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Heritage Foundation On Graham-Cassidy Health Care Bill

DAVID GREENE, HOST:

And the effort to kill the Affordable Care Act and replace it is certainly back to life. The Republican Party is taking another stab. And we're going to see what happens when the Senate votes next week on the latest bill to repeal Obamacare. The big question is, can it pass with Republican votes alone? Right now, at least one Republican senator, Rand Paul, is a solid no. According to the publication The Hill, there are at least 14 other Republicans who are undecided at this point.

And let's talk to Tommy Binion about this. He's congressional liaison with the Heritage Foundation, a conservative think tank in Washington. Hey, Tommy.

TOMMY BINION: Good morning.

GREENE: So you've been working with Republicans on the Hill. What's your sense here? Can this bill pass with all of these undecided members?

BINION: I think so. You've got the score correct. There is one Republican no vote, and they can sustain two. So right now, it is absolutely still a possibility. And I've got to say, this is really as close as they have been throughout this yearlong process and really seven-year-long process. So there are a lot of undecideds still to get to yes. But I think the more important score is that, at this moment, there is only one no. I think this is a real possibility this thing passes next week.

GREENE: OK. So this legislation - it's known as Graham-Cassidy for its sponsors. To summarize, I mean, it takes a lot of the funding for Obamacare, and it gives it to states as block grants to basically handle this. The undecided Republicans, they seem to divide into two camps. You've got some conservatives. You've got some moderates. Can you explain what those concerns are among those two camps?

BINION: Sure. The conservatives' concern, I think, is very important. And I do think it will be addressed by amendment over the weekend. Basically, the money that's going to the states can be spent in any way the states want, as long as it's spent on trying to bring down the cost of health care. Unfortunately, what that allows them to do is put all of the folks who are currently getting Obamacare subsidies on Medicaid or set up sort of a state-run single-payer program.

So what conservatives want to do is prohibit the states from doing that and sort of force them into providing market-based solutions. If they can't - if they put everybody on Medicaid or they set up single-payer run by the states, that will run into the same problems Obamacare did. So in order to make sure we're moving forward and getting better, we've got to tighten up those restrictions in the bill. I think that will happen.

On the moderate side, again, I think they'll come around. I think they're uneasy right now about Medicaid. But as we look into this, we'll see that Medicaid in this bill is really - it makes it more sustainable, and it focuses the resources on the most vulnerable population.

GREENE: OK. So one thing important to convince moderates is that Medicaid is not facing steep cuts, that, I mean, that program is going to survive, which is, according to many critics of the bill, not - certainly not a guarantee. Let me just ask you, though - looking forward, let's say this does pass by, like, one vote in the Senate. There's this deadline in September looming. And because of procedure in Congress, this would have to pass the House as is, no changes. Right? Is that likely to happen?

BINION: Yeah. So that's how it works. The deadline applies in the Senate. So if the House is working on the bill sometime after September 30, the Senate wouldn't be able to act on any changes the House made. So the House is going to be facing an up-or-down choice. And I think it will pass. Speaker Ryan thinks it will pass. Chairman Meadows, importantly of the House Freedom Caucus, thinks it will pass.

But the stakes couldn't be higher. They're going to get one chance at it. It's up or down. They won't be able to consider amendments. And if it goes down, so does, for now, the effort to repeal the Affordable Care Act. So it's going to be a really interesting scene in the House, sort of unprecedented.

GREENE: All right. Tommy Binion is congressional liaison with the Heritage Foundation. Tommy, we really appreciate your time, as always.

BINION: Thanks, David. Have a great morning. Transcript provided by NPR, Copyright NPR.