DAVID GREENE, HOST:
It looks like Senate Republicans are going to have their work cut out for them this week.
RACHEL MARTIN, HOST:
Yeah, ever since they unveiled their plan last week to replace the Affordable Care Act or Obamacare, there has been steady resistance, not just from Democrats but also from members of their own party. Two different Republican factions in the Senate say they will not back this current bill, and either faction alone can sink this thing.
GREENE: And so who are these two Republican factions? Let's ask someone who knows. It is our colleague Sue Davis. Sue, good morning. And who are these factions?
SUSAN DAVIS, BYLINE: Hey, David. You know, the factions, I would say on the one hand, you have conservatives who argue that this bill doesn't do enough. Think of people like Rand Paul of Kentucky, who has called this bill just Obamacare-lite. It doesn't go far enough to make good on their campaign promise, to repeal the law.
GREENE: He doesn't want anything that looks even remotely like Obamacare.
DAVIS: And this won't - and this won't accomplish what he thinks the goals should be. And on the other end, you have more centrist or moderate senators like Susan Collins of Maine, who worry that this bill does too much, that maybe it affects them - things like the Medicaid program too much and might do some harm. So this is sort of the balancing act that we're going to see play out this week and one that Senate Majority Leader Mitch McConnell has to navigate to try and get the votes he needs to pass the bill.
GREENE: Well, how do you navigate this if you're Mitch McConnell when it seems like the reality is if you please one side, you lose the other side and vice versa? I mean, is that what he's facing here?
DAVIS: Yeah, yeah, he has a very narrow margin of error, right? They have 52 votes in the Senate, so he can only lose two senators. There's a lot of changes that could still come. You know, there's going to be a big debate this week in the Senate. There's an amendment process where you can do things and add things into the bill to get people like Susan Collins on board.
I think you're going to see a lot of that sort of horse-trading play out this week. But it's a challenge. And I - but I would say, you know, I don't think you can underestimate the political pressure that most Republicans in Congress feel to vote on this bill and to pass something because every single Republican serving in Congress today campaigned on a promise to do just that.
GREENE: And you - and you go back home and you want to say you kept your promise...
GREENE: ...Somehow. Did - Sue, didn't President Trump get involved as time went on when the House bill was being debated? And are we going to see that this time here?
DAVIS: The White House certainly helped revive the House bill after it failed initially. They've had - taken more of a hands-off approach to the Senate. They've sort of entrusted Mitch McConnell to find the votes that he needs. But yes, I mean, again, I don't think we should underestimate how deeply committed the White House is to getting a bill to President Trump's desk and also President Trump's allies.
There's a super - outside superPAC, who, after Nevada Republican Dean Heller suggested he might not be able to vote for this bill on Friday, he said there - superPAC came out said they would run ads against Heller who - for opposing the president. So the president does have allies here. And on the big goal of the bill, which they say is to repeal and replace the health care law, you know, they're united on that idea, if not the details.
MARTIN: I mean, you said, Sue, this is all about keeping that campaign promise. It is worth just mentioning, the House voted to repeal Obamacare more than 50 times. We remember those headlines again and again, the House voting on this thing. So there's a lot, politically, that's at stake, even if this is a bill that, on its face when people look at it is not so popular, they're making a decision that the politics are outweighing that unpopularity in this moment.
DAVIS: And it's unpopular broadly, but when you dig into the details of that polling - the most recent polling that was out last week...
DAVIS: ...As many as 70 percent of Republicans say they still want to repeal and replace Obamacare.
GREENE: Repeal and replace but not necessarily a lot of support for the replacement, which is really interesting, which is the reality that Republicans are facing. Hey, Sue Davis. Thanks as always.
DAVIS: You bet.
GREENE: So we talked about drilling down into polls. We talked about what Republicans in different factions think about this bill. But what would this bill exactly do?
MARTIN: So we hope to get more answers today because the Congressional Budget Office is expected to give its assessment. Remember, this is the nonpartisan government agency that gives its score. So it's supposed to be above the partisan fray in this whole thing.
A reminder, the CBO on the House health care bill was a tough one. The agency estimated that the bill decreased - would decrease the federal deficit by $119 billion over a decade. So that was good news, especially for Republicans. But it would have left 23 million more Americans uninsured in the process. Even so, the House narrowly approved that bill. So we're going to see what the CBO says about the Senate's take on this.
GREENE: And let's bring in NPR health policy correspondent Alison Kodjak, who - you have the tough job of, like, digging into all this policy, Alison. I feel like we always turn to you in these tough moments. So what is - tell us about this CBO score we're getting and how important this is.
ALISON KODJAK, BYLINE: Well, the CBO score is certainly a big deal because what it's going to do is sum up what this bill does to the voters and the people who use the health care system, which is everybody. And it's a big deal for two reasons. The first one is technical and political, which is that the bill cannot pass if it increases the deficit more than the House bill did.
There's - they're passing this bill or they're considering this bill using a legislative technique that makes it actually a bill related to the federal budget. So there's that. And that has to - and within those strictures, it - they had to create this whole legislation. But the larger issue is the Congressional Budget Office is going to say how many people will remain insured under this bill compared to current law, which is the Affordable Care Act.
GREENE: And the House bill - I mean, they said that 23 million more Americans would be uninsured, which made it - which made it very unpopular - that version.
GREENE: What is - what happens if they come to a similar conclusion about the Senate bill?
KODJAK: Well, the bill's already very unpopular. And even if - I mean, that's the tough thing is, what happens if it's 10 million people? Like, is there an acceptable number for these senators who are on the edge? And it's not clear exactly what they're going to do to make that number palatable even if it's 15 million rather than 23 million. But as Susan said earlier, you know, they've - they're committed to doing something to, quote, "repeal Obamacare." So it's unclear how much that affects the actual voting in the Senate.
GREENE: So we have Republicans - we talked about the different factions of senators who are - who are not willing to be on board at this point. Senator Rand Paul of Kentucky says he can't currently support this bill. He was on ABC's "This Week" yesterday talking about one thing that he needs to change his vote.
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RAND PAUL: It's a false sort of over-promising to say, oh, yeah, insurance premiums are going to go down. But we're keeping 10 of the 12 mandates that cause the prices to go up. It's a - it's a foolish notion to promise something you can't provide.
GREENE: So he's talking there, again, about he doesn't want to see something that looks like Obamacare. I mean, what do you make of that - of that reaction from Rand Paul?
KODJAK: Well, I think there are two things. One is, he wants to vote on something that actually repeals Obamacare. And so the - keeping the 10 of 12 mandates - it - it's tough for him to vote on that and call it repeal. Secondly, it's not clear how much this bill will lower premiums across the board. It may lower it for some. But it going to raise it for others in that case.
GREENE: Winners and losers as we - was - talked about during the House - the debate over the House bill as well.
GREENE: NPR's Alison Kodjak. You're working hard right now. We appreciate it.
KODJAK: Thanks, David.
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GREENE: The big name on the White House guest list today is Narendra Modi.
MARTIN: Yeah, prime minister of India has come to town. He's going to be sitting down with President Trump. When - and obviously this could be an early indicator of where U.S. policy on India is heading.
GREENE: And let's talk about why that relationship is important with NPR foreign correspondent Julie McCarthy, who's on the line from New Delhi. Julie, it has been too long. How are you?
JULIE MCCARTHY, BYLINE: Good morning, David. I'm great.
MCCARTHY: Good to be here with you.
GREENE: ...It's good to hear your voice. I - help us understand if this relationship between India and the United States is important at this moment. Well, why is it important?
MCCARTHY: Well, you know, the United States and India have what they call this strategic partnership. So I think today, you can count on things like defense, security cooperation, counterterrorism being these marquee topics. And in today's world, that's often what you get out of these talks even - certainly, going into them. The U.S. hopes to sell and India hopes to buy more arms. Modi wants to modernize India's defenses, especially when China is making forays into the Indian Ocean.
But David, it's really interesting to note, this is not an alliance. This is a partnership. The Indians recall - recoil at the idea of an alliance. And they like to go their own way. And that makes it difficult, sometimes, for the American side. And then again, what you also have on the table - this perennial issue of trade, gaining access to each other's markets. Modi told a group of American CEOs yesterday, you know, all that red tape that you're strangled in, I'm going to cut that for you. I'm going to make it really easy for you to come to India and do business. Well, stay tuned.
GREENE: We'll stay tuned. Well, I'm interested that you call this a partnership, not an alliance. Is that how the press in India is covering this? Do they sort of want to create a distance when they talk about this relationship?
MCCARTHY: No, not at all, quite the contrary. The Indian media likes to create the idea that there's a great deal of simpatico between the United States and India. They said the fact that there's a working dinner here is the first of a foreign leader to have a working dinner at the White House. The other ones were in Florida. This are - these are in the White House.
GREENE: It's in the White House itself.
MCCARTHY: Yeah, exactly. So they're very keen on creating the optic that this is a - this is an up-and-going and very strong, robust relationship.
GREENE: What do you make of the relationship between the two - the two men, Trump and Modi?
MCCARTHY: Well, I think what you've got here is, you know, while the marquee is about defense and security, this is about nationalism. Modi wants American companies to come and build their stuff here in India, while Trump wants policies that protect jobs in America. They have to square that circle, David. And that's very difficult. And it's going to require a lot of personal charm and a lot of heft and intellectual know-how to get that done.
GREENE: The working dinner about to take place. India's prime minister meeting tonight with President Donald Trump. NPR's Julie McCarthy giving us the context from New Delhi. Julie, thanks.
MCCARTHY: Thank you.
(SOUNDBITE OF VIBRASPHERE'S "PEACE OF MIND") Transcript provided by NPR, Copyright NPR.