Senate Republican Leaders Unveil Proposed Health Care Legislation

Jun 22, 2017
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AUDIE CORNISH, HOST:

Today Senate Republicans unveiled their version of legislation to dismantle the Affordable Care Act, and it looks familiar. The bill pretty much mirrors the legislation the House passed last month. It repeals most of the taxes and mandates in Obamacare. It overhauls Medicaid, and it gives the states more ways to opt out of what services insurance companies have to cover. Overall, it's a very different vision for how the health care system should function than it does now.

NPR congressional correspondent Susan Davis joins us now to explain that vision. And Susan, to start, why do Republicans believe that this plan is essentially a better way to provide Americans with health insurance?

SUSAN DAVIS, BYLINE: You know, Audie, what the Republican Party is saying with this legislation is that they don't believe it's the government's responsibility to make anyone buy health insurance. That's why they unanimously opposed the Affordable Care Act when it was written seven years ago, and that's why their bill today puts no mandates and no burdens on individuals to buy coverage. Wyoming Republican John Barrasso has talked about this principle, and like a lot of Republicans, he says it's about freedom. This is what he has to say.

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JOHN BARRASSO: People didn't want to have to buy this product. This is a sinking ship. People are ready to jump off. When we eliminate the individual mandate, you'll see more people as free citizens making a decision to not have Obamacare insurance but certainly have more freedom.

DAVIS: You know, at the core, the Republican plan is about weakening the federal government's role in the health care system and shifting those responsibilities in decision-making to the states. Those decisions in this legislation include what each state's insurers would have to cover and how much each state wants to spend on the Medicaid program.

CORNISH: Senator Barrasso also mentioned the individual mandate. It was enforced through the tax code. And sometimes people forget that this is also a tax bill, right? What does it do on that front?

DAVIS: More specifically, it's a tax cut, and it could be as much as a trillion dollars over the next decade. You know, part of the reason why this debate has become so partisan is it really comes down to how sharp the philosophical divide is between the two parties over the redistribution of wealth. President Obama's health care bill taxed corporations and the wealthiest of Americans to help pay for insurance for lower-income people.

The Republican plan essentially repeals all of that. It repeals all of the taxes, and most of those benefits will go back to the top 1 percent of earners. And they pay for those tax cuts by trimming how much the federal government's going to pay to the Medicaid program, which is a program that primarily benefits pregnant women, the disabled and the elderly. One example of those tax benefits - Warren Buffett last month in an interview on CNBC said that if this bill goes into law, he'll get a tax break to the tune of $680,000.

CORNISH: Polls have shown that the Republican proposal is fairly unpopular (laughter). So...

DAVIS: Yeah.

CORNISH: ...Politically speaking, why are they pushing it?

DAVIS: You know, every single Republican that's serving in Congress today campaigned on the promise that they were going to do this. So they see this data, right? They know the risks, but there is a broader calculation that they've made that doing absolutely nothing would be much more politically harmful than keeping their promise to repeal Obamacare.

Polls also show just how deeply partisan this issue has become. The NBC/Wall Street Journal poll out today tells a part of that story. In it, it said 71 percent of Republicans say they support repealing Obamacare. Nearly the exact same number of Democrats said they don't.

CORNISH: Meanwhile, there are some Senate Republicans who aren't entirely on board yet, right?

DAVIS: Right. Four conservative senators have indicated that they could oppose it. Those four are Ted Cruz of Texas, Mike Lee of Utah, Rand Paul of Kentucky and Ron Johnson of Wisconsin. You know, it's not clear yet that this bill has the votes to pass. It also is going to need to pass the muster of more moderate senators like Maine's Susan Collins and Alaska's Lisa Murkowski. They're two women who have in the past been reluctant to support another one of these bill's goals, which is to block funds for Planned Parenthood.

CORNISH: That's NPR's Susan Davis. Thanks so much.

DAVIS: You bet. Transcript provided by NPR, Copyright NPR.