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'The Last Word with Lawrence O'Donnell' for Thursday, June 28, 2012

Read the transcript to the Thursday show

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Guests: Joe Epstein, Steny Hoyer, Ed Rendell, Christine Ferguson, Natoma Canfield, Michael Moore

LAWRENCE O`DONNELL, HOST: It is reasonable to construe what Congress
has done as increasing taxes on those who have a certain amount of income,
but chose to go without health insurance. Such legislation is within
Congress` power to tax -- so says the Supreme Court of the United States of


is over.

The time for games has passed. Now it`s time to deliver on health

CHRIS JANSING, NBC NEWS: Today, history will be made at the Supreme

MARTIN BASHIR, MSNBC HOST: The Supreme Court`s decision on the
president`s health care reform.

JANSING: Health care reform.

OBAMA: I know debate over this law has been divisive.


UNIDENTIFIED FEMALE: The American people should be frightened of it.

BOEHNER: Can you say it was done openly?


BOEHNER: Struck behind closed doors, hidden from the people, hell no
you can`t!

REP. NANCY PELOSI (D), CALIFORNIA: The bill is passed!

ALEX WAGNER, MSNBC HOST: Vindication is the order of the hour.

THOMAS ROBERTS, MSNBC ANCHOR: Breaking news topping this hour.\

WAGNER: In a 5-4 decision, the Supreme Court upheld the Affordable
Care Act.

JANSING: This is the decision.

UNIDENTIFIED FEMALE: A fascinating read.

ANDREA MITCHELL, NBC NEWS: The individual mandate is constitutional.

O`DONNELL: I have been explaining to them that the individual mandate
is indeed a tax.

JANSING: This was the centerpiece.

UNIDENTIFIED MALE: Chief Justice John Roberts --

MITCHELL: Chief Justice John Roberts --

ROBERTS: Siding with the liberal voices on the court.

CHRIS MATTHEWS, MSNBC HOST: Nobody predicted this one. Nobody.

RACHEL MADDOW, MSNBC HOST: The Democrats thought they were going to
lose. The Republicans thought they were going to win.

MATTHEWS: I think Roberts found the answer.

WAGNER: The Affordable Care Act is no longer a question, but indeed
quite possibly the answer.


O`DONNELL: It was a shock only to the poor, under-informed souls who
are not regular viewers of this program, that the Supreme Court found the
constitutional justification resides exclusively in Congress` power to tax.
The president interpreted what the Supreme Court did today, without ever
using that politically justices didn`t use that politically poisoned word


OBAMA: The Supreme Court also upheld the principle that people who
can afford health insurance should take the responsibility to buy health
insurance. This is important for two reasons. First, when uninsured
people who can afford coverage get sick and show up at the emergency room
for care, the rest of us end up paying for their care in the form of higher
premiums. And second, if you ask insurance companies to cover people with
pre-existing conditions but don`t require people who can afford it to buy
their own insurance, some folks might wait until they`re sick to buy the
care they`re need, which would also drive up everybody else`s premiums.


O`DONNELL: During the Supreme Court hear on the case, the most vocal
and emotional opponent of the individual mandate was sure, he was just sure
that his broccoli example would carry the day.


JUSTICE ANTONIN SCALIA, SUPREME COURT: Could you define the market --
everybody has to buy food sooner or later. So you define the market as
food. Therefore everybody is in the market, therefore you can make people
buy broccoli.


O`DONNELL: And as it happened, Justice Scalia`s broccoli argument
actually did convince a majority of the Supreme Court that the individual
mandate is unconstitutional under the Commerce Clause, which the Obama
administration cited as justification for it.

But the Commerce Clause wasn`t the only justification. The Obama
administration was hoping to win the case on the commerce clause instead of
the more politically uncomfortable power to tax.

The only part of the Affordable Care Act that the Supreme Court struck
down was the provision that requires all states to expand Medicaid coverage
substantially. That Medicaid expansion is now optional for the states,
which means millions of people who are going to receive that expanded
coverage under Medicaid will now receive nothing.

We will have more on the policy discussion on exactly what the Supreme
Court did today later. And those policy implications are much bigger than
anyone still seems to realize.

There were many surprises in the Supreme Court opinion, including the
ruling against the Medicaid provision which always seemed to be more on a
solid constitutional ground than the individual mandate. Much has been
made of the surprise Chief Justice Roberts siding with the president on the
individual mandate, but at least as surprising, if not more so was the
defection of the president`s former lawyer, the former Obama administration
solicitor general Elena Kagan who ruled against the president on the
Medicaid provision, as did Justice Stephen Breyer who was appointed by
President Clinton.


OBAMA: There will be a lot of discussion today about the politics of
all this, about who won and who lost.


O`DONNELL: And so, it`s time to give the president his wish and
discuss who won and who lost.

Joining me now is the host of MSNBC`s "NOW", Alex Wagner, MSNBC
contributor Richard Wolffe, the author of "Renegade: The Making of a
President"; and Julian Epstein, former Democratic chief counsel to the
House Judiciary Committee.

Julian, the ruling was striking today in so many ways -- obviously
using the power to tax to sustain the individual mandate. But also on the
Commerce Clause, saying very specifically that yes, Justice Scalia`s
broccoli example is accepted by the chief justices and actually a majority
of the court as knocking out the individual mandate under the Commerce

It seems that this opinion is trying to write a very strict limitation
on any future expansions of the Commerce Clause.

the conventional wisdom as people read it. But as you and I and so many
people got wrong the Arizona immigration decision. I think people are
greatly exaggerating that.

What the court did on the Commerce Clause today was to draw this
distinction between activity and inactivity. In other words, if you
weren`t part of -- if you didn`t want to buy health insurance, the federal
government couldn`t make you. That was the decision on which they said it
didn`t affect interstate commerce.

I think that impact on other social legislation is going to be minimal
to nil, because I can`t for a minute think of another example in which this
activity-inactivity distinction would be made.

So, I actually think -- and if you read the Roberts` opinion, Roberts
was actually backing up many of the earlier cases, Lopez and others, that
chipped away at the edges of the Commerce Clause, but basically kept in
place the jurisprudence for the last 60 years.

So, I actually think what the court did and what the people are saying
the court did on the Commerce Clause today is much, much more minimal
impact than as generally recognized.

The other thing that was really important as you pointed out very
presciently two nights ago on the tax element, what was so surprising about
what Roberts said in the decision today was it was kind of obvious.
Everyone thought it was kind of out of left field.

But he pointed out -- look, we have tax incentives for a whole variety
of things. Whether to go to school, to have a child, get married, buy a
home. This is no different than the tax incentives we have all throughout
the tax code. And he kind of said this was a no-brainer.

So, the idea that this came out of left field, I think Roberts in his
majority opinion kind of debunked that. And very much to the point you
made the other night.

O`DONNELL: Alex, it turns out that the chief justice also went on to
give an example of legislation the Democrats haven`t tried yet which was if
you wanted to provide a tax break for homeowners who made their windows
more energy efficient, that would be constitutional. I mean, he actually
went to great lengths just to show how solid that tax grounding is.

But still, obviously, the president and the Democrats don`t want to
rely on that word just because it has difficult political implications for

WAGNER: Yes. Certainly, I don`t think Democrats are going to be
touting the idea of a new tax.

O`DONNELL: By the way, it`s a tiny tax. It`s like, you know, 90

WAGNER: Exactly.

O`DONNELL: And it turns out you don`t even have to pay it because
there`s no enforcement provision.

WAGNER: And of course, the benefit here is extraordinary, Lawrence.
I mean, we`re talking -- the great thing about the Supreme Court case for
the Obama administration is they have done virtually no job -- they have
not sold it to the American public at all.

And we talked about his earlier today, Lawrence, the veil of secrecy
over the 2,700 page document is beginning to lift. And of course, these
provisions are going to take place. It`s not just children who can stay --
or youths who can stay on their parents` insurance plan until they`re 26.
We`re talking about major, major changes in American society as far as
health care.

People are not going to be denied coverage because they have pre-
existing conditions. You know, you and I think differ on the expansion of
the Medicaid coverage. I am of the mind that states are going to opt into
that program. That could cover an additional 17 million people who are
living at the brink of poverty. You were talking about families of four
that are making $29,000 a year. They are going to have access to health

I mean, this is a game-changer for American society.

O`DONNELL: Richard Wolffe, you`ve -- with your book, you`ve taken us
inside Obama decision making up close, including this difficult decision he
had on how he was going to vote on the confirmation Chief Justice Roberts.
And as you write, it`s very clear that he would like to live in a political
world where he actually could have voted for a learned legal scholar like

But the political practical side of it came down on him and he
realized that the rulings that the chief might do over the years would be
things that he might regret. But this, apparently, is not one of them.

tonight, it`s a bit ironic. He wanted to vote, as a new senator, he wanted
to vote for -- actually, this was when John Roberts was just nominated for
the Supreme Court. So, before he was elevated to chief justice.

And he was convinced otherwise, the new senator, Senator Obama was
convinced otherwise by someone as frankly mainstream and non fire brand-
like as Pete Rouse, his then-chief of staff, now a senior adviser, on the
basis that he would be held accountable for everything John Roberts did
over the next 20 years. The base, Democrats would hate him for it, and
Obama responded with, well, look, maybe if I each president, I would want
my nominees accepted if they were technically competent and that would be

And Rouse said look, in 20 years time, no one is going to remember
what you did, never mind give you any credit for it. And just as well,
John Roberts set aside the fact that Obama did not vote for him and ruled
on the law.

O`DONNELL: Richard, what I love about your account of that is that it
reminded me of virtually identical conversations I had while working in the
Senate with Democratic senators about the difficult question of voting on
Supreme Court confirmations and what they should base it on.

Julian, what do you make of the politics of this going forward for the
president? It seems to everyone, I think there`s one area of agreement.
Today was a political win day for President Obama and his re-election

EPSTEIN: Well, first and foremost, it was a win for the American
people, the tens of millions who don`t have insurance. It was a win for
the legitimacy of the Supreme Court. It was unquestionably a win for
President Obama.

More than anything else, this shows him as a leader at a time when
Mitt Romney is dodging questions about immigration, can`t articulate an
economic policy. This shows him as a guy who`s about action and who`s
getting stuff done.

Secondly, you know, there -- it`s going to be very, very difficult now
for the Republicans to actually try to repeal this. There are many
provisions of this the Republicans actually like now. Things like pre-
existing conditions. Benefits for seniors, benefits for the middle class,
there are benefits for children on their parents` health insurance systems.

So it`s going to be very, very difficult now for the Republicans to
take something away that`s going to become increasingly popular.

Third, you know, Mitt Romney is on record at least half a dozen time,
talking about the benefits of using tax penalties to go after the free
riders, exactly the provision the Supreme Court validated today. It seems
very hard for me to imagine how Mitt Romney is going to try to make this a
centerpiece of his campaign.

And, you know, look, the Democrat -- this has got to be a job of this
presidency -- we saw in the Congress today, at least in the House,
Inspector Clouseau , House of Representatives going after Eric Holder while
important work is getting done by the Democrats on health care and
important work is being done on jobs.

So, I think this contrast between the president and opposing party are
starting to sharpen. I think this is going to be a very, very important
arrow in his quiver.

O`DONNELL: Alex, Romney doesn`t seem to be on the same page as the
house Republicans. They just want to repeal. Romney is still doing that
repeal and replace song. And they don`t want any talk about replace.

WAGNER: What are they going to replace it? I mean, David Frum
actually had a great piece saying that this is the Republicans` Waterloo.
They`re not going to do any -- they`re not going to raise any taxes.
They`re proposing to replace a 2,700 document which is policy thick, with a
one-page document in a bid to show transparency.

I mean, the idea that there`s any stomach to renegotiate this battle
is a gross miscalculation. And, Julian, an Inspector Clouseau Congress is
a wild compliment at this point.

O`DONNELL: Julian Epstein, Richard Wolffe and Alex Wagner, thank you
all very much for joining me tonight.

WAGNER: Thanks, Lawrence.

EPSTEIN: Thank you, Lawrence.

O`DONNELL: Coming up, two LAST WORD exclusives, Democratic House Whip
Steny Hoyer will join me. And later, the director of the documentary
"SiCKO", about our health care system, Michael Moore, will get the LAST
WORD tonight.

And we`ll look beyond the individual mandate to what the Supreme Court
actually changed in the health care law and how thanks to the Supreme Court
the Affordable Care Act will now provide much less care for millions of


O`DONNELL: Today, the president talked about a woman with health care
problems, including cancer and leukemia, who sent him a letter that he
carried in his pocket every day he was fighting to pass the Affordable Care
Act. That woman, Natoma Canfield, will join me later.

And next, the Democratic Whip of the House of Representatives, Steny
Hoyer, will join me to discuss the Supreme Court ruling and the House
resolution passed today holding Attorney General Eric Holder in contempt.

And at the end of the show tonight, the man who showed what`s wrong
with the American health care system in his documentary, "SiCKO", will join
me. Michael Moore will get the LAST WORD tonight.

Oh, and Bill O`Reilly, he actually once promised he would call himself
an idiot if the individual mandate was ruled unconstitutional. And so
tonight, the brave Bill O`Reilly let someone else host his show.



OBAMA: The highest court in the land has now spoken. We will
continue to implement this law. And we`ll work together to improve on it
where we can. But what we won`t do, what the country can`t afford to do is
refight the political battles of two years ago or go back to the way things


O`DONNELL: Joining me now for an exclusive interview, House
Democratic whip, Maryland Congressman Steny Hoyer.

Congressman Hoyer, I know you thought you had final passage of this
bill two years ago, but it turns out final passage was today, when the nine
people across the street from you issued their report and they made the
Medicaid provision optional. Otherwise, left the entire bill standing.

What do you make of Supreme Court`s rewrite of your bill?

REP. STENY HOYER (D), MARYLAND: Well, when you say the rewrite,
essentially the bill is whole. We`ll have to look at the Medicaid
provision and see what might need to be done there, but we`re very, very

We thought the bill was constitutional. The Supreme Court has said
it`s constitutional. It`s within our powers and we think the American
public can be more secure today than they were yesterday with their
assurance that they`re going to have access to affordable, quality health
care. That was our objective.

Leader Pelosi worked very hard towards that end. President Obama
worked hard towards that end. We all did.

And we think this is a bill that is good for America and will bring
down costs, will provide for seniors with lower prescription drug costs,
will give young people the ability to stay on their parents` policy until
they`re 26 if they haven`t been able to find a job, will make sure the
insurance companies can`t put caps on insurance benefits when people get
really sick, and will particularly importantly make sure that people when
they already have an illness will be able to get health care insurance
which they need.

So, we think it`s a good day for Americans.

O`DONNELL: Congressman Hoyer, I`ve been saying for years, since 2009,
before you guys got down the votes on this, that the constitutional
authority for an individual mandate would lie in the power to tax. That`s
why the bills were in the tax committee, they were written there in the
House and the Senate.

Was it just the semantic risk of using the word tax publicly in the
past that made Democrats reluctant to cite that particular power?

HOYER: Well, of course, that was part of the presentation that was
made on behalf of the bill, as you know, although it was not the major
thrust. But the fact is, I think this is a contribution. And really, what
it is is taking personal responsibility for our own health care and our own
health care insurance, and not passing that along to others and expecting
others to pay the bills that you incur when and if and inevitably you get
sick and need medical help.

The Republicans, of course, are very disappointed today. They were so
sure this was going to be held unconstitutional. And of course, Justice
Roberts joined the opinion that the fact, in fact, it was constitutional.
And think they`re glomming on to this tax provision in the decision to
somehow make their continuing case that we don`t need to pay for what we

O`DONNELL: Congressman Hoyer, you wrote the bill designed to cover
over 30 million people currently without health insurance. CBO has
recently revised downward their estimate of how many it would cover, saying
it would cover 30 million, but 17 million of those, the majority of those
who are to be covered under the Medicaid statute, how do you think the next
CBO report will score how many people have coverage given that 26 states
went to the Supreme Court saying we don`t want the Medicaid coverage. Now,
it`s optional for all 50 states?

HOYER: We`re going to have to look at that. We`re going to address
that issue and we go on to make sure that we have -- as many Americans as
we possibly can covered under health insurance to give them, as I say, that
assurance of the availability of coverage.

O`DONNELL: And, quickly, before you go, Congressman Hoyer, I`d like
to get your reaction to that contempt vote against the attorney general at
the House of Representatives today.

HOYER: I thought this was a sad day for the Congress of the United
States. This was politics, not due process. That was choosing
confrontation over cooperation.

The normal number of days between a committee action and floor action
is 87 days. This was seven days. It was rushed to judgment. This is all
about politics and not in my opinion about the ability for Congress to get
the information it needs.

The attorney general has been extraordinarily cooperative, turned over
7,600 pieces of documents for the committee to see. And the committee`s
investigation on the underlying substance of this issue was superficial,
and they shut out witnesses asked to be called who knew about the incident
involved, who knew about the so-called Fast and Furious process.

That`s not what this is about. This is about politically going after
the attorney general for partisan purposes.

O`DONNELL: House Democratic whip, Maryland Congressman Steny Hoyer,
thank you very much for joining me on this historic day in the Supreme
Court and the historic day in the House of Representatives. Thank you.

HOYER: Thank you very much, Larry.

O`DONNELL: Coming up, another last word exclusive. The woman whose
letter President Obama told us about today. She will join me.

O`DONNELL: Lost in the excited reaction to the Supreme Court ruling
on the Affordable Health Act is the fact that the Supreme Court
significantly rewrote the health care law. I mean, shouldn`t we be
actually talking about what the Supreme Court actually did to the law

You want to try to guess what we`re going to do next? Someone`s got
to do it. And it`s what I do.



to talk about exactly what it means for you. First, if you`re one of the
more than 250 million Americans who already have health insurance, you will
keep your health insurance. This law will only make it more secure and
more affordable.

Insurance companies can no longer impose lifetime limits on the amount
of care you receive. They can no longer discriminate against children with
pre-existing conditions. They can no longer drop your coverage if you get
sick. They can no longer jack up your premiums without reason.

They are required to provide free preventive care like check-ups and

By this August, nearly 13 million of you will receive a rebate from
your insurance company because it spent too much on things like
administrative costs and CEO bonuses, and not enough on your health care.

Because of the Affordable Care Act, young adults until they`re 26 are
able to stay on their parents` health care plans, a provision that`s
already helped six million young Americans. All of this is happening
because of the Affordable Care Act.


O`DONNELL: That was the president today offering his clearest and
simplest explanation ever of what is in the Affordable Care Act. But the
Supreme Court made one significant change to the Affordable Care Act that
the president did not mention. As important as the individual mandate is
to the bill, the Medicaid provision is actually more important to coverage.

The Medicaid provision provides health care coverage to millions more
people than any other provision in the bill. Of the 30 million people the
Congressional Budget Office estimated would get the coverage from the bill,
17 million were going to get it from the expansion of Medicaid, which the
Supreme Court has now said is optional for the states, not mandatory.

Twenty six states went to the Supreme Court saying we don`t want the
Medicaid provision. So a majority of the states now might not adopt the
Medicaid provision. And the Congressional Budget Office estimate of the 17
million who would be covered will surely now have to be revised to a lower
figure. With all the Democratic party celebration for the
Constitutionality of the individual mandate today, virtually no one has
noticed how much health care coverage might have been lost today as a
result of the Supreme Court decision.

But one former Democratic governor who understands the decision and
had to administer Medicaid in his state is worried tonight.


the Medicaid ruling, because Medicaid is -- actually insured more people in
this bill than anything else.


O`DONNELL: Joining me now to analyze the newest provision of the
Affordable Care Act, as written by the United States Supreme Court, former
Pennsylvania Governor Ed Rendell, an MSNBC contributor, Christine Ferguson,
the former Massachusetts public health commissioner, and the newly
appointed director of Rhode Island`s Health Benefits Exchange -- she`s also
a professor at George Washington University -- and Krystal Ball, Democratic
strategist and the co-host of MSNBC`s new 3:00 p.m. show "the Cycle."

OK, governor, you`re up. This is now optional, this expansion of
Medicaid. And so in your state of Pennsylvania, which was one of the
states that went to the Supreme Court saying we don`t want it, it would
cost about another billion dollars in Medicaid to the state of Pennsylvania
just over the first six years of its implementation. That`s a state with a
Republican governor, a Republican legislature that would have now to accept
this new provision and spend more on Medicaid.

What are the odds of those Republicans in Pennsylvania saying OK,
yeah, well, the Supreme Court ruled in our favor, we don`t have to take it,
but now we will.

chance tomorrow of being able to comb my hair in a pompadour than that.
It`s not going to happen. That`s one of the real weaknesses of the Supreme
Court opinion. It can be fixed by the Congress, but with the Republicans
controlling the House, that`s not going to happen either.

It`s really a sin because Medicaid works. It has a lower
administrative cost than virtually any health care provider in the country.
And it was a great way to extend coverage.

By the way, Lawrence, I agree with you. Had the president made this
speech on the Affordable Health Care Act at the beginning, when he sent it
to the Congress, I don`t think we would have had half the problems we`ve

O`DONNELL: The key was how short it was. You have to keep it short.
It doesn`t sound complicated when you do that.

RENDELL: Boom, boom, boom.

O`DONNELL: Christine Ferguson, I wanted you to join us tonight for a
bunch of reasons, including to take a bow, since you are the actual author
of the individual mandate in our politics. You wrote the Republican bill
for Senator John Chafee back in 1993, which was the very first authorship
of the individual mandate in legislative language.

Back then, I was working on the other side of the aisle, but we talked
about it a lot. I always just assumed, and I think we all did, that the
Constitutional justification for it was in the power to tax. I don`t
remember you guys suggesting it was in the Commerce Clause.

Never suggested it was in the Commerce Clause. It was in the power to tax,

O`DONNELL: Christine, with your experience on the Republican side of
the aisle and in the state administration of Medicaid -- you worked for
Governor Romney in Massachusetts on health care. What do you think is
going to happen now that this Medicaid expansion provision is optional? It
covers, in the original version of the bill, 17 million people. It covers
most of the people who pick up coverage. What do you think is going to

FERGUSON: I think it`s going to be very challenging for the 26 states
that went to the court to just say no, we`re not going to take 100 federal
funds to provide coverage to our citizens. I think that`s going to be a
tough sell at the end of the day. I think there will be many fewer states
that won`t take advantage of the option.

O`DONNELL: Krystal Ball, Christine makes the point that it is free
money for a while. But then the window closes and the states have to pay
10 percent. Just, for example, some of the costs, even in blue state where
you think they would sign up for this -- California -- it will cost
California two billion additional dollars in the first six years. That`s
even considering the free money part of it. It averages out to a total
addition of two billion.

I`m in the state of California right now, where I can report to you
that one of the considerations for the budget crunch here is to cut the
number of public school days by 20, down to 160 days, in order to balance
the budget here. What are the odds that in a state like California, when
they`re struggling with education costs like that and all the other costs,
that they`re going to say OK, let`s add to our Medicaid costs?

KRYSTAL BALL, MSNBC ANCHOR: You do have to keep in mind that whether
they go with the federal government`s program of Medicaid expansion or not,
they`re still going to have a lot of poor people in the state who are going
to require some sort of health care. So I think the costs, in a way, have
been exaggerated.

But I share your concern. I don`t think that all of these 26 states
that went to court over this will ultimately say we`re not going to
participate. But places like Texas, where in that state alone you have 1.8
million people who would be impacted by this expansion of the Medicaid -- I
mean, to me, when you look at the fact that Texas has already severed their
relationship with the federal government over another Medicaid program
providing preventive health care to women over a dispute with Planned
Parenthood, and the fact that Rick Perry turned down half a billion dollars
in federal stimulus money, this is catnip for a Republican politician
trying to gin up their base, to say, look, I stuck it to the federal
government. I didn`t take that Obamacare money.

So I -- I share that concern. I don`t think that every state will
turn it down, but I do think we will see some red states that definitely
decide not to go with it.


FERGUSON: I also think that you`ve got to remember that there`s a
period of time during which there will be states that start really
implementing the entire health care reform act. And some of those savings
are going to accrue and be important parts of the municipality crisis with
the pensions. There`s a whole bunch of aspects of this that people aren`t
talking about right now, that have the impact -- the possibility of really
helping states and state budgets.

And I think at the end of the day, states are a whole lot more
practical than the federal government. And when it comes down to running
those numbers, and they see what other place have been able to do, I think
you`re going to see more states than not really try to pursue this.

O`DONNELL: I just want our audience to know that this show has had no
higher authority on this subject on the show than Christine Ferguson, a
much higher authority even than me. And Christine, with your experience
working at the federal level with Republicans and at the state level with
Republicans, I`m taking very seriously the optimism you`re giving us
tonight that a lot of this Medicaid expansion will occur.

But Ed Rendell, I want to talk about the pure politics, the pure
ambition politics of it. You`re a Republican governor. You want to be
president. You want to be considered in the future on a presidential
ticket, vice president or president. Can you dare to implement any of the
Affordable Care Act, including -- meaning the part that`s optional to you?
Some of it you`re going to have to implement that is mandatory.

But would you implement any of it that`s optional. Could you possibly
go into primaries in Republican presidential campaigns in the future
saying, oh, one of the things I did was implement part of that Obamacare

RENDELL: I think you`re right, Lawrence. I don`t think any
Republican governor that`s got any future ambitions is going to accept the
Medicaid money, because it`s going to mean down the road spending more
state dollars. Although there are offsets to those. Putting those people
on health care saves the state a lot of money, too. It`s not quite as

But I agree with you. However, on the exchanges, the states have the
option to let the federal come in and run their exchanges. I will be
interested in what Christine thinks, but I don`t think any Republican
governors, or very few, are going to turn those exchanges over to the
federal government.

O`DONNELL: Christine, on the exchanges?

FERGUSON: I totally agree with you on that. I think it`s -- I think
a lot of people who have talked about states just allowing this to go to
federal exchanges -- I can`t imagine a governor that I`ve ever worked with
or known that would -- that would actually allow that to happen. .

O`DONNELL: And Christine, you`re going to set up the exchange in
Rhode Island, aren`t you?


O`DONNELL: OK, Ed Rendell, Krystal Ball and my friend and health care
teacher and tutor, Christine Ferguson, thank you all very much for joining
me tonight.

BALL: Thanks, Lawrence.

FERGUSON: Thanks a bunch.

O`DONNELL: Coming up, two years ago, President Obama quoted a letter
about health care from Natoma Canfield. Then he mentioned the letter again
today. Natoma Canfield joins me next.



O`DONNELL: When you sent your letter to the president, in knowing, as
I`m sure you do, that he gets thousands and thousands of letters a day,
what was your biggest hope for what would happen to that letter?

Really just that I would be accounted for somewhere in statistics.



OBAMA: There`s a framed letter that hangs in my office right now. It
was sent to me during the health care debate by a woman named Natoma
Canfield. For years and years, Natoma did everything right. She bought
health insurance. She paid her premiums on time. But 18 years ago, Natoma
was diagnosed with cancer. And even though she had been cancer free for
more than a decade, her insurance company kept jacking up her rates year
after year.

And despite her desire to keep her coverage, despite her fears she
would get sick again, she had to surrender her health insurance and was
forced to hang her fortunes on chance. I carried Natoma`s story with me
every day of the fight to pass this law.


O`DONNELL: Joining me now by phone is Natoma Canfield. Natoma, thank
you very much for joining me tonight. I know that two years ago, all you
were expecting was that your letter would be dropped in the pile and marked
as one more in favor of the president`s health care reform. That letter`s
had an amazing journey. The president talked about it today, that he
carried it in his pocket every day when he was fighting for this bill.

How did that make you feel to hear what the president said today?

CANFIELD: It was just a very big honor.

O`DONNELL: And when we talked a couple of years ago, you were then
undergoing chemo and radiation treatments. The first thing I want to know
is how is your health today? The president said that you`re now well.

CANFIELD: Yes, I`m cancer free. Yes, I`m well. I`ve got a lot --
long way to go before I`m physically and mentally back to where I was. But
I`m going to beat this thing.

O`DONNELL: There`s another -- there`s a passage of your letter that I
remembered reading today, and I looked at again. It said "I live in the
house my mother and father built in 1958. I`m so afraid of the possibility
I might lose this as a result of my being forced to drop my health care
insurance." Are you still living in that house?

CANFIELD: Yes, I am.

O`DONNELL: That`s great to hear. And what happened to your coverage?
You`re not still in the private health insurance, are you?

CANFIELD: No. After I dropped my coverage, my worst fears came true.
I collapsed at work, and they sent the ambulance for me and I found out I
had Leukemia. From that, the Cleveland Clinic helped me get on disability
and Medicaid. You can be on Medicaid for two years, and now I`m on

O`DONNELL: Yes, it`s a special provision of Medicare that -- you`re
just 53 years old.

CANFIELD: Yes. But when you have a disability, yes.

O`DONNELL: Natoma, the president called you today.

CANFIELD: Yes, he did.

O`DONNELL: And what did you talk about?

CANFIELD: Well, first of all, he asked how my sister was. She had
introduced him at Strongsville, Ohio, when he came. She and my brother had
gone to the signing of the health care bill. And then he asked how I was.
And he told me I was welcome to come to his office and see my letter
hanging up in his office anytime I wanted.

O`DONNELL: Well, I hope you get a chance to do that.

Natoma Canfield, thank you very much for joining me on the show once
again tonight.

CANFIELD: You`re welcome.

O`DONNELL: Michael Moore is up next.



OBAMA: Well, it should be pretty clear by now that I didn`t do this
because it was good politics. I did it because I believed it was good for
the country. I did it because I believed it was good for the American


O`DONNELL: Joining me now, Academy Award winning filmmaker and
activist Michael Moore. Tomorrow is the five-year anniversary of the
release of his Oscar nominated documentary "Sicko" on the health insurance

Michael, thank you very much for joining me tonight. The president
said he didn`t do this because it was a political winner, but he sure
looked like a political winner today. And it seemed to me that he found a
way of describing what he was trying to do in health care that really got
through to people.

first actual time he`s been on TV and explaining what exactly the health
care law was about that made perfect clear sense. If everyone in America
had been tuning into that, I think there would have been loud cheers
throughout the country.

It`s a huge day. It`s a great victory. As you know, you and I very
critical of the bill that got passed, because we thought, you know, it was
fairly watered down and not as far as it should go. And it`s going to need
to go further in the years to come obviously. And we all need to keep
working toward a true universal health care system that doesn`t leave 26
million people uninsured, as the current law does now and as you so
wonderfully and eloquently pointed out on your show last night.

But having said that, I mean, our side, we get so few victories that
it`s important to celebrate when the ball gets moved down the field. Maybe
you and I want the ball to move 50 yards down the field, and make maybe it
only went 20 yards down the field, but it moved down the field. And that`s
the big news of the day. I think, is that -- is that there`s no going back

O`DONNELL: Yes, Michael. I think the huge win is that this bill will
go forward. Most of the implementation will go forward. We`re going to
see what happens on the Medicaid piece. But it won`t be scary anymore.
There was this scary sensation about it that the public had. And the
notion that it was unconstitutional I think added to this thing that the
public had about I`m afraid of that thing.

And now that`s settled. And it is settled by the chief justice of the
Supreme Court.

MOORE: Right, one of their own, on their side of the political fence,
did the right thing. I`m sure a lot of them are upset tonight .people that
-- conservatives, Republicans, people on the right. But at some point, I
guess, I don`t know, maybe Mr. Roberts is a man of conscience. And part of
that conscience says that it would be immoral to upend this bill.

What was so great about this, Lawrence, is that -- not just that he
sided with the liberals. That would have been enough to just kind of blow
all of our minds, right? But he then -- but he was the one who actually
wrote the majority opinion. And not only that, he -- he felt that the
government didn`t really make its primary argument about the Commerce
Clause adequately.

So he went and tried to help them essentially write their paper for
them, and came up with the tax clause. I mean, that -- he went the extra
mile to make this happen.

O`DONNELL: He did. And he said in the opinion that that`s the
Supreme Court`s job. He quoted Oliver Wendell Holmes saying, it is our job
to go in and find the Constitutionality support for it, even if counsel
does not make the right argument.

MOORE: Right. He does not like the idea of universal health care.
He, I don`t think in the past has cared much for Obama. President Obama
did not vote for him onto the Supreme Court. And Chief Justice Roberts
messed up his Oath of Office on the opening day.

So -- but I just think, you know, this should just -- this victory, I
think, really should be a mandate for all of us now to just keep moving
forward, so that everyone is covered and so that the private, profit making
insurance companies are not running the show. They`re still running the

That part -- that piece of it is going to screw this ting up somewhere
down the line. People are still going to be hurt on some level because the
decision about the bottom line is still going to be there. That has to be
removed. And we`re 65 years behind the rest of the western industrialized

I know that we`re slow learners sometimes. But Geez, this is like
come on now. We`ve got this piece of it. Now let`s move forward and get
the next piece and the next piece. There`s no going back, though. This --
we`re on the path that -- of leading toward this universal health care.
We`re not on the path back to Oliver Twist. Those days are gone.

The Republicans and conservatives who are sitting around thinking
tonight, yes, we`re going to turn this thing around, I`m telling you
friends, this is a huge locomotive. And as the American public experiences
the parts of this bill that are really great, they`re not going to want to
turn that train around. So you better get on the train or watch your party
implode. That`s my words of advice.

O`DONNELL: Michael, one of the things that`s great about it is that
the health insurance companies -- I`m remembering one of the scenes of your
movie with Linda Peno (ph), whose job it was to deny people coverage. That
is no longer a job in these health insurance companies. It`s no longer a
legal job, anyway.

MOORE: That`s right, that job is done. They actually hired doctors -
- she worked at Humana. And they hired doctors to sit there and decide who
gets to live and who gets to die. And she couldn`t take it anymore. She
went and testified in Congress because she essentially felt that she had
killed a number of people because the company was saying, look, we`re not
going to make a profit if you pay all these claims that people are sending
in to us.

This should never happen. Nobody should be sitting in charge like God
there. And nobody should be making a profit off of somebody`s misfortune
and illness. And that really has to stop all across the board.

O`DONNELL: And Michael Moore gets tonight`s LAST WORD. Thank you
very much, Michael.

MOORE: Hey, thank you, Lawrence.


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