Paul says conservatives won't support Republican health plan, hope to negotiate one more to their liking with Trump involved

Sen. Rand Paul (ABC image)

By Al Cross
Kentucky Health News

Republican U.S. Sen. Rand Paul laid out his objections to House GOP leaders’ bill to replace the Patient Protection and Affordable Care Act on CBS’s “Face the Nation” Sunday.

Paul called for an end to federal mandates for what insurance policies must cover, which the 2010 law called “essential benefits.” He said that change would enable consumers to buy the sort of coverage they want, at lower prices.

“Premiums will keep rising because they do nothing to fix the fundamental problem,” Paul told interviewer John Dickerson.

He also objected to the bill’s taxes, its “bailouts” for the insurance industry and the 30 percent surcharge that an insurance company could impose on someone who goes without coverage for more than 63 days in 12 months.

The surcharge is effectively a substitute for the current law that requires almost all Americans to have health coverage.

“The individual market will get worse when you get rid of the individual mandate,” Paul said, arguing that if someone loses a job, there will no incentive to sign up until coverage is needed. “You can’t have an insurance model where people wait ‘til they’re sick to get insurance,” he said.

Dickerson asked Paul about Medicaid, which covers 1.3 million Kentuckians, including 440,000 added through expansion of the program under the reform law.

The bill would set the first spending limits for the program, beginning in 2020, but Paul questioned whether the limits would be effective because the limit would rise with one measurement of inflation.

“It’s still building in the growth of an entitlement program that really isn’t paid for,” Paul said. “We have no money; we borrow a million dollars a minute.”

Paul, who has long made the federal deficit and the national debt his signature issue, shares those concerns with the House Freedom Caucus, a group of Republican representatives. Together, they pose significant obstacles to the bill, which is starting in the House.

If enough Republicans oppose the bill, it cannot pass. Paul said that if it is not changed, it will not pass, and that would begin talks that would include President Trump.

“I don’t think the president is rigid in support of the House bill. I think he's open to seeing how we can get consensus,” Paul said. “If enough conservatives to say no to the rule, then true negotiation begins.”

Paul was an apparent object of Vice President Pence’s Saturday trip to Louisville, hosted by Gov. Matt Bevin, who said Friday that he was closer to Paul on the issue.

Paul told Dickerson, “Right now I think there’s a charm offensive going on. Everybody’s being nice to everybody because they want us to vote for this, but we’re not going to vote for it.”