AUDIE CORNISH, HOST:
Now, we'll hear more from Republican senators about the so-called discussion draft elsewhere in the program. Meantime, Democrats are opposed to this plan. On the line now is Senator Claire McCaskill. She's a Democrat from Missouri. Welcome to the program.
CLAIRE MCCASKILL: Thank you.
CORNISH: Earlier you tweeted, I'm almost afraid to look. Now that you've had a look, what is your chief concern about this bill?
MCCASKILL: Well, there's so many. I think I have to start with the bizarre premise that foundationally what this legislation is doing is giving a big tax cut to wealthy folks in our country by taking away Medicaid dollars. And that doesn't make sense to me. These are really aggressive cuts to the Medicaid program. That's going to dramatically hurt rural hospitals in my state, rural nursing homes. Sixty-four percent of Americans that are in nursing home right now is being paid through Medicaid dollars.
CORNISH: Now, it does it far more gradually than the House version. Does it help for states to have time to make this transition?
MCCASKILL: You know, you can try to dress this thing up and stretch it out and try to pretend, but the bottom line is these cuts are deeper and are more permanent than even what was proposed in the House. So while the pain will be felt over more years, it will still be more pain.
And I think people forget that when people lose Medicaid coverage, they still show up at the hospital when they have a chronic illness or a traumatic impact on their health. And those bills are paid by the hospital who then passes those costs on. They do not have a magic fairy paying the bills for people who show up without insurance. Those bills are passed on to all the people in our country that do have insurance. That's why this bill is not going to break the cycle of higher premiums - because we're going to have fewer people insured.
CORNISH: Now, this is a very heated issue in your home state, Missouri. Right now, you do have counties that don't have an insurer offering a plan on the federal exchange. And Missouri could become essentially a poster child for some of the problems of Obamacare. How do you square your support with the Affordable Care Act with the problems that you actually have to deal with in your state?
MCCASKILL: Well, it's one of the reasons I have a sense of urgency about this. I'm very disappointed my state didn't take the monies that were available to them under the Medicaid expansion. And I'm seeing rural hospitals who have closed their doors in my state. But most importantly, we have a plan that we could help people in these bare counties. First, the administration ought to quit sabotaging the exchanges. I'm glad that this bill at least recognizes that the cost-sharing payments to insurance companies are important since they at least say they'll pay them for a couple of years. That's what's causing these counties to go bare.
My solution is, let every Missourian who's in a county that doesn't have an insurance policy they can buy - let them buy what we buy. Let them come and buy on the congressional exchange where all the members of our staff all over the country are getting their insurance. Use their subsidies, and by the same plans that we can shop on. I think that would be fair, and it would be an elegant solution to the problem of bare counties.
CORNISH: Given the reluctance by any Democrats to support these proposals, President Trump has accused you all of being obstructionist. Today your fellow senator from Missouri, Republican Roy Blunt, said in an interview that there was no reason for Republicans to try to work with Democrats on health care legislation. So where does that leave you? What is your strategy going forward in terms of making a mark on this legislation?
MCCASKILL: Well, I've tried for years to get Republicans to help us fix some of the mistakes that we made in the Affordable Care Act. There are things we can do to shore up the exchanges, to make those pools healthier, to bring down costs. I would like to see us work together on that. But this notion - I would agree with one thing. I don't think Democrats are ever going to get excited about cutting Medicaid to pay for tax cuts to wealthy people. I just don't think that's the direction we should be going in our country right now.
The 1 percent's doing very well in America. They don't need more help right now. But Medicaid does. And people who are going to be sleepless tonight because they're worried about what's going to happen in their families - they're the ones that we need to be looking out for right now and not so consumed with getting these tax cuts out the door.
CORNISH: Just a few seconds left, but I wanted to get your assessment about the chances that this bill has of getting enough votes to get through the Senate.
MCCASKILL: You know, it's very interesting to watch. I can't tell. Mitch McConnell is a professional arm twister. He's done this for many years. He has a lot of power in his caucus. He is firmly in control of this process. I'm not sure the White House has any input at this point. I think it's all Mitch McConnell. So we'll have to see if he can twist enough arms to get to 50. Clearly I've talked to some of my colleagues today that they're not there yet, so I think he's got a rough road ahead.
CORNISH: Senator Claire McCaskill of Missouri, thank you for speaking with ALL THINGS CONSIDERED.
MCCASKILL: Thank you.
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