washingtonpost.com
Rep. Eric Cantor makes remarks on insurance regulation at White House health summit

CQ Transcriptions
Thursday, February 25, 2010; 1:48 PM

CANTOR: Mr. President?

OBAMA: Yes?

Mr. Cantor, please.

Eric?

CANTOR: Mr. President, thank you, again, very much for having us and staying with us for the six hours. Appreciate that. I don't know if you will, after the six hours or not. But...

OBAMA: I gather -- I gather -- let me just guess. That's the 2,400-page health care bill. Is that right?

CANTOR: Well, actually, Mr. President, this is the Senate bill, along with the 11-page proposal that you put up online that really I think is the basis for the discussion here.

So -- but I do want to go back to your suggestion as to why we're here. And you suggested that maybe we are here to find some points of agreement to bridge the gap in our differences. And I do like -- to go back to basics, we're here because we Republicans care about health care just as the Democrats in this room.

And when the speaker cites her letters from the folks in Michigan and the leader talks about the letters he's received, Mr. Andrews his, all of us share the concerns when people are allegedly wronged in our health care system.

I mean, I think that is sort of a given.

We don't care for this bill. I think you know that. The American people don't care for the bill. I think that we demonstrated, you know, in the polling that they don't.

But there is -- there is a reason why we all voted no. And it does have to do with the philosophical difference that you point out. It does have to do with our fear that if you say that Washington can be the one to define essential health benefits, there may be a problem with that.

And that's the language in the Section 1302 of this bill, that it says that the secretary shall define for people what essential health benefits are.

But let's -- in the spirit of trying to come together, let's try and say maybe if -- if we assume that Washington could do that, could really take the place of every American and decide what is most essential, what -- what would be the consequences?

CANTOR: And that's also where we have a big difference, in this bill, and what would happen.

First of all, the costs -- and Jon Kyl laid out the tremendous costs and the nearly $1 trillion of this bill. And I don't quite know, because CBO said it couldn't assess how much your additions would cost to it, but we do know that there are plenty of taxes on income. Now you suggest investment income should be taxed. We have additional taxes on medical devices and the rest.

What is the consequence of that?

We know there are consequences that small businesses will feel because of the impact on job creation. But also, Mr. President, when we were here about a year ago, across the street, you started the health care summit by saying one of the promises you want to make is that people ought to be able to keep the health insurance that they have.

Because, as we also know, most people in this country do have insurance, and an overwhelming majority of people do like that coverage; it's just too expensive.

Well, the CBO sent a letter -- I think it was to Leader Reid -- about the Senate bill. And in that letter, it suggested that between 8 million and 9 million people may very well lose the coverage that they have because of this, because of the construct of this bill. That's our concern.

And so, as we are in -- as we are in the market, in the section of this discussion about health insurance reform, I know, Mr. President, that you have suggested strengthening oversight of insurance premium increases, because we want to make sure that there aren't excessive insurance premium increases that take place.

The problem is, when you start to mandate all of the essential benefits, there are going to be some insurance premium increases. None of us really want to see them, but if you stop them, who's going to pay for it?

Well, then we get back to the fact that businesses won't be able to pay for it, and people are going to lose their coverage.

So I guess my question to you is, in the construct of this bill, if we want to find agreement, we really do need to set this aside. And we really do need to say, OK, you know, the fundamental structure is something we can't agree on, but there are certainly plenty of areas of agreement.

And -- because I don't think that you can answer the question in the positive, to say that people will be able to maintain their coverage; people will be able to see the doctors they want in the kind of bill that you're proposing.

OBAMA: Well, let me -- since you asked me a question, let me respond.

The 8 million to 9 million people that you refer to that might have to change their coverage -- keep in mind, out of the 300 million Americans that we're talking about, would be folks who the CBO, the Congressional Budget Office, estimates would find the deal in the exchange better, would be a better deal.

So they -- yes, they would change coverage because they've got more choice in competition. So let's just be clear about that, point number one.

Point number two, you know, when we do prop like this, stack it up and you repeat 2,400 pages, et cetera, you know, the truth of the matter is -- is that health care's very complicated. And we can try to pretend that it's not, but it is. Every single item that we've talked about on the Republican side, if we wanted to exhaustively deal with fraud and abuse, would generate a bunch of pages.

So I point that out just because, you know, these are the kind of political things we do that prevent us from actually having a conversation.

Now, let me -- let me respond to your question. We could set up a system where food was probably cheaper than it is right now, if we just eliminated meat inspectors and -- and we eliminated any regulations in terms of how food's distributed and how it's stored.

I'll bet, in terms of drug prices, we would definitely reduce prescription drug prices if we didn't have a drug administration that makes sure that we test the drugs so that they don't kill us.

But we don't do that. We -- we make some decisions to protect consumers in every aspect of our lives. And we have bipartisan support for doing it. Because what we don't want is a situation in which suddenly people think they're getting one thing, and they're getting something else; they're harmed by a product.

What Secretary Sebelius just referred to, which is not a Washington thing -- in fact, state insurance standards in many states are higher than anything that's done in Washington, is as a consequence of seeing consistent abuses by the insurance companies and people finding themselves helpless to deal with it.

Now, we can have a philosophical disagreement about how much insurance regulation is appropriate. What you've indicated to me, just based on the bills that I've seen, is you guys believe in some regulations. You already said you did. You believe in making sure that you can't just drop somebody with coverage. Now, if you don't have a law there, let me tell you, that happens all the time. I've got a bunch of stories in here of folks who thought they had insurance, got sick; the insurance company goes back and figures out a way to drop them. I'm not making this up. I'm not trying to just add to the pages of that bill. It's in response to an actual problem, and you guys have agreed to it.

So, philosophically, at least, on a whole range of issues, you agree that we should have some insurance regulation. My suggestion had been that we try to focus on what are the specific regulations -- since we agree that there have to be some, what are the specific ones that you object to?

Now, let me just close by saying this. Pre-existing conditions is one that, theoretically, we all say we agree on. Theoretically, everybody thinks it's a bad deal if my wife's had breast cancer; I lose my job; I now try to buy insurance, and they say, well, you know what, if we're going to -- we can't cover you because your wife has a history of cancer. We all think that's -- that's a bad deal.

There are two options of -- two ways of dealing with that. One is what Kathleen raised, which is a high-risk pool. You could say, you know what, you can go in there and buy in a big high-risk pool.

And by the way, you could probably set up a high-risk pool without having as many pages in the bill. And it's an option that's been around for 30 years.

Here's the problem. What happens is the reason that all our rates, as members of Congress or as elected officials, are pretty low is we've got such a big pool. There are millions of federal workers. And as a consequence, any single one of us has cancer; any single one of us has a child with a disability, our costs are spread out over millions of people, and so all of us are able to keep our rates relatively low, even though, if any individual in that situation was trying to buy insurance, it would skyrocket.

That's the concept of pooling, is you get the healthy people and the young people alongside the not-so-healthy and the older people, but we're all kind of spreading our risks because each of us don't know, at any given time, what might happen. Maybe our kid's the one who gets diagnosed, heaven forbid, for something. And as a consequence, we insure ourselves by making sure that we're also insuring somebody else.

When you get into something like a high-risk pool, what happens is all the sicker, older people are in that pool. All the younger people -- they end up getting really cheap rates, and overall you could say, well, that's how the market works; it's a good thing; there's more choice. There's more choice for the young, healthy person but not for the person who, heaven forbid, got sick.

Now, on pre-existing conditions, we've got a similar situation. The challenge we have -- I'd love to just pass a law that said, insurance companies, you can't -- you can't exclude people based on pre-existing conditions. The problem is, what they'll say to you is, well, you know what, what prevents somebody from not buying insurance until they get sick and then going in and just buying it and gaming the system?

So we've tried to respond to a difficult problem by saying, well, let's make sure everybody has some coverage. Without that, it's hard to do.

So I just wanted to respond to, yes, we've got a philosophical objection, but let's not pretend that any form of regulation of the insurance market is somehow some onerous burden that's going to result in terrible things happening to consumers. We...

(CROSSTALK)

OBAMA: ... that's a good thing.

CANTOR: Mr. President, if I could respond?

OBAMA: Please.

CANTOR: We, again, have a very difficult bridge to gap here, because I know that this is something that we don't want to look at.

CANTOR: And that's also where we have a big difference, in this bill, and what would happen.

First of all, the costs -- and Jon Kyl laid out the tremendous costs and the nearly $1 trillion of this bill. And I don't quite know, because CBO said it couldn't assess how much your additions would cost to it, but we do know that there are plenty of taxes on income. Now you suggest investment income should be taxed. We have additional taxes on medical devices and the rest.

What is the consequence of that?

We know there are consequences that small businesses will feel because of the impact on job creation. But also, Mr. President, when we were here about a year ago, across the street, you started the health care summit by saying one of the promises you want to make is that people ought to be able to keep the health insurance that they have.

Because, as we also know, most people in this country do have insurance, and an overwhelming majority of people do like that coverage; it's just too expensive.

Well, the CBO sent a letter -- I think it was to Leader Reid -- about the Senate bill. And in that letter, it suggested that between 8 million and 9 million people may very well lose the coverage that they have because of this, because of the construct of this bill. That's our concern.

And so, as we are in -- as we are in the market, in the section of this discussion about health insurance reform, I know, Mr. President, that you have suggested strengthening oversight of insurance premium increases, because we want to make sure that there aren't excessive insurance premium increases that take place.

The problem is, when you start to mandate all of the essential benefits, there are going to be some insurance premium increases. None of us really want to see them, but if you stop them, who's going to pay for it?

Well, then we get back to the fact that businesses won't be able to pay for it, and people are going to lose their coverage.

So I guess my question to you is, in the construct of this bill, if we want to find agreement, we really do need to set this aside. And we really do need to say, OK, you know, the fundamental structure is something we can't agree on, but there are certainly plenty of areas of agreement.

And -- because I don't think that you can answer the question in the positive, to say that people will be able to maintain their coverage; people will be able to see the doctors they want in the kind of bill that you're proposing.

OBAMA: Well, let me -- since you asked me a question, let me respond.

The 8 million to 9 million people that you refer to that might have to change their coverage -- keep in mind, out of the 300 million Americans that we're talking about, would be folks who the CBO, the Congressional Budget Office, estimates would find the deal in the exchange better, would be a better deal.

So they -- yes, they would change coverage because they've got more choice in competition. So let's just be clear about that, point number one.

Point number two, you know, when we do prop like this, stack it up and you repeat 2,400 pages, et cetera, you know, the truth of the matter is -- is that health care's very complicated. And we can try to pretend that it's not, but it is. Every single item that we've talked about on the Republican side, if we wanted to exhaustively deal with fraud and abuse, would generate a bunch of pages.

So I point that out just because, you know, these are the kind of political things we do that prevent us from actually having a conversation.

Now, let me -- let me respond to your question. We could set up a system where food was probably cheaper than it is right now, if we just eliminated meat inspectors and -- and we eliminated any regulations in terms of how food's distributed and how it's stored.

I'll bet, in terms of drug prices, we would definitely reduce prescription drug prices if we didn't have a drug administration that makes sure that we test the drugs so that they don't kill us.

But we don't do that. We -- we make some decisions to protect consumers in every aspect of our lives. And we have bipartisan support for doing it. Because what we don't want is a situation in which suddenly people think they're getting one thing, and they're getting something else; they're harmed by a product.

What Secretary Sebelius just referred to, which is not a Washington thing -- in fact, state insurance standards in many states are higher than anything that's done in Washington, is as a consequence of seeing consistent abuses by the insurance companies and people finding themselves helpless to deal with it.

Now, we can have a philosophical disagreement about how much insurance regulation is appropriate. What you've indicated to me, just based on the bills that I've seen, is you guys believe in some regulations. You already said you did. You believe in making sure that you can't just drop somebody with coverage. Now, if you don't have a law there, let me tell you, that happens all the time. I've got a bunch of stories in here of folks who thought they had insurance, got sick; the insurance company goes back and figures out a way to drop them. I'm not making this up. I'm not trying to just add to the pages of that bill. It's in response to an actual problem, and you guys have agreed to it.

So, philosophically, at least, on a whole range of issues, you agree that we should have some insurance regulation. My suggestion had been that we try to focus on what are the specific regulations -- since we agree that there have to be some, what are the specific ones that you object to?

Now, let me just close by saying this. Pre-existing conditions is one that, theoretically, we all say we agree on. Theoretically, everybody thinks it's a bad deal if my wife's had breast cancer; I lose my job; I now try to buy insurance, and they say, well, you know what, if we're going to -- we can't cover you because your wife has a history of cancer. We all think that's -- that's a bad deal.

There are two options of -- two ways of dealing with that. One is what Kathleen raised, which is a high-risk pool. You could say, you know what, you can go in there and buy in a big high-risk pool.

And by the way, you could probably set up a high-risk pool without having as many pages in the bill. And it's an option that's been around for 30 years.

Here's the problem. What happens is the reason that all our rates, as members of Congress or as elected officials, are pretty low is we've got such a big pool. There are millions of federal workers. And as a consequence, any single one of us has cancer; any single one of us has a child with a disability, our costs are spread out over millions of people, and so all of us are able to keep our rates relatively low, even though, if any individual in that situation was trying to buy insurance, it would skyrocket.

That's the concept of pooling, is you get the healthy people and the young people alongside the not-so-healthy and the older people, but we're all kind of spreading our risks because each of us don't know, at any given time, what might happen. Maybe our kid's the one who gets diagnosed, heaven forbid, for something. And as a consequence, we insure ourselves by making sure that we're also insuring somebody else.

When you get into something like a high-risk pool, what happens is all the sicker, older people are in that pool. All the younger people -- they end up getting really cheap rates, and overall you could say, well, that's how the market works; it's a good thing; there's more choice. There's more choice for the young, healthy person but not for the person who, heaven forbid, got sick.

Now, on pre-existing conditions, we've got a similar situation. The challenge we have -- I'd love to just pass a law that said, insurance companies, you can't -- you can't exclude people based on pre-existing conditions. The problem is, what they'll say to you is, well, you know what, what prevents somebody from not buying insurance until they get sick and then going in and just buying it and gaming the system?

So we've tried to respond to a difficult problem by saying, well, let's make sure everybody has some coverage. Without that, it's hard to do.

So I just wanted to respond to, yes, we've got a philosophical objection, but let's not pretend that any form of regulation of the insurance market is somehow some onerous burden that's going to result in terrible things happening to consumers. We...

(CROSSTALK)

OBAMA: ... that's a good thing.

CANTOR: Mr. President, if I could respond?

OBAMA: Please.

CANTOR: We, again, have a very difficult bridge to gap here, because I know that this is something that we don't want to look at.

CANTOR: But these are, as you say, the complexities of what this is about. But when you start to mandate that everyone in this country have insurance and you lay on top of that now the mandates that we all would like to see in a perfect world, there are consequences to that.

We just can't afford this. I mean, that's the ultimate -- that's the ultimate problem here, is in a perfect world everyone would have everything they want. This government can't afford it, businesses can't afford it.

That's why we continue to say, go step by step, try and address the cost, and we could ultimately get there. But we're asking that you set aside this mandated form of insurance -- this mandated form of health care regulation and let's go back to things we can agree on, without this trillion-dollar attempt here, that's all.

OBAMA: I think the cost issue is legitimate, and whether we can afford it or not, we'll be discussing that. And I think that's an entirely legitimate discussion.

(CROSSTALK)

BIDEN: Mr. President, can I have 10 seconds? Literally 10 seconds.

We don't have a philosophic disagreement. If you agree that you can't be dropped, there has to be dependent coverage, if there's no annual or lifetime cap, then, in fact, you've acknowledged that is the government's role.

The question is how far to go. So, this idea we have a fundamental philosophic difference, you're either in or you're out. (inaudible) the government can't do it, none of it, or they can do some (inaudible) how much.

OBAMA: The cost issue is legitimate. We're going to address that. I want to...

(CROSSTALK)

CANTOR: Mr. President, if I could just -- it's not -- it's the cost issue, but it's being driven by the fact that you've got in the bill, which I assume that your proposal supports, that the secretary define what a health benefit package should be.

OBAMA: Only in the exchange. Only as part of the pool that people who don't have health insurance would buy into.

If you're -- you wouldn't -- if you were working at a big company that already has a big pool, then -- but you know what? I want to -- I want to make sure, because, Eric, we're going to end up in a back- and-forth that cuts everybody else out. I've got on the Democratic side, a couple of people that want to speak, and there are probably some -- a couple Republicans. We're already over time. I've burned some of it. I apologize.

Post a Comment


Comments that include profanity or personal attacks or other inappropriate comments or material will be removed from the site. Additionally, entries that are unsigned or contain "signatures" by someone other than the actual author will be removed. Finally, we will take steps to block users who violate any of our posting standards, terms of use or privacy policies or any other policies governing this site. Please review the full rules governing commentaries and discussions. You are fully responsible for the content that you post.

© 2010 Washingtonpost.Newsweek Interactive