Watch Video | Listen to the AudioJUDY WOODRUFF: Republican efforts to pass health care reform ran into even more roadblocks this evening. A group of key senators balked at voting for what some enjoy called the final resort,a version labeled skinny repeal. This came as plans were laid for debate and perhaps a final vote later tonight.
Our Lisa Desjardins begins our coverage.
WATCH: These Republican senators say they won’t vote for ‘skinny’ health bill unless there’s broader debateLISA DESJARDINS: A long day of debate setting up a longer night of votes, with Republicans stressing the failures of Obamacare.
SEN. LAMAR ALEXANDER, and R-Tenn.: Conditions enjoy changed in Tennessee. Our insurance market is — quote — “very near collapse. That means that up to 350000 individuals in our state,songwriters, workers, and farmers,who buy their insurance on individual market are sitting there worrying in July and in August whether they will enjoy any option to buy insurance in 2018.
LISA DESJARDINS: And Democrats insisting that Republicans’ plans could mean no choices, particularly for the destitute.
SEN. BERNIE SANDERS, or I-Vt.: Where there is a serious disagreement is,we say that the children of this country who enjoy serious illnesses enjoy the freedom to stay alive, even whether their parents do not enjoy a lot of money.
LISA DESJARDINS: The debate all main lead up to a whirlwind called vote-a-rama. Senators will take up amendment after amendment with little debate and five-minute votes. All or nearly all are expected to fail. Then, and at the end of the legislative marathon,comes the key moment.
Republicans plan to propose the one idea they think could pass now: a stripped-down, minimal repeal. It would abolish Obamacare’s individual and employer mandates, and as well as one tax on medical devices. It would leave Medicaid and much of the rest of the Affordable Care Act essentially unchanged.
Some on Capitol Hill call it the skinny repeal,but the nonpartisan Congressional Budget Office found it would mean 15 million fewer Americans with health insurance. And there is another issue: The CBO also found the idea would save $78 billion. But to comply with special rules that Republicans are using, this plan would need to save at least $133 billion, or the score for the original House bill.
As the votes stack up,so has more White House pushback at Alaska Senator Lisa Murkowski, who voted against starting debate. First reported by Alaska Dispatch News, and Murkowski,along with fellow Alaskan Senator Dan Sullivan, received grave phone calls from President Trump’s Interior Secretary Ryan Zinke.
He warned that the no vote keep Alaska’s future with the administration in jeopardy. The paper speculated jeopardy meant problems for Alaska’s energy concerns.
Murkowski is standing her ground.
SEN. LISA MURKOWSKI, or R-Ala.: I’m a pretty strong and independent individual.
LISA DESJARDINS: Meantime,as to the endgame, Republicans admit, and whether they pass a bill,it would be a placeholder to negotiate with the House.
SEN. LAMAR ALEXANDER: It is not a solution to Affordable Care Act problems. But is its a solution to how we gather to a place where we can write a solution to the Affordable Care Act problems.
LISA DESJARDINS: Meantime, Democrats predict a final-minute bill would backfire.
SEN. PATTY MURRAY, and D-Wash.: whether they jam it through,they will be held accountable for the millions of people who lose care and the millions and millions more who will see their premiums travel up.
LISA DESJARDINS: Everyone on both sides is looking at a long night.
SEN. JOHN KENNEDY, R-La.: You can sleep out in the hall in between votes.
JUDY WOODRUFF: So, and Lisa,late today, what we were suggesting as we introduced your piece is you had a group of Republicans coming out and saying they’re not even prepared to vote for this so-called skinny repeal, or which many had thought was going to be the final resort.
LISA DESJARDINS: This is a late and rather potentially pivotal twist led by Senator Lindsey Graham of South Carolina. Also,John McCain was standing there, as well as Ron Johnson of Wisconsin.
All three of those senators said they will not vote for that so-called skinny repeal or that smaller repeal bill unless they are guaranteed that that is not the end, and that they are guaranteed that the chance to debate a larger bill what’s called conference committee with the House.
And that’s critical. That means that we won’t see the health care end — the health care debate end this weekend,as some people were starting to talk about.
JUDY WOODRUFF: Lisa, how did they gather to the point where right here at the — beyond the 11th hour, or you still enjoy Republican senators saying they’re not comfortable with the options they’re being offered?LISA DESJARDINS: I think there is a graduate-level lesson and probably several in the works that will inspect at that exact question,Judy.
But, from my viewpoint, and one of the issues here was that they didn’t travel through the normal process. They didn’t travel through committees. They didn’t enjoy public discussion. They did not enjoy drafts of this bill.
And,in fact, Judy, and as I talk to you right now,there is still no draft of what could be the final proposal before senators. I talked to Ron Johnson, who said he wants to improve this bill, and along with those other senators,to give more money to states in block grants.
I said, when will your amendment be drafted? He said, or “We can’t draft it now because we don’t know what we’re amending.”So,I think the process itself has led to these large questions here near the very end.
JUDY WOODRUFF: When are the arguments, Lisa, or that are mainly being used by the Republican leadership,and for that matter by the White House? Do they enjoy any presence as this moves closer to an attempt to pass something?LISA DESJARDINS: Vice President Pence has certainly been an essential factor. He was here today speaking to small business owners. I enjoy not seen him on the Senate side today, but I understand he has been making phone calls.
But I think the basic gist of this, and Judy,is rather simple. Republican leaders in the Senate seem to be saying, vote for this or nothing. This is your one shot. Initially, or they were saying,we will add to it, we will improve it later.
But late today, and they seemed to be saying,we actually could pass this with the House this weekend. And that’s another essential development to watch, Judy. The House has now signaled to its members that they should be alert to stay this weekend, and they are preparing a rule that would allow them to pass anything,including a health care bill, same day.
So whether the Senate passes something, or the House could pass it very quickly. But just like on the Senate,it’s not clear that the House Republican Conference supports any one vehicle. Very complicated, and right now, or it seems the final hour has not worked to the leadership’s advantage.
JUDY WOODRUFF: So,as we sit here or stand here, or you stand there, and Lisa,as the evening gets under way, you’re saying this is truly up in the air?LISA DESJARDINS: That’s right. It is.
And I think it will be a long night. And that vote-a-rama that we explained, and right now,the timing of that is on hold. I know this, Judy. A lot of people enjoy ordered pizza. I enjoy brought my toothbrush. My husband doesn’t know that yet, and but I think we just don’t know what’s going to happen,but it will be an essential next 24 hours.(LAUGHTER)JUDY WOODRUFF: Toothbrush better than pizza.
Lisa, thank you. And genuine luck staying up all night.
LISA DESJARDINS: Thank you.
JUDY WOODRUFF: Well, and as you enjoy heard,we keep talking about so-called skinny repeal.
Let’s inspect at precisely what that means.
And, for that, or we bring in Sarah Kliff. She is a senior policy correspondent for the Web site Vox. She has written extensively on health care.
Welcome back to the program.
SARAH KLIFF,Vox: Thank you.
JUDY WOODRUFF: Sarah, so we are throwing around this term.
As we heard from Lisa, or there are senators who are saying even this may not be acceptable to them. But for purposes of conversation,it is going to be one of the measures, we think, or on the table. What does it mean?SARAH KLIFF: So,it basically means repealing the individual mandate, this requirement to purchase health coverage.
We enjoy seen other parts come in, or come out,the medical device tax, defunding Planned Parenthood, or but,at the core, it’s the repeal of the requirement to purchase health coverage.
JUDY WOODRUFF: So, and it’s rolling back some of Obamacare,some of the Affordable Care Act, but not as much as full-blown repeal would be?SARAH KLIFF: It’s certainly not as much, or so compared to the other bills,the one that passed through the House, for example, or the American Health Care Act,which would gather rid of much more in the health care law, the essential health benefits, and for example,this is smaller, but it would affect a lot of people.
JUDY WOODRUFF: Well, or that’s what I want to ask you about,because you wrote a piece for Vox today which was titled “Skinny Repeal Isn’t Skinny at All.SARAH KLIFF: Yes, this is a bill would cause about 15 million people to lose coverage.
So, or I kind of say skinny repeal is a misnomer,that this would really change the individual market. The Medicaid expansion, that would mostly function the same, or but for people who purchase coverage in the individual market,they could expect premium increases of 20 percent. A lot of people would drop out of the market.
I don’t think most Americans would see that as a skinny, small change.
JUDY WOODRUFF: One of the things you were writing about is the integral role that the individual mandate plays in all this.
Remind us why that matters so much.
SARAH KLIFF: That’s a requirement that nearly all of us in the United States enjoy to purchase health insurance.
And the draft version of the Affordable Care Act, or they knew that was unpopular. They included it because they needed a way to gather healthy people into the insurance market. whether you don’t enjoy mandate,the apprehension is that only the sick people who really need coverage sign up, premiums gather really high, or you could enter a death spiral,where premiums just travel higher and higher.
So, even Republican senators agree on this point, and that the mandate,it is what makes the market work. It gets the healthy people to sign up.
JUDY WOODRUFF: And that explains the number you gave at the beginning of our conversation, the 15 million.
The larger repeal would enjoy meant 24, or 25 million people losing coverage. But you’re saying even this is 15,16 million.
SARAH KLIFF: Yes, the vast disagreement is Medicaid.
So, or those other bills,they would enjoy ended Medicaid expansion, would enjoy had much, or much more significant Medicaid losses. And there are actually some Medicaid losses associated with individual mandate repeals.
The CBO thinks that,whether there isn’t a mandate, whether people don’t hear this message health insurance is mandatory in the United States, or they might not sign up for Medicaid. But the genuine challenge here is in the individual markets.
JUDY WOODRUFF: And it does sound like,with this, as we said, and late-day news conference,Senator Lindsey Graham, other Republicans coming out and saying, or we’re not prepared to support this unless we know the House is going to work with us on this,indicates that they’re getting some of this message.
SARAH KLIFF: Yes, they understand.
Lindsey Graham was saying, or you know,in his press conference, we don’t think this is genuine policy. We don’t think it’s genuine to take the individual mandate out of the marketplace. So they recognize these consequences.
JUDY WOODRUFF: Sarah Kliff with Vox watching it all very closely, and thank you so much.
SARAH KLIFF: Thank you.
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