budgets are not particularly sexy and exciting discussions, and a lot of people wonder about 1 trillion here and 100 billion there, what what does it all mean -- >> we believe this event and go live now to a conversation about what's next for health care policy after several republicans against repeal and replace the law. this is hosted by axios. >> thank you all for coming out so early. thanks all of you for joining us online and thank c-span for welcoming their audience here to axios. we want to thank delta dental and jason don for sponsoring this event. thank all of you for coming for those of you who are following online please use hashtag axios 360 and will get the conversation going online. axios events are like all of the manifestations of axios. we bring information you can trust, information that will help you make better decisions using smart brevity sake get smarter faster. we see that also with these events where we are honored to have three senators at the center of this conversation are going to be here with us one on one. we hope that together we will have a two of the landscape and also make some news, and make you smarter. we can count down how many of those we do and to keep this up i will welcome to the stage a axios host, reporter who has been in the capital, been at the center of this all through these amazing use of health care. what my colleague caitlin. good morning, caitlin. thank you for coming. thank you for your great coverage. appreciate it. so behind the curtain, it's 11:30 11:30 p.m. last night, what happened? >> i've been writing about the deal all day and i just turned off my lights, go to bed and i checked my e-mail. lo and behold there's a bill text, so still writing. >> how much of a surprise yesterday, was yesterdays announcement and what was the news in that bill text when you open at 11:30? >> alexander and right had been working on this since repeal of place died. >> let's hit pause and explain, if i checked out, if i'd been hiking amount yesterday and he came back, tell me what happened yesterday and why it matters. >> this is the first bi-partisanly to health care bill, least the latest individual market since obamacare past. i mean, the two parties have been feuding about this for eight years now. now have a bipartisan deal. that's a big deal. it's just a bill at this point, a committee chairmen and ranking member. this has press input. we don't know if it will have a vote but just that alone is a significant. and it's really significant because it has a huge impact on millions of peoples lives. >> and this often gets lost in conversation, and if i'm somebody who was taking advantage of the affordable health care plan, how has my life changed in the last year? >> if you are on the aca right now, you have a lot of uncertainty about what's going to come next. you don't know what's going to happen to your premiums injures going forward, you don't know if your plan will get canceled, you don't know which options will be. if you are a person on this exchange is know if you can afford to health care especially if you have an emergency. i think with this type to destabilize exchanges, gives those people some certainty that they're going to have coverage and what they need it something catastrophic happens, or even if something routine happens. so i think the goal is to keep those premium stable or even lower than to make it more affordable for people but also to make sure insurers stay in the market and that states have opportunities to entice those insurers to stabilize premiums. >> axios has had this great health care coverage. david was a managing editor, sam baker who does the vital newsletter, your coverage from the capital, how do you keep that human dimension in mind as you're covering these big policy fights? >> i think it's hard. this is such a political fight. you forget that this isn't just a back-and-forth about who is right and who is wrong about health care. there are millions of people who really, right now obamacare has been in place for what, three, four years? i mean, people are enrolled. this is peoples coverage and think that health care is it such a personal thing, you know? this is your family, your own medical care. while we are up here in washington fighting about to we repeal and replace or not going all the way to single-payer, it gets hard to forget there's a lot of people waiting for these decisions to be made. >> caitlin owns like a key part of journalism is being there. every time i pop into the capital for some lunch or something you are there, like you in the subway. you hang out at the elevators waiting for the senators spending so much time literally in the building because a great source video on access, one of our projects, our videos called sourced sort of take you there. the reality of politics, the reality of health care and there's a great source video of you by the elevator we spent so much time. what was the like to be in the building yesterday? it was a day at high drama for people in this room and others around the city who feel so passionately about these battles? >> i think the crazy thing about these health care fights as you suck quickly everything moves. >> which is everything everywhere, which is big idea axios, right? >> exactly. so yesterday we didn't have much notice that a deal had been made. >> it was announced after the policy lunches? >> yeah, during lunch it was like they have a deal, they're breaking the caucuses and alexander came out and did a giant scrum with all of us. there's so many questions like what does trump think, other republicans think? where's the bill, what's the impact? does this work? there so he thinks, so my questions to be answered it's kind of like all day long. >> you will be joining us with each of the three senators we are interviewing today. caitlin will join as with a question, make sure have missed the news or mess something up. but why it matters, walked to the three big guests today and tell me why they met in the scheme of things. so our first guest will be senator tim kaine, a democrat of virginia who's a member of the senate education and letters committee, tell me his role in this. >> first of all i just want said i think everyone here knows, i'm really excited about the three senators we have today, and you know, i think they might, today they struck the deal yesterday for us. senator kaine, he's a democrat on our panel today and he's i think, i may come he's been at the from the get-go. he was at all for help committee hearings on this topic, most of the hearing which if you know how these hearings were, people go in and out. they don't want to listen to the whole thing because it gets boring at times. he's really been pushing for the bipartisan deal. i think he's made a good-faith effort to meet republicans in the middle. he's got interesting thoughts about with health system ghostwriter besides these really partisan ideas. >> second we will be hearing from senator cassidy, republican of louisiana was also a member of senate health and senator rick cassidy is been a headline in all your and health care what he matters. >> he's also on help. he says he supports of this deal that was struck yesterday but he is the author of the planned republican say they want to go back to early next year and what the desert is essentially takes federal money and turns it to a block grants to states. i think you have some ideas about where we are going after the steel, if it passes. you know how it could potentially pass when it didn't last. >> caitlin come as a say goodbye, arthur guest b chairman lamar alexander, republican of tennessee whose chairman of help and the course was one of the two costars yesterday, his role in this drama is obvious. what's the number one thing you would like to learn from chairman alexander today? >> i think everyone wants to know if this is going to pass. is this going to become law, and then it so what happens after that? is this the white flag on both sides standing their ground and refusing to work together? will we have a future where it's conceivable health care isn't, i mean, something that creates such partisan warfare. >> and what would, what do you think is the number one thing that democrats would want to know from senator alexander if they got in on truth serum? >> does he still want to repeal and replace i guess is what the want to know. where do we go, is this just, where do we go from here? >> will try to answer that today. caitlin owens, take you for your great coverage. they to be telling us why it matters. thank you very much. for those of you joining us. i mike allen, cofounder of axios. welcome to this event. we like to welcome c-span who's joining us and like to welcome our guests online at hashtag axios360. axios360. would like to thank delta dental and jason for honor this. now we're honored to welcome to our stage senator tim kaine democrat from virginia and a member of the top committee. thanks for joining us. senator, going back -- i have been here all night. center, going back to the richmond times dispatch a day you've been my mayor, my senator and you've been my governor. >> i knew you when you are a cub reporter and now you are an international figure. >> the bios online are usually pretty standard but yours has a pretty nifty fact him. how do you possibly know that you are one of 30 people ever to exist for mayor, senator and governor? >> i was introduced that we once had into that unless it clearly that's wrong. there has to be more than 30 people who've been a mayor, senator and governor. i went back to the sin of storing and i said is this accurate? there's so many governors seven senators, it is accurate, there's only 30. then i remembered why. being mayor will kill you. [laughing] so that's the reason why there's been so field. >> senator kaine, fake news yesterday on health care, the introduction of compromise plan by sender lamar alexander who we will be hearing from later, senator patty murray of washington. this is a republican, as as a democrat we support it? >> absolutely. just a little back story. we need to show the american public we can do something bipartisan on health care. i've been making the argument that even something modest that's bipartisan in this very controversial area will be a really good sign in congress to the american people. >> you are acknowledging this is modest, a bridge. >> it is a bridge. it stabilizes the toughest part of the insurance market, the individual market, if we can get a pass. put it in private. it's not passed yet but the way it's working together and you have this from lamar, after the scheme repeal failed in late july, we started talking about now the door open for bipartisan solution. senator alexander and i did a dinner about five days after that failed vote. we got 14 democrats and republicans together to talk about the essential concept, which is how do you guarantee the cautioning payments to avoid this uncertainty that the president has created, and how to get states the flexibility that the aca intended for states to have through the waiver process but then most states have felt has been too cocky and hasn't about them to have the innovation and flexibility that was originally intended? and then that was a discussion that could not just in the committee but beyond. patty and lamar has a fantastic track record of being ghosted. they rewrote no child left behind when people thought that was impossible, and it has been slow and steady and we were almost there two weeks ago and the president poured cold water on it because he didn't want to see whether graham-cassidy could get a vote. but he was a delay tactic, not stopping for discussion and it's good to see that the reached the final accord yesterday. >> you've worked behind the scenes with a republican chairman alexander. why is he, what is his gift in this area or what do you see him doing behind the scenes to maybe, despite some parts of his party, pull this off? >> i could go on and on about that but let me say something that lamar did really well and something that patty did really well. what lamar did was isolate ended identify and narrow the problem. so health care, a lot of challenges, a lot of ways to improve it but lamar from the very beginning of the year has been focused on individual market. there are things that could be better but that's generally working for its individual market which if trying to buy health insurance, not to an employer it was tough before the aca and it continues to be tough so you focus on this particular problem, and focus ethic was at the think that he did. >> and then senator murray. >> what patty does is she's got to republican houses and a republican white house. to be able to negotiate and get a deal that protects core democratic credentials, people with pre-existing conditions, but you know i got to work with two republican, a republican chairman, she has a probe -- i soldered it with paul ryan in the budget due at the end of 2013. saw her do it with lamar on no child left behind and she has done it again. >> in the spirit of a health care event, let's put on your lab coat, let's be clinical. what are the changes this compromise will pass? >> i think it will. my prediction is that it will pass as part of some kind of a must-have piece of legislation. >> such as. >> could be the on the visit your appropriations or something else. i'm not sure it's going to go to stand alone all the way to invest but i think it would be connected to something. that's my cessna. >> you make the news of your own yesterday. you introduced medicare ask. sounds futuristic. >> it is. very futuristic. this is by all accounts even the president said this yesterday, he prays lamar threat and he said okay, this would be good for a couple of years. we thought that discussions about improving the health system. you will hear from senator cassidy is not only senator but a doctor who will talk about what he thinks a big id is. i have one, too, but it was important to stabilize for the near term and that have a more deliberate discussion not under pressure about the next big idea. senator bennet and i basically say will hear from her constituents is also what we hear from our republican colleagues. people shouldn't more choices and there's a real problem. in 2018 the will be 1500 counties in the united states weather will only be one or no insurance companies offering policies on the exchange. >> say that again. >> in 2018, this year, 2017 there's about 1200 but hundred but the prediction is next year there will be 1500 counties in the united states where weathel only be one or no insurance companies offering policies on the individual market. they write a group policies but are not offering policies to individuals. this hits rural america the hardest because the rural america tends to have a high percentage of people on the individual markets and so insurance company will often these their bear counties tende world, your patience, older, they tend to be sick and so it hits america order. michael ben and i hear our constituents, they want more choices, more affordable and we republican policy more choices, affordable. we call it medicare x and the ideas take advantage of medicare's provider network, reimbursement schedule and their low administrative costs, take advantage of that and track the hhs secretary to write an interest policy that would cover all the essential health benefits under obamacare and offer the policy on the exchange so the x is extra, expanded, it will be offered on the exchange. we would roll it out in 2020 in all of the jurisdictions that have one or no insurance companies writing policies and daddy would be by 2023 would be available of you and by 2020 were also available on the market for small biz and exchange. >> what buy-in do you have? >> we have no republican cosponsors right now. it's a problem for now but here's what i look at it. we've talked about this. now was at the time for us to talk about the big ideas if we can get alexander, , marie pastored we stabilize the market. let's have deliberate discussion about the big ideas. bill cassidy has two different bills. yes graham-cassidy but also as collins -cassie. there's a lot of that you want to put on the table before the committee. bernie sanders is a member of the committee. he's got a single-payer bill. he want to put that on the table. nothing wrong with big artistic. what's wrong is tied to jam them through with no committee process, the public hearings. use the committee process because as you know, this committee, lamar was governor, he knows medicator he was president of university of tennessee. patty is a fantastic negotiate. you have doctors on the committee to give another governor maggie hassan said people on the committee for doctor severn medicare programs, been insurance commissioner. now is the time for big ideas to come onto the table and to be discussed in a deliberate, if away with a lot of transparency. >> it's a long road but you think the time is right? >> i do. the more and more people constituents are saying i live out here in rural colorado, rural virginia, rural anywhere and there's just options for me. i don't think we're going to long tolerate big parts of the population not being able to buy insurance on individual market. >> that's a tweet right there. talking about big ideas. you with a vice presidential nominee last to year. you are from one of the most important states, the commonwealth of virginia, in presidential elections. to think big about your party, are democrats moving too fast to hug a single-payer? >> i think so. look, bernie's single payer bill has -- >> it's almost become a litmus test for people who want to run in 2020. is that a mistake? >> i don't know i would call it a litmus test. people have to decide what system they think works best and rather than common white sockets a single payer, i think michael and i have come up with the one, single-payer, and cassidy-graham both turn the system topsy-turvy. block grant is a single-payer system. what we do it medicare x is we take advantage of, we just stick right we are, no new taxes, the mandates status income the subsidies to people who are low income stay the same and then we add one element. the would be an additional offering on your exchange. we take advantage of the system as it is. we don't blow it up. we just add one element to it. what is the right way for the health care future of this country? is its work with what you have and add an element or is it to turn topsy-turvy? that's worthy of a good discussion. >> caitlin owens have come to in 30 seconds with the question, but senator cain, do you believe the nation needs a single-payer health system? >> i do like more choices rather than fewer. if someone wants to buy on individual market and the want, people bipolars all the time, if you want to fantastic. no skin off my nose. i just want more people to have more options and have been the more affordable. >> caitlin owens. >> so you are trying to take a middle-of-the-road approach, been very proactive about this, bipartisan stabilization deal. as a party assault was talking a single-payer and what not to do it -- single. are you for this will become the last version of repeal and replace where to be frank it's an idea of party filing around, kind of on the -- >> their question. >> but as a boy knows there's not the votes for at this time. so does it become this mythical thing you guys are campaigning on and chasing and talking up with your base that you can't pull off? >> caitlin, were in a room of health care people. i don't think there's anything wrong with putting big ideas on the table. there are big ideas on the table. i would say the block grant id is a big idea, a very different system, very different. i think mine is speaking though it takes advantage of the network but there's also some ideas on the table that a much more like bills out of a bipartisan backing. tom carper and i had a bill and reinsurance during doing a natl richard programmer there was reinsurance in the first three years of the aca that expired. that reinsurance, it's the backs of her high cost claims. that kept premiums down for everybody and establish this mechanism the high cost claims would be protected from insurance companies would get some certainty. we want to bring reinsurance back because we use for crop insurance, for flood insurance, under medicare part d. we used it for three years under the ac with republican support. there's some big ideas on the table that i'm not sure a lot of democrats will sign on to block grants. i'm not sure a lot of republicans aside onto single-payer but there's some more prosaic basic i i think ts will help your kesey states like maine, minnesota, alaska using reinsurance profitably under their own states. the alexander murray bill it's a bit of a push to more states for reinsurance. we could conceive something doing like that. use ideas that will spread the soda maybe spread the difference between his party but you also see some ideas that may enable us to do like alexander-murray chapter two, the next bipartisan thing we did because i do think congress owes the american public some important thing whether civil, we can work together and work together something that's been controversial but that is really important in your daily life. that's why we need to all focus on getting this deal past, , sed that message and that sometimes to get success may be build on it. >> are you good? senator kaine, and you want to -- jump in if you want. >> you know, -- >> her face at nice try on the answer but. >> the single-payer set you guys up for disciplining your base. >> you know, that's a political question. i'm trying to do something for people. i disappoint people every day and i make people happy everyday. that's the occupational hazard of the occupation i got into. my thought is i've always felt as amir, governor, good policy is good politics. advocate your best idea but be open to listening to the good ideas of others. i am sure if we get medicare x past, just use my own bill, it will not be exactly the way michael ben and i wrote it. we will have to listen to the ideas of others and that would be the case for any idea on the table, subjected to tough questions, take it public in the committee, the committee is composed of people know this stuff very well. nobody should be afraid of making the case in the process. >> in the last couple of seconds will touch on a couple other news of the day. you are just back from puerto rico. tell us when you were there and what your bottom line is. >> bottom line is a magnitude of the disaster is hard to convey but when i was there, i speak which was when? >> to saturday there with a ten member delegation. i realize okay, wow, i'm back in being a governor. i had enough circuit in virginia. we do. you have hurricane knocks at our but knocks out power in a quarter of your stay. the rest of the state of the hospitals are running and the power works and there's hotel to school functioning. and people can move a little bit while you're trying to fix this one part of your state. puerto rico, 70 minutes of house, the hurricane cut right across the island, every locality lost housing, power, road access, access to water, access to food, access to health care. schools are not open yet. every jurisdiction. the response has not yet been a response this as you are every bit as much an american if somebody in texas or florida is there it's just not. here is an example. we were there two weeks after the hurricane. in virginia when there's a hurricane and you go, when i was governor i would go. i would see the indiana utility in virginia time to get the creative act of. there's mutual aid agreements will be all help each other out. i wasn't seeing that in puerto rico. i would say the response agenda, some of its administration some of it is at this why have these utility, i would put it as idea response to i don't know i'd utility mutual aid agreements were not kicking in. they were thicker point, you didn't ask if we did ask and you said you were not sure you get paid. just order of magnitude. the governor told us that four weeks later, which would be six weeks after looking he hoped to power up to 25%. where else in america we people tolerate all become empires back on in 25% of our state state that's okay? we would not tolerate this anywhere else in the united states. these are american citizens who happen to one of the most notable records of service in our military ever since world war i, and we shouldn't tolerate the intolerable. >> we shouldn't tolerate the intolerable. [inaudible] last question is your thoughts about the president statement on iran on friday in the context of north korea? >> the three popular with the president is doing with iran, this might be the first thing the president has done it didn't just make them bad really sort of scares me. >> you said -- >> didn't just make me mad. it really scares me and here's why, three problems. when the head of the joint chiefs and the secretary of defense and the secretary of state are saying publicly iran is complying with the deal, when the iaea says iraq is that iran is complying, when our allies say iran is complaint with the deal, any step backward from that is extremely problematic. [inaudible] iraq doesn't have weapons of mass distraction program. the bush admin sessions and what do they know? we went to war and the iaea was right and we were wrong. the first problem is that brings back all this bad memories of politicians trying to overrule or tarnish these experts. so that's never one. number two, if the president says he wants congress to rethink the deal, if it's going to be renegotiated what is iran going to renegotiate givebacks and enrich uranium? this could put iran back on the path to finding a nuclear weapons program which make the world more dangerous and finally the most important a we're in a mist of negotiation with north korea. what's the chances of getting a get medicare with north korea? lesson 20% more than 0% or if china could leverage, you could find potentially and secretary tillerson and mattis over and over somewhere diplomacy first. but he does it use but backed out of a deal that is being complied with, you drop to zero the chance north korea will ever do a deal, that is extremely frightening. the the president should not por cold water on diplomacy if you do that. you raise the risk of unnecessary war. >> you've given us a great two of the landscape of social and health care where you are on the front lines because such a dynamic area. senator, would you come back in six months and tell us what progress there's been some debate? today? >> i would be glad to. >> mayor, governor, send it again, inc. is a much for joining us. >> appreciated. enjoyed it. thank you very much. we will see a quick word from delta dental and then i will be right back. >> my favorite line is we're trying to save south dakota one tooth at a time. >> there are challenges, transportation getting to places and some people are faced with not even having water, they're not able to brush their teeth. >> when we see a lot of kids have never been to the dentist as it don't even have an idea what's going to happen. >> we have a place in northwest south dakota where you can drop a landmass the size of massachusetts and not hit a dentist who can so we take the dental office to the people. >> you don't just buy a truck and start delivering care. you've got to have the sites they're willing to do the work ahead of us getting here in order to really make a successful visit. you've got to have the staff. you have your heart in the right place. >> ringing this year in our community is a huge asset to the people. either parent, just thrilled the kids are able to get teeth pulled, able to get cavities filled from able to get crowns. a lot of writers around her are full of medicaid patients are not just not accepting more. so the dental bus means an opportunity that get all the kids fix them get their teeth taken care of. >> healthy smile as i get your first job. it's how you meet and greet people when you see them on the street. >> it's everything. the confidence they have, just the help they have got a make such a difference in their lives. >> to select some of these kids, you know the power, it's the smile inside that makes the difference. when i feel like they can smile, that gives them the ability to do anything. >> thank you very much, and now we are honored to welcome to the axios stage senator cassidy, republican of louisiana, a member of the senate health education labors and pension committee at an actual doctor. i give her joining axios. appreciate it. [applause] >> tell us what you practiced in when you did honest work. >> gastroenterologist in my last light on the capital as a gas urology but prepared may very well for politics. if you're less than 50 your wonder -- you get the joke. >> data for joining us on such a newsy day. yesterday the compromise announced by senator lamar alexander, senator patty murray. will we support this government? >> it looks pretty good. the way the obama administration information the caution reduction payments has been ruled unconstitutional i at federal judge. trump said he wasn't going to do that, through to congress, congress has done something. this flexibility for states they could break into lower the cost of health care. that's very positive. the transition is a couple years. there needs to be something done more permanently but it allows something permanent to be unlamented within the interim. >> the expect president trump to support a? >> he has said he would together that i can you do, but so. he also i think endorse an approach like graham-cassidy for the long-term. >> what would you say is the outlook for this? will this become off? >> i think so. >> you on the front lines of this with your own plan. did you rush it too much? >> so, just to set the stage. tell us your planet tells what happened. >> -- plan. that is not a yes or no answer. our plan, if you will, begun with cassidy collins. senator kaine spoke about how block grants officially topsy-turvy year well, no, estate to receive the block grant and do exactly what they've been doing. nothing would have to change for that state. what if your state like tennessee with the individual market is totally imploded, of course. it's already topsy-turvy burkini did something different. so cassidy-collins envisioned that and effectively as block granted to state. we had worked on that and attempted to socialize about with the other party for about eight months. and no one was interested. so when it failed -- [inaudible] -- put together an alternative. now, if you say it happened too quickly, well, in one sense if you consider cassidy-collins -- [inaudible] i would say no. but it is a graham-cassidy which was different, but still had at its core giving states the option to do works and i would say no. but on the other hand, to get our policy changed and right where working 18 hours a day seven days we come did have a chance of pushback on the left which was misrepresenting the bill and in the case including was done too quickly, and senator send it or change criticism is a fair criticism. he go through the committee process. i totally accepted. i did not control that. that dictated by our short-term. >> in retrospect was at a mistake? what did you learn about what it takes to socialize and get people comfortable with such a massive change? >> i can i'm going to dispute the idea it's a massive change, except insofar as some states in which the status quo is failing would do things differently. but california if you love what they're doing they can do exactly what they're doing. >> what did you learn about what works and what doesn't work? >> what i learned is that some people are going to push back in a way which, got exactly what they wanted. they scored a bill over 11 and 20 years when we wrote it 14. so of course that all these people becoming uninsured but he was in year 11. we ran it to the chip program when it had to be reauthorized just like chip is rightly reauthorized. there would not have been a falloff buddy discord over 20 years and it does look like over 20 years when my habit for ten, does does look like there's trillion dollars in fewer resources for states. standard & poor's pick everything up. you have to realize that people are going to push back however misleading and then that will be echoed by others. >> so we can argue about different scores but just to talk about reality. the problem for republicans is all kinds of protections for pre-existing conditions are written throughout the ac. they are tucked in all kinds of places and republicans that if they get where they're going to draw a line. if more states, putting aside like this quickly of mention, if more states have more control, there are some sick people who will be worse off. >> i disagree with that. that reveals the prejudice of washington, d.c., which is you cannot trust a governor. it really is interesting. there's a thought that people have to be protected against of the know, corrupt governor scheming to take with her health insurance even though that governor typically is up for reelection or has been recently elected. now, i say that because in our bill we specifically say that if the state wishes to do something different, have waiver, they must show that whatever you do, let me see if i could remember the language exactly, is adequate and affordable for those with existing conditions. this agreement we just agree to, again i'm told, i have read it myself, but that the waivers now just have to show themselves to be of comparable affordability. you could argue there's wiggle room there. now, that's basically the kind of language we have. and let the contrast this. if there's somebody here is on individual market and earning 401% of federal poverty level for family a family of three, t $82,000 a year, you can't afford the policies now. in my state you could be anywhere, including deductible and premium, 30-or $5000 a year. that's affordable for a family with a pre-existing? of course not. by the way, glenn kessler fact checking on that. turns out glenn did note before hand, , i did but it turns out m right. so -- no pinocchios. i'm in a 30-second soundbite and had to give context. but the fact is he checked the fellow i referenced at a think he said the total would be $46,000. that's affordable? of course not. that's status quo. under our conditions we actually give it to the states allowing them to come up with a system which is affordable and we think our way is better. >> pull back the camera a little bit. if you repeal and replace, the number of people who lose coverage will not be zero. so how does the gop bigot where to draw the line? >> we have more coverage under graham-cassidy been under status quo. for example, and by the way everything you're saying i am disputing, but that was echoed by the left. if you think about what we opposed, we would allow states to do so called automatic enrollment. you are in and let you out. the example is medicare. if you turn 65 you on medicare. you can call them up and said i don't want to be otherwise you're on. there's about a 99% take-up. we would allow states to do what is called automatic enrollment. if you are eligible you would get a premium sufficient, get a credit sufficient for your annual premium. a state could in like and that we all these young immortals are in the pool. helping lower the overall cost because you're spreading the cost of the few sick over the many healthy. we would end up under that scenario more people enrolled than under status quo. >> okay. so you're committing yourself to a plan introducing and supporting a plan under which the number of people who would lose coverage is zero? >> it would be up to a state because again washington, d.c. does not dictate but it is in the vested interests of the state to resume people injured as possible. and by the way i am all about people having coverage. my background is a doctor in a public hospital system was trying to bring coverage to those who did not. right now we have families i'm told six-point people are paying the penalty as opposed to purchasing insurance. 78% of those households have adjusted gross income of $50,000. i am committed to those working families being able to afford insurance under status quo they cannot. >> did you plan to revive this plan, reviver efforts in 2018 and if so how? >> yes. obviously there's things i have to change. with one last year, a different set of uris for our ten year window. we're going to socialize it. virginia, said it again identified. the should've been a better process but under graham-cassidy, virginia would have speedy you think the should've a better process. >> totally. i said that all along. as i i mentioned it was a function. the august failure gave us until the end of september to put it together and we were on resource, recess for much of the time. my staff and i were not but others were. doing other things are busy but no committee hearings. send it again mentioned she bit better process. told a that. but under graham-cassidy there would be billions with a b, more in virginia to care for working families. they have a history of talented governors who would be able to take those dollars and is something in virginia that would expand coverage for the working uninsured. similarly, missouri would get billions more under graham-cassidy. he posted this as a partisan bill. i just listed tuesday prevacid by democratic senators what i could also list maine, florida, wisconsin, indiana and others that would do far better under graham-cassidy than under status quo and they represented by democratic senator. >> 2018 i'm mostly the same players, you don't have the votes. what you do but that? >> some of the people complaining about voting know if you will complain about the process. we now have more time for a better process. i would like to think that we could socialize it among our democratic colleagues. they have finally shown a willingness to give a bit on the aca, and so, so that given a little bit and this deal senators murray and alexander worked out, so maybe now as they say well, my state gets billions more for working families. families who cannot afford insurance now. maybe i need to look at this more closely, not through the lens of partisan politics but through the lens of what's for the best of families in my state if that's the case we think we win. >> caitlin owens, i will come to you in 30 seconds but first, send it, what difference did jimmy kimmel make? >> jimmy kimmel, , a couple things. a couple things. and first for people from ours, tell us your close encounter with the jimmy kimmel. >> jimmy kimmel son, we all, how can you not feel for this? was bored born with a congenitt disease. i'm a doctor. although it's been sometime since a been in a delivery -- >> and your wife, dr. laura? >> dr. laura, retired breast cancer surgeon. i can imagine what happened. the child was born, a nurse and doctor realize the child was blue. they quickly made a diagnosis and you the child would die and probably for the mother and the father, the baby was on his way, they are signing papers. who cannot relate to the emotional response? and i think that first episode in which i, unit, referring to them, said we should have a test to make sure that his child is addressed, needs are addressed, helped define the terms of the debate. that was so positive. jimmy kimmel live came after me talk to schumer, the nuke time said he talked of three times, never called me. i wish he had. i wish he had. not to confront but to explain. under grandma -- >> have you talk to jimmy kimmel? >> no. he never gave me a chance. >> we will make that happen. >> please. under graham-cassidy, there would be families in virginia, texas, florida, maine, indiana, missouri, i can go down states, who would now have access, states would have billions of dollars of resources to help purchase insurance for those or help those families purchase insurance in ways they otherwise would not have. >> but did the coverage of jimmy kimmel statements soften support come support, hurts the poor at the capital? did a cause you vote. >> was i to think it cost because democrats are not going to vote for anyone. a good been the best thing in the world but they're not going to vote for. ten democrats when i was trying to push cassidy-collins, and all said we are not touching this. >> all right. caitlin owens. >> senator, so you covered a letter so there's lots to go over but something went to touch on kind of combining this idea that, you are saying you don't know if -- >> isaac states that the ability to put in plan that would avoid it or even expand coverage. but he can't dictate what does. >> talking that democrats, which is about you plan is it shifted my among states. there's a big shift who gets what compared to current law. states that didn't expand medicaid generally benefited. a lot of those are red states. blue states that did expand medicaid, have lost a lot of money. california being a great example. first of all, i think this plan is shifting these resources, even if it didn't result in a net loss of coverage, i mean, how do you justify that loss in california the people would almost and every lose coverage of there? and then in turn how to ask democratic senators to support your plan. >> was a couple things. let's work backwards. how to ask a senator like senator kaine and warner whose state gets billion more than under status quo to support our plan? the way i phrase that begs the into how to ask claire mccaskill who states gets billion more under our plan the status quo to support. it begs the into the of course the people in the state do far better. and now going to earlier, transfer of wealth if you will from blue states to read. not really. the red states which have not expanded to have significant growth but the blue states which of our expanded end up with our more money because they're getting a set amount over time and the red states are growing over time. by the way, red states including virginia, missouri, maine, florida, all represented by democratic senators site also reject the implications it's a partisan. we also worked to mitigate so under graham-cassidy new york was held harmless. massachusetts was held harmless. as a couple of states that actually did have money relative to current law that they lost. let me ask you, should the federal taxpayer be on the hook for no matter what expense the state passes on to the federal taxpayer? if you have a high cost state which is delivery put in a system of care which is known to be far higher cost than other states, should the federal taxpayer subsidize those decisions? if you say yes, there is no hope for controlling health care cost. because a state legislature can give a special due to this union or special gift to those hospitals or special deal, the federal taxpayer should have the ability to save there should be some cap on how much is going out. if you compare this state to other states. one more thing i will say. states actually have the ability reimpose some of the penalties that graham-cassidy did away with for example, the employer mandate and individual mandate. if you reimpose those penalties that gave the state a heck of a lot of money that they could then use to subsidize their system. i will note peter, the head of cover california was reinstituting the health insurance the i think it was, i'm a little fuzzy on that, but reinstituting one of the fees is going to be lost undercounts executive action. he was going to use that to subsidize the policy. states could have done that which i just said california approved the example, , califora do not to lose resource attribute is set to levy on themselves as opposed to getting it from the federal government. >> you came to play. this has been a great conversation. you are going to stay at ground zero, stay on the front lines. would you be willing to come back in six months and updated some progress in disciplinary? >> absolutely. >> senator, as a second by, that's an lsu time? >> go tigers. >> so isn't this something of in common with james? >> he is a big lsu fan. he is at tulane now. >> is that the dmz? >> no, no, no. lsu football, you can set the rub shoulders with people you otherwise disagree with, and who cares rex should be able to put politics aside every now and then. >> thank you for a great conversation. appreciate. see you in six months. >> yes. >> thank you very much and that will hear from jason fun, delta dental buys president of government relations and then i will be right back. jason? >> thanks, mike. good morning, everybody. this is the part of the program were a guy reads to you. so get ready. in all seriousness, i hope you enjoyed and were moved by the video we just watched because it truly captures who we are at delta dental and what we care about. i've used them were not here to talk specific about dental care but it's our belief the current health care policy conversation needs to include oral health. polling shows that a person of americans view dental benefits as either a local bar or critical part of the public debates run health care legislation and according to the kaiser family foundation, in 2015 more than than one court of uninsured adults delayed or went without needed dental care due to cost. importantly, research on institute of medicine, hhs and many other sources shows oral health is a critical component of overall health. good oral health as a positive effect on overall health and well-being, reflects general health conditions, , and the social and medical impact of oral diseases in children is substantial. to be happy and healthy, america street exit to the high quality medical and dental benefits. everybody needs both. as health reform discussion move forward weekly oral health must be a central part of the conversation to ensure americans achieve optimal overall health. as the largest and most experienced dental benefits provider in the u.s., we believe delta dental is the perfect partner in helping americans achieve optimal overall health. because at delta dental we live in brief oral health. it's our only priority. we consider this partnership with axios to be exciting to elevate this issue in the conversation. that's why we're undermining this event and in that event we will hold early next year. thank you so much for joining us and now i handle things i go over to mike. >> thank you for the partnership. i appreciate it very much. thank you for making this possible, and now it's our honor to welcome to the axios state senator l'amour alexander, republican of tennessee, chairman of the senate health education and labor and pensions committee. mr. chairman, thank you so much for coming. appreciate you being here. senator alexander, i have been covering you since i had hair and you had flannel. >> that's a long time. >> so senator, caitlin owens says the news brief and caitlin just whispered a scoop to meetings she said you just got a phone with president trump or requited he said? >> he called me to say that, number one, he wanted to be encouraging about the bipartisan agreement that senator murray and i announced yesterday. number two, he intends to review it carefully to see if he wants to add anything to it. number three, he is still for block grants sometime later but he will focus on tax reform this year. so that's, i was thinking this morning, sort of the parlor game is president trump doesn't know what he's doing. on health care he probably does. in september against the advice really of paul ryan and mitch, he sort cleaned out the last half of september so the senate considered the cassidy-graham will you just talked about. he completely engineered the bipartisan agreement that senator murray and i announced yesterday in this way. he talked to senator schumer and occurred seem to ask me to do turkey called me twice over the last ten days to talk to me about bipartisan agreement for the short-term. a bridge, so people are not hurt. and he checked in this morning. >> why doesn't he just say he is for it. >> with welcome i think he wants to reserve his options. what we're going to do is with a number of republican and democratic senators we are going to introduce the bill thursday, or put on the senate bill so people can see it. then we'll see where it goes from there. and my guess is that it will be a part of discussion between the president, speaker ryan, senator schumer, mitch mcconnell. and i predict it will pass in some form before the end of the year is it's usually, most ideas fail for lack of the idea, this is a very carefully thought out compromise that advances some republican principles that haven't been advanced in eight years, some democratic ones as well. so i think it will happen for the end of the year. and i appreciate the fact that he encouraged me to do it, and i understand the fact that a president, whether any president who would want to review it, maybe tried at something to it and make it a a part of a largr negotiation before it's done. >> and what did he indicate as far as his general feeling about it? did indicate how he was inclined? >> he hasn't read it yet. he's been busy and we just introduced it yesterday afternoon, but he called me ten days ago and encourage me to do. i was impressed with the fact that he was willing, he understands that the graham-cassidy bill or any other bill to repeal or replace obamacare doesn't take effect until 2020 or 2021 so what do you do in the meantime? what you don't want to do in the meantime is create chaos and hurt millions of americans by skyrocketing premiums. and some counties when you can't buy insurance because the congressional budget office is it without the cost-sharing payments up to 16 million americans might live in counties where they can't buy insurance. well, , what does chaos do? is a four lane highway to a single-payer solution. it's a birthday present for bernie sanders i think the president is pretty shrewd to understand there's a gap that needs to be filled and the only way to fill it is by a bipartisan agreement like the one we suggested yesterday. >> and chairman alexander, you alluded to the fact there sometimes questions about the presidents mastery of policy but you said in health care you believe he does know what he's doing. tell us about that. >> well, i think he knows, i think i just did. in september he cleared the way so we could deal with the cassidy bill. in this case you recognize there's a gap and he worked with me so that i would work with patty murray and produce a bipartisan agreement to fill the gap. >> a better way to ask is what you believe in the basin what he said are what his big goal is, what is trying to cheat by moving -- >> i think is the goal is the same as my big goal, which is to move more decisions about the kind of policies that are written for americans to buy health insurance out of washington back to the states so people have more choices and lower prices. >> do you believe -- >> that's 80% of the dispute that's created the partisan statement over the last eight years. and by the way, there are three or four steps in the alexander-murray agreement that move in that direction. it is the first such steps with that in eight years. there is also compromise so democrats have some things, too, but you don't get a conservative when without a result. and we haven't had any result. we had a lot of speeches and a lot of lost votes. that's not a conservative victory. .. for ipo or appeared >> do you believe it will pass? >> i don't forget the senate very well. although i did just predict the january agreement will, in one form or another, pass before the end of the year. i hope it will. a major problem with the affordable care act is what i just said, is that too many of the decisions about the kind of insurance policies that are written are written in washington and it doesn't take into account what happens in the state. in the states as former governor right now we want to help people even more than people in washington do and we can make decisions about that and we can lower prices and offer more choices. that is what that's about enough of a vote for appeared >> mr. chairman, k-kilo new orleans, asked a question in 30 seconds, but first, is there a risk with the way this is being done in pieces and with ridges? is there risk that insurance companies will say the roller coaster is too much, exchanges just are worth the trouble. >> no. i think a two year bridge to whatever comes not a something that insurance companies can easily plan for appeared 28 teen are mostly set, but they now would have plenty of time to make their 20 night team right, what we will try to do is find a mechanism to make sure consumers get the benefit of the car sharing payments in 2018, not insurance companies. consumers automatically look at those benefits. i would expect if we pass our agreement sometime before the end of the year come they will have some effect on rates and 28 team and in 2019 rates will go down. >> you wear a lot of hats, bjorn of the great minds of the republican party is, someone who actually knows the country as he looked ahead to a tough midterm election, are you actually fortunate repeal and replace didn't pass or that you don't 100%? >> i don't think so. i don't look at life that way. and result oriented person not say we announced that agreement yesterday. i want to get something done while i'm here. we did that with no child left behind. that was "the wall street journal" said the federal power of the states in 25 years. that was the result. i don't know if i get elected or unelected waste on that but it the reason i'm here. i would like to see us succeed on changing the affordable care act. there is her variety of ways to do it with a short-term agreement to start with. executive orders are another way the president started that. we do need to take a look at the affordable care act and i would like to see power go back to the states. i don't know what the effect of that would be in november elections of 2018 but it's what we ought to be doing. >> no child left behind from your accomplishment you are talking to a young senator, someone who wants to be a leader, someone who wants to accomplish things. what the secret to passing something bipartisan? what is the secret to something modest with a permanent member? >> number one, get to know them. it's no secret. if you don't know each other, and you don't know about the agreement. number two, don't always try to do something comprehensive. go a step at a time. a good way to get where you want to go. number three, have a lot of patience. number four, keep your word. those are things that are important. if you do that you get a result. senator murray is part of the democratic leadership, so we don't agree on a lot, but she can do all of those things that i just mentioned. >> hey, senator. two questions for you i will ask at the same time so i don't get cut off. first one is about this deal yesterday. some conservatives are already blasting as insurer bailout. if the u.s. the republican party in the house, senate president successfully passed the bill and signed into law, is this a win for republicans and is this something truncates to say he is forced to deal or is this something going especially to the november election the republicans say they only have to insurer bailout. >> we will come back. >> a conservative victory requires a result. now, it's been eight years now. we've had 50 votes to repeal about to carry my foster mom. we've made a thousand speeches. we've got no result. there were three or her for her result embedded in this compromise. one is a catastrophic plan for people of all ages, so a medical catastrophe doesn't turn into a financial catastrophe. two is coming more importantly, a change in the affordability that is very wonky, but it gives more states opportunities to do the waiver is like the alaska waiver, iowa waiver, oklahoma waiver, minnesota waiver, new hampshire waiver. all of these are different ways of doing things. as i said earlier, the single biggest object to the republican consumer decisions out of washington back in the state and encourages interstate contracts on health insurance. it also streamlines four results and the compromise agreements. for more recall and conservatives have achieved in eight years despite all the speeches. that's what i would say to people who ask me about it. >> just following up on that, if this happens the president can say this is a deal he indirectly influences? is this a deal the president directly influences? >> i'm sorry. >> if this passes, how much an impact does trump have and is this something he can say he owned and is responsible for the result? >> well, the president engineered the bipartisan agreement by calling me and asking me to have senator murray do it. i talked three times in 10 days about it. if she decides in the end to make it part of something we signed, by then of course it'll be something he supports when he gets there. he's been pretty shrewd in the whole process in this case by giving himself a bipartisan option with roof or conservative wings on the way and get block grants again. a better version of what comes next. >> bill cassidy did a good job with this bill. he's got time to improve it between the next time he comes up. then allows states for insurance policies and more choices and that's it. that's most of the difference with obamacare. step one in the process is the executive orders that they issued last week to step two would be a bipartisan agreement to make sure that people aren't heard, that we don't have chaos in that we have a few conservative ones long-term change won't take effect until 21, 21, 22. the alexander murray agreement is an option i hope it is one that congress will adopt. >> out of step through the comes after comments that something you can work with senator murray on? democrats and republicans worked together on the bigger longer-term solution. >> this is step one. this probably said too. other issues can be considered like the employer mandate is about to kick in and employers are about to charge a lot of money. we could repeal that retroactively and cost of money. the affordable care act when you get to things like bob graham proposals or the senate and the house bill and the fundamental difference between republicans and democrats. democrats like decisions here and made in the states. that's why they continue to be partisan. >> caitlin, did you have anything you wanted? >> is it sustainable to have this debate every time the president changes? or do you eventually have to decide on something both parties can live with? >> it's better to do something durable. one of the managers of no child left behind is nobody's trying to repeal it every year with a consensus. which we worked out last year was the most important bill in congress, probably was the smart thing to do is to make step one bear likely to get results. as i said is you don't get a conservative victory unless you get a result. and you don't get a result in the senate unless you get 60 votes. the things that we might be of the get block grants with 51 votes when we will not get the result in the alexander murray agreement because most importantly they require 60 votes. >> alex rubin's given me the hook as a fantastic tour of this landscape. as you make progress, but would you be willing to come back six months in a bus on how things are going? >> as we see, tell us who the amateurs are. they are tim mccain. with seven harmonicas. one for each key that he knows and i have to change key when i play the piano though we've performed at the resonant words festival in the state line a couple months ago. so we called ourselves honestly the amateurs, which is inaccurate description. >> i like to think delta dental for making this possible. i'd like to thank caitlyn owens, mike colleagues for their great coverage my acting event colleagues who have been here all night and who are so fantastic. thank you a misty spin in your viewers for joining us. people are joining us online # ask leo's 360. center alexander, thank you for a fantastic conversation. thank you so much. [applause] ♪ [inaudible conversations] >> this morning from attorney general joe sessions will test the justice department oversight hearing before the senate judiciary committee. live coverage starts in about an hour at 10:00 eastern in a little under an hour on c-span online at c-span.org or you can listen with the free c-span radio app. general joseph h-hotel, creator of u.s. central command will be speaking an event put together by the national conference on u.s.-arab relations live shortly after 2:00 and you can see it on c-span 3. live on c-span.org and listen to it but the c-span radio lab. u.s. senate gavels in about 60 minutes or so at 9:30 eastern. we'll have live coverage on c-span2. right now remarks from senator patty murray and lamar alexander who you just saw on the floor of the senate yesterday talking about their compromise health plan. >> trade one later this week, senator murray and i with other senators will introduce bipartisan legislation with additional