Pelosi Says Democrats Have A Responsibility To Look For Common Ground On Health Law

Mar 15, 2017
Originally published on March 15, 2017 7:21 pm

When Democrats held a majority of the seats in the U.S. House of Representatives, and Rep. Nancy Pelosi was the House speaker, she helped pass the Affordable Care Act, also known as Obamacare.

Now, after more than six years in the minority party, she is watching House Republicans move to repeal and replace parts of the law.

She says that although Democrats don't have the votes to stop the GOP legislation alone, they can still show their opposition to it.

"In my office I have a painting of Abraham Lincoln, who said, 'Public sentiment is everything,' " Pelosi told NPR's Robert Siegel. "Regardless of the number of Democrats in the House, the number of people who are affected, 24 million [people] who would lose their care, I'm depending on public opinion. ... The fact is the more we point out the shortcomings of the legislation, the fewer votes [Republicans] will have."

The interview below has been edited for length and clarity.


Interview Highlights

On the shortcomings of the Affordable Care Act

Let's go back to where we were before the Affordable Care Act, because that was a time where [some people] wouldn't even be able to have any insurance. So what was the purpose of the Affordable Care Act? [It was] threefold. One, to lower cost. Two, to improve benefits. And three, to expand access for millions more people. And it's done all three. ...

Look, there hasn't been a bill ever passed of this magnitude, whether it was Social Security, Medicare, Medicaid, voting rights, civil rights bill, that was not revisited. Some of the improvements we [could] have [had] in the Affordable Care Act were there, but the Republicans prevented them from happening. So you can be a self-fulfilling prophecy and say, "I'm gonna make sure this doesn't work now. Now see, it didn't work."

On whether the Democrats could work with President Trump or House Speaker Paul Ryan on health care legislation

We have a responsibility to the American people to find as much common ground as we can. There has to be sincerity, though. ... I don't think he has the faintest idea — the president — about the health care thing.

[But Rep. Paul] Ryan ... is [a] philosophical, right-wing, anti-government [person], and so an act of mercy for him is to reduce the government's role. So we're talking about two different things. They're debating whether it's "Trumpcare" or "Ryancare," but neither of them wants it identified with themselves because it's such a failure in the public mind.

On Trump's knowledge of health care

The more the president might learn about [health care], then he might see where there's a path [to working with Democrats], because to tell you the truth, the Affordable Care Act is a private sector initiative. It contains many Republican ideas.

Understand this about Republicans, and then you'll understand part of what our challenge is here: They always are gearing whatever they do to benefit the high end. This is the biggest transfer of wealth in the history of our country, in terms of hundreds of billions of dollars going into the pockets of the top 1 percent of the people in our country, at the expense of the good health of our middle class and those who aspire to the middle class.

Copyright 2017 NPR. To see more, visit http://www.npr.org/.

ROBERT SIEGEL, HOST:

And we begin this part of the program on Capitol Hill. In a moment we'll hear from Kevin Brady, the Republican chairman of the House Ways and Means Committee, an architect of the House Republican Health Care Bill - but first a talk with the leading Democrat in the House, Nancy Pelosi. When Democrats were in the majority, Nancy Pelosi was speaker, and she shepherded the Affordable Care Act also known as Obamacare through the House.

Now after more than six years in the minority, she is watching House Republicans move toward repeal and replacement of that same law. And she's our guest today. Welcome to the program once again.

NANCY PELOSI: My pleasure.

SIEGEL: Out of 435 seats in the House, there are just 193 Democrats. With that number, can you do anything more than watch and protest as the Republicans do what they want to the Affordable Care Act?

PELOSI: Well, as you are aware, in my office, I have a painting of Abraham Lincoln, who said public sentiment is everything. And regardless of the number of Democrats in the House, the number of people who are affected - 24 million who would lose their care depending on public opinion...

SIEGEL: But in the legislative process, are - in this House, in this chamber, are you essentially spectators at this stage?

PELOSI: No, we're not because the fact is the more we point out about the shortcomings of the legislation, the fewer votes they will have.

SIEGEL: I want to ask you about something that Speaker Ryan has said. He says, yes, of course there'll be fewer people with coverage because people will be allowed to choose not to have health insurance. Should people have a right to choose whether or not they want health insurance?

PELOSI: Well, let me just say that the speaker has also said that this bill, which takes 24 million people off of health insurance - he calls this bill an act of mercy - an act of mercy. I don't think it's an act of mercy. But the fact is - is that we believe that health care is a right, not a privilege. In order for that right to be shared by everyone, it's very important that we eliminate free riders. Everybody should be participating. The bigger the pool, the lower the cost, the healthier the country.

SIEGEL: Here's a problem that we hear about with the Affordable Care Act. Obamacare mandates very broad coverage, covers lots and lots of things. Many middle-class people can only afford a policy that good if they take the option with very high deductibles. They go to the doctor. The checkup is covered, but a recommended, say, surgery - they don't do it because they have a $6,000 or $7,000 deductible first. And in Republican terms, they can't access the benefit that the law...

PELOSI: Well, most of...

SIEGEL: ...Provides them. How do you fix that problem?

PELOSI: Most of the people who can't afford it have subsidies and the rest to cover their insurance in the meantime. But let's go back to where we were before the Affordable Care Act because that was a time where they wouldn't even be able to have any insurance. So what was the purpose of the Affordable Care Act? There were threefold - one, to lower cost; two, to improve benefits and three, to expand access for millions more people. And it's done all three.

SIEGEL: Let me put a hypothetical to you. The Republican health care bill fails. The Affordable Care Act survives.

PELOSI: Yeah.

SIEGEL: More insurers, though, pull out of state exchanges for the same reasons they've been doing that for the past year or two. President Trump says to you and other leaders in Congress, look; Obamacare is still failing. It's your party's fault. It's the Democrats' fault. Do you then join in some process of replacing the ACA with something else, or do you resist and say, this is on you?

PELOSI: It depends on what he has to say. The fact is what they're doing right now is the biggest transfer of wealth in the history of our country (unintelligible)...

SIEGEL: Well, what could he say to...

PELOSI: ...And throws people off.

SIEGEL: What could he say to invite you in that process?

PELOSI: Look; there hasn't been a bill ever passed of this magnitude, whether it was Social Security, Medicare, Medicaid, voting rights, civil rights bill, that was not revisited. Some of the improvements we can have in the Affordable Care Act were there, but the Republicans prevented them from happening. So you can be a self-fulfilling prophecy and say, I'm going to make sure this doesn't work. Now, see; it didn't work.

SIEGEL: But is there something down the road that President Trump could say that you would see as a sincere invitation to compromise on health care?

PELOSI: It's very...

SIEGEL: Or is it over? Is it done?

PELOSI: No, it's not over. The fact is we have a responsibility to the American people to find as much common ground as we can. There has to be sincerity, though. They have to know what he's talking about, which so far we have not seen. I don't think he has the faintest idea, the president...

SIEGEL: The president...

PELOSI: ...About the health care thing. Ryan, though, however, is a philosophical, right-wing, anti-government - and so an act of mercy for him is to reduce the government's role. So we're talking about two different things. So they're debating whether it's Trumpcare or Ryancare, but neither of them wants it identified with themselves because it's such a failure in the public mind.

SIEGEL: But it sounds to me like one of them is never going to be a partner with Democrats - the speaker - because his ideas are so different from Democratic ideas. And the other one you're saying has no ideas at all about this.

PELOSI: I think that's right. And the more the president might learn about it, then he might see where there is a path because to tell you the truth, the Affordable Care Act - now, it is a private sector initiative. It is - contains many Republican ideas.

SIEGEL: Well, if - are there some changes they could make to their bill that would signal to you...

PELOSI: Their bill is systemically...

SIEGEL: ...All right, it could be...

PELOSI: ...Problematic because it is predicated - understand this about Republicans, and then you'll understand part of what our challenge is here. They always are gearing whatever they do to benefit the high end.

SIEGEL: And that's what's happening, you feel, with this bill.

PELOSI: This is the biggest transfer of wealth in the history of our country in terms of hundreds of billions of dollars going into the pockets of the top 1 percent of the people in our country at the expense of the good health of our middle class and those who aspire to the middle class.

SIEGEL: Democratic Minority Leader Nancy Pelosi of California, thank you very much for talking with us.

PELOSI: Thank you. Transcript provided by NPR, Copyright NPR.