RACHEL MARTIN, HOST:
Missouri Democratic Senator Claire McCaskill doesn't hold back when it comes to what she calls Trumpcare. Quote, "a disaster for Missouri," it says on the senator's home page. McCaskill sits on one of the Senate committees that must approve the bill in order for it to reach the floor. She joins us now to talk about the Republican plan to replace the Affordable Care Act. Thanks so much for being with us, senator.
CLAIRE MCCASKILL: Thank you.
MARTIN: Let's start with the CBO numbers. They say that the plan that House Republicans have put forward would cut the federal budget deficit by $337 billion over the next 10 years, also estimates 24 million fewer Americans will be insured in the next decade. What do those numbers tell you?
MCCASKILL: Well, it tells me the size of the massive cut that's going to occur in health care in this country for people who really need it. Keep in mind, there is a huge tax - a tax cut in here for wealthy people. So if you factor that in, the fact that it still saves 337 billion tells you that there's almost a trillion dollars in health care cuts in Medicare and Medicaid programs in this bill.
MARTIN: Republicans argue that the CBO figures for Obamacare were way off. They're raising questions about this CBO report. Why do you accept this assessment?
MCCASKILL: Well, the CBO report was way off in only one respect, and that was how many people were going to be insured. And they made an assumption that I think was a reasonable assumption at the time, that the states would all expand Medicaid to take advantage of the additional funding that was embedded in Obamacare for Medicaid programs in every state in the country. The majority of the states or almost half of the states did not expand Medicaid. So that is why that number ended up being so low. It wasn't because their calculations were off. It was because the Republicans decided to use the health care bill as a political weapon rather than applying it to help the people in their states.
MARTIN: So let's talk about the House Republican plan. It argues that they are giving more power, empowering states to make their own choices when it comes to health care using block grants, and that that fits local needs. What do you say to that?
MCCASKILL: That's fancy talk for a big cut. You know, it's one thing to give states flexibility. States can apply for waivers now. Many states have gotten waivers to do their own kinds of plans, such as Vice President Pence in Indiana when he expanded Medicaid. So this is just a way to dress up the facts of this bill. It is going to be much more expensive for older people to get insurance. It is going to cut health care for the most vulnerable in our country.
And keep in mind, these people are still going to show up at the emergency rooms. So we're still going to pay these bills, but these bills are going to be on everyone's insurance premiums instead of having some money from the federal government to help with this really serious policy problem.
MARTIN: Let's say the Republican plan goes nowhere. No one argues that Obamacare is perfect by any stretch. So if Obamacare continues to be the law of the land, what would you change to make it better?
MCCASKILL: Well, I think we could do some things around the individual markets. I think we could do some things around the mandate, maybe move to a automatic re-enrollment program. I think we could address some of the high copays and deductibles by maybe adjusting, having more catastrophic programs so that people are not required to buy as full a policy in every instance. There's a long list of things that we all have been able to - been willing to work on.
The problem is that the Republicans were more interested in using Obamacare as a political two-by-four with the very catchy phrase repeal and replace. That now has - that chicken has come home to roost, and they're having a great deal of difficulty with the repeal and especially the replace part.
MARTIN: Senator Claire McCaskill, Democrat of Missouri, thanks so much for talking with us.
MCCASKILL: Thank you.
MARTIN: NPR News invited White House officials and House Speaker Paul Ryan to take questions about the bill, and the invitation is still open. Transcript provided by NPR, Copyright NPR.