STEVE INSKEEP, HOST:
The Senate delay in voting to repeal and replace the Affordable Care Act is giving lawmakers extra time to discuss the legislation.
(SOUNDBITE OF ARCHIVED RECORDING)
RAND PAUL: If we get to impasse - if we go to a bill that is more repeal and less big-government programs, yes, I'll consider partial repeal.
BILL CASSIDY: Right now, I am undecided.
DEAN HELLER: Not the answer. It's simply not the answer.
INSKEEP: We heard Republicans Rand Paul, Bill Cassidy and Dean Heller all expressing various concerns about the measure. And this is key - they are different concerns. South Dakota Republican Mike Rounds is here.
Senator, welcome back to our studios.
MIKE ROUNDS: Thanks. Appreciate the opportunity to visit.
INSKEEP: Glad you could come by again.
Now, you told us in May - I looked this up - that the House version of this bill was projected to cause about 23 million more Americans to go off insurance. And you wanted to do better than losing insurance for 23 million people. Well, this bill, according to the CBO, 22 million lose insurance. Technically better, but is that good enough?
ROUNDS: Moving in the right direction.
INSKEEP: Is it actually a good bill in your view?
ROUNDS: It's better than the House bill. We can do better. We'll make changes in this one. I'm pretty confident of that. We'll have fewer people that will remain uninsured. And you have to remember, in this particular bill, you've got about 15 million that they're suggesting will be uninsured because they don't want to buy insurance. I think if we make it more affordable, there's a lot of folks out there that will buy it. This particular version - and once again, I believe we're going to be making more changes in it - it actually will reduce premiums, compared to the current law, by about 30 percent in the year 2020.
INSKEEP: Well, let's talk about that. The Congressional Budget Office did say that some people would pay lower premiums, as you just noted, but that they still might not find insurance to be worthwhile because deductibles would go up. The actual value of the insurance would change. How are you going to improve that?
ROUNDS: The actuarial value is what you're talking about, the amount of the costs involved. Under a silver plan, it's about .70. Under the current proposal, it's closer to what they call a bronze plan now, for comparison, at about .58. So what that means is is that there's less benefit in some of the coverages.
INSKEEP: This is a real person saying, I don't get any value for this insurance.
ROUNDS: Well, what they're saying is is that, even if I buy it, in some cases, I'll never meet the deductibles and co-pays. That's the part that we're trying our best to make modifications on. Some of us have talked. And this is - you know, this has been reported in the press. There are a number of taxes that are being repealed, appropriately so, because they impact everybody. And they're driving up the cost of health care. But there is one particular tax that was imposed by Obamacare that was on the incomes of individuals as families who earn more than 250,000 a year. If that particular one was not repealed, it would allow us about $172 billion of additional revenue coming in over this 10-year period of time that could be used to make some improvements in the benefits under the bill.
INSKEEP: OK, this is really interesting because we hear elsewhere in today's program from a representative of the AARP who says, as many people have, this isn't really a health care bill at all. This is a tax-cut bill that gets the money by taking money away from health care. You're telling me you're willing to get rid of one of the big tax cuts in this bill in order to have more money for health care.
ROUNDS: One of the reasons why leadership scored this bill the way that they did was to be able to find out where the revenue sources were and where the costs were. This is one of those areas where it is a revenue source coming in. We've got ongoing costs that will not be going down very rapidly. And even as we start to repeal provisions of Obamacare and replace them with more state opportunities to be competitive in the market, we've got what we call an Obamacare hangover. And that is these higher costs right now that are going to be, if we don't do something to offset them, folks that can least afford it are going to be the ones that are going to end up stuck with the costs.
INSKEEP: Are you speaking for yourself, for a few senators, for many senators when you say, let's not have as many tax cuts in this measure so there's more money for health care?
ROUNDS: I think all of us in the Senate would speak independently on it. So I don't want to speak for the entire group. But I can tell you that both privately and as a general group, we've talked about this issue. There's no consensus yet. That wouldn't be fair to call it that. But that's the reason why we wanted more time. It's the reason why leadership understood that even though they know that they have a time constraint - that they also want to do it right.
Look, I give our leadership team a lot of credit here. They're pushing as hard as they can because they understand that we've got to get things done, House and Senate, in order to send a message to the carriers and the states before January 1 so those premium increases that otherwise are going to go through the roof - they can start to stabilize.
INSKEEP: A reminder...
ROUNDS: That's the deadline that we're worried about.
INSKEEP: A reminder that huge premium increases are warned to be on the horizon. Senator, thanks for coming by - really appreciate it.
ROUNDS: Our pleasure.
INSKEEP: Senator Mike Rounds of South Dakota. Transcript provided by NPR, Copyright NPR.