Speaker Ryan calls House health care bill 'rescue mission,' says GOP is 'keeping our word'

Speaker Paul Ryan sits down with George Stephanopoulos for his first interview since the House passed the GOP's health care bill.
17:39 | 05/07/17

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Transcript for Speaker Ryan calls House health care bill 'rescue mission,' says GOP is 'keeping our word'
Good morning. It's good to be with you. Let's remember what is happening right now. Obamacare is collapsing. It's not working. What good is it for anybody, let alone for a person with pre-existing conditions if you don't have a health care plan you can even get. This is a rescue mission. We want to achieve the goals we all want. Getting the cost of coverage down and making sure everyone has access to affordable health care. Especially and including people with pre-existing conditions. Let me say a couple things. You have all these health insurers. If they're doing so well, why would they be pulling out of the marketplace. Over 1,000 counties in America have one plan to choose from. This week in Iowa, the last state-wide agency says they are pulling out. Aetna just pulled out of Virginia. The law is collapsing the. You can't get health insurance in these places, whether you have a pre-existing condition or not. We're trying to step in front of this collapsing law and make sure we can have a system that works. A system with choice and competition and affordable premiums. And we have multiple layers of protections for people with pre-existing conditions. So -- Let's talk about that, first. So they, too, can have the peace of mind to get affordable coverage. Let's talk about that first. Turned amendments you have, states will have the option to charge people with pre-existing conditions more. You heard Dr. Gawande and others say where they have had high-risk pools they have been underfunded. If you used all the millions, that would still cover only a fraction of those with pre-existing conditions. I get you there for a second? Under this bill, no matter what, you cannot be denied coverage if you have a pre-existing condition. But you can charge people more. Let me finish my point. You can't charge people more if you have a continuous coverage. Key is to make sure people stay covered and move from plan to plan if nay want to. It's like waiting until your house is on fire to then buy home owner's insurance. You want to make sure people stay covered. Sometimes people lose coverage through no fault of their own. That is one point. So I was getting there until you cut me off. The point of this bill in those states that get a waiver to do what they need to do to make it work better in their particular states has support for exactly that very person who, if, in the course between a year, get extra aid for support for pre-existing conditions. On the state waivers, on the condition that a state has a, twoing high-risk pool to help specifically that person with pre-existing conditions. An example. In Wisconsin, we had a really successful high-risk pool. 10% of people in the individual market were in the high-risk pool. They had eight or nine plans to choose from. They could go to any doctor or hospital they wanted. And their premiums and co-pays were cheaper than they are under Obamacare today. The other 90% had cheaper health insurance. Better choices. That's what we want to get to. You can't say one size fits all. One rule for the entire country. Our states are different. In Maine, they had an indivisible risk program. Physical you became catastrophically ill, subsidies kicked in and helped your health insurance and premiums. It lowered the cost of premiums for everyone. If a person gets help, all the other insurance plans don't have to cover those costs. You stabilize the marketplace. Our goal is this, George, get everyone access to affordable care including people with pre-existing conditions. That is not happening under Obama care. The premiums are going up double digits. The deductibles are sky high. Choices are evaporating to the point where 1 in 3 counties have one suinsurer left. We think we have better ideas. In Wisconsin, we had a good system. Many Maine, they had a good system. Different states are different. Let the states perfect this. We're proud of this. We're proud of the effort. It's us keeping our promises. There's a lot of under certainty over what tactually lit do, including the the senate. Senator Lindsey graham said a bill finalized yesterday has not been scored, amendments not allowed, and three hours of final debate should be viewed with caution. I want to go back to something you said in 2009 when Obamacare was being debated. I don't think we should pass bills that we haven't read and don't know what they cost. If we rush this through before anyone knows what this is, that's not good democracy. A lot of your members have conceded they didn't read the bill. There wasn't a single hearing or markup. There wasn't a cbo analysis of this bill. So have you met your own standard here? Yeah, I think this is kind of a bogus attack from the left. The bill has been online for two months. The bill has been -- Not the final version. The final version was an amendment that was three pages long. Takes 30 seconds to read. Obamacare was over 2,000 pages. This bill, under 200 pages. It doesn't take long to get through the bill. The final amendment three pages long. The most recent cbo score says we're perfectly compliant. The last amendment is not going to dramatically alter that score. It was narrow changes to the bill. The members who changed their vote said there were quite significant changes to the bill. Essential benefits. Pre-existing conditions. It added money as well. The last one, yeah. It's called the Upton law. Several others wanted this amendment. Is there a situation under any situation where the state getting a waiver if there is a person that could get charged higher health care costs because of their health status. We looked and decided there might be a situation where, within the course of one year, a person could conceivably get higher health care costs. This amendment affects that. We have multiple layers of protect to make sure that these families, these people. These are our friends and constituents. We want to make sure people get affordable coverage. That's not happening in Obamacare. If you can't get a health insurance plan, what good is it? You don't have health insurance. What we're trying to do here is have a system where we have more choices, more competition, and lower prices. And yes, this cbo score does say it lowers premiums. The goal here is two things. Get premiums down and get people choices. And make sure that people with pre-existing conditions get coverage. We have multiple layers of this. The federal government-run seasonal doesn't do that. The cbo analysis says over ten years, 24 million people will lose coverage. For most mrns, deductibles will go up. A lot of people short of medicare, 55-64 years old, particularly in rural areas, they'll pay thousands more every year. The aarp calls that an age tax. If you ax September up with part of the cbo analysis, do you accept all of them? What the cbo is saying, if the government is not going to force somebody to buy something they don't want to buy, then they're not going to buy it. They're saying people, through their own free choice, if they're not mandated to buy something unaffordable, they're not going to do it. Under this bill, everybody will get a refundable tax credit to buy a bill of their choosing. On the age point, you make a good point. Obamacare said we'll have younger, healthier people subsidize older people. Younger people refused. That's one of the big reasons the situation is collapsing. We're fixing that will. We're adding money. It's been out there for a month. We're going to add more money to the tax credit for those people you just mention FPD people 50 and 60 years old. That's what the senate is going to do. I think that's what Lindsey graham is talking about. We added money to the bill, which the senate will complete the job of making sure that the tax credits for those people in their older cohorts, 50s and of 0s, to reflect those changes. The fact that their health care costs more. What we learned with Obamacare is making younger people buy unaffordable insurance, they're not going to do it. That's one of the reasons it's collapses. Sounds like you wouldn't be comfortable with this bill being signed into law. No, this bill takes $85 billion and adds to it the tax credits. Let's figure out exactly how much more of a tax credit a 50-year-old gets and how much more a 60-year-old gets. So what the house bill did is it took this bill and said, we need to add more money to those refundable advanceable tax credits for older people. The senate is going to complete the job saying just how much more money. This is one stage in a multistage legislative process. You know how this works. They pass a bill through the house. Pass a bill through the senate. Go to conference and iron out the differences. We acknowledge we need to do more for people that are older and people are pre-existing conditions. But gives states the ability to craft and customize. I know the Wisconsin health insurance market really well. It's a lot different than the New York health insurance market or the Texas health insurance market. We have this one-size-fits-all rule from Obamacare that is crashes. Premiums are skyrocketing. They went up 116% in Arizona alone. We need to fix this problem. For the sake of just our constituents, or the American people. People want the peace of mind knowing they can get affordable coverage. Quite frankly, George, that's what we're achieving. A lot of people think it will be worse. Another point. This bill does cut taxes by about $900 billion. And medicaid and other subsidies by about $1 trillion. I want to show a chart. Just about everybody under$50,000 is going to be cut back. Small benefits for the middle class above that. But a huge, huge benefit for those making over $200,000 a year. Warren Buffett said he'll get a 17% tax cut. Critics say this is a huge transfer of wealth from the poor and middle class to the wealthy. How do you respond? Calm of things. We're keeping our word. Repealing and replacing the entire si of this law. All the Obamacare taxes. They're job-killing taxes that hurt economic growth and make health insurance more expensive. These taxes, most of them are aimed at the health care system, which makes the premiums higher. It makes it more expensive to buy health care. Most of benefits go the millionaires. Medicaid -- it's -- we're repealing all of the Obamacare taxes. Medicaid, we're giving the states the ability to customize medicaid to meet the particular needs of their vulnerable constituents. More and more doctors are refusing to accept people with medicaid. We want to give the states the ability to customize the medicaid program to work for their states. You're saying they can do that with $880 billion less. You're saying they can do it with $880 billion less. We're -- we're giving states the ability to run their own medicaid program. It's increasing for medical inflation. We recognize that for certain people in medicaid, the disabled, the ajd, the people in nursing homes, we're giving them a bigger increase. By giving states, the right to run medicaid, and giving them a bloc grant. A per capita grant, increasing the spending. You don't think anyone will be murt when you're taking $880 billion out of the system? No, no, I don't. I think the Mike rcro management of health care is a problem. When ever we have had a waiver Goich that state so they can customize, it works better. We want to give every state the ability to work for the unique needs of their populations. Obamacare says we're going to micromanage this. Telling every state and community how it will work. It's failing. Medicaid is not working. Obamacare is collapsing. People are not getting choices. We have to fix this. This is a rescue operation. You have to acknowledge, every state is a little different. What we're trying to achieve here, and what this bill does achieve, gives states the ability to meet the needs of their populations. Put the resources in there so everyone can have affordable health care coverage. You talk about state -- In micro managing this -- Senator Susan Collins is coming up. She says if a state wants to keep Obamacare, they can. If a state wants to experiment, they can. That's state flexibility. What about that bill? I think Susan Collins has made a tremendous contribution to this debate. If Maine, by the way, she comes from a great state which has an invisible risk insurance system that says, we're going to pay for the catastrophic illnesses for people catastrophicicly ill. What that's done in me he is lower the premiums for people with pre-existing conditions. We target the support for people with a pre-existing condition. That is the model we're copying in this bill. 1% of the people in if individual market drive 23% of the costs in health care in the individual market. 5% drive up almost 50% of the costs. We're saying let'sarget our support for that population so they get the peace of mind and get lower health insurance costs. That stabilizes the market for everybody else. We're looking at that Maine mod model saying let's do that nationwide. If Wisconsin wants to do something different, let them do that. So long as we maintain koej for people with pre-existing conditioning and give everyone equal access. It doesn't sound like -- These are important rules that we think are going to be maintained. The gold is, lower price, expand access and coverage. It doesn't sound like a full endorsement of senator Collins. One final question. On the politics. As you know, the Democrats got wiped out in 2010 after voting on Obamacare. It's one of the reasons you're speaker today. They smell real blood now. You saw leader Pelosi. On Friday, the cook political report shifted 20 seats away from the GOP. Dave Wasserman said, house Republicans willingness to spend political capital on a proposal that garnered the support of just 17% of the public in a March poll is consistent with past scenarios that have generated a midterm wave. How worried are you about a midterm wave? What are you telling your members? I'm not. Health care is a complicated, emotional issue. The system is failing. We're stepping? Front of it and rescuing people from a collapsed system. More importantly, we're keeping our word. That's really important sheer, George. People expect the elected leaders if they run and campaign on doing something, they expect them to do that. That's what we're doing. Keeping our word. I would argue we would spell disaster for ourselves, politically, if that's your question, for not keeping our word. It's us tieing to fix a real problem that real people are experiences in this country. Mr. Speaker, thank you for your time this morning. Thank you, George.

This transcript has been automatically generated and may not be 100% accurate.

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