1 00:00:01,666 --> 00:00:04,933 JUDY WOODRUFF: It is the Senate Republican health care bill version 2.0. 2 00:00:04,933 --> 00:00:09,933 Party leaders made it public today, but the path to passage remained anything but clear. 3 00:00:11,133 --> 00:00:12,400 Our Lisa Desjardins begins our coverage. 4 00:00:12,400 --> 00:00:14,366 SEN. 5 00:00:14,366 --> 00:00:16,266 MITCH MCCONNELL (R-KY), Majority Leader: So, it's time to rise to the occasion. 6 00:00:16,266 --> 00:00:19,066 LISA DESJARDINS: A critical moment for health care and Congress. 7 00:00:19,066 --> 00:00:24,066 Majority Leader Mitch McConnell unveiled Senate Republicans' second-draft bill, hoping it 8 00:00:25,233 --> 00:00:26,500 can win the minimum 50 votes he needs. 9 00:00:26,500 --> 00:00:28,566 SEN. 10 00:00:28,566 --> 00:00:31,400 MITCH MCCONNELL: The revised draft improves on the previous version in a number of ways, 11 00:00:31,400 --> 00:00:36,400 all while retaining the fundamental goals of providing stability and improving affordability. 12 00:00:37,600 --> 00:00:39,033 LISA DESJARDINS: What has changed? 13 00:00:39,033 --> 00:00:42,533 First, it keeps two Obamacare taxes on the wealthy. 14 00:00:42,533 --> 00:00:47,533 Second, it uses that money, in part, to add more than over $100 billion in new spending; 15 00:00:49,500 --> 00:00:53,833 $70 billion would go to insurers to stabilize markets and bring down out-of-pocket costs, 16 00:00:55,266 --> 00:00:58,000 and $45 billion would fight the opioid epidemic. 17 00:00:58,000 --> 00:01:03,000 On Medicaid, the bill still cuts future spending significantly, but does give states more leeway 18 00:01:04,433 --> 00:01:07,966 to expand who is eligible for the program. 19 00:01:07,966 --> 00:01:12,966 But perhaps the biggest change is the addition of a proposal by Texas Senator Ted Cruz. 20 00:01:15,000 --> 00:01:18,566 The so-called Cruz amendment would let insurers mostly opt out of all Affordable Care Act 21 00:01:19,566 --> 00:01:21,666 requirements. 22 00:01:21,666 --> 00:01:25,566 They could potentially offer cheaper bare-bones plans, as long as they offer a few plans that 23 00:01:26,433 --> 00:01:29,066 do meet Obamacare standards. 24 00:01:29,066 --> 00:01:31,866 At the same time, other Republicans are crafting their own ideas. 25 00:01:31,866 --> 00:01:33,400 SEN. 26 00:01:33,400 --> 00:01:35,433 LINDSEY GRAHAM (R), South Carolina: Well, you know. 27 00:01:35,433 --> 00:01:37,166 We're going to support Mitch's effort with his new plan, but we want an alternative, 28 00:01:37,166 --> 00:01:39,833 and we're going to see which one can get 50 votes. 29 00:01:39,833 --> 00:01:41,033 We're not undercutting Mitch. 30 00:01:41,033 --> 00:01:43,066 He's not undercutting us. 31 00:01:43,066 --> 00:01:46,666 LISA DESJARDINS: Senators Lindsey Graham of South Carolina and Bill Cassidy of Louisiana 32 00:01:46,666 --> 00:01:50,566 say their amendment would send more money directly to states. 33 00:01:50,566 --> 00:01:53,166 It's not clear how much support that has. 34 00:01:53,166 --> 00:01:54,166 As for Democrats: 35 00:01:54,166 --> 00:01:56,233 SEN. 36 00:01:56,233 --> 00:01:57,900 CHUCK SCHUMER (D-NY), Minority Leader: It appears that little has changed at the core 37 00:01:57,900 --> 00:01:59,933 of the bill. 38 00:01:59,933 --> 00:02:03,233 LISA DESJARDINS: Minority Leader Chuck Schumer says Republicans will still have a problem 39 00:02:03,233 --> 00:02:05,966 getting some key members of their own party on board. 40 00:02:05,966 --> 00:02:07,933 SEN. 41 00:02:07,933 --> 00:02:10,900 CHUCK SCHUMER: Moderate Republicans looking at this bill should be able to see that the 42 00:02:10,900 --> 00:02:15,900 incredibly modest change to the tax provisions, the small pot of funding for opioid abuse 43 00:02:17,866 --> 00:02:22,300 treatment, these other tweaks around the edges are like a drop in the bucket, compared to 44 00:02:24,166 --> 00:02:29,066 what the bill does to Medicaid, to seniors, to Americans with preexisting conditions. 45 00:02:31,033 --> 00:02:34,933 LISA DESJARDINS: All sides are now waiting for a pivotal report, the analysis of the 46 00:02:34,933 --> 00:02:37,866 bill by the nonpartisan Congressional Budget Office. 47 00:02:37,866 --> 00:02:40,433 Especially waiting is Wisconsin Senator Ron Johnson, a key vote. 48 00:02:40,433 --> 00:02:41,800 SEN. 49 00:02:41,800 --> 00:02:43,733 RON JOHNSON (R), Wisconsin: Show me your math. 50 00:02:43,733 --> 00:02:45,833 Show me what the first baseline was. 51 00:02:45,833 --> 00:02:48,733 Show me what the policy results in terms of spending. 52 00:02:48,733 --> 00:02:52,900 LISA DESJARDINS: Republicans have not yet announced when they will hold a vote. 53 00:02:52,900 --> 00:02:55,433 Leaders had hoped for next week. 54 00:02:55,433 --> 00:02:59,933 And of the 52 Senate Republicans, we already know that two of them are no-votes on this 55 00:02:59,933 --> 00:03:01,466 latest draft. 56 00:03:01,466 --> 00:03:03,966 That's Susan Collins of Maine and Rand Paul of Kentucky. 57 00:03:03,966 --> 00:03:08,266 Judy, of course, that means Mitch McConnell cannot lose any more Republicans, and there 58 00:03:08,266 --> 00:03:09,400 are many on the fence. 59 00:03:09,400 --> 00:03:10,733 JUDY WOODRUFF: Wow. 60 00:03:10,733 --> 00:03:11,766 So, Lisa, thank you. 61 00:03:11,766 --> 00:03:13,766 And, of course, stay here. 62 00:03:13,766 --> 00:03:17,266 We're going to bring in Julie Rovner, who we know well, chief correspondent, Washington 63 00:03:17,266 --> 00:03:20,333 correspondent, for Kaiser Health News, joining us too. 64 00:03:20,333 --> 00:03:22,266 I'm going to start with you, Julie. 65 00:03:22,266 --> 00:03:27,133 So, there have been some changes, as Lisa just reported, to Medicaid, a few, but not 66 00:03:28,300 --> 00:03:30,233 enough to satisfy these moderates. 67 00:03:30,233 --> 00:03:31,666 What exactly did they do? 68 00:03:31,666 --> 00:03:33,066 JULIE ROVNER, Kaiser Health News: That's right. 69 00:03:33,066 --> 00:03:35,133 The moderates have been unhappy with the Medicaid cuts. 70 00:03:35,133 --> 00:03:39,766 Senator Susan Collins, who, as we just heard, is already a no, came out and said, the changes 71 00:03:39,766 --> 00:03:43,000 that they would make to Medicaid go beyond repealing the Affordable Care Act. 72 00:03:43,000 --> 00:03:47,300 Medicaid was expanded in the Affordable Care Act, but these changes would actually cap 73 00:03:47,300 --> 00:03:50,933 the program, something Republicans have been trying to do since the 1980s. 74 00:03:50,933 --> 00:03:52,566 It's for the conservatives. 75 00:03:52,566 --> 00:03:54,733 Moderates are still unhappy. 76 00:03:54,733 --> 00:03:58,233 As Lisa pointed out, there is a little bit more money to deal with opioid abuse. 77 00:03:58,233 --> 00:04:01,100 They can get out of the caps if there's a public health emergency. 78 00:04:01,100 --> 00:04:03,333 But those are pretty much all the changes that they have made here. 79 00:04:03,333 --> 00:04:05,266 JUDY WOODRUFF: And how is all this going over, Lisa? 80 00:04:05,266 --> 00:04:06,633 LISA DESJARDINS: Right. 81 00:04:06,633 --> 00:04:08,733 There are a lot of big question marks on Capitol Hill. 82 00:04:08,733 --> 00:04:12,166 I think that you have got the same question marks on the right and the left. 83 00:04:12,166 --> 00:04:16,933 They tried to bring in moderates, and including giving them the ability to increase -- the 84 00:04:16,933 --> 00:04:19,566 states could increase who can be under Medicaid. 85 00:04:19,566 --> 00:04:23,066 But there's not as much money to do it, so you would have to make a choice between the 86 00:04:23,066 --> 00:04:28,066 number of people you could cover under Medicaid and how much you would give them in benefits. 87 00:04:30,066 --> 00:04:32,366 It doesn't really address questions of the overall need for health care some of these 88 00:04:32,366 --> 00:04:34,900 moderates have. 89 00:04:34,900 --> 00:04:38,166 JUDY WOODRUFF: Now, Julie, we heard in Lisa's report the reference to what Senator Ted Cruz 90 00:04:38,166 --> 00:04:41,733 has wanted, has to do with giving states more options. 91 00:04:41,733 --> 00:04:44,200 Describe exactly what that involves. 92 00:04:44,200 --> 00:04:46,666 JULIE ROVNER: Well, Senator Cruz and a number of the conservatives in the House too have 93 00:04:46,666 --> 00:04:49,733 complained that one of the biggest problems with the Affordable Care Act is that people 94 00:04:49,733 --> 00:04:54,466 who buy their own insurance are finding themselves paying much more, more both in premiums and 95 00:04:54,466 --> 00:04:55,466 in out-of-pocket spending. 96 00:04:55,466 --> 00:04:57,533 And he wants to help people. 97 00:04:57,533 --> 00:04:59,966 But basically the way he would do it is, he would say, for healthy people, if you want 98 00:04:59,966 --> 00:05:04,533 to buy fewer benefits, you can do that, and you would get less coverage. 99 00:05:04,533 --> 00:05:07,900 And that, in fact, is what they would do in this bill. 100 00:05:07,900 --> 00:05:11,933 The problem, according to the insurance industry and a lot of others who oppose it, is that 101 00:05:11,933 --> 00:05:15,266 it would make coverage for sick people pretty much unaffordable. 102 00:05:15,266 --> 00:05:20,266 It would leave only sick people in those plans that offer all the benefits. 103 00:05:22,233 --> 00:05:24,800 For the people who are lucky enough to get tax credits, and they have lowered the threshold, 104 00:05:24,800 --> 00:05:27,966 those people would be mostly protected from those increases. 105 00:05:27,966 --> 00:05:32,833 But people who are buying their own insurance and make too much money to get those tax credits 106 00:05:32,833 --> 00:05:36,566 would bear the brunt of those very much higher premiums. 107 00:05:36,566 --> 00:05:39,200 So that's a big worry about how this might play out. 108 00:05:39,200 --> 00:05:43,133 JUDY WOODRUFF: So, Lisa, and the leadership was making this gesture in Senator Cruz's 109 00:05:43,133 --> 00:05:44,133 direction. 110 00:05:44,133 --> 00:05:46,200 How is it going over? 111 00:05:46,200 --> 00:05:48,233 LISA DESJARDINS: These were intense negotiations to put this in the bill today. 112 00:05:48,233 --> 00:05:52,733 But, Judy, if you actually read the bill online, the entire Cruz amendment is in brackets. 113 00:05:53,600 --> 00:05:55,466 Literally, it is in brackets. 114 00:05:55,466 --> 00:05:57,966 And Republican leadership confirmed that means it's not final. 115 00:05:57,966 --> 00:05:59,166 It could still be taken out. 116 00:05:59,166 --> 00:06:01,300 It could still be revised. 117 00:06:01,300 --> 00:06:04,366 And one other tricky piece of choreography with all of this, multiple sources have told 118 00:06:04,366 --> 00:06:09,366 me that they are going to get a score from not CBO -- just from CBO, but also the Department 119 00:06:10,500 --> 00:06:11,866 of Health and Human Services. 120 00:06:11,866 --> 00:06:14,433 which is a very unusual step on this. 121 00:06:14,433 --> 00:06:17,266 They are going to see what the Department of Health and Human Services think the Cruz 122 00:06:17,266 --> 00:06:19,000 amendment will mean. 123 00:06:19,000 --> 00:06:21,933 And all of this is kind of adding new questions to the process as well. 124 00:06:21,933 --> 00:06:25,133 JUDY WOODRUFF: Presumably not knowing what the department is going to say. 125 00:06:25,133 --> 00:06:27,033 Is that right? 126 00:06:27,033 --> 00:06:28,566 Or do they assume the department is going to come in and say this is a good thing? 127 00:06:28,566 --> 00:06:30,233 LISA DESJARDINS: That, we don't know. 128 00:06:30,233 --> 00:06:32,033 We know there have been conversations for weeks with CBO. 129 00:06:32,033 --> 00:06:34,800 CBO has known the general outlines of these bills. 130 00:06:34,800 --> 00:06:37,033 Have they had those conversations with HHS as well? 131 00:06:37,033 --> 00:06:38,300 I don't know. 132 00:06:38,300 --> 00:06:40,333 JUDY WOODRUFF: Lisa, I want to stay with you. 133 00:06:40,333 --> 00:06:44,266 You have been following this day after day after day since the Senate went home for recess. 134 00:06:45,000 --> 00:06:47,066 They have now come back. 135 00:06:47,066 --> 00:06:49,700 What is the political calculus on the part of the Republican leadership in the Senate? 136 00:06:49,700 --> 00:06:53,533 LISA DESJARDINS: I think it comes down to one fact, that they feel they campaigned on 137 00:06:53,533 --> 00:06:58,533 this and that they have to at least give it their greatest try or have to show themselves 138 00:06:59,400 --> 00:07:01,433 as trying as hard as possible. 139 00:07:01,433 --> 00:07:03,433 Right now, it does look like it's going to be very difficult to get the votes for this 140 00:07:03,433 --> 00:07:08,200 to pass, but it also looks like they will hold that vote, even if it fails, to show 141 00:07:08,200 --> 00:07:11,433 their voters, we tried and this is as far as we could get. 142 00:07:11,433 --> 00:07:15,933 I think there is pressure from both conservatives an moderates to go both different directions. 143 00:07:15,933 --> 00:07:19,633 And that's what making this goal of reforming and replacing Obamacare impossible. 144 00:07:19,633 --> 00:07:21,666 JUDY WOODRUFF: Julie -- excuse me. 145 00:07:21,666 --> 00:07:24,000 Julie, you have done your own share of reporting on this for a long time. 146 00:07:24,000 --> 00:07:26,133 What are you seeing as to where this goes? 147 00:07:26,133 --> 00:07:30,166 JULIE ROVNER: I see exactly what Lisa said, that they're caught between this promise that 148 00:07:30,166 --> 00:07:34,666 they made to repeal and replace the Affordable Care Act and their ability to do it, which 149 00:07:34,666 --> 00:07:38,000 is difficult to find consensus within their own conference. 150 00:07:38,000 --> 00:07:41,633 So, I think they're going to sort of run out the string as much as they can. 151 00:07:41,633 --> 00:07:44,500 The bigger problem is, even if they get something through the Senate, then it will have to go 152 00:07:44,500 --> 00:07:46,566 back to the House. 153 00:07:46,566 --> 00:07:49,266 So whether you could actually get something through both chambers in any kind of timely 154 00:07:49,266 --> 00:07:51,533 way remains a big open question. 155 00:07:51,533 --> 00:07:55,400 JUDY WOODRUFF: And then we heard, Lisa, the president saying that he would be angry if 156 00:07:55,400 --> 00:07:56,700 the Senate doesn't get this done. 157 00:07:56,700 --> 00:07:58,800 LISA DESJARDINS: Right. 158 00:07:58,800 --> 00:08:01,600 And to be honest, sources I talk to, Republicans, aren't sure the president has helped-, because 159 00:08:01,600 --> 00:08:06,233 as much as he's behind the scenes sometimes encouraged them, when he's gone and criticized 160 00:08:06,233 --> 00:08:11,233 the House bill later on, for example, as being mean, they're worried that if they join forces 161 00:08:12,600 --> 00:08:14,566 with him, that later he might say something different. 162 00:08:14,566 --> 00:08:16,866 I think, overall, it's important to just remember the broad contours of this bill. 163 00:08:16,866 --> 00:08:18,933 There are a lot of details, a lot of changes. 164 00:08:18,933 --> 00:08:22,633 But as much as it deals with the Affordable Care Act, this bill in its heart is also a 165 00:08:22,633 --> 00:08:24,266 Medicaid reform bill. 166 00:08:24,266 --> 00:08:27,700 That was something they didn't have to add to this, but they did. 167 00:08:27,700 --> 00:08:30,333 And in doing that, they lost a lot of moderate votes. 168 00:08:30,333 --> 00:08:33,933 They're keeping with that because Republicans feel like it's important, but that was a big 169 00:08:33,933 --> 00:08:37,166 gamble that they took in actually putting two bills together here. 170 00:08:37,166 --> 00:08:40,100 JUDY WOODRUFF: All right, my producer is trying to tell me something about senators. 171 00:08:40,100 --> 00:08:41,866 Maybe there is new some information? 172 00:08:41,866 --> 00:08:43,100 (CROSSTALK) 173 00:08:43,100 --> 00:08:44,333 JUDY WOODRUFF: ... watch, particularly. 174 00:08:44,333 --> 00:08:46,000 LISA DESJARDINS: I think that's right. 175 00:08:46,000 --> 00:08:48,133 We need to watch a lot of key senators this week. 176 00:08:48,133 --> 00:08:49,633 Let's look at five very quickly. 177 00:08:49,633 --> 00:08:51,133 That's Ron Johnson of Wisconsin. 178 00:08:51,133 --> 00:08:53,166 We talked to him today. 179 00:08:53,166 --> 00:08:56,066 Mike Lee of Utah, he's not happy with the Cruz amendment as written, even though was 180 00:08:56,066 --> 00:08:57,466 one of its authors at the beginning. 181 00:08:57,466 --> 00:08:59,200 Shelley Moore Capito of West Virginia. 182 00:08:59,200 --> 00:09:00,966 Dean Heller of Nevada, he's interesting. 183 00:09:00,966 --> 00:09:04,966 His governor today said he has great concerns about the bill as it is. 184 00:09:04,966 --> 00:09:09,666 And, of course, Lisa Murkowski of Alaska, she had said she didn't like where this is 185 00:09:09,666 --> 00:09:11,166 going. 186 00:09:11,166 --> 00:09:12,400 And we're waiting to hear from all five of those. 187 00:09:12,400 --> 00:09:13,766 They can't lose any one of those. 188 00:09:13,766 --> 00:09:15,800 And that's just the beginning lineup of questions. 189 00:09:15,800 --> 00:09:19,633 JUDY WOODRUFF: I know the two of you are going to keep monitoring it every minute of every 190 00:09:19,633 --> 00:09:22,233 day until we know what the answer is. 191 00:09:22,233 --> 00:09:24,166 Lisa Desjardins, Julie Rovner, thank you both. 192 00:09:24,166 --> 00:09:24,733 JULIE ROVNER: Thank you.