CBO: 24 Million More Uninsured in 10 Years
ANDERSON COOPER, CNN ANCHOR: Good evening. Thanks for joining us. There is breaking news on three fronts. The Justice Department fails to meet a deadline to supply evidence to support the president's allegation that Obama wiretapped him. More than 100 people are facing what could be the biggest, nastiest late winter storm in decades. All that pink, that means a foot or snow or more, up to three feet in some place we're told. And this -- 20 million more people could be without health coverage by 2026, 14 million next year alone. Now, that is not what President Trump has been promising. It is what the nonpartisan Congressional Budget Office says about the House Republican bill to replace the Affordable Care Act. And that is where we begin tonight. Phil Mattingly has the latest on the CBO report, reaction to it, joins us now. So, let's talk more about the headlines, first of all, from the report.</s>PHIL MATTINGLY, CNN CONGRESSIONAL CORRESPONDENT: Yes. Anderson, start with the context. Republican aides knew this was not going to be a great number. They did not know it was going to be this bad. And you kind of hit the top lines -- 14 million uninsured after the first year. By 2026, that number jumps up to 24 million. Those are huge issues right now. They, again, knew it was going to be a bad number. They knew the numbers weren't going to match up perfectly well with Obamacare. But that is a big number with very real political repercussions and very real policy repercussions. Now, on the positive side for Republicans, there is a $337 billion decrease in the deficit based upon this bill. That is important for procedural reason, Anderson, moving forward. But it's also important because this is what they promised they would do. This is what they campaigned on. Now to the premiums, and I think this is one of the most important elements here that you're going to hear Republicans talking about a lot going forward. They're saying we don't necessarily want to promise that everybody will have care, but everybody will have access to care. In the near term, the premium numbers aren't as good going forward. There will be increases in premiums based on this bill. But as the bill moves forward, as it's implemented, you'll see premiums by 2020, by 2026 drop by roughly 10 percent. That is where you're hearing Republicans seize on right now. The top line budget numbers and the end game on the premiums are at least positives right now that the Republicans are trying to seize on, Anderson.</s>COOPER: Right. And Paul Ryan is certainly trying to do that. I mean, he is saying he is surprised as good as it is.</s>MATTINGLY: Yes, glass half full mentality I think from the speaker. But I think it's important to note -- this is exactly what Republicans campaigned on. They campaigned on repealing the individual mandate. They campaigned on repealing the Medicaid expansion program. These are the two primary drivers of why these numbers are so poor right now. And the speaker made very clear, this is exactly how they designed it. Take a listen.</s>REP. PAUL RYAN (R-WI), SPEAKER OF THE HOUSE: I'm excited about this analysis. And, yes, I think they sort of overestimate the uninsured number, just like they overestimated who would be insured by Obamacare. But I do believe that if we're not going to force people to buy something they don't want to buy, they won't buy it. And that's kind of obvious. They say costs are going down in 2020 when our reforms kick in. As you know, we're doing a transition period because we don't want to pull the rug out from under anybody.</s>MATTINGLY: Now, Anderson, that's going to be the pitch you hear going forward. But on the idea of not pulling the rug out of anybody, that's where the Medicaid expansion issue comes in. And when you talk to both conservatives and moderates on Capitol Hill, there is obviously sharp differences on how they view this going forward. This number only starts to cloud those defenses even more than they already stand as Speaker Ryan tries to make sure that they can move this bill forward through the House. These numbers just aren't helpful.</s>COOPER: What's the reaction from the White House?</s>MATTINGLY: Dismissal. I think this is the interesting element. While Speaker Ryan is willing to look at this report and say he's got some positive things, the White House is just saying -- rejecting it outright. Take a listen to what Health and Human Services Secretary Tom Price had to say.</s>TOM PRICE, HEALTH AND HUMAN SERVICES SECRETARY: We disagree strenuously with the report that was put out. We believe that our plan will cover more individuals at a lower price and give them the choices that they want, for the coverage that they want for themselves and for their family, not that the government forces them to buy.</s>MATTINGLY: Now, Anderson, an interesting element of this. The director of the CBO is somebody that Republicans put in place before this ever started to take place. The individual who put that director in place, then-House Budget Committee Chairman Tom Price, who is now attacking that individual. But I think you recognize by that response, by Speaker Ryan's response, kind of the divergent responses I've heard over the past hours on Capitol Hill, that Republicans know this is a project. I want to read one message I got from a Republican official who supports the House proposal right after he saw this number. He texted me, "Oof, we can recover. But this is not a good look for us." They recognize that keeping their moderates happy, making sure that conservatives are OK with the plan, those are all necessities just to move this forward in the house. Then you get to the Senate. This is very complicated process going forward, before this number came into play. This top line showing up, this top line number being the headline in all the newspapers going forward and the headline in Democratic attack ads going forward -- well, they're going to create problems going forward, Anderson.</s>COOPER: Yes. Phil Mattingly -- Phil, thanks. Just to underscore now before our panelists debate this. So, we're all talking about the full set of CBO conclusions. The report estimates the deficit will shrink a lot. Medicaid spending will shrink a lot more. Eventually, average premiums will drop. And not before rising in the next couple of years. And for older Americans, it will rise by up to 25 percent. Again, the CBO estimates that by 2026, 52 million Americans will be without coverage compared to 28 million under the Affordable Care Act. Joining us is CNN senior economics analyst Steven Moore. He's a former economic adviser to the Trump campaign. Also, Robert Reich, professor of public policy at Berkeley, former Clinton labor secretary and author of "Saving Capitalism for the Many, Not the Few". Steve, so, how do you square 20 million more uninsured by 2026, a 15 to 20 percent rise in premiums, we should point out in the short-term. Longer term, it's better. With what speaker -- how do you square that with what Speaker Ryan says the legislation does, which is lower premiums and improve access to quality affordable health care?</s>STEPHEN MOORE, CNN SENIOR ECONOMICS ANALYST: Well, Anderson, I don't believe this report. I think it's hocus-pocus. Remember, the Republican plan on health care throughout campaign and what they're saying today was two features. Repeal Obamacare. That's what CBO has scored. What they haven't scored is replace Obamacare. So, it's going to be replaced with something else that will reduce cost, that will provide more competition and will make it more economical for people to buy insurance. You can have a system -- I talked to the Republicans where they say for the first two or three years, people are in the system are not going to lose their health insurance as the CBO reports. One other thing, Anderson, I thought this report was a little bit exaggerated because under the current system, if we don't change things, tens of billions of people are going to lose their insurance because these costs are escalating so much. I was just in Arizona two or three weeks ago, Bob Reich. There, the premiums for health insurance have doubled. Well, people can't afford it. They're going to drop their health insurance. So, this idea that everybody is going to have insurance under Obamacare and nobody is going to have it under the Republican plan is I think fatuous.</s>COOPER: Secretary Reich?</s>ROBERT REICH, FORMER LABOR SECRETARY: Well, look, it's obviously a blow to the Republicans who are supporting this repeal and replace. And it was a replacement. That's what they advertised it as. It was supposed to replace Obamacare. And Donald Trump said over and over again during the campaign and he said again after he was president that nobody would lose coverage. Well, here you have the Congressional Budget Office whose director was appointed by the Republican Congress, saying in effect that you've got huge losses. I mean, 14 million people the first year, 24 million people over 10 years. Look, if I were a Republican, a member of Congress right now, I would be worried that possibly this bill could be enacted because then I'd have to run for Congress again and again, or I'd have to run for Senate when people were losing their health care and their health insurance and they're angry about that.</s>COOPER: Secretary Reich, is it people losing their health insurance or people choosing not to do it? I mean, it's not --</s>REICH: Well, look, now, that's mincing words. I mean, what kind of choice do you have if you can't afford it? I mean, that's when the Republicans are using these words like, well, you don't lose access. Of course, you lose access if you don't have any wherewithal. I mean, 80 percent of the people under the Affordable Care Act had subsidies, and they could afford to get the Affordable Care Act. Steve, when you say the premiums are going up, and yes, overall with regard to American health care, premiums and copayments and deductibles are going up. But if you have subsidies, if you are in the Obamacare Affordable Care Act, you are being subsidized. You are not actually suffering that kind of a loss. Under this Republican plan, people actually are going to be hurt. And we can debate politics all we want. There are real people who are really going to be hurt.</s>COOPER: Steven?</s>MOORE: Look, first of all, I think if the Republican plan is going to fly, the Republicans have to make a guarantee the people are not -- who are currently ensured are not going to lose their health insurance, through Medicaid or whether it's through the exchanges and so on. So, I think that's necessary, Bob Reich, that people will not lose their insurance for the first two or three or four years until we adjust to this new system.</s>REICH: But, Steve, how do you square request with what you just said with what the OMB said? I mean, do you think the OMB was completely out to lunch, that Keith Hall, a Republican conservative economist, you know him, I know him. He was appointed by the Republican Congress, you think he is wrong?</s>MOORE: No. I think he is not scoring the plan that Republicans are talking about. What he scored is what happened if you totally repeal Obamacare. What he is not taking into account, there is going to be a new system that reduces the costs of health care, brings premiums down. And, Anderson, the point I would make and I think Donald Trump would make this point is when you reduce the cost of the insurance, more people can afford it. I mean, the problem we have right now is we're going off this cliff, Bob Reich, where people average increase in the premiums across the country was almost 25 percent last year. Middle class --</s>REICH: Steve, I don't know --</s>MOORE: -- families cannot afford the current system.</s>REICH: Can you just -- can you just help me for a second. You say that he scored the repeal. He didn't score the replacement.</s>MOORE: Right.</s>REICH: Now, where is the replacement if it wasn't in the Republican bill? When are we going to see a replacement if it wasn't already provided by the House Republicans and it is now being -- it has been marked up by at least two committees?</s>COOPER: Right.</s>REICH: That's not a replacement? Where is the replacement?</s>COOPER: Steve, the Republicans are basically saying he didn't take into account other things that they're going to do in the future. But those things -- but there's no details on that.</s>REICH: What things?</s>REICH: Well, there are no details because there is no plan.</s>COOPER: Steve, go ahead.</s>MOORE: Let me give you a couple of examples. Number one, allow people to buy insurance across state lines. So, if I live in Virginia, I can buy a health care plan in Ohio or Pennsylvania or Utah that dramatically increases competition. Under Obamacare, one in three counties, Bob, there is no competition at all. There is only one insurance company. So, that's going to lead to higher costs over time. Another thing, we can do medical malpractice insurance reform. Another thing, well can provide subsidies to provide medical savings accounts that have proven in companies around the country.</s>REICH: You say that these are all possible. The Republicans had a chance to come up with a bill. They did not put any of this in the bill. They didn't put across state lines that you could buy health care across state lines.</s>MOORE: But it will be, though.</s>REICH: Why not -- but, but, you know --</s>MOORE: It's going to be a two or three-step process.</s>REICH: Why should Americans believe --</s>MOORE: The first step is to get rid of Obamacare. Step two is to come forward with things we just talked about. Step three is get rid of some of the regulations that add to the cost of Obamacare, the mandated benefit package and so. And if you do all those things and we have real competition in health care, prices will go down. But, Anderson, I'll make this point again --</s>REICH: Why -- I don't understand something.</s>COOPER: Don't talk at the same time. No one can understand you. Secretary Reich, just finish up and we've got to go. You're saying they should have done it all at once.</s>REICH: If Steve is correct -- if Steve is correct, why is a political matter when Republicans have put through this plan without a replacement? They would -- I mean, why would they have gone to all this trouble just to repeal without replacing when they say over and over again that it was repeal and replace? What is their strategy, Steve?</s>COOPER: Steve?</s>MOORE: What I'm saying is what the CBO said was essentially everyone who got health insurance under Obamacare is going the lose insurance under the Republican plan. That's a flat-out lie. There will be a system to provide subsidies to people who can't afford health insurance, but in a way that doesn't mandate various kinds of coverage, that doesn't destroy the job market and push people into part-time jobs and all the other problems that Obamacare has.</s>REICH: So, you think the Congressional Budget Office lied?</s>COOPER: We're going to continue this debate with our panel. Steve more, Stephen, great to have you. Robert Reich as well you. To be continue speaking politics. We'll talk about that, and possible implications for the 2018 elections, next. And later, breaking news on the deadline to provide evidence on the president's wiretap allegations, and new evidence the White House is trying to redefine what President Trump meant when he claimed that President Obama wiretapped him.