On her MSNBC show on Tuesday, anchor Andrea Mitchell decried President-elect Donald Trump’s “controversial cabinet nomination” of Georgia Congressman Tom Price as Secretary of Health and Human Services, warning viewers that he has been “a fierce critic of ObamaCare and has been a major proponent of overhauling entitlement programs like Medicare.”
She invited on one of the architects of ObamaCare, Dr. Zeke Emanuel, to spend the next several minutes blasting Price and stoking fears that millions would lose health insurance if Republicans repealed the unpopular healthcare legislation.
The brother of Chicago Mayor Rahm Emanuel began by ranting: “First, for many years he's proposed privatizing Medicare and not making it a government entitlement program but getting people into the private health insurance market. That makes a lot of people very nervous and scared...”
Moving on, Emanuel declared: “Second, he wants to take away the exchanges and what he wants to do instead is give people vouchers or tax credits so they can buy insurance....it’s a lot worse deal than the deal under the Affordable Care Act exchanges.”
Wrapping up his tirade, the doctor proclaimed: “And the last point I would make is if you look at all of the puts and takes in his plan it's probable that somewhere between 9 and 15 million people will lose their health insurance coverage....it’s going to adversely affect the affordability of health insurance in this country.”
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Rather than push back on Emanuel’s assertions by pointing out the already skyrocketing insurance premiums under ObamaCare, Mitchell avoided challenging her liberal guest and even invited him to attack another Trump appointee: “But there’s another piece of this, which is the potential nominee to run the Medicare part of HHS [Seema Verma]. And that is someone who has a very strong track record against Medicare as we know it.”
Emanuel whined: “Yes. So CMS runs both Medicare and the federal part of Medicaid. And she has been, again, a strong advocate for privatizing the Medicaid portion of it when she was in Indiana. And I think you can see that's a theme, more privatization.”
He wrapped up the exchange by repeating his attack lines: “And again, Congressman Price has been against the individual mandate, against employer mandates....the details we do have, as I mentioned, suggest that many millions of Americans are likely to lose their coverage either by cutting back Medicaid or by not being able to afford insurance in these new arrangements.”
Here is a transcript of the November 29 segment:
12:37 PM ET
ANDREA MITCHELL: President-elect Donald Trump with a controversial cabinet nomination today, Republican Congressman Tom Price as Health and Human Services Secretary. Dr. Price, he is a doctor, an orthopedic surgeon, is a fierce critic of ObamaCare and has been a major proponent of overhauling entitlement programs like Medicare.
Joining me now Dr. Zeke Emanuel, one of the architects of ObamaCare, chair of medical ethics and health policy at the University of Pennsylvania. Thanks very much, Zeke, good to see you.
Tom Price, he was – well, he is the budget chair on the House side, so he knows the numbers. He’s never run anything as large as HHS, but we’ve had past Democratic HHS secretaries who’ve never run big organizations. But what about the prospects for dismantling ObamaCare?
ZEKE EMANUEL: So let's emphasize two or three things about Tom Price's view of the world. First, for many years he's proposed privatizing Medicare and not making it a government entitlement program but getting people into the private health insurance market. That makes a lot of people very nervous and scared and I think that's one of the things he is likely to push for.
Second, he wants to take away the exchanges and what he wants to do instead is give people vouchers or tax credits so they can buy insurance. But I think the way he wants to do it, at least on the plan he has on his website, a lot of people would be paying a lot more money for those health insurance programs. Just to give you an example, if you’re 35 years old, you get $1,200. It’s not income adjusted so poor people get more and wealthier people get less – flat fee of $1200. And if you look at most locales across the country, health insurance for a 35-year-old runs between $4,000 and $5,000. That means you're going to be shelling out somewhere between $2800 and $3800 of your own money. That is a lot of money to buy insurance, it’s a lot worse deal than the deal under the Affordable Care Act exchanges.
And the last point I would make is if you look at all of the puts and takes in his plan it's probable that somewhere between 9 and 15 million people will lose their health insurance coverage. It's hard to tell because he doesn't have a lot of details, but that’s a lot of people losing their coverage. Hospitals having to provide more uncompensated care, doctors providing uncompensated care, and that has a tendency to actually raise insurance costs and it’s going to adversely affect the affordability of health insurance in this country. For a man who’s campaigned about affordability that seems like strange path forward.
MITCHELL: Now the facts, though, are that we – that ObamaCare was passed with a bare majority under the budget rules, reconciliation, so they only need 51 votes to get this passed. And that seems to be certainly within their scope.
EMANUEL: Well, Andrea, let's be a little clear. No, that's not completely true. So anything – in reconciliation, there are only certain things you can deal with. Those are things that affect the budget. And so parts that don't affect the budget cannot be dealt with in reconciliation.
MITCHELL: Okay.
EMANUEL: So actually the legal structure of the exchanges cannot be dismantled under reconciliation. Subsidies can.
MITCHELL: You we need 60 votes, okay.
EMANUEL: Yeah, that would need 60 votes. So again, we need to be clear. There are some things in reconciliation of ObamaCare that can be dismantled, those are things that effect the budget – tax credits or subsidies or other spending programs. But things that aren't spending, are not from the federal budget, cannot be done in reconciliation. They need regular legislative order, 60 votes in the Senate. So not all of the Affordable Care Act can be repealed that way.
MITCHELL: And that's an important clarification. Thank you for that. And also the fact that Donald Trump has said he wants to keep things which are the popular things, of course, the pre-existing condition, having young people continue to have insurance. But as you’ve just pointed out, you’ve got to pay for them with the other provisions and it all works together as it was carefully constructed.
EMANUEL: Right.
MITCHELL: We have a comment from Josh Earnest at the briefing just now saying, “What Price – Dr. Price, Congressman Price – will learn is that he will implement the President's plan, not his own. We'll see what proposals he’ll put forward, we’ll see if TrumpCare measures up.” Those are notes out of the Josh Earnest briefing. Obviously the President has been talking to the President-elect about a lot of things, presumably including this, and there may be some flexibility on it as well coming from the President.
But there’s another piece of this, which is the potential nominee to run the Medicare part of HHS [Seema Verma]. And that is someone who has a very strong track record against Medicare as we know it.
EMANUEL: Yes. So CMS runs both Medicare and the federal part of Medicaid. And she has been, again, a strong advocate for privatizing the Medicaid portion of it when she was in Indiana. And I think you can see that's a theme, more privatization.
Clearly if we’re going to have TrumpCare come out, there are a lot of details that need to be evaluated. And they have to work together. As you point out, you can't have – we’re not going to have the pre-existing condition exclusion. We are going to allow people who have things like cancer and heart disease to get insurance at affordable rates. The question is, how you make that possible without requiring people all to get insurance?
And again, Congressman Price has been against the individual mandate, against employer mandates. He wants independent health insurance pools. It's unclear how those are distinct from the exchange. A lot of details here that have not been defined that make it hard to fully understand the plan. But the details we do have, as I mentioned, suggest that many millions of Americans are likely to lose their coverage either by cutting back Medicaid or by not being able to afford insurance in these new arrangements.
MITCHELL: Dr. Zeke Emanuel, thank you so much for joining us from Philadelphia today.
EMANUEL: Thank you. We look forward to what’s going to evolve from this health plan.
MITCHELL: Indeed.
