Video: Axelrod: Congress will pass health bill

  1. Transcript of: Axelrod: Congress will pass health bill

    But first, the great blizzard of December of 2009 blanketed the East Coast . It dumped nearly 22 inches of snow on the nation's capital. It served as a backdrop for a flurry of activity in the halls of Congress this weekend, as Senate Democrats reached a compromise agreement to move healthcare reform one step closer.

    Joining me live this morning, the president's senior adviser, who traded loafers for snowshoes this morning, David Axelrod .

    MR. DAVID AXELROD: We call this a dusting in Chicago , David , I just want you to know.

    MR. GREGORY: Yeah, I know, I know. Well, I'm from L.A. and this is a big deal . Thank you very much for being here.

    MR. AXELROD: Uh-huh.

    MR. GREGORY: You appear to have this compromise now in the Senate , 60 votes now that Ben Nelson is onboard. Is this mission accomplished , or does this represent a selling-out of key principles that the president fought for initially on health care ?

    MR. AXELROD: Oh, no, I think this, this adheres to the key principles that the president set. It's going to bring more security to people who, who have insurance today in relation to their insurance companies , it'll reduce their costs over time as well. It's going to help people who don't have insurance, including small businesses who can't afford it or people who don't get it through their employer, get it at a cost they can afford. It's going to extend the life of Medicare and give seniors some, some more support in terms of prescription drugs and better care. And in the long run, it's going to reduce our deficits, the CBO said yesterday, by $132 billion in the first 10 years, over a trillion in the second, and, and, and stop the inexorable rise of healthcare costs that threatens to crush our budget...

    MR. GREGORY: Right.

    MR. AXELROD: ...family budgets, business budgets.

    MR. GREGORY: Well, we'll -- I want to break some of these down. But do you describe it as mission accomplished ?

    MR. AXELROD: No. I, I think it is a -- it's a landmark step, it's a, it's a great step. I agree with much of what Paul Krugman wrote in The New York Times last Friday, he's been a strong advocate for healthcare reform , and he said this is a great foundation for the future . It is light years ahead of where we were. Look, David , if you're a person with a pre-existing condition today, you're excluded from getting insurance by most insurance companies . I went through that with -- my child has a chronic illness , could not get her on insurance. A huge -- this was when I was a young reporter and couldn't afford the out-of-pocket expenses. Millions of people are going through this in this country, and there are myriad other examples of, of people who will benefit from these changes.

    MR. GREGORY: Let me back up, talk about just some procedure. Is this a done deal? Will this pass the Congress ?

    MR. AXELROD: I think it will pass the Congress . I mean, obviously, it is a big step along the way. We've got additional steps to take. The House has a bill, the Senate has a bill, they'll have...

    MR. GREGORY: And there are some key differences, including the House has a public option to create more competition, the Senate bill does not.

    MR. AXELROD: No. But the Senate , the Senate bill has some very tough restrictions in terms of how insurance companies can spend the money that they collect from premiums, it has a great accountability for insurance companies , it creates competition between private insurers and gives people options and choice, and that's what we were after.

    MR. GREGORY: But how hard will it be to reconcile the two?

    MR. AXELROD: Well, I think we're going to get it done. I think people understand that this is a historic crossroads, David . Seven presidents have tried to pass comprehensive health insurance reform, seven presidents have failed. We've been talking about it for 100 years. We're on the doorstep of getting it done, and it'll be a great victory for the American people .

    MR. GREGORY: Some people have raised the question about whether the Senate rules ought to be changed. In order to avoid a filibuster you needed the 60 votes, and you were able to get there with Senator Nelson . But a lot of people, including Planned Parenthood , condemning the abortion agreement where it would place greater restrictions on getting abortions in the states in these exchanges that had to be struck to get Senator Nelson onboard. He also got extra money for Medicaid . Do you think it ought to be changed in the Senate so it doesn't rely, all of this healthcare reform , on one senator?

    MR. AXELROD: Let me say first on the, on the issue of abortion, there have been concerns expressed both from the pro-choice groups and some anti-choice groups, pro-life groups on this. But the fact is it really doesn't change the status quo , and that's what we were after. The president said this should not be the vehicle through which the abortion debate and changes in the abortion law should come. In terms of the Senate ...

    MR. GREGORY: Yeah.

    MR. AXELROD: ...look, I'm not -- these are time-honored rules. I'm not going to -- I mean, obviously it makes it more difficult, they were structured that way. What we should be able to do, though, is move forward in, in, in good faith, and what we've seen is the rules being used time and time and time again to delay votes, to try and scuttle the legislation by -- through parliamentary maneuvers, because there's a majority of senators who support health insurance reform. We ought to have an up or down vote, and that's what all of this has been about.

    MR. GREGORY: Are you going to get this by the end of the year?

    MR. AXELROD: Well, I think that the -- I'm, I'm confident that the Senate 's going to vote on this before they go home.

    MR. GREGORY: Before Christmas . But then a final bill, a reconciled bill, do you think you get it by the end of this year?

    MR. AXELROD: Oh, no. I mean, I think that we're going to have some work to do when we come back. But obviously, this is a major step forward .

    MR. GREGORY: Let me talk about where the public is on this. This was our poll this week, Wall Street Journal / NBC News . Good idea, bad idea, the president's healthcare plan? Forty- seven percent say it's a bad idea, 44 percent say they thought it'd be better to keep the current system. Is the public really for this?

    MR. AXELROD: I think that there's a big anomaly in the polls that's worth discussing. When you ask people "do you support the bill that's working through Congress , the president's bill" and so on, they give you that result. When you describe what's in the bill, when you describe the fact that there are all kinds of protections for patients and consumers within the system, a, a, a, a patient's bill of rights on steroids, as -- we've had that debate for years, are we going to protect patients? When you'd say -- when you explain that small businesses are going to get tax credits and assistance so they can offer health insurance , and that individuals who don't get it through work are going to be able to get health insurance at a price they can afford, when you talk about the fact that it reduces deficits, extends the life of Medicare ; when you talk about all of those things, people are very strongly supportive. But that's not the picture they've gotten through this kind of narrow debate we've seen on television in Congress .

    MR. GREGORY: The fact that you have no Republican votes is striking here for healthcare reform . If you go back to Social Security or the Medicare vote in the '60s, significant Republican support. Is this a failure of leadership, that the president can't get one Republican to support this?

    MR. AXELROD: Well, obviously we live in different times. I wish we had the kind of spirit of, of cooperation that you saw in, in past generations. We live in a, a, a different time. As you know, at the beginning of this debate one of the Senate Republicans said, "If we can just defeat this bill, we can inflict a great political loss on the president and that will help us as a party." We shouldn't be thinking in those terms. We should be thinking about the people who can't get insurance today. We should be thinking about the people who get thrown off of insurance because they become seriously ill or go bankrupt because of a serious illness.

    MR. GREGORY: But how do you describe...

    MR. AXELROD: They will be helped by this legislation. And that's what we should be doing, Republicans and Democrats .

    MR. GREGORY: But talk about Republicans . How do you describe, how do you describe and assess the Republican minority in Washington today?

    MR. AXELROD: Oh, in what, in what regard? I mean, I think what's clear...

    MR. GREGORY: You -- do you...

    MR. AXELROD: ...is that they, they have adopted a strategy of opposition, and they have not offered alternative -- significant alternative ideas, other than to go back to what we've done before. Look, historically these health reforms have been beaten by the special interests , the insurance industry .

    MR. GREGORY: Right.

    MR. AXELROD: They are trying to defeat it now. The Republican Party historically has stood with the insurance industry in trying to beat back reform. And they're playing that traditional role, and that's a shame.

updated 12/20/2009 10:16:30 PM ET 2009-12-21T03:16:30

The little town of Libby, Mont., isn't mentioned by name in the Senate's mammoth health care bill, but it's one of the big winners in the legislation, thanks to the influence of Finance Committee Chairman Max Baucus, D-Mont.

After pushing for years for help for residents of the area, thousands of whom suffer from asbestos-related illnesses from a now-closed mineral mining operation, Baucus inserted language in a package of last-minute amendments that grants them access to Medicare benefits.

He didn't advertise the change, and it takes a close read of the bill to find it. It's just one example of how the sweeping legislation designed to remake the U.S. health care system and extend coverage to 30 million uninsured Americans also helps and hurts more narrow interests, often thanks to one lawmaker with influence or bargaining power.

Here's a look at some other winners and losers in the latest version of the legislation, which was expected to survive an initial test vote in the Senate around 1 a.m. Monday.

WINNERS

  • Cosmetic surgeons, who fended off a 5 percent tax on their procedures.
  • Nebraska, Louisiana, Vermont and Massachusetts. These states are getting more federal help paying for a proposed Medicaid expansion than other states are. In the case of Nebraska — represented by Sen. Ben Nelson, who's providing the critical 60th vote for the legislation to pass — the federal government is picking up 100 percent of the tab for the expansion, in perpetuity.
  • Beneficiaries of Medicare Advantage plans — the private managed-care plans within Medicare — in Florida. Hundreds of thousands of them will have their benefits grandfathered in thanks to a provision tailored by Sen. Bill Nelson, D-Fla., that also affects a much smaller number of seniors in a few other states.
  • Longshoremen. They were added to the list of workers in high-risk professions who are shielded from the full impact of a proposed new tax on high-value insurance plans.
  • Community health centers. They got $10 billion more in the revised bill, thanks to advocacy by Sen. Bernie Sanders, I-Vt.
  • A handful of physician-owned hospitals being built around the country — including one in Bellevue, Neb. — which would be permitted to get referrals from the doctors who own them, avoiding a new ban in the Senate bill that will apply to hospitals built in the future. Without mentioning Nebraska or other states by name, the Senate bill pushes back some legal deadlines by several months, in effect making a few hospitals that are near completion eligible to continue receiving referrals from the doctors who own them. Chalk up another win for Nelson.
  • AARP, the lobby for elderly people. The new Democratic bill has about $1 billion in extra Medicaid payments to states that provide visiting nurses and other in-home or community services to prevent low-income people from needing to be admitted to hospitals. In House-Senate bargaining, AARP also is expected to win one of their top priorities: a full closing of the so-called "doughnut hole," the gap in Medicare's coverage of prescription drugs.

LOSERS

  • Tanning salons, which are getting hit with a 10 percent tax on indoor tanning services, replacing the cosmetic surgery tax.
  • Progressives. They had to give up on their long-held dream of a new government-run insurance plan so that Democratic leaders could lock down the necessary votes from moderates.
  • People making over $200,000 a year. A proposed 0.5 percent increase in the Medicare payroll tax was bumped up to 0.9 percent in the latest version, putting the tax at 2.35 percent on income over $200,000 a year for individuals, $250,000 for couples.
  • Generic drug makers. They fought unsuccessfully to block 12 years of protection that makers of brand-name biotech drugs — expensive pharmaceuticals made from living cells — will get against generic would-be competitors.

To read more on the latest on health care reform, click here

Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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