The Battle To Repeal And Replace Obamacare
POPPY HARLOW, CNN HOST: As opposition mounts to the Republican plan for repealing and replacing Obamacare, how Sec. Tom Price forcefully defended it last night in CNN's town hall, promising it will increase choice and bring those costs down. But what is actually going to happen? What will it really mean for consumers if it is implemented the way it stands now? Joining us now, economics professor at MIT, Jonathan Gruber. He's one of the architects of Obamacare. Also with us in the studio, CNN chief medical correspondent Dr. Sanjay Gupta. Gentlemen, very nice to have you here.And Sanjay, let me begin with you. One of the most poignant moments last night -- I love these town halls --</s>DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes.</s>HARLOW: -- because it's the real people --</s>GUPTA: Yes.</s>HARLOW: -- asking the questions that their life sometimes depends on.</s>GUPTA: Yes.</s>HARLOW: This is case in point. A cancer survivor asking this question to Sec. Price -- listen.</s>BRIAN KLINE, CANCER SURVIVOR: Medicaid expansion saved my life and saved me from medical bankruptcy. Now, I earn $11.66 an hour at my retail job and, obviously, I cannot afford to pay for my cancer care out-of-pocket. My life really depends on having access to my doctors and medical care. Why do you want to take away my Medicaid expansion?</s>SEC. TOM PRICE, HEALTH AND HUMAN SERVICES: We have one-third in the physicians in this nation, Brian, who are not seeing Medicaid patients. And so, if we want to be honest with ourselves as a society, it's important that we step back and say why is that? Why are those doctors not seeing Medicaidpatients? And let me just suggest it's because the Medicaid program, itself, has real problems in it.</s>HARLOW: Sanjay, is that an accurate portrayal of Medicaid as it stands right now?</s>GUPTA: I think -- I think the first part is accurate in the sense that I think there are many doctors who do not accept Medicaid patients -- that's true. Probably about one-third do. The interesting thing is the sort of second point that he makes. We're going to fix it by taking away more money. I mean, look, part -- just simply, part of the problem -- part of the reason many doctors don't take Medicaid patients is because they don't reimburse as much and so, therefore, they think well, I'm going to get more money from a private insurer. Why would I take a Medicaid patient? Now you're going to take more money away from it. I mean, it doesn't take a lot to sort of figure out that that doesn't make a lot of sense in the -- in the overall scheme of things. So, they want to take away $1 trillion -- $880 billion dollars over the next several years. How that's going to solve that problem, I don't know. He was asked about that. Wolf and Dana asked him several times and he said well, look, it's not just about money, it's about individualizing care. I'm a doctor. I'm not exactly sure what that means.</s>HARLOW: So, Jonathan, given that you were one of the architects of Obamacare and you know the problems that exist within Obamacare of becoming increasingly not affordable for a number of Americans, one of the core arguments here is that if you give Americans more choice, right -- the private sector argument -- give Americans more choice -- you definitely get lower costs. Is that a guarantee?</s>JONATHAN GRUBER, ECONOMICS PROFESSOR, MIT: No, it's not a guarantee. But, more importantly, there's nothing in the proposal that gives Americans more choice. This is simply taking away choice from the poorest, the sickest, and the oldest Americans who would pay five times or more what they're paying today. So I don't understand how charging poor, sick, and old Americans more is adding choice. There's -- choice, as a word, is the centerpiece of Tom Price's argument, but there's nothing in the proposal that actually promotes choice.</s>HARLOW: So I think they would argue that you get more young people in the risk pool and that gets more insurers back in who've pulled out, like a Humana, like an Aetna. But the argument they also make, Sanjay -- I'm interested in your take on that -- and the argument they say parts two and three will include, they say, buying insurance across state lines. Does that fix the problem?</s>GUPTA: Well, that's been a -- you've been hearing that for some time and, basically, it feeds into this idea that look, the free market can help solve these problems better than the government can solve these problems. You know, again, you know, allowing an insurance company to set up across state lines sounds pretty good. It's pretty hard to do. You have to develop relationships with the hospitals. It's longstanding, sort of, relationships. But the other point, and I think what Jonathan is saying about this more choice issue, you can get more choices and lower costs, I think, if you offer people plans that are just not that good a plan. I mean, you know, the nature of insurance is you don't really know how good your plan is, oftentimes, until you use it.</s>HARLOW: Until you're living it.</s>GUPTA: Many people, you know, they just don't know. They go I'm insured, I've got it. But they actually have kind of what's called a skinny plan, a so-called junk plan. A really low cap so that if you get sick it's not going to cover much. That's not what people really want and, you know, you worry if that's the choice, you know, people aren't going to be really happy with that in the long run.</s>HARLOW: Jonathan, to you. The president has said -- we know he said in the meeting he had at the White House with some of the folks not on board with this -- you know, if this doesn't make it through we're just going to let Obamacare implode and blame the Democrats. Can you talk to us about what an implosion of Obamacare would actually look like because there are liberal governors, including in my state of Minnesota, who have said this is unaffordable for American people at this point in time? What does an implosion look like? Are there failsafes?</s>GRUBER: Well, first of all, Obamacare is not imploding and it's not just my opinion. Actually, another aspect of the Congressional Budget Office report that was devastating for the Republican alternative was pointing out that Obamacare is fine. Indeed, the premiums are exactly where CBO projected they'd be. What happened --</s>HARLOW: But it's not fine -- it's not fine for a number of American families who've told me they can't pay for it.</s>GRUBER: Absolutely. It is absolutely not fine for everyone but there's no risk of a death spiral. There's no risk that the exchanges are going away. The problem here is not solved by pulling money out of the program. The problem is that underlying health costs are too high for middle-class families, and the answer to that is not to pull away coverage from the poor, the sick, and the old. It's to try to address the fundamental problems for middle-class families by expanding the availability of these subsidies and by taking the next steps towards --</s>HARLOW: Right.</s>GRUBER: -- cost control that are so important.</s>HARLOW: So, Sanjay, I mean, is there a failsafe? What happens, because there are increasing amounts of Americans who cannot pay for their Obamacare plan?</s>GUPTA: Well, when I think when you decide that you're going to provide more insurance for more Americans across the country, which is what, you know, happened over the last several years, that there was a belief that there was going to be -- that it was going to have a certain price tag to that. I think that that -- so, costs were, I think, always expected to go up. I think it's worth pointing out that the costs were going up for premiums, even before the ACA was implemented. Costs would go up even if the ACA is taken away. So people are looking at this as a -- as a point in time. Yes, I don't think it's perfect in that sense. I think that you have, as Jonathan points out, certain populations that have really shouldered much more of the burden of these costs. But still, this idea that it was going to cost a little bit more, I don't think that that's a surprise to people.</s>HARLOW: All right, guys. Thank you very much, Jonathan. Sanjay, nice to see you.</s>GRUBER: Thank you.</s>GUPTA: Thank you.</s>HARLOW: Thank you very much -- Chris.</s>CHRIS CUOMO, CNN HOST: Good discussion there, Poppy. President Trump breaking his silence, doubling down on his wiretapping claim, except he says wiretapping now means a lot of things. Lawmakers say there is no proof of anything. The top Democrat on the House Intelligence Committee, Adam Schiff, joins us next.