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GOP Tweaks Current Effort To Replace Obamacare

MARY LOUISE KELLY, HOST:

We are tracking reports that the latest Republican health care bill is changing. The bill is aimed at repealing the Affordable Care Act.

DAVID GREENE, HOST:

According to a draft that is circulating, the newest version of this legislation would shift more money to states like Alaska and Maine, which are home to Republican holdouts, Senators Lisa Murkowski and Susan Collins. Now, this weekend, Collins was voicing doubts on CNN's "State Of The Union."

(SOUNDBITE OF TV SHOW, "STATE OF THE UNION")

SUSAN COLLINS: It's very difficult for me to envision a scenario where I would end up voting for this bill. I have a number of serious reservations about it.

GREENE: OK. Let's do the math here. Two Republican senators have already said they will vote no - Rand Paul of Kentucky and John McCain of Arizona. This means the bill cannot lose any more Republican support if it's going to pass by the Friday deadline.

KELLY: That's right. So let's remind people the full name of this bill is Graham-Cassidy-Heller-Johnson. And the Johnson in question is Senator Ron Johnson. He is a Republican from Wisconsin. He is one of the chief sponsors, and he's on the line now. Good morning, Senator.

RON JOHNSON: Good morning, Mary Louise and David. How are you doing?

KELLY: We are well. Thanks. And thanks for being with us. So this revised draft of your bill that's coming out today - we mentioned it includes more money for states that are home to senators whose votes you need. Why make that change?

JOHNSON: Well, first of all, the formula to make the distribution of federal health care dollars more equitable across the states has been an iterative process. And there have been changes all along. It's a complex problem. You know, you have Medicaid, which is - you know, there are all kinds of waivers out there. There's nothing unique about a state being unique. And so we have 50 unique states. And so this is - again, this has just been iterative process. And there's been an awful lot of changes just in the last week or so not only just for those states - for a number of states. So, again, it's there's nothing unusual about this. We're trying to make this as fair as possible.

KELLY: But let me respond - let me let you respond...

JOHNSON: Sure.

KELLY: ...To the question some people will have which is, if you are giving more money to states whose votes you're going to need - how do you respond to people who may see that as an effort to buy votes for your bill?

JOHNSON: Well, again, what I've been involved in is a process where formulas have been changing to, for example, extend the time period it's going to take to bring greater to equity the distribution of health care now. So it affects a number of states. Alaska and Maine will be probably part of that process, in terms of the adjustment. Probably every state's going to be part of that adjusted process, as well. So...

KELLY: But you're not giving more money to every state in this new version.

JOHNSON: No. Those states that currently get a disproportionate share - a larger share - of federal health care dollars, particularly in Obamacare funding - will see a reduction in what their increase probably would be. Some states might actually get a slight decrease. But, you know, currently, it's really been quite unfair. I know that, you know, California and New York and Massachusetts - they represent about 20 percent of the population. They get close to 36 percent of Obamacare funding. It's just simply inequitable. So we're - I think it's one of the major features of Graham-Cassidy-Heller-Johnson - is to try to bring greater equity in terms of federal funding. You're never - it's never going to be perfect. The funds right now are being distributed basically under Cassidy-Graham based on the population of people 50 and 138 percent of the poverty line - again, directed toward those individuals that actually need the funding.

KELLY: So we're sitting here, talking on Monday morning. Let me put the same question that I put elsewhere on the show this morning to Senator Ron Wyden, your Democratic colleague. If you had to put a percentage on this, where would you put the chances of this bill passing this week?

JOHNSON: Well, I'm still cautiously optimistic. But if we don't get it done this week, Senator Graham and I have both told the leadership in the Senate that we won't vote for a budget resolution that that won't give us the same possibility of passing a health care reform within that same process of budget reconciliation. But, you know, what I would say is that would be the last resort. I've been pretty critical of this process.

I think we all should've started reaching out to the other side, talking about the problems - the real problems - we face in the health care system, the real problems created by Obamacare, acknowledging the benefit. Twenty million more Americans got health care. Nobody wants to pull the rug out from underneath those. Work in good faith. But if Democrats in the end don't work in good faith and really address the problem, which I would say is skyrocketing premiums that have doubled, leaving, in many cases, people with pre-existing conditions unable to afford health insurance, particularly if they continue to work.

KELLY: So...

JOHNSON: There's no absolute guarantee of people being covered - guaranteed - with pre-existing conditions under Obamacare.

KELLY: Just real quick - I'm hearing you correctly - may I just jump in?

JOHNSON: Sure.

KELLY: Because I just want to make sure I'm hearing you correctly. You would like for this to pass this week, but you are still - you are already looking forward to maybe tying this to a budget vote if it doesn't?

JOHNSON: For next year if we don't pass this year. We'll give ourselves that option for next year, as well. We can't stop this effort. Obamacare markets are collapsing. Premiums have already doubled nationally. So this is a real problem. I'm personally hoping that we can pass it this week. We set up this process of federalism, where we turn to funding over to states so they can be innovative. And I think - truthfully, I think there's going to be more opportunities for us to work in a bipartisan fashion as governors start coming to Washington, D.C., looking for greater flexibility.

KELLY: That's Wisconsin's Ron Johnson. He is a sponsor of the Republican health care repeal effort, which is working its way through the Senate. Senator Johnson, thank you.

JOHNSON: Have a great day.

KELLY: We also have here in the studio with us another voice, NPR's Susan Davis, who covers Congress. So you were listening there, hearing Ron Johnson defend his bill. What struck you?

SUSAN DAVIS, BYLINE: When he talked about the fact that he and Senator Graham have suggested that they would vote against the next budget resolution if they don't get health care passed, that is hugely significant. And that is hugely significant because the next budget resolution is what Republicans want to use to pass tax legislation. And if Republicans are willing to hold that hostage to keep the repeal-and-replace fight alive, that could down two Republican priorities this year, which is health care and taxes. And the fact that they're willing to make that play is the next major fight to look for in Congress.

KELLY: Not that we needed more fights to look for in Congress.

(LAUGHTER)

KELLY: NPR's Sue Davis, thank you.

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