Senate Health Bill Favors Elderly Over Poor: Charts | Morning Joe

DO DOESN'T GET DONE.DONE. WE'RE BEHIND A VERY AMBITIOUS
SCHEDULE SET BY PAUL RYAN. >> SHOWING PROJECTIONS OF THE
HEALTH CARE SENATE BILL AND STEVE HAS CHARTS ON THAT.
TAKE IT AWAY. >> I'LL TAKE IT AWAY.
IT'S IMPORTANT TO LOOK BEYOND THE FIRST TEN YEARS.
WE'VE ALL FOCUSED ON THIS TEN-YEAR WINDOW BUT WHEN YOU SEE
WHAT GOES ON IN THE LONGER TERM --
>> TEN-YEAR WINDOW ON THE CBO CHART?
>> IN GENERAL ALL THE SCORING AND THE DISCUSSIONS ABOUT THE
NEXT TEN YEARS. >> SUMMARIZE QUICKLY THE FIRST
TEN YEARS JUST FOR OUR VIEWERS THAT AREN'T AS FAMILIAR.
WHAT DOES THE FIRST TEN YEARS SHOW?
>> BASICALLY SHOWS A BUNCH OF REPEAL OF OBAMACARE TAXES IN
ORDER TO FUND THE REDUCTION OF BENEFITS FOR MEDICARE AND FOR
PEOPLE BUYING INSURANCE ON THE SUBSIDIES AND IT'S ESSENTIALLY
BUDGET NEUTRAL. IT MIGHT CREATE A LITTLE BIT OF
A BUDGET SURPLUS BUT IT'S TAKING AWAY FROM THE AFFLUENT, THEIR
TAX BREAKS, GIVING IT MORE TO THE POOR FOR THEIR HEALTH CARE.
>> OKAY. >> SO WHAT HAPPENS AFTER THAT IS
ACTUALLY QUITE INTERESTING, BECAUSE WHAT'S REALLY BECOME
CLEAR IS THAT THE REPUBLICAN PLAN FAVORS THE OLD OVER THE
POOR, SO IF YOU LOOK DOWN HERE IN THE RED LINES YOU CAN SEE
MEDICAID AND WHAT HAPPENS TO MEDICAID.
MEDICAID WAS PROJECTED TO GROW FROM ABOUT 2% OF GDP AT THE
PRESENT TO 2.7%, BUT THE REPUBLICAN PLAN WOULD TAKE IT
DOWN TO 1.4%. MEANWHILE, MEDICARE, WHICH IS
MORE EXPENSIVE PROGRAM AND IS CURRENTLY IN THE 3% RANGE, WOULD
ACTUALLY GROW ALL THE WAY UP HERE TO THE 5% RANGE, 6% RANGE
OVER THE SAME PERIOD OF TIME. AND AS YOU KNOW, DONALD TRUMP
HAS PROMISED TO DO NOTHING TO MEDICARE, SO THEREFORE, YOU HAVE
A CHASE WHERE MEDICARE IS GOING TO RISE SHARPLY.
MEDICAID IS GOING TO -- >> ALSO HE CONFLATED MAYBE
BECAUSE HE DIDN'T KNOW THE DIFFERENCE AT THE TIME AND ALSO
SAID HE WASN'T GOING TO DO ANYTHING TO MEDICAID.
THAT'S IMPORTANT. HE WASN'T GOING TO TOUCH
MEDICAID. >> NOW LOOK WHAT HE'S DOING TO
MEDICAID. HE HAS SAID THAT, BUT THE
REPUBLICANS SORT OF TOOK THE BALL AND SAID WE'RE GOING TO GO
AFTER MEDICAID. >> IF YOU LOOK AT THE LINES,
FRANK, CONSERVATIVES WHO ACTUALLY HAVE COURAGE HAVE BEEN
TALKING ABOUT HOW MEDICAID, MEDICARE AND SOCIAL SECURITY
TOGETHER WERE GOING TO BANKRUPT THIS COUNTRY OVER THE PAST 20
YEARS. ALSO A LOT OF DEMOCRATIC CEOs, A
LOT OF DEMOCRATIC THINK TANKS AGREE, AND SO HERE YOU HAVE THE
REPUBLICAN PLAN THAT TAKES CARE OF ONE OUT OF THOSE THREE, BUT
COINCIDENTALLY, THE ONE THAT THEY ATTACK TAKES CARE OF THE
POOR. >> BUT THEY'RE ALSO WORKING WITH
THE PRESIDENT WHO DURING HIS CAMPAIGN AND THIS IS ONE OF HIS
MANY POINTS OF TENSION WITH THE REPUBLICAN PARTY WAS SAYING HE
WASN'T GOING TO TOUCH ANY OF THAT.
I DON'T THINK THEY KNOW HOW TO GO FORWARD WITH HIM IN MANY
RESPECTS BECAUSE THIS IS ALSO A PRESIDENT WHO IS SO
INCONSISTENT, PRAISED THE HOUSE BILL AND TURNED AROUND AND SAID
IT WAS MEAN, SAID THAT REPEAL AND REPLACE HAD TO BE DONE AT
THE SAME TIME AND THEN TWEETED NO, MAYBE WE'LL SEPARATE THEM.
I DON'T KNOW HOW YOU MOVE FORWARD COHERENTLY AND
EFFECTIVELY WHEN THE PERSON AT THE VERY TOP KEEPS GIVING YOU
SUCH MIXED MESSAGES. >> BOB COSTA, YOU CAN'T GET
ANYBODY TO TALK ABOUT THE ISSUES THAT REALLY MATTER ON LONG-TERM
DEBT IN AMERICA, AND THAT IS FIGURING OUT HOW TO SAVE
MEDICARE AND SOCIAL SECURITY. THEY'VE GOT THE MEDICAID PART
DOWN BUT YOU KNOW, MAYBE YOU'VE
GOT A HANDFUL OF TRUE BELIEVERS IN THE HOUSE AND MAYBE ONE OR
TWO IN THE SENATE BUT NOBODY ELSE IS TALKING ABOUT THE
PROGRAM THAT'S EXPLODING THE MOST AND THAT'S MEDICARE.
>> NO ONE'S TALKING ABOUT IT. IT REMAINS A POLITICAL THIRD
RAIL. HOUSE REPUBLICANS INCLUDING
HOUSE SPEAKER PAUL RYAN DO WANT TO TACKLE ENTITLEMENT REFORM,
BUT FOR NOW THEY'RE JUST REALLY GOING AFTER THIS MEDICAID
EXPANSION UNDER THE AFFORDABLE CARE ACT.
FOR THE GOP WE'RE GOING TO HEAR ABOUT MITCH McCONNELL, WHETHER
HE HAS THE VOTES IN THE SENATE BUT THE REALITY IS THAT THIS LAW
HAS TAKEN ROOT IN MANY OF THESE STATES, MANY REPUBLICAN
GOVERNORS, REPUBLICAN LEADERS IN THE STATES ACROSS THE COUNTRY
ARE COUNTING ON THE MEDICAID EXPANSION.
REGARDLESS OF ANYTHING McCONNELL COULD DO TO TWIST ARMS, THAT
REALITY MAKES IT VERY DIFFICULT TO PASS THIS BILL.
>> IT WILL DEVASTATE THE BUDGET. YOU GET RID OF A MEDICAID EXPAN
MEANS A LOT OF GOVERNORS AND REPUBLICAN STATES ARE GOING TO
BE SCRAMBLING TO MAKE MASSIVE CUTS.
>> I MEAN, THAT'S WHY YOU SEE REPUBLICAN SENATORS AND
REPUBLICAN GOVERNORS REALLY PUSHING BACK ON THAT.
THEY UNDERSTAND THAT MEDICAID IS NOT JUST FUNDING PEOPLE'S TRIPS
TO THE DOCTORS, BUT YOU PUT UP THAT CHART TALKING ABOUT OLD
VERSUS POOR, THE PEOPLE THAT ARE BENEFITING FROM MEDICAID ARE
ALSO OLD POOR PEOPLE, SO YOU THINK ABOUT THE NURSING HOMES
THAT ARE GOING TO BE KEPT OPEN IN OHIO OR MICHIGAN, MY TRIPS
I'VE GONE TO MISSISSIPPI WHERE PEOPLE ARE SAYING THAT IS A
CENTRAL PART OF HOW OLDER POOR PEOPLE GET THERE TO GET THEIR
HEALTH INSURANCE, SO THIS IS A THING THAT REPUBLICANS KNOW IS A
BIG PROBLEM AND AS FRANK SAID, "THE NEW YORK TIMES" HAS PUT OUT
A PRETTY COMPREHENSIVE LOOK WHO IS HIDING FROM THIS, HIDING FROM
THEIR CONSTITUENTS BECAUSE THEY UNDERSTAND PEOPLE UNDERSTAND
THIS SO WELL. >> ALL RIGHT, LET'S PUT SOME
FLESH AROUND WHAT IS THE POINT, AND LOOK AT WHAT'S GOING TO
HAPPEN TO MEDICAID UNDER THE REPUBLICAN PROPOSAL AND HOW MUCH
THE CUTS WOULD BE. THIS IS ALL RELATIVE TO WHAT
OTHERWISE WOULD BE SPENT, WE CAN HAVE THAT DEBATE.
NEW ANALYSIS THAT JUST CAME OUT, AND IF YOU GO TO 2036, EXCUSE
ME, YOU CAN SEE WHAT HAPPENS TO EACH OF THESE DIFFERENT GROUPS.
IT'S IMPORTANT TO REMEMBER MEDICAID IS NOT JUST WOMEN, POOR
WOMEN, IT COVERS A WHOLE RANGE OF THINGS.
64% OF NURSING HOME BILLS ARE PAID BY MEDICAID, 50% OF ALL
CHILD BIRTHS ARE PAID BY MEDICAID.
24% OF AMERICANS ARE ON MEDICAID, SO WHAT YOU CAN SEE
WHAT HAPPENED UNDER THIS BILL IS THE EXPANSION ADULTS, THOSE
GETTING MEDICAID FROM THE AFFORDABLE CARE ACT, THESE ARE
NOT THE POOREST AMERICANS, BETWEEN 100% OF THE POVERTY LINE
AND 400% OF THE POVERTY LINE, THEY ARE GOING TO LOSE 53% OF
THEIR BENEFITS AND IF YOU GO UP FURTHER INTO OTHER ADULTS,
CHILDREN, AGED, NURSING HOME PHENOMENON, AND DISABLED, YOU
CAN SEE THE NUMBERS ARE NOT QUITE AS LARGE, BUT STILL VERY
LARGE. AND THESE PEOPLE AS ELUDED TO
GET REIMBURSED FOR A LOT OF SERVICES THAT MEDICARE DOES NOT
COVER AND THAT THEY NEED IN ORDER TO HAVE A REASONABLE
STANDARD OF LIVING. >> LET ME ASK BOB COSTA, WE HEAR
FROM A LOT OF REPUBLICANS THAT THERE AREN'T ANY MEDICAID CUTS.
IT'S A TALKING POINT. PEOPLE THAT I'M A HUGE POLITICAL
FAN OF WILL GO OUT AND SAY, NO, THERE ARE NO MEDICAID CUTS.
WHAT AM I MISSING? >> I'D LIKE TO GET STEVE'S
ANSWER TO THIS QUESTION, BECAUSE THIS IS WHAT REPUBLICANS ARE
TALKING ABOUT. THEY WANT TO ROLL BACK THE
MEDICAID EXPANSION UNDER THE AFFORDABLE CARE ACT AND IN PLACE
OF THAT EXPANSION PUT IN A GUARANTEE, THIS IS THE WAY THE
BILL MAY PASS, A GUARANTEE THAT IF MEDICAID COSTS RISE, THE
FUNDING WILL RISE, ALONG WITH THE COST OF MEDICAL INFLATION.
IS THAT -- WHAT'S THAT DO TO THE MEDICAID POPULATION, STEVE, FROM
YOUR ANALYSIS IF THEY DO THAT? >> YOU STILL WOULD NOT BE ABLE
TO MEET THE NEEDS OF THE MEDICAID RECIPIENTS, BECAUSE THE
NUMBER OF RECIPIENTS IS ALSO GROWING, SO SIMPLY RAISING IT BY
THE AMOUNT OF MONEY FROM THE EXISTING POOL AND THAT MAY NOT
BE ENOUGH, ISN'T GOING TO DO IT. IT'S SIMPLY ANOTHER WAY, AND, IN
FACT, SOME OF THOSE NUMBERS ARE IN WHAT I SHOWED YOU, IT'S
ANOTHER WAY TO CUT MEDICAID. LOOK, I WILL BE THE FIRST TO
ADMIT THAT MEDICAID IS A VERY, VERY FAST BURNING PROGRAM AND
PROBABLY ONE THAT WOULD BENEFIT FROM A TOUGHER LOOK AT SOME OF
THE WAYS IT'S DELIVERED. IT MAY WELL BE COST SAVINGS, BUT
SIMPLY TAKING A BATTLE AX AND SAYING WE'RE GOING TO CUT 53%.
>> YOU HAVE BEEN PART OF THE GROUP THAT SAID, I THINK
RESPONSIBLY, WE'VE GOT TO LOOK AT MEDICAID, MEDICARE, SOCIAL
SECURITY, AND, YOU KNOW, A LOT OF PEOPLE, RESPONSIBLE PEOPLE ON
BOTH SIDES OF THE POLITICAL DIVIDE, UNDERSTAND ENTITLEMENTS
NEED TO BE TAKEN CARE OF. THIS IS JUST A DISPROPORTIONATE
WHACK AT ONE OF THOSE THREE AND IT HAPPENS TO BE THE ONE FOR THE
POOR. >> EXACTLY.
I TALK TO A LOT OF THINK TANKS AND EXPERTS ON BOTH SIDES OF THE
AISLE HERE IN D.C. AND THEY ALL AGREE SOMETHING NEEDS TO BE
DONE. THE PROBLEM IS THAT PRESIDENT
TRUMP IS REALLY KIND OF BOXED HIMSELF IN IN PROMISING OVER AND
OVER AGAIN THAT HE WASN'T GOING TO TOUCH SRS AND MEDICARE AND
NOW MEDICAID. NOW WE HAVE THE ADMINISTRATION
SAYING MEDICAID, THE WAY WE'RE TOUCHING IT IS DIFFERENT THAN
THE CAMPAIGN TRAIL AND THEN WHEN THEY ARE CUTTING SOCIAL SECURITY
DISABILITY, WHICH IS PART OF SOCIAL SECURITY GIVEN BY ITS
NAME, THE BUDGET DIRECTORS SAY THAT'S NOT ACTUALLY SOCIAL
SECURITY, THAT'S SOMETHING DIFFERENT, TOO.
SO THEY ARE TRYING TO KEEP PROMISES TO THE BASE THAT MADE
DONALD TRUMP POPULAR AND REALLY, FRANKLY, MADE HIM POPULAR AMONG
PEOPLE WHO WERE EITHER DEMOCRATS BECAUSE HE WAS RUNNING ON ISSUES
TO THE LEFT OF HILLARY CLINTON SAYING HILLARY CLINTON WAS GOING
TO BE THE ONE TO TAKE AWAY HEALTH CARE, TELLING PEOPLE
HILLARY CLINTON WAS GOING TO TAKE AWAY ENTITLEMENT PROGRAMS
AND NOW THAT HE'S IN OFFICE, HE UNDERSTANDS HE HAS A PRESSURE TO
KEEP THAT PROMISE, BUT IT'S FISCALLY IRRESPONSIBLE, PEOPLE
AGREE, TO NOT DO ANYTHING ABOUT THE OTHER TWO PROGRAMS THAT ONLY
TOUCH MEDICAID. >> STEVE, THAT GRAPHIC IS REALLY
PERFECT AS HOW DIFFICULT IT IS TO REDUCE OUTLAYS FROM THE THREE
MAJOR ENTITLEMENT PROGRAMS. AS YOU SAY, IT'S A NECESSARY
EVIL, BUT WE HAVE TO DEAL WITH IT EVENTUALLY.
BUT WE DON'T WANT TO USE THE BATTLE AX.
THE BATTLE AX IS NOT FAR OFF. ONE OF THE IDEAS CIRCULATING
OVER THE WEEKEND, MAYBE WE HAVE TO PASS A REPEAL OF OBAMACARE
AND LET IT SIT THERE FOR A YEAR, BECAUSE NOBODY WILL EVER LET
THAT HAPPEN, RIGHT? IT'S TOO INSANELY STUPID, YET
I'M REMINDED OF THE BUDGET CONTROL ACT AND SEQUESTER, WHICH
WAS DESIGNED TO BE REALLY STUPID.
NOBODY WOULD LET THAT HAPPEN, YET IT HAPPENED.
WE'RE INCHING TOWARDS THE BATTLE AX, WHETHER WE LIKE IT OR NOT.
>> THAT WHOLE IDEA IS STUPID AS YOU IMPLY.
>> BUT POSSIBLE. >> BUT POSSIBLE.
REMEMBER, WE ARE FACING ANOTHER OVERARCHING BUDGET PROBLEM, THE
CBO LAST WEEK RAISED THE ESTIMATE OF THE DEFICIT BY $135
MILLION, SOMETHING LIKE THAT, RAISED THE OUT YEAR DEFICITS AND
WE'RE BASICALLY IN A POSITION WHERE BECAUSE OF ENTITLEMENTS,
OUR DEFICIT IS GOING TO GROW AND GROW AND GROW.
WE HAVEN'T REALLY WRAPPED THAT INTO THIS CONVERSATION, BUT
DEALING WITH THAT IS A BIG PART OF IT.
>> SUM IT ALL UP IN 15 SECONDS. >> KIND OF HARD TO DO.
>> INTERESTINGLY, THE REPUBLICANS HAVE LOST THE
MESSAGING WAR HERE AND CONVERSATION.
THERE'S AN IMPORTANT CONVERSATION TO BE HAD ABOUT
WHAT THE GOVERNMENT CAN AND CAN'T AFFORD AND BECAUSE OF THE
CLUMSY WAY IN WHICH HEALTH CARE HAS BEEN PRESSED FORWARD, THE

Senate Health Bill Favors Elderly Over Poor: Charts | Morning Joe | MSNBC

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