STEVE INSKEEP, HOST:
What do Senate Republicans do now? They intended to vote this week on a bill to repeal and replace the Affordable Care Act. They didn't have enough votes to pass their version. So Senate Majority Leader Mitch McConnell said he will wait. And he issued a warning to his colleagues. They might, if they don't get their act together, have to compromise.
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MITCH MCCONNELL: Either Republicans will agree and change the status quo or the markets will continue to collapse and we'll have to sit down with Senator Schumer. And my suspicion is that any negotiation with the Democrats would include none of the reforms that we would like to make, both on the market side and the Medicaid side.
INSKEEP: We are hearing many people with a stake in the outcome of this legislative fight, including Dr. Rod Hochman, who's on the line. He's the CEO of Providence St. Joseph Health, which has hospitals in seven states, including Washington state, which is where we find him. Good morning, sir.
ROD HOCHMAN: Good morning. How are you doing?
INSKEEP: I'm doing OK. Darn early where you are. Thanks for joining us.
HOCHMAN: (Laughter) It is. It is.
INSKEEP: What's at stake for your hospitals?
HOCHMAN: Well, you know, overall, you know, for us, you know, what we're seeing is that basically, $772 million is going to go out of health care. And it's going to go, basically, what we see, for tax cuts and trying to balance the budget.
INSKEEP: All $772 billion you're saying, that's the amount of money that is said to be saved mainly through cuts to future spending on Medicaid, right?
HOCHMAN: Exactly. And I think what gets missed is this isn't just about the exchanges. It's really about Medicaid. That's what worries us the most. So in our states, we have about 5 million people that were covered with the Medicaid expansion.
INSKEEP: Right.
HOCHMAN: Just last year, we took care of a million more people that never got health care coverage before.
INSKEEP: You're talking about Medicaid - people who use Medicaid in your hospitals - a million more people.
HOCHMAN: Exactly. So Medicaid and also with the exchanges - so in total, about a million. And what we've seen is that their care has gotten better. And these were folks that never had health care coverage before.
INSKEEP: Can I ask about the people who are on Medicaid because there's been much discussion about just exactly who they are. Are they the poor? Are they the working-poor? And Presidential Counselor Kellyanne Conway was on ABC the other day. And she said, essentially, that the government doesn't need to be providing health care through Medicaid.
She said, quote, "if they're able-bodied and they want to work, then they'll have employer-sponsored benefits like you and I do." Is that true?
HOCHMAN: Absolutely not. Fifty percent of the children born in the United States today are born on Medicaid. Sixty percent of the seniors that are in nursing homes that are our moms and dads are on Medicaid. So this is a program that is the safety net for our children and for our elderly. And it's folks that we all know.
So there's this misnomer that Medicaid is for people that just can't work. And it's anything but that. And it is the safety net program for our children and for our elderly.
INSKEEP: Is it accurate to contend, as Republicans do, that President Obama's Medicaid expansion did extend Medicaid to some people who could be working, could be earning their own living, in fact, in some cases are earning their own living?
HOCHMAN: Some but what we've seen, for the most part, it's really been getting help for folks that never had health care before. And we've seen some dramatic changes in folks that couldn't get access to clinics, couldn't get access to care. And ultimately, what we believe, and particularly as a physician, that we've got to get the health of America better. America as a country is older and poorer.
And we've got to protect the health of those Americans. And we see this program really doing what it was intended to do is really improve the health status of all Americans.
INSKEEP: Older and poorer than it used to be. You're saying...
HOCHMAN: Yes.
INSKEEP: ...That the country is aging a little bit and many demographic groups have less money than they used to have.
HOCHMAN: Absolutely. And, you know, this is not the time to eviscerate a program that was started back in 1965. And we don't - we think we're going back to pre-1965 with what's happening to Medicaid. So this, you know, this is really frightening to us in terms of what its effects can be on the poor and on the elderly and particularly on children - 50 percent of children on Medicaid.
INSKEEP: Can I just ask, though, because we heard Ron Johnson, Republican senator from Wisconsin, on the program earlier this week. And he's somebody who's been very skeptical of this - wanted to slow down, wanted to think really hard about what's in the bill.
But he's also open, very clearly, to taking money out of Medicaid, future spending out of Medicaid. He says it doesn't necessarily mean better care. Let's listen.
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RON JOHNSON: This is the problem with Washington, D.C. Rather than look at the root cause of the problem, rather than driving - helping drive premiums down that were artificially increased, all we're doing is throwing more money at it. It'll never solve the problem.
INSKEEP: Now, he's talking about premiums. Of course, that's people on the exchanges who pay health care premiums. But is he right that more money doesn't necessarily mean better care? We already pay a lot for health care and don't necessarily get the best health care in the world.
HOCHMAN: You know, no question. And I think what most of us who are in health care were hoping for as we move to the next version, 'cause most of us have said, and I think you'll hear both Republicans and Democrats say that we needed to do something post ACA. And I think as clinicians, as health care providers, we were really looking to say, we've got to make health care more affordable.
There's no question. But we looking at, you know, what we got is the health insurance bill. Those of us in health care were now saying let's dig in and really look at how we can improve health and health care. So we know there's a lot of waste in health care. We know that, you know, there's inappropriate use of medications. We were hoping in this next version to really make health care more affordable by looking at how we deliver health care.
And that's what's been frustrating for a lot of us as physicians, as hospitals, that we wanted to really dig in and say, let's make health care better and more affordable. We agree. I think we're spending, in total, enough money.
INSKEEP: All right. Dr. Hochman, thanks very much - really appreciate it.
HOCHMAN: Great, thank you.
INSKEEP: Rod Hochman is president and CEO of Providence St. Joseph Health, part of a debate that will continue after the July 4 holiday. Transcript provided by NPR, Copyright NPR.
