Transcripts For CSPAN Senators Bill Cassidy And Tom Carper D

Business washington impact campaign, which is a yearlong programming series. For more information on this series, view the url on the back of the card. Grateful tolarly the person who runs Public Policy and was instrumental in organizing todays conversation. Now i would like to introduce the global and u. S. Managing harder for health care. She will be offering a few remarks before we begin. She has been representing Health Care Clients for more than 25 years. She has worked with Academic Medical Centers and managed care organizations. Please join me in welcoming and anne. [applause] thank you eric for cohosting this. The space is gorgeous. We are pleased at how everything turned out. This is the first one of this kind that we have posted and we would like to do more in the future. I am pleased to present our two moderators. They will introduce the two senators. We have mary hamrick. She is our National Managing principal for Public Policy initiatives. As such, she leaves the Public Policy initiatives for Graham Thorton in washington. She has been in washington for 30 years and has done this for a number of other organization. We are pleased to have her with us right now. She liaisons with members of congress, with accounting standard centers and other influencers. She represents our positions and our client positions. Along with jonathan nicholson. We are glad to have him as well. Ands with bloomberg bna focuses on matters involving the federal budget and house leadership. Anathan is considered foremost expert of the federal Budget Initiative here and he writes on a lot of them. As you can expect, health care falls squarely into his wheelhouse and he is very well renowned here and around washington. Thank you jonathan, and welcome to both you and mary moore for leading this discussion with the senators. [applause] good afternoon. I am thrilled to be here today and i am honored to introduce senator bill cassidy. Dr. Cassidy is uniquely qualified to help us understand the complexities of Todays Health Care debate. As a graduate of lsu medical school, he provided care in the Louisiana Charity Hospital System for almost 30 years. He has taught medical students. He has provided Emergency Health care for Hurricane Katrina evacuees. Sen. Cassidy s served in the and wasa state senate elected in 2014 to the u. S. Senate where he serves on the Influential Health Education Labor Committee and the finance committees. A local newspaper wrote one on one, his attentiveness and kindness stand out. His approach to voters resembles the way a good doctor handles patients with a gentle but informed bedside manners. Please join me in welcoming senator cassidy. [applause] jonathan senator carper is a nature of west virginia. Went to ohio state where he got a degree in economics. He knows about health care from having served in various levels of government including as a member of congress before becoming governor. Came to the senate in 2001 and was reelected in 2006 and 2012. His reputation is as one of the more thoughtful and arguably wonky people for the democrats in the senate. He is the ranking on environment and public works, and also Senior Member on Homeland Security and government affairs, two of the more not showboat, but workmanlike committees, arguably. I can personally attest to his wonky nests because he is one of the few people that reporters have ever talked about with an expedited decision. It is something one of these little odd to budget details where you try and give money back. Sen. Carper the focus of my remarks today. Jonathan if i was running this. Those are our introductions. The two members are going to give opening remarks and then we will do our questions and then save some time or q a. Sen. Cassidy i am a graduate of lsu. It is a way of giving a shout out to steve scullys steve scalise. Thanks for having me. What a time to be here. We were speaking in the green room, right when things came to a head this happened to be schedule. We talked about doing this months ago. It was serendipity, i hope. I approach this as a physician. If you think about the letter i got this past weekend, a fellow who is an attorney makes good money apparently describing how he and his family are paying 20,000 a year for their premium , and their deductible is going to 14,000. And he is saying he cannot afford this. Now we hear this story across the nation. My sisterinlaw in san francisco, exact same story. An insurer, the exact same story, kind of culminating. 39,000 last year. We cannot afford that. If you approach it as a doctor, you say how is the family doing . They are not doing well. This is the individual market. It is not just anecdotal. Or maybe it is anecdotal but anecdotal writ large. Folks cannot afford the deductibles they have, and it describes the family in new york in which the 6,000 deductible would prohibit their receiving treatment, except that they are able to get help from charity to pay their deductible. This is not the way it is supposed to be. When President Trump ran, he made a commitment along the following lines he would care for preexisting conditions, eliminating the Affordable Care act mandates that people do not like and lowering premiums. Susan collins i introduced a bill and now we have or other republicans senators who have cosponsored, deliberately designed to reach across the aisle that democrats would be able to sign on and not feel like they were doing damage to their support for the Affordable Care act. We give power back to the states. A blue state can do a blue thing and a red state can do a red thing. We allow that power to return to the states. We allow the power to return to the patient. If there is one Common Ground i know i have is that the patient should be the focus of all considerations. Whatever comes out, if she is the focal point, if she has the power, we will have done our job. The challenge remains making sure she remains our focal point. Sen. Carper thank you very much for joining us. Jonathan didnt mention i spent almost half my life in the military. Southeast asia and others. Then i was the commanderinchief of national guard. One of the things i loved about military was access to health care. I dont care what base you are on, you have access to health care. You have an annual physical. The pay is pretty good. A must every base i have been on there is a gym and you are encouraged to exercise. There is a focus on prevention. Most people dont think of the Affordable Care act as a focus on prevention. There is a huge focus on value. Ever since harry truman talked about providing Health Care Coverage to the American People, all of the American People during one president after the other that and broke their sword on doing that. President , obama can he said when we look around the world and see what works. One of the things we ended up building is something they were doing in massachusetts with governor romney, who actually stolen idea from senate republicans. John chafee, orrin hatch, Chuck Grassley who had this brilliant idea in 1983 to create exchanges in the 1993 to create exchanges. The folks who had low income would benefit from a sliding scale tax credit. As income goes lower 1993just legislation in and 2004 in massachusetts, the idea was the individual mandate. People had to get coverage and employers had to provide coverage for the employees. The fifth provision was if you are a Health Care Insurer and want to stop people from getting coverage, you cannot do that. That turned out to be the foundation of the Affordable Care act. At many people know it. The stuff my republican friends are most critical of is their stuff. Go figure. Everything i do, i know i can do better. The Affordable Care act can be better. We had 80 days worth of hearings, roundtables, discussion in committee. Over 300 amendments were offered. Process,t a perfect but very much an open process. One of the things that concerns me these days is that this process is closed. Democrats a couple years ago, we had a saying in the Homeland Security department if you see something, say something. If you see something about the house bill you dont like, we found a lot we did not like. We dont know what the republicans are not working on now. It is just not an open process. Something this important that deals with hundreds of American People and maybe a sixth of our economy, this is something we should not do as republicans or, frankly, as democrat. If you want to go fast, go low. You want to go far, go together. The American People want us to go together. In the end we will go further and get a lot more done. Who knows, it might even double our own arrangement. Mary lets talk a little about process before we get to the particulars. Dr. Cassidy, can you tell us where the senate is on health care and written you expect a bill to hit the floor . Sen. Cassidy leader mcconnell is indicating keep once the bill to come out soon. It has been in an iterative process, piecemeal by the cbo. There are rumors afloat, but i cannot comment on the rumors, expect it soon. This guy has been careful with his approach. Senator Chuck Schumer sent a letter to his counterpart in the senate suggesting something that we dont do often enough is go to the old Senate Chamber, close the door. Maybe not bear our souls, but open up to one another and say have you thought of this, have you thought of that . If we are interested in preserving the best parts of the aca and fixing the parts which need to be fixed, saying amongst ourselves what might fly. Chuck has suggested that to mitch. If it fails, so goes. Mary i want to hear from both of you. We are thrilled to have this bipartisan conversation. Where do you think the senate is currently making progress and what are the sticking points . Where can we make progress . Had aould love if we bipartisan conversation. Tom nine or so other democrat extenders. When susan and i announce theyre going to enter our bill, were not filing a, no one had read it. Chuck schumer condemned it in no uncertain terms. He had not read the bill. Since we have introduced it, it has been praised by the right and the left respecting federalism. Vox sarah clip of fox said was good. Chuck schumer criticize it immediately before he read it. Chuckso admit that opening play makes me think this might just be politics. It does make me just a little cynical about how the process might go. I wonder if Chuck Schumer is , republican oror democrat, to criticize a bill he has never read. Focus on the positive. Where can we make progress on bipartisan areas of agreement . Why dont you each comment on that . Sen. Carper i said economics was a highstakes. Enough to keep my Navy Scholarship and graduate. One of the things i was always interested in is how to get honest Market Forces for a good purpose. One thing i like about the foundation on which romney built his plan is the Market Forces. One of the Market Forces is the exchanges. Coverage wouldve like to be part of a larger purchasing pool can join the exchange and get help. One of the things that is critical for this to work is to have stability in the marketplace. When the Insurance Companies come in and ensure whoever is trying to get the coverage, they make money and they will not lose insurance. One of the things they depended on and asked for was that we would make sure there is Something Like reinsurance. Cost sharing. A couple different provisions that they said are needed for us to make money in this. And you know what . Win in 2014, when Lucy Charlie Brown the football. The Insurance Industry said we are going to have to raise premiums and deductibles and copays in order to cover, and they did. They lost money in 2014. They lost less money in 2015. They put much broke even in 2016. They the cost sharing arrangements, they were going to do that and force the individual mandate. Theyre not interested in reinsurance. Five months ago, people could get coverage in an exchange in every county in every state at the beginning of this year. They cant do that anymore. What the Insurance Companies are asking us to do, i think we can agree on the cost sharing. There are some other things as well. There has to be some way to have an individual mandate or something that really make sure that we get Young Healthy people into the exchanges. So it is not just sick, elderly and unhealthy people. Sen. Cassidy one area is the individual market. I dont care for the individual mandates out there. The one under the Affordable Care act did not work that well. One thing the cassidycollins plan encouraged was open enrollment. A former official in the Obama Administration and a conservative economist i dont think mandates will do well. Hink we can possibly go one thing should be Common Ground is giving power back to the states. I have no problem with massachusetts doing romney care. My problem is taking that state experiment and horsing it on everybody else. Washington, d. C. And alaska have about the same people. D. C. You can walk across in a morning. Youll clearly have a different solution for two vastly different population centers. I think we should do more state autonomy. I think one of the flaws of obamacare is it to power away from the states to washington. Programs a reinsurance called the invisible high risk fool that everyone is looking high risk pool that everyone is looking as a solution. It went out of business because the Affordable Care act could not be in business. It was a state solution working for maine and yet the law said you could not do that. I would suspect tom would agree that that is unfortunate. We should give more power back to the states. Ultimately it is up to the state capitals. I would trust that i dont trust a state politician more than the admiral. We should give the power bambis adderall picked at a state politican more than the federal. Agree . We where do we agree . We are one of the early states tooktually increase we medicaid coverage up to 100 . We did this as a way to make , theyeople want to work would not lose their Health Care Coverage right away. We what people to work and we want them to be better off than when they werent working. One of the things that i think we agree on is state should have the ability to get waivers. Many states do have a waiver in medicaid. Maybe some copays for the medicaid. Those waivers are granted by the state. Think including indiana. Secretarys under price, they would be interested in granting waivers. There might be some agreement. The individual mandate, which is what romney did in massachusetts , i talked to people who worked with that. They had to do it over again, they would raise the amount of the fine work ugly than they did and got more young people into the exchanges. We were too slow, we were too modest on the uptake on the fines to encourage people into the exchanges. There is more than one way to skin a cat. Have continuous coverage kind of stuff. That was going to be my question, how to be encouraged that younger population to enter into the exchanges without a mandate . From medicare, people turn 65 years old and are on medicare, they dont want it they call up and say they dont want to be enrolled. 401k, if you opt out, you get 95 enrollment. If you say first you have to opt income you get 65 enrollment. Those eligible for credit would receive a credit sufficient for the annual rhenium and they would automatically be enrolled. If they dont want to be, you wont be anywhere out. The people who only have insurance when the mother calls up and says you need insurance. It gets that young person. Louisiana, where there is the 39,000 premium for couple, those eligible enrolled, you lower premiums by 20 just by that feature. I do think auto enrollment is a way to go. Would work not just for louisiana but another state. That is the plan to make that a state option. Herewant to go back because there is a lot of uncertainty is the calendar and the way things are going. There has been talk about maybe you guys should stick around for the recess. Takes both of your quick on the recent activity and the likelihood of that happening. My suspicion is most people look forward to the recess. Some just cover their states. ,t is an easy train ride for me but a lot of people are from places like alaska and hawaii and idaho. They just dont get home as much as the rest of us. County in their state. I do that on most every day. [laughter] it is not that hard. A private survey youask everybody, if thought by staying here through the month of august, that we could hammer out a real compromise on the Affordable Care act and what bills susan has been working on, if we thought we had a shot of doing that, i think everyone would stay and we should. Im a big believer that the amount of work we spend and deadlines force action. Read a quote so much that he could only get it done in 11 months. That we coulde further the agenda, repeal and replace