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The Future Of The GOP Health Care Plan


President Trump is at his home on his golf course in Bedminster, N.J., this weekend. Most members of Congress are back in their districts. Before they left, Republicans voted to repeal and replace the Affordable Care Act. But that vote was close. And many senators have already said they're opposed. NPR senior editor and correspondent Ron Elving joins us. Ron, thanks so much for being with us.

RON ELVING, BYLINE: Good to be with you, Scott.

SIMON: So many different claims were made this week. We're going to turn to you as a voice of reason. Do we actually know what's in the American Health Care Act?

ELVING: Let's remember, it was voted on on the House floor 24 hours after it was filed with a lot of new amendments in it and with no budget impact score from the Congressional Budget Office. So how much would you expect the average member of Congress to know about any bill this mammoth, this complex, after just 24 hours? I think Lindsey Graham, the Republican senator from South Carolina, said it best. He says, we don't even know if this baby's a boy or a girl yet.

SIMON: And it just squeaked by - 217 votes to 213. What does that final tally tell you?

ELVING: It says a lot of Republicans didn't want to vote for it. Twenty said no. And they're worried about the hundreds of billions of dollars that are going to be taken out of Medicaid. That's one of the big things that people are worried about. And, of course, they like the tax cuts that are also hundreds of billions of dollars. But the voters, the people around the rest of the country, are mostly concerned about pre-existing conditions.

That seems to be the big issue. Obamacare said such things had to be covered if you were already sick. And this legislation will put a lot of those people into what are called high-risk pools with very high premiums. And the bill says they will try to help them pay for it.

SIMON: What's the landscape look like in the Senate? Democrats certainly seem to be unified, as they were in the House. What are the divisions, though, among some Republicans which - the party there in the Senate has even a few more moderates?

ELVING: You know, in the Senate, the landscape always includes a lot of very high peaks. And some of those high peaks of self-regard in the Senate are going to be calculating that they have to oppose anything that is not straight repeal. But you also have a lot of Republicans who would not mind something closer to just patching up the flaws in Obamacare because they come from states that have expanded Medicaid generously.

And what happens to those millions of Americans on Medicaid, most of them low income? So this bill got over the top in the House with the promise to be fixed in the Senate. The question is, what do you promise the senators, who's going to fix it next?

SIMON: The president and Republican members of the House who voted for the bill posed for photos at the White House. Given what the bill faces in the Senate, was this a little bit like popping open the champagne in the locker room at halftime?

ELVING: Yes or spiking the ball at midfield. You know, you could say this legislation has not even actually reached midfield or halftime because not only does it need the Senate, but then there's going to be a conference committee between the House and Senate to work out the differences between their bills, which may be quite vast. And then whatever that conference comes up with has to be taken back to the House, taken back to the Senate, voted on again in identical form with no amendments. Those are not just procedural niceties. That's what the Constitution requires.

SIMON: Let's look ahead to this week. Sally Yates, who was briefly the former acting attorney general, is going to testify before the Senate on Russian meddling. What are you listening for, especially given today's news from France?

ELVING: We're listening for new names, if she should be able to bring up any new names to illustrate any of these other connections or new details on how she learned what she learned about Mike Flynn and his conversations with the Russian ambassador.

But we also understand she's going to be constrained in some respects because of the classified nature of much of what she learned when she was the acting attorney general. So yet, she might reveal more about what the Justice Department knew, when it knew it and who else the Justice Department might know something about.

SIMON: NPR senior editor and correspondent Ron Elving. Thanks so much.

ELVING: Thank you, Scott. Transcript provided by NPR, Copyright NPR.

Ron Elving is Senior Editor and Correspondent on the Washington Desk for NPR News, where he is frequently heard as a news analyst and writes regularly for NPR.org.
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