STEVE INSKEEP, HOST:
Oklahoma Congressman Tom Cole is on the line. He's a member of the House Republican leadership team. He's a deputy whip, which means his job is to help round up votes as Republicans are trying to do again today for a repeal and replacement of the Affordable Care Act.
Congressman, welcome back to the program.
TOM COLE: Hey. Great to be with you.
INSKEEP: How would you describe the state of play? Would you say you do have the votes or you hope you will have the votes later today or what?
COLE: I think we have the votes. Again, you never know you have them until you actually schedule the vote and hold it because some of these guys are pretty adroit and fairly slippery.
(LAUGHTER)
COLE: But we think we've got all the fish in the bucket, so we'll see.
INSKEEP: Aren't you actually making some of the calls yourself? I mean...
COLE: Oh, yeah. I've been working very hard, like all the other, you know, people involved in the whip operation. So I feel certainly good about the people I've talked to, and I trust the people that are actually doing the count.
INSKEEP: OK. So people are saying to you things like, I'm with you but maybe not I will be with you. Like, you're not entirely sure of some of them? Or...
COLE: Oh, there's always a few like that. But, you know, we're pretty sure.
INSKEEP: OK.
COLE: Again, people know this is an important moment. And the last thing you want to do at a time like that is to mislead other people. I mean, yes is yes. No is no. That's fair. But, you know, don't play games this late in the game. And that has consequences for you down the line. So again, actually, in the end of the day, most people are pretty honest.
INSKEEP: OK. And of course I'm talking about this because there was an effort to vote on this before. And in the end, it had to be pulled back.
Let me ask you about the bill in the form you're going to vote on, Congressman. There is a provision, as some people will know, which allows states to opt out of some of the provisions of Obamacare, the Affordable Care Act. There are provisions that were quite popular. There are essential benefits that are required in insurance plans. There is protection for people with pre-existing conditions. Now you have a bill that would allow states to opt out of those protections. Why do that?
COLE: Well, first of all, it - we think it's basic federalism. We think people in Oklahoma probably make better decisions for Oklahomans than people in Washington, D.C. - same in California, same in New York. Second, this particular provision, you know, can't be exercised for several years. In other words, you have to build up the risk pool.
But at the end of the day, you know, you either trust your governor and your state legislature or you don't. In my case, I do. And it's far easier, if they make an error, for people to frankly correct them and - or fire them if they need to, than it is to deal with a sort of faceless, federal bureaucracy that's in many cases thousands of miles away.
INSKEEP: Although you're going to ask your members to make a vote to say I'm going to remove essential benefits - that's how this is going to be framed.
COLE: Well, it will be framed that way probably by critics. But that's really not the case. They're making a vote to say, I'd rather have people in my neighborhood, in my state make this decision than somebody else. And I think at the end of the day, it's very unlikely that any governor of any state will remove the pre-existing conditions clause. And if they do, the people in that state can correct it pretty quickly. And there's all sorts of very stringent conditions that they would have to meet before they could apply for the waiver. And again, remember, they have to apply for the waiver. The waiver has to be approved. So I think it's the appropriate thing to do. But it's not as if there's not a lot of safeguards there.
INSKEEP: Let me ask about another thing, Congressman. The last time you tried to vote on this, the Congressional Budget Office did an analysis of the bill and found - among other things - that, over time, something like 24 million people would lose or drop their insurance coverage, would no longer find it to be worth it to them or affordable. This time, there's not a Congressional Budget Office scoring at all. Why not wait to allow one?
COLE: Well, I think, number one, we look at this as a fairly - we have a score. We think if this does anything, it probably improves things. But remember, you know, we're again in a very complex federal system. This thing is going to go to the United States Senate. It's going to change, in my view, in the United States Senate in some way. Then we have to have a Congress - a conference to work out the differences. If we can do that, then it has to still pass the House and the Senate again before it ever gets to the president. So, you know, at some point, you just have to move. And we think this is it and that this will create some momentum. Again, I'm interested to see what our friends in the Senate will do in response.
INSKEEP: Kind of awkward to do that, though, isn't it, Congressman? Telling your members, pass this bill, which is unpopular - or many provisions are going to be unpopular - and it's just not going to be law in that form anyway.
COLE: Well, no, actually I don't think - they're pretty sophisticated about knowing how things work. And this is not a hard bill to grasp. This is not like Obamacare, which was 2,400 pages long. This bill is 113 or '14 pages - or '17, I think, the last time I looked. And these amendments are, you know, less than a page apiece. So they're not hard to understand or comprehend.
And in my case, this is certainly better than what we've got today. Look, I live in a state where we're down to a single provider who's losing money. We have a 69 percent rate increase coming for people that don't have - aren't subsidized in the pool. And finally, because we're not a Medicaid expansion state, you know, we've got hospitals taking care of classes of patients that in other places they get compensated for - not here. So...
INSKEEP: Congressman, got to stop you there.
COLE: You bet.
INSKEEP: But thank you very much. Really appreciate it.
COLE: Thank you.
INSKEEP: Tom Cole of Oklahoma. Transcript provided by NPR, Copyright NPR.