Breaking Down the GOP's American Health Care Act

a lot of Tom prices commentary they're centered on competition in the insurance marketplace do you acknowledge that that has not gone as was designed or well that there is an issue of competition here and does this legislation do you think it would take any steps to correct them well I I don't think so i think there are a lot of reasons why insurers decide to enter certain markets and not enter other markets and i'm not sure what this legislation does to encourage that clearly under the Affordable Care Act we had provisions to stabilize the insurance markets to guard against some of the increases in premiums that some of the exchanges have seen as a result of sicker people coming into the market earlier Congress is withheld those funds from going to insurers to prevent those those bumps and premiums and that certainly would do quite a bit and and i think you know would make a big difference well let me turn to you hear over and over again we heard the secretary of health and human services say this is about patients let me have a little bit of fun here with a homonym it doesn't seem like Republicans are that patient to wait for a CBO score here how fatal a mistake do you think that could be we see the divisions within the Republican Party why not wait for the CBO to score this thing I think obviously the CBO score the CBO determination on cost and coverage is going to be important but i think the philosophy here frankly is to get a piece of legislation out there so that we can have a discussion about actual pieces of reform and i think that the challenge we had before the legislation came out is that no one was exactly sure what it is was going to compose the republican plan and so now at least there is a plan that can be discussed for good or for ill and i do think that strategically that was an important thing to do I asked John Sela before at Tom Price got started there during the daily press briefing about his reaction to the legislation itself based on what you worked on what you were hoping for how closely does that cue with what we're seeing from the Republicans I think there are a lot of elements here that make sense certainly on the repeal side they have done as much of repeal as is practical through this budget reconciliation project process on the replace side they've done a number of things that I think are good is it a perfect piece of legislation no clearly it's not I think you're seeing conservative disagree about that but in my view there are a lot of things that are to come as part of this negotiation so as an opening bid it's a pretty darn good start an opening bid here something that Tom Price brought up John Salib is this notion that you'd be able to buy insurance across state lines much in the way that you can cross the state line from Massachusetts New Hampshire and buy liquor I suppose people know how to do that might want to do it with health insurance care as well how difficult is that and why is that something that you think Republicans are caring so much about here I I don't know why Republicans care about it so much but but I think that some of the challenges with that policy are a as I was mentioning I think there are a whole host of reasons why insurance companies do want to provide coverage in the state and not provide cover their whole lot of economic reasons for them to do so I think one of the other challenges there is that in an unregulated insurance marketplace which is what this legislation would move to what you might have happen is it all of the insurance companies domicile in a state that has very few regulations and allows them to offer plants that don't provide very much in the in the in the in the in the way of consumer protections and coverage for for individuals lonnie chennai look at this piece of legislation i see the preservation of say insurance benefits for those who are young a bit younger younger than 26 how difficult is it going to be the maintain parts of the Affordable Care Act that people like you look at polling people like and still be the sort of wholesale changes they're being proposed in this legislation I think that is the major challenge here that they're using a particular legislative process you know this budget reconciliation process is our cane not all that many people certainly not many Americans have spent time really understanding it and that restricts the ability frankly of Republicans to effectuate wholesale repeal on issues like insurance regulations for example the requirement that all plans cover the same set of what are known as essential health benefits that is something that apparently through this process you can't repeal the provision you've mentioned earlier regarding people under 26 being able to remain on their parents plans that is something else which frankly I don't think is repeal abul through this process so they're going to have to keep peeps or bits and pieces and the question does become going forward how much of the previous system will work with the new system they're trying to bring in behind it I think they've done as I said the best they can to date and to this point the question is whether the votes are there both in the house and the Senate to get this thing across the finish line

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