caucuses can move on. >> join us on book tv saturday at noon eastern. 2:00 p.m. on c-span3, american history tv, working with cable partners as we explore the american story. washington journal continues. host: kimberly leonard is the head reporter of the "washington examiner.' one of those aspects, medicare. tell us about the president's thinking on the program. guest: it looks at what the projections are over the next 10 years, and a lot of democrats raised alarm because it looked as though president trump was suggesting that he would want to cut 800 billion -- $800 billion over 10 years. a closer look shows that that projection is doing a lot of heavy lifting. it assumes that the drug policy

proposals of president trump are going to work and that medicare will spend less because drug pricing will go down. it proposes giving doctors and hospitals less funding. direct cuts are less significant, what is something that my cuts are seizing on. governmentoes the believe that savings could be found? guest: they have put forward proposals that have to do with lowering what individuals pay for drugs or being able to better negotiate different parts of the system. some of them require an act of congress. to even reach those thresholds, they would need to pass legislation. it is important to say with the budget that the president's suggestions are suggestions, and they have to do with his personal priorities and congress is the one who decides what the budget will be. host: the president had talked about, i do not know if he had

talked about changing medicare or medicaid. was that a surprise to find it? guest: it was. that is why we were looking at it closely, and thinking back to when president trump was running, he vowed that he would not cut medicare or medicaid. if you look at the budget, it looks like medicare cuts and broken promises is what democrats will be saying. the more significant overhauls have to do with the medicaid system. people 65 ands older and certain disabilities. indicate covered low end people -- medicaid covers low end people. the bigger changes that president trump is proposing have to do with medicaid. host: one of those is to treat it as a block grant. describe what that is and why they think it is the best proposal. guest: it is something that a lot of republicans supported for a while and it was something

they wanted to do in the repeal and replace measure. medicaid is a joint state and federal effort. when state spend money, the federal government matches what they need to pay for the expenses. what republicans and president trump have proposed is giving states a specific amount of money, and allowing states to do more of what they want with the funds. right now medicaid has a lot of rules on what it can and cannot be spent on. dates have to apply individually if they want to make changes. if they want medicaid to cover more patients who have a mental illness, they have to apply for a waiver through the trump administration. that has historically been the case because the federal government is paying so much and they get a say as to what happens. and so, the proposal would end federalng what the government spends on medicaid. that would be a big overhaul and

something that a lot of patient advocacy groups fight against. host: when it comes to the medicaid side are those who go to hospitals or doctors will pay more for that. guest: what is on the medicaid side has to do with the resident proposed more -- with the president proposing more states enact work requirements. arkansas put the plan into work already. 18,000 people lost health insurance. dedicated work requirements require people who are not disabled -- medicaid work requirements require people were not disabled to work 20 hours a week. it is similar to food stamp probe lamp -- programs. it appears that people either have to follow the work requirements are not following them or unable to record they are following them. in a case in arkansas, there is a court hearing that looks at

medicaid court requirements. the trump administration would like to see those implemented across the board. right now, the process i mentioned earlier is how states are applying to have the requirements go in. host: the topic of our discussion with kimberly leonard. if you want to ask your questions, democrats it is 202-748-8000. republicans, 202-748-8001. independent 202-748-8002. you can reach us on twitter. generally, the democratic reaction, how would you categorize this? guest: they would weaponize this. looking at cuts to medicaid and toicare, they are ready seize on this as political attacks. just to go back a second. mit012, met romney --

romney used a lot of arguments about medicare cuts saying that obamacare had cut medicare. -- the arguments that were used had to do with some of the same proposals you are seeing in the trump budget. lower payments to hospitals and doctors. one of the big differences we would see if the budget were to have a change is that doctors who work in a hospital would get the same payment as those who perform certain procedures outside of the hospital. that is one of the big changes that the obama administration had proposed. host: the health and human inretary on capitol hill front of the house energy and commerce committee was asked about these cuts. i would like you to take a listen to the exchange. [video clip] how do you reassure the american people that what they count on,

what is really necessary in their lives, medicare beneficiaries, medicaid beneficiaries, that these numbers, what these numbers will do to them? these are massive cuts. >> on medicare we are putting it on a sounder footing for the future, and these are provider cuts. hospitals are not happy. the drug companies are not happy. >> how does that affect the beneficiaries? >> it reduces their cost-sharing. as we end the abuse -- the abuse and minimize it, their sharing goes down. lessenwould providers their coverage if you will take almost $460 billion out of that? are you going to depend on the goodness of their hearts? >> a lot of them need to be in medicare. the hospital will not be in

existence if it is not a medicare provider. >> what about the patients? coverage for medicare? >> i do not believe any of those three major areas of reduction will impact in any way patient access to services. end video clip] host: what is the general reaction to that. guest: the hospital industry is upset. they set out press releases and they say they do not want to see cuts. they will fight against it. certain actions by the trump administration will work out. it assumes that going after a lot of abuse in the system will end up saving bonds -- funds. it assumes that drug payments that happen in hospitals will go through. if you look at different

analyses, it is all about the politics. if you look at different analyses, they would say that this has little impact on patient access, although hospitals argue that if they get lower paces -- payments, how will they provide the care. host: do doctors have the same kind of reaction? guest: it depends if they work in a hospital or private practice, because that will impact their ability to receive payments. host: the first call from virginia. you are on. caller: my concern is based on the policy that the trump administration is going after. they want their money for the stupid wall. so the people with medicare and medicaid, and social security are the dems of -- vic them -- victims of the scam. why did they not negotiate prices for medicare patients?

eful lot ofave an aw money doing that. i know you are not close to collecting medicare, some people, that is their only way of getting care. they do not have supplemental insurance. you are going after them. the billionaires are making more money every single day, and you are just doing it because of the wall. 5% cuts across the board for the federal government, and that is to take care of that stupid wall. host: thank you. guest: i think she is expressing what a lot of voters are saying with the tax bill. let us talk about drug negotiation. medicare part b is the portion -- part d is the portion that covers prescription drugs. they actually do negotiate the prices. people say they want medicare to be able to negotiate, they say

they -- they mean they want the government to step in. different projections show that they would not necessarily do a better job than the private companies unless they were to say that we would exclude these specific drugs. you have to do what other countries do, which is to say no to certain drugs up until a certain amount of time or to say you have to start with generics and then you can move on to more expensive drugs. that would be the trade-off. host: john from california. hello. caller: hello. can you hear me? host: go ahead. ,aller: i am a retired worker both federal and state government. i am very displeased with this particular argument about medicaid and medicare. medicare is not an entitlement. when i was working, i had to pay into it. when i was working for the state, you do not pay into

medicare. they do not get that sort of retirement benefits. it seems to me that what we are doing is something that obama claimed he would not do, which was give illegals medicare and so forth. they have not paid anything into the system. i am not against illegals or anything like that. i think they need to contribute before they start receiving benefits. we are talking about the budget being out of proportion. that is primarily because we are taking people -- taking care of people who have not paid into the system. it should be some sort of waiting period before they start receiving benefits. host: thank you. guest: i do not have the impression that they are receiving benefits. a lot of the people in the country illegally do paid taxes. california would like to spend

state dollars on expanding access to people in the country illegally. right now the state has proposed a plan where people up to age 26 who are low income would be able to qualify for medicaid, so you would have to be low income and it would have to be only state funds paying for it. because otherwise the federal government will decline to pay for those costs. host: what is the current fiscal situation for both programs? guest: medicare is set to become insolvent, which means they will have to cut what people receive unless they do something to fix it. that is why you have a lot of conservatives saying that it is time to reform medicare. what is interesting about the president's budget is that it does not do what a lot of others have proposed, which would be to privatize the program and give people a set amount of money to be able to buy private health insurance, and that was

something that paul ryan had proposed. when we are talking about some of these different cuts, we are not looking at that proposal in the budget. that is one of the big differences. next, california. hello. guest: how would cutting -- caller: how would cutting connectedffect people to hmo's, particularly the kaiser foundation? they run their own hospitals. i would think with a certain grant and a budget, that would stabilize the cost of medicare. --hink since people perform prefer medicare, that is the way medicare will go. i do not think with that concept, that medicare would go belly up quite as fast. guest: i can say the trump administration, based on interviews, they have encouraged

people to go towards medicare and they want people to choose the plan that is best for them. they have done a lot to educate the people in medicare advantage. if you get regular medicare, you have to buy a prescription drug plan separately. you have to do that as an add-on. if you have medicare advantage, you have more included. the problem is that people do not know what they will need and what needs to be covered, and so forth. there are some concerns that sicker into -- individuals and up worse off. a lot of that has to do with people trying to assess their plans and health, and figure out what works for them. host: how did the obama administration treat the medicare program? and does it still have impact today? guest: they had done a lot in terms of the affordable care act, reducing about $700 billion if not more in medicare.

cut,ould look at that as a or as savings. a lot of it had to do with reducing funding to medicare advantage, which is the private plan. and also reducing what medicare pays doctors and hospitals. it did that in order to help fund the court -- the affordable care act. allowedrdable care act -- a different payment applications to be functional. planswhat are democrats' for medicare? guest: there is a growing action in congress, will start with leadership. leadership is focused on thick sing the affordable care act. that is what they want to do and that is what the industry wants to see. they want more funding to go into the affordable care act so that people on this plans are paying less in premiums and so people who were uninsured will be a tight -- enticed to go in.

then you have a separate portion gradual it as a more stepping stone towards a more universal health care coverage. they either want to let people buy into medicare at a younger -- or -- at a younger age for anyone to buy into medicare as a separate option. or instead of employer plans. then you have 107 democratic house members who have signed onto the medicare for all act. it is very important to be clear is what we are talking about when we say medicare for all is different from what medicare looks like now. the bill covers more services than medicare currently does, for example, long-term care. it would cover all medical care without any co-pay i individual patients. it would enroll everyone who currently -- whatever health insurance plan you have, whether it is private or not, it would

enroll everyone into this system. those are kind of the different steps that are emerging. democrats say that we could consider more gradual steps, but where they are focused as the affordable care act. host: this is kimberly leonard with the "washington examiner." from new york, bob. hello. caller: good morning. is, i do not necessarily need to go on medicare. several senators mentioned the same thing. of do i not have the option not enrolling in medicare? my retirement from the state provides my insurance that i paid for that i would prefer to have. why do we not have the option not to go into medicare? some reformerse who believe that there should be

a closer look at who gets medicare and who does not. you have people who can still qualify, and we all pay into medicare, which is why it is something people want to have later on. people who support the current system say that you never know where you'll end up. you do not know where you'll end up older than that. probably,g, there are when it comes to the health care industry, they would make -- they would like to make sure that medicare stays in place, and it is well-funded. adding that the system is highly abused by providers and clients alike. you heard alex say the same thing. what are we talking about when we talk about abuse? guest: things like overbilling, performing the same tasks and procedures. across-the-board you would have health care providers

acknowledge that there is a lot of waste and difficulty getting records from one place to another, so you can have a blood test one day and have it again another weeks later even though it has been performed and you did not need another test. you have a a lot of red tape as you go through the system. you have individual providers who are fraudulently brilliant -- telling medicare first -- for procedures that you have not performed. budget would's specifically deal with abuse. host: greg, from massachusetts, republican line. i just started medicare, and i just had my wellness -- are you there? guest: yes. caller: i just had my wellness exam, and the bills are rolling in. for $11 forn eob

someone to put a band-aid on the pin hole when they took blood. i am wondering -- my question is when are they going to start getting the hospitals to tell you what drug prices are, and procedures before you have stuff done. this is crazy. you get these ridiculous bills. how would anybody like it if the plumber kept sending someone customer bills a month later for things like putting on a band-aid? that is crazy. host: thank you. guest: this is one of the areas where i would say, as someone who spends a lot of time on the hill, that is -- there is bipartisan agreement that something must be done. the health-care industry is on the same page when it comes to the issues that we mentioned earlier, not on the same page when it comes to out-of-pocket medical bills.

the hospitals blame insurance companies and say they should be covering more. insurance companies blame hospitals and say why do you not tell your patient? why are you charging ridiculous christ -- prices? drug companies get blamed a lot. there is an effort led by senator bill cassidy along with look atic lawmakers to out-of-pocket medical bills and say how will we go about doing this. are we going to require more transparency were for states to have an intermediary who will work these debates out for patients so that patients do not have to do it themselves? it is a huge frustration and something that a lot of people can relate to. host: if i am a patient, i would like to know a procedure -- how much a procedure will cost. is there a website that will list it out? guest: under trump

administration rules, hospitals have to post different procedures on their website. they do not have a penalty not to do it, but that is on the table. it is something that the trump administration is looking at to be able to say what would be the next step. you have to put these online, so now you have to post a certain format. it might encourage consumer shopping, although it is going to be hard. it is not like shopping for other items. you cannot compare and see ratings. i think the idea for conservatives, and also for liberals, is that people would costs,at the procedure why, and just to be aware before they make different choices. host: bobby, in mississippi. go ahead. caller: good morning. report that before long medicare is going broke.

if do you figure that in more people are paying into it today than there has ever been? guest: it is going to become, and the word is insolvent. it does not mean it is going away, it means that the payments that go toward covering your medicare services are not going to be as much as they were and you will not be getting as much coverage and you as a patient will have to pay more out-of-pocket. congress will have to deal with it, it is something they have done before, that means adding more funding or cutting payments. host: under the current system, how much does the government pick up versus how much does the consumer have to pay? guest: it depends on what you make and if you are also on medicaid. there are a lot of factors. generally, medicare is a popular program. that is why the slogan medicare

for all works. that is why when you pull people about that, they tend to be positive about that. it is something that almost every provider will take, medicare because it has a large population. it is why a lot of democrats are considering at looking medicare as a way to extend health care insurance coverage. host: cheryl, in texas. caller: i just want to comment that none of the medicare advantage policies are accepted at mda and cancer center in houston, which is the largest cancer hospital and it has the largest breast cancer department. i was diagnosed with breast cancer four years ago and i have been missed diagnosed -- miss diagnosed 46 -- for three years

and told i had a cyst. by the time i was able to get to anderson.on, -- md i have been told i have a 40% chance that it will come back. i might be dead by now if i had not been able to go to md anderson. i would not have been able to go with any medicare advantage policy. medicaid,medicare, and many specialty doctors and hospitals, you are not allowed to go there if you have a medicare advantage policy. i happen to live in the state with the most uninsured people in any of the states. it is a big issue. host: thank you for sharing. guest: that has to do a lot with what i was talking about. when you are shopping for medicare, you have to decide if you are going to use the traditional plan or medicare advantage. the trump administration has

created tools that people can use online to compare what is in these plans and to be able to look at what providers are covered. has a lothis work -- of foresight. with that collar, she did not know she had breast cancer. it is a lot of heavy lifting for individuals consumers to figure out what health insurance plan might work for them and to make predictions about their lives. host: now that we have this presentation, if it goes nowhere, what is next? isst: right now, congress house firstin the of all they are looking at stabilizing the affordable care act. republicans have told me, forget it. however, where they have coalesced has to do with pricing. what i talked about in terms of understanding what your hospital bill might be. looking at drug prices.

they do not agree on how to go about it, my credits have said that they want to let the government negotiate, and republicans have said that we need more transparency. one of the big issues that i have seen them come together are brand-name drugs keeping generic drugs off the market. generics are copies that are cheaper. brand-name drugs have these ploys that they used to keep them from getting approved by the food and drug administration and reaching the market. that is something that i have seen them coalesced behind. the trump administration has proposed, an interesting part of the budget has proposed that seniors have a cap on what they spend on their drugs if they are on medicare. that is something that democrats usually suggest. who knows if there is a motion behind that. probably not from republicans, that might mean medicare spending. with the president's blessing, there can be a green light to

move ahead with different policies that might otherwise be considered. washingtonexaminer.com is where our guest rights. kimberly >> c-span's washington journal, live every day with news and policy issues that impact you. thursday morning, jim banks on president trump's $750 billion pentagon budget request. then robin kelly talks about the budgetnt's fiscal 2020 request and u.s. trade policy. be sure to watch c-span's at 7:00on journal, live a.m. eastern, thursday morning. join the discussion. live thursday on the c-span networks, the house debates and votes on a resolution to make the mueller report available to the public when it is released. that is at 9:00 a.m. eastern on

c-span. on c-span2 at 10:00 a.m., the senate debate the resolution to terminate the president's national emergency declaration to build a wall on the u.s. mexico border. a final vote is expected in the afternoon. at 10:00 a.m. on c-span3, wilbur ross appears before the house oversight committee to talk about the upcoming census including the addition of the citizenship question. c-span cities tour tour is on the road, exploring the american story. with the help of our partners at media,, we visit cedar rapids in the central iowa. it is the piece that everybody knows, and a lot of times, people will not know the isist or the title, but it an iconic piece. it is probably the most iconic piece of american art today. have not been great at

selecting the next president. it seems that the caucus, perhaps their highest function is winnowing the field. we talk about three tickets out of iowa, the top three finishers in the caucuses can move on. as wen us on book tv speak with authors. sunday, american history tv. working with our cable partners as we explore the american story. the house debated a nonbinding resolution calling for special counsel robert mueller's report to be made available to the public and the congress once it is released. next, wednesday's rule debate on the resolution. this is just over 45 minutes. , mr. speaker. mr. speaker, for purposes of debate only, i yield the customary 30ut