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Self-Imposed GOP Deadline Looms To Vote On Health Care Bill


We are nearing the Fourth of July, which means we are nearing a deadline that Senate Republicans imposed on themselves. They want a vote by then on a replacement for the Affordable Care Act, which has already passed the House. In a heated political atmosphere, Republicans are drafting their version of the bill in secret, without public hearings or input. Even some Republican senators have said they dislike this process, although they have not acted to change it. We've called Republican Congressman Leonard Lance of New Jersey, who's been watching from the sidelines. He voted against the House version of the bill and now waits to see what happens next. Congressman, good morning.

LEONARD LANCE: Good morning to you, Steve.

INSKEEP: You're watching the Senate process - or shut out of the Senate process, I guess, I should say. Should legislation be drafted this way?

LANCE: I would prefer that it not be drafted this way. And I hope that there is sufficient time to review any proposal that comes from the Senate Republicans.

INSKEEP: Although there's - let's be frank, I mean, if they keep to the schedule, if they keep with the way the Senate leadership says they're doing it, there's not going to be.

LANCE: There'll be very little time. But certainly, I think there should be as much time as possible. And there's a whole history to this. And while there were deliberations in 2009 or 2010 regarding the original Affordable Care Act, many provisions that resulted in that law were written privately as well. And I don't think that we should replicate that process.

INSKEEP: I think that's a fair point to bring up. Although, one is reminded that in 2009, House Democrats, who were in charge, came up with a bill, held a dozen hearings on it, discussed it some more, held several more hearings, once held a three-day committee hearing. President Obama was involved in a large, public, televised meeting with Republicans. There were a lot of discussions of a very complicated issue. You're saying it was still not nearly enough. And here we are in a situation doing, actually, none of that.

LANCE: I agree that we should have a better process. And I didn't like the House version. I don't think that it will lower premiums for working Americans. And also, I want to make sure that nobody is denied coverage based upon a preexisting condition.

INSKEEP: I'm glad you mentioned the House version. And we'll remind people you voted against that. There was one provision of the House bill that people said, don't worry about it; the Senate is going to fix that - because the Senate will do its own version of the legislation. And this is a provision having to do with insurance subsidies who buy insurance on these Obamacare exchanges. People, right now, get a subsidy based on their income.

The formula would change under the House bill. And there're millions of people who may lose insurance because if - for example - you're in your mid 50s, you got high insurance rates, you don't have a very high income, your subsidy's going to go down. Insurance might become unaffordable for you. People in the House we're told don't worry about that; the Senate is going to fix that. Do you have any indication that the Senate is fixing that?

LANCE: I do not know either yes or no because I do not know what's occurring in the deliberations in the Senate, Steve.

INSKEEP: (Laughter) This is getting to be a frustrating discussion. I would imagine it's frustrating for you.

LANCE: It is. And I also want to see a CBO score. We had a CBO score before voting on the bill in the House - on the floor of the House. And certainly, there should be a CBO score before there is any Senate vote on the floor of the Senate.

INSKEEP: The Congressional Budget Office, which, I guess, didn't get a score in time for the second version of your House bill, but at least had a CBO score for the first version of your - of the House.

LANCE: That is correct. And the second version was, I think, at a very slightly lower level than the first version as to who might lose coverage.

INSKEEP: A number of Senate Republicans have made public statements indicating they're as uncomfortable as you are with the secrecy. What would you urge Senate Republicans who are uncomfortable to do?

LANCE: To speak with their leadership. I'm close friends with Bill Cassidy of Louisiana and Shelley Moore Capito of West Virginia. These are extremely competent members of the Senate - conservative but moderate conservative, as I believe I am. And I think that they are in a good position to make sure that their leadership recognizes that there has to be a period to review any legislation that is written.

INSKEEP: Well, let's discuss one thing that could be affected by the Senate legislation and certainly is by the House legislation. That's Medicaid. Some people will know that hundreds of billions of dollars over a period of years is taken out of Medicaid, the health program for the poor, under the House bill. Although there's also flexibility given to states, it is said, so that they can perhaps save some money that way. But tell me what's at stake here. What is at risk for millions of people now on Medicaid if this legislation becomes law in the way that you've seen it?

LANCE: Thirty-one states expanded Medicaid. As you know, the original legislation required an expansion. The Supreme Court ruled that provision as being unconstitutional. And the states that have expanded Medicaid rely on the federal match. And the federal match is very generous. It's going to be at 90 percent, and that's different from more traditional Medicaid where the match is much lower. And certainly, this is of great importance, particularly to those states that expanded Medicaid.

INSKEEP: And that includes New Jersey, your state, I suppose.

LANCE: It most certainly does include New Jersey. A Republican governor, Chris Christie, and a Democratically controlled legislature in New Jersey expanded Medicaid. And 500,000 New Jerseyans have received coverage as a result of that.

INSKEEP: Congressman Lance, thanks very much. Hope to have you back when there's more details that we're able to discuss.

LANCE: Thank you very much, Steve.

INSKEEP: Republican Representative Leonard Lance of New Jersey. Transcript provided by NPR, Copyright NPR.