The recess. They are not good for controversial legislation. Collins, probably the most moderate one to get on told that wasas like him she was enthusiastic that she was opposing it. Senators are pretty pessimistic about it. Right now it is not doing great. Mitch mcconnell does want to bring it back next week. He is still trying to tweak the legislation of bring senators on board. Once they come back every to for the august recess. Written,et the bill scored, everybody on board and try to get 50 votes. That seemed like a high task. Host will there be in august recess . Guest some republicans are calling for the recess to be canceled in part because of this. It is too early to say right now. It is late july and the feeling they are making progress. Perhaps he could be delayed one week. That august recess is somewhat sacred to washington and folks do like to get home. But if they have the option of making progress on this, setting seven your Campaign Pledge to repeal the Affordable Care act i , could see them sticking around longer. Host he traveled back on the kentucky. The Associated Press reported on his visit. If my side is unable to agree on an adequate replacement, then some kind of action with regard the private Health Insurance market must occur. That is senator Mitch Mcconnell. Speaking at the rotary Club Luncheon southern kentucky. He made the comment after replacing obamas law, no action is not an alternative, he said. Weve got the Insurance Markets imploding all over the country. Including in this state. Guest republicans now are working one party only on this bill. Democrats have said there was no way the are getting up or to repeal president obamas legacy legislation. They have been working one party only. This idea of a bipartisan bill has been a fantasy for a little while. There have been a handful of republicans and democrats who said they would like to do it, but it has not been a political possibility at all. Mitch mcconnell made in syria same comment after a white house meeting with the president. I should say two weeks ago. I thought the comment in kentucky was interesting because it is not just a warning to the conservatives and his party to get on board. They might fail here. For the majority leader to open the door to failure, is a pretty big deal. It is sending a message not only to ted cruz and mike lee, who oppose the current version of the senate bill, for he is sending a message to everyone that there will be a bill this year. The obamacare markets are in trouble right now. Everybody agrees they need some help. The insurers say there is too much uncertainty right now. They need some assurance that there will be a law in effect next year. They will be funding to backup all the things they are liable for. I think a truly bipartisan bill to repair the Affordable Care act is a long way off. I do not think we will get to that point this year. But some small patchwork fixes are possibility. Host so this response from senator Chuck Schumer says with the issues with exchanges are flexible and open the door to Bipartisan Solutions to improve our health care system. As we have said time and time again, said senator schumer, democrats are eager to work republicans to stabilize markets and approve the law. At the top of the list should be ensuring costsharing payments that are permanent and will protect health care for millions. Host guest he would love to have bipartisan negotiations. Democrats have not been involved in these republican talks. This is both sides playing politics right now. The take away i got from sconnell mcconnell comments was this idea that even President Trump has this view of lets not let obamacare collapse is not going to be an option. If the law does collapse as republican say that would look , like insurers not offering plans next year. Republicans, at least mcconnell in the comment made it sound like he doesnt want republicans to be liable for that. If they had come in in january when they had taken over washington and said we will this law collapse, that wouldve been one thing. Now republicans have an talking about health care for six or seven months. They cannot say it is all the democratss fault. Host the senate is returning this week. Health care will be issue number one that we will be focusing on. With coverage on cspan2. Richard is joining us from bethlehem, connecticut. Caller good morning. I have a simple question for your guest. Which you rather be healthy or have to get healthy . Host and you ask the question why . Caller because she is covering congress with 535 men and women who are working on a path to get healthy built rather than be healthy bill. Host thank you, richard. Guest there has been a lot of focus on when you are healthy, your insurance is likely to be very cheap. You are not expensive for the Insurance Companies to cover. Is for folks who have longterm Health Care Problems that are difficult to cover. Its an issue either republicans or democrats have been able to solve. What we want to do about these folks . A patient in iowa cost 1 million a month to ensure and this patient is just skewing the Iowa Health Care market. Insurers do not want to be there because there is this 1 million a month patient increasing everybodys premiums. You can argue that not everybody should carry that cost, but what do we do about that patient . Do we as a country state we are not going to cover your health care . I think society has decided we are not going to do that. But in a policy sense, neither republicans nor democrats have come up with a way to make sure that patient has access to health care, but everybody else can afford to premiums. It is a problem that both parties do not have an answer to. Host she began covering business for the Washington Times and no one health care beat. Her work available at politico. Com. John from beaverton, oregon. Good morning. Caller good morning. Jennifer, youre a graduate from a fine jesuit institution. I wanted to point out i am a , democrat and my uncle is a republican. He works in Southern Illinois on a rural health center. I work in portland, oregon. We can talk about health care. Hey that is bipartisan. , what is keeping the senate and the house, and also the catholic bishops have four times come out of the Republican House and senate, and the cha, the ama and other associations that deal with health care have come out against this. Host thank you. We will get a response. Guest the caller raises a good point. Most Major Health Care organizations have come against the republican bill. Many supported the obamacare Affordable Care act, including the American Medical Association and the house riddled groups. They do not want to see folks uninsured. Hospitals have a huge interest in seeing their patients covered. That is a financial interest. They do not want to have to cover patients who do not have insurance. Physicians oppose the republican bills now and they supported the Affordable Care act. As far as the question on the partisan nature of the conversations, i think the Affordable Care acts passage drove both parties into the respective camps. There were no middle ground. There was no republican that supported the Affordable Care act and both parties were able to stay a lot of their ground in that. So if you are a republican for the last seven years, you have to oppose obama care. If you did not, you are probably not in washington now. If you were a democrat, you saw all these attacks on the Affordable Care act and said, we have been fighting for this and fighting for universal coverage for 50 something years. We will stick with it. I think sense president Obama Left Office they become more emboldened and ensuring that legacy will not go away and that is driven a lot of this. Host let me go through a couple of quick tweets. Vivian says this gop bill is a tax cut bill for which donors. Rich rich donors. Guest there was a big tax on high income earners in the Affordable Care act, which helped pay for the bill. Republicans want to eliminate that tax. There has been a criticism they are really repealing that tax and driving up costs for low income folks. Senator Susan Collins and senator bob corker and moderates in the senate have called to keep that tax in obamacare to help lowincome people, whether it is a Premium Reduction Program or Something Like that. That is an idea that connell has mcconnell has taken into consideration. We can see that change in the bill if it gets released and revised in july. I think one of the concerns that republicans are trying to come up with money to further reduce premiums. Also, they are cognizant of that criticism that the person on twitter put out there. This is viewed as a bill that increases cost for low income folks and eliminate taxes for rich folks. It is not hard to see how that will play out in the 2018 election and beyond. Host which is what steve is tweeting about. The house could fall to democrats even with gerrymandering in 2018 partly on health care. Guest i think you will be a big issue in 2018 the matter what happens with the legislation. The house already voted on the bill so they are on record in support or opposition to this. We can discuss whether the house is actually in play because of things like gerrymandering. It will definitely be a huge issue and we will see this in 2018. So far this is the only thing washington has been working on, so there isnt much more to talk about at this point. Host we welcome our listeners on cspan radio and sirius xm. Christine, new york, democrat line. Good morning. Caller good morning. The arguments they are making in favor of the repeal bill are not they are pretty ridiculous, the host talking about the free market and competition in the Insurance Market and the insurers need more competition. It does not make sense. If there is only one insurer in that state, the chemical profit. And howmarket failure is competition going to make a better situation in those states it even one insurer cannot make a profit . Host thank you. Guest the issue there, republicans are making an argument this is a free Market Solution and if they eliminate some of obamacare regulations, insurers will come back to the market and start trying to offer policies again. There are several states where insurers are not offering plans because they either feel like it is not a good financial opportunity or whatever the reason is. There are states where there are only one Insurance Company so there are no options. This is the argument republicans are making, that the counterargument is if you eliminate the regulations that ensures do not like and they will be able to cherry pick again. If you have been sick or a preexisting condition, it will be harder to get coverage. Host howard, good morning. Howard, good morning. Go ahead. Caller yes jennifer . , guest yes. Caller i think i can solve the Health Care Problem with two simple statements. Give us the same health care that our politicians have at the price they pay for it. Guest yep, this is a really common criticism i hear. A lot of folks like this idea of having the same coverage as a member of congress. Members of congress are under the Affordable Care act for the most part unless they found another insurance through a spouse. But under the Affordable Care act, they were kicked out of the plan the federal employees were get, and they had to go on obamacare exchanges. So most get coverage through the exchange in d. C. And some chose to go back on their home state exchange so they can save your on the same plane as her voters. I have asked a lot of numbers of congress what they think of their plan. Predictably, it falls under party lines. But they see the same price tag as you are i would under the exchange here in members of congress get some financial help for their plan because the are federal employees. If they buy through the exchange here in washington, d. C. , the federal government does pay a portion of their bill as their employer. Most major employers do pay a portion of your Health Care Plan and that is the case here. Host lets go to georgia. Kenny on the independent line. Caller right. If the congress is truly representative of the country, then why does the gop shoot for 50, plus the Vice President . That is like the skin of your teeth, man. Half the country is not going to like it, but that is how small they are willing to go and they will consider that a win. That is my comment. Guest that is a good points. Republicans are on the edge in the senate. There are 52 republicans. Mitch mcconnell needs 50 per this to pass. At the beginning of the year they thought they would have 52. It seems like this is going to be a 5050 about if republicans are even successful in getting to that point. The Vice President would have to come in and break the tie as , president of the senate. There is a bit of politics behind the callers question. The Affordable Care act was extremely divisive. Was a poll of the Kaiser Family foundation does every month on the a formal care act. Thats why questions are favorable and unfavorable opinions. Those numbers were stuck in concrete for seven years. If the law was slightly more unfavorable than favorable, that really did not change until the repeal effort became a possibility. At that point, it became slightly more favorable. I think that is weighing on every republican is considering voting for this will that whatever they do here is going to be remembered in the short term by their voters and in the longterm. It will be the skin of your teeth vote. Host i will ask you about the process of this week that we we got in maxine from north carolina. Republican line. Caller good morning. I wanted to ask about the Medicaid Expansion. North carolina did not expand their Medicaid Program and my sister is a director of patient management at shelby hospital and most of the doctors around here do not take medicaid, so the patients end up in the emergency room anyway. Why is there such a fight over the expansion of medicaid when i do not know they have done a study or what, but most doctors refuse to take medicaid and etiquette patients in the end up in the emergency room, which obamacare was supposed to take care of that . Guest this is a huge problem, as well. The Supreme Court in 2012 a desk eight states the option of expanding medicaid. 2012e Supreme Court in gave states the option of expanding medicaid. Obamacare was supposed to expand medicaid all over the country and it became an option. Every governor had to decide whether to expand medicaid and embrace the Affordable Care act or do i not . State like dr. Lannett but not expand medicaid, there are folks in a gap. They do not qualify for medicaid, benefits of the Affordable Care act, and they are really stuck in a position where nothing grilli is provided for them under this law that was supposed to help everybody. It was one of the big failures of the Affordable Care act once the Supreme Court ruled. I think in the republican bill, they are trying to repair that. They would let more folks qualify for subsidies, but the issue with physicians not accepting medicaid has been a longstanding problem predating the Affordable Care act and it will probably postdate this bill. Some physicians argue that medicaid does not reimburse high enough for them to make it financially viable to take medicaid patients. In some parts of the country that is particularly true. Host theres this from roger in regards to Insurance Companies, didnt the Affordable Care act ensure that Insurance Companies have a 15 profit margin . Guest no, it did not. There is a requirement that insurers have to spend 85 of what they take in in premiums on health care. If it is more less than that, the patient we get a rebate. That might be what he is talking about come over that 15 is for administrative costs in addition to profit, not just profit. Host brenda is next, st. Louis, missouri. Democrat line. Caller good morning, jennifer. Guest good morning. Caller my question is i read in the new tax bill they are trying to pass for health care that the senate, congress and their employees are excluded from having the same insurance we would have. Guest that was an issue in the house bill. The house did not it would have essentially undone what obamacare did, which made members of congress get the same insurance as us. The senate bill would keep that, would keep members of congress in obamacare plans. Whether that changes, that is to be determined but members of congress would still be on the plans and exchanges, just like a lot of americans. Host lombardo from salt lake city, independent line, good morning. Caller thanks for taking my call. I am interested in finding out if it will be possible to have the insurance i mean the government create an insurance arm for those that are uninsurable. If the political environment allowed it. Guest yeah, this has come up several times in the debate over health care. This would be Something Like a public option which essentially the government would provide andrance to folks directly this has never taken off because conservatives and independents do not like the idea of government in health care, which is a little ironic because medicare is essentially a Government Run Health Care program an extremely popular. No politician is going to ever suggest taking away medicare. It is going to become a favorite of liberals, progressives, some kind of public option, medicare for all or expanding it under a 65 years old. I do not see that becoming a political viability soon. Host in terms of what happens next, you mentioned senator Susan Collins and ted cruz and rand paul very critical of the legislation. So where does that put the bill . What is the process this week and potentially next week . Guest Mitch Mcconnell now is trying to get to the 50 votes. He has stated that side if i go after the moderates like Susan Collins, make it more in the middle, or do i go after folks like ted cruz and rand paul and mike lee and make more can evident . Make it more conservative . Four senators it off of that and he can only lose two. He has added Opioid Funding which is something the moderates want. He asked the Congressional Budget Office discord policies that the conservatives like, which would allow Insurance Companies offer plans to offer noncompliant plans. This would provide cheaper coverage, less thorough coverage to folks. And whether mcconnell can find that magic bill that gets the 50 votes its still to be determined. As of now, i am skeptical that exists because too many folks that have too many issues with this bill. Host and complicating this, senator dean heller, up for reelection and he faced criticism within his own party from a protrump Political Action committee. Guest he is probably the most vulnerable republican senator in 2018. He came after the senate bill was passed and said i cannot do this. His governor is a big fan of the Medicaid Expansion and doesnt want to see it undone. He really attached himself to the governor and said if the governor does not like this medicaid rollback i cannot get , behind it either. It hurts people in my home state. He will be a hard vote to get on board, making it more difficult for the super pac alliance with the white house came out with ads against them almost immediately after the press conference. Those ads have been retracted and mcconnell is trying to get him back in the fold and get his vote back in the mix. I think heller will be hard person to get on board. Host rob portman of ohio, you mentioned the opioid epidemic. He has been laboring a little bit. Guest he is worried a lot of at the opioid problem and Medicaid Expansion. His state did expand medicaid under john kasich and embraced the Affordable Care act to expand medicaid. Rob portman has led a group of republicans from Medicaid Expansion states to stop the Medicaid Expansion rollback or slow it down to the pointer it is further into the future. He will be a hard vote to get to. Host