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Back In Session, Congress Focuses On Affordable Care Act


Today could mark the beginning of the end of Obamacare. Debate about the future of the Affordable Care Act starts later this morning on the Senate floor. President-elect Donald Trump and Republican leaders have promised to repeal and replace the law. President Obama went up to Capitol Hill to strategize with Democrats on ways to preserve this part of his legacy. Vice president-elect Mike Pence was meeting separately with Republican lawmakers. We spoke earlier to Republican Congresswoman Marsha Blackburn of Tennessee. She's the vice chair of the Trump transition team.

The president-elect has said he'd like to be able to keep a couple of popular parts of the law, including protections for people with pre-existing conditions and allowing young adults to stay on their parents plans. Is there a consensus among Republicans about keeping those parts of the plan?

MARSHA BLACKBURN: Well, actually we're pleased that he would want to keep those because those are plans that Republicans brought to the table. And individuals that say, well, what are your plans and what is your approach? Just go back to the Blair House health care summit in 2010, and you see there very clearly where the administration laid out a government-controlled path, and we laid out a very clear reform methodology for patient-centered health care. So you've got those two approaches. Having a way for those with pre-existing conditions to buy health insurance through state-run high-risk pools, of course, those are things that are important to do. And those young adults who are still students and staying on parents' insurance, that's just good common sense.

MARTIN: More than 20 million Americans have insurance currently through the Affordable Care Act. Donald Trump has yet to say whether or not they're going to lose their coverage if and when Obamacare is repealed. Will they?

BLACKBURN: My anticipation is that as you break those numbers down and look at what makes (unintelligible) number, you see - get a clearer picture of how people will retain and hold and actually have access to affordable health care because right now it's not affordable. Now, about 12 million...

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MARTIN: So you don't believe there will be a gap in care if there's - if Obamacare's repealed?

BLACKBURN: No, because you do systematic orderly process of a phase-out and a phase-in. Now, when you look at your 20 million number, you're looking at about 11 million of those that are - have come in to the process through the Medicaid process. And what we would like to do is see Medicaid sent back to the states so that they can deliver it in a method that will help produce better outcomes and be more cost effective for those that are right there where you're...

MARTIN: Congresswoman?

BLACKBURN: What you also have to look at is that those that are in the exchange, many of those had health insurance prior to Obamacare and then were forced into the exchange.

MARTIN: I think we're working with a difficult phone line. Let me just ask you this. Yesterday, we spoke to Zeke Emanuel on this program, one of the architects of Obamacare. He said he believes Donald Trump wants a bipartisan bill. Have you been in touch with Democrats on this? Are you seeing a way forward to make this a bipartisan effort?

BLACKBURN: Oh, absolutely. Democrats do want to participate in this because their providers, their constituents - they're hearing from their constituents that the insurance is too expensive to afford and too expensive to use. And they're hearing from providers that the networks are too narrow, and they cannot properly refer people for appropriate care.

MARTIN: Last question. Just briefly, could you vote to repeal but then not implement the rollback for a couple of years while you figure out replacement?

BLACKBURN: Of course there's going to be a pathway. You have to have a period of time.

MARTIN: Do you know what period of time is yet?

BLACKBURN: Well, we are working to solidify that. You have to work with your provider networks and your insurance networks to determine what is going to be that period of time.


BLACKBURN: The insurance marketplace has to have a period of time to do the actuarial and underwriting...

MARTIN: It's complicated process, and we're going to have to leave it there. I'm so sorry to interrupt you - Representative Marsha Blackburn of Tennessee. Transcript provided by NPR, Copyright NPR.