Transcripts For KQED Washington Week 20170624

Of premiums. We also need to negotiate over whats good, whats bad and what we can get in the bill to make it better. Robert President Trump remains optimistic, there is room for compromise. President trump we will hopefully get something done and it will be something with heart and very meaningful. Robert we look at the real costs and benefits of this latest prescription. Plus, the blame game, how this weeks special election in georgia is reverberating on capitol hill, raising questions about the leadership of the Democratic Party. We explore it all with susan davis of npr, sarah kliff of vox, Philip Rucker of the washington post, and Kelly Odonnell of nbc news. Celebrating 50 years, this is Washington Week. Funding is provided by their leadership is instinctive. They understand the challenges of today. And research the technologies of tomorrow. Some call them veterans. We call them part of our team. Additional funding is provided by newmans own foundation, donating all profits from newmans own Food Products to charity and nourishing the common good. Koo and Patricia Yuen. Through the yuen foundation, committed to bridging cultural differences in our communities. The corporation for public broadcasting, and by contributions to your pbs station from viewers like you. Thank you. Once again, live from washington, moderator, robert costa. Robert good evening. The Senate Republicans plan to dismantle the Affordable Care act continues to get pushed back, not just from democrats but from fellow republicans. Senate Majority Leader Mitch Mcconnell stands by the bill, saying it will repeal most of president obamas Signature Healthcare law, reduce governmentpaid healthcare and return power to states. Democrats insist the g. O. P. Plan will increase premiums and take healthcare away from millions of elderly and lowincome americans. Complicating matters for mcconnell today are five republican senators ted cruz, ron johnson, dean heller, mike lee and rand paul four of whom immediately rejected the bill saying it does not go far enough to gut obamacare. We can do better than this and my hope is not to defeat the bill but to make the bill better. Robert moderate dean heller of nevada was the latest to speak out against the senate bill. At this point it seems no one seems to love it but as republican senator pat roberts of kansas said, the senate bill was not the best possible bill but the best bill possible. Were looking at a real challenge for senate Majority Leader Mitch Mcconnell. Whats he going to do, kelly, to close it . Kelly hes going to work all weekend and so will all the people on the team. The phone lines will be burning up. The personal meetings will be happening and theyre looking for ways to find some things that can induce some of these members. One to be watching for, opioid. Opioid money is an attractive inducement to some of the members. Im thinking of rob portman of ohio who could be brought along. Shelly morcappitto of. A lowkey donald trump, where the president is helping but a bit under the radar, letting Mitch Mcconnell run this but its high stakes. I havent talked to anyone who will say it will pass but theyre going to work like heck to get there and they think that if they dont do this, its a major failure for the party. The house did act, however their process was, however messy and unpopular their bill is, Senate Republicans feel immense pressure that they have to do something and weve got a recess coming when theyll have some judgment at home. But if they could get it done, they can then move on to some other things that might be more popular to build up momentum for those that are up for reelection and may be vulnerable. Mitch mcconnell has going for him what House Speaker paul ryan had going for him is that every single republican in his caucus campaigned and won their elections saying they were going to do this and to senator roberts point, they dont love this bill. There is something in this bill for every republican to have a problem with but this is the repeal and replace bill that they have and i think the way you saw the house bill come together, there is just tremendous pressure not only from the partys base but as you said, i think we underestimate how much the white house wants a bill because they have had such a light touch in the policy shaping of it and the message that i hear from Senate Republicans as the white house is telling them, we just want a bill. And i dont think we can underestimate the power of the presidency putting the pressure on his own party in power in congress to deliver on the single Unifying Campaign promise of the Republican Party for the better part of the last decade. Robert you said it was low key on the white houses end. Phil, youre the bureau chief for the post. Whats the story with the president s involvement with the healthcare bill. At one point he said the bill was mean, a word he used in a private meeting. But now he was making a call, i was told, on thursday, to senator cruz, trying to get him to come along. Is there an intense effort to get it passed . Philip one thing, the president s impatient. This is not a man known to want to wait for things. Hes impatient about the legislative process. He wants a victory. Hes been in office five months and theres no signature legislation yet, this could be it but hes taking a back seat to Mitch Mcconnell, he knows he wont be effective persuading more moderate senators to come on board but hes working with members quietly on the phone to try to make a deal happen. He doesnt care so much about the details of the bill but just wants something to sign but sean spicer today, the press secretary, said at the white house, that the president likes the Senate Version better than the house version. He thought the house version was too mean on poor people. Robert lets talk about some of the specifics here. There are challenges from the senator and from the right. The Senate Version of this bill eliminates the individual insurance mandate and obamacare taxes on the wealthy, slashes federal funds for medicare and phases out the expansion of medicaid. It allows states to waive a federal mandate to essential Health Benefits raising questions about coverage or preexisting conditions. It shrinks obamacare subsidies to pay for premiums. What remains unchanged, young people could stay on their parents plan until age 26. Sarah, its great to have you here. Youre an expert on healthcare. What everyones wondering is, if this Senate Bill Passes and becomes law, what does it mean for people who rely on the Affordable Care act . Sarah it means a lot of changes, it would overhaul the Way Healthcare works for a group of 20 million people, generally people who dont get Health Insurance through work but get it through medicaid or the individual market. Folks on medicaid would probably notice the biggest change with Medicaid Expansion phasing out starting in 2021. By 2024, that program would be gone and that covers an estimated about 12million orso lowincome americans, people earning less than 15,000. People in the rest of the Medicaid Program would notice very big changes, as well. One of the big things this does that isnt about obamacare, it rejiggers how the Medicaid Program is funded. Right now, the federal government has an openended funding commitment. Under this bill, the bills would be capped, essentially. That for each person there would be a lump sum of money and do the best you could as a state to cover that person for that set amount of money so that would be a big change and i think the concerns you hear democrats raising are that this lump sum wouldnt be enough to cover those on medicaid and would grow slower than medicaid typically grows. You also have big changes in the individual market where people would see much smaller tax credits, much less help from the government and they would generally see skimpier Health Insurance plans so one of the things that a lot of obamacare enrollees i talk to, they complain about high deductibles. You heard Mitch Mcconnell talk about high deductibles. This plan seems clear the deductibles would go up and people have to pay more out of pocket before getting to their benefits. Robert often this bill is talked about a tax cut for the wealthy, a bill to overhaul obamacare but what youre really saying is its also an overhaul of medicaid, a program thats been around decades. Sarah i dont think its an underestimation to say it would be the biggest change to medicaid since it were created in 1965, changing the relationship the government has had with medicaid saying no matter what the bills are, well kick in a portion and states will kick in the rest. It would be a pretty unprecedented rollback of welfare programs. Usually one of the things we see in the United States and abroad is it is very hard to roll back benefits once theyre out and its a key challenge that republicans have dealt with in this debate, is that there are 20 million or so people relying on obamacare and its very hard to take something away once its been given out. Robert phil, you were on the campaign trail with President Trump and you heard him say he doesnt want to go after medicare and medicaid but now he seems to be rallying behind this ideological agenda of Congressional Republicans on healthcare. Why . Philip he wants to win. He wants to be able to do what he said he would do, get rid of obamacare and change it which he calls a disaster so he wants a change but its risky for him. He was elected on the backs of working class people in states like michigan, wisconsin, pennsylvania. He had so much support in West Virginia and these are states that are really probably going to be battered by these changes to the markets. And where there is policy, theres also process. Its not as sexy to talk about but one of the issues republicans have, they only have 52 votes. They can only spare two and they have the Vice President to come in and break a tie. When the Affordable Care act was put into place, democrats had 60 votes. They had a lot more flexibility. And under reconciliation, which is a term used to describe this kind of legislation, all of the specifics are so narrow. If we watch courtroom dramas, you know sometimes there are rules of evidence that come in and only that can argue the case. For republicans, they have to thread a needle of difficult rules and that is part of where its tough because they cant necessarily bring in some of the things that people might want to bring them along because they have to fulfill certain requirements under the legislation. Its a boring part of it but it is the underpinning of why this is so hard. Robert sue, whats your read on who determines how this bill shakes out . Is it moderates . Is it heller . Is it murkowski or conservatives like cruz . Susan we saw dean heller from nevada is the only republican in a blue state up for reelection next year who has probably come up so far the harshest against it although he gave himself room to go for a yes at the end. On one hand, you have conservatives who say this is obamacare light, not what we came here to do and then you have moderates like Susan Collins of maine and Lisa Murkowski of alaska who have other issues with the bill including the proposal to block planned parenthood reimbursements so how mcconnell skins that cat to get the various parties to hold hands and vote for the bill will be tricky. How much do conservatives have to say, i dont really like the bill the way it is, maybe give them amendments, get to say they improve the bill and get to yes in the end. Robert what about preexisting conditions . This was the big hangup when it was being written in the house. How does it look in the senate . Sarah it would not allow preexisting continues to be treated differently but it still creates a market that isnt friendly to people with Serious Health conditions. Under the senate bill, states could apply for a waiver from those benefits, covering things like maternity care, Mental Health services, prescription drugs things that were often left out in the individual market because they can be excite expensive to cover. So this can, essentially, be a backdoor way of getting the sick people out of the Insurance Market because lets say you have a Health Insurance plan that doesnt cover Cancer Treatment or certain prescription drugs. It technically accepts everybody. So it is certainly true these plans do not discriminate on preexisting conditions but its also not attractive to someone who actually needs to use a lot of healthcare. So it is both true that republicans can say, our plan treats people with preexisting conditions the exact same and democrats can say, youre creating a market that is worse for sick people. Robert president obama has weighed in with a forceful reaction to this senate bill, saying its something that really goes against everything he tried to do to cover people. Is that going to have an impact . Philip i dont know that its going to have an impact with the votes in the senate but it certainly has an impact with the politics surrounding all of this. I think hes trying to help galvanize democrats who dont really have a Strong National party leader right now. Obamas been very quiet through a lot of the Trump Presidency so far. Hes nod weighed in not weighed in as he did on healthcare this week and thats because this is his signature bedrock historic acomeempt from his presidency and he wants to protect it. Robert the Healthcare Industry doesnt seem to like the bill but the Business Community seems to like it as a tax cut. Kelly part of how you can look at the two bills, the obama era healthcare and what the republicans are talking about the republicans are talking about trying to have entitlements but also trying to drive people to private insurance, also a core republican view. Part of what the democrats were trying to do was expand coverage so it did create a much larger pool to try to drive down costs. Weve seen that, didnt quite play out. So what republicans need to do and it will be difficult, is to try to support an Insurance Market that has taken hit after hit after hit. Its not clear how they will bolster, when weve seen different insurers leave market places but theyre trying to find a way to drive people toward private insurance and incentivize that and not to incentivize an expansion of governmentbacked insurance. Part of that is theyre looking down the corner and around when perhaps democrats are back in power and it could not be far from single payer so deep philosophical differences about how this would play out. Robert sue, when youre talking to lawmakers on capitol hill, republicans, how do they weigh promising the base to repeal obamacare with being maybe tagged as the party that went after medicaid . Susan that is a great question. Theres a raw political answer to this when we look at the midterm elections and the fact of the matter is you could not have a better map in the senate to put forward a politically risky bill like this. Republicans arent that vulnerable in the senate and theyre on the offense, not on defense. So if youre going to take a political risk, its a good election cycle to do it. Mitch mcconnell is a raw political strategist. Im sure hes looked at the map. Its absolutely a political risk, though. As a matter of Health Policy which people feel very deeply about this country, and to kellys point, this is also a bill that at its heart a tax cut and fundamental reimagining of an Entitlement Program and those are two huge victories for conservatism. Robert i spoke to senator toomey of pennsylvania, republican, a few hours ago. He said there will still be a vote next week but well have to wait and see. A lot of looming issues for this healthcare bill. As healthcare consumes washington, were also getting clues on how that and other issues are playing out across the country. I began the week in georgia covering tuesdays special election. Republicans won the 50 million political battle. The democratic defeat stoked sharp discussions about how democrats can win in red states. Republican karen handel beat firsttime democratic candidate, john ossif, to win georgias sixth district. President trump took a victory lap during a rally in iowa the day after the election. President trump all we do is win, win, win. We won last night. I cant believe it. Were 50 in special elections. 50. Robert phil, how vulnerable it was the fourth special election excuse me for democrats last year. A small but vocal group of democrats in that party are suggesting the party needs new leadership at the top and are taking aim at minority leader nancy pelosi, the california lawmakers who remains defiant. Were paving the way for a new generation of leadership. I respect any opinion my members have but my decision about how long i stay is not up to them. Robert President Trump couldnt resist the chance to show his support for pelosi. He tweeted i certainly hope the democrats do not force nancy p out, that would be very bad for the Republican Party and please let crying chuck stay. Phil, back to you. What is the state of the Democratic Party right now . Are they rallying against leader pelosi or is she pretty safe . Philip the one thing that could keep her in this position is shes such a prodigious fundraiser. All of her members in the Congress Really rely on her to bring them money but the bigger problem for the Democratic Party right now is they need fresh faces and a fresh message. They cant run just as the resistance party. Thats what we learned in georgia and the other special elections. They need a vision for the future, a message, an agenda, some policy ideas. Go out in the country, try to figure out what a movement could look like and theyre not there yet. They might get there by 2018 but they have a lot of work to do as a party. Robert this is a party of mostly baby boomers at the top. Susan the frustration with nancy pelosi is symptomatic of a bigger problem. The top three leaders in the Democratic Caucus have 93 years of service. There hasnt been a lot of turnover at the top. Luminaries in the party, popular people in the party but theyve been around for a long time and there is a lot of frustrated ambition particularly in the Democratic Caucus. At the beginning of the congress, pelosi was challenged and a third of her colleagues voted against her staying on and she said if Hillary Clinton would have won, she was prepared to step down. Were certainly in the Twilight Years of Nancy Pelosis leadership. Its unclear how much longer shell serve but i think there is a real concern that in these races where you have to win on the margins in tough seats that she could be the margin, that shes an anchor in swing suburban districts where theyre trying to appeal to a republican constituency and that republican constituency does not like nancy pelosi. If she werent from San Francisco, that builds into the ad so nicely, when they want to talk about california values or hollywood values, that makes her an easy target. She also has enormous name i. D. Which makes her an easy foil in gain ads but her ability to raise money, shes the velvet hammer of the Democratic Party with a soft touch but really delivers. She has a way of keeping her caucus together and its tough at the top because its almost as if they were all waiting for the other one to retire and its really tight at the top but i think she really showed her resolve. No ones going to tell her to leave until shes ready. Robert shes a tough politician who grew up in baltimore, whose father was the mayor. She thinks she could be the next speaker of the house. But how democrats handle the policy front. Do you see democrats fully seizing the healthcare issue . Sarah its interesting and i think a lot of it will depend on what happens over the next week, if the healthcare bill passes, you can bet that democrats are going to be out there campaigning on it. One of the interesting fissures to watch is if you do see single pair or more National Healthcare System Movement emerge out of this. It seems possible to me that at this point democrats might look at what the republicans are doing and say, you know what, we tried to do the compromise route. We thought the Affordable Care act was our attempt to do kind of a partpublic program with medicaid, part private with the marketplaces. What we really wanted in our hearts, what president obama will tell you, if i could start from scratch, i would do singlepayer and i think that will be interesting to watch. To phils point, that would certainly be a policy to run on, a very different and bold statement. I dont know how exactly it would play out. Weve never seen the Democratic Party embrace single payer but i think it will be interesting to watch in the wake of the republican debate, if they want to really refuel around this particular provision. Robert as the democrats think it through, phil, the president wases in iowa celebrating, defiant as we saw in the clip, win, win, win. Hes had a string of success in special elections but what does it tell us about whats revealing about the president s confidence at this moment . Philip youve got to put the rally in context. Its the first time hes been out there on the political front, a campaignstyle rally since russia heated up, since firing comey and the comey testimony and special Council Counsel and hes had all this energy stewing, pent up in the white house and he let it rip. He didnt talk about russia specifically except for a reference to a witch hunt but he was taking victory lap in that arena and loving it and he loved the adoration of the crowd. Thats him in his element. Hes not a governing president but a campaigning president and i know the white house officials want to get him out there. Robert whats the debate within the Democratic Party about russia, about whether to target that ahead of 2018 or not . I dont think democrats see russia as the most potent campaign issue. Regular voters have a hard time connecting russia to their lives. Its amorphous and hard to understand. I think healthcare, if the bill moves forward, if it passes and becomes law, i think healthcare is familiar ground that theyd rather litigate the 2018 midterms on although part of the reason why the loss in georgia was so rattling to democrats is i think they thought this was a test case for those messages and coming up short has kept them soul searching and part of the situation with georgia, it showed trumps win was not a fluke. Robert what a week. 25 million in that georgia race, the most expensive house race in history 50 million overall. Thanks, everyone. Our conversation continues online on the Washington Week extra where well tell you why President Trump, admitting he does not have tapes of his conversations with former f. B. I. Director james comey, has a few people scratching their heads. You can find that friday after 10 00 p. M. At pbs. Org washingtonweek. Im robert costa. Thanks for watching. Enjoy your weekend. Funding for Washington Week is provided by boeing. Newmans own foundation, donating all profits from newmans own Food Products to charity and nourishing the common good. Koo and Patricia Yuen through the yuen foundation, committed to bridging cultural differences in our communities. The corporation for public broadcasting and by contributions to your p. C. P. Pbs station from viewers like you. You. Thank you. Narrator truly california presented in association with. Narrator next on truly california. Drag queens, fed up with abuse, rioted against the San Francisco police. St. Jaymes all those plate glass windows here were broken out. Narrator . And inspired a wave of transgender activism. St. Jaymes we had to fight for our rights as not gay people, but as human beings. Narrator a revolutionary act uncovered