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Speaker 1: The Senate Republican healthcare bill, drafted in secret, was unveiled yesterday.

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Speaker 1: The bill includes sharp cuts to Medicaid for the poor

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Speaker 1: and disabled, eliminates Obamacare's taxes on the wealthy, insurers, and others,

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Speaker 1: and would repeal Obamacare's mandate that most Americans have health insurance.

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Speaker 1: Here are reactions from Senate Majority Leader Mitch McConnell, Independent

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Speaker 1: Senator Bernie Sanders, and Republican Senator Rand Paul. We agreed

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Speaker 1: on the need to free Americans from Obamacare's mandates, and

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Speaker 1: policies contained in the discussion draft will repeal the individual mandate,

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Speaker 1: so Americans are no longer forced to buy insurance they

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Speaker 1: don't need or can't afford. This is barbaric, Frankly, this

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Speaker 1: is what oligarchy is all about. It's the wealthy and

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Speaker 1: powerful saying we need even more tax breaks despite the

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Speaker 1: fact they're doing phenomenally well, and if it means people

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Speaker 1: in America dying, if it needs throwing twenty three million

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Speaker 1: people off of health insurance. As we look at the

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Speaker 1: expense of the BILM, we actually believe in the first

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Speaker 1: year or two that it may well cost more than Obamacare.

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Speaker 1: The hardest hit are likely to be low income families

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Speaker 1: and seniors, but the bill will deliver tax cuts to

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Speaker 1: the wealthiest Americans. My guests are Timothy jaws To, professor

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Speaker 1: at Washington and Lee University Law School, and Abbey gluck Of,

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Speaker 1: professor at Yale University Law School. Tim what stands out

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Speaker 1: to you in this Senate healthcare bill, Well, I think

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Speaker 1: precisely what we've been hearing about for the last couple

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Speaker 1: of minutes, which is that it includes massive tax cuts

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Speaker 1: for wealthy Americans and for corporations, particularly people earning more

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Speaker 1: than a quarter of a million dollars a year. Uh,

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Speaker 1: it's going to cut back on federal support for the

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Speaker 1: Medicaid program and phase out coverage under the Medicaid expansions

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Speaker 1: in many states. And although it is a little bit

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Speaker 1: more generous arguably than the House bill with respect to

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Speaker 1: the premium tax credits for lower income people, UM, it

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Speaker 1: is going to um that the tax credits are going

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Speaker 1: to purchase only that will be key to plans with

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Speaker 1: very very high deductibles and cost sharing that will be

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Speaker 1: almost useless to low income people. And finally, it would

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Speaker 1: allow states to waive UM some of the most important

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Speaker 1: protections under the Affordable Care Act. So it is a

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Speaker 1: very serious step backward from the Affordable Care Act. Abby.

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Speaker 1: What's your take? Um, You know, enterprisingly, I agree agree

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Speaker 1: with much of what Tim said, but I would just

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Speaker 1: add to additional points. Uh. One point I would say

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Speaker 1: is that this bill does not actually do anything to

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Speaker 1: resolve what the Republicans said the problems with Obamacare were

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Speaker 1: in the first place. So they said they were coming

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Speaker 1: in to reduce out of pocket costs for consumers and

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Speaker 1: stabilize the insurance market. And this bill is almost certain

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Speaker 1: to do the opposite, worsen our out of pocket costs,

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Speaker 1: not to for the poor, very importantly for the average

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Speaker 1: middle class American, and also continue to be stabilized the

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Speaker 1: insurance market. And the other thing I would just point

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Speaker 1: out that people and some people understand, is that it's

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Speaker 1: sort of a joke to say that this is a

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Speaker 1: repeal of Obamacare, because although it guts the provisions of

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Speaker 1: Obamacare and is stingy and will wind up in a

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Speaker 1: much less a much less effective version of Obamacare, it

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Speaker 1: actually keeps in place some of the things that Obamacare initiated,

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Speaker 1: most particularly the reforms on the insurance industry that now

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Speaker 1: require insurers to ensure all of us are essentially equal prices.

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Speaker 1: So in some ways it's actually a testament to how

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Speaker 1: many people actually like some of the innovations of Obamacare,

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Speaker 1: and the Senate Republicans are trying to kind of have

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Speaker 1: it both ways, to try to keep the things that

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Speaker 1: are popular, but they also want to say they did

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Speaker 1: something different, and the result is a bill that's just

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Speaker 1: going to be the worst of every world. Tim what

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Speaker 1: if that older people in this this would allow insurers

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Speaker 1: to charge older people five times as much as younger people.

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Speaker 1: The limit now is times? How how many how do

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Speaker 1: you have an idea, how how many people that might affect? Well?

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Speaker 1: That is correct? The House bill UM I believe that

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Speaker 1: the Office of the Actuary of CMS said that it

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Speaker 1: would lead to about eight hundred thousand people over fifty

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Speaker 1: losing coverage, But it would also lead to many people

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Speaker 1: over fifty paining a whole lot more than their pain now.

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Speaker 1: The UH Senate Bill um UH modifies the formulas that

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Speaker 1: are currently used under the Affordable Care Act. Currently, a

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Speaker 1: person up to age sixty four who earns less than

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Speaker 1: fo in the poverty level has to spend the maximum

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Speaker 1: of well when they're up at that level, has to

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Speaker 1: spend a maximum about nine point five of their income

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Speaker 1: before they can get coverage through the premium tax credits.

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Speaker 1: The Senate bill would change that for so that people

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Speaker 1: page close to age sixty five would have to pay

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Speaker 1: sixteen and a half percent of their income. It almost

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Speaker 1: doubles it. Uh And frankly, that's just going to be

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Speaker 1: unaffordable for many older people. So the a r P

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Speaker 1: has been very exercised about this because it really is

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Speaker 1: going to be very bad news for older people. Might

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Speaker 1: make it a little bit more affordable for young people.

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Speaker 1: I've been talking to Timothy Johns, to professor at Washington

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Speaker 1: and Lee University Law School, and Abby Cluck, professor at

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Speaker 1: Yale University Law School about the Senate Republican Healthcare Bill Abbey.

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Speaker 1: Under the Senate bill, the federal government would continue paying

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Speaker 1: crucial subsidies to health insurance companies through Is that a

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Speaker 1: strategy to get through the mid terms without insurers dropping

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Speaker 1: out of the exchanges or hiking rates? Um? You know,

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Speaker 1: pop way, I think that it's important to break that

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Speaker 1: out a little bit. Um. For the last several years,

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Speaker 1: the House Representatives has been engaged in the lawsuit that

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Speaker 1: is attempting to stop these critical stabilization fund city insurance industry,

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Speaker 1: and that is contributed to the destabilization of the insurance markets.

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Speaker 1: What you have in this bill is sort of UH

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Speaker 1: an olive branch or are arrived in the insurance industry

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Speaker 1: to say, past this bill the way we've written it,

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Speaker 1: because we're including those crucial subsidies to the industry now,

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Speaker 1: but it doesn't solve the bigger problem of distabilization of

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Speaker 1: the insurance exchange. Is one thing this bill is missing

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Speaker 1: is an incentive for individuals to go out and get insured.

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Speaker 1: And the insurance markets need more customers out there to

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Speaker 1: be able to sort of stabilize to move out the rates.

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Speaker 1: They need young healthy people on the exchanges. That was

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Speaker 1: effectuated under the Affordable Care Act by the UH, widely

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Speaker 1: hated by the Republicans insurance purchase mandate. And while this

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Speaker 1: bill gets rid of that, it doesn't put anything in

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Speaker 1: its place. So on the one hand, insurers might be

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Speaker 1: temporarily happy, but on the other hand, I can't see

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Speaker 1: the insurance industry feeling very confident about the content of

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Speaker 1: this bill. Tim. Now let's talk about whether it's going

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Speaker 1: to pass or not. McConnell says he wants a vote

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Speaker 1: on the bill next week. There are four Republican senators

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Speaker 1: who said in a joint statement they weren't ready to

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Speaker 1: vote on the bill, but and there are other senators

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Speaker 1: who have said they're unsure of of certain provisions. So

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Speaker 1: is it likely to pass, um boy. I'm a law professor,

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Speaker 1: not a someone who can prognosee that, UM the I

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Speaker 1: think it is. I'm not sure it's going to pass

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Speaker 1: by June, which is the last date for the July

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Speaker 1: fourth recess and the target date that Senator McConnell has

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Speaker 1: been working on. UM. But I think that the four

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Speaker 1: whom you noted are going to try very hard to

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Speaker 1: move this bill to the right. The moderates are expressing

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Speaker 1: concerns but seem a little softer. I think it's quite

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Speaker 1: possible that the bill will be pulled before the the

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Speaker 1: June thirtie vote. But I am pretty confident it's going

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Speaker 1: to be back next month, and I think it's quite

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Speaker 1: likely it'll pass by the end of the month because

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Speaker 1: they really have to do something. I mean, they've been

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Speaker 1: promising this for years and years, and I just don't

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Speaker 1: see how they can go back to their constituency without

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Speaker 1: doing something to say that they have in some way

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Speaker 1: repealed the Affordable Care Act. Have you what are your thoughts? Um?

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Speaker 1: I think that uh him is right that the chances

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Speaker 1: are probably better that that the bill will pass and

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Speaker 1: that it won't pass. But I do think that there's

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Speaker 1: a big uh marketing problem again by the Democrat to

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Speaker 1: respect to this bill. Just like when the Affordable Chaik

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Speaker 1: was rolled out, the Democrats did a really lousy job

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Speaker 1: of blaming the American public what was in the bill

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Speaker 1: and why they should support it. I think people really

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Speaker 1: don't understand within this bill. I think a lot of

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Speaker 1: people out there think this is a medicaid bill. Poor

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Speaker 1: people are going to have their health benefits cut back.

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Speaker 1: Some people don't want the government's helping poor people. But

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Speaker 1: I don't think the message has really gotten out there

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Speaker 1: about how this is going to help people who aren't

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Speaker 1: at the lowest levels of poverty, how this isn't going

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Speaker 1: to this really going to hurt the middle class. And

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Speaker 1: I think that the Democrats have a lot of work

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Speaker 1: to do to sort of start making clear the bill's

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Speaker 1: effect on the average American. I think if they can

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Speaker 1: do that, um, they have a better chance of holding

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Speaker 1: it up. I think him is right through under pressure

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Speaker 1: to appeal and replace. But to what ends, you know,

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Speaker 1: have have they shown us anything to show that this

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Speaker 1: bill is going to improve healthcare quality, is going to

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Speaker 1: reduce costs? At this point, we have no evidence at all,

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Speaker 1: and this is something worth doing, and their Democrats really

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Speaker 1: have to get their message out there tim more than

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Speaker 1: Chuck Schumer's saying mean er. Will we really learn more

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Speaker 1: when the congret Congressional Budget Office releases a score next week. Yeah,

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Speaker 1: I'm sure that we will. My guess is that the

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Speaker 1: it's going to come in on target with what they've

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Speaker 1: been trying to do in terms of deficit reduction because

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Speaker 1: they have to get there to get it through the

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Speaker 1: Senate UM, with the with the budget reconciliation rules, uh,

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Speaker 1: and that it The CBO will probably score it as

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Speaker 1: knocking fewer people off of health coverage because it is

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Speaker 1: a little bit more generous for lower income people and

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Speaker 1: people who live in high cost areas, and doesn't cut

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Speaker 1: Medicaid quite as quickly, although it cuts it more dramatically

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Speaker 1: in the long run. But how much how much better

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Speaker 1: it's going to look? I don't know. And again, as

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Speaker 1: Abbey has said, um, people who do get coverage are

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Speaker 1: going to get such skimpy coverage that will be virtually

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Speaker 1: useless to them. About thirty seconds, Abbey, do the Democrats

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Speaker 1: in a short amount of time, if the bill gets

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Speaker 1: voted on next week, have enough time to get the

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Speaker 1: message out to middle class people. Um, you know, that's

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Speaker 1: up to them. I think that this hasn't been a

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Speaker 1: lot of distractions with Russia and everything that's going on

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Speaker 1: with Trump, He's very good at that. They've got to

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Speaker 1: get out there. They have to pound the pavement. The

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Speaker 1: first time to still was before the House in March.

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Speaker 1: I think there was a very effective effort to generate

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Speaker 1: public outrage about the bill. We kind of let our

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Speaker 1: guard down in May the House bill got through, and

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Speaker 1: the Demnocrats really have to wake up and get out

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Speaker 1: there and start yelling at the top of their lungs

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Speaker 1: about how this is going to affect you, You who

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Speaker 1: makes a hundred thousand dollars a year, how we're going

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Speaker 1: to affect you. Have to leave it at that. Thank you.

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Speaker 1: Abby Gluck of Yale University Law School and Timothy just

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Speaker 1: of Washington and Lead University law school coming up. Mayor

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Speaker 1: Dublasio's plan to close down Rikers Island jail. I'm jun Grosso.

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Speaker 1: You're listening to Bloomberg Law. This is Bloomberg