- Wisconsin Republican Senator Ron Johnson put the brakes
on a vote this week on his chamber's version
of the Obamacare repeal and replace bill.
He said it was because he needed more time to study it.
The ardent opponent of the Affordable Care Act also has
said he doesn't think the Senate bill goes far enough.
Senator Ron Johnson joins us tonight.
Thanks very much for being here.
- Hello Frederica. How are you doing? - Good.
I wanted to ask you right out of the chutes your position
on repealing the ACA now and replacing it sometime later.
- Let me first explain.
I don't think I've ever said it doesn't go far enough.
It doesn't fix the problem.
I certainly thought a week after a discussion draft was presented
to the public and also to CBO, it was way too soon
to really take a vote on it.
So I wanted the extra time.
We had intense discussions.
I think there will be improvements made to the bill.
Nothing will be perfect, but the architecture of Obamacare
particularly in the individual markets just has failed.
Premiums on a national average have increased 105%.
They've doubled.
Some places tripled as well.
We've got to fix the problem.
- As to this question about your position on repealing the
ACA and then replacing it later.
- Well, I'd rather do it at the same time.
Now, I think what's abundantly clear,
we don't have the votes for total repeal.
I would like to do that because I think it's a whole lot easier
to replace with something that would actually work.
But for quite some time, after the election,
it was pretty obvious that we probably didn't have the votes
for full repeal.
So that's one of the reasons I started talking about let's
focus on repairing the damage done and that's primarily in the
individual markets.
And then it'd be nice if we could work in a bipartisan
fashion, transition to a system that actually works.
From my standpoint, having participated in a free market
system, is bring in more consumer-driven free market
competition to restrain prices, improve quality and customer
service.
- So altogether what's it going to take for you to vote yes
on a Senate health bill?
- First of all, I never said I was no on any bill.
- Right.
- I just said no. We can't vote on it this week.
It has to be an improvement.
I guess that's my manufacturing background.
I do not expect perfection.
This is such a mess.
It is so complex.
We're not going to come close to perfection.
But I will evaluate anything I am going to have to vote on
in the end.
Is it going to put us in a better place tomorrow
than we are today?
I have to admit that's a pretty low bar.
But I think going in so many of us have said
we don't want to pull the rug out from anyone.
I don't think we are.
I want to make sure we're focusing on premiums.
The gross price of premiums, because if we can bring those
down, recognizing what caused premiums to artificially
increase, we can solve so many problems.
That's really been my primary focus.
- A lot of people are focusing on Medicaid.
Do you think the measure should reduce available federal funding
for Medicaid by more than 25% in out years?
- First of all, what we're focusing on is eliminating
the additional expansion of Medicaid expansion,
which Wisconsin is not participating in.
- Right.
- In 2008, we spent about $200 billion on Medicaid.
Last year, nine years later, we spent $400 billion.
So it's not exactly like Medicaid has been starved.
What I'd like to do is devolve the management of core Medicaid
back to the states.
I think like Wisconsin, we do a far better job.
What we're trying to do is stop the Medicaid expansion which is
going to threaten the stability of core Medicaid.
When everybody is talking about how much we're cutting Medicaid,
what we are doing is we are putting Medicaid expansion on a
glide path so we can focus on core Medicaid so people with
disabilities, young, elderly, those core beneficiaries of
Medicaid, that those populations are protected.
- A lot of people want to know how do you protect states like
Wisconsin from being hurt because they did reject
the Medicaid expansion?
- Well, that's one of the things I've been fighting for,
is there's a disparity.
There's always been a disparity.
Some states get more federal funding than Wisconsin.
And what's really unfair about it is responsible states,
states that have high-quality health care at a relatively
affordable cost, we get penalized in the doling out of
federal funds.
One of the reasons I think devolving the administration of
Medicaid back down to states would be in the end, fair.
But I don't want to lock into a system right now that is unfair.
It's not going to be completely fair,
but that's one of the things I'm really fighting for.
- Do you think any bill should include protections
for pre-existing conditions? - Absolutely.
But the architecture of Obamacare puts those
protections, the burden, the cost burden of that,
on a very small slice of the American public.
That's why premiums have doubled,
in some cases tripled on the individual market.
What we need to do is separate that population out.
Those with high-cost and pre-existing conditions
and we need to subsidize those.
We can do that, keep premiums at a reasonable level,
an affordable level without penalizing the people
Bill Clinton talked about.
Those folks out there busting it, working 60 hours a week.
They make enough money
they don't qualify for any government assistance.
They've literally been priced out of the insurance market,
which is why I'll come back to, I want to focus on bringing down
the gross price of premiums.
It solves so many problems. But no.
I think our country has decided we want to protect people with
pre-existing conditions.
We can do it in a manner that doesn't collapse these
individual markets and doesn't unfairly put the cost burden on
a very small slice of the American population.
- How do you do it?
- Through things like, for example,
Maine passed guaranteed issue.
That's what this insurance policy is called to protect
people with pre-existing conditions, guaranteed issue.
You guarantee that anybody can buy insurance at just about any
point in time.
That collapses insurance markets.
The analogy literally is, who would buy auto insurance,
collision insurance, if you didn't have to buy until after
you crashed your car?
That would crash the insurance market?
The same thing happens in health care.
When Maine passed guaranteed issue,
their premiums skyrocketed.
So without even repealing guarantee issue,
they supplanted it with something called
an invisible high-risk pool.
A little bit different operation
than what Wisconsin's high-risk pool.
Wisconsin's high-risk pool isn't perfect,
but it worked pretty well.
So we should take a look at those best practices example.
That's the path toward guaranteeing people coverage
with pre-existing conditions without collapsing markets and
without causing premiums to skyrocket.
- You've said this week that you could support maintaining
some of the tax increases in Obamacare? Which ones?
- Well, first of all, again, we're not repealing Obamacare.
We're keeping an awful lot of the architecture and certainly a
lot of the benefits.
Again, 20 million Americans got health care.
We don't want to take that away from them.
So when you're going to be basically carrying on about $443
billion of Obamacare subsidies forward,
that's in the current Senate bill.
I think we ought to maintain whatever revenue flow
to fund those benefits.
I'm very concerned about the fact we're $20 trillion in debt.
Over the next 30 years, according to CBO and we've
turned these into dollars, $129 trillion of additional deficits.
I'm concerned about that.
So if we're going to offer government programs,
we ought to be able to pay for it.
The first one under discussion is the investment tax.
That has nothing to do with premiums,
has nothing to do with cost of health care.
That would probably be the first one not to repeal
or basically to retain.
- We need it leave it there. Senator Ron Johnson, thanks very much.
- Thank you.
- For her part, Wisconsin Democratic U.S. Senator
Tammy Baldwin had this to say about the Senate plan.
The people of Wisconsin did not send me to Washington to take
people's health care away.
We should be working together to make things better, not worse.
And the CBO makes clear that the Senate repeal plan will leave
millions of families behind.