AILSA CHANG, HOST:
There's been a lot of unexpected news in Washington lately. That includes the fact that Republicans now appear to have a real chance at repealing the Affordable Care Act. That's in large part because of South Carolina Senator Lindsey Graham. He's promoting a measure built around block grants. Those grants would get rid of a lot of federal mandates and instead turn money directly over to states.
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LINDSEY GRAHAM: So I believe that most Republicans like the idea of state-controlled health care - versus Washington, D.C.-controlled health care.
CHANG: Something else that's unexpected is a key figure who's behind this push. NPR's Scott Detrow explains.
SCOTT DETROW, BYLINE: Last week, Lindsey Graham walked up to a lectern to talk about health care and introduced several other Republican senators.
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GRAHAM: Bill Cassidy's going to walk you through the details. Rick Santorum's going to tell you how history's on our side. Ron Johnson's going to talk about numbers 'cause that what he does (laughter). And Dean Heller's going to tell you about why this is a good deal for Nevada and the country as a whole.
DETROW: All the names made sense except one. Rick Santorum hasn't been a United States senator for more than a decade. The one-time Pennsylvania senator was the runner up to Mitt Romney in the 2012 Republican presidential primaries but didn't get out of Iowa in 2016. But there he was, standing with four current GOP lawmakers and jumping in to answer questions.
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RICK SANTORUM: I'm going to just - because Bill gave a great answer. He gave an answer that I would give. But I'm not too sure he specifically answered your question so you would understand it.
DETROW: That's because Santorum is the one who came up with the idea to begin with. The latest bill is loosely based on a major welfare overhaul Santorum helped draft back in 1996. He said both measures come down to the same basic idea.
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SANTORUM: And that is get the money out of Washington. Give it to the 50 states. Give them the flexibility to design the program. And let them treat the population that the money is designated for in a way that meets the needs of the people sitting across the table from them, not, as Lindsey said, with bureaucracies.
DETROW: Maybe none of this would be happening if Santorum hadn't bumped into Graham in the Capitol barber shop this spring.
SANTORUM: And Lindsey was in the chair. And Lindsey said - he asked me what I was doing. And I thought to myself, well, let me bounce it off Lindsey.
DETROW: It was the early stages of the block-grant approach, which Santorum had been talking about with House Republicans. Graham and Santorum got to talking. And the two presidential also-rans were on the same page. Santorum says during his time in Washington, haircuts had never been this productive.
SANTORUM: (Laughter) It might be a first.
DETROW: Here's a little bit about what the bill would do. It would loosen a lot of the federal requirements tied to Obamacare and turn a lot of federal funding for subsidies and Medicaid into those block grants to states. There would be less money going to states than is currently projected to be spent. And many states would see a big shift in the amount of money they're receiving.
Obamacare defenders worry all this would lead to unstable markets and not a whole lot of protection for people with expensive medical conditions. With this bill, Santorum is back in the mix in Washington, enough that, for a brief moment, someone recently floated the idea that maybe Santorum could step in as House speaker if conservatives revolt against Paul Ryan. Santorum says he's not interested, but he didn't quite laugh it off as farfetched.
SANTORUM: I think that came about because we're putting together a plan here in health care that people were looking at and, said, you know, gee, why couldn't our leadership do something like that?
DETROW: Today, Santorum was back in the Capitol, pitching Senate Republicans on this bill, which now appears to have a shot at passing. Scott Detrow, NPR News.
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