JUDY WOODRUFF: It is the
Senate Republican health
care bill version 2.0.
Party leaders made it public
today, but the path to passage
remained anything but clear.
Our Lisa Desjardins
begins our coverage.
SEN.
MITCH MCCONNELL (R-KY),
Majority Leader: So, it's
time to rise to the occasion.
LISA DESJARDINS: A
critical moment for
health care and Congress.
Majority Leader Mitch McConnell
unveiled Senate Republicans'
second-draft bill, hoping it
can win the minimum
50 votes he needs.
SEN.
MITCH MCCONNELL: The revised
draft improves on the previous
version in a number of ways,
all while retaining the
fundamental goals of
providing stability and
improving affordability.
LISA DESJARDINS:
What has changed?
First, it keeps two Obamacare
taxes on the wealthy.
Second, it uses that money,
in part, to add more than over
$100 billion in new spending;
$70 billion would go to insurers
to stabilize markets and bring
down out-of-pocket costs,
and $45 billion would
fight the opioid epidemic.
On Medicaid, the bill still cuts
future spending significantly,
but does give states more leeway
to expand who is
eligible for the program.
But perhaps the biggest change
is the addition of a proposal
by Texas Senator Ted Cruz.
The so-called Cruz amendment
would let insurers mostly opt
out of all Affordable Care Act
requirements.
They could potentially
offer cheaper bare-bones
plans, as long as they
offer a few plans that
do meet Obamacare standards.
At the same time,
other Republicans are
crafting their own ideas.
SEN.
LINDSEY GRAHAM (R), South
Carolina: Well, you know.
We're going to support Mitch's
effort with his new plan,
but we want an alternative,
and we're going to see
which one can get 50 votes.
We're not undercutting Mitch.
He's not undercutting us.
LISA DESJARDINS: Senators
Lindsey Graham of South Carolina
and Bill Cassidy of Louisiana
say their amendment would send
more money directly to states.
It's not clear how
much support that has.
As for Democrats:
SEN.
CHUCK SCHUMER (D-NY), Minority
Leader: It appears that
little has changed at the core
of the bill.
LISA DESJARDINS: Minority Leader
Chuck Schumer says Republicans
will still have a problem
getting some key members of
their own party on board.
SEN.
CHUCK SCHUMER: Moderate
Republicans looking at this bill
should be able to see that the
incredibly modest change to
the tax provisions, the small
pot of funding for opioid abuse
treatment, these other tweaks
around the edges are like a
drop in the bucket, compared to
what the bill does to Medicaid,
to seniors, to Americans
with preexisting conditions.
LISA DESJARDINS: All sides
are now waiting for a pivotal
report, the analysis of the
bill by the nonpartisan
Congressional Budget Office.
Especially waiting is Wisconsin
Senator Ron Johnson, a key vote.
SEN.
RON JOHNSON (R), Wisconsin:
Show me your math.
Show me what the
first baseline was.
Show me what the policy
results in terms of spending.
LISA DESJARDINS: Republicans
have not yet announced
when they will hold a vote.
Leaders had hoped for next week.
And of the 52 Senate
Republicans, we already
know that two of them
are no-votes on this
latest draft.
That's Susan Collins of Maine
and Rand Paul of Kentucky.
Judy, of course, that means
Mitch McConnell cannot lose
any more Republicans, and there
are many on the fence.
JUDY WOODRUFF: Wow.
So, Lisa, thank you.
And, of course, stay here.
We're going to bring in Julie
Rovner, who we know well,
chief correspondent, Washington
correspondent, for Kaiser
Health News, joining us too.
I'm going to start
with you, Julie.
So, there have been some
changes, as Lisa just reported,
to Medicaid, a few, but not
enough to satisfy
these moderates.
What exactly did they do?
JULIE ROVNER, Kaiser
Health News: That's right.
The moderates have been
unhappy with the Medicaid cuts.
Senator Susan Collins, who, as
we just heard, is already a no,
came out and said, the changes
that they would make to
Medicaid go beyond repealing
the Affordable Care Act.
Medicaid was expanded in the
Affordable Care Act, but these
changes would actually cap
the program, something
Republicans have been trying
to do since the 1980s.
It's for the conservatives.
Moderates are still unhappy.
As Lisa pointed out, there
is a little bit more money
to deal with opioid abuse.
They can get out of
the caps if there's a
public health emergency.
But those are pretty
much all the changes
that they have made here.
JUDY WOODRUFF: And how is
all this going over, Lisa?
LISA DESJARDINS: Right.
There are a lot of big
question marks on Capitol Hill.
I think that you have got
the same question marks
on the right and the left.
They tried to bring in
moderates, and including
giving them the ability
to increase -- the
states could increase who
can be under Medicaid.
But there's not as much money
to do it, so you would have
to make a choice between the
number of people you could cover
under Medicaid and how much you
would give them in benefits.
It doesn't really address
questions of the overall need
for health care some of these
moderates have.
JUDY WOODRUFF: Now,
Julie, we heard in Lisa's
report the reference to
what Senator Ted Cruz
has wanted, has to do with
giving states more options.
Describe exactly
what that involves.
JULIE ROVNER: Well,
Senator Cruz and a number
of the conservatives
in the House too have
complained that one of
the biggest problems
with the Affordable
Care Act is that people
who buy their own insurance are
finding themselves paying much
more, more both in premiums and
in out-of-pocket spending.
And he wants to help people.
But basically the way he would
do it is, he would say, for
healthy people, if you want
to buy fewer benefits,
you can do that, and you
would get less coverage.
And that, in fact, is what
they would do in this bill.
The problem, according to the
insurance industry and a lot of
others who oppose it, is that
it would make coverage for sick
people pretty much unaffordable.
It would leave only sick
people in those plans that
offer all the benefits.
For the people who are lucky
enough to get tax credits, and
they have lowered the threshold,
those people would be mostly
protected from those increases.
But people who are buying their
own insurance and make too much
money to get those tax credits
would bear the brunt of those
very much higher premiums.
So that's a big worry about
how this might play out.
JUDY WOODRUFF: So, Lisa, and
the leadership was making
this gesture in Senator Cruz's
direction.
How is it going over?
LISA DESJARDINS: These were
intense negotiations to
put this in the bill today.
But, Judy, if you actually read
the bill online, the entire
Cruz amendment is in brackets.
Literally, it is in brackets.
And Republican leadership
confirmed that means
it's not final.
It could still be taken out.
It could still be revised.
And one other tricky piece of
choreography with all of this,
multiple sources have told
me that they are going to get a
score from not CBO -- just from
CBO, but also the Department
of Health and Human Services.
which is a very
unusual step on this.
They are going to see what
the Department of Health and
Human Services think the Cruz
amendment will mean.
And all of this is kind
of adding new questions
to the process as well.
JUDY WOODRUFF: Presumably
not knowing what the
department is going to say.
Is that right?
Or do they assume the department
is going to come in and
say this is a good thing?
LISA DESJARDINS:
That, we don't know.
We know there have
been conversations
for weeks with CBO.
CBO has known the general
outlines of these bills.
Have they had those
conversations with HHS as well?
I don't know.
JUDY WOODRUFF: Lisa, I
want to stay with you.
You have been following this
day after day after day since
the Senate went home for recess.
They have now come back.
What is the political calculus
on the part of the Republican
leadership in the Senate?
LISA DESJARDINS: I think it
comes down to one fact, that
they feel they campaigned on
this and that they have to at
least give it their greatest
try or have to show themselves
as trying as hard as possible.
Right now, it does look like
it's going to be very difficult
to get the votes for this
to pass, but it also looks
like they will hold that vote,
even if it fails, to show
their voters, we tried and
this is as far as we could get.
I think there is pressure from
both conservatives an moderates
to go both different directions.
And that's what making
this goal of reforming and
replacing Obamacare impossible.
JUDY WOODRUFF:
Julie -- excuse me.
Julie, you have done your
own share of reporting
on this for a long time.
What are you seeing
as to where this goes?
JULIE ROVNER: I see exactly
what Lisa said, that they're
caught between this promise that
they made to repeal and replace
the Affordable Care Act and
their ability to do it, which
is difficult to find consensus
within their own conference.
So, I think they're going
to sort of run out the
string as much as they can.
The bigger problem is, even if
they get something through the
Senate, then it will have to go
back to the House.
So whether you could actually
get something through both
chambers in any kind of timely
way remains a big open question.
JUDY WOODRUFF: And then we
heard, Lisa, the president
saying that he would be angry if
the Senate doesn't
get this done.
LISA DESJARDINS: Right.
And to be honest, sources I talk
to, Republicans, aren't sure the
president has helped-, because
as much as he's behind
the scenes sometimes
encouraged them, when
he's gone and criticized
the House bill later on, for
example, as being mean, they're
worried that if they join forces
with him, that later he might
say something different.
I think, overall, it's
important to just remember the
broad contours of this bill.
There are a lot of
details, a lot of changes.
But as much as it deals with
the Affordable Care Act, this
bill in its heart is also a
Medicaid reform bill.
That was something they
didn't have to add to
this, but they did.
And in doing that, they lost
a lot of moderate votes.
They're keeping with
that because Republicans
feel like it's important,
but that was a big
gamble that they took
in actually putting two
bills together here.
JUDY WOODRUFF: All right, my
producer is trying to tell
me something about senators.
Maybe there is new
some information?
(CROSSTALK)
JUDY WOODRUFF: ...
watch, particularly.
LISA DESJARDINS: I
think that's right.
We need to watch a lot of
key senators this week.
Let's look at five very quickly.
That's Ron Johnson of Wisconsin.
We talked to him today.
Mike Lee of Utah, he's not
happy with the Cruz amendment
as written, even though was
one of its authors
at the beginning.
Shelley Moore Capito
of West Virginia.
Dean Heller of Nevada,
he's interesting.
His governor today said
he has great concerns
about the bill as it is.
And, of course, Lisa Murkowski
of Alaska, she had said she
didn't like where this is
going.
And we're waiting to hear
from all five of those.
They can't lose
any one of those.
And that's just the beginning
lineup of questions.
JUDY WOODRUFF: I know the two of
you are going to keep monitoring
it every minute of every
day until we know
what the answer is.
Lisa Desjardins, Julie
Rovner, thank you both.
JULIE ROVNER: Thank you.