Republican from wisconsin. I want to welcome you from around the world. We are being seen on cnn, cnn in espanol and international. Welcome to those listening on the Radio Network and cnn channel 116 on sirius xm and as if that werent enough, hello to service men and women watching right now on the American Forces network. Thank you for your service and thanks for joining us. It is eight days until donald trump takes the oath of office to be the next president of the United States. The Republicans Control Congress and soon the white house. Speaker ryan has not always seen eye to eye with the president elect. He is emphasizing his better way agenda for the path ahead that covers key issues that impact the lives of all americans. Jobs, the economy, national security, tax reform and of course repealing president obamas health care law. We invited folks from all over the country to pose questions to speaker ryan and reviewed them to make sure we cover a variety of important issues and a variety of perspectives. There was not one subject that was off limits. Join me now in welcoming the speaker of the house, paul ryan. Hey, everybody. How are you doing . Have a seat. Thanks for being here. The number one issue is the repeal of obamacare. The Senate Passed the first measure to begin the process. The house is going to do that tomorrow. We have lots of questions on obamacare and a lot of other issues. I want to start with a question about health care. During the campaign, donald trump was asked about health care on 60 minutes and said this is an unrepublican thing for me to say, but everybody has to be covered. When he was asked who is going to pay for it, he said the government is going to pay for it. Do you share that philosophy at all that the government should guarantee insurance . I think we all have to be a part of it. I think there is a role for health care, no doubt about it. Let me say this. I believe we can and should have a system where everybody can have access to Affordable Health care including people with preexisting conditions. Thats not what this law is doing. It is failing on that front and there is a much better system that can be put in its place. I dont want you want me to get into this because im sure there are questions. Obamacare came in with fanfare and promise. If you like your plan you can keep it. That was proven the lie of the year. It was going to lower premiums 2500. They skyrocketed since then. Remember you will have all these choices. Five states and you only have one choice. 31 of all the counties in america, one choice. Thats a monopoly. The problem is the premiums are so high and deductibles are higher. The law is collapsing. We have got to rescue people from the collapsing of this law and fix this problem. Thats what i would love to engage in and i know you have questions. Absolutely. You mentioned preexisting continues. I know you want to engage. Jeff is from sedona, arizona. He was a lifelong republican and something happened. Come back. I was a republican and i worked for the reagan and bush campaigns. Just like you, i was opposed to the Affordable Care act. When it was passed, i told my wife we would close our business before i complied with this law. Then at 49, i was given weeks to live with a curable type of cancer. We offered three times the cost of my treatments which was rejected. They required an insurance card. Thanks to the Affordable Care act, im standing here today alive. Being both a Small Business person and someone with preexisting conditions, i rely on the Affordable Care act to be able to purchase my own insurance. Why would you repeal the Affordable Care act without a replacement . We wouldnt do that. We want to replace it with something better. First of all, im glad you are standing here. Really. Can i say one thing, i hate to interrupt. I want to thank president obama from the bottom of my heart because i would be dead if it werent for him. Par you mentioned you come from arizona . Sedona. Sure. Our old city manager was a manager down in sedona now. My family is from janesville. Really . Whats your last name . Jeans. Kraft was my grandfather. We digress. Arizona. This year the premium increases for people on obamacare is 116 . Oklahoma 69 . Tennessee 63 . Minnesota 59 . The problem is these increases were doubledigit last year and really high this year. This thing is collapsing. Do we want to make sure that a person like yourself with preexisting conditions gets Affordable Care . Of course. Of course. There is a better way to fix that problem without giving everybody else all these increases. The did you ductible is so high it doesnt feel like insurance anymore. Go to our website and take a look at our plan. Let me give you a few ideas. We believe that state high risk pools are a smarter way of guaranteeing coverage for people with preexisting conditions. We had a good one in wisconsin. Utah had a great one. We had a congresswoman from washington saying how good their state high risk pool is. What i mean is about 8 of all the people under 65 have that kind of preexisting condition. My motherinlaw had cancer, melanoma in her 20s and Breast Cancer in her 50s and ovarian in her 60s. People just have these things. We dont want people to go poor or bankrupt because this happens to them. We want to have a system where they can get affordable coverage without going bankrupt because they get sick. We can do that without destroying the Health Care System for everybody else. Thats the point im trying to make. What we should have done is fix what was broken without breaking what was working and thats what obamacare did. By financing state i had risk pools to guarantee people get affordable coverage when they have a preexisting condition like yourself, you are dramatically lowering the price for everybody else. If we say as taxpayers and i agree with this, finance the coverage for those 8 of americans under 65 in the condition like yours, they dont have to be covered or paid for by their Small Business or insurer who is buying the rates for the rest of the people in their insured pool and lower the price for the other 92 of americans. Lets fix that so that everybody else can get more competitive rates and dont have to pay for insurance to cover for those really expensive people. The problem with obamacare, its called a death spiral and a gruesome term. Its a mathematical term when the insurance gets so expensive, Healthy People dont buy it. Its a trade off. The penalty to not buy it is a lot cheaper so Healthy People wont participate in the pool to cover the losses that sicker people who have to have it buy it. Thats whats happening to obamacare now. You have unHealthy People buying it and Healthy People not buying it. Thats why all the insurers are calling out. Think about last year united pulled out of obamacare. Aetna pulled out of obamacare. States are down to one insurer. Over 1,000 counties are down to one insurer and they are getting doubledigit increases because they have a monopoly. Clearly thats not working. The worst is yet to come. Insurers are going to pull out of whole states. We have to step in front of this problem. As republicans we can just sit back and watch it all happen and say look what the democrats did. That would be irresponsible to do. We have to step in and rescue people from the collapse of this law. There are good objectives that they sought to achieve. We think young people should be able to stay on their parentss plan until they are 26. There needs to be a solution which we have for people with preexisting conditions. We want more choices. Lower prices and more competition and no monopolies. Thats what we want to replace it with. Im sorry to interrupt. There are other questions about obamacare and you want to get to them, but to put a point on this, one of the things that jeff was asking is you have begun the process of repealing obamacare. Is the process of replacing it going to coincide . Yes. Without getting all the legislative mumbo jumbo, we want to do this at the same time. In some cases the same bill. We want to advance repealing the law with its replacement at the same time along the lines of what i described. People are not buying insurance. If you get it, the deductible is so high, the out of pockets are so unaffordable. We have to fix that problem. Thank you for a lot of people. Maybe not in january. I want to introduce you to don jones. An officer with the u. S. Navy from huntingtown, maryland. As much as im for Affordable Health care, i dont think obamacare is hitting the mark. For example, College Age Children who are healthy are required to obtain health care but they dont have the money to pay for it. What can congress do to help them get Affordable Health care or opt out of it for those who cannot afford it . Whats happening more and more these days because obamacare is so expensive are the healthier people are not buying it and they are going without insurance. The part of the law that is counterproductive in this way is you can wait until you get sick and get the insurance without a penalty. Thats why they had the governmentrun system that is collapsing. We believe the right way to go. Our plan is the refundable tax credits to buy affordable coverage. A young person, maybe a person in college that didnt stay on their paperss plan that doesnt have a tax liability, you get that rarlz of how much money you make. Total the subsitty in law is you get to exclude it from your income. What we are saying is the person in the highest income bracket get the biggest tax break for health care. Thats not who you struggling to pay for it. We want to make sure that we have tax credits so everybody can buy it. Go buy a plan of their choosing. We dont want to make people buy something that we dont want to buy. We dont want them to force them to buy all these benefits. They want the choices that they want and the options they want and more important low we want competition. We dont want one insurer in one state. We want a lot of insurers competing for our business as consumers. This is the real big problem with obamacare. They basically decided that they had the government run it and now its a monopoly that is crashing. What we want to do is make sure that anybody, young person, old person, in between, gets a tax credit to buy a plan of their choosing among a lot of choices that are competing for their business. More competition means better quality and lower prices. We think Health Savings accounts are a critical piece of this. Let people save taxfree or let employers or parents or whoever put money in a savings account to help them without of pocket costs or premiums. Do you have a date to repeal and replace or just this year . I dont have a date, but we are working on it right now. We are working on this as fast as possible. We see this law collapsing faster this year and because we see more Insurance Companies pulling out and people with any or no choices and another round of increases, we feel we need to step in and provide better choices and options. First 100 days. Its definitely a plan to get moving. I want to introduce you to sherry rigs who didnt vote because she was recovering from a heart attack. One point i want to make is this fits in with what you were saying and what you are about to be asked. Medicate was expanded in o damma care. A lot of people who are lower income who wonder whether they are on medicaid or not. Where are you from . Florida. You want to give tax credits instead of insuring people. What if a person makes its tax write offs to buy insurance. What if a person makes so little they dont have to pay taxes. Will they still have access to the federal health care . Thats what we are going to say here. The tax credit, the way we say refundable, you get it whether you pay taxes or not. Its like a voucher to buy Health Insurance. For medicaid, some states do a great job and some not as well. The problem we are seeing in medicaid is more and more doctors dont take it because they lose money. Its so overregulated and bureaucratic that physicians wont take the patients and our concern is that people on medicate cant get a doctor and if you cant get a doctor, what good is your coverage . We think there are a lot of good recoveries. Wisconsin has done good reforms to make sure people get good coverage and get access to care and get doctors that will take that care. We want more solutions to make sure that coverage works. You are right on the numbers. About 10 Million People got it on medicaid. There are 11. 5 million that got health care on obamacare. At this time it was supposed to have 23 Million People. Its 11 million instead of 23 million. The problem is more and more people are getting a plan they cant use because their deductible is so high or we have a medicate problem. We want to make sure states can innovate it to work for their citizens and they can get care. Thank you so much. Part of your plan for repealing obamacare is to defund planned parenthood. I want to bring in a physical therapy graduate student here at gw and wants to ask you about it. Where are you from . Its complicated. I moved here for grad schedule, but im from northern california. Among a lot of other things we have heard in the news, planned parenthood provides Cervical Cancer screenings and annual examinations and Critical HealthCare Services and i will continue and i have used these services for the next four years. I can tell you personally that planned parenthood provided help when i couldnt go to anybody else. So my question for you, speaker ryan, is if planned parenthood is defunded, where will millions of low income groups go . Its a good question. I want to make sure you get the care you need. We want all women to get the care they need like preventive screening and Services Like you are talking about. We believe this can better be done boy putting money into federal Community Health centers. I have a lot of experience with them myself. By putting these dollars into the Health Centers that provide the same kinds of services for every planned parenthood there are 20 federal Community Health centers. They are bigger in network and so many more of them and they provide the Services Without all the controversy surrounding the issue. Can i ask you, you believe in providing more choice for people when it am cans to Health Insurance except for planned parenthood. There is a long standing principle we believe in. This is for pro choice and pro life people that we dont want taxpayer funding for an abortion. They dont want it for an organization that provides abortions and we want to make sure people get their coverage. These doctors can go to centers that provide the services and have a Larger Network than the planned parenthood clinics that are surrounded by controversy and we dont want to commit taxpayer dollars they believe is morely unconscionable. Thats a long standing principle we want to maintain. Taxpayer dollars dont fund abortions. They get a lot of money and money is used and they use other money. They dont have this controversy by funding Health Centers. A lot of people want to ask you about medicare. Your plans for medicare. Donald trump during the Campaign Said about you you want to knock medicare way down. And im going to let you respond. He said im not going to cut it and raise ages and im not going to do all the things that they, meaning you, want to do. You say medicare needs to be changed or it wont survive. What are you going to say to president elect trump to change his mind . We had a couple conversations about it. We dont all agree on everything. I think people know that. Heres the issue with medicare. More than half the money is money we borrow. Medicare goes bankrupt in the next decade. Medicare along with Social Security are the two most important they have. After my dad died, we were living on medicare and Social Security. I watched that program do Amazing Things for my family. Know that we want to be successful. If we want that was coming. The kinds of reforms that we have been pushing for and talking about are reforms designed to save the program. They are before choices. Heres the thing. If we can improve medicare for the next generation for the tapper and ryan generation on down, we dont have to change the benefits in or near retirement and we can continue to afford the cash flow for the promise that has been made to them. There is no way on the current path we are on medicare will be for our generation when we retire. We better be prepared to fix the problem while it is solvable without affecting the choices like my mom. Thats something that we had to own up to in this country. Its the biggest part of the debt crisis in the future. This is something we had to deal with. If you want to choose from the list of competing health plans that are comprehensive that are guaranteed and that was like federal employees, you should choose that too. If you like your plan you can keep the plan. That choice has been proven. You will hear this thing. It has been proven to drive down costs. It makes those insurers compete for our business. We will take a quick break. Russias hacking and what will congress do about it with Speaker Paul Ryan. We are live from the George Washington university. Stay with us. Bl e over but if you hurry, you can still get the best de