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Sen. Kaine Backs Measure To Stabilize The ACA's Insurance Markets


And a new bipartisan health care proposal in the Senate looks to stabilize insurance markets that were shaken by President Trump last week. This bill put forth by Senators Lamar Alexander and Patty Murray would, among other things, restore cost-sharing reduction payments that insurance companies rely on. It initially got some tepid praise from the White House. President Trump's feet seemed to go cold yesterday, though, as the White House press secretary, Sarah Huckabee Sanders, said they want a solution that provides relief for all Americans and, quote, "doesn't just bail out insurance companies."

Tim Kaine is in the Senate. He represents the state of Virginia. He's a Democrat and joins us this morning.

Senator, welcome back to the program.

TIM KAINE: Hey. Good to be back with you, David. Thanks.

GREENE: So you ready to support this bipartisan proposal?

KAINE: Absolutely. I've worked hard on this with my chair, Lamar Alexander, the ranking member, Patty Murray, beginning, really when the repeal effort failed in the Senate in July, we started to work to put together this bill. And one day in, we've got six Republicans who've signed on as co-sponsors, many Democrats as well. And it's a very, very good thing to help people keep their premiums low and give insurance companies stability so that they'll stay in markets and write policies.

GREENE: Now, it sounds all bipartisan now. But Lamar Alexander, the Republican sponsor of this bill, he says this does not mean they are not going to keep trying to repeal and replace the Affordable Care Act - Obamacare - later. Is that the reality you're facing, that the erosion of the ACA is just inevitable?

KAINE: No, that's not the reality. But there is a reality that Lamar is correct about, which is this is a stabilization move. I mean, it basically does two things. We make the cost-sharing payments, which are all geared to help insurance companies keep low-income people's premiums and deductibles and co-pays low. So the cost-sharing payments help keep insurance affordable. We do that, and then we also give states additional ability to tailor their programs the way that they want to with innovative and flexible practices. So that's what the bill does.

But we all agree, all this will do is will stabilize the insurance markets for the next two years, keeping premiums lower than they would otherwise be. But we still need to have a bigger discussion going forward about other improvements to make. And so there are a lot of ideas on the table from, you know, the Graham-Cassidy idea of block granting, Bernie Sanders' single-payer idea. And Michael Bennett and I have introduced a bill that we like, which takes advantage of the existing system and adds in a public insurance option for people. We call it Medicare-X.

GREENE: This is Medicare-X. Right? And I wanted to ask you about that.


GREENE: It's certainly not quite Bernie Sanders' Medicare for all, but it would allow people in rural areas with few insurance companies, you know, to buy into Medicare. Republicans seem delighted to run against Democrats on this issue and to run against anything that looks like it's doing what you're doing. Are you worried that this would appear to be moving to the left and it could really backfire at the polls?

KAINE: I'm not worried at all. In fact, it's responsive to what folks are telling us as we travel around our states. And it's responsive to what Republicans are saying. They want more choices, and they want more affordability without giving up protections like pre-existing conditions.

And so what our plan would do is keep the network just as it is. But beginning in 2020, in the counties that have only one or fewer insurance companies writing on the exchange, there would be a second policy offered. And it would be - it would take advantage of three aspects of Medicare. One, there's a provider network in place. There's a reimbursement schedule in place. And they have low administrative costs, and they serve every ZIP code in the United States. And so we would put together a public plan that meets the essential health benefits of Obamacare and offer it, first in those counties that have limited choice, but by 2023, in every ZIP code in the United States. More choice, lower cost - what's to complain with about that?

GREENE: Let me just ask you a broad political question, not just about health care. But you have...


GREENE: You have a really competitive governor's race in Virginia. Democrat Ralph...

KAINE: We do.

GREENE: ...Northam, Republican Ed Gillespie - a lot of questions still about Democrats' ability to connect with rural, white voters, which you were talking about in part with this health care idea. Can you say with confidence that Democrats have gotten better at doing that since you and Hillary Clinton lost?

KAINE: I think we're - I think we've been good at it in Virginia for a while. That's why we've won the last three presidential races and three of the last four governor's races. And I'm confident that Ralph Northam's going to win. I'll tell you why. He is an Army veteran and a pediatric neurologist running at a time when health care is the most significant domestic issue on people's minds. Ralph is an unusual person, a good fit for the times. And that's why I think he's going to win.

GREENE: But nationally - I mean, just in a few seconds - you're confident you're doing a better job?

KAINE: Yeah, I am. I am.


Senator Tim Kaine, Democrat from the state of Virginia - I really appreciate you taking the time this morning.

KAINE: OK. Thanks, guys. Transcript provided by NPR, Copyright NPR.