Jackie Judd talks with PBS NewsHour's David Chalian about the GOP presidential candidates' health law repeal rhetoric, the varying level of nuance among their viewpoints and how each is attacking the President's – and each other's – stances.
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JACKIE JUDD: Good Day, this is Health on the Hill, I’m Jackie Judd. What would a week be without another debate among the Republicans candidates for president? Well Thursday, the current group of eight will meet in Orlando, Florida. We want to step back today to discuss what we know so far about the candidates’ positions on health care and the reform law. Here’s a sampling:
VIDEO CLIP OF GOP CANDIDATES SPEAKING
NEWT GINGRICH: Obamacare is a disaster.
MITT ROMNEY: It’s not going to work. It’s massively expensive.
HERMAN CAIN: An individual mandate to buy ...
MICHELE BACHMANN: … buy a product or service against their will …
HERMAN CAIN: … is not constitutional.
RICK SANTORUM: They have passed oppressive policy, oppressive regulation after Obamacare being first and foremost.
RON PAUL: That’s what freedom is all about: taking your own risk.
JON HUNTSMAN: The most important thing we can do in this health care debate is talk about personal responsibility.
MITT ROMNEY: And one thing I’ll do …
RICK PERRY: … On Day One …
MICHELE BACHMANN: … As president of the United States …
MITT ROMNEY: … I’ll direct the secretary … to grant a waiver from Obamacare to all 50 states.
RICK PERRY: And Obamacare will be wiped out as much as it can be.
BACHMANN: I won’t rest until I repeal Obamacare.
END VIDEO CLIP
JACKIE JUDD: Joining me to discuss the GOP field is David Chalian, political editor for the NewsHour on PBS. Welcome back, David.
DAVID CHALIAN: Thank you very much.
JACKIE JUDD: Clearly a theme is emerging there: Repeal the president’s health care law, the Affordable Care Act, Obamacare, whatever you want to call it. Is there nuance among the candidates and what they’re saying?
DAVID CHALIAN: I don’t think there’s a terrible deal of nuance there. I think, in fact, your editors put that together very brilliantly to show that you can actually substitute some of the identical words that each of the candidates used. I do think though, that what the candidates bring to their desire to see the Obama health care law overturned and repealed, that’s where the nuance exists, it’s almost in their history and their records on the issue. For instance, Gov. Mitt Romney implemented the Massachusetts health care reform plan that the Obama health care reform plan is very much modeled on. That’s a big vulnerability for him inside the Republican nomination contest. And so he does this very vociferous thing about ‘I will direct the HHS secretary on day one in the Oval Office to waive all 50 states away from the law, issue waivers to them.’ Whereas Michele Bachmann - the Republican congresswoman from Minnesota, head of the Tea Party Caucus, was one of the most vocal critics throughout the entire health care debate - she uses her legislative knowledge and know-how and says she knows how to go about getting Congress to overturn that law, because it, of course, has to be done legislatively. And she has a lot of credibility on the issue inside the Republican Party.
JACKIE JUDD: Having listened to all the debates as closely as I know you have, does it seem like Michele Bachmann is running harder on this issue than some of the other candidates?
DAVID CHALIAN: Yes, I think that’s a fair assessment, Jackie. I do, because her base of support is the Tea Party crowd that came so much to life throughout the health care debate in August of 2009 at those town halls, you remember. And she uses it all the time in her remarks to identify with that base. Whereas I think, although she also talks about the economy and jobs, and that’s the number one issue, the other candidates are more willing, to sort of check the box on ‘Yes, let’s repeal what they call Obamacare’ and then move on to their issues of choice. This actually is an issue of choice.
JACKIE JUDD: Are there any other candidates on the stage who, to your mind, are helping to drive the debate in one direction or another? I’m thinking specifically of Ron Paul, who as you saw in that clip, spoke about personal responsibilities. Is that a theme that he forces the other candidates to address as well?
DAVID CHALIAN: Well, right after that statement that he said, Wolf Blitzer followed up, right, and said, ‘should you just let somebody die …’
JACKIE JUDD: Who’s not insured …
DAVID CHALIAN: Who’s not insured right, and somebody from the crowd, it was a tea party debate, and the tea party crowd said, ‘Yeah.’ Every candidate has been asked, if they’ve done interviews since this debate, to respond to that. So in that way, Ron Paul has forced the other candidates to answer questions subsequent to the debate about personal responsibility. The personal responsibility piece though, is less about, ‘Should we just let somebody die if they are uninsured?’ and more, I think, that you hear these Republican candidates time and again refer to health savings accounts. This is something that President Bush put forward, John McCain put forward in his campaign plan.
DAVID CHALIAN: …The notion of that kind of personal responsibility. You have a personal health savings account and allow the market pressures to work its will on health care costs, because you’ll be more familiar with the costs; you’ll have the savings account; you may not spend as freely as not knowing what the cost of health care is. And I think that’s when you see the personal responsibility piece in there a lot more often from the candidates.
JACKIE JUDD: And another sub-thing – maybe it doesn’t rise to the level of big thing yet – is something that Governor Perry talks about and that is giving the states more authority, more autonomy from the federal government regarding Medicaid.
DAVID CHALIAN: Right, the desire among governors, especially Republican governors, for block-granting Medicaid to the states to give them that freedom to figure out how to make the system work as best they see fit in their states. This is something – Gov. Perry’s not alone in this at all. Mitch Daniels of Indiana is a big proponent of this. And this is actually, I think, one of the arguments within Republican circles that – some polling indicates - has some appeal among independent voters as well about Medicaid reform, in this way. We have not heard, other than the Democrats knee-jerk response to it, ‘Oh, that it will just slash benefits for people on Medicaid;’ it’s just code for ‘let’s cut Medicaid.’ I have not yet heard the President’s campaign or really from the White House yet make a point-by-point argument against the block granting, other than they just fear that it will slash benefits.
JACKIE JUDD: The last couple of months, during which time we’ve probably had four to six Republican debates, there have been a lot of other issues for these candidates to address. The issue of health care, the entitlement programs really haven’t been front and center. Is that okay with the candidates?
DAVID CHALIAN: I think it’s okay because it’s not the top of mind issue for the voters right now. We’re in a different place than we were in 2009 when this debate centered – I mean, our entire political process was viewed through the prism of health care. And in the 2008 campaign, do you remember how much time Barack Obama and Hillary Clinton spent debating back and forth about the individual mandate? It was as if the whole election was going to be about that one issue in health care reform. Because of where the economy is, because of the job situation, health care is just not rising to that level. However, what we have talked about here, there are two points about health care that constantly do come up: One is Mitt Romney’s problem – and since he is one of the leading candidates – his problem on the individual mandate because the others get to use that as a government overreach argument, and too much federal government in your lives. And it’s not necessarily about health care specific, but it is an important theme that they want to hit…
JACKIE JUDD: The proxy.
DAVID CHALIAN: Exactly, it serves as a proxy. The other is on Medicare. Remember, throughout the 2010 midterms, Republicans were bashing away at President Obama and the Democrats for the Medicare savings inside the health care bill – right – and saying that they were going to destroy Medicare. And then this year, Paul Ryan’s House Republican budget passes and it becomes the Democratic talking point to say: ‘No, no, no, they’re going to kill Medicare.’ And, I think, you’re starting to see these Republican candidates stepping up to their argument to saying: ‘We’re trying to save Medicare for future generations.’ We’ve started to hear it and I think you’re going to hear more – even as politically precarious as the Ryan plan is polling wise – you’re going to hear these Republican candidates defending that approach more: that Medicare must be dealt with. Because they like the contrast with President Obama, calling him a failed leader, because he keeps putting Medicare reform really to the side of all these fiscal issues that he’s battling with right now.
JACKIE JUDD: All right, thank you so much. David Chalian of the NewsHour.
DAVID CHALIAN: Thank you.