Interview with West Virginia Senator Joe Manchin: Healthcare

(Sinclair Broadcast Group)

EDITOR'S NOTE: Boris Epshteyn formerly served as a Senior Advisor to the Trump Campaign and served in the White House as Special Assistant to The President and Assistant Communications Director for Surrogate Operations.

WASHINGTON (Sinclair Broadcast Group) -

BORIS EPSHTEYN: Let’s talk about healthcare overall. You are one of 24 senators from both parties who’ve co-sponsored Senators Patty Murray and Lamar Alexander’s short-term bipartisan bill to stabilize the insurance markets. What do you think is needed to get that bill to a vote?”

SEN. MANCHIN: I think it’s going to get to a vote. I really do. I think the president is going to say, and I understand he has his reservations. He’s very clearly throughout his campaign even up to today, “I want to repeal.” Well, you know, I disagree respectfully and he and I have had this conversation. I said, Mr. President, we can repair, we can really fix this thing. We have good examples out there that have worked and basically for the six or seven years it’s been into effect. We know what’s wrong with it, how bad, what’s wrong, what needs to be fixed. We know how we can repair: reinsurance. Which it’s basically a glorified high-risk pool. Alaska has done a wonderful job. They have kept their rates down very low. Because Alaska and the United States teamed up they put money into reinsurance pool.

They took the sickest people they had, the people with chronic illnesses, end of life, all the very expensive, because 5 percent of the population in America uses and consumes about 50 percent of healthcare dollars we’re told. If you get this 5 percent over here and able to backstop them so the insurance companies say okay this person we’re not going to deny them. They can buy insurance and they can reasonably pay this much. But it’ll cost more. The insurance company says listen I gotta do one of two things I can not insure them and I’ll go out of business or I gotta have someone paying something.

So the reinsurance takes care of that, now the 95 percent have much lower rates and that has proven effective in Alaska so we have an example that works. The other thing is that my Republican friends are concerned about Medicaid expansion. Just ballooning and going completely wild. Well look at Indiana, Indiana did a very good responsible plan, it’s called the 2.0 plan. Everybody pays a little bit of something and everyone pays a little and holds them accountable and responsible. And then this manage carry? You can’t do that just because you were going to the emergency room now you got this expansion you can’t do that. You’re going to have to have, someone’s going to have to manage your care to get you to a healthier lifestyle knowing you have to get certain visits you have to have your tests done your screenings and preventative care. We can do that and Indiana has kept it’s costs down .

So we are looking at things that have worked and that’s why I said let’s try some of these that have worked. So the Patty Murray and Lamar Alexander has flexibility it means these states can do these things. Where they were prevented before because you kind of had to have a pure waiver, took forever to get waivers, it took out the bureaucracy that’s good. And I just think it basically stabilizes, the president doesn’t like CSR he thinks he’s supporting the insurance companies. They’re going to do just fine but the CSRs were there for a point to get people into the marketplace when they didn’t want to be and the CSR no matter what the president will do if he will be successful you’re still going to have that transition for a 2 year period.

That’s what they’ve worked upon and maybe we can have some of these other fixes. So in West Virginia just the insurance companies knowing that we have the CSRs, the backstop. That would reduce our premiums where they’ve increased them to. It would reduce them 15 percent. They are telling me 15 percent of the costs they are passing off is because of the uncertainty they won’t have the reimbursement. Well with the CSRs stabilized you will.

BORIS: The view is that’s a federal handout, so the view is that means the system doesn’t work well on its own if you need federal money to continue….

MANCHIN: True, but we are going to get transition into that where if we have the waiver provisions and states are able to find a pathway forward that they’re saying okay this is my charges I’m not denying anybody. So pre-existing conditions they are not going to be denied, we are going to take care of them, we’re going to reinsure them and to take them out of the pool where the insurance companies are coming in so we’re going to get more than one exchange. We’re going to one exchange in West Virginia.

BORIS: Right that’s been happening across the country.

MANCHIN: I need competition. I need competition in here and you create competition because you’re able to say okay I got 95 percent of the people but really if they manage their care we keep them in a healthier lifestyle. It’s much more cost effective. It’s less expensive and we all save.

BORIS: So in terms of the legislative schedule, right, tax reform is taking up a lot of time, sucking up a lot of oxygen. Is it realistic to think that healthcare reform gets addressed still this year?

MANCHIN: I think healthcare reform, this is my take on it, just my own personal opinion. Healthcare is T’d up and ready to go and if we sign off on, put it on the floor, it passes today. Well they say what about the House? That’s up to the House, we’re not involved in the House. If it passes this Senate in a bipartisan way, with over 60 votes, it’ll be hard pressed for the House to not look to not look at something when we represent the entire state, they represent certain districts.

BORIS: Do you think that’s realistic?

MANCHIN: I do think it’s realistic because I will think this: the president has showed he can get through his differences he can come to the middle we can stabilize something and go back and repair in more depth. So I’m thinking there’s no way we walk out of this year without healthcare.

BORIS: This year, 2017?

MANCHIN: This year, 2017. We’ll walk away from here with healthcare because it’s T’d up, it’s ready to go, we’ve all agreed, we’ve all signed off. You got 60 votes right now signed off on it. You don’t let that settle in the sideline and go home.

BORIS: Well the American people wanted to see that just in this week’s election in virginia, majority of voters said that the issue they cared the most about is health care.

MANCHIN: Well, You’re one illness away from bankruptcy if you don’t have some form of formal of care. You’ve got people talking about the single payer system, you’ve got Bernie Sanders, all them, I respect all of that. I got a critical need in my state right now: do we save affordable healthcare for 175,000 people? Can I help educate those people to use it much more cost effective, much more efficient way for them to be more healthier. I said this, 20 million people got healthcare, not one word of instructions. You can buy a box of cracker jacks, get the prize inside they tell you how to use the prize.

We’ve got cracker jacks okay, tell me how to use it so I get my full effectiveness from this little prize. You give me health care, the greatest wealth card you could give me you haven’t told me anything. If I never had health care before you know how I would use it? I’d go to the emergency room because I know they won’t turn me down. That is the most expensive delivery of systems that we have, that cost us more than anything else. If I can prevent that and show people how to live a healthier lifestyle. I’ve got an educator so that’s my Republican friends, work with us.

Let’s work through an educational process and there can be penalties if people don’t adhere to it. People have to be held accountable and responsible and I think that’s where my Democrat colleagues sometimes are drop the ball and don’t look like they are going to be holding people accountable and responsible. I think if you want to give somebody, give them the self-dignity of earning something and doing it the right way. And say I’ve earned this, I’ve earned my education I’ve earned my healthcare because I’m using it more effectively and efficiently.

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