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More Time Is Needed To Study Health Bill, Sen. Johnson Says


The Senate version of the Republican health care bill is still expected to head for a vote later this week, even though opposition to it within the Republican Party itself is growing. Much of that concern has come in response to news of the score from the Congressional Budget Office. The CBO estimates that under the bill, 22 million more Americans would be uninsured by the year 2026.

Moderate Republican Senator Susan Collins has already declared she will vote against the bill in its current form. Here she is on ABC News.


SUSAN COLLINS: I'm very concerned about the cost of insurance for older people with serious chronic illnesses and the impact of the Medicaid cuts on our state governments, the most vulnerable people in our society and health care providers.

MARTIN: The bill can only afford to lose one more GOP lawmaker and still pass. But on the right, several conservative Republicans are also saying they may vote no. They say they will vote no because the bill doesn't go far enough in rolling back the Affordable Care Act or Obamacare. One of those is Senator Ron Johnson of Wisconsin. He is on the line now.

Senator, thanks so much for being with us.

RON JOHNSON: Good morning. I will just correct a little bit what you said there. I have not said I'm going to vote no on the bill. It's just that I'm not a yes yet, and I don't think we should be really voting on it this week at all. I think we need more time to gain feedback from our constituents, really review the bill. This bill now saves another $200 billion in terms of deficit. I mean, there's things we can work on over the next couple weeks to improve it.

MARTIN: So it's too early for you. Thanks for clarifying that. What needs to change for you to get behind this?

JOHNSON: Well, one of my primary concerns is Obamacare on the individual market - this is nationally - increased premiums by 105 percent. Premiums have doubled. And, you know, the 22 million people you're speaking about, the CBO estimates will - or estimates will no longer have coverage. 15 million in 2018 would be uninsured - and this is an exact quote - primarily because the penalty for not having insurance would be eliminated.

Now, there's a real problem if the only reason people are carrying insurance is because they're coerced into doing it. I would say what we ought to focus on is bringing down the premiums that were artificially increased by Obamacare. We should focus a whole lot more on, you know, bringing those premiums down...

MARTIN: So if...

JOHNSON: ...By really removing all the mandates for Obamacare which caused them to increase.

MARTIN: If you remove the mandate, if you remove the requirement for every person to get health insurance, how do you get a pool big enough to defray the costs?

JOHNSON: Well, first of all, you can actually cover people with preexisting conditions without class insurance markets. So Wisconsin had a pretty effective high-risk rule. Maine, when guaranteed issues when their premiums doubled, instituted something called a invisible high-risk pool and pretty well cut those premiums in half. So there's a way of doing this without collapsing insurance markets.

Obamacare obviously has failed. So I would really ask people just go back to - take a look at where premiums were prior to Obamacare. Look at what elements of Obamacare caused them to double and triple, and let's repair the damage. I come from a manufacturing background. Do a little root cause analysis here. We haven't done that yet, and we should.

MARTIN: Do you believe that there is a role? I mean, are you comfortable with the idea that government has a responsibility to provide health care to people?

JOHNSON: Well, obviously government does, you know? For example, Medicaid - I'm hearing all these, you know = these words, you know - slashing Medicaid. The fact is in 2008, our federal government doled out about $200 billion into Medicaid. This current fiscal year will almost be at $400 billion. So in about nine years, we doubled spending in Medicaid. That's not contemplating slashing.

Now, what I'm concerned about is we're $20 trillion in debt. Over the next 30 years, according to Congressional Budget Office, we'll accumulate another $129 trillion worth of deficits because of these entitlement programs that are unsustainable. They're out of control.

We're trying to devolve the management of things like Medicaid back down to the states where it will be managed more efficiently, more effectively, more tailored to individual states because every state is different. The one-size-fits-all model...

MARTIN: Every state is...

JOHNSON: ...Coming out of Washington, D.C. doesn't work.

MARTIN: Every state is different, but even lawmakers in those states are saying that that's going to mean that they're going to have fewer federal subsidies. They're not going to be able to expand Medicare they - the way that they had hoped, the way that they see that their constituents need. And they're very concerned that people who sometimes are working, sometimes are employed, but they can't make ends meet enough to buy health insurance, that those people are the ones who are going to be suffering.

JOHNSON: I'll go back to the basic fact that in nine years, we doubled spending on Medicaid from $200 billion to $400 billion. I have been here six years now. I have yet to be in a hearing where we're talking about a problem often exacerbated by government. And I will say Obamacare exacerbated the problem where the government witness didn't say the solution was - you guessed it - more spending.

So, no, this is the problem with Washington, D.C. Rather than look at the root cause of problem, rather than driving - helping drive premiums down that were artificially increased, all we're doing is throwing more money at it. It'll never solve the problem.

We need to be looking at primarily - what do we need to do to restrain the growth in health care costs which have been driven up because we've largely driven consumer-driven free-market competition out of health care?


JOHNSON: We need to reinject free-market competition into that as much as we can.

MARTIN: So what kind of pressure then do you put - or are you planning to put on industry or drug companies to be more transparent about how much treatments cost so individuals can make better choices and perhaps pressure them into lowering some of those costs?

JOHNSON: Well, that's what free-market competition does. When consumers are actually paying more of health care dollars - you know, right now it's only about a dime out of every health care dollar spent is paid directly by the patient. Prior to Medicaid and Medicare it was about 48 cents.

So when you actually have consumers directly purchasing things, they will demand the price. They'll put a great deal of pressure on providers to have the lowest possible price, the best quality, best - best - best possible customer service. That's what free-market competition does in every other area of our economy where it exists. We've largely driven the benefit of that free-market competition out of medicine, and we're not happy with the results.

MARTIN: So you are in the minority within your own party right now. And this - what you're arguing for would be politically untenable for your colleagues in politically purple states. I'm thinking of Senator Susan Collins, who we heard that clip from earlier. So how do you get what you want in this situation?

JOHNSON: Well, first of all, what I want is just a little bit more time. I'm not asking months, but I think it's ridiculous to be voting on this week, you know? Let me make my case to the White House. I don't think our - our case has been heard by - by the Senate. So I'm just asking for some time to work with the White House and our House members...

MARTIN: You want to slow things down.

JOHNSON: ...Improve the bill, to improve the bill.

MARTIN: Senator Ron Johnson, Republican from Wisconsin. Thanks so much for your time this morning.

JOHNSON: Have a great day.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.