these fronts simultaneously, then you are worried about everything. we are going to construct this incredibly elaborate deal. we will roll back our and then try to re-craft the whole bargain from scratch on all of these issues. skills of test the the wisest and most experienced statesman we had. couldybe if we thought we pull that off, that would be one story while we are doing the domestic stuff. >> china also holds over a trillion dollars of our treasury. >> but you see the problem. rebuttal to basically the kind of strategic approach that eric and i are counseling which is not so much ducting a fight with china but rather how

it.econstruct the chinese leaders know a difficult phase is coming but they would like to channel that constructively and manage the internal threats in their world. purposeption with a rather than just disruption. >> let us go to the audience and take three questions. and then we will come back to the panelists. jack and i am unaffiliated. how many different major initiatives can the new president handle and his team and how would you split that between domestic where you have legislative issues versus there are al where lot of things not under your control but there are important things like china, russia, and the middle east? peter blum, retired foreign

service officer. you spoke extensively about before we get too much involved in foreign policy, about preparedness. what would your definition be? a military budget which could hurt the domestic budget. what i would like your definition of what preparedness really means in the context of what you're talking about. >> and a third question? eric, which you like to start, priorities and preparedness. if the president elect is going to make good on his philadelphia speech in which he talked about rebuilding the military, then i hope you would take advantage of the window of opportunity that people in previous panels have talked about in terms of united government to seek a reveal of the budget control act and the

end of the sequestration of the defense budget and move back to a topline as we did in the bipartisan national defense panel that i reported on two years ago at the request of the congress. that it be at the level that bob budgetad for the fy 12 approach -- proposed by the obama administration. in the next 10 years, it would restore a lot of the money that was cut out of the defense budget during the last eight years. because i think that is going to be an issue for having an effective diplomatic effort. i am fond of quoting george tenet to my foreign service colleagues who gave a lecture at the national war college in which he said -- we have no idea how much more civil and polite diplomatic exchanges are when you have a little bit of military power sitting behind

here. and i think that is an important facilitator for the president. i would add that i think there ought to be a supplemental, and emergency supplemental as and senatorrnbury tom cotton have called for to deal with some of the readiness problems that have been identified by the obama administration and the chiefs by now. >> on the question about the number of priorities. that is a shrewd question. after this question in 2001. if my memory is correct, there were two big ones, taxes and education, both on the domestic side. this administration currently is planning to do at least four, possibly five, huge lists. immigration, tax reform, health care, supreme court. that is four.

if you want to throw in infrastructure? balancing, budget lifting sequestration, and budget targets. and we could go on. but you are already getting the sense of the scale. an unusualhave constellation of circumstances may beple in which much possible but then the question the be how much and again, net has implications for how you want to manage your confirmation , your foreign policy. if you are thinking strategically. the question about preparedness exactly rightt is to which i would add two things. one is, think about, i believe both the foreign policy and the defense policy institutions are actually fundamentally still stuck in the late 20th century. and are highly optimized to win the cold war. and remains -- and remained so

20 years later with areas clip ons that have been snapped on over the last 25 years. i think both foreign and defense oftitutions are in need profound overhaul and rethinking of the kind that occurred in the 1920's and 1930's but also the memory of what we did in the 1970's and 1980's after vietnam. especially on the defense side. but we need that kind of gravity of thinking now. take the example of cyber security alone. the newsvery much in today. in terms of the level of our capabilities -- even if we had made negative conclusions. if you started asking yourself what we would do about it if we came to negative conclusions about foreign intervention and our country's politics? what would we do about that? what could a president consider under the current circumstances?

you begin to see the concerns about preparedness. but it is not just a defense matter. and above all, if you make it -- ifspend more money" you spend more money on broken and dysfunctional institutions, you will get 20% thermal efficiency for your spending. you will make a much better case for -- with congress for more spending if you couple that with dramatic and vivid interests in a different story of how the money will be invested. after 9/11, don rumsfeld effectively was given between fy 01 and fy 06, $1 trillion of additional defense investment. not counting the oc oh budget. or than a trillion dollars. a trillion dollars. did we get a trillion dollars worth of band -- of bank? -- of bang?

i would contend we did not. >> donald trump tweeted about the 747 and said boeing is overcharging. about the f 35d are two expensive. about the ideank that we need a new story here and should we expect that donald trump is going to take on the defense industrial complex? that iree with philip would not invest a trillion dollars going forward in the program as it exists today. the department of defense have -- has been living on the benefits of the carter, reagan defense buildup for a long time and we have not been investing in maintaining our qualitative edge over potential adversaries for a very long time which is

why both secretary hagel and secretary carter have been very focused on the potential of our losing that edge and the importance of what they call the third offense strategy, an effort to find ways to leap ahead in new technologies. that is a very important effort. it will be interesting to see what the new administration does with that effort as they come into office. i am troubled, by the way that the president elect has been attacking the wing and lucky -- lockheed.d is president has a norm power. i do not know if he appreciates how much what he is doing is affecting the stock market of these -- the stock price of these companies, it will shape the way that they respond to different kinds of defense department requirements and contracts.

whole chain, a cap nation of things that will flow from this and i do not think he is thinking through all of these things. and it is troublesome. do have their problems as a program but i do not think tweeting is the way to deal with it. [laughter] >> and we will leave it with that. thank you all very much. [applause] we want to thank the people that pulled this all together on the governance studies side at brookings and the general staff she or at brookings and our own staff from the miller center particularly karen mcgrath and tony and howard witt and tom. and the advisory council for the first year project, many of whom are here. i would try to nail -- i would try to name them all.

but i would likely leave someone out. thanks to this terrific panel. [applause] >> follow the transition of government on c-span as president-elect donald trump selects his cabinet and the republicans and democrats prepare for the next congress.

we will take you to key events as they happen, without interruption. watch live on c-span. watch on-demand on c-span.org. >> and as we promised you earlier, we will show you this -- the scene from outside of pahrump tower earlier today. there were protesters chanting outside. chanting]ernible chanting "we are all

americans." >> no kkk.

usa.scist no trump >> [chanting] kkk. no fascist usa. no trump.

> and some of the scene outside of trump tower today. stock, a number of folks -- stopping by to see donald trump. including carly fiorina a who arrived there shortly before 10:00 a.m. eastern. she describes her meeting as productive. [indiscernible] >> what about your past with mr. trump?

>> hello, how are you? a reallyna: we had productive meeting. it was such an honor to meet the president-elect. he has really cool stuff in his office. all of these athletes have given him a incredible memorabilia. i was particularly taken by shaq o'neal's shoe.

it is huge. i guess it takes a champion to know at champion. in any event, we got down to more serious stuff and spent a fair amount of time on china. andalked about hacking whether it is chinese hacking or purported russian hacking. we talked about the opportunity that the president elect has to literally reset things. to reset the trajectory of the economy. to reset the role of government. theeset america's role in world and how we are perceived in the world. and i think it is why he is getting such fantastic people in his administration. the high quality of people he has named already says so much about his executive abilities but it also says that people recognize the opportunity that our new president elect has really make a huge impact on people's lives in this country and on events around the world.

so, it was an honor for me to be there. thank you all so much. [indiscernible]

>> and there was part of the scene earlier today at the trump tower. you saw kellyanne conway there with carly fiorina. congressional lawmakers also visiting the trump transition team today. steve scalise of louisiana met with republican national committee chair reince previous and after his meeting then spoke briefly with reporters.

mr. scalise: i had a really good and we with priebus talked about the agenda we are working on to create jobs and strengthen our economy and military. we have a great opportunity to get the country that contract. we are excited about the opportunity but we know it will be a busy first few months. our members will need to buckle up and strap on. it is exciting to have a president focused on creating jobs and getting the country back on track and making america great again. >> do you support the congressional investigation into russian hacking? mr. scalise: there is nothing wrong with an investigation. barack obama sat on the sidelines when other countries hacked us for many years.

that was senator joe manchin of west virginia at trump tower today. his meeting was originally scheduled for friday but was postponed, there you see him. but was postponed as lawmakers negotiated a government spending bill and extended health benefits for retired mineworkers. there are reports that he is being considered for energy sector. idaho republican representative labrador also attended a meeting. this is after his hitting the ind for the campaign october.

rep. labrador: it was really good. we talked about a lot of issues. about how we can work on making westernt the

constituents are being listened to. it was a great meeting. we talked about a lot of different things. >> would you want to help this administration? rep. labrador: i would be willing to help in any way that i can't. i am excited for america that will have an administration ready to hit the ground running. i can help the administration in congress. about the russian hacking probe. what do you think about that? rep. labrador: we need to look into that. but i do not serve on any of those committees. we need to look at it. i do not know exactly what people are saying. it is interesting to me that as a member of congress, you had the cia say that something has happened but we have not been briefed on any of those issues. i would like to see what information they have. >> [indiscernible] rep. labrador: ok, thank you

very much. cathy mcmorris rodgers, the republican representative from the state of washington, also at member of the house leadership. she also took the donald trump tower elevators. she is being considered for interior secretary in the administration.

>> what did you talk about? ms. rodgers: a lot of things. it is always an honor to spend time with the president elect. i walked away reminded that he is a man of action and i am and is yesterday leadership he is bringing. his commitment to making america great. and getting our economy going. creating jobs. and really rethinking these federal agencies. he wants them to work. way is to get it done ahead of time and the low budget. it would be welcome to the federal government and it was great to spend time with him today.

>> what about the department of interior? scenes was some of the inside the lobby today. back outside, tourists and protesters. let us take a look and see what took place there today on fifth avenue. >> [chanting] >> we are all of americans. we are all americans. [chanting] >> [chanting]

no kkk. no fascist usa. no trump. >> [chanting] no kkk. no fascist usa. no trump.

>> [chanting] no kkk. no fascist usa. no trump.

>> tell me what democracy looks like. >> this is what democracy looks like. tell me what democracy looks like. >> this is what democracy looks like. [chanting] >> what does democracy looks like, guys? >> this is what democracy looks like. [continuous chanting]

>> [indiscernible protesting] >> [chanting] united, will never be defeated. united, will never be defeated.

>> [chanting] united, will never be defeated. united, will never be defeated. neverople, united, will be defeated.

>> [chanting] tell me what democracy looks like? this is what democracy looks like. tell me what democracy looks like. this is what democracy looks like. tell me what democracy looks like. this is what democracy looks like. protesting]nible

>> [chanting] no hate. no fear. immigrants are welcome here. no hate. no fear. immigrants are welcome here. no hate. no fear. immigrants are welcome here. no hate. no fear. immigrants are welcome here. >> [indiscernible chanting]

[chanting] hate will not of make our country great. our leader fall of hate will not make our country great. hate will notl of make our country great. our leader, full of hate. will not make our country great. hate, will full of not make our country great.

>> i am here to support women's rights and the protests. in light of everything that has showned, we are here to that it matters. there are a lot of things that are not right that we can come together peacefully and demand changes here in new york. support this. to it is not too late.

>> [chanting] hey, hey, ho, ho. donald trump has got to go. hey, ho, ho, donald trump has got to go. hey, hey, ho, ho, donald trump has got to go.

>> [portesting and chanting]

>> [chanting] we are the popular vote. we are the popular vote. we are the popular vote.

>> [chanting] we are the popular vote. we are the popular vote. we are the popular vote.

we are the popular vote. we are the popular vote. are the -- we are the popular vote. we are the popular vote. >> [indiscernible chanting]

>> [chanting] my body, my choice. your body, your choice.

my body, my choice. your body, your choice. my body, my choice. your body, your choice. >> [chanting] >> some of the scene earlier inay outside of trump tower new york city. a story in politico.

hillary clinton's adviser john podesta said the campaign is supporting an effort by members of the electoral college to request an intelligence briefing on foreign intervention in the presidential election. backedcconnell today calls for a congressional probe into russian interference in the u.s. election throwing his support behind a call to investigate the issue. >> [indiscernible] think this has been one heck of a year. i hate to see it end. it was topped off on saturday night. you can see i have my louisville sweater on. the marchex and won the heisman trophy topping off a terrific year. the things that i care about like holding the senate and

electing the president. i know the main subject you are interested in this morning. i will read a statement which i typically do not do but i want to make sure you fully understand what i have to say. issue have to say on the that is mostly on your mind this morning. any foreign breach of our cyber security measures is disturbing. and i strongly condemn any such efforts. prior to the election, the direction of national intelligence released a statement saying the russian government directed re-think compromises of emails from u.s. persons and institutions including from u.s. political organizations. that is what the intelligence community believes can be said in an unclassified remarks without risking sources and methods. anything else, anything else, is irresponsible, likely illegal, and potentially for partisan political gain.

i agree with senator schumer, chairman mccain, burr and others that this cannot be a partisan issue. let me remind all of you that the senate intelligence committee on which i and the chairman of the armed services committee said as ex officio members is more than capable to conduct a complete review of this matter. and senator schumer will soon join us on the committee and you can review this matter through the regular order. i have every confidence in chairman bert that he will review the matter in a responsible way. the obama administration is also launching a review and when the office of the director of national intelligence completes its review there will be additional affirmation released to the public. in a responsible manner. mccain has announced he will conduct a review within the armed services committee of the threat we face from cyber attacks. that will be useful. as we need to integrate our cyber capabilities into our

overall were fighting doctrine. the obama administration for eight years of to reset relations with russia. and sat back wall russia expanded its sphere of influence, intervene it in crimea coming eastern ukraine, syria and attempted to bully the baltic countries. it defies belief that somehow republicans in the senate are reluctant to either review russian tactics or ignore them. so last, let me say that i have the highest confidence in the intelligence community, and especially the central intelligence agencies. the cia is filled with selfless patriots, many who anonymously risk their lives for the american people. may i have some water? some here? yes.

let me just say with regard to congress and i will open to questions. by any objective standard, the 114th congress looks pretty good compared to the previous one. ,verything from the chores bill the first high-tech -- long-term highway bill in 20 years. faa, the water resources bill, permanent tax relief. we addressed the opioid prescription drug epidemic in a major way. a complete rewrite of no child left behind, the k-12 education issue. the accountability, cyber security bill, human trafficking . and many others. even though there were some differences in a time of divided government, i think we were able

to search for the things -- it was my desire to search for the things that we have some agreement on and make progress for the country. there were a number of things upon which we were able to score some points for the american people. with that, let me throw it open. from what you understand, do you believe the russian government tried to sway the election for donald trump? the reason i read that statement is i believe that thoroughly covers what i am prepared to say about that issue. >> you talked about an investigation. you support a bipartisan investigation. or would you do this through the intelligence committee? >> we will follow the regular order. this is an important subject and we intend to review it on a bipartisan basis. >> you mentioned the obama administration resetting with russia.

does it likewise concerned you the signals coming from the new attitudeation, the new and more friendliness towards russia? >> let me speak for myself. the russians are not our friends. they invaded crimea. senator mccain and i and some of our democratic friends met with a delegation from the baltic countries just this last week. to say that they are nervous about the russians would put it mildly. they also say as i said last year that nato is important. we intend to keep the commitments that are made in the nato agreement which i think by any objective standards has been one of the most if not the most successful military alliance in world history. i think we ought to approach all of these issues on the assumption that the russians do not wish us well. though thatroblem

the incoming president is sending signals to russia that he has been sending? i am going to save us a lot of time by saying that i have just addressed how i feel about the russians. and i hope that those who are going to be an position of responsibility in the new administration share my view. >> human did your confidence -- you mentioned your confidence in the u.s. intelligence community. but he is now questioning the credibility of the cia. myi have already addressed own view about where we are on those issues and i really do not have any intention of further elaborating. >> should president-elect donald

son asnominate tiller' secretary of state? impressedbeen very with the nominations so far and we will have to wait and see who is nominated for secretary of state. we will treat whoever that is with respect. go through the regular process and respond to questions and we will see where it will come out. do you think he could be confirmed in the senate if he was nominated? >> let us wait until we get nominees. of those we are already aware of, i am optimistic that they will all be confirmed. comment ont want to a phantom nominee today. >> can you go back one more time and clarify for us. skepticism in some

closed door meetings. clarified for you what i had to say about that in my statement that i read at our opening. that thisthink president elect is getting off on such a great footing with the intelligence agencies overall? trajectory from day one, right now? >> i will comment on who has been nominated so far. i think mike pompeo is an excellent choice for cia. general mattis is a great choice for defense. he willimistic that have a good national security team, all aspects of it. but with regard to his

relationship with the intelligence agencies -- >> i think i pretty well covered that. >> but with a three-year transio replace a obamacare. on the house side, conservatives are saying that is too long. >> let me make sure everyone understands. the status quote is not sustainable. the notion that we could do the currentallow law to implode is unacceptable. so, i hope no one believes that no action is possible or appropriate. therefore, we will move right after the first of the year on an obamacare replacement resolution. and then we will work expeditiously to come up with a better proposal then current law because current law is simply unacceptable and not sustainable. and we will be working with the various stakeholders to get their best advice about what comes next.

and with regard to the phase in period, the timing of all of that has yet to be determined. let me say again, doing nothing is not an option. because it you have seen the headlines across america all of last year about the status quo. >> do you have a personal preference? >> when we get through deciding how we are going to do that, i would be happy to let you know. >> you mentioned the stakeholders you will be working with. thee are warnings about dangers if there was a repeal from hospitals, medical associations. how does that factor into your decision? areone that you mentioned happy with the status quo. they want changes also. we will work with them to come up with a better system than this one stress city that was left behind by the obama administration. >> will there be any framework established before you do repeal?

>> we will let you know. we are first going to work on on thema care -- obamacare replacement resolution. legislatively, what comes first, comes first. then we will determine what the replacement is going to be. >> while you are putting willher that replacement, one of the principles be that you are going to try to cover as many americans as are currently covered? >> 85% of americans have coverage and their is still roughly 25 million that do not. if coverage was the issue, obamacare was an abysmal failure. surely, we can do better for the american people and that is what we intend to try to do. that means as i said earlier that we will move first with the replacement resolution and then we will come with what the replacement will actually be. that the replacement will be

faced -- phased in piecemeal. will that be separate? is that the approach you would like? >> i don't know how many times i have to say the same thing that we will be working on the phase-in. -- on the phase-in period and what it looks like once we get to step two. step one will be the replacement resolution which we will turn to after the first of the year. >> can you turn back to russia? what was the intelligence community going to be doing? ryanyou spoken to speaker -- will the house have some sort of role? mccain and i think senator burr will both be

looking at this issue and doing it on a bipartisan basis. as i indicated. fiscal 2017 budget resolution. will it be the same type of document on the senate side? anticipate doing two budget resolutions this year. the first will be the obamacare repeal resolution and then we will do one later in the spring which will largely be dedicated to tax reform. there will be two this year. and they will set up the followed onen vehicles for us to address two very important issues that the president-elect talked about and we all care about. repealing and replacing obamacare and doing

comprehensive tax reform. we are all concerned about the shoring up of u.s. jobs. the biggest reason for that is our tax structure which makes it very difficult in many instances to stay here the cousin the corporate tax rate and now the individual tax rate that most businesses use as well is way too high. and it is a noncompetitive situation. the president-elect has made it clear that he will move on as many regulatory changes as he can make as soon as he takes office. much of that was done by executive order or regulations of one kind or another. the two biggest impediments to growth in our country are overregulation and the tax structure. and the president-elect seems to bothmmitted to addressing of those and the republican majorities in the house and senate are as well. >> you said one of george top goals for the last year is --

you said one of your top goals for the last year -- you failed in that. >> i did not. but to refresh your memory -- the democrats decided to foul up the appropriation process which you can do if you have enough of a minority to do it because they wanted us to end up in a year in situations like we did. we will see if they have a different view next year. i hope so. toave up to its six weeks process individual appropriation bills but the democrats would not let them out of the senate. let us put the failure where it belongs. caucus will be even smaller next year. the same will be true on the house side. why should we be doing any better here? >> there will be enough senate

democrats to foul up the process again if they choose to. but to what end? what they concluded this past year is that when they have a president that they process when you have a different president of a different party in the white house makes sense. maybe they'll have more incentive to cooperate on trying to get back to a regular appropriations process, which the speaker and i would both very much like to do. >> so it's all on them? mr. mcconnell: it certainly was this year. and the minority in the senate is not irrelevant unless it's a little-bitty minority. yes?

>> senator, last week, democrats tried to get the president-elect to weigh in on the coal miner issue and buy america. did you speak with him or encourage him to stay out of it? and what do you make of the fact that he didn't kind of take the bait. yeah, i haven't discussed it with him. my own view on that is the coal miner health care issue, i had hoped we would get a full year. we ended up getting enough -- a fix through the duration of the c.r. at the end of april. and it's my goal to try to get that coal miner health care issue fixed. yes? >> senator mcconnell, in the past, have talked a lot about the massive debt we have. it's going to be $20 trillion the next time the debt limit expires. are republicans going to take any affirmative action that will actually reduce the debt? and are you going to be committed to pay-go and tax reform paying for itself, etc., and doing things like that you talked about before the election that you hope to do next year, things like medicare and social security, which are obviously very difficult to do politically?

mr. mcconnell: again, i can only speak for myself, but i think this level of national debt is dangerous and unacceptable. and so whatever we choose to do next year, i hope we will not lose sight of steps that we could take that would exacerbate the problem. and so i am concerned about it and all of those things -- i think we ought to take into consideration on each of the things that we do going forward. >> because the president-elect has talked about a massive infrastructure plan, over $1 trillion. he talked about a lot of other huge tax cuts, which nonpartisan outside experts say could add trillions of dollars to the debt. would you commit to saying things that will add to the deficit? well, mynell: preference on tax reform is that it be revenue neutral to the government, that it not exacerbate the issue that you raised. and on the infrastructure issue, it will be interesting to see how this is put together. we want to it see -- i'm

interested in seeing what is the administration going to recommend, and i think the details are really important. what i hope we will clearly avoid, and i'm confident we can will, is a trillion-dollar stimulus. take you back to 2009. we borrowed $1 trillion and nobody could find that it did much of anything. it seemed to me basically what it did was plus-up a bunch of federal accounts, and when you looked around trying to find examples of things that actually occurred, they were darn few. so we need to do this carefully and correctly and the issue of how to pay for it needs to be dealt with responsibly. >> so this won't be -- sort of a legacy question. i'm curious how you would describe your last eight years dealing directly with president obama, and moving forward, how you describe your relationship working so far with president-elect trump? how often do you guys speak? i understand he speaks very frequently, almost daily, with the speaker. mr. mcconnell: well, i think

president obama's a very smart guy. he wanted to move the country significantly to the left and he did. he did it the first two years because he had total control of congress, $1 trillion stimulus, obamacare, dodd-frank. and then i was wrong in my prediction three times. i thought after the 2010 election, president obama would pivot to the center. he didn't do that. i thought after the 2012 election when he didn't get the house back, he'd pivot to the center. he didn't do that. i thought surely, after the 2014 election, he would pivot to the center, and he didn't do that. so it's pretty clear now if you look back over the last eight years, the president wanted to move america significantly to the left. what i would call the europeanization of america --

high taxes, overregulation, and what you get in the end is slow growth, and we've been underperforming from a growth point of view through these years, the poorest recovery after a deep recession since world war ii. so if you bear in mind that that's what he wanted to do, i think he moved the country significantly in a european direction. the good news for us is that a lot of that was done by executive orders and regulation. and to get the country going again, in my view, as i said earlier, we have to deal with the regulatory onslaught and tax reform to take our foot off the brake and get it on the accelerator. and so i think the president was very effective at doing what he wanted to do. will wanted to do. bear in mind, reagan never had the house for eight years. he moved to the middle, raised the age for social security, did the last comprehensive tax

reform 30 years ago. clinton, when he lost the house and senate, did welfare reform and we balanced the budget three years in a row. i think we can safely say about president obama, he was not a centrist. and with regard to the new president, we have a terrific relationship. and he's a very high-energy person. just to give you an example, in talking to my colleagues on the floor last week, it was astonishing how many of them had been talking to him. he's very, very accessible, very energetic. i wonder if the man ever sleeps. and i think we're all excited about the energy and the direction that he seems to want to take the country. and the best evidence of that i think are the appointments that have been made so far, all of which i think have been pretty impressive. >> senator mcconnell, during the obama years, you said the debt ceiling should be used as an instrument to actually cut the deficit. do you want to apply that

principle during the trump years? and do you view that as an instrument that should? mr. mcconnell: well, on one occasion it was helpful. the budget control act in august of 2011 actually did end up reducing government spending for two years in a two for the first time since right after the korean war. and the much-reviled sequester has put a lot of pressure on domestic discretionary spending. there have been other times when we have raised the debt ceiling and not done it in connection with some effort to reduce spending. but at least on that one occasion, i think it was -- it brought us all to the table. this was the first of three deals that i did with the vice president, who is very transactional and a terrific negotiator. and i think if the president had

wanted to do more deals with us, he would have designated biden. but that was all in the first term. there were three major deals negotiated in the first term. i did all three of them with biden -- the august 2011 budget control act, going back to the year before, the two-year extension of the bush tax cuts at the end of 2010, and then the fiscal-cliff deal new year's eve of 2012. obviously, the vice president was not freelancing. the president gave him the opportunity to negotiate. in the second term, mccain, who has a wicked sense of humor, as all of you know, said, "joe was in a witness protection program." so their best negotiator was not around here in the second term. and i think there was nothing the president wanted to negotiate. i'm sorry for rambling on here, but i think it's unclear to me whether the raising of the debt ceiling will end up carrying other things with it or not.

>> senator mcconnell? mr. mcconnell: one more. you're up. >> will senate republicans respond when legislatively if president trump revokes the 2012 executive order that president obama did affecting about 750,000 dreamers, the young immigrants who came here -- mr. mcconnell: about what? >> the different action for daca, the 2012 executive order -- yeah, i don't -- we'll have to wait and see what the new administration recommends in that whole area. well, have a great christmas, everyone. we'll see you next year and we'll go back at it. thank you. c-span delaware history unfolds daily. created ase band was a public service by america's

cable television companies. atthis morning, we looked what the future holds for medicare and medicaid. continues. a monday morning roundtable, we are joined by stephanie armour of "the wall street journal," amy goldstein --the "wall street "washington post. " to january, on the repeal side can you explain what republicans mean. is this a complete repeal? are there components that they want to save? guest: that is a good question. part of the answer is we do not quite know yet.

for six years since this law has been passed, republicans have been saying they want to get rid of it. in the house they passed more than 60 bills to do so knowing that they never had a chance. now with the election of donald trump, they will be able to do it. there is a lot of debate going on. that there ares some things that can be done quickly. those are the parts of law that can be undone with the budget agreement. for instance, the subsidies many people get him be undone. the mandate that people have insurance can be undone. the penalty for the law for people who do not have insurance can be undone. some of the structural things like the markets the aca created will be harder to do through the budget process. host: that is the reconciliation process? caller: exactly. the reason that is important is

because the reconciliation process requires only that the votes in the senate to pass the bill. there are 52 republicans in the incoming senate. host: headline from last week saying that republicans say the repeal will begin in january. how long is that process going to take? all these things amy goldstein just talked about, is that weeks or months or years? guest: that depends who you are talking to on the hill. the plan from those i have spoken to is that they want to get this done quickly. they are expecting president-elect donald trump take executive action on his first day to knock down parts of the law. in the house and senate, they expect to go very quickly in the first 100 days to dismantle key pillars of the law. the real debate that is going on right now is in terms of a transition time or replacement. how quickly should that be done?

some republicans say we will need two or three or even longer years to keep things largely as they are now while we hammer out a new plan. other republicans, especially the freedom caucus say let's repeal and replace at the same time were much more quickly. you are seeing some feuding going on. host: democrats have vowed to fight this process every step of the way. where might the democrats might be able to find victories or slow the process down? guest: the democrats are in an interesting position because they don't want to help the republicans. on the other hand they are eager not to have millions of americans stranded without health insurance. where the balance between that lies and how much cooperation they should provide is up in the air. host: millions and millions of

americans without health insurance, there have been studies on this of what the repeal process would mean for the number of people who would lose health insurance or fall through the cracks. can you give us a sense of what the best estimates are? guest: urban institute and others have done studies that have indicated significant increase in the number of i'm sure. we are talking millions of people. a strongd to get number until we know exactly what the republicans want to put together. there is real debate over medicaid expansion. republicans in a number of medicaidve expanded and don't want to see it go away. we are talking between 12 and 15 million people who have gotten coverage for medicaid expansion. can we say because people will be uninsured? i don't think we can. guest: can i jump in?

there was a bill that was passed last year that went to the white house. president obama vetoed it. the congressional budget office look at what the impact would have been on the number of insured people under that bill. it would have been about 22 million people losing coverage or 22 million more uninsured people at the middle of the next decade. tost: republicans i talked said they passed that knowing it would be voted. havereedom caucus members been talking about looking at subsidies. that is why it is nebulous to put a number on it at this point. host: you mentioned the urban institute report that democrats in congress were sending links to. , this was an estimate based on a partial repeal the reconciliation, which we talked about without a possible replacement plan.

that is the study they looked into. they found the number of uninsured people would rise from 28.9 million to 58.7 million by 2019. 20 million would be newly uninsured, that would be from eliminating the premium tax credit and the individual mandate. those are some of the numbers. democrats have been talking about those a lot. the lines are open as we are having this discussion on the current state and future of the affordable care act. republicans (202) 748-8001. democrats (202) 748-8000. independents (202) 748-8002. we will start on our line for independents. bob is in massachusetts. good morning. caller: good morning. i would like someone to answer

me at least one good question. we have over 300 million americans in the country. people are now covered under this obamacare, 10 million of them already had insurance. or $330,000trillion per head for 10 million people to get insurance. thank you. guest: most people in this country who have insurance still have insurance through employers. that part of the insurance system, while not perfect, and some people have found it getting more expensive, that is not the part of the insurance system that was really broken. the part that was broken was the people who are buying policies on their own. the individual market. that is what the aca marketplaces were designed to address. younding on the numbers use, between 10 million and 12 million people have gotten

coverage that way. that is the number that tends to get thrown around. host: i will give you home or from louisiana. think that. caller: how are you this morning? appreciate you taking my call. i understand there was a republican gesture years ago. why did they fight it so hard and now they are going to come back to it? i am confused. i'm a daily listener. i don't understand. they have been up in washington too long. i think they get up there and make up their minds for us. it is their minds. i hope i'm making sense. host: thank you for your call. and for being a listener in louisiana. perhaps we could go to some of the early history of the affordable care act. guest: it is a good question. the affordable care act was passed in 2010.

it was not a bipartisan bill ultimately. republicans were not very supportive of the affordable care act. they have been opposed to the law since its passage. you are now seeing the situation because of the election that there is an opportunity and they see a mandate for them to knock down and repeal this law that they have seen as leading to higher premiums and fewer insurers participating and requirements for coverage, all of which they say is hurting america. now they see this opportunity. the problem is everywhere they look there are potential landmines. one staffer said we have to be careful what we wish for because now there is a landmine everywhere. it is a tricky process. they want to get some bipartisan support from democrats. host: perhaps you can fill us in. this comes up from time to time with viewers, this idea that the

affordable care act had its genesis in massachusetts under mitt romney as governor. that is exactly right. there is a little irony in how hard republicans have been fighting this law. some of the ideas, the insurance exchanges, came out of republican and conservative thinking from the heritage edition. in massachusetts, 2006 that pays -- that state passed a law under republican mitt romney as governor. host: mike is in cleveland, ohio, a democrat. caller: thanks for taking my call. noticedthing that i while i watched it on the news gone from the house to the it was rewritten so

that the insurance companies one out.-- won the one key issue that affects a lot of families is the fact that previous conditions will be covered, so if you have a cancer victim in your family, the insurance will cover them for what they need. one of the issues that i don't agree with his the fact that unions are being taxed to support health care. if they do rewrite this law, i would like them to repeal the union taxation. thank you. host: do you want to pick up on any of that? guest: it's interesting that the union tax was obviously an issue for those who initially supported the health law to have some opposition toward it. the issue that you brought up

that i think is especially important is the pre-existing condition upon it. -- component. what will happen with this, we really don't know at this point. continuing and a number of republicans on the hill support this. how you do this without some of the other requirements of the law like requiring others to have health insurance. how do you pay for that? there is some dialogue on the hill now where they would set up a system where everyone would have coverage, but those who would let it lapse go into a high risk pool. has been used before in states. unfortunately it has not been effective. people had to wait for a long time. it has not been adequately funded. they're going to do this is really the $10 million question. host: health insurers seek

clarity. a quick repeal of the 2010 overhaul law will stymie their market. can you talk us through what health insurers are saying and fear as they look ahead to what may happen in january? guest: i think health insurers are very concerned at this point. they had not seen this coming and had not planned for it. but many people don't understand about health insurers is that they have to decide early like in the spring of next year whether they are going to participate in the health insurance exchanges for 2018. they'll have the luxury of waiting to see what the republicans are going to come up with. they have to make the decisions now. the fear is that the current system of the affordable care act may have problems. they were losing money and a number of them were leaving the exchanges. they want to see fixes to what is currently there, but at the same time, if those fixes don't go through, they may not want to participate in 2018.

the have a lot of requests that they want to see done and there's lobbying on the hill to get some of these changes to go through. republicans are in a position where if they agree to some of them, they did not want to seem as if they are giving a bailout to insurers. host: good morning. caller: great discussion about this affordable care act. i'm an independent businessperson and i remember back 25 years ago when i first started having insurance. it was $180 a month back then. i was employed by corporation who had their insurance pay for them. every year, it kept going up and it would be like $210, $260, $300 this was like 25 years ago. now people are complaining about paying $400 a month.

back then, business people were paying as much as they are paying now. back then, i couldn't afford it anymore. i was unable to have insurance. i did not have insurance for 15 years until the affordable care act. now i have a managed medicaid, which works marvelously here in new york from my situation. i know there are valid concerns about the act not addressing some issues. they might want to talk with medical personnel and get their input because they have a lot of good insights on how it can be improved. host: one of those medical personnel who will have a lot input is congressman tom price. can we talk about where he is right now on this law and what he's telling donald trump right now? guest: we don't know exactly what he's telling the president-elect, but what we do know is that in choosing dr. price as the next secretary of health and human services

department, which obviously oversees a lot of things, including the execution of the affordable care act and perhaps the dismantling of the affordable care act, the president-elect has chosen one of the members of the house of representatives who has been one of the strongest proponents for the repeal. this is not someone who is subtle about his thoughts on the law. he has been very influential in what has become a consensus house republican plan called a better way that has ideas for how to deconstruct the law. it is putting in the position at hhs someone who has been front and center in the repeal effort over many years. host: stephanie armour, i want to go through donald trump's health care plan. he has talked about what he wants to see included. repealing the affordable care act, modifying the existing law that inhibits the sale of health insurance across state lines,

allow individuals to fully deduct health insurance premium payments from tax returns, allow individuals to use health saving accounts, block grant medicaid to states, and remove the barriers to entry into the free market for drug providers -- some of the things that he's put on his website. let's talk about insurers selling insurance across state lines and why that is seen as such a big fix by donald trump. guest: that's a good question. obviously, this has been one of the main things he talked about when campaigning -- removing the lines around the states. host: what does that mean? guest: currently, insurers can sell across state lines. there's nothing that prohibits them from doing so. you see large ensures that do so currently. and there are under the affordable care act compacts that can be set up across states

lines. what's different is that if you are an insurer and you are based in new york and you sell a plan in california, you have to abide by the rules of california and what they require you and your insurance policies to have. they may say, for example, you have to cover these benefits or you have to deal with consumer issues under california. what president-elect trump would do instead is say that this insurance company can sell a policy in california or they can sell it in arizona and it needs to abide by the regulations where it is based or licensed, for example, new york. they can sell that policy anywhere, but they can be located in a state with very little regulation. they are saying that would erode a lot of the consumer protection and would lead to more "skinny plans" with benefits. host: would that lead to a lot of states with the least amount of regulation? guest: it's like with credit

cards. everyone went to delaware. the idea being that insurers would be most likely to locate themselves in states that have scant regulation. host: new york is one of those states? guest: no, new york has lots of regulations. i just use it as an example. it is collocated understand. host: what state has fewer regulations? guest: i do not know what state is the most lax. there are insurance commissioners in each state. i think the concern is that there is a free-for-all that states would raise themselves to see how far they can relax regulations to get business. host: a so-called race to the bottom. taking your questions and comments about the state and the future of the affordable care act. stephanie armour with "the wall street journal" and amy goldstein with "the washington post." good morning.

caller: i have two points to mention. the first point is how does st. jude's shriners hospital for children -- how do they manage? they manage on charity. i think that's a marvelous example and perhaps health insurance providers should go seek and see how they are doing it. because they're doing something right. they have survived a lot of this debacle. my second point is this -- there are a lot of mothers who can do the shopping at costco. i work there. and my husband, he is our health care provider. we have always gotten our health insurance through him. and like a lot of other mothers in our community, there was a lot of sadness and frustration when obama gave us obamacare.

our paychecks, we lost $1000 in our paychecks per month, plus the employer was providing another $1000 for his end of our insurance benefits. so what do we get from it? well, we used to be able to go to the doctor's office and pay a copay for $35 a visit. now there is no copay. now i have to meet a deductible, a $6,000 deductible for a family of four. that was not very pleasant. so after we pay roughly $2000 a month, i have to come up with $150 to $300 for the office visit. am i going to the doctor? no, and i think that was the sneaky trick in the obamacare health care.

we need to shave people off the health system. and first of all, no one is going to go to the doctor because it hurts. those tests are hurting. unless you are running a fever and you got a sore throat, you really don't go to the doctor. but if you have a fever and you are hurting, you go to the doctor. host: thank you for sharing your family's situation. amy goldstein, what are you hearing there specifically about what she sees as an effort to get people out of the system, to price people out of going to the doctor? guest: i'm not sure that through her description of whether she is on a aca marketplace or getting private coverage. either way, there have been over the last number of years a trend toward having people have to

pay more for their insurance, or pay more for their out of pocket costs. some of that is under the law, but some of that is being in the private insurance marketplace. i'm not sure which descriptor situation, but she does make a point that many people on the exchanges or off the exchanges are experiencing -- that they have to pay much more upfront. that is a real phenomenon. for those people, as we were saying a little while ago, maybe 11 million people who are getting coverage from the aca marketplaces, they are increasingly finding insurers are losing money in that part of the business and they are charging more. understandably people don't like it. host: how much do you think the affordable care act gets blamed fairly or unfairly for these increases that have been happening for years in health care just in general? guest: that's a really good

point in your question. because people conflate what the law itself is doing from their own experiences, which are unrelated to the law. there may be experiences parallel, but they are not caused by the law all the time. host: eric is a democrat, good morning. caller: when i was in the evening, health care plans have gone up. host: you are on. go ahead. caller: why are republicans adamant about repealing this law? this law is about helping each individual in the united states. it's not the democrats' fault that each state has its own individual rules for how they go about implicating the law. i think their truck to kill this man's legacy. you can tweak it and work on it and get better, but you just cannot go out there and spend billions of dollars to repeal a law that isn't going nowhere. what trump is doing is promising

the people that ain't going to happen. it's not going to happen. this is my question -- why is it so important that the republicans repeal this law? host: stephanie armour? guest: there was a survey done shortly after election and it showed that -- i can't remember the exact number, but it was between 40% and 50% of people who voted for trump wanted to see the law repealed or changed. i think the republicans i spoke to on the hill really feel like they have a mandate to knock down the law. they feel like the voters and their constituents are unhappy with the law and want to see the law changed and replaced with something else. you are seeing now with the republican victory in the election is that they feel like there's an opportunity but also a need for them to follow through on the promises that they made. that is partly why there is a push from some republicans to do this quickly. they feel the voters were not happy with the law and want to

see the law changed. that said, there are studies that show strong support for the law from other voters. there is a great divide going on over this law. that's why it has been polarizing since its passage. host: i have the kaiser survey. 43% would like to repeal the law entirely or scale back what the law does. 30% wanted to expand what the law does and 19% wants to move forward with implementing the law as it is. on the politics of this, after whatever happens in the next year, does this become trump care? are republicans now the ones who will be blamed or get the credit for whatever comes of this? guest: we don't know what it will be called. we do not have a catchy name for

whatever the law will be yet. this is very much in the republicans' hands at this point. it is very clear to them that whatever happens with this law will impact them and will be seen largely as being on their shoulders, whether it fails or succeeds. that is one of the concerns, the 2018 midterms. republicans are not vulnerable should voters not be happy because they are only defending eight seats in the senate. but i think they are very cognizant of the need to not have this completely cause tumult in the mark and that is why they are debating a transition period. host: let's go to robert in greenwich, connecticut. caller: good morning. how are you? am i on? host: yes. caller: oh good. i find it ironic that a doctor is put in charge of repealing

this. or seems to have put himself in charge of this. i seem to recall the hippocratic oath is first do no harm. that's what doctors have to swear an oath to when they become doctors. it occurred to me that putting 20 million people out of the health care system might cause them a little stress and possible harm. i was just wondering if he had any way of reconciling that. host: amy goldstein? guest: in the house of representatives, there is a doctor caucus, or physician caucus. tom price is part of that group. among republicans, the fact that these folks do have medical degrees, i think gives them a little bit of stature for their policy beliefs. physicians can disagree about what is best for the health care system, but within the republican caucus, the fact that he is a doctor makes dr. price's

colleagues think he has some weight and legitimacy. host: what makes it different between a doctor? guest: recently, it has not happened at all. recently has been governors who have come to the position. sylvia burwell came from the head of the office of management and budget. it's often people with executive or managerial experience is accurate. this is a very big agency. we have been talking about the aca, but this agency and the department also oversees the centers for disease control, the drug administration, so it's a big place. host: stephanie armour, who is verma? guest: she is working under dr. price.

she has a strong amount of support from republicans. she brought a lot of changes to medicaid that i think republicans feel is on the right trajectory of what they would like to see happen with medicaid. for example, moving into a block grant program is one thing that they would really like to see, as well as some of the other things that she supported the given states more control over medicaid. for her, at hhs, my guess is that you are going to see a lot more waivers in states that change the way medicaid functions or operates. for example, there may be more work requirements or people are asked to pay a small premium in order to maintain coverage. host: the office that she would take over is the centers for medicare and medicaid. cms. last month, the current acting administrator of cms appeared at the american academy for actuaries. viewers can see his entire speech on c-span.org.

he talked a little bit about the sustainability of the marketplace. it's a topic we have been talking about this morning. here's a bit from that appearance. [video clip] >> the first thing we have to do is step back and acknowledge that we are ensuring people with no questions asked without regards to the health, and we are asking companies to do that without any data and very little understanding of that cost. what has happened is that in the first couple of years, many folks -- through no necessarily real fault of their own -- are priced too low. so and some i think expanded too fast. i think in this fourth period you are seeing some folks adjust. and certainly many markets, the prices moving higher than they

have been before. i would point out, in the third year currently in 2016, overall premiums in the marketplace are about 18% below cbo's original estimates. we have been tracking below. i think we will see greater increases this coming year, and i think we will be more balanced and spot on to where cbs thought we should be. some of it is to make up, but it's also a very new business for companies. i think what's most encouraging is to see that there are a large number of companies who really understand that it's a new business, are not treating it like the old individual market or the medicare market or some other market, but are really adapting product designs, network designs, and the best companies are expanding it as they view this new retail world. there are things that we are doing. as we look at the data to make sure that elements of things

that were driving costs unnecessarily, like third-party payments, are managed better, and i think we have taken some steps and we can obviously continue to take those. finally, i would say that probably the open question remains the same one that occurred before the aca, which is that there are some markets in this country where there is not enough competition. particularly rural parts of this country. that has always been the case. and i think this is getting more of the aca expose some of that reality. i think there is a real question. we have selected a model that is private-sector driven. the real question is whether or not we need something that feels more like medicare. i think that is part of the debate and we will have to look at particularly those rural communities. host: if our viewers want to see that entire speech, go to c-span.org.

stephanie armour, a reading what he is seeing in the marketplace and the data. it's different from what the republicans are reading and seeing in the data. guest: it's like the blind man and the elephant. it's there, but everyone see something different. he was definitely talking about ways that the law has worked, ways that people have gotten subsidies to make health care more affordable. he is also talking about changes being made to help make a lot more sustainable. whereas, republicans see the opposite. they see premium increases in the double digits. they see insurers, such as united, who say they are losing money and leaving the exchanges. no matter how you look at it, the one thing that is very true is that the affordable care act as it currently was working was having trouble and challenges. the democrats' answer to that to some extent was let's fix it and add public option. that's a government option that would be an insurance option that people can pick from. that's not going to happen.

instead, we are going to go down a different path with what the republican see. the republicans really want to point out that there are problems with the law already. you see a lot of defense of the law right now from democrats. host: we have 20 minutes left to take your questions about what those paths might look like and what the current state of the affordable care act is. george is a republican. go ahead. caller: yes, i think when mitt romney introduced the act, it was affordable. what happened was once the government was going to pay for it, the banks increased the cost. and people are lost out. i think the republicans -- the laws that they were passing, they even made it harder on pittsburgh to maintain the cost. because if you look at the cost

rates, it has doubled. so the banks are hitting a double-digit thing. they are getting paid by the government and getting repaid by individuals. the poorer you get, more cost to actually do it. the banks need to get out of health care, period. because if they continue in it, we are going to create a debt bubble like we did in the housing industry. host: amy goldstein, can you pick up on that -- the banks involvement in this process? guest: i'm not sure i understand his point about the banks. let me make a couple of observations. in massachusetts, even though it was a precursor to what became federal law, massachusetts actually had a little bit easier job. because massachusetts historically had a very low rate of uninsurance. the number of additional people who had to get covered was not as great as it was in all parts the country.

the second point is that these exchanges, which as you have been saying, stephanie, have had the things and bad things about them. they have really had a hard mission because they happen -- have been picking up people, who in many cases had not been without health insurance or with health insurance, who had neglected medical problems. those people have used a lot of health care more than the insurers were expecting. they were expensive to cover. there has been some built-in problems with the way things played out nationally that were not quite as true in massachusetts. host: let's head to vero beach, florida. good morning. caller: thank you for taking my call. i believe in universal health care and also pension for everybody. what we should do have is

progressive taxes according to the income. taxes go up or down according to inflation. it's like the euro. we should have both. we should have universal health care and universal pension. other than that, i think it's the best way to do it. if the taxes go up or down, that's part of the inflation. host: these topics come up when we have discussions on health care in the united states -- comparisons to our system and other countries. could we model our system on one that works better? is there one or two that the donald trump administration is looking at or any ways to better improve the american health care system? guest: the republicans i talked to on the hill pointing to health care and other countries

as what we do not what to do. it is the opposite. they see canada, for example, or some of the government-provided health care as just a way they do not want to go. their point is that they want less federal involvement in health care. they are very much opposed to the public option earlier voted by democrats. at least going forward that is unlikely to be something on the agenda and will continue to be something more along the lines of what republicans see as being more beneficial, which is much more a free-market approach. host: let's go to alabama. good morning. caller: good morning. i was interested in what was going to happen to these lower income people caught between working service jobs that are only available now since insurance was attached to mainly manufacturing jobs and everything else. those people are barely making

it from week to week. it's not going to do them any good to have a health care savings fund. if they get a voucher, they're probably not going to be able to afford it. i was a nurse for a long time and i got injured. i lost my insurance. my husband was on disability. he was covered by medicare. i was injured severely and i had no insurance. i cannot afford $1500 to pay out. i listen to people call in. there are people who can never go to a doctor because of expenses and they will be lost in all this. host: i thought you were done. amy goldstein, pick up on that. guest: it's something that's really fundamental. one of the things that the aca has done is that for the first time giving working-class people and people a little bit into the

middle class subsidies, government money to help by but private health insurance. about 85% of the people who have insurance policies through these marketplaces are getting this federal money. now subsidies are not something the incoming administration likes at all. there's another issue which is that since the late 1990's there has been a children's health insurance program, chip. that is specifically for the children of working class people. that law is going to come up for renewal fairly soon. and it is really unclear what's going to happen with it. host: what is a health saving account? guest: a health savings account is something that exists now. it has been a longtime republican favorite in health policy. it enables people to set aside money that they can withdraw tax free. they can withdraw it without any penalties and use it for medical purposes. many people in this country have

it, people of all incomes. there are some research literatures that show higher income people are better able to save money that way who have been benefiting the most from these health savings accounts. president-elect trump says he wants to expand them. he has not been specific on how he wants to do so, but something he talked about repeatedly during his campaign. host: what is a way to expand that? guest: better tax breaks. this is hypothetical since we really do not know what he will do. better tax breaks. there are limits on how much money you can set aside, so those limits could be expanded or gone. it's a little unclear, but it's something that he really likes. host: let's go to wayne in littletown, pennsylvania. good morning. caller: how are you doing this morning? host: doing well. caller: look, this here should be eliminated. this free market -- it's bogus.

it is all for the rich. pharmacies can charge what they want. people have got to realize. the republicans -- special interest is being handled by some of them. they are going by the special interests, all that money coming in from pharmaceuticals, hospitals -- i ain't got time to explain it all. john, just a minute. the big thing is if all industrial countries, like what bernie sanders said can afford to do it -- i know people in canada. this stuff is ridiculous. people going in debt and losing their homes. their mother is going into nursing homes and they cannot afford it. people care and love each other. help. no, but everyone's going to go in debt or lose everything they've got to keep the pharmaceuticals and all the

others, bigtime money. host: thanks for the call from pennsylvania. stephanie armour, can we remind viewers of bernie sanders and this health care issue and what he had to say about it on the campaign trail. guest: bernie sanders was and is very much in support of a more expansive than a public option. basically government insurance. basically government insurance that anyone could get it would be on the market and would be available. while it's important to remember what bernie sanders wanted and many supporters rallied around, i still think we need to have to focus on reality and that that is very unlikely to be happening at this point and this point going forward. i do think the point that he was raising is important about all the various players that are going to be involved in whatever is drafted going forward. the pharmaceutical industry, the health insurance industry, and that's going to be a real challenge for republicans. how do they keep these various aspects happy?

because you really cannot get something passed it seems to me without the support of the pharmaceutical industry, as you saw in 2010 with the affordable care act. they really needed to bring them on board. host: just about 10 minutes left if you have a question or comment. jared, good morning to you. caller: i have a question about competing across state lines. are not the prices with hospital networks negotiated based on geography? i'm wondering how that works. with someone from another search, they would have to have a certain number of people to negotiate a lower price with the hospitals? i'm wondering how that would work. guest: there are a couple

different issues at the that this caller raises. how that would all work is insurers, as you are saying a little while ago, are able to bypass state regulations. and what the geographic basis would be for setting prices is really not knowable now. there are wide variations in hospital prices for the same services. and that has been true for a long time, whether it's anything republicans might come along with to address that, we just don't know. guest: another good point that he raises is that is the biggest stumbling block to this selling insurance across state lines. the reason it has not taken off is that it's hard for new insurers to come in and build up those networks. they are at a competitive disadvantage. host: a recent headline from "u.s. news & world report."

"obamacare repeal efforts --" "mental health care would undo recent progress made in the critical areas." mental health care was one part of the legislation passed last week and president obama is set to sign with the toy for century cures act. why is this being seen as a flashpoint? guest: there has been a years- long drive toward mental health parity, which is good coverage for mental health services or -- for physical medical services. this is one of those ways in which the aca incorporates all kinds of goals that people had with the health care system. the aca required -- this is a regulatory thing, not a law thing -- required health and human services to oversee a definition of what standard benefits would be included in

people's insurance, not just on the exchange, but all kinds of private insurance. and equality from at the health services was part of that definition. people who care a lot about this issue now feel that this could be at risk. host: could the legislation passed last week, once it is signed on tuesday -- could that be changed or pulled back with whatever happens with the repeal of the affordable care act? guest: the cures act definitely focuses on addiction, treatment, and some mental health. that is very separate from the insurance plans must provide mental health coverage as one of their "essential or mandatory benefits." i definitely think republicans are interested in scaling back the mandatory benefit requirements. they want less regulation of insurers. so i think the concerns about eroding the protections for mental health coverage are

a legitimate concern that people have. guest: if i can expand on that, there are many groups of people who care about different aspects of health coverage who are now concerned. among them are women who care about reproductive rights. there's a whole set of women's health benefits that are now included under the standard or essential health benefits. some of that includes coverage for things like contraception, which the incoming vice president pence is not a fan of. there are lots of moving parts to this law that could be thrown up in the air now. created79, c-span was and is brought to you today by your cable or satellite provider. >> followed the transition of government on c-span as donald trump select his cabinet and

they prepare for the next congress. we take you to keep events as they happen without interruption. watch live on c-span. listen on our free c-span radio app. >> it was another busy day at trump tower. the transition team was busy with inauguration day a month away. several people came and went to the course of the day. here's a look at some of those who were seen and heard. >> what are you doing here at trump tower? and my hungry? -- am i hungry?