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  This Week With George Stephanopoulos  ABC  March 12, 2017 8:02am-8:15am PDT

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we'll cover it all today. we begin with the top trump lieutenant on health care. the director of the off o off oo management and budget, mick mulvaney. good morning. i want to get a sense of how the president will deal with competing promises. to repeal and replace obamacare. he wants a plan that will help everyone. we'll have insurance for everybody. much less expensive and much better. and during the campaign, he promised no cuts in medicaid. a tweet from may 7, 2015, i was the first and only potential gop candidate to state there will be no cuts to social security, medicare, and medicaid. as you know, so far, the independent analysis shows that 6 to 15 million americans will lose coverage they now have under obamacare. and about $370 billion less in federal funding for medicaid over the next ten years. how do you square that impact with the president's promises? >> george, as a lot of moving pieces at one time.
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let me see if it can break it down to smaller pieces and parts and we can talk about a bunch of different ones. talk about the coverage levels. the number of people covered. we continue to think, and have for a long time, that the cbo is scoring the wrong thing. they're scoring obamacare as it exists today. not tomorrow. obamacare is this close from completely collapsing. for example, i live in south carolina. we're down to one provider in that state. there are four or five states down to one provider. the cbo is failing to take into consideration what happens to folks in south carolina when there are no providers, which there may be as soon as next year. we don't think the cbo is counting correctly that way. but at the same time, we don't think they're counting the right thing. go back to the original idea of obamacare. people could afford to go to the doctor. they can't. they can afford to have coverage. a plastic piece of paper that says they have an insurance policy. they can't afford to go to the doctor. >> the president said insurance for everybody. >> i was on obamacare when i was in the house.
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my family's deductibles were over $15,000 a year. other folks who don't make as much money as i did were on the exact same plan. do you think they could afford to go to the doctor? that's what we're trying to fix. not coverage for people. not coverage they can afford. but care they can afford. when they get sick, they can go to the doctor. that's what the donald trump plan is working on. that's where we think it will be wildly successful. >> they'll have less money to pay for that coverage right now. less money to pay for that care. on the point of medicaid, the president said in the campaign he would not cut medicaid. this bill is going to reduce federal medicaid funding by about $370 billion over ten years. >> and still give better care. because we're actually giving the governors what they want. i was here with i think about 46 of state governors about two weeks ago. one of the things they kept asking for was more control over their own medicaid. i was in the state legislature, we would have begged for more control over how our medicaid dollars got spent. >> they're not begging for fewer
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dollars, mr. director. >> but they're begging for better control to get more efficiency and better ability to serve their people. the medicaid system today is a one-size-fits-all system. we fixed that. you can provide better services for less if you get the federal government out of the way. >> are you saying if the congressional budget office says fewer people will be covered, many millions fewer people will be covered, the costs will be going up, that you're simply rejecting that analysis? >> i don't think the costs will go up at all. in order for this to be passed on budget reconciliation, it has to reduce the debt and thus save money. >> on the coverage, though, if it says fewer people will be covers, you simply reject that? >> if the cbo is right about obamacare to begin with, there would be 8 million more people on obamacare today than there actually are. i love the folks in the cbo. they work really hard. they do.
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sometimes we ask them to do things they're not capable of doing. and estimating the impact of a bill of this size is probably not the best use of their time. >> it sounds like you'll reject. senator tom cotton coming up next. he says it's time to slow this down and start over. he told our jon karl that your bill is going to make the system worse than it is now. let's listen. >> i'm afraid it could make it worse in some ways. insurance rates would continue to go up. americans would have less control and less choice. over their health care systems. that's why i say it's time to take a pause. take stock of how we got to where we are. >> what do you say to senator cotton? >> tom's a good -- senator cotton is a good friend. i would tell him he knows how the house and senate work. thing move through the house relatively quickly. this is still slower than obamacare went. we already had two committee hearings. i believe two more than obama care got.
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we'll have another committee hearing this week. another one next week before the vote goes to a vote -- the bill goes to a vote on the floor. then things will, as they always will, and as the founding fathers intended them to, slow down in the senate. i'm sure senator cotton will have a chance to review the bill to amend the bill. but let's not get lost on that, george. this is the framework. this is the bill the president has looked at and said, yes, this is what will work. if the house thinks they can make it a little better. if the senate thinks they can make it a little better, we're open to talking about those types of things. there's no reason to rush it. it's not being rushed as things stand now. >> he says this will increase premiums. >> i happen to disagree with tom -- senator cotton. one of the things many of my friends on the right, i used to be a member of the right wing caucus on the house. they would make the same complaints. my point to them is -- i think they're discounting the value of competition. again, go back to the example where i live in south carolina. one provider. under the plan that we're talking about now, we already know that more providers will come into south carolina.
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that competition, the competition republicans so often want in so many parts of our economy, that competition will tend to drive down premiums. >> your former colleagues in the house have met with president trump. they say he's open to moving up the date to phase out the medicaid expansion. perhaps as early as 2018. are you willing to ne gauche gnat that in the house? >> i was in those meetings. i'll tell you what we told them in the meetings. the bill here is a framework. it's a nice framework. we like it. it's a good repeal and replacement bill. if there are ideas in the house. i think congressman barton from texas had some good ideas. i think congressman griffin had good ideas. like changing the expansion date. perhaps putting work requirements in on medicaid. it would improve the bill. if the house sees fit to make the bill better, they would have the support of the white house. >> you're behind that right now. how about the opposition of the aarp. they've put out an ad where they're saying this bill is going to be an age tax on middle income americans. let's listen.
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>> as insurance companies to charge an age tax on older american, combined with fewer tax credits, this could mean an $8,000 a year premium hike on those who can least afford it. unacceptable. second, the bill gives big drug companies a sweetheart tax break while doing nothing to lower drug costs for everyday americans. >> meantime, the new york sometimes is reporting that the joint tax xhecommittee is showi your bill will provide $157 billion in tax cuts to people with high incomes. middle income americans will pay more for insurance. how is that fair? >> i think that's the same group that did the television ads of a guy looking like paul ryan pushing granny off the edge of a cliff when we first started talking about budgetary reforms back in 2010. my guess is that the millions of e-mails that that group and other groups are sending out today have a click here to
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donate at the bottom. they're not in the business of fixing things. they're trying to protect their own self-interests. to raise money. that's unfortunate that that's where a lot of folks will get their information. look, we promised to repeal the taxes for obamacare. that's what the bill does. i think we should focus more on the benefits folks are going to get from the improved health care, the affordable health care, not just affordable health coverage, that this new level of protection, this new bill would provide. >> they're pointing out, older americans, those from 55 to 64, are going to be paying more because insurance companies will be able to charge them more. >> and i seriously doubt that any of those account the use of hsas. the lower premiums from competition. listen, everybody's got skin in the game. everybody has an interested party. they're trying to protect their own. what we're trying to do is make things better for as many people as we can. right now, the bill is doing exactly that.
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>> the burden may be falling hardest on older, middle income americans. your critics are saying this is a massive transfer of wealth from lower income americans to upper income americans when you combine the tax cuts with the loss in subsidies for middle income americans. >> i'm not sure where they're getting that. a massive transfer of wealth? we're making sure that the truly indigent still have care. medicaid is still there. we think it's going to be even better. the people who are just above medicaid but still have difficulty buying their own premiums will not only have the refundable tax credit. they'll have the ability to use hsas to pay for their -- their health care on a tax advantage basis. just like you and i get. so, i don't understand the criticisms lobbed in that fashion. the bill actually helps a great many people. and helps them get something they need. which is health care. not health coverage. >> millions will be paying more. and the wealthy get a tax break. let me move on to the state of the union.
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>> george, i'm sorry. i won't let you move on from that. you're taking that as if it's gospel truth. it's the argument of a group of people who don't like the bill. we repeal the taxes in obamacare. it's what the republicans have done from the very beginning. the fact that certain groups will pay less tax is not central to the issue. we have done this in a fashion that allows the people who cannot afford health care now to get it. i don't know why some people are so dead set against other people benefiting at the same time. >> but those getting subsidies right now, they're going to be getting fewer -- the tax credit is going to be worth less than the subsidies. insurance companies will be free under your bill to charge older americans more. >> and you're falling into the exact same trap that i talked about at the beginning of the segment. you're worried about giving people coverage. it's almost as if -- >> the president said he wanted everyone covered, sir. the president said that. >> he wants everybody to get care. >> that's not what he said.
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the president said he wants everyone covered. >> what people want is to get care. when people get sick, they want to be able to afford to go to the doctor. that's where obamacare has failed them several times over. that is the problem that we're fixing. so that when you're watching this program, when you get sick, you can afford to go to the doctor. i had it, george. i have livered through this firsthand. you didn't have obamacare. i did. $12,000, $15,000 deductible for my family. luckily, we could afford it. people making much less than i do had the same plan. they could not afford to go to the doctor. that was a broken system. that was one of the many, many reasons that obamacare was failing and people are begging us to replace it. and that's exactly what we're going to do. >> finally, congressman cummings is coming up on the program. he met with president trump earlier in the week. here's what he said after the meeting. >> he was -- enthusiastic.
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and, he -- he was clearly aware of the problem. and clearly, and he made it clear to us that he wanted to do something about it. >> so is the administration going to get fully behind this idea that medicare negotiate drug prices directly? >> the one i'm more familiar with, george, is where we're trying to find a way to drive down drug prices. congressman cummings and i served on the oversight committee together. we participated in a hearing together on the high price of the epipen, the one that cost $600 for two here and a couple dollars each over in europe. he and i both learned together, it's government regulation. the inability for drug companies and medical device manufacturers to get things approved. government intervention that is driving up the cost. i do know for a fact the administration is going to be looking directly at trying to figure out a way to fix that. i hope we can count on congressman cummings' support.
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>> so he was wrong? the president is not committed to giving medicare the power to negotiate drug prices? >> i wasn't at that meeting. it's consistent to what the president is trying to do. trying to drive down the cost of actual health care that men and women in this country have to pay.