NBC News - Meet The Press
"3.12.17"
(BEGIN TAPE)
CHUCK TODD:
This Sunday, repeal, replace, and revolt. The Republican health care plan.
PAUL RYAN:
This is the closest we will ever get.
CHUCK TODD:
Supported by President Trump.
PRESIDENT DONALD TRUMP:
We must act now to save Americans from the imploding Obamacare disaster.
CHUCK TODD:
But attacked on one side by conservatives.
REP. MARK MEADOWS:
This is just Obamacare with a different label.
CHUCK TODD:
On another side by Republican moderates.
SEN. LISA MURKOWSKI:
Pulling the rug out from under these vulnerable populations is not really the direction we want to go.
CHUCK TODD:
And on all sides by Democrats.
REP. NANCY PELOSI:
Robin Hood in reverse.
CHUCK TODD:
This morning I'll talk to H.H.S. Secretary Tom Price, who oversees the overhaul, Kathleen Sebelius, the former H.H.S. secretary who oversaw Obamacare implementation, and Governor John Kasich of Ohio, who says both parties need to work together. Plus, the Russia connection. Democrats threaten to pull out of the investigation if it becomes too partisan. And when we hear statements like this--
PRESIDENT DONALD TRUMP:
'17 would be a disaster for Obamacare. That's the year it was meant to explode because Obama won't be here.
CHUCK TODD:
--are we becoming conditioned to dismiss what the president of the United States says? Joining me for insight and analysis are David Brooks, columnist for the New York Times, Stephanie Cutter, former deputy campaign manager for President Obama, CNBC's Rick Santelli, and Helene Cooper, Pentagon correspondent for the New York Times. Welcome to Sunday. It's Meet the Press.
ANNOUNCER:
From NBC News in Washington, the longest-running show in television history, celebrating its 70th year, this is Meet the Press with Chuck Todd.
(END TAPE)
CHUCK TODD:
Good Sunday morning. And congratulations for remembering to set your clocks forward an hour. Well, who knew that health care could be so complicated? House Republicans revealed their replace version of repeal and replace of Obamacare to decidedly mixed reviews. President Trump offered qualified support, allowing that changes could still be made to the bill.
But the proposal got hit on all sides by Freedom Caucus Republicans who say the bill doesn't go far enough in eliminating Obamacare, to moderate Republicans who say it goes too far, and to Democrats who are in effect folding their arms and just saying no. The left-leaning Brookings Institution predicts that at least 15 million people will lose coverage under this Republican plan. Many powerful health care organizations came out against it this week. And the White House is already casting doubt on the expected cost estimates to be made by the Congressional Budget Office.
(BEGIN TAPE)
SEAN SPICER:
If you're looking to the C.B.O. for accuracy, you're looking in the wrong place.
(END TAPE)
CHUCK TODD:
Well, those numbers should be coming out tomorrow or the next day. Still, proponents argue that any new plan, even if not perfect, would be a vast improvement over the current Obamacare system. And the time they say to make any sweeping change is right now.
(BEGIN TAPE)
PAUL RYAN:
This is the closest we will ever get to repealing and replacing Obamacare.
CHUCK TODD:
Republicans racing the political clock to push through a health care replacement bill have a message.
REP. KEVIN BRADY:
Republicans unified.
REP. VIRGINIA FOXX:
We are unified.
REP. DIANE BLACK:
We are unified.
REP. GREG WALDEN:
We're really excited about the unified votes.
CHUCK TODD:
But the fight over health care is exposing divisions within the Republican Party between small government conservatives, swing state moderates, and a president who ran as a populist and is governing as a nationalist. This week, two key House committees approved a plan to overhaul the Affordable Care Act but not before conservatives rushed out to pan the bill both in the House--
REP. MARK MEADOWS:
This is just Obamacare with a different label.
REP. MO BROOKS:
It appears to be the largest welfare program ever proposed by Republicans in the history of our country.
CHUCK TODD:
--and in the Senate.
SEN. TED CRUZ
The bill as written is not going to pass the Senate.
SEN. TOM COTTON:
Simply would not pass the Senate.
SEN. RAND PAUL:
It's dead on arrival.
CHUCK TODD:
Conservatives say tax credits are a government giveaway. And they want Obamacare's Medicaid expansion phased out more quickly. Then there are the Republican moderates, meeting fierce opposition at town halls. They are pushing back on the plan to phase out the Medicaid expansion by 2020 and to cap federal funding for Medicaid enrollees.
SEN. ROB PORTMAN:
In Ohio we have this expanded Medicaid. It is critical to covering people who otherwise would not be getting health care.
SEN. LISA MURKOWSKI:
Pulling the rug out from under these vulnerable populations is not really the direction we want to go.
CHUCK TODD:
During the campaign, the president even was open to further expanding Medicaid.
PRESIDENT DONALD TRUMP:
We will get--
CHUCK TODD:
You will expand Medicaid?
PRESIDENT DONALD TRUMP:
We will-- You can do it through Medicaid. You can do it through some other way. But I'm just saying very simple. And this has nothing to do with single-- This has to do with humanity. This has to do with having a heart.
CHUCK TODD:
And in January Mr. Trump promised insurance for everybody, telling the Washington Post, "There was a philosophy in some circles that if you can't pay for it, you don't get it. That's not going to happen with us." But conservatives want to scrap Obamacare completely. And they call the current House Republican bill “Obamacare Lite.” Will the president use his own political capital to insist that Republicans put aside ideological differences and support the bill? On the campaign trail, Mr. Trump promised he would own health care.
PRESIDENT DONALD TRUMP:
We'll call it Donaldcare.
CHUCK TODD:
But this week, Mr. Trump has preferred to stay behind the scenes, schmoozing lawmakers but so far not twisting arms. It was Vice President Mike Pence in Kentucky on Saturday selling health care, not the president.
VICE PRESIDENT MIKE PENCE:
For us to seize this opportunity to repeal and replace Obamacare once and for all, we need every Republican in Congress. And we're counting on Kentucky.
(END TAPE)
CHUCK TODD:Yesterday afternoon, I spoke with the secretary of health and human services Tom Price whose job it will be to implement the Obamacare replacement. I started by asking him whether the Republican plan, which leaves much of the Obamacare architecture in place, is an acknowledgement that the health care system can’t be run by the free market alone.
(BEGIN TAPE)
SECRETARY TOM PRICE:
No, not at all. And obviously this is a transition that we're going through, but the important thing is to appreciate that the market as it is right now is failing. Obamacare, the ACA, has failed. You’ve got premiums going up, you've got deductibles where people have an insurance card but they don't have any coverage, got a third of the counties in this nation that only have one insurer offering coverage, five states with only one insurer offering coverage.
That's not a choice nor is it responsible to the individuals who are going to be selecting the coverage. So what we need to do is to fix this, to move in a direction that puts patients and families and doctors in charge of their health care, and not Washington, D.C.
CHUCK TODD:
I know there's a lot of talking points that are being used that Obamacare is failing. But if you have a system where, yes, premiums went up, but also enrollees-- enrollment went up too, that's not the definition of a failing system.
SECRETARY TOM PRICE:
Well, in fact the number of individuals who actually got coverage through the exchange who didn't have coverage before, or who weren't eligible for Medicaid before is relatively small. So we've turned things upside down completely for three or four or five million individuals. Now, what's happened is that premiums didn't go down as the previous president promised, they've lost the coverage that they had, they've lost the ability to see the doctors or the provider that they wanted to see. So we need to move in a direction again that respects the principles of accessibility for all, affordability for all, quality, and choices for patients, making certain that we, again, have that patient-centered system.
CHUCK TODD:
Well, let's go to the affordability aspect a little bit. First of all, can you say for certain that once this bill is passed nobody, nobody will be worse off financially when it comes to paying for health care?
SECRETARY TOM PRICE:
Well, I'll tell you right now, there are a lot of people that are worse off right now when they're paying for health care and they aren't getting the care that they need. Again, the premiums are up and deductibles are up. If you're an individual out there making fifty, sixty thousand dollars and your deductible is eight, ten, twelve thousand bucks you may have that insurance card, but you don't have coverage. And I hear from my former colleagues all the time about patients who come into their office and they recommend something for them, and they're not able to get it because the deductible is so high.
CHUCK TODD:
But I notice you ducked the aspect of whether you can guarantee that nobody will be worse off financially?
SECRETARY TOM PRICE:
I firmly believe that nobody will be worse off financially in the process that we're going through, understanding that they'll have choices that they can select the kinda coverage that they want for themselves and for their family, not the government forces them to buy. So there's cost that needs to come down, and we believe we're going to be able to do that through this system. There's coverage that's going to go up. Remember Chuck, there are 20 million folks right now in this nation who said to the federal government, "Phooey. I'll pay a penalty or I'll take a waiver. I'm not even going to get coverage in the system that we currently have." That may be a system that works for government or insurance, but it doesn't work for people.
CHUCK TODD:
So you believe your system--
SECRETARY TOM PRICE:We need a system that works for people.
CHUCK TODD:
You believe your system's going to add an additional 20 million over the 20 million that have had expanded coverage? You really believe that?
SECRETARY TOM PRICE:
We believe that-- We believe, I believe and the president believes firmly that if you create a system that's accessible for everybody and you provide the financial feasibility for everybody to get coverage, that we have a great opportunity to increase coverage over where we are right now. As opposed to where the line is going right now where people are losing coverage, and we're going to have fewer individuals covered than we do currently.
CHUCK TODD:
All right, let me go to this financial feasibility issue here. Because in Fayette County, West Virginia, this is one example, Kaiser Family Foundation estimates the following: That the $4,000 tax credit that a 60-year-old making $30,000 a year that will get under the American Health Care Act is almost $8,000 less than they would get under Obamacare.
This is a county, by the way, that voted overwhelmingly for President Trump. The point is this, is you say this is going to make it more affordable, and access to coverage under this plan, in this county, in this state, less money and more expensive for these folks.
SECRETARY TOM PRICE:
That's looking at it in a silo. If you look at it in the way that the market will allow, then, for individuals to have choices, who knows what that 60-year-old wants? I know that the federal government doesn't know what that 60-year-old wants. I know that he or she knows what he or she wants. And the way that you provide decreasing cost and choices for folks, you make it so that the system can actually be responsive to that individual. That's the way you drive down costs.
CHUCK TODD:
Why not means test the tax credits? Why do it by age, where you may essentially have it where you're incentivizing folks not to buy health insurance until they actually need it?
SECRETARY TOM PRICE:
Yeah, it's a great question. In fact, I've been working on this for so long I've gone through the phase where I had it completely related to income, and then became convinced by the folks who actually do this on a day to day basis, day in and day out basis that the most predictive element of an individual's life in terms of what health coverage will cost is not income, and it makes sense, it's age.
As your age increases, your health care costs increase, and the cost of the coverage increases. So they've pegged it to age. There's an opportunity to put some means testing in there but that's not the most, that’s not the correlation factor to what it actually costs. Age is the thing that correlates best to what health coverage costs.
CHUCK TODD:
Okay. But age is also-- And this is, look-- And this is a part of Obamacare that didn't work, which was to try to get as many young people on the system. They needed 40% of folks under 35 in the system to keep premiums down, it hasn't gotten to that high. But how do you do it? How does it do it here? Because again, this system seems to essentially say to folks under 35, "Don't worry about it. If you don't want to get health care, we're not going to make you do it." And that only increases premiums for folks, for older folks, does it not?
SECRETARY TOM PRICE:
No. What we do is actually say to that 30, 35-year-old individual, "You know that you need health coverage. What we're going to do is provide a system that allows you an array of choices so that you can respond and choose the coverage plan that works best for you and your family, not be dictated to by the federal government and have to purchase something that you most likely do not need."
CHUCK TODD:
We have two pieces of information we do not have yet, and yet there is already voting going on in Congress. One piece of information is the estimate of this bill of how many people would be covered, and the second is on what's the hit to the deficit. On the coverage issue-- We don't know the financial issue yet. On the coverage issue, a couple of estimates out there, one as high as 15 million fewer people covered, according to one estimate for Brookings, that that's what they believe the Congressional Budget Office is going to end up showing when they finally are able to come out with an estimate. Fifteen million, is that an acceptable number to you? If that's what it really is, do you go back and say, "We got to tweak this?"
SECRETARY TOM PRICE:
Well, I'll tell you that the plan that we've laid out here will not leave that number of individuals uncovered. In fact I believe, again, that we'll have more individuals covered, and I think we'll have folks that are evaluating this and modeling this come out and say, "Yes indeed, this plan will, in fact, cover more individuals than are currently covered," remembering right now the trend line is down on the number of individuals being covered, it's not increasing.
And the CBO estimate five, six, seven years ago when this started, they estimated that over 20 million people would have coverage at the end of the ten-year window. In fact, it's about half of that right now. So CBO has been very adept in not providing appropriate coverage statistics.
CHUCK TODD:
All right, this plan has some Medicaid expansion in it to a form, although you cap it in certain respects, this plan has tax credits, another name for a subsidy. It's made some on the right say, "You know what? This is Obamacare Lite. You're essentially accepting the architecture but just trying to remodel the building." What say you?
SECRETARY TOM PRICE:
No, absolutely not. In fact, this is a little puzzling because independents and conservatives for decades have said, "Shouldn't we equalize the tax treatment of the purchase of health coverage for folks who get it through their employer and folks who aren't able to get it through their employer?" And that's exactly what the tax credits do. We don't dictate to people what they ought to buy or what they must buy.
What we do is say, here's an opportunity for you to use a tax benefit that every, the 175 million individuals that are getting their coverage from their employer, those folks have a tax benefit. It's the moms and the pops out there--
CHUCK TODD:
By the way, should those folks have--
SECRETARY TOM PRICE:
--it's the person who's working at the corner grocery or the corner cleaners.
CHUCK TODD:
Should those folks have a tax benefit or should people like you and me have to pay taxes on those health insurance benefits?
SECRETARY TOM PRICE:
If part of our society has a tax benefit for the purchase of health coverage then I'm of the belief and the president is of the belief that it needs to be fair for everybody. And that's the kind of system that we're looking for--
CHUCK TODD:
So you either tax-- but you don't want to raise ta--
SECRETARY TOM PRICE:
--that's why you've got to have a tax credit.
CHUCK TODD:
So that's why you want a tax credit, but you're not going to get that revenue from upper income folks who get generous health insurance policies from their company?
SECRETARY TOM PRICE:
Well, that's another system that's been in place. As I say, 175 million folks are getting their coverage through their employer right now, and that's a debate that we ought to have. But the fact of the matter is, is that the vast majority of the American people support making it equal for individuals who are getting it from their employer and not getting it from their employer. They're out there in the individual and small group market, which has literally been destroyed by the ACA. And that's what we're trying to reconstitute. That's what will reinvigorate the insurance market, but it will also drive down costs because you'll have competition and transparency in the system.
CHUCK TODD:
You accept this bill, you own this bill; President Trump accepts this bill, he owns this bill. Fair?
SECRETARY TOM PRICE:
We strongly support the plan, which is this bill, the regulatory opportunity to modify the system in a way that works for patients, and the other pieces of legislation that are required that can't go through on the first part.
(END TAPE)
CHUCK TODD:
My thanks to H.H.S. Secretary Tom Price, who I spoke to yesterday. Last month, President Trump famously said, "Nobody knew health care could be so complicated." Well, at least one person did. Kathleen Sebelius was the Secretary of Health and Human Services for almost half of the Obama administration. And she was and is a strong advocate of Obamacare. Kathleen Sebelius joins me now. Nice to see you. Thanks for coming in.
KATHLEEN SEBELIUS:
Nice to see you. Thanks.
CHUCK TODD:
Let me start with a question about the Republican plan and whether you accept the idea that this is “Obamacare Lite.” Do you believe they've kept the architecture of Obamacare in place?
KATHLEEN SEBELIUS:
Well, I'm not sure exactly what the goal is. We were pretty clear in the Obama administration about what the goal was. Insure everybody. Get everybody into the health system. We knew we had to change insurance rules to do that. No more preexisting conditions. People who were buying insurance on their own needed some financial help in the marketplace because they didn't have an employer contribution.
You could keep kids on their parents' plan and make Medicaid equal across the country. So whether you lived in Georgia or California, you qualified as a low-income adult at the same level. I'm not sure what the goal is here. So they have kept some pieces. The preexisting condition. They have kept some subsidies but I would say in sort of the wrong place to the wrong folks. And people will have trouble--
CHUCK TODD:
Wait. Look, I understand on that. But if this were the plan in place and you and President Obama were back in office in four years and you could re-implement Obamacare, could this architecture that the Republicans are putting together essentially be used to re-implement Obamacare?
KATHLEEN SEBELIUS:
I don't think so. Because I think this does serious damage to the whole marketplace theory. And companies will flee given the uncertainty and the likelihood this quickly becomes a high risk pool.
CHUCK TODD:
Now, they make the argument, by the way, that companies are fleeing now because they feel as if it's too expensive to try to insure everybody. And we do have this issue in rural America. It's truly the rural counties that have been hit the hardest on Obamacare, they don’t-- when it comes to the word choice.
KATHLEEN SEBELIUS:
Well, I think that's true, Chuck. There's no question this is a young and fragile market. It's been made that way sort of intentionally by Congress, who blocked the risk sharing. I was interested in the piece in this bill that has a state stability pool, recognizing that you really do need to get a stable market.
This also was a monopolistic market for decades before the Affordable Care Act. So the notion that somehow it blossoms overnight. There are new insurers in. I was in Florida last week. Pat Geraghty, who is the head of the Blue Cross Blue Shield of Florida. Florida has not been a welcoming state to this law. Pat Geraghty ended up 2016 open enrollment with 1 million members in the Florida marketplace and as a company in the black. He said, "Of course this works. We can make it work. We can go forward."
CHUCK TODD:
I want to play something that former President Bill Clinton said on the campaign trail and get your reaction to it when it comes to health care. Take a listen.
(BEGIN TAPE)
BILL CLINTON:
The people who are getting killed in this deal are small business people and individuals who make just a little too much to get any of these subsidies. So you've got this crazy system where all of a sudden 25 million more people have health care. And then the people are out there busting it sometimes 60 hours a week wind up with their premiums doubled and their coverage cut in half. It's the craziest thing in the world.
(END TAPE)
CHUCK TODD:
Obviously Republicans took those comments and had a field day with them.
KATHLEEN SEBELIUS:
You bet.
CHUCK TODD:
Did he have a point?
KATHLEEN SEBELIUS:
Well, he does have a point. There is a cliff. It was set in this bill at 400% of poverty. And then you don't any longer have a subsidy. In the marketplace right now, about 85% of the folks have a subsidy. So every talk about premium increases, that isn't what consumers are paying because actually their subsidies rise with the premiums' rise.
Again, this is fixable. You could have a much more graduated subsidy system. You could have a higher income point. That could easily be done to stabilize the marketplace. But that wasn't what the Republican Congress wanted to do. They wanted to actually dismantle this bill from the outset.
CHUCK TODD:
One of the pledges that Secretary Price made to me in that interview was there will be more people covered under his plan. What do you make of that proclamation?
KATHLEEN SEBELIUS:
Well, what I know right now, and this is a real fact, is that we are at the lowest point of uninsured Americans that has ever been recorded. Under 10% of Americans lack coverage. That's still too many, but that's where we are. There is no estimate looking at this bill that with less money going to subsidies, with older Americans being able to be charged five times what younger Americans are being charged, and with no variation based on income that more people will have coverage. There is every estimation that anywhere from two 2 to 15 million people will lose coverage in this bill. And they are going after Medicaid expansion, which is a lot of lower income working adults who will also lose that coverage, so--
CHUCK TODD:
But what do you say to conservatives who worry that the Medicaid expansion that's in Obamacare will only make it a permanent entitlement program, that people will never get off Medicaid? What do you say to that criticism?
KATHLEEN SEBELIUS:
Well, actually that's a good point. And I think they have gone, they've doubled down on Medicaid. Republicans for a while in the Congress have been really fundamentally opposed to the 50-year-old partnership with states and the federal government about Medicaid, a health safety net.
They not only in this bill go after the expanded population, which is actually much cheaper to insure in Medicaid than it is in the private market. Lower premiums, lower out-of-pocket costs. But they have gone after the traditional Medicaid program, disabled individuals, poor kids, pregnant moms, half the births in the country, the largest payer for nursing home care, and said, "We're going to cap what the feds pay." Those populations don't go away. I used to run a Medicaid program as a state. We have 11,000 people a day turning 65. There are going to be more people in nursing homes. More-- And that cost shifts to the state. It shifts to the local government. But more it shifts to taxpayers.
CHUCK TODD:
All right. Kathleen Sebelius, I have to leave it there. Former H.H.S. secretary, I have a feeling though you'll be back because this debate is not ending anytime soon.
KATHLEEN SEBELIUS:
You bet.
CHUCK TODD:
Nice to see you. Thanks for coming in. Coming up, the winners and losers under the Republican plan. There's a lot of irony in the answer. And later, the Russia connection. Democrats threaten to pull out of a congressional investigation if they believe it's become too partisan.
***COMMERCIAL BREAK***
CHUCK TODD:
Welcome back. Panel is here. Rick Santelli from CNBC. Helene Cooper, Pentagon correspondent for the New York Times and author of this new book, Madame President. It's a fantastic book. Trust me. Stephanie Cutter, former deputy campaign manager for President Obama. And David Brooks, columnist for the New York Times. Welcome all. Let's dive into some health care politics. Rick Santelli, you're a free market guy. Where are you on this? And what do you think of this Republican plan? Too much Obamacare? Too little Obamacare? What is it?
RICK SANTELLI:
You know, I think health care is a mess. I think that as a free market person, you can't even have that discussion unless you know what the service cost. I mean, I go to the doctor. I have a daughter for a while that didn't have insurance. She gets a different price than people who have insurance.
I think we need more market spirits and competition. I certainly don't see it in this bill. But I do understand that repeal and replace would have been easier if there was a mandate. President Trump won. We could argue about the mandate. There's a problem here. If you deal with the reality of politics, I understand phase one and phase two. If we want to fix it the correct way, I just think the politics are impossible to accomplish that. Here we sit.
CHUCK TODD:
Yeah. What do you think of that, David? I think he's right. We may be in a position where we can't fix this if neither party is going to participate in the other party's bill.
DAVID BROOKS:
Yeah. No. Well, here's what I don't get about what's going on this week. We just had 2016, an election about the working class. Election where we learned that a lot of people are out of the job market. The social fabric is fraying. And so the lesson is pay attention and help these people.
So the Republican Party could help these people with market-based mechanisms, which I support. Do they do that? No. They have huge tax cuts for the rich. This investment income tax credit only goes to people above 250. And that has been stable in all the plans that they've come up with and thrown around.
And meanwhile they're throwing 8, 10, 15 million people off the rolls. So it's declaring war on their own voters. And then there's a wing of the party that's saying, "No, that's too much. We need to totally decimate them." So the Republican Party has to figure out, "Are we going to help our voters? Or are we still the party that, you know, we're still going to be the party of the rich?"
CHUCK TODD:
Stephanie, it does seem as if they're united on the politics of health care. But I think what you're hearing is they're not united on the policy of what they want.
STEPHANIE CUTTER:
Well that’s because they aren’t actually, you know, I hate to, you know, shed truth on this. But they're not looking to actually fix the policy. They're looking to fulfill a campaign promise. And I agree with David that Trump was on the campaign trail making promises to his voters about lowering costs and increasing coverage.
This bill does nothing on either one of those accounts. So, and the fact that they're pushing it through in the dark of night, 4:30 a.m. this bill comes out without C.B.O. scoring, which, you know, it's a very inside Washington thing. But that's the independent thing to tell you exactly how many people are going to be covered, how many people are going to lose their coverage, what it's going to cost, and what it's going to do to impact the deficit. We don't know any of that. They're voting on this with no information on what their bill actually does.
HELENE COOPER:
What I find really interesting is that they're already trashing--
STEPHANIE CUTTER:
Right.
HELENE COOPER:
--what the C.B.O. is about to come up with. Tom Price just sat there and said, "Well, they've made mistakes in the past." They're already positioning. You can hear exactly what's going to be coming out--
CHUCK TODD:
They expect a bad number. Right.
HELENE COOPER:
They expect a bad number. And so they're already trying to discredit it, which I find really, really funny.
CHUCK TODD:
But, you know, it's interesting. And you point this out, Rick, sort of in your first answer. Ross Douthat writes this in Wednesday in the New York Times. "In fairness to its designers, there was no bill that could have united all of the right's disparate factions. Because on health care policy, as on a range of issues, the Republican Party is an organism that does not know what it believes in anymore." You think that's right?
RICK SANTELLI:
Well, I think it's partially correct. I think when it comes to this particular issue, first of all we're watching the sausage get made. And we're watching it with a lot of eyes broadcasting to the entire country. We don't actually know. I believe Trump's a compromiser.
I've said from day one when Donald Trump gets in there, he's going to make an equal number of Republicans unhappy as Democrats unhappy. And I don't think we've gone through the process. The one thing I will stand up for. As messy as this is, I don't like Borgs. I like everybody to have different ideas. I think this bill's going to get marked up. And I think what the president allows the markings to do to get it passed will be surprising to both parties.
STEPHANIE CUTTER:
Yeah. Agree.
DAVID BROOKS:
I would just say the Republicans are at a historical pivot where we used to have this old argument the government versus the state or the market versus the state. And it was pro-government, small government. Now, the social fabric is decaying. Capitalism isn't working for a lot of people.
So if you want to be pro-market, you've got to people the security so they can compete in the market. And you have to use the state to give them that security. And so therefore if you want to be pro-market, you got to be pro-government at least in some form. And Republicans are caught in that historical pivot.
STEPHANIE CUTTER:
You know, I think for health care it's sort of an impure test on the politics because you're dealing with life and death issues. And for both parties, it’s not-- you can't have purity. There needs to be a mix of free market as well as government intervention and government stability. And so we went through this how many years ago?
CHUCK TODD:
Well, right.
STEPHANIE CUTTER:
Eight years ago? And without Republican-- Even though we were putting forward Republican ideas, Republicans refused to participate. And it caused factions in our own party.
CHUCK TODD:
It poisoned the well.
STEPHANIE CUTTER:
Ultimately, it poisoned the well because Republicans wouldn't participate. But ultimately it's going to take everybody coming together to fix this problem. This is a--
CHUCK TODD:
And what’s the likeli-- And, Helene, what's the likelihood--
HELENE COOPER:
There’s no likelihood of that. Yeah.
CHUCK TODD:
--of this town doing that this year?
HELENE COOPER:
I’m also-- I'm going to be curious to see whether the White House actually gets behind this in a real way. I've seen nothing in this past week that-- Yeah.
STEPHANIE CUTTER:
Well, there's a reason why they're not saying it's Trumpcare.
CHUCK TODD:
But that’s-- But, by the way, to pick up on Rick's point, if you're a negotiator, then it is smart to have some distance. But we'll be curious how much distance does he have. When we come back, Ohio Governor John Kasich on why our two political parties need to stop being at each other's throats and on the credibility of President Trump. We'll be right back.
***COMMERCIAL BREAK***
CHUCK TODD:
Welcome back. Even though Governor John Kasich of Ohio won only one primary, Ohio, last year, he developed a reputation as a Republican who was willing to work with Democrats and really say what's on his mind. And Friday he had an op-ed column in the New York Times arguing that Democrats created Obamacare without Republican support and that Republicans are now trying to repeal and rewrite the law without Democrats. He said Democrats were wrong then and Republicans are wrong now. Governor Kasich joins me now. Not surprising to hear something like that from you.
GOV. JOHN KASICH:
Well, it's not sustainable. If you don't get both parties together, nothing is sustainable. I mean, if they pass this just by themselves, we'll be back at this again.
CHUCK TODD:
In three years when Democrats take over or whatever.
GOV. JOHN KASICH:
Well, you know, look. The other thing is I was there when we created the CHIP program, the health program for children. It was done on a bipartisan basis. It was sustainable. I was there in '97 when we did the budget deal. I was one of the architects. It was sustainable. But when you jam something through just one party over another, it's not sustainable. It becomes a point of attack.
CHUCK TODD:
All right. I want to get to some of the substance of this new bill. Here's what Vice-president Pence said to an Ohio TV station, clearly lobbying you and Senator Portman. Take a listen.
(BEGIN TAPE)
VICE PRESIDENT MIKE PENCE:
I'm very confident that this legislation will give Ohio both the resources and the flexibility that your governor, your legislature will need to be able to meet those needs going forward and literally offer our most vulnerable citizens even better coverage.
(END TAPE)
CHUCK TODD:
Is he right?
GOV. JOHN KASICH:
No, he's not right. I mean, first of all, Medicaid expansion, which has covered 700,000 people in my state, a big chunk of whom are mentally ill and drug addicted and have chronic diseases. They tend to churn and move off of that program. Then they have to go to an exchange that's broken.
Look, the bill needs fix. The current system doesn't work. That's why it's possible to get Democrats involved. But you don't want to throw the baby out with the bathwater. And let me just ask you this, Chuck. If I put you on an exchange for your family and I give you a $4,000 tax credit or a $3,000 tax credit, what kind of insurance are you going to buy for $3,000?
CHUCK TODD:
Are you going to offer any? Will you be able to offer that in the state of Ohio?
GOV. JOHN KASICH:
Well, that'll be up to the private market. But what I would tell you is the exchange needs to be fixed. Because in some places there's only one insurance company. I mean, that can be fixed. I've said it all along. It's not like we love Obamacare. It means don't throw the baby out with the bathwater.
Don't kill Medicaid expansion. And you've got to fix the exchange, but you have to have an ability to subsidize people at lower income levels. Chuck, let's forget all this. Here's what we're talking about. If you're drug addicted, if you're mentally ill, you have to consistently see the doctor. From what I see in this House bill, the resources are not there.
If you're chronically ill, you're going to have to have consistent coverage. Under this bill, you don't have it. Now, my hope is this is probably going to pass the House. It's going to get to the Senate. And that's where I hope that they will make improvements. And that's where I hope Democrats will come in and work with Republicans to bring about the improvement so we can reform the system yet still not cut off these people that need this help.
CHUCK TODD:
Before we figure out how you incentivize Democrats to get involved in this, let me ask you about President Trump here. Because candidate Trump made it seem as if he was open to a lot of ideas, including maybe expanding Medicaid in one interview with me. But certainly saying there was going to be insurance for everyone. There wasn't going to be people that were going to be priced out of the market. He is supporting this bill. How, I know he’s obviously spent-- I know he's been lobbying you and you've been lobbying him back and forth--
GOV. JOHN KASICH:
Well, I talked--
CHUCK TODD:
You guys have spent a lot of time talking about this. Do you think he is firm on this bill? Or is he negotiable?
GOV. JOHN KASICH:
Well, how can I speak for him? But if I were to guess, no. I think that he's very open to compromise. He's told me that. For example, he and I talked about the significant increase in pharmaceutical costs, drug costs in Medicaid.
CHUCK TODD:
Do you think the right's pushing this bill too far?
GOV. JOHN KASICH:
Look, what’s happening this bill right now -- I'm the governor of the state. With my people, we have to treat people who have these illnesses. And the fact of the matter is it will put us in a bind. Now, that doesn't mean that we can't fix this along the way. But we need to have Democrats involved so that what we do is going to be not only significant but will last.
And then we get to the real problem, Chuck, which is the rising cost of healthcare. And that's where Santelli really hit the nail on the head. We need to get to more of a market-driven system where we pay for quality, not for quantity in health care.
CHUCK TODD:
You know, you were talking about incentivizing Democrats--
GOV. JOHN KASICH:
I think the president, by the way, would be flexible. I have no doubt about that he would be flexible. He just wants to get something through.
CHUCK TODD:
The idea of getting Democrats involved here. The other day, President Trump kind of expressed what sounded like a conspiracy theory about Obamacare implosion in 2017. Take a listen.
(BEGIN TAPE)
DONALD TRUMP:
'17 would be a disaster for Obamacare. That's the year it was meant to explode because Obama won't be here. That was what it was supposed to be. It'll get even worse. As bad as it is now, it'll get even worse.
(END TAPE)
CHUCK TODD:
Is this any way to incentivize Democrats to get involved? If you go down this road of saying, "Oh, it's a conspiracy," and, "They were hoping that it would implode when it wasn't on his watch"?
GOV. JOHN KASICH:
We're all big boys and girls in this town. I mean, if you really want to be a leader. Look, I believe the political parties are disintegrating before our very eyes. I think more and more people across this country see no purpose for political parties.
CHUCK TODD:
Do you?
GOV. JOHN KASICH:
Because -- I'll tell you something. You talk to people. There are more and more independents because of the squabbling. What's at risk here to Democrats is you can't turn your back on these people. And to Republicans, you need to invite Democrats in because we're talking about lives.
All this consumption with who gains politically, you know, life is short. And if all you focus on in life is what's in it for me, you're a loser. You are a big time loser. And this country better be careful we're not losing the soul of our country because we play politics and we forget people who are in need.
CHUCK TODD:
If you were just a citizen and not an elected official, would you be a member of the Republican Party right now?
GOV. JOHN KASICH:
Well, I'm not going to be a Democrat because the problem is they're top-down people. The Republicans should be bottom up. And I think right now they're trying to fulfill campaign promises. But I have to tell you that you have to put people first. And we have to drive a system from the bottom up.
CHUCK TODD:
You sound like a guy -- you sound like a guy ready to move to the independent wing of this country.
GOV. JOHN KASICH:
No, I'm a Republican because I'm a conservative. But we have to always examine our beliefs and our philosophies. And I would say on this bill you have to be in a position where you reform the system but you don't leave people behind. You just can't do it because these are people that could be in your family, live right next door to you.
We have to care about people. And we can get this done. We can reform it. We can change it. We can save money and have a better system. I don't have any doubt about it. We can do it. And I can prove it to you in my state where we have controlled Medicaid and yet been able to reach out and help so many people who live in the shadows.
CHUCK TODD:
Nothing more contagious sometimes than your enthusiasm for policy. It's always good to have you on, sir. Governor John Kasich--
GOV. JOHN KASICH:
Thank you, Chuck.
CHUCK TODD:
--Republican from Ohio, thanks for coming on and sharing your views. When we come back, the latest political lesson in why you might want to be careful about what you wish for.
***COMMERCIAL BREAK***
(BEGIN TAPE)
CHUCK TODD:
Welcome back, Data Download time and we’re looking at the new winners and losers of the House Republican healthcare plan to repeal and replace Obamacare. In fact, we’re going to take a closer look at this with a county-level analysis from the Kaiser Family Foundation and overlay it with a little politics.
Starting with Clark County, Nevada, home to Las Vegas. Clinton, by the way, carried the county with 52 percent of the vote. Under the Obamacare, ACA, a 60-year-old making $40,000 a year qualifies for a federal subsidy of $4,380 per year for a mid-level insurance plan. Under the proposed House Republican plan, they would just get a flat credit of $4,000. Which means they’d have to find another $380 more per year out of their own pockets.
Now, let’s move over to rural Northumberland County, Pennsylvania. Donald Trump won this county with 69 percent of the vote. With Obamacare, the same 60-year-old qualifies for a subsidy of, ready for this, $11,150. With this new House Republican plan, he or she would get just $4,000 - it’s that same $4,000 tax credit. Which means they’d have to dig out more than $7,000 out of their own pocket to pay for additional coverage.
Let’s look at 81 percent of the counties that voted for Hillary Clinton overall. In fact, a 60-year-old making $40,00 a year would see their subsidy decline overall. The same would be true for 93 percent of the counties carried by Donald Trump. In fact, Trump counties would also see bigger subsidy cuts. This is a point that many democrats have been making.
In fact, here’s another way to look at it which is two examples from The New York Times’ upshot. Those who stand to gain at least $2,500 in subsidies, they were split in November 47-46, Clinton over Trump. But those set to lose anywhere from $5,000 to $7,500 in federal assistance for healthcare, they voted 60-35 Trump over Clinton. So, in other words, financially in this plan it is Trump folks who get hurt more than Clinton voters.
Look, President Trump and republicans in Congress were elected largely on one of the promises being to repeal and replace the Affordable Care Act. Trump’s strongest supporters may get the repeal that they wanted, but higher costs could come as part of that deal.
Coming up, why the Trump administration suddenly thinks the jobs report that was once 90 percent fiction is now right on the money.
(END TAPE)
*** COMMERCIAL BREAK ****
CHUCK TODD:
Welcome back, let’s turn our attention to just the economy as a whole. There was a pretty decent jobs report this week, but what was amazing was the reaction to the jobs report from the Republican side of the aisle. Take a listen:
(BEGIN TAPE)
DONALD TRUMP:
And you take a look at that jobs report. The jobs report is fiction. Because all of the people that gave up—
CHUCK TODD:
It’s total fiction?
DONALD TRUMP
I would say…honestly
CHUCK TODD:
You don’t think there have been improvements from the crash obviously…
DONALD TRUMP
Honestly I would say a 90 percent...we all have improvements from crashes.
SEAN SPICER:
I talked to the president prior to this and he said to quote him very clearly. They may have been phony in the past, but it is very real now.
(END TAPE)
CHUCK:
Sean Spicer trying to use humor there. For comparison’s sake, here is the last three Februaries jobs numbers: 235,000 this last February, it was 237,000 in ‘16, and 2015 it was 238,000. So, Rick Santelli, thousands of jobs have been lost. We’ve lost 2000 jobs. Is it a mistake sometimes that the president , when he was a candidate, said too many crazy things like that?
RICK SANTELLI:
I think it is a mistake for candidates, or once they get elected in office, to be dwelling too much on the topic of markets. Markets are unforgiving, and sometimes they move for reasons we can’t possibly foresee. But when it comes to jobs, jobs, jobs - and I might be the first person to yell it that way--
CHUCK: Sure
RICK SANTELLI:
What I would say is this. Why are jobs important? Because it needs to translate into growth. And there's a step that's been missing there. I think that the president is wrong. I think we have a consistent low-variance monthly report on jobs. What we need to work on is the notion of why we cover it so closely. We need enhanced productivity. And maybe that's on the regulatory side to be addressed in the future. But we need to get more Americans being able to be better consumers. And the best way to do that's put more money in their pockets.
CHUCK TODD:
You know, Stephanie, it struck me in this jobs report he shouldn't have said this was a good jobs report. If you want to get a trillion-dollar infrastructure plan and you want to create a sense of urgency that you need to do this, don't you say this isn't enough? Don't you make Rick's argument?
STEPHANIE CUTTER:
Well, I mean, first of all, who can explain what Donald Trump says about anything? And I find it kind of insulting that Sean Spicer was laughing that now Donald Trump thinks these numbers are--
RICK SANTELLI:
But it was a little--
STEPHANIE CUTTER:
--credible.
RICK SANTELLI:
--funny the way it was phrased.
STEPHANIE CUTTER:
As somebody who lived through those job reports, and I know you did, too, they were actually--
STEPHANIE CUTTER:
--once very important. When we were shedding 700,000 jobs a month, they were very important barometers of how this country was doing. I agree with Rick that we've got to look at other things. If we want to increase productivity, we do need to make investments in things like infrastructure. So I'm not sure that President Trump thinks that far ahead though. He's looking for that easy victory, that easy score.
CHUCK TODD:
And, David, this gets at this other issue with President Trump. And it goes to this weird comment he made that, "Oh, Obamacare was designed to implode in 2017." He so easily grabs onto a myth to make a quick point in the moment. And it does always backfire on him.
DAVID BROOKS:
Yeah. You know, one of the reasons this country is great and pretty successful is that we've got pretty good institutions that are basically pretty honest. Of course they make mistakes because we're all human. We've got the Congressional Budget Office, the Bureau of Labor Statistics, the intelligence agencies. They make mistakes, but they make us smarter. And what's happening is this administration, a lot of people out there in the world, are saying they're all corrupt. The deep state, they're all--
CHUCK TODD:
You hear the deep state phrase--
CHUCK TODD:
--which is real paranoia.
DAVID BROOKS:
It's all corruption. They're all dishonest. They're all rigged. They're actually not all rigged. If you get to sit in these offices, you go visit them here in Washington, they're filled with people you can't figure out why they're working there. Because they're not making much money and they're pretty good people. And they're just trying to do their job and serve the country. And it's sort of intellectual pollution to say that it's all corrupt and rigged.
HELENE COOPER:
But this is what you get I think with a president who has made it almost his mission for the last two months now that he's been in office to turn into an opposition party just about everything that doesn't necessarily conform to his view of the world or agrees with him.
It's including the intelligence community, including what we just heard about the C.B.O., including what he said in the past about the Bureau of Labor Statistics. If they're giving him something that he doesn't agree with, he's going to say it's all, you know--
CHUCK TODD:
This deep state talk feels very, very destructive, Rick.
RICK SANTELLI:
You know, I think the deep state topic in general is very destructive. Just consider this. We now have the technology to pretty much hear everything. Can you imagine how our holiday dinners would be if every relative's entire conversations from birth to that moment in time was shown to every other relative?
See, we're really playing with dynamite here. And I think this really transcends some of the stories of the day. And when it comes to Bureau of Labor Statistics or the C.B.O., what I find is inaccuracy is nonpartisan, okay? Because we can have a conversation about accuracy. I think it's the intention behind it that really is the issue.
CHUCK TODD:
All right. I'm going to take a quick pause here. We'll be back in 45 seconds. End game. And I'm going to have a little fun here. What if we used the Obamacare language we've been hearing all week to repeal and replace another very important part of our American culture? Stick around.
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CHUCK TODD:Back now with End Game. We’ve heard so much talk this week about replacing Obamacare and with the NCAA Tournament, NFL draft, baseball’s opening day all coming up we wondered what would happen if we applied repeal and replace language to improving sports in America.
(BEGIN TAPE)
CHUCK TODD:
First it’s time to empower players, to choose their own strategy. You can’t have a one-size-fits-all system designed by bureaucrats in Washington, DC. That may work for the Redskins, the Nationals and the Wizards, but not the teams beyond the beltway.
Next we need to give athletes greater access to home runs, touchdowns, and slam dunks. These things shouldn’t be out of reach for any player. Let players choose the success that’s best for them. Another key element, teams need the ability to cross state lines. States are the laboratories of democracy. Don’t limit the Colts to Indiana or the Dodgers to California. Give teams the freedom they need. After all, the New York Giants play in New Jersey. And they’ve won four Super Bowls.
Now, the Congressional Budget Office is skeptical, but they also predicted the New England Patriots would win the last Super Bowl, and yes, using CBO scoring they did win. But if we apply “dynamic scoring” or “by our own estimates,” the Atlanta Falcons won 59 of the game’s 64 minutes. So who’s the real winner here? Ultimately, if we do nothing, sports will collapse on its own. Consider this, on any given day half the teams that play lose. Think about that. 50 percent of all teams are already losing, hashtag sad. And it’s only going to get worse.
Sports is in a death spiral. We have to do something.
(END TAPE)
CHUCK TODD:
It really comes down to a binary choice. This is the chance and the best and the only chance we’re gonna get. And one final point, if we don’t build a wall around our sports culture, the country’s gonna be flooded with sports that are popular in other countries like soccer, with all of its nill-nill ties. Sports is for winners, not losers, right Helene?
HELENE COOPER:I take great umbrage at that.
CHUCK TODD:
I knew you would.
HELENE COOPER:
I completely disagree with your last sentence.
CHUCK TODD:But it gets us to this last, and I do want to sort of wrap up. We’ve had a big healthcare show in general. What is this going to look like in a year? Do you think this bill is actually going to pass the United States Senate?
DAVID BROOKS:I do not. It’s hard to pass a healthcare bill. Everybody seems to be against it, the senators are flaking out, and so I think we’ll get without a Trumpcare, we’ll be stuck with Obamacare which is in deterioration.
CHUCK TODD:Do you think this is--
STEPHANIE CUTTER:I think we’re gonna see it slow down, even this week when those CBO numbers come out. I think we’re gonna see a lot of hesitancy.
CHUCK TODD:And senators are going to run for the hill?
RICK SANTELLI:I think the bill’s gonna pass.
CHUCK TODD:Both the House and Senate?RICK SANTELLI:
Absolutely, but we have no idea what that bill looks like yet.
CHUCK TODD: You think what we see now is nowhere near what it looks like?
RICK SANTELLI:It’s gonna go through some changes in my opinion, yes.
CHUCK TODD:And Helene, do you think we make it--
HELENE COOPER:
I-- No.
CHUCK TODD:
--does it happen this year?
HELENE COOPER:I don’t think it’s gonna pass, and I also think that we are gonna be stuck with Obamacare except we’re not gonna fix what’s wrong with it, which puts us in a worse position.
CHUCK TODD:Well--
DAVID BROOKS:The differences, and the reason I disagree with Rick, is the differences within the Republican party are structural. It’s not like there’s a magic solution out there that will please them because their structure--
CHUCK TODD:I was just gonna say, there’s seems to be an ideological divide that can’t be fixed.
RICK SANTELLI:I think the Tea Party, the Freedom Caucus they call themselves now, is a nice pull, and I think they’re going to get some of their values and ideas embedded in some changes in this policy.
CHUCK TODD:Let me ask you this--
HELENE COOPER:Do you think Democrats are gonna go for this?
RICK SANTELLI:I think that-- you know what? Let’s go back to sports. How far would the Green Bay Packers get if the team they’re playing, after four downs, doesn’t like the way it went and they take the ball and the referee and they go home. You know what? I certainly would like to think that we can work together to some extent and I think 2018 elections in some of these districts in contention--
HELENE COOPER:Where have you been?
RICK SANTELLI:
--are going to get some of these senators to work together.
STEPHANIE CUTTER:Well, it’s going to have to move a long way for Democrats to work.
CHUCK TODD:All I know, another election --
RICK SANTELLI:Be optimistic.
CHUCK TODD:--that will be all about health care. A quick note before we go, on this week’s podcast, Helene and I had a chance to spend some time talking one on one about her new book and about her other passion, those nill-nill ties in soccer. In all honesty, Helene, this book, Madame President, about Liberia's first woman president, the continent of Africa's first woman leader, it's an amazing book and an amazing story you tell on the podcast. So please go listen to it. That's all we have for today. We'll be back next week. If it's Sunday, it's Meet the Press.
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