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Republican Rep. Dave Brat Says He Can't Support Revised ACA


Republicans have wanted to repeal and replace the Affordable Care Act since it came into being. Now, they control the White House, the Senate and the House, so Republicans get their chance, and last night, they revealed their plan. The proposal keeps some of Obamacare's more popular provisions, like allowing parents to keep their children up to the age of 26 on their insurance, but it does away with other parts, including the insurance mandate and the income-based tax credits that some Americans use to help afford insurance. For more, we are joined now by Congressman Dave Brat of Virginia. He's a Republican and a member of the conservative House Freedom Caucus. Thanks so much for being with us this morning, Congressman.

DAVE BRAT: Yeah, you bet. Thanks for having me.

MARTIN: What do you make of this bill? Can you support it?

BRAT: Well, no, I can't support it because if you look at what went wrong with Obamacare, ACA - right? - it was a federally run program that's now in a death spiral, and anyone could see that eight years ago. And so you have to design a program that works in the first place, right? So the first hint - when those insurance titans of industry went in to the White House eight years ago, they were looking at their shoes. They couldn't look at your cameras because they were embarrassed about the product. They were getting 18 million more people covered, but they knew they had a system that didn't work. And so the last thing we need to do is replicate a system that doesn't work.


BRAT: And what do I mean by that?


BRAT: It's going to be federally run system, right? It's going to create a new entitlement program - and I'll get to that in a minute if we have time to - what that all means. It keeps the insurance regulations. The expansion of Medicaid - it's not clear, but it goes off for about eight more years. And it basically keeps too many of the bad pieces which will collide with each other, and it will collapse, right? And so...


BRAT: ...We didn't run on this however (ph). We voted on the 2015 plan through the House and the Senate, which was a repeal. And all of a sudden, all this new stuff at the federal level comes up and is clouding the picture.

MARTIN: How do you square the fact that now Americans expect the federal government to provide some kind of health care? I mean, even your party has conceded that, that the Obama administration put into place something and a package of benefits that now Americans turn to the federal government to provide in some form.

BRAT: Yes. Good and that's a good - and this is where the news needs to do a better job, right? The news all likes the politics, but the policy matters. It's easy to square because the federal government right now has a $100 trillion in unfunded liabilities in these mandatory entitlement programs - $100 trillion we're - we promised to pay. We don't have the money. Medicare is insolvent. Social security is insolvent. And so do we want to create another entitlement when we're already $100 trillion light and the kids are - have $20 trillion in debt? And so it's easy to square, right?

And so - but I hear your concern, and it's legitimate also. Obama created basically another entitlement program, and we do want to help out everyone. We want to make sure that the rug's not pulled out from anyone, et cetera. But we're confusing having a free market insurance market with having a safety net system that works for all Americans.

MARTIN: But it's not just...

BRAT: And those are two separate issues.

MARTIN: I hear you. It's not just pulling out the rug from someone, saying that you don't want to do that. I mean, there's a real risk here that 18 million people who have health insurance now under the Affordable Care Act won't and not least of which is a concern about a gap in care between repealing and replacing. So do you - do you take that in consideration? Are you prioritizing, making sure people don't lose their health care for a period of time?

BRAT: Yeah, absolutely, but the question you just asked shows the bias of the media and of folks who haven't thought about this thoroughly yet on both sides.

MARTIN: Tell me how. Tell me how.

BRAT: Because the current system is collapsing under its own logic. So when you have a bad promise and the other side designed a system and the car's in the ditch and socialism didn't work, then the bonus - the onus of the argument is all of a sudden on our free market guys, right? If you look at the cost of health care, if we wouldn't have had 20 percent cost increases over the years and premium increases, et cetera, and you had a free market system - you got heart procedures here that are 150 grand that in India are 15 grand.

MARTIN: But you agree that the federal government now still has a role in providing some baseline level of care. You concede that. Even though it's uncomfortable, you agree that there's a role now.

BRAT: Yeah. Well, yes. Milton Friedman - smart guy, Nobel Prize winner in economics, right? I taught economics for 20 years. You've got to aim for the target. So this target - I want a clean insurance market. On the other hand, we can have a generous safety net system for folks across the board that handles everything - right? - food stamps, housing, health care, everything, right? But those things need to be lumped under the target so that families are taken care of. To combine everything constantly with the federal government - when the federal government, everything it touches right now is insolvent - is the wrong way to go.

MARTIN: Let me ask you one more question with the seconds we have remaining. A handful of senators, Republican senators, have said they don't want to support any plan that calls for rolling back the Medicaid expansion. That means too many of their vulnerable citizens won't be protected the way they think they need to be. Does this thing run the risk of falling flat in the Senate?

BRAT: It shouldn't. And think about this next sentence carefully because it's true. There's just as much money in the states as there is in Washington, D.C. So states are more than free to do Medicaid expansion, and that's what we want, right? We want to put this government closer to the people who can take care of individuals much better than we have in the past. The current system is down in flames. It's in the ditch. We can't do that again. So I don't want to be part of owning the next system that collapses, and that's what this vote will represent. So those senators are - their concerns are well-founded. Design the system at your state level. There's just as much money - if you add up all 50 states - as there is in a country. But everyone efficiency-wise (ph) just wants to say, federal government, solve every problem I have.

MARTIN: Republican Congressman Dave Brat of Virginia, thank you so much.

BRAT: Hey, you bet. Thank you. Transcript provided by NPR, Copyright NPR.