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GOP's Latest Health Care Bill Is In Big Trouble


What do Republicans do now? Graham-Cassidy, the latest bill aimed at replacing the Affordable Care Act, seems like it is in big trouble. There was a potentially decisive blow last night when Maine Senator Susan Collins became the third Republican senator to say she would vote no.

Republicans are racing against a deadline coming this weekend. It is their window to pass a bill with just GOP support, and after that, the party could face a tough choice about next steps. We have Senator Mike Rounds in our studios this morning. He's a Republican from South Dakota.

Thanks so much for coming in, Senator. We appreciate it.

MIKE ROUNDS: You bet - appreciate the opportunity.

GREENE: Seems like you came so close again, in terms of vote count. How frustrating is this?

ROUNDS: Well, it's - the real concern here is that we still know that we're going down a path in which there's going to come a stop. And the fact is that Obamacare is not going to continue on, at some stage of the game. And the reason why it's not is because it simply is not self-sustaining. It currently still receives a subsidy. The president has voluntarily been making those. It's about 7 billion a year. They're called CSRs. And at any stage of the game, in any month, those will stop. Obamacare, right now, in its current form, simply is not going to be able to move forward. It doesn't have the votes to do so.

GREENE: But not everyone agrees with you on that. I mean, people who believe in this program and believe in this law think that it could keep going and maybe involve some tweaks you could make. So that's not a unified thing that everyone accepts.

ROUNDS: Well, actually, everybody agrees that there has to be major changes made. And the difference is, is Republicans think it's going down the wrong path to begin with. Dems, for the most part, feel that we can do it, as you suggest, with some tweaks. But you got to have the votes to get the tweaks.

And right now, I don't think the votes are there for the tweaks, as you might call them. And most Republicans believe that that simply delays the inevitable. The reality is right now that if the votes were held today, we know that under the announcements that have been made, that we don't have the votes today for...

GREENE: ...For Graham-Cassidy.

ROUNDS: ...For the Graham-Cassidy.

GREENE: Right.

ROUNDS: We also know that between now and the end of the year, there's a really good possibility that those cost-sharing, or the CSRs, may very well be stopped. The courts have already indicated that they are not a legal form of payment, and they - the president had asked for time, had asked - actually asked to delay the final court determination stopping him from doing so while they tried to negotiate this alternative plan. When that stops and when those negotiations stop, at that stage of the game, I suspect that the president will simply not continue those payments forward.

GREENE: But that is a decision that the president would be making. It's almost a self-imposed thing.

ROUNDS: Actually, right now, I think the president would suggest that the courts have already made the decision that the continued payments are not legal, and that while he can delay them, it would not be appropriate to simply voluntarily continue to make them and ignore what has now been a court determination.

GREENE: Well, it seems like one option on the table now is to work with Democrats.

ROUNDS: There's a group of this...

GREENE: You have Lamar Alexander. You have, I mean, a bipartisan plan with Patty Murray that would stabilize the markets and seemed to give you a lot more time to debate this. Are you willing to support a bipartisan solution right now to keep things stable?

ROUNDS: We've been working on one. And Senator King and I have been working with Lamar Alexander and Patty Murray.

GREENE: Angus King of Maine and...

ROUNDS: Yes. And what we've tried to do was to figure out a way to combine the continuation of the cost-share - the CSRs, the cost-sharing arrangements with a revision in what they call Section 1332 of the existing Obamacare product. That would allow for state flexibility to be able to make some determinations in their own plans with approval from HHS. They've not been fruitful discussions so far. Well, we continue to talk...

GREENE: Why not?

ROUNDS: Some limitations with regard to what would be allowed under 1332 - the - so far, the Dems have not felt comfortable with the ability to expand 1332 beyond really what's available there right now.

GREENE: But you're open to have these bipartisan conversations in...

ROUNDS: Yeah, we've continued them through the weekend. We actually had discussions over the last week just basically indicating that, look, we have to continue talking. We've got to continue to try to figure out a plan B. In both cases, either with or without it, we knew that the other plan would not start until 2020. So we needed this one in place just to get till 2020, regardless.

GREENE: OK, Senator Mike Rounds - a Republican of South Dakota. Thanks so much.

ROUNDS: You bet.

GREENE: I have NPR's Geoff Bennett here. Just briefly, Geoff, are you hearing from Democrats that they're ready to work with Republicans like Senator Rounds?

GEOFF BENNETT, BYLINE: Yeah, that's certainly the case. I mean, there are some Democrats who backed the Bernie Sanders Medicare-for-all bill, which was real - more of a political statement than a viable legislative push. I will add, though, that the people on Capitol Hill who believe Republicans may still find a path forward on this are Democrats who've been burned before by thinking that this repeal effort was dead, only to see it come back time and time again.

GREENE: All right, NPR's Geoff Bennett, we appreciate it. Thank you.

BENNETT: You're welcome. Transcript provided by NPR, Copyright NPR.

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