>>> THIS WAS THE SCENE OUTSIDE SENATE MAJORITY LEADER MITCH
McCONNELL'S OFFICE THURSDAY AFTER HE REVEALED THE HEALTH
BILL. THE ONE A SMALL HANDFUL OF
SENATE MEN SPENT WEEKS CONCOCTING IN SECRET.
WHAT IT REALLY DOES IS DEVASTATE MEDICAID.
THE LARGEST HEALTH CARE PROGRAM IN THE COUNTRY.
IN EXCHANGE FOR A MASSIVE TAX CUT FOR THE RICH.
LIKE THE HOUSE VERSION, THE SENATE BILL WOULD CAP FEDERAL
MEDICAID SPENDING FOR THE FIRST TIME, THE CBO HASN'T SCORED THE
BILL YET BUT IT PREDICTED THAT THE HOUSE BILL WOULD CUT MORE
THAN $800 BILLION FROM MEDICAID OVER 10 YEARS.
$800 BILLION. THAT'S NEARLY A QUARTER OF THE
MEDICAID PROGRAM. AGAIN, REPUBLICANS WANT TO CUT A
PROGRAM THAT COVERS 20% OF ALL AMERICANS.
A PROGRAM THAT COVERS HALF OF ALL BIRTHS IN THIS COUNTRY, THAT
COVERS 60% OF CHILDREN WITH DISABILITIES, AND 64% OF NURSING
HOME RESIDENTS. A QUARTER OF THAT PROGRAM GONE.
MILLIONS OF THE MOST VULNERABLE LEFT WITHOUT ACCESS TO MEDICAL
CARE SO REPUBLICANS CAN GIVE TAX CUTS TO THE RICH.
THE HUNDREDS OF BILLIONS CUT FROM MEHDI CADE WOULD FUND
HUNDRED OF BRILLION IN TAX CUTS. 40% OF WHICH WILL GO TO THE
RICHEST 1% OF AMERICANS. SO HOW CAN REPUBLICANS JUSTIFY
VOTING FOR IT? JOINING ME IS REPUBLICAN
CONGRESSMAN TOM REED OF NEW YORK.
I DO THANK YOU FOR COMING ON TO TALK ABOUT THIS BILL.
NOT EASY TO GET REPUBLICANS TO COME OUT AND SORT OF SUPPORT IT,
SO I WANT TO ASK YOU TO TELL ME HOW YOU CAN JUSTIFY THE FACT
THAT YOU HAVE A BILL THAT WOULD CUT BILLIONS, HUNDREDS OF
BILLIONS ON MEDICAID TO GIVE TAX CUTS, THE RICHEST .1% AVERAGE
$2700 AND EVEN ELSE 265.
HOW CAN YOU JUSTIFY CUTTING HEALTH CARE FOR THE POOR AND THE
ELDERLY AND CHILDREN TO PAY FOR THAT?
>> THANKS FOR HAVING ME ON, JOY. I REJECT YOUR PREMISE.
WE'RE REFORMING MEDICAID. YOUR PREMISE SPENDING MORE IS
GOING TO TAKE CARE OF THE HEALTH DELIVERY IS FALSE.
MEDICAID IS ON A PATH OF UNSUSTAINABILITY.
MEDICAID NEEDS TO BE THERE, I SUPPORT MEDICAID, AND MY FELLOW
REPUBLICANS DO. FOR YOU TO SUGGEST THAT'S WHY
WE'RE TAKING ON MEDICAID IS FALSE.
>> CAN YOU EXPLAIN WHAT IS MEDICAID?
>> BACK STOP FOR LOWER INCOME FOLKS, THE FOLKS THAT ARE
STRUGGLING AMONG US, OUR COLLEAGUES, OUR PEERS, FRIENDS,
AND MAKING SURE THERE IS A SAFETY NET THERE.
I SUPPORT THAT. MY FELLOW REPUBLICANS SUPPORT
THAT. >> ISN'T MEDICAID MONEY THAT THE
FEDERAL GOVERNMENT PROVIDES TO STATES SO THEY CAN REIMBURSE
HOSPITALS TO CARE FOR THE POOR? SO IF THERE'S LESS MONEY BEING
PAID TO STATES TO CARE FOR THE POOR, HOW DOES THAT REFORM THE
PROGRAM THAT IS LITERALLY BASED ON MONEY TO PAY HOSPITALS TO
CARE FOR THE POOR? >> BECAUSE THAT MONEY IS HARD
WORKING AMERICAN TAXPAYER DOLLARS, THAT IS NOT AN ENDLESS
POT OF MONEY. WE'RE RUNNING DEFICITS OF A HALF
TRILLION. 20 TRILLION IN NATIONAL DEBT
IT'S NOT SUSTAINABLE. HARD WORKING AMERICANS CANNOT
AFFORD IT. >> WHAT YOU ARE ESSENTIALLY
SAYING IS TAXPAYERS CAN'T AFFORD TO PAY FOR HEALTH CARE FOR THE
POOR SO THE POOR SHOULD SIMPLY RECEIVE LESS.
THAT'S THE LOGICAL CONCLUSION. I WANT TO SHOW YOU WHAT THE
CENTER FOR AMERICAN PROGRESS HAS -- THEY LOOKED AT THIS AND
SAID BY 2026, 18,000 TO 27,000 AMERICANS ADDITIONAL AMERICANS
WOULD DIE, THIS IS BASED ON DATA SHOWING HIGHER MORTALITY RATES,
ASSUMES ON THE LOW END 15 MILLION MORE UNINSURED IN 2026
AND ON THE HIGH 23 MILLION. IF YOU ACTUALLY TAKE AWAY THE
MONEY FOR PEOPLE TO GET HEALTH CARE, THEY CAN'T GET HEALTH
CARE. SO WHAT YOU'RE SAYING
ESSENTIALLY IS THAT TAXPAYERS ARE MORE IMPORTANT THAN THE
SICK. >> NO.
WA I'M SAYING WE NEED TO MAKE THE PROGRAM SUSTAINABLE.
WHAT YOU HAVE TO DO IS CHANGE THE WAY WE DO MEDICAID.
AND PUT PRESSURE, BECAUSE WE HAVE TO BE MORE EFFECTIVE, MORE
EFFICIENT. GOT TO REWARD QUALITY NOT FEE
FOR SERVICE NOT EXPAND, NOT REWARD STATES THE MORE THEY BILL
THAT'S HOW THEY ARE PAID. THAT'S HOW THE FORMULAS ARE NOW
WITH THE STATES SO. FOR OUR PERSPECTIVE DO BETTER.
I HAVE TO BE PART OF THE EFFORT, I BELIEVE TO MAKE SURE THE
STATUS QUO IS NOT CONTINUING TO GO FORWARD BECAUSE THAT WILL
FAIL AMERICANS. WE NEED TO SAVE THIS AND FIX
THIS SO AMERICANS HAVE ACCESS TO THIS SAFETY NET THAT I SUPPORT
AND I KNOW MY FELLOW REPUBLICANS SUPPORT.
>> SO IN ADDITION TO THE FACT YOU GUYS ARE SAYING YOU'RE GOING
TO FIX MEDICAID BY GIVING IT LESS MONEY, ESSENTIALLY STARVING
IT OF MONEY AND REFORMING IT, WHEN YOU HAVE TALKED ABOUT, WHEN
YOU YOURSELF AND YOUR COLLEAGUES TALKED ABOUT THIS BILL, YOU
HAVEN'T REALLY TALKED ABOUT REFORM.
I HAVE A MEMO HERE THAT WAS PUT OUT BY THE MEMBERS OF NEW YORK
DELEGATION, THIS IS IT FOR PEOPLE TO SEE.
APPLAUDING THE HOUSE PROPOSAL THAT INCLUDED A PROVISION THAT
ONE OF YOUR COLLEAGUES JOHN FASTO GOT PUT INTO THE BILL.
AND HERE'S WHAT THAT IS. FROM "THE BUFFALO NEWS", GOP
HEALTH CARE BILL WOULD BAR NEW YORK FROM CHARGING UPSTATE
COUNTIES FOR MEDICAID MEANING NO MONEY WOULD COME FROM UPSTATE
COUNTIES TO GO INTO THE MEDICAID PROGRAM.
YOU SIR SUPPORT THE AMENDMENT, YOU PRAISED MR. FASSO FOR
GETTING THAT THROUGH AND IN YOUR PRAISE OF IT YOU TALKED ONLY
ABOUT TAXES, YOU SAID ESSENTIALLY THAT YOU PUSHED THIS
ITEM FOR LOCAL PROPERTY
TAXPAYERS FROM THE REASON, HE WAS PROACTIVE IN PUSHING THIS
FOR THE LOCAL PROPERTY TAX PAYERS FROM THE REGION.
HE ONLY TALKED ABOUT THE TAXES. HE TWEETED THIS NEW ACHA BILL
INCLUDES MY PROVISION TO ELIMINATE NEW YORK'S MEDICAID
MANDATE AND SAVE NEW YORK 19 MILLIONS OF DOLLARS.
IF THIS IS REFORMING MEDICAID WHY IS IT YOU AND YOUR
COLLEAGUES ARE TALKING TAX CUTS? YOU ARE PRAISING TAX CUTS
>> I WHOLLY SUPPORT THE AMENDMENT BECAUSE OUR PROPERTY
TAXPAYERS IN WESTERN NEW YORK ARE LEAVING IN DROVES BECAUSE
THEY CAN'T PAY THEIR BILLS. THEY CAN'T PAY THEIR TAX BILL,
THEY CAN'T TAKE CARE OF THEIR HOMES.
WE SHOULD PUT THE BURDEN BACK ON THE STATE CAPITOL.
THE STATE CAPITOL CONTROLS HOW THIS IS DELIVERED AT THE LOCAL
LEVEL. NEW YORK IS ONE OF THE ONLY
STATES THAT PUTS IT ON OURLOGICAL TAXPAYERS AND LOCAL
GOVERNMENTS CANNOT PROVIDE BETTER SERVICES UNDER THE
PROGRAM. THIS IS A GREAT AMENDMENT THAT
NEEDS TO BE SUPPORTED AND REDUCE THE PROPERTY TAXES TO 40%, $145
MILLION IN MY LOW INCOME AREAS ACROSS THIS DISTRICT, ARE GOING
TO BE RELIEVED OF THAT TAX BURDEN.
THAT'S THE RIGHT THING TO DO. >> -- IS NOT A LOW INCOME
DISTRICT. WE'RE TALKING A MORE AFFLUENT
DISTRICT. PUT OUP THE TWEET.
IT TALKS ABOUT THE AMEND OF MONEY THAT TAXPAYERS WOULD SAVE.
THIS IS WHAT HIS FOCUS WAS. THOSE ARE PRETTY SIGNIFICANT
AMOUNTS OF TAX MONEY MEANING THAT THESE ARE MORE AFFLUENT.
WOULDN'T IT BE MORE HONEST TO SAY WHAT REPUBLICANS ARE TRYING
TO DO IN THIS SBIL SAY WE DON'T WANT TAX DOLLARS, OUR TAX
DOLLARS TO GO TO PAY FOR LOW INCOME HEALTH CARE.
WE DON'T WANT TO THE HAPPEN SO IT ISN'T ABOUT REFORM, IT IS
ABOUT EXACTLY WHAT YOU PRAISED, MAKING SURE THAT TAXPAYERS DON'T
HAVE TO PAY FOR LOW INCOME HEALTH CARE.
>> THAT'S ABSOLUTELY FALSE. IN MOO DISTRICT THE AVERAGE IS
ABOUT 30,000 A YEAR. TO SAY THAT'S AFFLUENT YOU DON'T
KNOW THE FACTS. WE'RE TALKING ABOUT A PROGRAM
THAT RELIES UPON TAXPAYER DOLLARS THAT IS UNSUSTAINABLE
AND THAT IS GOING BANKRUPT. THAT IS CRUSHING OUR LOCAL
TAXPAYERS. ACROSS THE BOARD.
WE NEED TO DO BETTER THAN THAT JOY.
I'M ALL ABOUT TRYING TO PUT THE PRESSURE WHERE THE PRESSURE
NEEDS TO BE, THE POWERS THAT DECIDE HOW THIS PROGRAM OPERATES
AND HOW IT'S DELIVERED NEED BEAR THE PRESSURE AND BURDEN OF
MAKING SURE THEY ARE DOING IT IN AN EFFICIENT EFFECTIVE WAY.
>> YOU ARE RIGHT ABOUT YOUR DISTRICT, IT'S NOT AFFLUENT
TAXPAYERS SO I STAND CORRECTED ON THAT.
THE POINT YOU'RE MAKING IN THE AMENDMENT THAT YOU SUPPORTED IS
IT ESSENTIALLY YOU ARE SAYING YOU DON'T BELIEVE THAT TAXPAYERS
SHOULD PAY WHICH IS NOT GOING BANKRUPT.
JUST EMPIRICALLY. THERE IS NO EMPIRICAL EVIDENCE.
RIGHT. IT'S NOT -- WHAT YOU'RE SAYING
IS YOU WANT TO TAKE THE MONEY OUT OF MEDICAID.
THE PLAIN FACT HERE IS THAT THIS IS NOT ABOUT MEDICAID REFORM.
YOU SIR BELIEVE THAT MEDICAID SHOULD JUST RECEIVE LESS MONEY
AND THAT IT SHOULDN'T BE GETTING ITS MONEY FROM PROPERTY
TAXPAYERS. OR FROM TAXPAYERS.
>> NOT CORRECT. IT'S GOING TO BE A TAXPAYER
FUNDED SAFETY NET FOR AMERICAN PEOPLE LOW INCOME HAVING A HARD
TIME. WHAT YOU HAVE TO DO IS MAKE SURE
THAT YOU DON'T REWARD INEFFICIENCY LIKE WE DO.
THIS IS WHAT THE PROBLEM OF THE PROGRAM IS.
THE MORE THEY SERVE, THE MORE MONEY THEY SPEND THE MORE THEY
GET FROM THE AMERICAN TAXPAYER, WE NEED TO CHANGE THAT FORMULA.
WE NEED TO MAKE SURE THAT THE FORMULA REWARDS DOING MORE WITH
LESS. NOT ENCOURAGE US TO DO MORE
INEFFECTIVE INEFFICIENT DELIVERY OF HEALTH CARE.
>> LET'S TALK ABOUT THE MEDICAID EXPANSION THIS IS ONE OF THE
STICKING POINTS. THIS ISN'T ABOUT WHETHER OR NOT
MEDICAID DOES MORE WITH LESS OR SPENDS MORE.
THIS IS ABOUT ADDING MILLIONS OF PEOPLE JUST TO THE ELIGIBILITY
SO THEY CAN GET IT. IF THE EXPANSION IS ROLLED BACK
THOSE PEOPLE WHO FIT IN THE NEW FORMULA, MEANING UP TO I THINK
125% OF THE POVERTY RATE THEY JUST GET MEDICAID AT ALL.
THAT MEANS THAT G GROUP OF PEOP JUST DOESN'T GET MEDICAID AT
ALL. WHAT SHOULD HAPPEN TO THOSE
PEOPLE? HOW SHOULD THEY GET HEALTH CARE?
>> THAT'S EXACTLY WHEN YOU'RE TALKING TO PEOPLE OF 100% OF THE
POVERTY LEVEL OR LESS, WILL GET MEDICAID.
WILL CONTINUE TO. >> I'M SAYING THE EXPANSION.
YOU WANT TO GET RID OF THE EXPANSION.
SO THEY WILL NO LONGER GET MEDICAID.
THEY WON'T HAVE INSURANCE. HOW DO YOU BELIEVE THOSE PEOPLE
SHOULD GET HEALTH CARE? >> THAT IS WHERE WE HAVE TO MAKE
SURE WE DESIGN A HEALTH CARE SYSTEM THAT IS LOWERING THE COST
FOR DELIVERING BETTER OUTCOMES BASED ON LOWER COST AND GET THE
COST OF HEALTH CARE UNDER CONTROL SO THAT HEALTH INSURANCE
COSTS THEN GO UNDER CONTROL AND PEOPLE HAVE ACCESS.
>> THOSE PEOPLE WOULD SIMPLY NOT HAVE, I MEAN THE SITUATION THEY
WERE IN BEFORE THE EXPANSION THEY DIDN'T HAVE A POLICY AT
ALL. THEY DIDN'T HAVE AN INSURANCE
CARD TO GO TO THE DOCTOR. IF YOU GO BACK TO THE SITUATION
WHERE THEY DON'T HAVE AN INSURANCE CARD, MORE EFFICIENCY
IN THE SYSTEM WON'T CHANGE ANYTHING.
THEY WON'T HAVE INSURANCE. HOW WILL THOSE PEOPLE GET HEALTH
CARE AT ALL? >> ABSOLUTELY.
THAT'S WHERE THE REPUBLICAN PLAN PUTS THE TAX CREDITS IN PLACE TO
PROVIDE THE RESOURCE TO PURCHASE HEALTH INSURANCE AND THE WHOLE
IDEA IS GET HIGHLIGHT INSURANCE COSTS DOWN GETTING HEALTH CARE
COSTS UNDER CONTROL. THAT'S THE THIRD STEP OF THE
PROCESS. >> YOU DON'T GET TAX CREDITS,
YOU GET A TAX REFUND. THESE ARE NOT PEOPLE ITEMIZING
AND CAN GET A TAX CREDIT. TALKING ABOUT PEOPLE WHO ARE
125% OF THE POVERTY LEVEL. THAT'S NOT A LOT OF MONEY.
>> ACTUALLY JOY, THAT'S WRONG. THESE ARE ADVANCEABLE REFUNDABLE
TAX CREDITS FOLKS GET THEM UP FRONT THAT THESE GO TO THE
CARRIERS TO RELIEVE THE PREMIUM COSTS THAT THEY ARE GOING TO BE
ABSORBING IN THAT EXPANSION POLICY.
WE PHASE OUT OF MEDICAID EXPANSION THAT IS THE BACK STOP
UPON WHICH WE REPLACE IT WITH. >> YOU ARE SO WE UNDERSTAND WHAT
YOU GUYS WANT TO D DO YOU ESSENTIALLY WANT TO GIVE A VERY
SUBSTANTIAL TAX CUT IN YOUR CASE YOU DON'T WANT THE TAX PAYERS IN
YOUR DISTRICT TO FUND MEDICAID. ROLLING THAT BACK MAKING IT
UNLAWFUL FOR YOUR TAXPAYERS IN YOUR DISTRICT TO FUND MEDICAID,
CUT OVERALL THE COST OF MEDICAID, IT GETS LESS MONEY,
AND THEN GIVE INDIVIDUAL PEOPLE TAX CREDITS.
THAT'S THE PLAN. >> THAT'S THE FUNDAMENTAL
ESSENCE OF WHAT WE ARE TRYING TO DO IS EMPOWER PEOPLE THAN
EXPANDING GOVERNMENT TO A POINT WHERE IT'S NOT SUSTAINABLE.
AMERICAN TAXPAYERS CAN'T FOOT THIS BILL ENDLESSLY AND WITHOUT
A LIMITATION BECAUSE THEY ARE TAPPED OUT.
>> ALL RIGHT. SORRY, ONE SECOND.
WE HAVE A GUEST HERE WHISPERING THAT SHE WANTED TO ASK YOU A
QUESTION. I WANT TO LET ONE OF MY GUESTS
IN. SHE HAS A QUESTION FOR YOU.
TARA, YOU SEEM TO HAVE A QUESTION FOR THE CONGRESSMAN.
IF YOU DON'T MIND I WANT TO LET HER ASK THAT.
>> THE TAX CREDITS ARE LESS UNDER THE SENATE BILL, SO THEY
ARE LOWERED SO WHILE YOU ARE TAKING AWAY MEDICAID THEY WON'T
BE ELIGIBLE FOR THE SAME LEVEL OF TAX CREDITS THAT THEY WOULD
HAVE BEEN ELIGIBLE FOR BEFORE. SO YOU ARE GIVING -- LESS.
>> WELL, BECAUSE WHERE WE'RE GOING TO END UP THEY SOUGHT TO
DO THE AMENDMENT PROCESS. OUR CREDITS IN THE HOUSE WERE
BASD PRIMARILY ON AGE, THE SENATE TOOK A STEP IN THE RIGHT
DIRECTION WHEN YOU INCORPORATE INCOME INTO THAT EQUATION.
INCOME HAS GOT TO BE THE CORNER STONE I THINK.
THAT'S A SWEET SPOT I THINK TO GET THIS TO THE FINISH LINE.
>> SO YOU ACKNOWLEDGE THE FACT THAT FOR THOSE PEOPLE WHO ARE
NOT GOING TO BE ELIGIBLE FOR MEDICAID ANYMORE, THAT THE TAX
CREDIT THEY RECEIVE IS LESS WHICH WILL PUT A GREATER
FINANCIAL BURDEN ON THEM IN TERMS OF PURCHASING INSURANCE.
>> NO, NO. THEY WILL HAVE -- THEY WILL HAVE
ACCESS TO A TAX CREDIT THEY CAN ACCESS THEMSELVES TO PURCHASE
THE INSURANCE THAT WORKS FOR THEM.
IT'S NOT LOWER, IT'S A DIFFERENT WAY OF GETTING HEALTH CARE
RATHER THROUGH GOVERNMENT, AS ACTUALLY THROUGH THEMSELVES AS
INDIVIDUALS. >> I THINK WE UNDERSTAND WHERE
YOU'RE GOING WITH THIS. ESSENTIALLY YOU WANT PEOPLE TO
ESSENTIALLY, IT IS A ROLL BACK OF MEDICAID, IT'S A DECREASE BUT
I WANT TO ASK YOU THIS QUESTION IN THE END.
WILL YOU STAND BY IN THE END THE IDEA THAT THE WEALTHIEST PEOPLE
IN THIS COUNTRY, AS A RESULT OF THIS BILL, IF IT IS SIGNED INTO
LAW, WILL GET A TAX CUT THAT IF THEY ARE IN THE RICHEST 1% MORE
THAN THE AVERAGE INCOME IN YOUR DISTRICT SO THE AVERAGE VERY
WEALTHY PERSON GETS $37,230 BACK AND AT LEAST 20 MILLION PEOPLE
WILL HAVE NO HEALTH CARE COVERAGE IN YOUR VIEW IS THAT A
FAIR TRADE-OFF TO GET AN OBAMACARE REPEAL ENACTED?
>> THERE'S NO DOUBT I BELIEVE IN REDUCING THE AMERICAN TAX BURDEN
AND THAT INCLUDES WHAT WE'VE DONE IN THIS BILL.
AND AT THE END OF THE DAY YOU KNOW WHO FOOTS THE BILL IS HARD
WORKING AMERICANS THAT ARE PAYING THE COSTS WHERE THE TAXES
ARE ASSESSED BACK TO AND FROM MY PERSPECTIVE ANYTHING WE CAN DO
TO ALLEVIATE TAX BURDENS IS IN THE RIGHT DIRECTION FOR
AMERICA'S FUTURE. >> I THINK YOU MADE IT VERY
CLEAR. THANK YOU SO MUCH FOR COMING AND
DOING THIS. APPRECIATE IT.
>> I APPRECIATE THE DEBATE. THANK YOU.
>> THANK YOU. WHEN WE COME BACK, TARA AND