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How to Fix Obamacare? Roundtable With Senators Vitter And Sanders

Aired November 6, 2013 - 18:28   ET



ANNOUNCER: Tonight on CROSSFIRE, what will it take to fix Obamacare?

KATHLEEN SEBELIUS, HEALTH AND HUMAN SERVICES SECRETARY: There is no excuse for what has been a miserable five weeks.

ANNOUNCER: Did Tuesday's elections show voters will eventually accept it? Or is it becoming a political disease for Democrats? On the left, Van Jones. On the right, Newt Gingrich. In the CROSSFIRE, Senator Bernie Sanders, an Obamacare supporter, and Senator David Vitter, one of his harshest critics. Fixes Obamacare or playing politics, tonight on CROSSFIRE.




In the CROSSFIRE tonight, we've got two U.S. senators: Bernie Sanders, who supports Obamacare; and David Vitter, who does not.

Tonight Republicans are all jumping up and down on their pogo sticks, they're so happy. They're saying Obamacare is terrible. It's going to help us win races. Look, if you look at the actual election results, you're going to see a much different story.

Here's the truth: New Jersey governor Chris Christie embraced Obamacare's Medicaid expansion, and he won. Virginia governor-elect Terry McAuliffe was in a close race. He embraced Obamacare. He won. The guy who spend the whole time fighting Obamacare, lost. There is no wonder, therefore, that the president is in Texas tonight arguing that giving millions of people access to health insurance is a good idea, and it's still good politics.

GINGRICH: You have a wonderful fantasy life.

First of all, Chris Christie said openly he opposed Obamacare.

JONES: Took the money.

GINGRICH: Would accept the money, because he didn't see any reason to punish the state. But he opposed Obamacare. Second, in Virginia, two weeks ago, Terry McAuliffe was up 15 points.

JONES: ... shut down.

GINGRICH: And Attorney General Cuccinelli turned on the Obamacare issue, and despite being outspent by four to one, he cut that lead from 15 points to under three points in less than two weeks. So I would think if I were a Democrat, I'd be a little worried. And if you look at the Democratic senators up for reelection, they aren't behaving like they think this is a good deal.

JONES: I'm sure we'll get into it.

GINGRICH: In the CROSSFIRE, Senator Bernie Sanders, a Vermont Independent who supports Obamacare; and Republican Senator David Vitter of Louisiana, who opposes Obamacare.

And I want to ask you. You know, a number of senators went down to the White House, and particularly people up for reelection, and have begun to ask the president -- these are Democrats -- begun to ask the president to -- to draw things out, to open up the bill, to reconsider certain things.

Do you think that, given the problems we're having with the Web site, and the problems we're having with implementation, that it is legitimate to say that some modification has to be made, because the schedule is simply not going to be met?

SEN. BERNIE SANDERS (I), VERMONT: Look, over a period of time it's always good to improve. And while I voted for the Affordable Care Act, let me be very clear. From the very beginning, I had disagreements with it. I am a single-payer Medicare for all advocate. I believe that the United States should join the rest of the industrialized world and guarantee health care as a right for all people.

I worry very much that, at the end of the day, despite the fact that we have 48 million people today with no health insurance, we end up spending almost twice as much per person on health care as any other nation, without particularly good health care outcomes. So Newt, my own feeling is we started off with a really bad situation in terms of health care. The Affordable Care Act takes us a step forward. It still leaves some 28 million people uninsured. To my mind, it is still much too complicated. I think we can do better.

GINGRICH: You know, you raised Medicare. Let me ask you one thing which I just noticed yesterday, which involves Medicare, and that is that the Moffitt Cancer Center, which is the premier cancer center in Florida, is being dropped by UnitedHealth on their Medicare wraparound provisions because of budget problems.

And the question I would raise is aren't we, in fact, seeing a drift away from centers of excellence, as these various government programs run low with money. And you're going to see it, also, I think, with Obamacare, that they have all these packages that say, well, except you can't go to the Mayo Clinic or except you can't go to M.D. Anderson, because the centers of excellence are more expensive and therefore don't fit into government-run health care?

SANDERS: Well, you know, I think you're touching a broader issue about our spending priorities. I happen to believe that investing in research and development, trying to understand and get a better handle on cancer, Alzheimer's disease, is a good investment for our country. So I would invest more into these programs and into the NIH. I'm not sure that my Republican friends agree, but that's what I would do.

JONES: Let me go to you. I assume you are not a single-payer advocate. Is that right?

SEN. DAVID VITTER (R), LOUISIANA: That's a safe assumption.

JONES: So I would assume that you actually want the private health insurance to do the job. Is that right? There have been these reports coming out now that say the private health insurance -- insurance companies are actually abusing people, blaming Obamacare, but they're actually sending out these notices that are actually false and misleading, tricking people into signing up for much more expensive plans, basically abusing the law. Would you...

VITTER: Van, if those abuses are happening, absolutely we should stop them, but that's not the biggest set of cases out there. The biggest set of cases, for instance, are the 93,000 folks in Louisiana that have gotten truthful legitimate notices that they're being kicked off the health plan they had.

And that goes to the biggest lie of the whole Obamacare debate. The president said over and over and over, if you like the health-care plan you have, you can keep it. That's not true. It was never true, and there are 93,000 of my constituents who are getting that note in the mail today.

JONES: And this has been a great talking point day after day after day, but here's what I don't understand.

VITTER: I don't care about political talking points.

JONES: Listen, you care about people getting their notices.

VITTER: I care about reality, and that's the reality.

JONES: But here's the problem. You now have -- and it's coming out now -- that these insurance companies are actually -- it could be, in 93,000 of your people, there could be a large percentage of those people who actually are being mistreated. What are you doing to make the insurance companies actually honor the law...

VITTER: Van, let me be clear. If anybody's lying about what's going on, they should be prosecuted criminally, if possible. But I guarantee the vast majority of those 93,000 cases are cases produced by the core of Obamacare. And again, it goes to the biggest lie of the whole debate.

JONES: Well, first of all, a couple of things I'm curious about. It seems to me that people were being thrown off of insurance programs and insurance plans for a very long time before Obamacare. In fact, we had a situation where that was happening so regularly that people were up in arms about it. I didn't hear you or any other people in the Republican Party being concerned about those people being thrown off. So is it -- is there an inconsistency on your part...


JONES: ... for the insurance company to throw somebody off and they do it for corporate greed, it's OK with you. If they do it because of regulations in place, you hate it. How does that make sense?

VITTER: Look, we had plenty of solutions put forward from the conservative side.

JONES: One of them being (UNINTELLIGIBLE) mandate, right?

VITTER: No, not from me. Absolutely not, never. Targeted fixes that could have made a difference.

But throwing out the whole system, the baby with the bath water, is not the way to do it. And these 93,000 Louisianans are a perfect example. And that's not a glitch with the roll-out. That's not a problem with a Web site. That's the core of the Obamacare law. And I think we're moving to that phase two now of folks realizing the problems. It's more than a Web site.

SANDERS: If I could just jump in.

VITTER: More than a Web site. It's the core of the law.

SANDERS: You have a great state. I've been there, and it's a beautiful state and great people. But 20 percent of your people live in poverty, about 20 percent of the people in Louisiana have no health insurance at all. and when you vote against the Affordable Care Act, what you're telling those people, that they're not going to get health insurance. So...

VITTER: Absolutely not, Bernie. What I'm saying...

SANDERS: Let me finish. Let me finish.

As you well know, your state, and I gather you, has rejected the yesterday that Medicaid should be expanded and Medicaid. Other Republican governors have done the same.

So it seems to me that when you have people who are working really hard trying to make the living who desperately need health insurance, and with the Affordable Care Act, we're going to expand Medicaid, and you and others are saying, "Oh no, no, it's OK for over 200,000 people in Louisiana not to take it," I think that's wrong.

VITTER: Bernie, the biggest reason those folks are uninsured is cost. And cost is going up, and it's going up even further under Obamacare. I think the first maxim of health-care reform is, if you think health care is expensive now...

SANDERS: You didn't answer the question.

VITTER: ... just wait until it's finished.

SANDERS: Let me just ask you something. Medicaid, how much does it cost for somebody to go on Medicaid? This is a federal program which costs zero dollars. So you're telling something in your state who can get -- finally get health care that they can't afford I.E., which doesn't cost them anything, but you're not going to accept that?

VITTER: It doesn't cause zero dollars to society, and it doesn't cause zero dollars to the state of Louisiana.

SANDERS: It sure does, for the first three years, it does cost zero dollars.

VITTER: And then we get a significant cost.

SANDERS: Not a significant cost. Ninety percent is picked up by the federal...

VITTER: Bernie, let me explain Louisiana budgets. We've been cutting health care and higher education for four years, and you want to put an additional cost and...

SANDERS: David, what I want to do for Louisiana -- I want in Louisiana, in Vermont and all over this country, people to have health care. I would be concerned...

VITTER: Absolutely.

SANDERS: Twenty percent of people in my state.

VITTER: And Obamacare is not leaning in that direction.

SANDERS: Well, the expansion of the Medicaid would have helped the people of Louisiana.

GINGRICH: We're going to come back to this. We're going to come back to this, but senator Vitter has a plan that will be extremely popular with voters and wildly unpopular with Congress. We'll ask him about it next.


GINGRICH: Welcome back. In the CROSSFIRE tonight, senators Bernie Sanders and David Vitter.

Back in 1994, Congress agreed to apply to itself all the laws it imposes on everybody else. Senator Vitter is proposing exactly that when it comes to Obamacare. His idea is to have members of Congress and their staff, as well as presidential appointees and the White House staff, buy health insurance from the Obamacare exchanges without extra subsidies.

After all, what's good enough for ordinary voters ought to be good enough for the people who represent them in Washington. Now Senator Sanders, I mean, given your really, in many ways, populist background, isn't it fair to say that the self-employed professionals, the small businesses and others who are going to be forced into these exchanges without any kind of underlying subsidy, they get an income- based subsidy, but they don't get some underlying subsidy, that having the Congress and other decision makers in Washington treated the same would be a form of equity?

SANDERS: Well, I think what's a form of equity is to treat federal employees the way every other major corporation in America treats its employees. So if you're at Microsoft or you're at IBM and you work for those companies, they pay a significant part of your health-care costs. It's called an employer contribution to health care. Federal government has always done that, and I think it should.

To say to an employee, "I know it's good politics. We can beat up on the federal government. Everybody hates Congress." It's a good sound bite. But the reality is we have people in your office, David, in my office are working, making $30,000, $40,000 a year.

And to say no, you're going to have to pay 100 percent of the cost of your health care unlike people in every other major employment environment in America, I think it's dead wrong. It's unfair. And also what it does, Newt, it sets a really bad example for the rest of corporate America. So you're IBM, you're a big corporation. You say to your workers, "Well, you know what? Look what the federal government is doing. They're not providing any employer-based health care. We'll do the same." Bad idea.

VITTER: Bernie, let's forget about politics. Let's start with the law. The Obamacare statute mandates this. This isn't my original idea. It is in the Obamacare statute that every member of Congress and all official staff go to the exchange, and there is no mention whatsoever with this huge taxpayer-funded subsidy.

And guess what? That proposal was made, that language was there. It was specifically not included. And no other American gets this huge taxpayer-funded...

SANDERS: Wait, David...

VITTER: That's just flat-out wrong.

SANDERS: No American going to the exchanges gets this huge subsidy. You get a subsidy based on income. And the whole point of this provision, which is in the statute -- this isn't just my idea, it's law -- the whole point of this provision is Congress should face the same reality and the same experience as 8 million-plus Americans, who are forced against their will into the exchange.

JONES: I just think this is terrible.

VITTER: Well, change the statute, Van. Change the law, because that's where it is.

JONES: It's not the law. VITTER: I want to expand it to the administration...

JONES: I'm sorry. Go ahead.

VITTER: I do want to expand it to the administration. That's not the law now, but it is the law with regard to Congress.

JONES: Well, first of all, it's been interpreted the opposite way of what you're saying. So you feel that way, but others don't.

But here's what I think is awful about what you're saying. You have kids who come up here to Washington, D.C. They could go work in corporate America. They could go do other things. They come here, because they're a part of the "Give a Darn" Party. Some of them are Democrats, some are Republicans. They give a darn about their country.

And they come here and they work really hard for you, and for this senator, and for you to say to them that, I think for political purposes, you're going to take away their employer subsidy that every other employer is giving their employees, I just think that's awful.

VITTER: Again, Van, we had this debate, and that's in the statute.

JONES: What about those kids? What about the kids who come up here and work hard, both? Are you going to punish them to make your political point?

VITTER: I think folks who make the law, members and staff, should have to eat their own cooking. I think that's important because of fairness, and I think it's important for a very practical reason.

JONES: Let me tell you where you're right and then where you're wrong.

SANDERS: David -- David...

VITTER: The sooner laws apply to Congress and staff, the same way as other Americans...

SANDERS: You are saying -- you are saying that's the law. Many of your Republican colleagues are not saying that that's the law.

VITTER: Bernie, read the statute. Read the statute.

SANDERS: What I'm telling you is most people in the Congress, including many Republicans, don't agree with you. And I think Van...

VITTER: They don't like the outcome.

SANDERS: Federal employees should not be treated differently than other employees in corporate America. Historically, as you know, forever, the federal government has done what other large employers do, and pay an employee...

VITTER: Bernie, as you know, I'm not talking about all federal employees. I'm talking about policy makers and folks who...

SANDERS: You're talking about kids who are making $30,000 a year working in your office.

VITTER: If they make $30,000 a year, they do get a subsidy, just like anyone else making $30,000 a year going to the exchanges. They do get an income-based subsidy, so they would get help.

JONES: Why don't -- I'm sorry.

GINGRICH: I just want to ask a practical question about the history of the law, because I'm confused. I thought amendments were offered that would have solved this, and they were defeated.

VITTER: Correct. The language was there that specifically included a subsidy, and that language was not put in the bill. Language was put in the bill, in contrast, which did not include that.

JONES: The bill is silent with regard to this, you're right. There's legislative history. But there's also an interpretation that goes the other way. And a lot of Republicans agree with me.

VITTER: And you can find a lawyer in this town to interpret that blue is green. You know that.

JONES: Let me ask you a question.

VITTER: That doesn't cover for violating and ignoring the law.

JONES: OK. So you want this to be fixed. Reid has offered you an opportunity to have a vote on this and to get this out of the way. And you've been -- you've been demagoguing it.

VITTER: He'd offered me a gag rule. I get one vote, and I can't...

JONES: How many votes do you want to have?

VITTER: How many votes does he want to have on his nominations?

JONES: If it's such a great...

VITTER: Last week, he filed a motion to reconsider on two nominations ideologues. Is he going to bypass that? Is he never going to file motions to reconsider again? He does that twice a month. If he will -- if he will forego that right as a senator, I will.

SANDERS: I think -- I think David is hesitant about a vote, because you're going to lose the vote. And you should lose the vote. But the point is, David, I don't know the exact -- we're talking about a few hundred people, a few thousand people. Right?


SANDERS: That's what we're talking about. That's what, you know, we're talking about here. The reality is that what we're trying to do in this country and what the real issue is, you've got 48 million people have no health insurance.

The Republicans, I have to say this. It's easy to criticize, and God knows that criticism of Obamacare is valid and we should do it. But what's your plan? What are you going to do about providing health care to 48 million people who have no health insurance?

VITTER: Bernie, you address me directly on this...

SANDERS: Let me finish. You tell me. Newt, you may want to jump in. You were speaker. Where is the Republican ideas so that the United States joins the rest of the world and makes health care right for all? Tell me what you're going to do.

VITTER: Let me start by saying why my proposal is important. Because the sooner those few thousand folks walk in the same shoes as Americans going to the exchange, the sooner Washington is going to start getting it right. And we don't do that now. We're created...

SANDERS: Your definition of getting it right is to do nothing about 48 million people who have no health insurance.

VITTER: Absolutely not.

GINGRICH: Let me answer -- let me answer that at a couple levels that you may not like.

First of all, everybody wants to focus on insurance, not on care. The fact in the British national health service, you are much more likely to die, much more likely to die of breast cancer. You are more likely to die of prostate cancer. These are just statistical facts.

Medicaid is so badly run in much of America that uninsured people have about the same health outcomes as Medicaid recipients. Nobody in the Congress wants to talk about how do you reform the care part of health care as opposed to the insurance part? There are a lot of ideas for how you can solve this.

John Goodman has been going around this country for 15 years saying you can solve it with a tax credit. And there are a lot of ways to do it that return power to the individual. You don't have to have a Washington-centered system. So I think there's a certain amount of...

SANDERS: Let me just say this. It is -- you know, I don't know the statistics about the U.K. on those issues. But the fact of the matter is that, compared to many other countries, in terms of our health-care outcomes, in terms of life expectancy, in terms of infant mortality, we're doing worse. You talk about the U.K. You know what? We're spending about two and a half times per person of what they are spending.

JONES: All right. Well, listen, stay here. We're not done. We're going to have a "Ceasefire" and see if there's anything in here we can actually agree with each other on. We'll have to see.

And we also want you at home to weigh in on today's "Fireback" question: "How do you think that Obamacare has affected the Democrats in yesterday's elections?" Tweet "hurt" or "helped" using #CROSSFIRE. We're going to give you those results after this break.


JONES: Coming up, the answer to our "Fireback" question: "How do you think Obamacare has affected the Democrats in Tuesday's elections?" There is still time for you to vote. You can tweet "hurt" or "helped." Use #CROSSFIRE. We'll be right back.


JONES: We are back with senators Sanders and Vitter. Now, we're calling a "Ceasefire," and we're going to see if there's anything we can actually agree on. What do you think?

SANDERS: There is an area that we may have agreement on. One of the reasons I voted for the Affordable Care Act is that we managed to get $12 billion new into community health centers, federally qualified community health centers. In my view, it does a great job of providing excellent primary health care, dental care, mental health counseling and low-cost prescription drugs to people who need it. Cost-effective care, real access for the people.

JONES: What do you think about that?

VITTER: I agree with that. In post-Katrina New Orleans, there are a lot of different versions of that. Many more examples than we ever had before, often teamed up with universities that are effective. But I also think it proves the point, there's no one simple answer. It will have to be a few different pieces of the puzzle coming together to provide coverage and care for a lot of different communities.

GINGRICH: I want to build on that. I went down and saw a number of these centers in New Orleans, having graduated from Tulane. I was very impressed with their creativity. The other thing I say, when I was a member I would visit them regularly in Georgia. I think they may be the most cos- effective federal health intervention we have in the entire country.

JONES: Good enough. Well, we want to thank both of you guys for being here.

VITTER: Thank you.

GINGRICH: And thanks, Senator Bernie Sanders and David Vitter.

Go to Facebook or Twitter to weigh in on our "Fireback" question: "How do you think Obamacare affected Democrats in Tuesday's election?" Right now, 45 percent -- 44 percent of you say hurt; 55 percent say helped.

JONES: See, the debate's going to continue. I think that's pretty close. I'm happy with that outcome, I must say. It's going to continue online at as well as Facebook and Twitter.

We also want to congratulate you again, sir, for your great new book, called "Breakout." I hope people pick it up, check it out. New ideas in there.

From the left, I'm Van Jones.


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