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Senator Lamar Alexander On Obamacare Repairs

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Tennessee’s Senator Lama Alexander joined me this morning to talk about the very narrow path to a set of Obamacare repairs:




HH: Joined now by United States Senator Lamar Alexander from the great state of Tennessee. Good morning, Mr. Chairman, great to have you on the program.

LA: Good morning, Hugh, how are you?

HH: I’m terrific. I want to get right to the core of this, though, because yesterday, Speaker Ryan said that he prefers the Obamacare stabilization plan put forward by Kevin Brady and your colleague, Orrin Hatch to the one that you have been working on with Patty Murray. What’s your response to that, Mr. Senator?

LA: Well, my response is that’s a step forward, because they, Brady and Hatch, both see the need for continuing the cost-sharing reduction payments for the next two years. That’s been the big hang up for most people. And so for the Speaker to say he prefers that, that’s a step forward. Of course, to get a result, you have to get Democratic support as well as Republican. We’ve got that in the Senate. So I think we’re on our way to a short-term bipartisan agreement by the end of the year that reduces premiums and avoids chaos, and that’s a lot of progress in the last three weeks.

HH: Now my first question is what do Republicans get out of this, because you know, to sell this deal to the Freedom Caucus, they’ve got to be able to answer that question fairly quickly and cogently.

LA: Well, the first thing is less money for Obamacare subsidies and more savings for the taxpayers. The Congressional Budget Office said yesterday the Alexander-Murray proposal saved the taxpayers $3.8 billion dollars. That means less Obamacare subsidies. That’s where the savings come from. And if we don’t do it, it’s $194 billion more in Obamacare subsidies over the next ten years, according to CBO. So that’s the first thing. The second thing is you get the Iowa Waiver, and you get the Oklahoma Waiver, and you get other waivers that states have asked for to give them more flexibility in giving more choices and lower prices. Third thing you get is a catastrophic health care plan. That means a young person who’s healthy and who doesn’t want to pay these high prices can have a low, lower premium, high deductible plan, and be able to afford health insurance. That helps everybody else, too, because it brings healthier people into the pool. So those are significant changes. They’re the only changes that we’ve gotten in seven years to the Affordable Care Act, and we couldn’t ever get these changes in a budget bill with 51 votes, because they all required 60 votes in the Senate, which means some Democratic support.

HH: Now Senator, as a longtime critic of Obamacare, the one that appeals to me, the waivers don’t much matter to me. But the less money for Obamacare, I’m not really trusting the Budget Office. But the catastrophic health plan has a great attraction to me. Would you explain to me where that will be available to people and what you will mandate be in it?

LA: Well, the catastrophic health plan would be available both on the exchanges and off the exchanges. You would not have to pay a penalty in order, I mean, it wouldn’t cause you to have to pay a penalty because it’s not one of the other Obamacare penalties. It does have to have in it the protections on preexisting conditions and the existing health benefits. But it will be cheaper than what you can buy today. Today, in the law, only people 29 or under can buy a policy like that. This takes that cap off and says anybody of any age can buy it.

HH: How much demand do you think there is for that policy?

LA: Well, the Congressional Budget Office said it should slightly reduce premiums for everybody. I don’t know what the demand will be. But I think with the tremendously high prices, for example, in Tennessee, the premiums have gone up 176% in four years, another 38% this year. I mean, that’s terrifying to people. So if they can find something that’s cheaper, even if they have a higher deductible, I think more people will buy it. I can’t tell you how many, but I think it’s a very attractive option.

HH: Now the other two things that Republicans wants are interstate sale of policies, the reduction of barriers to that…

LA: Yeah.

HH: And of course, they would like the penalty for not buying insurance to go away.

LA: Right.

HH: Is there any opportunity on those two matters?

LA: Well, on the first, we have in our bipartisan bill steps toward more interstate compacts. For example, if the two Dakotas wanted to go together and form a market, it would make that easier. Or if the New England states want to do it, it would make it easier. So we’ve got that in there. What was the other one?

HH: The other one is whether or not…

LA: Oh, the mandate.

HH: …mandate can be pulled back, yeah.

LA: I’d like to get rid of the mandates. The mandates cost money. Our bill has not only, doesn’t cost anything, it saves the taxpayer money. When you start taking away the employer mandate or the individual mandate, all of which I’d like to do, you have to come up with a lot of money to pay for it. For example, one of the most attractive things to do would be to delay the collection of money on the employer mandate. A lot of the employers are about to get a bill for their employer penalty that wasn’t collected in 2015 and ’16. Many don’t even know it’s coming. But to do that costs $5 or 6 billion dollars a year. So we’ve have to have an agreement with the administration and Democrats, as well as Republicans, to find that much money.

HH: So now procedurally, Senator, do you expect to get this out of the Senate before the tax bill is voted on?

LA: No, I don’t.

HH: Okay.

LA: I think that would be, I don’t think we have time to do that. Plus, senators are still studying it. The President’s studying it. I think it’s more likely to be done in December when the end of the year legislation. And the most important thing that happened yesterday was the Congressional Budget Office reaffirmed what Senator Murray and I intend, which is that all of the benefits for the cost-sharing payments in 2018 got to consumers or to taxpayers, and they’re not to bail out insurance companies. I’ve talked to the President four times on this. He’s called me four times in the last two weeks, first time to ask me to do it, and that’s his major concern. So I hope this helps persuade him of that.

HH: All right, now let me turn to the tax bill. First of all, your colleague, Bob Corker, is on MSNBC as we speak. Do you expect Bob Corker to support tax reform?

LA: Well, I can’t vote for Bob or any other senator. I know he wants to. And he’s, he would tell you if he were there, and I don’t think he minds my saying, that while he’s a deficit hawk, he doesn’t, he thinks our $20 trillion dollar federal debt, as I do, is a national disaster. And he made, in his view, some compromise with Senator Toomey to create a framework in which we could do this bill. So I know that he wants to be able to vote for it.

HH: Now again, he’s your friend. He’s your co-state. I do not understand how he thinks we’re on the verge of World War III and Secretary Tillerson has been kneecapped when he has a hold on all these ambassadors. What is that all about, Senator Alexander? You can’t say we’re on the verge of World War III and then not send an ambassador to India, Germany, Estonia. He’s got holds on all these different people.

LA: He does? I didn’t know that. I thought other senators did. He’s chairman of the Foreign Relations Committee.

HH: Yeah, it’s him.

LA: Most of what he does is to try to get them out. So if that’s the case, I didn’t know it. I’m not sure that’s true.

HH: I do believe it. You can check on that.

LA: Yeah, if you know it, I’m not going to dispute it.

HH: Yeah, you can check on that.

LA: But I haven’t, I’ll go check on it. I hadn’t heard that one.

HH: Because it just, these blue slips make me crazy, Senator Alexander. Do you use them?

LA: Well, blue slips are the Judiciary Committee on judges.

HH: Right, but holds…

LA: I haven’t used them.

HH: …and blue slips are the same thing, you know, basically.

LA: And that’s been a tradition in the Judiciary Committee, both with Republican and Democratic senators.

HH: But do you approve of this, because I think the bigger issue, Senator Alexander, you’ve been a governor, you’ve been a presidential candidate, you’ve been a senator, you’ve been a secretary, is that the Senate is the source of all dysfunction in Washington, D.C. That is the growing belief. And you’ve got the best leader of my lifetime in Senator McConnell, but still nothing happens. Is it time to really fundamentally change the rules of the Senate?

LA: Well, you know, everybody thinks the Senate is dysfunctional. The President came over and had lunch with us Tuesday, and this is what he said. He said he’d accomplished more, signed more legislation in the first 100 days of his administration than any president since Harry Truman. Well, if that’s true, that means the United States Senate is the most productive Senate than any president since Harry Truman in the first 100 days of President Trump’s term. Plus, the Senate confirmed Neil Gorsuch. Now what the Senate is, is it slows things down. But you want to slow a lot of things down. There are more bad ideas up here than there are bad apples. And you don’t want things running through here just because you’ve got a majority of the moment that thinks it’s a great idea. Otherwise, we’d be rid of, you know, Lyndon Johnson tried to get rid of the right to work law when he had huge majorities, and Everett Dirksen many years ago stopped him because of the filibuster. So there are things about the Senate that need to work better. Nominations need to go faster, and I’ve worked on that for years. But you, we’re not the only source of Washington not working. And in fact, according to the President, nobody’s had a more productive Senate in his first 100 days since Harry Truman.

HH: Now we do see Steve Bannon leading a charge against your colleagues. You’re not on the ballot. You don’t have to worry about this. Bob Corker retiring, Jeff Flake retiring, Roger Wicker probably going to get a challenge. What do you say to people who think that the Senate is in need of top to bottom, I’m not supporting that, by the way. I’m not a Bannonite. I’m, I like all these people that are up there, and I’m sorry to see them go. But I understand the frustration.

LA: Well, if you had, if you didn’t have a Republican majority, you wouldn’t have had the bill to fix No Child Left Behind, which the Wall Street Journal said was the biggest devolution of power from Washington to the states in 25 years. You wouldn’t have had Neil Gorsuch on the Supreme Court. You wouldn’t have President Trump saying that he’d passed more legislation in the first 100 days than anybody. What you would have is you’d have a Senate full of Democratic chairmen investigating President Trump, and you would not have conservatives heading up major agencies in the government having to do with labor, health, education and other areas who are dramatically changing the way America works. And you would not have had the 14 Obama-era regulations that we overturned, which is 13 more than have ever been overturned before through the Congressional Review Act.

HH: Yeah.

LA: So it moves slowly, but you’d be moving rapidly in the other way if we didn’t have a Senate majority.

HH: Last question for you, Senator, I just have to ask about this GPS Fusion study. This turned D.C. on its head, turned me on its head. It was paid for by Team Clinton, by the DNC, and then it was given by Director Comey to the President-Elect. What is going on here? This is weird.

LA: I don’t know what’s going on. You know more about that than I do, probably. I read a story about that last night. I have no idea what it’s about.

HH: All right. I just, I hope you get to the bottom of that one. Senator Alexander, good luck.

LA: Okay, Hugh.

HH: Thank you very much.

LA: Thanks for your time.

End of interview.


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