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CROWLEY: Here to look ahead to today's vote and the high stakes politics surrounding it, House Democratic Caucus Chairman, John Larson of Connecticut, and the House Republican Conference Chairman Mike Pence of Indiana. Gentlemen, thank you both for joining me.
PENCE: Thank you, Candy.
LARSON: Great to be with you, Candy.
CROWLEY: State of play, where are you? 216, do you have it locked in?
LARSON: This is a historic day. And we are happy warriors. We are so proud of the Democratic caucus, that we will be a part of history, joining Franklin Delano Roosevelt's passage of Social Security, Lyndon Johnson's passage of Medicare, and now Barack Obama's passage of health care reform.
CROWLEY: So you have got the 216?
LARSON: We've got the votes. And the reason for that, Candy, I think it started earlier this week with Natoma Canfield becoming the poster child for -- or lady for health care reform. And that struck such a cord within our caucus. And Dennis Moore standing up to give a speech in the caucus was Blackberried by a woman who works with him in Kansas. She said thank you for voting for this. I know I am losing my job at the end of this year, and unfortunately, I have just been diagnosed with cancer. Without this bill, I'm lost. Dennis ended by saying, and she is 24. You could have heard a pin drop.
This is about whose side you are on. And clearly, this historic moment in the people's chamber, we are on the side of the American people and those that have been denied access to health care, and those who have pre-existing conditions who have been denied, and those who have had their policies rescinded.
CROWLEY: Congressman Pence, I think that puts you on the side not of the people, if we take his calculation. What is left for Republicans to do? Congressman Larson says they have the 216. So it is all over but the shouting? You guys vote no and move on?
PENCE: Well, I don't know if they have the votes. House Republicans are going to use every means at our disposal.
CROWLEY: What is that?
PENCE: Well, stay tuned, Candy. It's going to be an interesting day.
CROWLEY: Can you disrupt the vote? I mean, what's available?
PENCE: We are going to use every means at our disposal to oppose this government takeover of health care. Because quite frankly, as thousands gather at rallies all across this country and here in the nation's capital, yesterday, you know, the American people are sick and tired of runaway federal spending by both parties, of borrowing and bailouts and takeovers. And I believe this is going to be a historic weekend.
LARSON: It is.
PENCE: But I think it is going to be different from the way John thinks it is going to be. I think this is going to be a historic weekend because I think this weekend is going to be the beginning of the end of business as usual in Washington, D.C. I think the American people see an administration and see a Congress that are in a headlong rush to confront the very real challenges that we have in health care with more government instead of more freedom.
They know -- the Republicans have been offering solutions from the beginning. Let people purchase health insurance across state lines, pass malpractice reform, cover preexisting conditions. All of that can be done without a massive, trillion-dollar expansion of the federal government and burdening future generations with more deficits and more debt.
CROWLEY: But the reality of this day is that you don't have the votes to stop it. You may have the means to delay it. PENCE: Right. You know, the Republicans, it shouldn't be a news flash to anybody, Republicans don't have the votes to stop anything in the House of Representatives. We are in a decisive minority.
CROWLEY: (inaudible) politically.
PENCE: But what's remarkable about this one-year debate has proven my point, that a minority in Congress plus the American people equals a majority. Republicans -- the reason they weren't able to do this last year -- remember all the deadlines? We had deadlines in the summer, we had deadlines in the fall, we had deadlines at the end of the year. The American people don't want this government takeover of health care. And I don't know if they have the votes today, but I guarantee you, the American people know they have the votes in America.
LARSON: The American people who are already on Medicare, all of our veterans who already receive Tricare, understand the importance and the value of having insurance coverage. For 47 million Americans who have none, 31 million will now be able to have access to insurance, lowering costs, lowering costs for small businesses, lowering the national debt. First, $138 billion, and then $1.2 trillion. We can't afford not to do this. And taking care of those people--
CROWLEY: I want to talk about the debt. Hang on one second. I have got to take a small break--
CROWLEY: We will come back. I do want to talk about the costs. There are some figures out there floating. I'll do that, we'll be back with Congressmen Larson and Pence right after this.
CROWLEY: We are back with Democratic Congressman John Larson of Connecticut and Republican Congressman Mike Pence of Indiana. We were talking about the cost of this. The CBO has said over 10 years this health care bill will reduce the deficit by $143 billion.
However, that doesn't include what might come and what has been promised, with more than a wink and a nod to doctors, which is to up their Medicare payments, their reimbursements, which would cost $208 million, which then means it actually would be -- would add to the deficit.
Is that -- is my math correct there? LARSON: Well, if that were to be true. But here is the thing, there is no question about the fact that we need to take care of the docs and we need to emphasize primary care. But also what never gets discussed, Candy, is something that Reuters came out with earlier this year, $700 billion annually in inefficiencies in this system, lack of interoperability in hospitals, lack of a continuum of care, and fraud and abuse -- $700 billion.
I think that we're going to -- that's $7 trillion over a 10-year period. I think that we're more than going to be able to wring out the cost in there. I think that's why the president brought people down to Washington, to the White House, that's why he brought the six (ph) in to try to wring out those costs as we go forward.
You know, we spend 20 percent of gross domestic product. The closest country to us is Switzerland. I can't believe that we can't get that money out of there.
CROWLEY: Can't we get that money out of there?
PENCE: Yes, yes, we do such a great job here in Washington wringing out the cost.
LARSON: Now that's in the private sector.
PENCE: One-point-six trillion dollar deficit this year, you know, only in Washington D.C. could you say with a straight face that you are going to spend $1 trillion and save tax-payers money. Look, you point out the doc fix. This is a total fraud. The Democrats are leaving out $200 billion in spending that the speaker of the house committed again this week to spend, which makes this -- even using this CBO's numbers, it makes it a bill that adds to the deficit in the short term and in the long term.
But look, even beyond that, Candy, the American people know that you expand the federal government's role in health care without giving the American people more health care choices by purchasing across state lines, without passing any medical malpractice reform at all -- roughly a third of health care costs in this country I hear are actually defensive medicine driven by junk lawsuits.
The American people know this is going to cost more and add more to the deficit, add more to the debt, cost higher taxes even than the rosiest scenarios that are presented...
LARSON: The CBO is the bible. The CBO says...
CROWLEY: It is, but it's not always accurate, as you know.
LARSON: We have arguments with them all of the time, but...
CROWLEY: Somebody once told me that predicting...
LARSON: ... that's all that we can -- that's all that we can vote on.
CROWLEY: Sure, absolutely. But it still is one of those things that we might not find out...
PENCE: And the president...
CROWLEY: ... except for 10 years from now.
LARSON: And the president has put in numerous reforms that are going to take effect, including the inability to rescind your insurance policy, pre-existing conditions. For women across this country, Candy, I mean, there birth is a pre-existing condition, domestic violence is a pre-existing condition, a C-section is a pre- existing condition, in-vitro fertilization, come on.
PENCE: My wife had to -- John, my wife had a pre-existing condition. I lost my job about 15 years ago. My wife had a pre- existing condition. She was pregnant with our daughter Audrey. We went to the state guarantee fund, a fund that would be replenished if we passed medical malpractice reform, we could use the savings to strengthen those funds to cover people like my wife was covered.
You don't need a government takeover of health care. You don't need to mandate that every American purchase health insurance whether they want it or need it or not, and you don't need to put us on a pathway towards socialized medicine.
LARSON: Where is the takeover by the government?
PENCE: And that's what this crowd is doing today.
LARSON: Where is the takeover by the government? CROWLEY: Let me ask you something, just turn...
LARSON: Humana runs Medicare currently. Tricare is run by them. Where is the takeover of government?
PENCE: Well, I'll break it down. John, if you mandate that every American purchase health insurance, you mandate that every business provide it...
LARSON: Do we mandate that people get car insurance?
PENCE: ... you create a...
PENCE: ... so that people end up in government-run insurance, and you provide public funding for abortion, you mandate insurance plans, cover it within the exchange...
LARSON: There is no funding for abortion in this bill.
PENCE: It is a government takeover of health care.
LARSON: There is no funding for abortion in this bill. It follows Hyde. That's not -- that's the case. PENCE: John, you know that is not true. The Catholic Church...
LARSON: I know it's absolutely true.
PENCE: ... the Catholic bishops, the right to life says...
LARSON: Sixty thousand nuns can't be wrong.
PENCE: ... public funding for abortions is in this bill.
LARSON: Thank God for the sisters of Notre Dame, that's what I think.
CROWLEY: Let me call a time here, because we are out of time. But for more of this, our audience can tune into the House debate starting this afternoon. And I suspect that pass or not pass, this debate continues as we watch how it goes.
LARSON: That's right. Very strong disagreements. But Mike Pence is an honorable man. And I look forward to this debate, and as are our colleagues. I hope that we do ratchet down the conversation though, because when two of our colleagues are spat on and hurled racial slurs, it is time...
CROWLEY: It did indeed happen.
LARSON: ... it's time to ratchet down things a little bit.
PENCE: Well, I'll tell you, I was in Selma with John Lewis, if what is reported to have happened was reported is contemptible, I denounce it in the strongest terms. But I assure you, this debate will not end today.
LARSON: I agree with that.
CROWLEY: Or probably on this show.
LARSON: I agree with that.
CROWLEY: Thank you very much, I appreciate it.
LARSON: There is going to be a lot of work to go to...
CROWLEY: If health care reform wins passage in the House today, the measure heads back to the Senate. Up next, a quick tutorial on what happens next. And then a conversation with Democratic Senator Dianne Feinstein and Republican Senator Orrin Hatch.
CROWLEY: A quick reality check for those who today's House votes will bring us to the finish line, not quite, not yet. If House Democrats muster the votes today, two things happen. First the Senate version of health care reform will be passed by the House and will then be ready for the president to sign into law. Second, House Democrats will pass a fix-it bill, a companion measure of sorts to correct the things they don't like about the Senate measure. That bill has to go to the Senate. If the Senate goes the easy route, they will pass the fixes without change and send it off to the president. But if the Senate changes anything, if it adds or subtracts from the House measure, it must go back to the House for another vote before it goes to the president.
Senate Republicans have some options which could delay or change the bill, including parliamentary challenges to any part of it as unrelated to the budget. Why didn't the "Schoolhouse Rock" teach us about this? We will do our best to get answers on what comes next from senators Orrin Hatch and Dianne Feinstein right after the break.
CROWLEY: As we explained, even if the health care reform bill wins passage in the House later today, it still has another legislative hurdle to clear, back to the Senate for those changes or fixes, if you will, that House Democrats want.
Joining us, Democratic Senator Dianne Feinstein of California and Republican Senator Orrin Hatch of Utah.
So the other day I noticed, Senator Hatch, that you said it would be nuts for anyone to believe that this is the House's last word on this. You think the Senate will change the fix-it bill that's coming over to you?
HATCH: Well, if the rules are followed, they'd have to. Because there is a Social Security component. And you can't do that on reconciliation. There's also an appropriations component as well.
So if -- if the parliamentarian upholds that and Joe Biden doesn't overrule the parliamentarian, which would be a first, then it seems to me that it's going to have to be sent back to the House. So anybody that thinks that this is only going to be a one-time deal today in the House, I think, is grossly mistaken.
CROWLEY: Senator Feinstein, do you think it's possible for the Senate to take that bill and just go, OK, fine with us?
FEINSTEIN: Yes, I do. And I think that's exactly what we'll do. And I really disagree with my friend and colleague. I believe there are at least 51 votes there. I think the bill has been carefully vetted with the parliamentarian. I believe he will stand for each part of it.
And the bill that the House passes today goes to the president. He signs it. Then the reconciliation bill comes over to us. We'll probably begin debate on Tuesday. It will be posted -- it takes some time -- begin debate on Tuesday.
Now, I'm sure what Senator Hatch's party will do is submit a whole host of amendments. We'll have a major vote-a-thon. And this will go on for several days. And I believe, at the end, more than 51 Democrats will hold firm and will pass the reconciliation bill and we will have health care reform. I can say, for my state, the reconciliation bill is very important. Because we have now 8 million people without any insurance in California. The number has gone up 1 million people a year for the last two years. So this bill is necessary.
CROWLEY: Senator Hatch, I want to ask you about the vote-a-thon, but I first want to play something Senator Reid said recently.
(BEGIN VIDEO CLIP)
SEN. HARRY REID, D-NEV., SENATE MAJORITY LEADER: We're in the last minute of play. The shot clock is turned off. The other side knows what the outcome will be. So they're trying to foul us and foul us and foul us and foul us again, just to keep the clock from reading zero. They're not just delaying the inevitable; they're delaying the imperative.
(END VIDEO CLIP)
CROWLEY: Are you going on after -- after the shot clock has...
I mean, you know, Senator Feinstein calls it a vote-a-thon. I mean, is this the Republican approach to this now, is just to delay the inevitable?
HATCH: Well, not really. I think it's to try and get amendments passed that really are valid amendments. I think, if you have a Social Security component in it, it has -- it has to come back to the House. And a parliamentarian has to rule the right way.
But who knows? I don't know what the parliamentarian is going to do. All I can say is this. You know, as I walk around this country, and I've been all over the country, people come up to me from everywhere, Democrats, Republicans, saying, we can't afford this; we can't do this. We do not even have solid, final scoring on this.
As a matter of fact, the actuary at CMS said he cannot get the final scoring. They also don't include the doc fix in it, which is $371 billion, and that's at present worth. And that doesn't even take care of Medicaid.
Of the 31 million people you're going to cover, 16 million are pushed into Medicaid.
I mean, let me just tell you, we're coming to a Europeanization of America. And the American people sense it. They feel it. They know that we can't afford this.
And, frankly, the doc fix that they have on Medicaid...
(CROSSTALK) HATCH: He's a letter -- here's a letter from my governor saying -- now, for two years, they say they'll hold the states free. But then you go off the clip because they cannot afford to pay for it in the federal government.
And -- and Medicaid, they're paying -- the doctors are getting 66 percent of what the private sector pays doctors. And they're up in arms. They're not going to take patients now. You can imagine how bad this is going to be if this bill goes through.
CROWLEY: Senator Feinstein, do you worry about either unintended consequences or changes in the economy that could, in the end, if this is made into law, really ruin some aspects of health care?
FEINSTEIN: Well, of course. This isn't the perfect bill. We all know that.
HATCH: Well, that's for sure.
FEINSTEIN: We all know that there are going to have to be fixes down the road, just as every major program has had; Medicare has had; Social Security will likely have because of the explosion of costs.
Having said that, you have to look at the basics. And the basics are that we pay far more than European nations do for health care. And they have a much better performance.
We're about 15 percent; France is 10 percent. And in overall performance by the World Health Organization, France is ranked number one. I think we're ranked 17.
We spend a lot of money, but we don't necessarily spend it in the right way or the right places.
Now, let me just finish. This bill is really important. Because, if we don't pass it now, you can forget health care reform forever after, I believe. So this is the opportunity. We're right at the goal line. I believe it's going to pass the House. It will be signed by the president. We should pass a reconciliation bill.
And I would really appeal to my good friend, Senator Hatch. Let this reconciliation bill get passed. Then, you can see. If it's wrong, you'll certainly say so. If it works, hopefully, you'll say so as well.
CROWLEY: And we'll get your answer right after this, because I've got to take a break. And we'll find out if you listened to her appeal, right after this.
CROWLEY: We are back with two top senators, Democrat Dianne Feinstein and Republican Orrin Hatch.
When last we met, she was asking if you would just let this reconciliation bill go through and see what happens. FEINSTEIN: Suggesting.
HATCH: Well, let me tell you, Republicans are dedicated against this bill. We consider it an awful bill.
Do you realize they're going to subsidize families that make over -- families of four that make over $80,000 a year?
I mean, we're getting to where 50 percent of the people in this country are going to depend on subsidies. And, of course, I know Dianne can't agree with that or doesn't believe in that.
But -- and all I can say is -- is, everywhere I go, people say, how do we pay for this? You know, in all honesty, they have jacked up the costs of Medicare. They're going to take better than $500 billion, now, out of Medicare. They're going to increase taxes by over $500 billion. They're going to sock it to individuals who don't -- who can't afford to buy insurance. They're going to have to pay 2.5 percent of their gross income.
Businesses are now going to have to pay up to $3,000 per employee if they don't provide health insurance.
You reach a point where you say, who is going to pay for all of this? And it's going to come down to us taxpayers. And like I say, it's the Europeanization of America, and that's the worst thing that could possibly happen to our country.
CROWLEY: You -- you said earlier that, of course, there were things that worried you about the bill. If you looked at in the totality, what worries you the most?
Is there anything that he says that you think, you know, yes, that is a worry of mine?
FEINSTEIN: Well, there -- the bill is a combination of a number of different things designed to cover more people. The bill has very big strong points. For example, right away, there's a $5 billion fund for people with pre-existing conditions who can't get health insurance today.
HATCH: We're both for that. We're both for that.
FEINSTEIN: That's a very positive thing.
FEINSTEIN: So the bill, when really accumulated, the Congressional Budget Office says, will save, over 10 years, $138 billion.
Now, Orrin will say, well, it's not this; it's not that; it's not the other thing. But that's the fact that we go on when we assess a bill. CROWLEY: But isn't also true, Senator...
FEINSTEIN: So over 10 years, this bill, I'm confident, will not cost more.
Now, as I said, are there certain parts that may have to be tweaked, that don't work exactly right? But he has given a litany of complaints about the bill. The thrust of the bill is to provide more people with coverage.
One of the good things the bill does is it reduces the nonpremium costs for those 85 percent of people that have medical health insurance. It reduces it from 20 percent to 15 percent so that more money from insurance companies will actually go for medical care. And I think that's important.
CROWLEY: Politically, isn't it going to be hard to argue, should this bill pass, and we think it will, just given the numbers, to say, listen, people are now going to be -- not be thrown off their insurance because they got sick. There will be no more caps.
CROWLEY: There will be help for people down the road, to help subsidize it. How can you argue against that? Isn't that a pretty political powerful package?
HATCH: Well, I'm not arguing -- I'm not arguing against that. I think Republicans certainly -- we could agree on a large percentage of things together. But there was really no effort to get us involved.
All I can say is this, is that everywhere I go -- and I've said it over and over -- people say, how are you going to pay for this? How do you pay for it?
Now, the CMS actuary -- that's the actuary for the administration -- says the cost curve will not be bent, that premiums are going to go up. I have to say that I believe that -- that CBO -- of course they have to decide these budgetary matters based upon the papers given them by the House of Representatives and by the Senate, and those papers are stacked in favor of trying to live within our means, but they don't.
The fact is that they double-count in this bill. They have all kinds of other gimmicks in this bill that try to get this bill down to -- everybody knows that this, extrapolated over 10 years, is going to be $2.5 trillion more on top of what we're already spending, $2.4 trillion.
You cannot tell me that this country can afford to do that and that we can't find a way, by working together, to really come up with a health care system that will work and work within financial means.
CROWLEY: I'm going to give you the last short word. And that is, are you comfortable with the cost of this bill...
CROWLEY: ... and comfortable the country can afford it?
FEINSTEIN: Yes. I believe we can. And I believe that will be sorted out over time.
I think there's one thing that isn't in the bill, that the president was good enough to take my bill, which would give the secretary of health and human services some control over the rate of premiums to ensure that they are reasonable for people who have private-sector insurance. Unfortunately, the parliamentarian said that could not be added to the reconciliation bill. I have introduced it as a separate bill.
I believe this is a huge problem out there. You have Anthem in California and 800,000 policies just jacking up premiums up to 39 percent in California and then saying there may be another increase in the middle of the year.
And so people are being pushed off of their health insurance because of the cost of premiums. And this is one thing we need to strengthen, in my view, and hopefully will as a separate piece of legislation.
CROWLEY: Senator Dianne Feinstein, Senator Orrin Hatch, I can't thank you both enough for coming. I appreciate it.
FEINSTEIN: Thank you.
HATCH: Thank you.
CROWLEY: More of this on the Senate floor next week...
FEINSTEIN: Oh, you bet.
CROWLEY: ... we promise. (LAUGHTER)
FEINSTEIN: Thank you.