CBO Report Fuels Battle Over Health Care Bill
CHRIS CUOMO, CNN HOST: All right. More Republicans are backing away from the House health care bill after a bruising assessment by the Congressional Budget Office. GOP senators warning it will not pass without changes. Tensions boiling over when CNN asked one lawmaker where she stood -- watch this.</s>MANU RAJU, CNN SENIOR CONGRESSIONAL REPORTER: Can you support the House health care plan?</s>SEN. LISA MURKOWSKI (R), ALASKA: Could you give me a minute to get to my constituents, please?</s>RAJU: Yes or no, do you support the House health care bill?</s>MURKOWSKI: Would you please be respectful?</s>RAJU: I'm being very respectful.</s>MURKOWSKI: I've been sitting there for 10 -- for two hours. Come on.</s>CUOMO: Some respect? Manu Raju, CNN reporter, just asking whether or not she was going to vote for the bill.</s>POPPY HARLOW, CNN HOST: It's a hard -- it's a question that she clearly doesn't want to answer.</s>CUOMO: Yes, that's clear. Let's discuss with CNN senior political analyst and senior editor for "The Atlantic" Ron Brownstein. And, CNN political analyst and Washington bureau chief for "The Daily Beast" Jackie Kucinich. So, Ron, we have been discussing this for some time now --</s>RON BROWNSTEIN, CNN SENIOR POLITICAL ANALYST, SENIOR EDITOR, THE ATLANTIC: Yes.</s>CUOMO: -- about what Trumpcare would make better and what would make it worse and they find themselves in a demographic pinch. How so?</s>BROWNSTEIN: Well, look, this has been an issue we've talked about sinceJanuary, what I call the "Trumpcare Conundrum." The core Republican answer to reducing the cost of health insurance is to deregulate health insurance, is to reduce many of the mandates, roll back the requirements for mandatory minimum benefits, and limiting the disparity in age -- costs by age that were imposed by Obamacare. The problem with that is it does, in fact, lower initial premiums for many younger people. But as the CBO reported again, it substantially raises costs 20 to 25 percent and reduces access for older working-age Americans, people that are basically between 45 and 64. And the core problem they have is that is now the core of their coalition. A majority of Donald Trump's votes came from whites over 45. Sixty percent of the House Republicans represent districts that are older than the national average and those are the biggest losers under their approach. That has been the issue from the beginning and is the issue again today.</s>HARLOW: Not to mention older folks, Jackie, just vote more than younger people do. So, given that sort of political conundrum that that leaves Republicans in heading into the 2018 mid-terms, are we -- are we supposed to believe that, you know, the party -- that Republicans didn't look at this politically at all? I mean, what is the math? What is the equation that they're doing then if they know that this will hurt them politically with those older key voters?</s>JACKIE KUCINICH, CNN POLITICAL ANALYST, WASHINGTON BUREAU CHIEF, THE DAILY BEAST: I think it's why this might not be able to get through the Senate and that's what you're hearing from, you know, senators on the Republican side kind of across the ideological spectrum. They're going to the White House and going to Paul Ryan and saying listen, we need more to help seniors, to help lower-income people who are going to be booted, essentially, off Medicaid because of this -- because of this -- the plan that they've put forward. And what you're hearing is you're hearing from Paul Ryan and the president saying some of these things will be added later. Some of these things -- this is just to get this bill through the -- through reconciliation. Well, health care is more personal than that and the fact that this does lower the deficit, according to the CBO -- or it does save money, according to the CBO -- that doesn't matter if you can't get health care and you're sick.</s>CUOMO: Let me ask you something, Ron. Just on a very basic level who is this better for, Trumpcare? You know, so for all the people out there who are saying my premium is too high, my copays --</s>BROWNSTEIN: Right.</s>CUOMO: -- my deductibility. I have coverage but I can't get care. I'm on Medicaid -- my doctor won't take it. What does this make better?</s>BROWNSTEIN: Well, it -- what it does is -- first of all, the people that are complaining the most about that tend to be older working-age people. I mean, the core problem that Obamacare has had is that in many places is not enough young people have signed up - the risk pool.</s>HARLOW: Yes.</s>BROWNSTEIN: It's called the risk pool -- has been disproportionately taken --</s>CUOMO: But you've got families, too, Ron.</s>BROWNSTEIN: -- for people with greater health -- what's that?</s>CUOMO: You're hearing from them, we're hearing from them. You're hearing from younger families --</s>BROWNSTEIN: Right.</s>CUOMO: -- who are saying it's just too expensive.</s>BROWNSTEIN: And right, because there aren't enough of them in the risk pool, right? So the overall cost is too expensive --</s>HARLOW: Right.</s>BROWNSTEIN: -- because the people who signed up tilted toward people with greater health needs. This threatens to push that further in that -- in that direction and the estimates have been consistent from CBO and others that if you are younger and healthier this will reduce your initial premiums --</s>HARLOW: Right.</s>BROWNSTEIN: -- in many cases. But for older people with greater health needs this would substantially increase your premiums. And for both groups it is likely that even if the premiums are lower, the out- of-pocket expenses will be higher. In essence, what this is -- what we're talking about is kind of rolling back the degree to which the insurance is comprehensive and that does allow you to bring down premiums on some younger, healthier people. But, you know, the core debate so far has been the -- has been from the right, saying this doesn't go far enough, fast enough in uprooting Obamacare. CBO coming in and saying it's 24 million fewer people with coverage and you're back to the pre-Obamacare levels of uninsurance. That has got to give a lot of pause to people on the other side of the Republican Party in the more moderate and centrist wings.</s>HARLOW: So, Jackie, the question of which plan is better could really only be answered by how rich or poor you are, how old or young you are. Part of the big --</s>CUOMO: And how healthy you are.</s>HARLOW: -- and how -- exactly. And part of the big sell here in phase two and three that we haven't seen yet is that look, you'll be able to buy across state lines and that's going to make things a lot better. I don't get -- and a lot of economists -- and I don't think you get, either, how that makes anything better because there's no penalty now for young folks to buy it so, arguably, fewer will buy insurance. And by the way, if they cross state lines from a state where there's more regulation into a state where there's less regulation to buy these cheaper plans --</s>BROWNSTEIN: That's right.</s>HARLOW: -- how does that actually help the system? How does it actually bring the premiums down? It would be the insurance companies getting less money.</s>CUOMO: Yes, Jackie.</s>HARLOW: Yes, Yes.</s>KUCINICH: Am I missing something here? You can't just make these promises to people and expect them to just say OK and take your word for it, and that's the problem here. And this is why it's so perplexing that this wasn't a plan that they could put out right now. They've had seven years to do this, to explain to people, to prime people for these changes. And instead, they're putting together sort of an-- it's sort of an ad hoc process, right? And so, you can't just say we'll do this down the line because they don't even know what we're talking about, even with all these promises, if that can pass. So, you know, worst case scenario for people who don't like Trumpcare is this bill that no one likes goes through and then what -- they're stuck.</s>BROWNSTEIN: Poppy --</s>HARLOW: We've got to wrap it up.</s>BROWNSTEIN: OK, real quick. I say interstate sell accelerates exactly what you're saying.</s>HARLOW: Yes.</s>BROWNSTEIN: The redistribution from younger --</s>HARLOW: Of course.</s>BROWNSTEIN: -- to older, without question.</s>HARLOW: I want to buy car insurance from the cheapest place I can buy car insurance. That's how it works. Guys, thank you very much. We appreciate it. A programming note for all of you. You're going to want to watch CNN tonight, 9:00 p.m. Eastern. Join Wolf Blitzer and Dana Bash for a town hall with HHS Secretary Tom Price. He will be asked these tough questions. What will he say? Again, 9:00 p.m. Eastern, only right here on</s>CNN. CUOMO: So, in our political dialogue we start hearing a lot more about this term "nationalism." What does it mean in the current manifestation in our politics? Is it on the rise? You have politicians in Eastern European and now Central European countries certainly fanning the flames of nationalism, but does it mean the same thing here that it means there? Is this man, Mr. Wilders, who is trying to become the prime minister of Netherlands -- is he a look at our future, next.