Published: Mon, June 26, 2017
USA | By Kelli Rowe

Senator Rand Paul says would consider partial repeal of Obamacare

Senator Rand Paul says would consider partial repeal of Obamacare

Julie, thank you so much for joining us.

Senate Majority Leader Mitch McConnell released his health care bill to a mix of indecision and opposition. And the main issue is we are fundamentally in both bills changing the structure of Medicaid from the way it's operated for the last 52 years.

ROVNER: It differs in some significant ways.

According to Senator Kamala Harris (D-Calif.), the GOP health care bill "makes draconian cuts to Medicaid that will impact our nation's children, low-income Americans and seniors". Unlike the House bill, it pegs tax credits to income rather than age. And plans might be able to offer less coverage. At least five Republican senators have said they can't vote for the latest version in its present form. Apparently the Senate Republicans didn't get the memo.

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ROVNER: Well, they've been kind of skirting that. "But I think we all ought to be very sober to the fact that there's nothing really that can be done to fix the situation that they're in right now". "Well, they're also four good guys, four friends of mine, and I think that they'll probably get there", he said.

ROVNER: Well, the piece of the Affordable Care Act that's most at stake is what we've just been talking about, the people who buy their own insurance in the individual market. The Senate bill also proposes eliminating many ACA taxes, and the employer penalties associated with the employer and individual mandates would be repealed retroactively, dating to the start of 2016.

An outside political group aligned with the White House, America First Policies, said it is planning an advertising campaign targeting Heller for his opposition to the bill.

What Doctors Are Saying Groups representing doctors and hospitals are overwhelmingly opposed to the Republican approach, because it's likely to result in millions more uninsured people. It would phase out Obamacare's expansion of the Medicaid program for the poor more gradually, waiting until after the 2020 presidential election, but would enact deeper cuts starting in 2025.

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MARTIN: This is also a longtime goal, mainly Republicans but also some Democrats, to kind of rein in this very significant entitlement program. Expressing frustration, he complained about "the level of hostility" in government and wondered why both parties can't work together on the Senate bill as GOP critics expressed doubt over a successful vote this week. Though Trump lauded its passage in a Rose Garden ceremony, he called the House measure "mean" last week. Medicaid is run jointly by states and the federal government, but conservatives have long decried it as wasteful and bloated with spiraling costs.

"It shifts the cost from healthy people to sick people, it shifts the cost from younger people to older people, there's a lot of cost-shifting going on but not cost-reduction, and that's the problem", he said. Or they may cut back on categories of people that they would otherwise cover. They could lower what they pay healthcare providers, which is already pretty low for the Medicaid program. Ron Johnson, an ardent Obamacare critic, who said he finds it hard to see how he can vote yes on the bill by this week. Now, this is a discussion draft. "So if that happened to you and then your deductible went up, you would just want it repealed", said Beverly Gossage, Republican and insurance expert. Without adequate coverage to access treatment and health care, people struggling with problematic substance use could relapse to riskier opioid and other drug-use behaviors that increase risk for developing costly medical conditions, contracting and transmitting blood-borne disease, and experiencing life-threatening overdose. The question is whether they can afford to make premium payments. If they make it better for conservatives, the moderates will peel off.

MARTIN: That's Julie Rovner. She was kind enough to join us from the Aspen Ideas Festival in Aspen, Colo.

BAACKES: Thank you very much for this opportunity.

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