>> HERE IN AMERICA HEALTH CARE
IS A RIGHT FOR ALL, NOT A
PRIVILEGE FOR A FEW.
SO COME JANUARY, WE ARE GOING TO
WORK QUICKLY WITH CONGRESS TO
DRAMATICALLY RAMP UP HEALTHCARE
PROTECTIONS, GET AMERICANS
UNIVERSAL COVERAGE, LOWER
HEALTHCARE COSTS AS SOON AS
HUMANLY POSSIBLE.
WE WANT EVERY SINGLE AMERICAN TO
KNOW, IF YOU’RE SICK, IF YOU’RE
STRUGGLING, IF YOU’RE WORRIED
ABOUT HOW YOU’RE GOING TO GET
GOING TO GET THROUGH THE DAY, WE
WILL NOT ABANDON YOU.
THAT IS A PROMISE.
MARIA: THAT WAS JOE BIDEN
SPEAKING OUT LAST WEEK ON THE
AFFORDABLE CARE ACT COMMONLY
KNOWN AS OBAMACARE.
CAME THE SAME DAY THE SUPREME
COURT HEARD VIRTUAL AGREEMENTS
AGAINST HEALTHCARE ACT
CHALLENGING PROTECTIONS OF
PREEXISTING CONDITIONS AND
PREMIUM SUBSIDIES.
THE COURT TO ANNOUNCE DECISION
ON CONSTITUTIONALITY ON LATE
SPRING AS JOE BIDEN HAS MADE
HEALTH CARE A KEY ISSUE IN HIS
CAMPAIGN.
MY NEXT GUEST IS CONSIDERED KEY
ARCHITECT OF OBAMACARE AS WELL
AS MASSACHUSETTS ROMNEY CARE.
THE AUTHOR OF JUMP-STARTING
AMERICA, COAUTHOR JONATHAN
GRUBER.
JONATHAN, GOOD TO SEE YOU THIS
MORNING, THANKS FOR BEING HERE.
JONATHAN: THANKS FOR HAVING ME,
MARIA.
MARIA: WHERE DO YOU THINK THIS
IS GOING IN TERMS OF THE SUPREME
COURT, JONATHAN?
JONATHAN: WELL, LOOK, WE HAVE TO
START WITH THE FACT THAT
LITERALLY EVERY EXPERT INCLUDING
THE LAWYER WHO IS BROUGHT
PREVIOUS CASES AGAINST ACA THINK
THIS IS A STUPID CASE, IT REALLY
HAS NO MERIT, AND FORTUNATELY
LOOK LIKE THE ORAL ARGUMENT
SUPPORTED THAT AT LEAST 5
JUSTICES OR AT LEAST KEY
JUSTICES JUSTICE ROBERT AND
KAVANAUGH AGREE THAT THERE’S
SIMPLY NO REASON WITH REGARDS
MANDATE TO TAKING DOWN THE WHOLE
LAW BASED ON THE
CONSTITUTIONALITY ON THE
MANDATE.
BASED ON THE ARGUMENTS THE COURT
CASE WILL GO AWAY AND ACA WILL
STAND.
I’M FEELING PRETTY GOOD ABOUT
THAT.
IF IT DOESN’T, ACA IS IN BIG
TROUBLE, AS LONG AS REPUBLICANS
RETAIN CONTROL OF CONGRESS, IT’S
GOING -- IT’S GOING TO BE HARD
TO REPLACE ACA.
MARIA: WHAT ABOUT THOSE PEOPLE
THAT HAVE INSURANCE THROUGH
THEIR COMPANY, 180 MILLION
PEOPLE WHO HAVE PRIVATE HEALTH
INSURANCE AND THEY DON’T WANT
THAT TO GO AWAY?
>> WELL, THAT’S ABSOLUTELY
RIGHT.
SO BASICALLY IF YOU THINK ABOUT
THE WAY THAT THE AFFORDABLE CARE
ACT IS REALLY INTERTWINED WITH
OUR HEALTH CARE SYSTEM IN MANY
WAYS.
AS WE DISCUSSED BEFORE, MARIA,
IT DOES PLAY A SMALL ROLE.
THE EMPLOYERS HAVE OFFER THEM
REAL INSURANCE COVERAGE, NOT
COVERAGE THAT, FOR EXAMPLE, HAS
ANNUAL LIMIT SO THEY GO TO
HOSPITAL STAY AND END UP WITH
HUGE BILL.
WITH THE 180 MILLION AMERICANS
THE AFFORDABLE CARE ACT DIDN’T
MUCH AFFECT THEIR LIVES, WHETHER
IT GOES AWAY OR NOT WILL NOT
HAVE A HUGE IMPACT ON THEIR
LIVES.
FOR THOSE PEOPLE THE REAL ISSUE
IS HOW DO WE CONTROL HEALTHCARE
COSTS.
MARIA: SO HOW DO WE CONTROL
HEALTHCARE COSTS, THAT’S ONE OF
THE MOST IMPORTANT ISSUES I
AGREE WITH YOU.
>> IT’S A REALLY CRITICAL ISSUE,
MARIA, AND NEITHER PARTY HAS A
BRILLIANT ANSWER ON IT.
IT’S HARDEST ISSUE GIVEN THE 12
YEARS OF BATTLE OVER THE
AFFORDABLE CARE ACT.
IRONICALLY THAT WAS THE EASY
PART, COVERAGE OF SPENDING
MONEY.
COST CONTROL IS ABOUT SAVING
MONEY.
THAT IS AS YOU KNOW THE HARDEST
PART AND IT MEANS REVAMPING A
SYSTEM WHERE A LOT OF PARTIES
HAVE A VESTED INTEREST IN NOT
LETTING IT CHANGE AND THAT’S THE
FUNDAMENTAL POLITICAL CHALLENGE
THAT WE FACE AND TRY TO CONTROL
HEALTHCARE COSTS.
MARIA: LET ME ASK YOU ABOUT
GEORGIA AS CONTROL OF THE SENATE
WILL BE DECIDED BY THOSE TWO
RUNOFF ELECTIONS IN JANUARY,
JONATHAN.
IF BOTH DEMOCRAT CANDIDATES WIN,
THE DEMOCRATS GAIN CONTROL OF
THE SENATE, WHAT DO YOU SEE
HAPPENING IN TERMS OF HEALTH
CARE?
JONATHAN: IF DEMOCRATS GAIN
CONTROL OF THE SENATE, JOE BIDEN
HAS LAID OUT 3 THINGS HE WOULD
LIKE TO GET DONE.
THE FIRST IS EXPAND GENEROSITY
OF THE SUBSIDIES ON THE
EXCHANGE, WHILE I’M A BIG
BELIEVER IN ACA EXCHANGE, THEY
AREN’T GENEROUS ENOUGH FOR
PEOPLE WHO ARE LOW INCOME.
YOU CAN SPEND 20% OF INCOME ON
HEALTH CARE IF YOU ARE ON THE
EXCHANGE AND SO BIDEN WOULD END
THAT.
HE WOULD MAKE GENEROUS AND HE
WOULD MAKE THEM AVAILABLE WITH
SUBSIDIES TO EVERYONE.
NOT JUST THOSE BELOW 4 TIMES THE
POVERTY LINE.
THAT’S NOT POLITICALLY
CONTROVERSIAL.
THAT’S JUST A BUDGET ISSUE.
REPUBLICANS I THINK DON’T WANT
TO SPEND THE MONEY, DEMOCRATS
WILLING TO.
SO THAT’S SIMPLY IT’LL HAPPEN IF
DEMOCRATS CONTROL THE CONGRESS
AND WON’T IF THEY DON’T.
MARIA: YEAH.
GO AHEAD.
TELL ME ABOUT THE PUBLIC OPTION.
GO AHEAD.
>> YEAH, SO THE PUBLIC OPTION,
MARIA, I CALL THEM PUBLIC OPTION
LIGHT AND PUBLIC ACTION HEAVY.
THE PUBLIC OPTION LITE IS
ADVANTAGES ON EXCHANGE.
WITHOUT FEDERAL GOVERNMENT
REGULATED RATES TO PROVIDERS,
LITE AND HEAVY.
HEAVY IS HAVING SOMETHING LIKE
MEDICARE THAT REGULATES THE WAY
PROVIDERS ARE PAID.
PUBLIC OPTION LITE, THE BIG
ADVANTAGE OF IT IT OFFERS MORE
COMPETITION ON THE EXCHANGE
WHICH IS GOOD BUT MOST
IMPORTANTLY IT OFFERS A ROUTE TO
BRING COVERAGE TO MILLIONS OF
AMERICANS WHO WOULD BE DENIED
INSURANCE IN STATES LIKE GEORGIA
AND TEXAS AND FLORIDA WITH THE
FEDERAL GOVERNMENT OFFERED TO
PAY 90% TO HAVE COSTS OF
COVERING LOWEST-INCOME CITIZENS
WITH INSURANCE, BUT THEIR STATE
LEGISLATURES HAVE TURNED IT DOWN
SELFISHLY.
THAT’S THE BIG GAIN THERE.
THE PUBLIC OPTION HEAVY, THAT’S
ANOTHER STEP, THAT WOULD INVOLVE
REGULATING RATES AND THAT WOULD
BE OPPOSED.
THAT WOULD BE OPPOSED BY
INSURERS, IT WOULD BE OPPOSED BY
PROVIDERS WHO MIGHT BE WORRIED
ABOUT GETTING LOWER RATES.
THAT’S GOING TO BE A HEAVIER
POLITICAL LIFT, I’M NOT SURE
HAVING 50 IN THE SENATE IS
ENOUGH.
I THINK THAT’S GOING TO BE MORE
OF A BATTLE.
I THINK IT’S VERY IMPORTANT TO
REMEMBER.
MARIA: JONATHAN, WE TALKED ABOUT
THIS BEFORE.
GO AHEAD.
JONATHAN: VERY IMPORTANT,
THERE’S TWO ASPECTS, REGULATING
THE RATES BUT OFFERING A ROUTE
TO MILLION LOW-INCOME AMERICANS
WHO HAVE BEEN REALLY JUST
SPITEFULLY DENIED HEALTH
INSURANCE BY STATE LEGISLATORS.
MARIA: SPITEFULLY?
COME ON, SPITEFUL.
JONATHAN: THE FEDERAL GOVERNMENT SAID TO FLORIDA WE WILL SEND YOU
SAID TO FLORIDA WE WILL SEND YOU
BILLIONS OF DOLLARS TOOVER -- TO
COVER LOW-INCOME IN YOUR STATE
AND THE REST TO HAVE COUNTRY
SAYS WE WILL SEND YOU MONEY,
FLORIDA, TO COVER LOW-INCOME
CITIZENS AND FLORIDA SAYING NO,
HOW CAN THAT MAKE SENSE.
MARIA: I KNOW WHO IS UPSET ABOUT
IT BUSINESS.
THAT’S ONE OF THE REASON THAT IS
THEY HAD TO PULL IN MONEY ON
OTHER THINGS LIKE RAISING
SALARIES OR INVESTING IN IT OR
R&D.
JONATHAN: MARIA, YOU AND I
AGREE.
I’M SO GLAD THAT YOU LIKE MY
BUSINESS AND BUSINESS CAN SPEND
MORE R&D, BUT THIS IS A SEPARATE
ISSUE, THIS IS LITERALLY THE
FEDERAL GOVERNMENT SAYING WE
WILL -- NO, I CAN IMAGINE VOTERS
IN OTHER STATES.
MARIA: LET’S BE CLEAR.
WE DON’T AGREE ON EVERYTHING.
JONATHAN, WE DON’T AGREE ON
EVERYTHING AND WE AGREE ON SOME
THINGS AND I’M GLAD THAT YOU’RE