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NBC: "Meet the Press" - Transcript: Affordable Care Act Exchanges


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DAVID GREGORY: Good morning. The Obamacare fix is on, but will it work? The latest developments: the end of November is the timeline the administration is targeting to have the Obamacare website running smoothly. The latest report is 700,000 applications filed but no one will say how many actually enrolled. Health and Human Services Secretary Sebelius is now expected to testify this week before Congress as some Republicans continue to call for her ouster. And even Democrats are urging change. 10 Senators are calling for open enrollment to be extended beyond the current end day of March 2014.

We wanted to help you understand some of the impacts of the President's health care plan around the country. We'll talk to the CEO of Florida's largest health insurer-- cancelling 300,000 of its policies this week-- in just a minute.

First, I want to turn to Democratic Governor Steven Beshear of Kentucky, and Republican Governor John Kasich of neighboring Ohio. Governors, welcome both. I wanted to talk to you and take this out of Washington because, in Kentucky, you set up your own health care exchange; in Ohio, Governor Kasich, you declined to do so, and so the federal government has come in to do that. So let me start with you. The president said there's no excuse for this terrible rollout of Obamacare through the-- the-- the website. Are you as frustrated with how all of this has started? Governor Kasich?

GOV. JOHN KASICH: David, is that to me?


GOV. JOHN KASICH: Yeah. Well, look, David, I mean, the-- the problem is Obamacare is-- it doesn't control costs. Secondly, it's gonna drive up the cost for the vast majority of Ohioans. It threatens the ability of small business to grow beyond 50 employees. And frankly, I think it's got to concern everybody. This economy is stalled and people don't know what the future's going to bring. And when people are uncertain about the future, they sit on their wallets. And that's why we're not seeing the kind of economic growth that we need to see, that's so vital--

DAVID GREGORY: All right, but that's--

GOV. JOHN KASICH: --to creating jobs here in the State of Ohio.

DAVID GREGORY: Sir, that's the argument against Obamacare, but Obamacare is here. I'm asking specifically about the damage done by a troubled rollout that you're seeing in your state?

GOV. JOHN KASICH: Well, that's got everybody just shaking their heads. And that's like three things: The government almost shut down, now they're tapping somebody's phone, and now this thing. This is creating an issue of confidence in the minds of the American people, and doubt with people around the world, which is really serious.

Now, here's what I think, David, at the end of the day. I think people need to sit down. The Obama administration needs to open itself up and figure out how we can get some sort of bipartisan support to move forward. If Steve Beshear and I were sitting in a room, we'd figure out what's good, what's bad, how do we fix it. The problem is, in Washington, they talk past one another and they're so polarized--

DAVID GREGORY: Alright, well, let--

GOV. JOHN KASICH: --they can't seem to get anything done. It just doesn't make any sense.

DAVID GREGORY: Governor Beshear, let's start on that beginning point, though. We've got a system that is the law of the land. Republicans like Governor Kasich don't like it, think it won't work, but for now this is the plan, and it's not working when it comes to implementation. How disappointed are you with this rollout, where you think you've got a good story to tell because you set up your own exchange?

GOV. STEVE BESHEAR: Well, first of all, David, at 12:01 a.m. on October 1, when our exchange opened up to enrollment, Kentuckians started swarming all over our exchange, all over our toll-free lines. And in about four weeks, we've had over 300,000 Kentuckians trying to find out and finding out about affordable health care. We've signed up over 26,000 people so far.

DAVID GREGORY: Most Medicaid, though. They're mostly--


DAVID GREGORY: --getting Medicaid. So it's not the young and healthy people getting the insurance plans that are really necessary to make this system work, correct?

GOV. STEVE BESHEAR: Of the 26,000, 21,000 are in Medicaid, 5,000 are in qualified health plans, but we've got another 10,000 going onto the plans, that are in the process of choosing. You know, it-- it's a lot quicker to get somebody enrolled in Medicaid, once you find out they're eligible. When you go to the plans, they've got to look at all the details and pick the plans that they want.

You know, this is working in Kentucky. We had, and have, some of the worst health statistics in the country, and it's been that way for generations. The only way we're going to get ourselves out of the ditch is some transformational tool. That's what the affordable care act--

DAVID GREGORY: What damage has been done?

GOV. STEVE BESHEAR: --is going to do for us.

DAVID GREGORY: How frustrated are you at the troubled rollout at the federal level, which is impacting, what, 36 states that have not set up their own exchanges?

GOV. STEVE BESHEAR: Well, number one, I'm happy about Kentucky. Number two, you know, the thing's not working on a federal level yet, but it's going to. You know, the advice I would give the news media and the critics up here is take a deep breath. You know, this is a process. Everybody wants to have a date where they can declare victory or defeat or success or failure; that's not what this is going to be all about. It took us about three years to get Medicare really working--

DAVID GREGORY: But, Governor, wait a minute--

GOV. STEVE BESHEAR: --the way it should. And this is going to work--

DAVID GREGORY: --the president is the one who said, "If this is going to be successful, you've got to get young and healthy people signed up by a date certain or else the model doesn't work to keep premium prices down." Is it the news media doing that? Or is it the ones who drafted the law who said, "This has to happen or else it can't work"?

GOV. STEVE BESHEAR: In Kentucky, about a third of folks going on Medicaid and getting qualified health plans are under 35 years old, and that's what's going to happen all over this country. People are going to sign up for this. It will take us a while to get it in process, but I'll guarantee you, we're going to make it work because it's good for the American people and it's good for Kentucky.

DAVID GREGORY: Governor Kasich, I assume you think there ought to be--

GOV. JOHN KASICH: David. Hey, David. You know, one thing I've got to tell you. One thing I've got to tell you: the rollout is the least of the problem here. I mean, the rollout looks like a disaster. But in my state, most Ohioans are going to pay higher costs, and in fact this is not going to control health care costs.

Here in Ohio, we have reduced our Medicaid growth from 8% or 9% to less than 3%, and we believe we have to have significant payment reform that, when people do the right thing to drive towards quality and lower prices, there ought to be a sharing of the savings among everyone. I mean, the problem with Obamacare is it doesn't get to the nut of the problem which is higher health care costs that have been out of control. So when you roll it out, if it rolled out perfectly, it's not going to achieve what America wants.

DAVID GREGORY: But wait a minute. But, Governor--

GOV. JOHN KASICH: That's the difficulty here.

DAVID GREGORY: --you took on your legislature because you said, "We need to accept federal money for Medicaid," because you said, you know, "More important when you go to heaven than whether you kept government small was what did you do for the poor?" You seem to be articulating a view that's not just compassionate but that reflects the belief that the more people you help, that ultimately you can cull costs that way. If there's more health care, better health care for more people in Ohio, costs will have to come down. So how are you not in line with what the president believes about the potential strength of--


DAVID GREGORY: --Obamacare?

GOV. JOHN KASICH: Yes. Well, first of all, David, as you can tell, I've articulated my opposition to Obamacare. But Chief Justice Roberts gave every state an opportunity to try to get federal dollars to improve Medicaid. Now, we have many mentally ill people in this country who are being treated terribly; we have people who are drug addicted, and drug addiction is in every demographic, every race, every income level. And we also have many veterans who aren't covered.

So Ohio gets a good deal. We get $14 billion of Ohio money back to Ohio to deal with some of the most serious problems. And, you know, I'm not going to ignore the mentally ill and I'm not going to ignore the drug addicted or veterans or very working poor people on my watch. But that doesn't mean I embrace Obamacare because I think it's not right.

We have our own program out here that has reduced health care costs. We're involving the public sector, the private sector in a payment reform that we believe will improve quality and lower costs. That's the direction we ought to be going, not some, you know, laboratory, cooked up-- I'm convinced the people that created Obamacare never worked in business and probably never spoke to a businessperson as they were putting this together.

DAVID GREGORY: What do you think, Governor Beshear, is the ultimate future of this program? Does somebody have to get fired before they get it right at the federal government? And, to the Governor's key point, although you might take on, since there's a lot of remnants of health care that go back to Mitt Romney who most certainly was in business when he was the governor of Massachusetts laying out that plan, will prices stay low enough for consumers to justify Obamacare?

GOV. STEVE BESHEAR: Yes. You know--

DAVID GREGORY: You believe that will be the case?

GOV. STEVE BESHEAR: I believe it's going to be the case.

DAVID GREGORY: Should somebody get fired for how poorly the rollout has gone thus far?

GOV. STEVE BESHEAR: You know, I'm not going to give the president advice on hiring and firing. But you know what? When things go wrong, like they go wrong in our state, I take responsibility for it and I fix it. And that's what Secretary Sebelius and the president are doing. They're taking responsibility for a bad rollout of this website. They're going to fix it.

Look, this is going to take some time to get done, but everybody needs to chill out because it is going to work. These plans and Medicaid are directed toward prevention and wellness, and that is the future of health care and I think everybody knows it.

DAVID GREGORY: Alright, I'm going to leave it there. A lot more to discuss on this as time goes on. I appreciate your time, both of you, this morning. Thanks very much.

BOTH: Thank you. Thank you.


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