system is not building upon and improving. It is basically saying it has failed and we shall do something else. That is what has been said. And I will go back. Who has the power? You, the state you live in, or the federal government?
Amy has told us several stories. When her state had the power, her state did such good things for the people in that state. But now we have premiums of $39,000 a year because somebody in Washington, D.C., has the power.
BASH: And, Senator, I want to stay on that subject about affordability. We have another questioner here, Michelle Harris, who is a retired waitress who lives in Arizona with a question for Senator Klobuchar.
QUESTION: Senator Klobuchar, Obamacare was a huge lie to the American people. Our insurance premiums did not go down. We did not get to keep our insurance plans. We did not get to keep our doctors. And our taxes did not go down. The cost for Obamacare fell onto the backs of the middle class, while the protests ring loud from those receiving free or low cost health insurance were the only cries our representatives seemed to hear.
They -- and they demand health care as a right to which they're entitled, but it's us hard-working middle-class taxpayers who are paying for it. Have you taken the time to listen to us who are trying so hard to convey our message? We can no longer afford to pay so much so that so many can pay so little.
KLOBUCHAR: Thank you so much for sharing that. That's one of the reasons I go around and visit all 87 counties in my state every single year so that I can talk to the people in my state. And especially in the rural areas, I've heard that, too, about the premiums.
And there's a reason. And that is that we passed a bill, as Bernie explained, it did some good things, but you don't pass a big bill like that and never able to improve it or change it.
And what Senator Cassidy just told you, I think that's a false choice. It's not just between one or the other. There is a middle ground here of things we can do to fix it. I've mentioned the pharmaceutical prices and actually taking that issue on. It's nearly 20 percent when you count hospital pharmaceuticals of the health care cost. We need to take that on. We can't just let it sit.
The ideas that I brought up that actually are on the table now, the effort was almost there and it was just stymied because this bill took up all the oxygen this week. They're ready to go back and pass something. And there's a lot of people, Democrats and Republicans, that want to make these changes and help the states.
And then the third thing I'd say is, I've heard a lot from small- business people. There's more we can do there, too. A tax credit, there's a tax credit right now that you can only take for two years for small businesses. Let's make it permanent. Senator Stabenow has a bill to do that. And it would really help a lot of our small businesses to pay their employees' health care.
BASH: Senator Cassidy, what about those ideas?
CASSIDY: First, controlling pharmaceutical cost is a bipartisan issue. It is something that I have focused upon. It is something I'm passionate about. It is not as if you believe in single payer, that you're the only folks who care about those issues. I'm a doc. I understand that if somebody can't afford her insulin, that is a problem.
Lindsey talked about the profits since Obamacare passed of insurance companies. You ought to look at the profits for pharmaceutical companies. Was this the solution for those industries? And by the way, as those profits have climbed, so have your premiums, so have the taxpayer outlays. There's a direct relation between you paying more for your premium and the profits those industries are getting. If that is the answer, we got a bad problem.
I'll also say about power to the people and power in Washington, D.C. Why did they do so well? Read a book called "Bitter Pill." A guy named, I think, Steven Brill. He talks about how Obamacare was crafted. Everybody was at the table -- pharma, AMA, big insurance, hospitals -- but not you and me. And that's why our premiums rise, and that's why our taxes go up. And that's why they do so well.
If we give the power back to you, back to the state, that totally changes. And Washington, which is hard-wired for them to do well, now has to come to you and get your approval for these things. I'm about you having that power.
SANDERS: Well, I'm glad...
SANDERS: I'm glad to hear -- glad to hear that Senator Cassidy is concerned about the high cost of prescription drugs, because you're quite right. Last year, the five major pharmaceutical industries made $50 billion in profit. You got CEOs in the pharmaceutical industry who make millions and millions and millions of dollars in compensation. And one out of five Americans cannot afford the medicine they need. Are you going to join me in saying that Medicare should negotiate drug prices with the pharmaceutical industry, which is what every other major country on Earth does? Are you going to join me in saying that pharmacists should be able to get the same exact medicine in Canada or abroad at a fraction of the price they have to pay for in this country? Are you on board with that legislation?
CASSIDY: I've heard Bernie say in a V.A. Committee hearing that if we can't afford a medicine, the government should just take over the intelligence property. It should commandeer, it should commandeer the manufacturing plants, the distribution chains, it should become the pharmaceutical company.
Lindsey Graham is right. Bernie's the most honest person in the Senate. He's a socialist, and he believes it. And he believes that the creativity of the pharmaceutical industry, that's not important. Oh, we can take that, but where do the cure for Alzheimer's come from, if now, when there's a cure, the pharmaceutical company knows that their profit will be commandeered? I can tell you, it's a cheap -- it's a cheap fix to commandeer. And the price is tremendous. There won't be that cure for Alzheimer's, there won't be that cure for cancer, there won't be because there was a short-term grab. There are solutions, but it is not socialism.
SANDERS: You know, you think -- do you think -- do you think negotiating drug prices through Medicare, which purchases huge amounts of money, is a bad thing? You think it is wrong for pharmacists to be able to buy cheaper medicine, same exact brands from Canada? Are you going to come onboard that legislation? I don't know what you're really talking about, about taking over drug companies.
CASSIDY: I was quoting you.
SANDERS: What we want to do -- what we want to do is lower the outrageously high prices in this country. I've given you two approaches that can work, re-importation, Medicare negotiating. Are you onboard?
CASSIDY: Re-importation does not work. Canada has 10 percent of the population of the United States. You could take the entirety of Canada, shake it like a piggy bank, and all the drugs would come out, and it still wouldn't be enough for us all.
CASSIDY: ... there are ways to address this. There are ways...
BASH: ... Senator Klobuchar... (CROSSTALK)
KLOBUCHAR: ... I can see Canada from my porch, OK?
And I can tell you this, that the drug prices in Canada are half what they are in our country. And that's why Bernie's been involved in this, Lindsey's good friend, my good friend, Senator McCain, has a bill with me that would allow for this re-importation to bring in less expensive drugs. It has strong bipartisan support. Senator Collins is supportive of this bill.
So that's what we'd like to work on, things like that, the Medicare Part D negotiation. I worked in the private sector. I know socialists, OK? And what I want to see is more comparison. That's what this is about. By either having competition with generic companies and stopping them from paying each other off or having competition with drugs from other countries, because that is the only way we're going to bring these prices down right now.
Four out of 10 of the top 10 selling drugs in America have gone up over 100 percent in just the last few years. Insulin, up three times. Naloxone up over 100 percent. That's a drug that you use for opioid overdoses, this epidemic that's sweeping our country, and they have the gall to increase the prices of that drug like that. We have to take on the pharmaceutical companies strong, now.
BASH: Senator Graham, there's rare -- rare agreement on an issue. So if I'm at home watching, I'm saying, OK, so why can't they at least get this done?
GRAHAM: Well, the one thing I want you to all know, that we started talking about Obamacare and why it was failing, and we spent most of our time on pharmaceutical companies. Now, what does that tell you? It tells you they're not really explaining why Obamacare is failing. They don't have any ideas to fix it. It's all about something else.
So let's talk about our idea to fix it. Our idea is to take basically the same amount of money we would spend on Obamacare, give it to a bureaucrat you'll never meet or know or could care less about you, and block grant it back to the states in a fashion to give it to people closer to where your daughter lives, and you can have a say about what they do for your family and there are guardrails. You can't build football stadiums with it. You can't build roads and bridges. You've got to spend it on health care.
This worked in welfare reform in 1996 when 74 United States senators said let's take welfare and block grant it back to the states and see if they can do a better job. Since 1996, we haven't had one penny increase because they did a better job.
I'm confident, I'm very confident if you get the money and power closer to the patients, you'll get a better outcome than what we have today, because what nobody wants to talk about on this side is how to fix it.
Now, want to talk -- let's talk about pharmaceuticals. The idea of Medicare maybe negotiating a better price, Bernie, that might actually be a good idea. The idea of re-importing drugs to the country from foreign countries, I don't know, let me think about that. John McCain says it's a good idea.
The one thing I do know, that Obamacare is going to fail and Bernie's solution is more government, not less. I don't see how in the world that Medicare is going to survive for the next generation unless we reform it now. I'm willing to pay more in Medicare premiums, I'm willing to not take a dime in subsidy because when I retire I'm going to do well. I've got a military retirement, a congressional retirement, and I think I should pay more into Medicare and I think I should take less in Social Security, because when I was 22 years old, we needed every penny coming into my family...
BASH: Senator, thank you.
GRAHAM: Wait, please. So here's the deal. It's about Obamacare failing. And Chuck Schumer said tonight to Republicans, don't even come into the room until you take repeal off the table. Don't even come into the room unless you take repeal off the table. That's a good negotiation if you believe in Obamacare.
But if you believe like I do, there's no amount of money in the world to save it, then that means you're just doubling down on a system that you've invested in. You've told us all you could keep your doctor if you like it, you could keep your coverage if you like it. Well, it's not working, and it's never going to work, and I'm not going to spend more money, good after bad, fixing a system that can't be saved. We need to find a better way.
BASH: Senator Sanders, would you like to respond? Senator Sanders, he invoked Senator Sanders. Senator Sanders, would you like to respond, since Senator Graham mentioned your name?
GRAHAM: You all don't have any commercials?
SANDERS: I will just -- first of all, when you ask the American people about whether or not they like Obamacare compared to your plan, overwhelmingly the American people like the Affordable Care Act.
GRAHAM: How many people know who Graham-Cassidy are?
SANDERS: Second of all, one second. One second. Second of all, it is easy to beat up on big, bad federal government. Guys, do you know what the most popular health insurance program in America is? It's not the private insurance industry. It is...
SANDERS: Medicare, yeah!
GRAHAM: Which is falling apart.
SANDERS: Senator Cassidy and I are both on the Veterans Committee. Go out and talk to veterans. And what the polls show is that veterans are very, very positive toward the V.A. Does it have problems? God knows it does. But veterans feel very good about it. It, in fact, is the second most popular health care program in the country. OK?
So the point is it's easy to say Obamacare isn't perfect. Everybody knows that. But the truth is that what people in this country see is a health insurance system designed to make insurance companies and drug companies huge profits. They want a cost-effective system that, in fact, deals with the needs of our people and not just the CEOs of large corporations.
And that is why I personally believe that if Medicare is working well for seniors right now, we can make it work for every man, woman, and child in this country through a Medicare for all program.
BASH: We actually do have commercial breaks.
GRAHAM: There it is.
BASH: And we're going to take one right now. But don't go anywhere. Stick around. We're going to have a lot more on debate night in America. And also, we want to tell you that President Trump just tweeted about the health care debate. We'll tell you what he says when we come back.
TAPPER: Welcome back to CNN's health care debate. The future of Obamacare is on the line in the U.S. Senate this week. And as we've been here debating, President Trump has just weighed in moments ago. He tweeted this attack on Republican Senator John McCain accusing him of flip-flopping. After years of promising to repeal Obamacare, he tweeted an extensive video clip and wrote, quote, "A few of the many clips of John McCain talking about repealing and replacing Ocare. My, oh, my, has he changed. Complete turn from years of talk."
Senator Graham, that's your -- that's your best friend he's talking about. Is it helpful for -- is it helpful for President Trump to be attacking Senator McCain at a time like this?
GRAHAM: He is one of my dearest friends in the world. And John McCain can do whatever damn he wants to. He's earned that right.
Now, John has said he wants to repeal and replace Obamacare. He's voted in 2015 to repeal Obamacare through the same process. He also says that we want to have a bipartisan solution. The difference between John and myself is, I really don't see much space here. And if I thought I did, I would tell you otherwise. But let me tell you about Senator McCain.
He's not for Berniecare, Bernie. I know you like the vote he took, but he doesn't want socialized medicine. And I know you do, and I think you believe it's best for America. I believe it's the end of health care as we know it. I believe it's the end of innovation. I think it will bankrupt the country. And the federal government is pretty good at a couple things, like defending the nation.
So Senator McCain has talked about a better process. John, if you're listening, if we fall short, we'll try to have a better process. Nobody respects you more than I do. So to any American who's got a problem with John McCain's vote, all I can tell you is that John McCain was willing to die for this country and he can vote any way he wants to, and it doesn't matter to me in terms of friendship (ph).
TAPPER: Senator Klobuchar?
KLOBUCHAR: So just look at John McCain's speech that he gave on the floor after he got that diagnosis of brain cancer. And I love John McCain. And Lindsey is his best friend in the Senate. There's no better friend for John than Lindsey.
But when he gave that speech, he talked about how the Senate has to work across the aisle, that people have to come together and have hearings and figure out major bills. That's why, when you hear these there are only two choices here, that's not true. There is another choice.
That choice is right in front of us, where we have had those debates. We brought in Republican and Democratic governors, and this is something that will be one of the fixes that we can make to the Affordable Care Act. And I think it is so important we get this done.
So anyone who's with me on this, make your voices heard, because this is the time and this is the moment. And that's what John McCain is talking about.
TAPPER: Senator Sanders, you obviously want to speak.
SANDERS: It is beyond my imagination -- I cannot understand how somebody like a Donald Trump could attack an American hero, one of the most decent people in the United States Senate. Look, John's views are different than mine, but everybody knows that he's a man of incredible integrity and a man of incredible courage. I just don't understand why you have this president who seems to think he can attack people right and left.
Second point, on a different issue, and that is that Lindsey, we're not talking about socialized medicine. We can have an argument. GRAHAM: Yeah, we are.
SANDERS: No, we're not.
GRAHAM: Yeah, we are.
SANDERS: We are talking about -- we are talking about maintaining -- I am talking about maintaining the same system except you have one payer. That is the federal government. You go to private doctors. You go to private hospitals. So let's call it what it is. It's a Canadian system. It is not a British system.
GRAHAM: Call it socialism.
SANDERS: And I know that you know the difference, all right? And last point. The point that Senator McCain made, that Amy just talked about, what he said is, in so many words, how could anybody support a process where you're dealing with one-sixth of the American economy, you had one hearing today, we still don't have a full CBO report, you change the bill three times in the last day. No sane person thinks that this is a process to deal with one of the major issues facing this country. That is what McCain was talking about, and he's absolutely right.
TAPPER: Senator Cassidy?
CASSIDY: Let's work backwards. It's not one-sixth of the economy that Graham-Cassidy is attempting to change. It is the individual market, which is 4 percent, and Medicaid. We don't touch employer- sponsored insurance or Medicare, TRICARE, we don't touch any of that, unlike the single-payer system that they are proposing, which touches it all.
If you have employer-sponsored insurance, you lose it. If you have Medicare, there's suddenly 200 million more people in that pool, a pool which is already going bankrupt in about 17 years. What about process? You know, I worked for -- I'm a Republican. I worked for how many years in a public hospital for the uninsured. Probably most of my patients were Democrats.
On the other hand, they never asked me if I was a Republican. I never asked them if they were a Democrat. They are a child of God, a fellow American, and it was my Hippocratic oath to try and serve them, and I did. And they just gave me so much in return.
So when we took it -- what I began to look at this, I didn't say blue state, red state. With Susan Collins, I fashioned a bill which would allow a blue state to keep Obamacare if they wished, and a red state to do something different if it was failing in their state. And you know, I talked to 10 different Democrats, and know how many decided to help me? Zero. Even though we let them keep status quo, there wasn't enough concern about people in my state paying $39,000 for premiums. I'm all for bipartisanship. I wish we had had it. On the other hand,
I made a serious attempt and got zero result. At some point, you have to work for those families that can't afford their premiums even if the other side will not help. Thank you.
BASH: Senator Cassidy, I want to turn to one of the specific issues that has been a flashpoint, and that is on Planned Parenthood. There is a key Republican senator from Alaska, Lisa Murkowski, who has not yet said how she will vote on your bill. She told me it is, quote, "unfair" to ban Medicaid recipients from using Planned Parenthood because telling women they can't choose their health care provider is, quote, "inconsistent with Republican values."
Every Republican proposal so far, including yours, has done just that. So we want to bring in Lori Hawkins, who lives in Wisconsin, who objects to your proposal on Planned Parenthood.
QUESTION: Senator Cassidy, when I was in my mid-20s, Planned Parenthood discovered that I had large cysts and benign tumors in and on my ovaries. I'm grateful for Planned Parenthood, because without their care, it's quite probable that my husband and I would not have been able to become parents.
Why would you advocate for a bill that would block women like me from the essential care that helped me to become a mother, provides affordable cancer screenings for thousands and thousands of people, especially for those who live in the many parts of this country that are not served by community health centers?
CASSIDY: A couple things. You know, first, most Planned Parenthood settings are in urban areas, urban areas that have lots of OB/GYNs. I suspect you did not get your child delivered by the doctor who saw you at Planned Parenthood. You went someplace else, and you had another OB see you.
Now, as it turns out, the folks who don't have access to those cancer screenings live in rural areas. They live in areas where there are not enough physicians. So the idea is that we want someone to have to drive -- a lower income person drive three hours to a Planned Parenthood facility there to get her screening or would we rather take that money and put it back in the rural area to allow her to get her health care there?
Now, I favor bringing health care to the person as opposed to making the person come to the health care. And if you saw a Planned Parenthood in a city, there's lots of OBs there. It's just a question of how you distribute those dollars.
One more thing. Folks say we're trying to deny folks -- trying to deny folks contraception. No, I favor making birth control pills over the counter. That's the ultimate you've got the power. And by the way, so does the American college of OB/GYN. So we're all about lowering costs. You don't have to pay for a doctor's visit to get your prescription. We think that's a better way to go.
KLOBUCHAR: Thanks, Lori, for sharing your story. You're not alone. One in five women get their health care from Planned Parenthood. And I am strongly opposed to this bill's provisions to defund Planned Parenthood, number one.
Number two, the bill changes what are called essential benefits, and that was one of the positive changes that was made with Obamacare. And what that said is maternity care has to be offered and contraceptions have to be offered, contraceptives have to be offered.
This changes that. And 50 million women aren't going to be very happy about that, right? So that is one of the major reasons we're opposing this. I still remember that debate about making maternity care an essential benefit. One of the Republican senators said to Senator Stabenow, "I don't know why you'd include that. I would never use it." And without missing a beat, she should, "I bet your mother did."
And guess what? It got included, and it's still included. And that's something we have to protect. One more thing I'd add. I love these guys, but maybe if we added a few more women senators, I could be a little...
BASH: Senator Graham, you wanted to respond? Go ahead.
GRAHAM: Yeah. Well, I've got -- Lindsey's a, you know, bipartisan name.
KLOBUCHAR: A gender-neutral name.
GRAHAM: That's right, gender-neutral. So all I can say about this debate about Planned Parenthood, a lot of Americans that were pretty upset when they saw the videos of selling body parts of aborted children. Now, your dollars do not go to pay for abortion at Planned Parenthood facilities. We took the money for one year and gave it to other health care providers, and at the end of the year, that's over.
The money that goes to the states has Hyde protections. You can't use federal dollars under this proposal to pay for abortion except in case of rape, incest, or medical necessity. We can have this debate about whether we're pro-life or pro-choice, but those Hyde protections follow the money here and they've been in the law for a very long time.
This is not about abortion. It's not about pharmaceuticals. It's about Obamacare failing and what do we do about it. Lamar Alexander and Patty talked for weeks, and nobody gave a damn on the other side until we came along. All of a sudden, everybody's interested in bipartisan solutions to fix a system that's failing because I think we struck a nerve.
I think what we did, Bill, is we told people we're willing to make a trade-off. We'll keep the money in place -- as a Republican, we'll keep the taxes in place, but we're going to make sure somebody else gets that money other than the people under Obamacare, because they're not doing a good job with it. It's that simple.
As to a governor, what they do to your family, what they do to offering -- I'm 62. I probably don't need to buy maternity coverage. But I want to make sure it is there for people who need it. And I bet you this, that every state in which you live, your political leaders will offer that to you. If they don't, they will lose their job.
SANDERS: The issue of Planned Parenthood is really interesting. What's interesting about it is you hear from my Republican colleagues how they're really into choice, got to have the right choice, that's what freedom is about.
Well, 2.5 million women have made a choice, and the choice they have made, as you have made, is that they want to go to Planned Parenthood to get their health care. And generally speaking, most people think that Planned Parenthood does an excellent job.
And for rather crass political reasons, these guys are talking about this is just one year. They're right, one year in this bill. But every single piece of legislation that they have voted on has banned, defunded, defunded Planned Parenthood.
And when we continue to talk about compassion and choice, please do not forget, today, CBO reported their legislation would throw millions of people off the health insurance they currently have. Their legislation, according to the CBO report a few hours ago, would cut a trillion dollars from Medicaid, which provides health care for some of the most vulnerable men, women and children in this country.
TAPPER: I want to change the subject to Obamacare, Washington's inability...
GRAHAM: I thought that's what the debate was about.
TAPPER: Well, we were talking about -- she was talking a provision in Graham-Cassidy. So I want to switch it back to Obamacare. Washington's inability to take action on health care has created further instability in the insurance market today. The list of insurers downsizing or pulling out of Obamacare exchanges includes Humana, Aetna, Anthem. I want to bring in Courtney Shove from Memphis, Tennessee, where there is currently only one insurance provider available on the Obamacare exchange, and she has a question for Senator Klobuchar. Courtney?
QUESTION: Hi, good evening. Considering the scant marketplace options in my state, what would you do for health insurance if you were me? And note, I don't qualify for a government subsidy. And then kind of as a second part to that question, I know that the health care that congressmen and women receive is something that's very stellar. So what do you do to put yourself in the place of those that aren't as lucky as you are?
KLOBUCHAR: OK, let me start with that. When the Affordable Care Act passed, Senator Grassley, a Republican, put an amendment in there that said that members of Congress and our staffs wouldn't be on the federal health care plan anymore, that we would go on the exchanges. He said if we pass this law, we better live by this law. And that's where we are now. We're on the exchanges.
But I actually think that everyone should have access to that kind of health care. I agree with you. And Senator Claire McCaskill of Missouri has a bill that would just do that. That is an example of what we should be doing.
We need to, number one, make these immediate changes that I just discussed that are led by Republican Senator Alexander of Tennessee, Democrat Senator Patty Murray of Washington. They work together really well. We've got a bunch of ideas, the exact kind of things Senator McCain has asked us to do.
And then you add to that the other work that needs to be done, and that is creating a less expensive option for people to buy into, like yourself. One way to do it would be Senator McCaskill's idea. Another idea would be Senator Schatz. We have been working together on an option that you could buy into for Medicaid. That's a very efficiently run program. That's a bill that's going to come out in the next month or so.
And then Senator Murphy of Connecticut is also working on one with Medicare. So these are options. I'm just tired of hearing about this false choice that it is just -- the bill that's on the floor right now or one other bill.
And Senator Sanders and I have the same goals here, and that is to bring more affordable care to the people of this country, but we have to look at these other options. That is exactly what John McCain was talking about when he took to the floor that day. So let's get going and get those things passed.
TAPPER: Senator Cassidy?
CASSIDY: When they say they want a bill with fewer, that's more -- fewer benefits, that means your deductible is not $6,000. That means your deductible is $8,000.
Now, I'm a physician. I know. I can kind of read through that code. So what we hope, instead, I'll go back to the Graham-Cassidy -- now, you could do it, by the way, by doing single payer, Medicare for all, but let me talk a little bit about that. Senator Sanders says it's only a 2 percent overhead. Well, actually, the premiums are much higher, so 2 percent is a lot more. Regular insurance is a lot cheaper, so 15 percent is not as much less.
Secondly, there's so much fraud in Medicare. Go, Google Medicare fraud. It just tumbles out.
And, thirdly, they outsource. So the Department of Justice does their prosecution for fraud, they're suing to recover dollars, that's with the insurance company. It is false that it's 2 percent relative to 15 percent. It is much higher than 2 percent.
As to what you could do differently, if you give states the ability to innovate -- this is what Maine did. They set up what they call an invisible high-risk pool, where they put a little lump sum of dollars there, and when you got into the system, maybe you had a problem, you never knew it, but the insurance company got some assistance from this high-risk pool to lower your premiums and to lower everyone else's. That was a state solution that was squashed by Obamacare.
That's why I say, if you have the power or your state has the power, there will be innovation in this country. If not, not. By the way, the CBO report they continue to speak of, it specifically says that we think, CBO, that states will experiment and those that do well will be copied by others. We think we can do a lot better than the Affordable Care Act is doing right now.
TAPPER: Senator Sanders?
SANDERS: Well, let's reiterate what the CBO just said. Trillion dollars in cuts -- let me finish. Trillion dollars in cuts to Medicaid. Now, this is preliminary, because you keep changing the plan every day, and CBO has not had the time to do the kind of thorough study that the American people want us to do.
But there have been numerous, numerous studies out there that suggest that your plan will throw over 30 million people off of the health insurance they currently have. And let's once again, from a human point of view -- we've heard some of that discussion tonight -- understand what it means when people who are struggling with cancer, heart disease, diabetes suddenly get the word that that legislation passed and they lose the health insurance they have. That is their lifeline for literally staying alive.
Our job as a humane society is to do a couple of things. It's not to throw 30 million people off of health insurance. It's to do what every other major country on Earth does, guarantee health care to all people as a right. That's what we should be doing.
And second of all, what we have got to be doing is come up with short- term solutions. And I think Amy mentioned some of them. Why don't we make sure that in every state in this country there is a public option, a strong set of benefits, and an affordable course to compete with private insurance? I think that's a very, very good idea. Some want to do it through a Medicare option; some want to do it through a Medicare option. But people should have the option to go beyond the private insurance company in their own community. I think that would be a successful effort, and I would hope that you would support us on that.
CASSIDY: Let's get through the rhetoric. When they say we cut Medicaid by a trillion dollars, it means we move it over into a flexible block grant. The money is still there for the state to use. It is -- it is trying to scare you with things which essentially are not true to say that the money is not there.
Indeed, CBO says that some states will continue their Medicaid expansion program. That's what CBO says. It's just it's going to be under another rubric.
Let's talk about the 32 million people being kicked off. They say that because we end the individual mandate, the individual mandate in which the federal government tells you if you don't buy insurance, the long arm of the government is going to grab you and penalize you and shake you until you pay it. It turns out 58 percent of those who pay report on their income tax less than $50,000 in income. Republicans think that we should help those families, not penalize them.
And one more thing about that. That individual mandate, Jonathan Gruber is the architect of Obamacare. He wrote a study that was published in the New England Journal of Medicine. He said the individual mandate does not work, has no statistically significant effect upon getting folks insured. CBO still claims it. They admit it openly. But the data shows it doesn't. Know what does work? Getting a governor engaged. If a governor is engaged, she or he gets the people in their state enrolled. We get the governor engaged.
TAPPER: Senator Klobuchar?
KLOBUCHAR: Let me tell you what. Your own governor, Senator Cassidy, your own governor opposes this bill. I would add the Republican governor of Nevada said what this bill does is that it pits people with seniors, people against each other, people with mental illnesses against kids, because they're all trying to grab at a reduced pile of money. That's what this does.
The 50 Medicaid administrators in the country, the group that represents them has said that this cuts Medicaid severely, so -- and they can't administer it. So I want people to remember that. And there is a reason that the American Medical Association, the Alzheimer's Association, the Arthritis Association and the AARP -- that's just the A's, guys, OK? Those are just the ones beginning with A -- have come out against this bill.
These are independent groups that many of you trust because you may have the diseases, you may have reasons that you're working with those groups. So I ask you to look at what they've said about this bill and to -- this bill, we have a preliminary analysis on money. We don't even have a full analysis on how it impacts each state, something that Senator Susan Collins put out in a really good statement tonight that you should read about why she opposes the bill. Because she's seen many versions, doesn't know how it impacts her state, and that's why we have these analyses.
So, please, every piece of legislation, major one has gone through a thorough analysis. Look at Social Security privatization. That didn't pass, right? That had a CBO analysis. Medicare benefits for drugs, Medicare Part D, that had a CBO analysis. That passed.
That's what we need. And the reason that they aren't waiting to get that thorough analysis is because they know exactly what it will show, what every other repeal bill has showed, 10 million, 20 million, 30 million people kicked off insurance.
TAPPER: Thank you. Thank you, Senator We're going to take a quick break. We'll be right back with more from CNN's debate on health care in America. Stay with us.
BASH: Welcome back to CNN's debate night in America on the future of health care. We want to get to a brutal issue that is plaguing this country, and that is opioids. Drug overdoses, as you know, Senators, are currently the leading cause of death among Americans under 50, a number that is rising due to opioid addiction.
Republicans have proposed eliminating funding for Medicaid expansion, which helps pay for substance abuse treatment. I want to bring in Ashley Hurteau, a recovering heroin addict from New Hampshire, and she has a question for Senator Graham.
QUESTION: Senator Graham, in March 2015, I lost custody of my son and then three months later on June 11th, I woke up to find my husband dead next to me, lifeless from an overdose. My addiction was so strong and I was so sick that not even his death or losing our beautiful son were enough to get me to stop using. I ended up in jail for crimes that were fueled by my addiction and eventually got treatment through New Hampshire's drug court program, which was 100 percent covered by Medicaid expansion.
So my question to you is, if Medicaid expansion is cut, what protections would there be to ensure people suffering and dying from addiction would continue to have access to health insurance coverage for treatment?
GRAHAM: Really great question. Number one, congratulations on overcoming something that is just incredible. We're all one pill away. You don't know. You don't know until you take the first pill. It's not a character problem. It's just the body. You never know, if you get hurt and you take a pill. We've just got to deal with it.
But it's not Medicaid expansion that saved you. It was somebody who knew what they were doing who walked you through how to get better.
Let's talk about $20 trillion of debt. Let's talk about Medicaid. Medicaid, Medicare, Social Security, and interest on the debt is going to consume all the money you send in the future in taxes. Do you care about the debt? Do you care about her? Can we do both?
So here's what I would say about Medicaid. Medicaid is growing twice as fast as health care in other areas. I want to make sure that Medicaid is sustainable and affordable. What do we do to save a trillion dollars? We lower the inflation rate eight years from now. So your state in New Hampshire is going to have the money to design programs that would help your family. They're going to get money that a bureaucrat would have gotten in D.C., their share of the $1.2 trillion, and they can take 20 percent of that to spend on the Medicaid that they want to.
They can take money in the second block grant and go well beyond where Medicaid would let them go. They're going to have more money to help people like you. And here's what I bet. They'll do a better job than the guy running Obamacare or the gal running Obamacare. So if you want to save the country from going bankrupt, we need to get
Medicare on a sustainable footing. Charge me more. I can afford it. Younger people, you're going to have to wait a little bit longer to retire because we're living so much longer, but we'll give you decades to get there.
As to Medicaid, make it work. Instead of running to the emergency room when you have a headache or a cold under Medicaid, and sending all of us the bill, let that Medicaid patient into a family physician network where they can get treated. Better for them, better for you.
All I can say is, if you do nothing, if we just play like nothing's going to change unless somebody makes it change, Medicaid is unsustainable. We don't cut a dime out of Medicaid. We slow the growth. Eight years from now...
BASH: Senator, thank you.
GRAHAM: ... we'll give the state the flexibility they don't have today. Here is my bet. They'll do a better job with the money than the Obamacare guy or gal.
BASH: Senator, thank you.
SANDERS: Let me just say two things. All of us are and should be concerned about the deficit and the national debt we have. These guys, though, are going to support a tax proposal which over a 10-year period would repeal the estate tax and give $269 billion in tax breaks to the top 0.2 percent. That to me is not an effective way to deal with the deficit.
Second of all, let me read directly from the CBO report that came out today. And I would disagree with Senator Cassidy's interpretation. They are cutting a trillion dollars. All told, federal spending on Medicaid would be reduced by about a trillion dollars over the 2017- 2026 period under the legislation, and the program would cover millions fewer enrollees.
What that means, in terms of what you raised, the question you raise, we've got a real issue in New Hampshire. We've got one in Vermont. This is a national tragedy. When you cut back on Medicaid and you don't get money to the states for prevention and for treatment, there is nobody who doubts but that a lot more people are going to die and not get the care that they need.
So if we are concerned about the opioid epidemic, the idea of cutting a trillion dollars from Medicaid, which is one of the major sources of funding at a local level to deal with the opioid epidemic, is absolutely crazy.
TAPPER: Thank you, Senator. I want to stay on the issue of Medicaid, but not Medicaid expansion. Medicaid currently insures roughly one in five Americans, including lower income Americans and the disabled. Republicans have been advocating to reduce federal funding for the program which would force states to make some choices on their own about whom to cover, what services to provide, as we just discussed. I want to bring in Andraea LaVant from Maryland. She has a question for Senator Cassidy. Andraea?
CASSIDY: Senator Cassidy, if Medicaid funding gets shifted to the states and they cap and cut Medicaid, optional services like home- and community-based assistance, which currently allow me to live and thrive independently, will be first on the chopping block. How will you ensure that disabled Americans and seniors get the life essential care they need, especially when many states already have long wait lists and an increased need as Baby Boomers age?
CASSIDY: There is a section in our bill -- again, I started this as a physician. I am first a doctor. I just -- the young lady who just spoke, I used to treat patients in a women's prison and in a men's prison. I understand that scourge of opioid addiction. We preserve mental health parity. The resources will be there, because all the money -- sure, it's not from Medicaid. It's in the flexible block grant, but the money would be there if your state needs it.
As regards this, on page 100 of our bill, there's a section. It says ensuring continued access to home-based and community services. That is a whole section of our bill to ensure that stays.
Secondly, as regards this flexible block grant, some of that money can be used to whittle down waiting lists for those who have disabilities. But it isn't Washington telling your state to do it. It is the state deciding to because the state realizes it has a need with opioids or it realizes it has a back -- kind of backlog of folks going onto disability.
So we ensure that you continue to have access. We give the state the flexibility to cut down that waiting list. We think the state knows better than the federal government or a single payer how to take care of you.
TAPPER: Senator Klobuchar?
KLOBUCHAR: Thanks for your story. And I think you know you're not alone. Forty percent of people with disabilities get their insurance through Medicaid. That's a fact. That's how they get their health care. And what this bill does is cut Medicaid, and that's why all the major disability groups are opposed to this bill.
It is a pre-existing condition. I remember on Fourth of July walking in parades on the Iron Range and moms would come out with their kids. I specifically remember one with Down syndrome. And the mom said, "I love my little boy here, but this is a pre-existing condition. He is a pre-existing condition, so help him."
Over 50 percent of Americans have pre-existing conditions. There are two twins out there from Minnesota -- not the Minnesota Twins baseball team, as exciting -- but two twins, the Wiltraut (ph) twins. They're 14 years old. And they play on their softball team. And one is a pitcher, and one is a catcher. One has diabetes; the other one doesn't. But guess what? Does it matter which one has diabetes and which one
doesn't, the pitcher or the catcher? What really matters with these identical twins -- I see them right there -- is that they both should be able to be healthy and have affordable insurance, not be hurt because one has a pre-existing condition.
TAPPER: We'll be right back with more from CNN's debate on health care in America. Stay with us.
BASH: Welcome back. Senators, you've heard from people whose lives will directly be impacted by your actions. And we now have time for closing statements. You each get one minute, and we're going to start with Senator Sanders.
SANDERS: Well, let me thank both of you and CNN for hosting this debate. We're a great nation. We have led the world in so many ways for so many years, but there's something wrong today.
We are looking at legislation supported by the majority party which is opposed by every major health care organization in the country. It's opposed by the doctors in the AMA. It's opposed by the hospitals in the American Hospital Association. It's opposed by the American Cancer Society. It's opposed by virtually every organization concerned about the well-being of their patients. So our job right now short term is to defeat this proposal, and with a little bit of luck, that's what we'll do.
But that is not good enough. Our job now is to come together to craft serious short-term solutions that addresses the real problems that exist, high deductibles, high copayments, high premiums, high cost of prescription drugs. But longer term, we have got to come together and finally conclude that as a nation we cannot be the only nation, major nation on Earth not to see health care as a right.
Thank you very much.
TAPPER: Senator Graham?
GRAHAM: We end where we began. Obamacare is failing, and I don't see a solution other than just throwing more money at insurance companies. I'm not going to do that. Do you get that? I'm not going to do it. Forty-five percent of the counties in this country have one provider. Forty-five counties have no choice. It gets worse over time, not better.
Here is the idea. Take the same amount of money that you're going to spend on a bureaucrat that never knows your name and give it to the people you can vote for in your state with guardrails, focusing on you as an individual and your state as a unique place, and I bet you a dollar you'll get better outcomes because it worked with welfare reform. And I bet you this: My good friend, Bernie, Obamacare is a
placeholder for Berniecare. Berniecare is socialism full-born. He's a nice man, but if you want Medicare for all, you're going to wind up with Medicare for nobody. You'll have a card without a real choice. Don't consolidate all your hopes and dreams for your family into the arms of the federal government, because it's not going to work.
I'd just end with this. We're going to go one of two ways in this country. We're going to create a future for our children that they can actually afford. We're going to deal with a $20 trillion debt or we're going to pass it on to somebody else. And driving the debt is Medicare, Medicaid, Social Security, and interest on the debt. Somebody needs to deal with this. I choose to be that somebody.
Medicaid is a program we're saving, but it's highly inefficient, and we need to match it up with a sustainable growth rate, not cut it, and give people flexibility to run it better than they have today.
So all I can tell you about this fight, it's just beginning. And to my friends on the other side, every group you cited told you that Obamacare would work. Every insurance company is against this bill, and if I were them, I'd be against it, too, because we take money from them and we give it to the state government to help you.
And all these other organizations, you don't think they'll have a voice in your state? You don't think somebody in your state will listen to them? This is not about -- this is not about caring. This is about changing things while we still have a chance, because 10 years from now, if we don't fix it today, it's going to collapse, and God help us all.
TAPPER: Thank you, Senator. Senator Klobuchar?
KLOBUCHAR: So let me end where I began, and that -- that this is about people. This is about the retiree in Minnesota who actually saves her insulin injector -- she has diabetes -- just to get those extra drops because the price has skyrocketed. This is about the farmer with heart disease. It's about the teacher with breast cancer.
And the bill -- and I think you can tell we like each other up here, right -- but this bill doesn't help those people. It makes things worse. It jacks up the premiums. It kicks millions of people off of health care. And for me, one of my life's work, it doesn't do anything about those skyrocketing prices with the prescription drugs.
So I am asking people to join me as we go forward. And how we go forward -- and we can do something quickly -- to fix the Affordable Care Act, to do something about the issues that were raised about those premiums, and to join the work that's been going on now for weeks with the two senators who lead that committee across the aisle -- yes, that's a word -- across the aisle to make some fixes. And I think these three senators up here will join me, too, but I ask all of you to do that, as well, and put the politics aside and the people first. Thank you. TAPPER: Senator Cassidy?
CASSIDY: It has been such a privilege to be with you all, and thank you for having me. There are several things we agree on tonight. We agree we have to do something about pharmaceutical costs. We agree that there should be access. We actually agree that Obamacare is broken because there's advocates for single-payer health care.
What we disagree on is where the power should be. When I was a doctor, I learned, if the patient had the power, if you had the power, the system lined up to serve you. If the state has the power, it can be more responsive to those who live in the state. If it is a federal bureaucrat, it's a formula.
And so if we have a waiting list for those with disability, I'm sorry, you don't make the formula. If you need more money for opioid addiction, I'm sorry, you don't meet the formula. Under our plan, these dollars go to the state in a flexible block grant. And if there's a waiting list, you use it for the waiting list. If there's an opioid crisis, you use it for the opioid crisis. Ultimately, you use it for the patient, because you have the power.
I will end where I started. If it is a choice between you and the federal government, our plan chooses you. If you are for single payer, you choose otherwise. Thank you.
TAPPER: Thank you, Senator.
BASH: Thank you, Senator Cassidy. And thank you, Senator Cassidy, Senator Graham, Senator Sanders, and Senator Klobuchar, and also thank you to our fantastic studio audience for being here tonight.
TAPPER: "CNN Tonight" starts right now. Thanks for watching.