Rep. Greg Walden joined me this morning, chair of House Energy and Commerce:
HH: Joining me to discuss the substantive changes, Chairman Greg Walden from Oregon. He is a radio guy. He’s one of us, and so he actually knows of which we speak. Mr. Chairman, welcome.
GW: Hey, good morning.
HH: I was just getting my list of questions for you, and a block there on the name there, so I’m sorry.
GW: Not a problem.
HH: But let me ask you, Greg, the House conservatives are said in the Wall Street Journal to have the votes to block the health bill. What do you think about that?
GW: Well, I think with these changes that have come out, we’re earning support every day, every minute, every hour. The President of the United States is going to be in the Republican Conference this morning about 9:15. Nobody knows how to close a big agreement better than the president of the United States. He’s worked tirelessly on this to bring different factions of the party together to repeal and replace Obamacare, engaged in the biggest entitlement reform in the history of the country, and protect pro-life provisions that are so important, the National Pro-Life Organization is key voting this, which you know, Hugh, is a big thing. This means it’s one of their top priorities. And so I mean, I think we’ve done a lot here. We want to do so much more in other legislation going forward. We’re limited, as you know, by the rules of the Senate on what we can do in this budget reconciliation bill. But we’re just beginning this process.
HH: Are there any more changes potentially on the table to bring over reluctant Republicans?
GW: Well, you know, we have an open and transparent process under Paul Ryan. We go to the Rules Committee tomorrow, and members of the House can offer up their amendments there. If they earn the support of the Rules Committee, they’ll be vote on, on the House floor, and the whole House can consider them. So you know, we’re continuing to listen. We made changes yesterday, as you know, up until the time we had to file the bill. And there’s still opportunity in the House. And moreover, there’s lots of opportunities in the Senate. They’re an equal legislative body, and in fact, some of what we’re doing here we anticipate with our partners in the Senate that they’ll have a chance to improve it, where they have more say over their own rules. You know, we don’t have much say over the Senate rules, as much as we’d like to.
HH: Now Congressman Walden, you tilted the tax credits towards the older and poorer Americans, which was smart.
HH: And a lot of people wanted that to happen.
HH: Maybe not as much as I was expecting towards older and younger Americans, but you’re making the transition from Medicaid a little bit easier.
HH: You’re adding work requirements. You’re giving states a lot of flexibility.
HH: Let’s go to the three areas where I find most conservative critiques come – no tort reform, no reform of the essential benefits, no competition across state lines. Why not use the tax code to dis-incentivize bad behavior? For example, add surcharges on policies in any state that has a pain and suffering damage limit that is too high?
GW: That would trigger referral to the Judiciary Committee. It would make the entire reconciliation bill fatal in the Senate. They wouldn’t be able to take it up without 60 votes.
HH: Why is that when you’re just doing a tax provision? You’re not actually reforming. You’re not telling them to do it. You’re just saying we will tax a policy…
GW: Yeah, I love the creativity of it, but unfortunately, when we’ve tried this before, and we did in reconciliation, the Senate parliamentarians years ago said no how, no way, nice try. Yes, it saves 50, at that point, $54 billion dollars just to federal taxpayers by getting rid of junk lawsuits doing what California does, their micro program, and we got ruled out of order. Well, they didn’t rule it out of order. They said it would make the bill fatal. And so we can’t risk that here.
HH: But did you try it…
GW: But we are coming back straight up with tort reform. We believe in it…
HH: But we know that that takes 60 votes, and I agree with sort of Ted Cruz saying the third bucket’s a sucker bucket, and Tom Cotton saying there is no third bucket.
HH: But just stick with me for a second.
GW: Well, I disagree with both of those, because I think you’re going to see association health plans. You favor those, I’m sure.
HH: I do. I do.
GW: We’re moving that forward. That’s third bucket stuff.
HH: You’re not going to get anything from them. the Dems are dug in. This is it.
GW: Well, with your help, we can.
HH: Well, we’ll try.
GW: You can help affect it. Come on, man.
HH: Stick with me for a second on tort reform.
HH: When you tried tort reform years ago, did you try it as a tax provision to tax policies of states without a cap on pain and suffering damages? Did you try it that way?
GW: I don’t think they tried it that way.
HH: You see, I’ve been reading the Reid Rule. I actually go home and do my homework and think like a legislator.
GW: And a lawyer.
HH: Yeah. What about essential benefits, because it seems to me again, you could tax policies in states that are too generous with their essential benefits.
GW: Well, you know, it’s a better question for the Ways and Means Committee, but indeed, as we looked at some of these things, we removed essential benefits on the Medicaid Advantage population. We reduced the actuarial ratio on essential benefits down to 50% from the metal tiers. We repealed the metal tiers. You know, part of this, too, Hugh, is trying to round up the votes in the House, and that’s, as you know, a difficult proposition right now. We’ve got members on the left, members on the right, all of whom say we didn’t go far enough here, didn’t go far enough there. We’re trying to find that sweet spot, and I think we’re getting as close as we can doing as much as we can. But this isn’t the only opportunity, and remember, you’ll have reconciliation in a few months to do tax reform. We’ll have reconciliation again next year where we can try some of these things. This is just the first step. We’re, you know…
HH: Next year’s reconciliation is tax reform, though, isn’t it, Greg Walden?
GW: Yeah, but you’re, but that’s what we’ll pass in about a month. You have next year to come back and do another budget bill, where you’ll have another reconciliation, where you can do additional fiscal matters. So you know, eat a big donkey one bite at a time. They used to say that about elephants, but that’s the symbol of our party, so I’m not going there.
HH: All right, let me ask you about where you have the most problem. Do you have the most problem with moderate Republicans like Charlie Dent, or the most problem with Mark Meadows and the Freedom Caucus at this moment on this day?
GW: You know, it’s on the right, I would say. It’s probably more the Freedom Caucus. I mean, I’ve seen those quotes in the press far more than others. Obviously, there are members who want, I’m dealing with members, frankly, Hugh, who want repeal only, no replace, and I think you know, the President’s made clear, our Better Way agenda made clear, we’re not going to pull the rug out from under people. But I have caucus members who think it’s okay just to repeal and leave it alone, and let people sort of fend for themselves. I’m not in that camp. I think we have to have a transition here. We’re landing an airplane, not a helicopter. You need a glide path for people. We can’t pull the rug out from under them. This is really their health care.
HH: You don’t have to persuade me. I like the bill. I’m just trying to get it over, and I think tort reform and essential benefits are the two things that conservatives have left to bitch about.
HH: I mean, I don’t see much to complain about, other than a lack of creativity on tort reform and essential benefits, because I think those are the drivers. I would have expected you to tell me Tom Price will handle essential benefits. That’s, you know, that is a second bucket issue.
GW: Well, and we’ve been told there’s no second bucket. I mean, it’s the same people criticizing the bill say there’ll be no second bucket or third bucket. You know that’s wrong, because he’s got 1,400 authorities granted to him. He just can’t tell us in advance, but he’s already asked states for the 1132 waivers that speak right to the issue of benefits, right to the issue of major reform. We’re federalists. We believe in letting the states work on these issues. In Maine, where they did this, as you probably know, look at the Wall Street Journal editorial today, they did a great job reforming their markets, saving it, restoring it, and making it work for people. And we…
HH: You know, I think he can. I think…
HH: I believe in the second bucket. I don’t believe in the third bucket. But if I could sell you on one thing, I’m going to lobby you now, and I’m not getting paid by anyone to lobby you. You know, honest to goodness, this is free lobbying.
GW: I know, I know.
HH: If you were to go back and put in a tax provision that said any policy sold in any state that does not have a cap on pain and suffering damages of $250,000 or $300,000 shall have a 10% surcharge on it, all of those states would impose those caps lickety split, and the Plaintiff’s Bar would be out to lunch, and we would save all of that, you know, defensive medicine that is out there. And you know that’s a problem, Greg.
GW: Well, sure I know. I was on a hospital board for five years. I saw it up close and personal. I voted to reform it every chance I’ve gotten. It’s a new idea. I’m happy to take it back to our team.
HH: And tell me, by the way, when this comes down to a vote, it’s tomorrow night, right? And if it loses, is it dead, dead, dead?
GW: Well, this is the make or break vote. I’m not aware of any Plan B. It’ll come out of the Rules Committee on Wednesday. We’ll vote on it on the House floor on Thursday, and I think we’ll have the votes. I know the Vice President’s working hard on it, the President’s worked hard on it. This is Donald Trump’s signature issue in the administration so far, and I know the White House is fully engaged, very effectively engaged. And I think he’s, you know, this is the big vote.
HH: Well, I hope you get it through. Remember, add some tort reform, and I don’t think the Freedom Caucus dare vote against it at that point. Greg Walden, chairman of House Energy and Commerce, thank you for joining me this morning. Good luck in the next 48 hours. I doubt you’ll get any sleep at all.
End of interview.