Republican Health Care Bill Undergoes Final Changes Ahead Of Vote

NPR's Kelly McEvers speaks with Republican Rep. Bradley Byrne of Alabama about the final changes to the GOP health care bill before it goes to a vote on Thursday.

KELLY MCEVERS, HOST:

The Republican health care bill comes to a vote tomorrow in the House. And it's not clear if the party has the votes to pass it. Earlier today, I talked to Republican congressman Bradley Byrne of Alabama. He supports the bill. I asked him what would happen if it doesn't pass.

BRADLEY BYRNE: Well, if it doesn't pass, then it doesn't pass. Some of the no votes on the Republican side seem to think that there is an alternative - there isn't. There's either passage of this bill or there is the defeat of this bill. And I think the reality of that is beginning to sink in with some of them. And that's why so many of them are beginning to change their minds.

MCEVERS: Can you relate to them at all though, some of the people who - in your party who don't like the bill? I mean, they say that this party's been fighting for years to repeal the Affordable Care Act. And this bill doesn't actually do that.

BYRNE: Well, actually it repeals the most important parts of it. It repeals virtually all of the taxes, for example. So this is almost a $900 billion tax cut, which for conservatives is a big win. It repeals a big part of the Medicaid expansion. And over time, this all equals up to about a $300 billion decrease in the deficit. And at the same time, we're able to lower premiums.

So when you add all that together, it actually turns out to be a pretty substantial repeal of Obamacare law. It preserves some things that are very popular, like allowing 25 year olds to stay on their parents' insurance policy. It keeps the provision that says you can't be denied insurance for a preexisting condition. So there's some things that we have bipartisan agreement on and those are going to stay.

MCEVERS: Another thing your Democratic colleagues have said is that the new plan would take away health care from millions of the most vulnerable Americans. Will there be any changes to deal with that?

BYRNE: That turns out to be bogus.

MCEVERS: OK.

BYRNE: That turns out to be bogus. I was just going through a pretty detailed review of that CBO analysis. They say 24 million people will, quote, "lose insurance." Eleven million of those people - and this is CBO's analysis - won't lose their insurance. They're presently required to have insurance. And they're going to elect to drop their insurance because they don't want to have to have that insurance - 11 million out of the 24 million.

MCEVERS: And just a clarification here. We checked the congressman's numbers. And he's sort of right. If the requirement to have insurance goes away, a lot of people likely will drop their plans. But many will drop those plans because they won't be able to afford them if subsidies shrink or disappear. OK. Now back to the interview.

Yesterday, President Trump came to Capitol Hill to try to convince some of your Republican colleagues who say they won't vote for the bill to vote for the bill. And he warned them, you know, he said they could lose their seats if they don't get this done. But a lot of these lawmakers come from safe districts where they easily win re-election. I mean, does that mean that this warning just doesn't mean much to some of these lawmakers?

BYRNE: No, it means a lot. There's no such thing as a safe district. You may be, quote, "safe," closed quote, in a general election because you have a large number of Democrats or a large number of Republicans in your district. But that doesn't mean you're safe in a primary. And I can tell you that from personal experience.

What the president was saying yesterday, it's not that he's threatening anybody - it's very clear that he wasn't - but that he thought that there was so much support for this repeal and replace plan among Republicans, that if a Republican member voted against it, that they would be inviting somebody to run against them in a primary. So I think there's a real threat here. And I think he was correct in his assessment.

MCEVERS: One more sort of big picture question. You know, what's the rush to push this bill through tomorrow? You've got, you know, still some conservative Republicans who don't like the bill, obviously Democrats who don't like the bill. Why not wait until there's a sense that more people would be onboard?

BYRNE: What we are hearing from people in the health insurance industry is that these plans are deteriorating so rapidly that we cannot wait. If we don't get something going now, we're not going to be in a position to try to repair these insurance markets before they fall apart.

We have one insurer on the exchange in Alabama. If that insurer pulls out of the Alabama exchange, there will be no insurers on any health care exchange in the state of Alabama. That would be a tragedy for people. So we have to act now to protect people from what's going to happen to them if we just let this thing fall apart, which is what it is doing.

MCEVERS: Republican Bradley Byrne of Alabama, thank you so much.

BYRNE: It's good to be with you.

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