Frederica Freyberg:

From Wisconsin to Washington, the House of Representatives narrowly passed its version of so-called American Health Care Act late this week. At a White House gathering after the vote, House Speaker Paul Ryan claimed that ObamaCare is no longer viable.

Paul Ryan:

And that is why we have to repeal this law and put in place a real vibrant marketplace with competition and lower premiums for families. That’s what the American Health Care Act is all about.

Frederica Freyberg:

Under the bill passed in the House, subsidies for people to help pay for plans are based on age instead of income. Expanded Medicaid would go away. Penalties for not having insurance are eliminated and states would be able to decide how to cover people with pre-existing conditions and which essential health benefits to offer. Tax increases on high-income earners that help pay for the Affordable Care Act are eliminated. Here’s what Wisconsin U.S. Senator Tammy Baldwin says about the bill, quote, President Trump promised insurance or everybody but the House Republicans broke that promise today by putting millions of people at risk of losing health care coverage and forcing millions to pay more for less care.

Frederica Freyberg:

High political drama played out over the Republicans’ House vote this week. In tonight’s Capitol Insight, we turn to Republican Bill McCoshen who is managing partner with Capitol Consultants and Democrat and executive director of One Wisconsin Now Scot Ross. Thanks to both of you for being here.

Bill McCoshen, Scot Ross:

Thanks for having us.

Frederica Freyberg:

I saw this quote from a Kentucky congressman this week saying the American Health Care Act is like a kidney stone. The House doesn’t care what happens to it as long as they can pass it. How real is that?

Bill McCoshen:

I think there’s some truth to that. I mean it’s obviously been a pretty high mountain to climb for Speaker Paul Ryan and the Republican conference. They tried in late March and failed to get this over the goal line. And it was critical to this forward but I think it’s important for your viewers to understand it’s just step o. It’s going to go to the United States Senate. They’ll make modifications to the bill. And then it’s likely to go to conference. So there’s a long way to go before it actually hits the president’s desk.

Frederica Freyberg:

Does this put politics over really important policy?

Scot Ross:

I think absolutely. When have you a bill that passes basically by two votes on something that’s one-sixth of the American economy where 24 million people are going to lose their health care. We’re going to lose protections for pre-existing conditions. What are going to be those essential services that are cut? I mean some of those essential benefits are things like maternity care, childhood immunization and even substance abuse programs. So there’s a real challenge out there. And it was a terrible vote. And I think it’s a vote that’s put things like Glenn Grothman’s district in play for 2018.

Bill McCoshen:

I’d say this. There was a lot of risk for Republicans. There was risk of doing something and there was risk of doing nothing. Truthfully as a Republican strategist, I’d say there was a far greater risk of doing nothing for the Republican house. If this is their number one promise they’ve had since 2010. It is the one thing that’s galvanized social conservatives and economic conservatives for the last seven years. And if they did not deliver on this, Republicans would have been wiped out in 2018.

Frederica Freyberg:

And yet is it really construed at this moment as a big, big win for Paul Ryan the way this went down?

Scot Ross:

I don’t think you can call it a big win for Paul Ryan because he looked so feckless for a month or so when they first tried this and then he had to pull it back. I think the challenge that Ryan has is there’s so much bad that’s going to come out of the bill. If they got this bill through the Senate and they’re not going to — essentially he would be at risk of losing his speakership because there are so many people who are going to lose their care. You may not remember who gave you your health care but you’re sure as heck going to blame who took it away from you.

Frederica Freyberg:

What about that? He says that Glenn Grothman’s district is in play because of this. Is that real?

Bill McCoshen:

Not a chance. He hasn’t had serious opposition in that seat. I mean the way that—I just don’t think any of our Wisconsin congressman are going to be at risk as a result of this vote because they’re going to get one more kick at the cat. Some like Congressman Mike Gallagher have said he had some concerns about this bill. He’s hopeful the senate will make modifications and I think probably folks like Duffy, Sean Duffy and Glenn Grothman feel the same way.

Scot Ross:

Wait, Mike Gallagher said something about this piece of legislation because for six weeks he didn’t say a word despite when the media would contact him. And then finally he put something out after the bill last night. I think that’s a huge, huge indication as to how challenging that vote he took as a freshman member of Congress is going to be in the upcoming 2018 election cycle.

Bill McCoshen:

Voters that follow this on both sides are very savvy. This, to use a baseball analogy, this was a double by the House of Representative to get the ball–to score a run, they gotta get the bill through the Senate and also through conference and ultimately to the president’s desk.

Frederica Freyberg:

You're saying voters are savvy on the issues?

Bill McCoshen:

I think they are. I think they understand. Clearly Republican voters have been motivated by this issue for six straight years, three election cycles. Now potentially Democratic voters will be motivated by this. And we don’t know how that’s going to play itself out yet.

Frederica Freyberg:

Do you feel like voters who might be recipients of some of the current coverage understand what some of this means?

Scot Ross:

I think they will if they lose their coverage or if for instance they lose their pre-existing conditions or for instance, the estimate by one esteemed economist says if you had cancer and then you try and get insurance your premiums are going to be $140,000 a year. That is an obscenity. And that is not coverage. If you cannot afford coverage, you’ve lost your coverage. And I’ll agree with Bill. You can defend action. You cannot defend inaction but this piece of legislation is going to trickle down into state races. Governor Walker came out Friday and said he would be willing to get a waiver to eliminate pre-existing conditions protections here in the state of Wisconsin. You’ve had Brad Schimel and John Nygren talking about opioid coverage for the last year and a half. And those things could be gone as a result of this.

Frederica Freyberg:

What about that point?

Bill McCoshen:

This bill attempted to do three things: to lower premiums, to lower deductibles and to provide states more flexibility. The jury’s out on the first two quite frankly but it certainly would provide state’s more flexibility on what type of coverage. The good news for Wisconsinites is we have some of the best health care here in the country and we have the lowest uninsured population in the country.

Scot Ross:

Yeah, but we also –just remember this, here in the state of Wisconsin we have people who have been denied access to care because of the actions Governor Walker has taken related to not taking the Medicaid money and things like that. You just have to think when push comes to shove if seniors are paying five times more for their coverage as a result of this, that is going to a huge impact especially in a 2018 election where it’s an older population.

Frederica Freyberg:

It may well be tough. Let me get both of you to respond to the transportation plan that came out of the state legislature this week, Bill?

Bill McCoshen:

Pretty creative. Representative Dale Kooyenga from the Milwaukee area got the support of his leadership and his caucus, the Republican Assembly Caucus to do what we would call a big, bold plan. It includes–they call it “The Road to the Flat Tax.” It includes a long-term comprehensive transportation plan, which by the way would have the first increase in revenues for transportation in the past decade. But it also has some pretty significant tax reduction. We’ll see. It’s step one. It’s a good starting point but it’s got a long way to go.

Scot Ross:

“The Road to the Flax Tax” is going to roll right over the middle class. We’re talking about double taxing your gasoline so that they can cut the top 1% income tax rate in half. So the richest man and woman in Wisconsin, John Menard and Diane Hendricks are going to have their tax rates cut in half essentially, the tax rate. And you’re going to pay twice on your gasoline to pay for that.

Frederica Freyberg:

We'll leave it there. Scot Ross, Bill McCoshen. Thank you.

Scot Ross, Bill McCoshen:

Thanks for having us.