David Greene speaks with Republican Rep. Blake Farenthold of Texas. He originally didn’t like the GOP health care bill, but has changed his position after meeting with the president.

DAVID GREENE, HOST:

And the other big story we are covering this morning – a moment of truth for President Trump and his party. Republicans have talked about repealing the Affordable Care Act for a long time and today comes a vote in the House on a possible replacement but it is not clear if the party will have the votes it needs. President Trump has made last minute appeals to some GOP lawmakers to come around. One member who has and plans to vote for the bill despite earlier reservations is conservative Congressman Blake Farenthold, a Republican from Texas. And I asked the Congressman, what changed his mind?

BLAKE FARENTHOLD: Well, I’ve – still don’t believe it’s the perfect solution, but one of the things I’ve learned in Congress is the perfect is the enemy of the doable. And this looks like the vehicle to repeal Obamacare, which is something I promised to do when I first ran in 2010, and looks like we’re finally going to get around to it.

GREENE: Well, if it’s not perfect, but it’s gotten to a place where you can support it, was there something critical that happened that brought you there?

FARENTHOLD: Well, the president called about a dozen of us over to the White House, and he personally asked me to vote for it. They added some provisions that give more control to the states with respect to block grants and giving the states the authority to add a work requirement for able-bodied adults with no children. And, you know, we’re just moving it towards a more conservative solution. The problem still remains, though, that there’s a lot still to be done in these other pieces of legislation that are going to require 60 votes in the Senate. And the president said he was going to really help turn up the heat on those senators to get the 60 votes when we need them.

GREENE: But I hear you saying that he turned up the heat on you, and it worked.

FARENTHOLD: Listen, I was – I’m committed to repealing Obamacare. And the only vehicle that’s going to get us there is a vehicle that the president supports and is going to sign. You know, again, nothing’s perfect, but the fact that the president told me he was behind it 100 percent – actually he said 1,000 percent – and was going to be an advocate for making it better, that’s what it took for me. I’m taking Donald Trump at his word.

GREENE: I understand it this week he told many Republicans that they risked losing their seats if they didn’t get behind this bill. Did he say that to you?

FARENTHOLD: He said it in the House Republican Conference, and I think that’s true. Every single one of us ran on repealing Obamacare, and this is the bill that’s going to move forward to repeal Obamacare. I would hate to go back home and have my constituents tell me, Blake, you had the opportunity to get rid of Obamacare, and you didn’t do it. Why are you still in Washington?

GREENE: I mean, if I may, that sounds like putting politics, in a way, ahead of substance. I mean, if you don’t think the bill is perfect, why not spend some more time getting to a place where you feel good about a bill? This is making it sound like, you know what? I got to get rid of Obamacare. Maybe the law is not something I like, but I got to do it to make sure I keep my seat.

FARENTHOLD: Well, it’s about keeping promises. The situation we’re in right now is – my conservative friends and the folks in the tea party say the bill doesn’t go far enough. And the more moderates, whether they’re liberals back in the District or whether they’re more moderate Republicans here in Washington, are saying the bill goes too far. So we really are very close to the sweet spot on this, and it’s going to take some pressure from President Trump to move anything forward.

GREENE: I want to ask you about one of the specific changes that you and some of your colleagues were pleased about and helped you come around. Under the previous law, if you were getting a tax credit that was actually more than the premium you were paying, you got to keep that money and maybe put it in a health savings account. You wanted to get rid of that provision because you were worried that some people might use some of those tax credit dollars for abortions. Is that right?

FARENTHOLD: Well, there’s a provision in there that was added that says you cannot use those excess dollars for an abortion. That’s long-standing Republican policy. But the idea is you need to have more options available, and we’re increasing the health savings account, but we don’t want to do it at a point that breaks the bank.

GREENE: But if I may, as I understand, I mean, there would be relatively few people who would actually get a tax credit that was more than their premium and even far fewer people who would actually decide to use that money for an abortion. So we’re talking about very few Americans here. Is that fair?

FARENTHOLD: I think the issue is whether – for those of us who are extremely pro-life, like I am, just saving one unborn baby is a big deal.

GREENE: So I’m hearing you say that a big part of this is not just making health care better for Americans, but you needed to be able to sleep at night and feel like you were supporting a law that remained true to your conservative values on issues like abortion.

FARENTHOLD: That’s 100 percent correct. And again, as I say, this bill is not perfect. President Trump has said he’s going to continue to work to make it better. We’re treading on thin ice here in the House because we don’t want to send something over to the Senate that is going to go afoul of the Byrd rule and not be able to pass with 51 votes. So we’re giving them a framework, and we’re counting on the president and the senators to make it even better.

GREENE: You mentioned how there are people in your party who are more conservative, who are more moderate, kind of on both sides who have some real concerns about this replacement bill. Are you talking to them? Are you going to them and saying, you know, we really should come around here? And if so, what are you telling them?

FARENTHOLD: My message to my colleagues, whether they’re to the left of me or to the right of me, is you ran on repealing Obamacare. If you can show me a path that’s going to get us there other than this, I want to hear it. And none of them have been able to come up with a path to getting rid of it other than this bill that the president says he’s 1,000 percent behind and that’s going to come up for vote.

GREENE: All right, Congressman, thanks so much for taking the time. We really appreciate it.

FARENTHOLD: Thank you very much.

GREENE: Blake Farenthold is a Republican member of Congress from Texas.

Copyright © 2017 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

We look at the House Freedom Caucus, a key Republican faction that opposed the American Health Care Act. The GOP healthcare bill was later withdrawn over lack of support.

MICHEL MARTIN, HOST:

Now for the regular segment we call Words You’ll Hear. That’s where we try to understand stories we’ll be hearing more about in the coming days by parsing some of the words associated with them. Today our word or phrase is Freedom Caucus, also known as the House Freedom Caucus. You probably heard about it during the failed – during the health care debate. The Republican-backed bill failed in the House of Representatives, largely because members of the Freedom Caucus refused to support it.

Just this morning, President Trump tweeted that Democrats are smiling because the Republican Freedom Caucus helped save Obamacare. So if you’re wondering what exactly it is and what the members want, Domenico Montanaro is here to explain. He’s NPR’s lead editor for Politics. Welcome back. Thanks so much for coming.

DOMENICO MONTANARO, BYLINE: Hi there, Michel.

MARTIN: So what exactly is the House Freedom Caucus? Who’s in it?

MONTANARO: So this is a group of almost 40 members. It’s not exactly clear who they are exactly because they’re invitation only. They’re a little bit private about that. So they’re almost 40 House members who are the most conservative members – hardline, ideological. And when you look at their vote ratings, for example, if you want to actually quantify this, they are almost a third more conservative in their voting than regular Republicans.

MARTIN: Why does it exist? I mean, how did this all start? Because presumably, I would imagine that everybody in the House of Representatives and the Senate for that matter would say that they believe in freedom.

MONTANARO: Sure. So on their Twitter handle, they say (reading) we support open, accountable and limited government, the Constitution and rule of law and policies that promote liberty, safety and prosperity of all Americans.

So those are some grandiose kinds of terms, but you can read between the lines there and see what they stand for. They’re kind of an outcrop of the Tea Party from 2010. They’ve started to kind of become more – a little bit more powerful. And in 2015, they formally formed themselves and were frankly responsible for the ousting of House Speaker John Boehner.

MARTIN: Is that where they first asserted themselves or came to public attention because of the…

MONTANARO: Yeah.

MARTIN: …John Boehner – well, he would say he stepped down.

MONTANARO: He would say he stepped down, but he was facing pressure from this right-wing, hardline faction. You might remember the thing called the grand bargain that John Boehner was trying to strike with President Obama when it came to tax reform and other measures. They weren’t able to get it done largely because of this same faction of folks. They stuck together, and then they became more formal.

Mark Meadows, who is a congressman from North Carolina, is their chairman. And he’s the one who took out what’s known as a motion to vacate – first time it was used since 1910 – to be able to say that they wanted to have an open vote to get John Boehner out as speaker of the House. And to give you a sense of the kind of nostalgia, the kind of Tea-Party-foundational-founding-fathers kinds of thinking that they have, Mark Meadows talks about this moment that he decided that he was going to go for it with this motion to vacate.

His son Blake had sent him a text and with part of a speech from Teddy Roosevelt that said, it’s not the critic who counts. The credit belongs to the man who is actually in the arena whose face is marred by dust and sweat and blood and who, at the worst, if he fails, at least fails while daring greatly. Meadows – that brought tears to his eyes and says he still keeps it on his phone and was the reason why he was able to go forward.

MARTIN: Does it seem as if this group has the ability to guide legislation or policy beyond stopping things they don’t like? Is there any record of advancing things that they do like?

MONTANARO: Well, inherent in that is a fundamental question that has divided Americans generally, and that’s the role and scope of government. And for these folks, they don’t want to have the government involved and do a lot of things. It’s to the point of frustration for someone like Boehner and Paul Ryan and allies of theirs, someone like Devin Nunes, who is the House intelligence chairman, who had said, when they were first coming to prominence, described them as lemmings with suicide vests.

So if they’re lemmings with suicide vests, in leadership’s view, do you think they really care whether or not they’re able to govern?

MARTIN: We’ll leave that there. That’s NPR political editor Domenico Montanaro. Domenico, thank you so much.

MONTANARO: Thank you.

Copyright © 2017 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

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Republicans pulled their health care bill on Friday after failing to secure enough votes for it to pass in the House. In a statement, President Trump said he wanted to move onto tax reform.

KELLY MCEVERS, HOST:

And now we’re back with NPR’s congressional correspondent, Sue Davis. Hi there again.

SUSAN DAVIS, BYLINE: Hey there.

MCEVERS: And we have White House correspondent Scott Horsley also. Hi, Scott.

SCOTT HORSLEY, BYLINE: Hi.

MCEVERS: So, Scott, we’ll start with you. I mean, usually when congressional leaders are in a tough spot like this, they keep negotiating. I mean, we just heard this from Congressman Kelly. You know, if you’re close, keep working on it. But President Trump did not want to do that. He wanted to, say, push a vote and move on. Why?

HORSLEY: That’s right. He was really responsible for this standoff this afternoon. And Trump fancies himself a good negotiator. Part of the art of deal making, he would say, is knowing when to walk away. So yes, during the last two and a half weeks, he had a lot of meetings. He made a lot of phone calls trying to sell this bill.

But by now, he said it was, you know, sort of time to cut bait. In conceding defeat at the White House this afternoon, Trump said he had long imagined a different strategy. Here’s what he had to say.

(SOUNDBITE OF PRESS CONFERENCE)

PRESIDENT DONALD TRUMP: I worked as a team player and would have loved to have seen it pass. But again, I think you know I was very clear because I think there wasn’t a speech I made or very few where I didn’t mention that perhaps the best thing that could happen is exactly what happened today.

HORSLEY: Republicans have long argued and campaigned on the idea that Obamacare is collapsing on its own.

MCEVERS: Right.

HORSLEY: And that’s sort of where Trump is today. But polls suggest voters aren’t buying that. You know, we have the nonpartisan Congressional Budget Office which says Obamacare is not in a death spiral. We have seen some rising premiums, but they’re really only back to about where the forecasters expected them to be.

There are places where there’s not much choice. But most Americans still have three or more insurance companies to choose from. And premiums, for those of us who get insurance from our employers, have been rising at a much more slow rate than they were before the Affordable Care Act passed.

MCEVERS: We just heard the president say, you know, perhaps this was the best thing all along. I’ve been saying that, you know, that this is the best thing that could have happened. And politically speaking, Sue, I mean, he’s been saying this. Does this mean he’s wanting to undercut Speaker Paul Ryan and this bill of his?

DAVIS: Well, that – what he said publicly is directly what contradicts what the president told Republicans when he was on Capitol Hill on Tuesday. In a closed-door meeting, he told Republicans that he thought if they failed at this, that they would put their congressional majorities at risk next year in the midterm elections.

House Speaker Paul Ryan had said prior to the failure today that he believed doing nothing was more politically dangerous than trying to advance a repeal or replacement bill. So yes, there are absolutely political consequences to this. We just don’t know what they’re going to be yet. But we do know that Republicans, every Republican who ran for the House and Senate and White House last year, ran on a promise to do this.

Now, there is a debate over whether it was the right thing to do and the merits of the policy. But this is what they promised voters. And this is what they won an election on. And they failed to meet that promise. And there may be consequences for that.

MCEVERS: And, Sue, the president says he wants to move on to other things like tax reform. That’s obviously something that has to go through Congress. Is that the plan? And how likely is it that there will be cohesion in the Republican Party on that?

DAVIS: You know, that is the plan. But remember that the health care equation was supposed to be the easy part of this.

MCEVERS: Right.

DAVIS: If I told you I couldn’t finish a 5K today but I’m going to run a marathon this weekend, you might have reason to be skeptical.

MCEVERS: No, I’d believe you.

DAVIS: So yes, the president – and the president has said that tax reform is a bigger priority for him, that he’s ready to dig in, that he wants to do this. But, you know, political capital gets spent in this town. And they put a lot of political capital into this promise. And they failed.

So they are going into the tax reform fight hobbled. And I would say that there is less consensus on what tax reform would look like. There’s more opposition to it from lobbying forces. And they face the same problem they faced on health care. Can they find a governing coalition to pass anything in the House of Representatives?

MCEVERS: Scott, you covered the fight eight years ago to pass the Affordable Care Act, Obamacare. How tough was that for Democrats compared to what we’re seeing here for Republicans?

HORSLEY: Well, I think former President Obama and Nancy Pelosi must have had a little rueful smile when they heard President Trump complaining about how there was no Democratic support for this repeal and replace bill. Of course, there was no Republican support…

MCEVERS: Republican support, right. Right.

HORSLEY: …Seven years ago for the Affordable Care Act even though goodness knows president – former President Obama tried, I mean, and tried for months. Remember, that debate lasted over a year as he searched for that elusive one or two Republican votes. And in fact, he had basically adopted a Republican plan, Mitt Romney’s health care plan. So it’s a little rich to hear President Trump complaining now about the lack of Democratic support.

MCEVERS: You know, when something like this happens, you start to see finger pointing in Washington, Scott. Are we starting to hear people saying who’s to blame for this?

HORSLEY: You know, publicly it was all smiles and congratulations today…

MCEVERS: Yeah. Happy to work with my colleagues, yes.

HORSLEY: …President Trump saying – exactly. But I’m sure that the knives will be out and the finger pointing will start when the microphones are turned off.

MCEVERS: NPR White House correspondent Scott Horsley, thank you.

HORSLEY: Good to be with you.

MCEVERS: And NPR congressional correspondent Sue Davis, thanks a lot.

DAVIS: You bet.

(SOUNDBITE OF THE FUNK ARK SONG, “FROM THE ROOFTOPS”)

Copyright © 2017 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Republican leaders are trying to bridge the divide on their bill to alter the Affordable Care Act. NPR’s Ron Elving explains the options available to them, and the potential consequences of failure.

KELLY MCEVERS, HOST:

And to help us understand what’s happening on Capitol Hill tonight, I am joined by NPR’s Ron Elving. Hello there, Ron.

RON ELVING, BYLINE: Good to be with you, Kelly.

MCEVERS: So tonight the president threatened that if the House does not vote on this tomorrow and does not pass their own health care bill, that he is going to move on and leave Obamacare in place. How serious a threat is that do you think?

ELVING: It sounds pretty serious. It is certainly an escalation in the war of words over all this. But you know, if you’ve read “The Art Of The Deal,” you know that Donald Trump is not averse to the art of the bluff. So we don’t know. Would he really be willing to walk away from the entire issue of health care and the entire promise that he made and the entire Republican Party has been making for the last seven years to repeal Obamacare and replace it? One wonders.

MCEVERS: I mean what are the options right now for House Speaker Paul Ryan to get this thing done?

ELVING: It looks as though the plan, since the president has sent Mick Mulvaney, former House member and now the OMB director, director of the president’s budget office…

MCEVERS: Right.

ELVING: …To say on his behalf, OK, we’re done negotiating. We’ve got a deal as far as we’re concerned. You guys vote on it tomorrow. And it appears to be stripping out the essential health benefits package – this is 10 things that include maternity care and so on – saying, no longer will that be required. That will be up to individual consumers and insurance companies to negotiate. They get rid of that. That lowers costs, and that makes them happy perhaps. Although, they’re still asking for an ironclad guarantee that people’s premiums will go down – a tough one.

And if they are happy – if the House Freedom Caucus is happy and you get those last 25, 30 people on board, then the moderates probably will get rolled tomorrow, and they will actually pass something if all those things are true and if the moderates are rolled. And then they’ll go to the Senate, which will not consider the bill in its current form. It will not consider a bill without the essential health benefits package.

MCEVERS: Right, right. So in order to get this passed the House, they’re going to pass a thing that the Senate will very likely not pass. That’s what’s going on. So if you’re President Trump, like, what’s your calculus then?

ELVING: Calculus is that once you’ve gotten a bill through the House, there’s just one more chamber to go. And even if they pass something quite different – distinctly different, then you come back to the House and say, you have to conference with the Senate. You guys get together in a big conference committee. Everything’s on the table. Nothing is set in stone until everything is agreed upon.

You negotiate that out with a lot of help from the White House, no doubt. And then we’ll take it back to both chambers and twist some arms and incentivize people and threaten to walk away and say we’re going to stick you all with Obamacare and say whatever you need to say to get the deal done sometime – weeks, months – from now but before August recess if at all possible.

MCEVERS: Right, so the way things usually get done in Washington then, yeah.

ELVING: That would be true, especially when you’re moving a sixth of the national economy and changing something that has been such an emblem for the Republican Party and for the Trump candidacy.

MCEVERS: Let’s talk about if this fails in the House. I mean what are the consequences for Paul Ryan if that happens?

ELVING: That is a stickier proposition. Paul Ryan has really invested all of his speakership in getting this done and done in the way that he wants to have it done. He has brought to this all his intellectual energy, all the things he has tried to do as a member of Congress, as chairman of the Ways and Means Committee. He is all in on this bill. If they can’t get it through the House, they will have to go back to the drawing board and try further maybe without a lot of help from the president. Maybe that will be a facilitator. Maybe it will be a deal killer.

But if the bill goes down tomorrow – and I’m not saying that it will. If the bill goes down tomorrow, then Paul Ryan is really left with few options of any kind, let alone any good ones. And he may actually have to truly start over from scratch and push this whole issue down the road months and try to turn to something else like tax reform.

MCEVERS: That’s NPR’s Ron Elving talking about what’s going on in Capitol Hill tonight with the Republicans’ health care plan. Thank you so much, Ron.

ELVING: Thank you, Kelly.

Copyright © 2017 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

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On this week’s edition, we answer your questions about the Republican health care proposal.

LOURDES GARCIA-NAVARRO, HOST:

And this is The Call-In. After the long-awaited GOP health plan was released, there were reactions from both sides of the aisle. But for many people, what lingered were their questions.

MELISSA MCSWIGGAN: Hi, my name is Melissa McSwiggan. I’m calling from Pittsburgh, Pa.

HERMANN VOGELSTEIN: This is Hermann Vogelstein in Rochester, N.Y.

UNIDENTIFIED WOMAN #1: From Hilo, Hawaii.

MCSWIGGAN: And I have a comment (inaudible) about the new Republican plan.

UNIDENTIFIED WOMAN #2: Why are we not talking about a traditional Medicare model for all?

VOGELSTEIN: Would those on Medicaid get a tax credit?

UNIDENTIFIED WOMAN #3: How will it work for employers? Thanks very much.

VOGELSTEIN: Thank you very much.

MCSWIGGAN: OK, bye.

GARCIA-NAVARRO: We asked you what you wanted to know about how the Republican health proposal would affect you. NPR’s Gisele Grayson runs NPR’s health reporting project with member stations and Kaiser Health News. And she has been following the bill, so she joins us now to answer your questions. Big subject, tough one. I don’t envy you. Hi, Gisele. How are you?

GISELE GRAYSON, BYLINE: (Laughter) I must say, when I saw these questions I was so happy because I’m like, wow, I’m going to learn things that I, you know, hadn’t dived into before. So let’s do it.

GARCIA-NAVARRO: All right. Let’s start with this question from Louise Young. She left us a voicemail.

LOUISE YOUNG: How would people who currently get subsidies pay for their premiums? Currently with the subsidy, their premium is reduced upfront. With tax credits, how would that work?

GARCIA-NAVARRO: So right now people are, under the Affordable Care Act, getting subsidies. They’re getting tax credits to pay for the expenses of health care. And she’s asking, how would it work under the Republican bill?

GRAYSON: What’s going to be the same is there is going to be help for people. People are going to get tax credits. And it’s going to work – the filing is roughly going to work the same way. Here’s the big difference. In aggregate, it’s going to be a lot less money. People are not going to probably get as much to pay for their premiums in the end. Plus there was another pool of money that the Affordable Care Act put aside to help people who really have low incomes. That pot of money is gone completely.

GARCIA-NAVARRO: All right, Louise also had a second question. Here it is.

YOUNG: If you’re a large employer, you currently have to provide health insurance coverage at a very low cost for certain people based on your wage rates. What would happen to this provision in the law if the individual mandate goes away?

GRAYSON: All right, good question. There are two mandates in the existing Affordable Care Act. One is that people have to have insurance. And the other is that employers have to provide an offer of insurance that’s some sort of reasonable percentage of their income. Both of those mandates go away under the GOP bill. A lot of people aren’t actually particularly concerned about the employer mandate going away. I talked to a woman named Caroline Pearson. She’s with the consulting firm Avalere Health. And here’s what she said about the employer mandate and its impacts.

CAROLINE PEARSON: That does not necessarily mean that employers are going to start dumping coverage. You know, I think employers offer insurance for a lot of reasons. Most of them have nothing to do with the mandate. Except in sort of rare cases, I think most employers will continue to offer coverage.

GRAYSON: So I think as long as the economy is good and as long as employers like to dangle health insurance in front of people because people think it’s pretty important, that will mostly stay intact.

GARCIA-NAVARRO: All right, another question for you, Gisele. Take a listen.

MARTY ALLEN: My name is Marty Allen. I’m going on to Medicare in April. I don’t know how the Republican plan is going to affect Medicare, but I’m hearing here and there that it will. Do you have any answers to that question? I realize it’s rather large and broad, but I don’t know how to make it more specific.

GRAYSON: That’s a great question. So how about I make the answer large and broad and then try to get specific? Trump has said he is not going to touch Medicare. End of story. I’m putting that on the table. The bill does actually repeal some taxes that right now go to fund Medicare. That’s actually more of a political problem. Politicians are going to have to figure out how to fund Medicare. I’m not sure somebody who’s actually on Medicare is going to really feel that. But here’s a sort of more nuanced answer. Medicare is the health insurance for people 65 and older, and it takes care of routine medical care. It will also take care if you need to go to the emergency room. You break a hip or something, you need to be hospitalized for a bit, that’s Medicare.

Say you’ve got Alzheimer’s and you need long-term care. That’s actually Medicaid that pays for that. Medicaid pays for a lot of seniors who need longer term care – they’re in nursing homes, they’ve got disabilities. And Medicaid under this bill is actually going to be cut substantially. And states, when they lose this money from the federal government, are going to have to make some pretty tough decisions about who they’re going to cover.

GARCIA-NAVARRO: We got a number of good questions from Hermann Vogelstein up in Rochester, N.Y. Let’s start with this one.

VOGELSTEIN: Would there still be online marketplaces to compare plans? Would plans still be classified by metal grades so shoppers would know that they’re comparing apples to apples?

GRAYSON: All right. Yeah, this is actually a pretty big difference in this bill. There’s not going to be a requirement. It’ll probably depend on where you live. So you had to – in order to get the subsidies under the Affordable Care Act…

GARCIA-NAVARRO: You had to…

GRAYSON: …You did have to go through healthcare.gov.

GARCIA-NAVARRO: And you’d have to see everything lined up and you could compare them. And then you’d go through the system there.

GRAYSON: Right.

GARCIA-NAVARRO: And this bill does what?

GRAYSON: That requirement is gone. You can buy insurance and get the subsidies without going through the exchange. Some states like California will probably try to maintain a pretty robust exchange and have all the offerings there. But other states that weren’t so enamored with the Affordable Care Act, these exchanges might sort of fizzle out or not become as useful to a consumer because they won’t have all the plans listed.

GARCIA-NAVARRO: All right. And here’s another question from Mr. Vogelstein up in Rochester, N.Y.

VOGELSTEIN: Would there still be minimum standards of coverage under the proposed plan so people don’t unwittingly buy junk plans only to find out that coverage is inadequate when they need it?

GARCIA-NAVARRO: Another really good question.

GRAYSON: Yeah, and another complicated answer – kind of. There are still some really strong consumer protections in place. The plans have to offer these essential health benefits. They have to offer minimum standards of coverage. The amount of money a consumer can spend out of pocket still remains capped. There are some provisions in the bill that will let insurers offer plans where you might have to pay a little bit more. They might have a little bit more discretion in tweaking some of the benefits. I’d say for the first few years we’re going to see plans remain pretty robust. But this is definitely something to watch because the bill can’t do too much right now. But Tom Price, the secretary of Health and Human Services, is going to have a lot of discretion in defining what makes a robust plan. So it’s something to keep an eye on.

GARCIA-NAVARRO: NPR’s Gisele Grayson. She runs NPR’s health reporting project with member stations and Kaiser Health News. Thanks for running us through what is and will continue to be a very complicated issue.

GRAYSON: You’re welcome.

Copyright © 2017 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.