The Corner

Politics & Policy

Cotton on Ryan’s AHCA: ‘It’s Fixable, But It Needs a Lot of Fixing’

Arkansas Sen. Tom Cotton has emerged as one of the more intriguing members of Congress in the Trump era. He never opposed Trump, and spoke at the 2016 GOP Convention. He’s been described as “a reliable Trump ally”, “one of Trumpism’s leading voices” and had no real criticism of Trump’s first executive order on refugees and immigration. But he’s been doing everything he can to convince House Republicans that the American Health Care Act won’t pass the Senate, the idea of a later “Phase Three” of health care reform is magical thinking, and that they need to go back to the drawing board on replacement legislation.

“I think it’s fixable, but it needs a lot of fixing,” Cotton said during an interview with Mona Charen at the National Review Institute’s Ideas Summit in Washington today. “The House bill doesn’t get at the main problem most Americans have, which is increasing premiums.” He pointed out that while the Congressional Budget Office’s assessment of the bill concluded that insurance premiums would come down in the long run, roughly 10 percent, the assessment projected they would increase in the first three years.

But the Arkansas senator remains somewhat optimistic that the bill will be modified to generate a broader Republican consensus. Charen asked, “a McLaughlin-style question: on a scale of zero to five, zero being no chance, five being metaphysical certitude, how likely is it that a health care reform bill will get signed into law?”

Cotton replied, “the bill as written is close to one; for a modified bill, [it’s] three and a half, approaching four.”

He discussed a recent town hall meeting at Springdale High School, where he heard a loud and sometimes vitriolic response from supporters of Obamacare.

“We probably had 200 of my old campaign volunteers and loyal Republicans I recognized… and maybe 2,000 other people there,” Cotton said. “I recognize that even if I have two-thirds of my constituents agreeing with me, that still means that a million Arkansans disagree with me. Those people are my bosses. None of us in Congress work for anyone else in Washington; we work for the people back home.” 

“I make no bones that many people have benefited form Obamacare, but many more people have been hurt by it,” Cotton said. He contended that a key problem of Obamcare was that it treated  “cost and access as two different problems, when they’re really two sides of the same coin – it did something about access without really addressing costs.”

“You want to get people off Medicaid and into market-based insurance,” Cotton said. “[Medicaid] should be there to help the most vulnerable, but you want people to move to employer-based insurance or purchasing it on the individual market using tax credits.”

He lamented that Medicaid had a “dysfunctional design from the very beginning,” encouraging profligate state spending, and said that if done correctly, a health care reform bill that replaced Obamacare would qualify as “the biggest reform of an entitlement system in a generation.”

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