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The GOP Factional Split On Health Care


Senate Republican Leader Mitch McConnell is giving up on trying to repeal and replace the Affordable Care Act before July Fourth. But he says he is not giving up.


MITCH MCCONNELL: We will not be on the bill this week, but we're still working toward getting at least 50 people in a comfortable place.

INSKEEP: That's what McConnell needs and currently does not have to pass legislation. Those following this with great interest include Matt Schlapp, chair of the American Conservative Union - is in our studios. Thanks for coming by.

MATT SCHLAPP: Great to be here.

INSKEEP: Good morning. What happens politically to Republicans if nothing passes?

SCHLAPP: I think it's a big problem. When you go around the country for seven years saying that Obamacare is an abomination, you talk about all of its deficiencies, you say that there are Republican solutions to the health care problems we have in this country and then when you get elected president, get a majority - big majority in the House, a slender majority in the House - not a super majority - but even in that scenario, if you can't get it done, I just feel like it's put up or shut up time for Republicans.

INSKEEP: They have said there are Republican solutions. Have we found out there aren't actually Republican solutions?

SCHLAPP: We found out there are Republican solutions. But the legislative process is one by which you kind of haggle it out. And because the Republicans have not come up with their kind of concrete alternative through the legislative process, they find themselves having that kind of debate amongst themselves right now, which I'm glad they're getting started on that process because we got to get it done.

INSKEEP: Getting started on that process, but they've known about this for years. And...

SCHLAPP: They made a political calculation that it would probably be better to just talk about the deficiencies of Obamacare instead of what their own plan would look like. It worked politically to win in these election cycles. But if they don't get the legislation done, I think there'll be hell to pay.

INSKEEP: So one thing that people did not like about Obamacare was that many people - their premiums went up. The subsidies might also go up for many people to help cover it. But premiums are going up. And so Republicans are promising with this legislation that premiums will go down. We find out from the Congressional Budget Office that the way that premiums go down under the Republican bill is that less is offered in the insurance plans. There's higher deductibles to the point where millions of people would presumably decide it's not even worth it to buy the insurance. Does that make sense?

SCHLAPP: Well, the pro-Obamacare people really don't have a leg to stand on when it comes to premiums. We have seen just astronomical increases, double-digit increases, doubling of premiums.

INSKEEP: Along with subsidies, yeah.

SCHLAPP: We've seen it in our - even those of us who don't have subsidies in my own family, we've seen ours double. So you know, do we go back to the world before Obamacare? We probably can't, you know, make that happen. But we have to go from here. And from here I think what we need to do is have those - you know, those increases in the premiums be more manageable for American families. And I actually think this Republican plan has the potential to do that.

INSKEEP: Although it doesn't by offering less. You would get less. You would be covered less.

SCHLAPP: No, actually, we're covered less now. So if you look - like, I know my own situation - it's, like, almost 20 to 30 grand out-of-pocket every year before I see my first dollar of insurance coverage. We actually have almost been pushed into catastrophic plans under Obamacare and paying double what we paid for non-catastrophic plans previously.

They really - the Obamacare premise is simply failed. And I think what the Republicans are trying to say is that first of all, we're all talking about Medicaid. Let's try to set up this individual market again so that Americans aren't forced onto Medicaid. That's not the preferred choice to get your health care insurance. You really want to be in that private individual market.

INSKEEP: So I want to ask about one other thing before I let you go. When Democrats passed Obamacare with Democratic votes...


INSKEEP: ...Many people, including many Republicans, said this is really unstable. This is really bad.

SCHLAPP: That's right.

INSKEEP: A huge change like this needs some buy-in from both parties. Otherwise it's a horrible idea.


INSKEEP: So Republicans come in and are attempting to pass their own legislation without a single Democratic vote. And in fact, Mitch McConnell...

SCHLAPP: We'd like Democratic votes.

INSKEEP: ...Was saying - he was warning the other - he was actually warning the other day, if we don't get this done, we'll be forced to negotiate with the Democrats as if it's a tragedy. Would it be a tragedy if in the end the Republicans negotiated with Senate Democratic Leader Chuck Schumer?

SCHLAPP: I don't have any problem with Democrats joining the bill now. The fact is the difference here is is that when Nancy Pelosi was writing Obamacare in her office and she told the American people we have to pass it to know what's in it, that was a revolution legislatively. We've now been talking about this, Steve, for more than eight years. So we know where the Democrats are roughly. We know where the Republicans are roughly. So it's unfair to say we don't have an idea of what a Republican version of reform looks like. Second of all, the Democrats are #Resistance. This time in the Senate is really sparse because of what they're doing on these nominations and everything.

INSKEEP: I just got to do a little bit of fact-checking there. Nancy Pelosi, according to the fact-checkers - pass it to find out what was in it. She was saying, if you passed the bill, you'll see how great the effects are. There were many hearings and so forth.

SCHLAPP: No, no, no, the fact...

INSKEEP: I understand your point there were...

SCHLAPP: Let me fact-check you back. We also didn't know what was in it because they didn't have a process, right? So if you're going to accuse the Republicans of not having a process, we actually didn't know what was in it. Bart Stupak didn't...

INSKEEP: Dozens of hearings...

SCHLAPP: ...Know what the language was on abortion until he hit the floor.

INSKEEP: It is true that there was so much language in there that people did not necessarily know every detail. Thanks very much for coming by. I really appreciate it.

SCHLAPP: Thank you, Steve. I appreciate it very much.

INSKEEP: Really enjoyed talking with you. We've been talking with Matt Schlapp, chair of the American Conservative Union. Transcript provided by NPR, Copyright NPR.