Former Pennsylvania Senator Rick Santorum told Breitbart News in an exclusive interview on Monday that he is working with a broad coalition of Republicans in both the House and Senate, along with several governors, to develop a new effort to repeal Obamacare.
The effort, which comes after serious tumult with prior legislation in both the House and the Senate, would devolve power over healthcare away from the federal government and back to the states. It would allow each of the 50 states to individually craft their own plans, and would mirror the effort led by Santorum in the mid-1990s which saw the only successful entitlement reform in the nation’s history.
During the administration of former President Bill Clinton, Santorum—then in Senate GOP leadership—devised a strategy to win bipartisan buy-in that Clinton signed ending guaranteed cash benefits in place since Franklin Delano Roosevelt’s presidency and devolved much welfare power back to the states. Since then, the Santorum-led reform—which was essentially block granted out—has held strong and not seen any significant problems.
This effort on healthcare, Santorum says, would mirror that effort: Allowing the states to handle these affairs to better custom-craft healthcare systems to the needs of their constituents.
“In short, this is the last chance for a healthcare bill to pass, and this is the best idea that’s been floated yet,” Santorum told Breitbart News in an exclusive interview on Monday afternoon. “Winston Churchill said that ‘America does the right thing after they have tried everything first.’”
Santorum has been working with Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA) among others, as well as with House Freedom Caucus chairman Rep. Mark Meadows (R-NC). He has also been working with a large group of Republican governors, including Wisconsin’s Scott Walker, Arizona’s Doug Ducey, Arkansas’s Asa Hutchinson, and Mississippi’s Phil Bryant. Two of those states—Arkansas and Arizona—are Medicaid expansion states; the other two are not.
Santorum said that the effort to include a broad array of governors from vastly different states is designed to show how this plan can work all across America in each of the 50 states and be popular nationwide. It also, he says, shows the potential for some bipartisan buy-in; while no Democrats are as of yet committed to working on something at all, this could be the very reform that revives GOP efforts to repeal Obamacare and decentralize control of healthcare, killing off chances of dangerous single-payer once and for all while winning some support from Democrats desperate to get past the failed saga of Obamacare.
“Republicans have tried everything else first and now we have the right thing to do,” Santorum told Breitbart News. “I have no question that we can get very broad support among the Republican base and frankly this will get support from a Democrat or two. The reason is because of the way that Obamacare is structured, it benefits a handful of states. There are four states in order of how well they do: Massachusetts, California, New York, and then Maryland. Those four states which comprise about 21 percent of the population of the country get close to 40 percent of the money under Obamacare.”
Santorum’s plan comes after prior efforts by House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell have failed. Ryan pulled the House GOP leadership’s healthcare plan after multiple failed attempts earlier in the year, and the House was only able to pass a bill after Meadows and then Tuesday Group co-chairman Rep. Tom MacArthur (R-NJ) banded together to pick up the pieces while Ryan was traveling in Hollywood and in Europe. In the Senate, multiple approaches failed culminating with a historic vote by Sen. John McCain (R-AZ)—who had just been diagnosed with brain cancer—coming back to the chamber to vote against repealing Obamacare.
Santorum’s states-and-governors-focused pitch is designed to help governors put pressure on members, and allow for each state to customize their healthcare plans to the needs of their constituents—something that allows many different senators and congressmen from across the political spectrum to come together, even though their individual states may approach healthcare differently.
“If you think about this, if you wanted to create a system to allocate the money fairly across the states and gave the governors the flexibility to their program to best meet the needs of their people, you can’t help but improve—maybe not 36 states, but the 19 states that didn’t expand [Medicaid] as well as a whole host of others that are lower cost Medicaid states than these four Medicaid states that I talked about,” Santorum said. “What you can do is redistribute this money that has been heaped upon these four ultra blue, very wealthy states by the way, and don’t need a lot of federal support because they’re very wealthy states. Yet that’s where the money is going because Obama wrote it that way. If anyone had any questions that Obamacare is Romneycare, Massachusetts is two percent of the population and they receive seven percent of the money. More than any other state per capita; it’s not even close. So you have it written for these high-cost states and states like Massachusetts, which Obamacare was designed to marry.”
A lot of centrist Republicans and nationalist populists have been afraid of a clean repeal of Obamacare because they believe it would pull a healthcare safety net out from under people who have just become used to it in recent years, while a number of hardline conservatives believe Republicans need to ensure that they follow through on years-worth of campaign promises to repeal Obamacare. The hard question of how to repeal—and then replace—Obamacare has jeopardized prior reform efforts. But Santorum believes that this effort—not a last-ditch Hail Mary play, but more of a seriously thought-through reform that kicks the issue out to individual states—alleviates that issue and potentially even attracts moderate Democrats. Santorum also says that he previously warned Republicans party-wide their previous efforts would fail when he pitched this idea earlier this year, but they were not ready to do something like this at the time.
“The bottom line, is we came up and I shared it some folks in the Freedom Caucus and Sen. Lindsey Graham and they both took an interest in it in the early spring, when it was still in the House,” Santorum said. “Both of them said, ‘Well look we don’t want to upset the apple cart let’s keep working on and see if this fails.’ I told them, ‘Let me assure you everything will fail’ and if there’s one thing that I know—and I’ve worked on entitlement reform before back in 1996—I was the floor manager and one of the authors of the ’96 Welfare Reform Act.”
Santorum believes if the lessons he learned from welfare reform in the Clinton administration 1990s are applied, there can be great success yet for Republicans seeking to help President Donald Trump repeal and replace Obamacare and reform healthcare once and for all.
“And we learned something in ’96 that has not been applied,” Santorum told Breitbart News. “We tried a lot of plans with welfare reform and only one plan did. It succeeded by ending a federal entitlement, reducing the amount of federal expenditures, decreasing poverty and increasing work. That’s a pretty big success. We did it by learning two lessons in the process. Number one, moderate Republicans and moderate Democrats don’t like to vote against vulnerable populations. They don’t like to see that they’re cutting money from vulnerable populations. They will support block grants if there’s enough money to take care of the problem. So we learned in ’96 don’t make folks cast hard votes if they can cast an easy vote to give money to the states so they can do the hard work and they can say there’s plenty of money to do the work. And that’s what we did, that’s how Bill Clinton signed it, because we kept putting more money in. I will remind you that the TANF block that was put in 1996 for welfare to replace Aid to Families with Dependent Children, guess how many times that has been increased since 1996?”
The answer to Santorum’s question, as he said a moment later, is “never.”
The idea, Santorum says, is simple.
“It’s the best idea, it’s the most politically viable idea. It’s the only one that can still pass, and it’s the easiest one to explain because all we’re doing is draining the swamp,” he said. “We’re taking the money out of Washington and giving it to the governors in two block grants. The first block grant has been described as in both the House and the Senate bills. We basically don’t change the McConnell block grant. For Medicaid, for traditional Medicaid, pre-expansion ACA Medicaid, stays the same. The second block grant is made up of all of the money that we spend on Obamacare today. What is that? [Medicaid] expansion dollars, the tax credit dollars, the cost-sharing reduction payments, and the two special Obamacare deals for Minnesota and New York. Which is about three and a half billion bucks a year. So all of that money comes together and we put into a formula, the formula is reflective of the number of people in your low income not covered by Medicaid. It would just be low income 38 to 50 percent of poverty, we’re still jiggering with the numbers. But it will be low-income not eligible for Medicaid.”
He continued with his explanation: “That will be your denominator, the pot of money that is available. That money will be for the formula. What’s important is that there will be no individual entitlement for this money. So someone is 100 to 138 percent of poverty, so people that aren’t entitled to any money, that money that comes to the states we have to pick a number and does this make sense? The other thing is that we’re going to weight it, this formula, so it won’t just be the pure number, we’ll weight it for older people that will get a little more–they may count as 1.2 people, the lower-income which you could say would be 100 to 250 percent of poverty, it may count as 1.2 people. At the high end of the scale that may count as .75 people. Right? So weight it for older and we can’t count sick and we weight it for older and low-income Americans, and then we will weight for density because rural populations are more expensive than taking care of people in cities. Those are the kind of factors and we will do cost of living, and higher cost areas will cost more, and we will weight these in a formula that will reflect the population of the state that they are trying to take care of. So, there will be this formula. The block grants will start in 2020. New money in some states, everyone will shift out of the older Obamacare. There will be some states like California and Massachusetts that will take a substantial reduction form, what they received the previous year, but we are creating a floor so everyone will match the new formula over a seven-year period to 2026. By 2026 everyone is on the formula.”
Santorum added that the Congressional Budget Office (CBO), long a thorn in the side of GOP efforts to repeal Obamacare because of its predictions that millions upon millions will lose health insurance if they do, will “have a hard time scoring this” because “we are giving governors the right to design their own formula.”
“I don’t know how CBO is supposed to score this to be honest with you,” Santorum said.
“That’s the idea is to give everybody in America the same amount of money for their population and let every state design their own program I want this be very clear: this is not a Medicaid expansion,” Santorum said. “Now, having said that if California simply wants to expand Medicaid with this money, good luck. They’re going to have to cut their program dramatically because they don’t have the money with what they’re funding now. But if they want to take that money and create high-risk pools, HSAs, they have flexibility to do anything.”
Santorum said that his idea would also, importantly, “put a stake in the heart of single-payer health care.”
“Now that every state will have their own health care system, no way will the government be able to take it back,” Santorum said.
What’s more, with 50 separate laboratories, different states will try different ideas and eventually the best and most effective ideas will be implemented—and it will be much easier to implement healthcare reforms when managed at the state level than at the federal level.
“Well that’s what happened if you look at what happened with welfare, you saw that Tommy Thompson did incredibly innovative things with welfare and mostly other states copied that,” Santorum said.
And while Santorum has had a modicum of success getting the ball rolling on Capitol Hill, he has made real strides with governors.
“I’ve been working with the governors,” Santorum said. “The governors who have been really engaged on this are Scott Walker, Doug Ducey, Asa Hutchinson, and Phil Bryant. Two [Medicaid] expansion states, two non-expansion states. Other governors have provided feedback, other folks like Gary Herbert and Rick Scott. I actually met with about 20 Republican governors in Aspen about a month ago, and they have provided a lot of feedback and we’re trying to get to the point where we can have 25 Republican governors on board with this and come out and say, ‘You need to pass this.’ This whole thing is being designed with and for the governors. Present it to Washington as a solution outside of Washington.”
Santorum expects that something needs to pass Congress by Sept. 30, a daunting task given that the debt limit looms as does a congressional funding bill.
“There was a draft that was never introduced, but Bill Cassidy, Lindsey Graham talked about this during the night of the budget thing, and they never introduced anything because it was a work in progress, it still is a work in progress,” Santorum said. “So the answer is that we hope Sen. Graham, Cassidy, and I, we’re all working on this with the governors to get a consensus by the end of the month. We have to pass this thing by September 30. Absolutely we have to start building momentum for this thing. Hopefully by the end of the month we’ll have something that everyone can agree to, get it to the CBO, get it scored within a week or so, and then have a couple of hearings in committee I think that’s appropriate, and then go. This is a solution from outside of Washington. If they [Congressional leadership] can get 50 votes and it has conservative ideas in it, they’re for it.”
Santorum added that he believes it will be hard for a red state Democrat up for reelection in 2018 to vote against this plan, because they would be turning down money for their states and healthcare relief.
“Let’s take a Democrat senator from a non-expansion state,” Santorum said. “His states get almost no money right now and it could get a huge amount of money and it could be designed by their own state, how are they supposed to vote no? No, I want to keep all the money in Washington so California and Massachusetts can keep it all? This plan provides real incentive to the governors. This is a block grant with no match requirement. So unlike Obamacare, where starting in 2020 all of these states are spending all of this money have to come up with 10 percent to make up the difference now. Under our plan there is no match. So, it’s just a straight block grant. Or if you’re the governor of Montana you’re an expansion state, and you’re going to get a little more money because you’re a low-cost Medicaid state and you don’t have to come up with 10 percent. Now if you’re a senator from that state and your state gets to design that program to meet the needs of your people and they have more money and you don’t have to tax your own people for the match, how do you vote no? You would think that the cost is pretty serious. You don’t vote for something that your state benefits from doing in order to keep federal control, and I’m a Republican and I love running against someone like that. Look at Bill Nelson; he’s going to have a race and Rick Scott is going to run against him and Bill Nelson is going to vote no, where now Florida gets $6 billion in tax credits and under this proposal they’ll double that number. Bill Nelson is going to have to say that it would benefit Floridians, vote against twice as much money, and design it ourselves, but I’m a no.”
Santorum added that given the broad coalition of support for an idea like this, he believes that something can and will get done—a huge win for President Trump if so.
“Lindsey Graham, Bill Cassidy, Mark Meadows, a lot of folks across the aisle, we’re working with Lee and Cruz on flexibility–that’s a big part of this, making sure the governors have flexibility, everyone is working with the parliamentarian to make sure that flexibility is a part of this,” Santorum said. “Even McCain and Dean Heller are working on this too. There is a very broad coalition, working to make this work. I have no doubt that we can get 25 Republicans [governors] or more on board, it will pass through the House and the Senate. I have no doubt about that whatsoever.”
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