AUDIE CORNISH, HOST:
As we mentioned, the GOP health care plan as it now stands would allow states to opt out of certain rules under Obamacare. States could choose not to require insurers to cover what's known as essential health benefits, and they could get rid of the ban on charging higher premiums to people with pre-existing conditions. Now, for this latest version of the bill to go anywhere, it'll have to get support from more moderate Republicans, and so far, not enough have signed on.
Leonard Lance, Republican congressman from New Jersey, is one who remains opposed. He joins the program now. Congressman, welcome to the program.
LEONARD LANCE: Thank you, Audie, for having me.
CORNISH: Now, the amendment put forth yesterday was negotiated in part by your fellow New Jersey congressman Tom MacArthur, a self-described moderate. Can you talk about why you can't get on board with it?
LANCE: I favor legislation that reduces premiums for the American people and certainly continuation of no denial of coverage based upon a pre-existing condition. And I don't think the legislation, either in the form in which it existed before the Easter recess or in the current form, is good enough in either of those areas. And that is why I continue to oppose it.
CORNISH: So you flagged particularly that issue of states being allowed to say, hey, we want to be able to let insurers charge higher premiums in our state for people who have so-called pre-existing conditions.
LANCE: Yes, and New Jersey has the state legislation that would prohibit that, but I don't think this should be something that is different state to state. Health care insurance should be both accessible and affordable.
That doesn't mean that there aren't challenges with the ACA. I see significant challenges, particularly regarding the exchanges. And I challenge our Democratic colleagues to come to the table because I do think that we need to reform the ACA, and I hope that we can do that in a bipartisan way.
CORNISH: To your point earlier, you know, House Speaker Paul Ryan said today that this would all give states greater flexibility, that a cookie-cutter, one-size-fits-all health system doesn't work for America. I mean, what's your response to that? I mean, why shouldn't you be able to decide in New Jersey what you want and someone else in Mississippi or Kentucky decide something else?
LANCE: I don't favor a cookie-cutter approach, and I agree with the speaker to the extent that the states should have the ability to be innovative. I do think there is a responsibility, however, to make sure that those with pre-existing conditions can purchase policies at an affordable rate.
The whole concept of insurance is to spread the risk, and spreading the risk means that those with pre-existing conditions will have to pay for coverage, but the payments should not be so great that, in fact, there is not accessibility.
CORNISH: Now, the head of the conservative advocacy group Club for Growth, David McIntosh, has said that, quote, "many GOP moderates who stand in the way at this point are proving that they simply don't want to keep their campaign promises to get rid of Obamacare." What's your response to that?
LANCE: I have campaigned repeatedly on what is known as repeal and replace, not simply repeal. This is documented. And I've also campaigned repeatedly on making sure that there's no denial of coverage based upon a pre-existing condition. I have always stated that, and I continue to state that.
CORNISH: You mentioned earlier about hoping Democrats would come aboard. But, you know, I think a Democrat watching this would see what kind of trouble moderates (laughter) Republican moderates are going through right now, the kind of pressure and focus, and it doesn't look like there's a lot of room for negotiation. I mean, what do you see?
LANCE: I hope there is always room for negotiation. And the fact that in one-third of the counties in this country, not one-third of the population, but one-third of the counties, largely in rural America, there is only one insurer in the exchanges is very concerning to me.
In New Jersey, we originally had five insurers for the exchange. We're now down to two. And that is why I hope that at some point - and I would hope at some point soon - the Democrats might come to the table on this issue.
CORNISH: Republican Congressman Leonard Lance of New Jersey, thank you for speaking with ALL THINGS CONSIDERED.
LANCE: Thank you very much, Audie.
(SOUNDBITE OF DR. DRE SONG, "XXPLOSIVE - INSTRUMENTAL VERSION") Transcript provided by NPR, Copyright NPR.