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tv   The Last Word With Lawrence O Donnell  MSNBC  June 27, 2017 10:00pm-11:01pm PDT

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white house, this is the pie in the face today for protesters who have been hammering their senators for weeks and opposition for the bill is a huge victory. there is a reason why people are celebrating tonight conceding it is too early to celebrate. that does it for us tonight, we'll see you again tomorrow. >> that was good, too. it looked absolutely dead and over. here we are again in the senate, but bringing this back in the senate will be even harder than it was to bring back in the house, but you're right. it is not over until it's over, but this is a very big day for people who want to preserve obamacare. and tactically, it's interesting to have seen the senators learn from the house. the house did it openly, crashed and burned, amended it secretly
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and that's how they got it through. the senate started off doing it secretly. they also crashed and burned. the question is what can they now evolve to to try to pass it after this recess and we just don't know yet. >> i think now we know there were probably a handful of republican senators who were so happy when it crashed and burned in the house the first time and thought, okay, it's not going to come our way. we dodged that one. >> guess what? it followed you home. >> thank you, rachel. >> thank you, lawrence. today president trump invited all the republican senators up to the white house to convince them to vote for the republican health care bill they had just decided to not vote for. in fact, they had decided not to vote at all. it was another big winning day for the resistance. >> mcconnell didn't have the votes because evidently health care is complicated. >> it's a very complicated subject. >> nobody knew that health care could be so complicated. >> i had hoped that we could have gotten to the floor this
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week but we're not quite there. >> people hated this thing. >> even trump voters didn't like it. >> the only way this bill could be more cartoonishly evil is if it mounted damsels in distress on the railroad tracks. >> this is put up or shut up time for republicans. >> when did we get to the point where we said no, we're not going to talk to democrats about a fix? >> we'll work with anyone on health care. >> they're not interested in participating in this. >> this would be great if we get it done, and if we don't get it done, it's just going to be something that we're not going to like, and that's okay and i understand that very well. >> this is a big, complicated subject. mitch mcconnell knew this day was coming. since election night when donald trump was declared the winner of
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the electoral college and the loser of the people's vote, mitch mcconnell knew this day was coming, he just didn't know it would be this bad. mitch mcconnell knew that with a republican president, the republican senate was actually going to have to try to deliver a bill that would repeal and replace obamacare. republicans in the senate had pushed bills like that under president obama when they knew it wasn't a real legislative thing. they knew the democrats would filibuster the senate and the senate would veto just whatever they passed. of course the president would veto it. mitch mcconnell knew and has known for years that it would be impossible to write a bill that repeals and replaces obamacare that would not be described as mean by any reasonable person or even an unreasonable person. mitch mcconnell had every right to believe that he dodged this disaster in march when paul ryan would not let his health care bill go to the floor of the house for a vote because he didn't have the votes. that was when paul ryan and donald trump did the most
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unprofessional thing that any house speaker or president has ever done in a legislative exercise. they both publicly gave up on their big promise to repeal and replace obamacare. >> i don't know what else to say other than obamacare is the law of the land. it's going to remain the law of the land until it's replaced. we did not have quite the votes to replace this law, and so, yeah, we're going to be living with obamacare for the foreseeable future. >> i think we have to let obamacare go its way a little bit overall and we'll have to let things go. i'd love to see it do well, but i can't. >> his fans were not happy with that surrender. when paul ryan gave up that time around, all he had to say was he was going to continue to work on the bill and work on getting votes. that's all he really had to say. which is actually what paul ryan ended up having to do, much to mitch mcconnell's surprise and perhaps horror, because then mitch mcconnell knew his day was coming. after it got through the house, mitch mcconnell always knew that the mean idea of throwing 22 or 23 million people off their
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health care coverage was going to be difficult for some of his republican senators, he just wasn't sure how many. he could afford to lose only two of them. three of them. he could first lose only two of them, and that's why mitch mcconnell never once expressed any confidence in actually passing a bill. in the senate, mcconnell simply announced that he would deal with the bill one way or another before the 4th of july recess. mcconnell always publicly allowed for the possibility that he could lose that vote on the senate floor, and he always made it clear that if he did, he was going to move on to the next republican agenda item which was supposed to be a massive tax cut. the one thing mitch mcconnell and all the republicans know how to do, a massive tax cut. the one big problem for mitch mcconnell was republican voters, especially trump voters, were led to believe this was going to be very easy. >> you're going to have such great health care at a tiny
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fraction of the cost, and it's going to be so easy. >> we're going to come up with health care plans that will be so good and so much less expensive both for the country and for the people, and so much better. >> i'm going to take care of everybody. i don't care if it costs me votes or not. everybody will be taken care of better than they're taken care of now. >> while campaign trump was saying all that, another candidate was saying things republican audiences did not want to hear. >> i have not set up an exchange. he knows i'm not for obamacare and never have been. but do you know who expanded medicaid five times to try to help the folks and give them opportunity so they could rise and get a job? president ronald reagan. the fact of the matter is we expanded to get people on their feet, and once they're on their feet, we're giving them the training and efforts they need to get work and pull out of that situation.
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>> john kasich won today. and donald trump lost. john kasich, the republican governor of the all-important electoral college state of ohio opposed mitch mcconnell and donald trump's bill. governor kasich made it impossible for ohio senator rob portman to vote for the mcconnell bill, but rob portman, in a typical delay of senatorial courage, did not announce his opposition to the bill until mitch mcconnell announced he was giving up and that he would not even bring the bill to a vote. mitch mcconnell announced that when enough republican senators announced clear enough opposition that would lead mitch mcconnell one or two votes short of passing the bill in the senate, that's when he pulled the bill. some of the senators left enough vagueness in their willingness to negotiate with mitch mcconnell that wasn't really completely clear how many of them really would vote against it if mitch mcconnell brought the bill to the floor. but now that he's pulled the bill, we have republican senators on the floor tonight.
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that means he would have gotten 20% of the senate floor. no one felt ashamed or humiliated by that. it would be a clear loss, but not an outright humiliation. but the truth of the senate is mitch mcconnell wasn't going to come close to 41 votes. and he knew that, and that is why he pulled the bill. mitch mcconnell was willing to lose and move on on a roll call vote. he said so very clearly at the beginning of this process. that was both a threat and a promise to republican members. his willingness to have a vote and lose and move on. the threat of that being, you will have one chance to vote on your promise to repeal and replace obamacare. the promise of that was that the senate would move on to other business no matter how that vote turned out.
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mitch mcconnell promised republicans in the senate that they wouldn't have to live with endless wrangling about a health care bill. mitch mcconnell made it very clear to his members that he did not consider this a must pass bill. when a senate leader has a must pass bill, the senate leader always expresses total confidence that it will pass because he cannot afford to have any of his members doubting that it will pass, because if enough members doubt that it will pass, then virtually no republicans will cast that tough vote. a mean vote. to take health care away from 22 million people. here is mitch mcconnell last week publicly refusing time and again to express any confidence at all about passing his health care bill. >> senator mcconnell? >> yeah. >> you must be very confident that this bill is going to pass, number one. and two, are you willing to burn
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a reconciliation package if it's not? >> we are going to make every effort to pass a bill that dramatically changes the current health care law. >> but that's not confidence necessarily. you wouldn't bring a bill up unless you were confident, right? >> so the truth of what mitch mcconnell was facing today, he was not facing the defection of three or four senators. he wasn't facing the defection of nine senators of a roll call vote if he brought this bill to a vote. mitch mcconnell wasn't going to come close to 40 votes on the senate floor. the best mitch mcconnell would do, five votes. that's what he was going to get. mitch mcconnell was facing the prospect of losing 95-5 on the senate floor. that's not losing, that's being wiped out. that's what the majority leader of the senate couldn't afford to do. mitch mcconnell himself is only one of only five senators, five, who said they would vote for this bill.
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no major bill has ever been advanced by a majority leader in the senate that had only five senators in the majority leader's party saying they would support the bill. we have never seen less support for an important bill brought by a majority leader in the history, the recorded public history, of the senate. that's how bad this was. only five votes. that's what he had. all the rest, all the rest of the republicans have said absolutely nothing about the bill or have publicly indicated that they were undecided, and now a total of nine say that they were outright opposed. if on the senate floor mitch mcconnell was going to come up short of the 50 votes he needed -- he only needed 50 because then vice president mike pence would have given him the 51st vote to pass it -- mr. mcconnell knew he was going to come up short.
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he knew that if he was going to hit 49 votes, the bottom would fall out. there was no space between 49 votes and five votes. everybody between 49 and five would just defect. they would just immediately move into the no column. mitch mcconnell knew that would happen on television, on the senate floor, in a 15-minute or so roll call vote. the country would see that happen. that's why mitch mcconnell pulled the bill and president trump didn't argue with him about that, because mitch mcconnell knew that the republican party and the united states senate could prove with their votes how big a lie the repeal and replace obamacare promise was. it was a lie because republicans didn't know how to do it. it was a lie because one republican in the senate who tried to do it this year came up with a bill that only five republicans said they could vote for. that was the picture that america was on the verge of seeing if mitch mcconnell
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brought that bill to a vote. 90% of the republicans in the senate were willing to vote to preserve obamacare instead of vote to repeal obamacare. the reason senate leaders always try to schedule votes on controversial legislation right before big recesses like the 4th of july recess is because when members of the senate go home during the recess, they only become less supportive of the controversial legislation. because they always hear more from the opponents than from the supporters. and so mitch mcconnell knows that the very best chance he had to pass a health care bill was this week. and he did not come close. the resistance won. again. and this time the resistance included republican governors like john kasich and republican senators. joining us now is adam gentleson and the senior executive and john barrows.
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adam, i want to get your view of the senate floor. you've heard mine that is common in situations like this that there is really no space between 49 and the bottom falling out at five, and when the leader sees that, that's when you pull a bill. >> i agree with that completely. i think this bill will either pass with 50 votes or the vote will be somewhere near 20. i think what we saw this week was republicans getting spooked and stampeding away from what they thought was a very terrible vote. there's no question this was a major failure for mitch mcconnell. he definitely wanted to put the bill on the floor this week, and he definitely wanted it to pass, there is no question about that. i think it is important to know that he has a long time to put it back together, but this is a clear sign that pressure works, and this is a clear loss for mitch mcconnell and the republican party.
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>> john, mr. mcconnell has seen every side of this crusade, from the clinton crusade that failed, the obama crusade, he saw what paul ryan went through. he knew this week was his best shot. he knows it only gets worse from here. >> i don't know about that. he knew this vote would fail. i disagree with some of your theory in that i don't think it is a must pass legislation for him, but i think it's a piece of legislation that he would like to pass. and i think it became clear he was not going to have the votes, and there would have been a jailbreak. he wouldn't have gotten 50 people. probably somewhere in the 20 to 30 range. i think he believes there is some chance that they can negotiate in the next two weeks, that he can give some conservative members some deregulation of health insurance from obamacare, give some members on the moderate end of the conference some funding for opioids, he thinks there is some
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and he needs to take some time because the total is less embarrassing. there is some time he will pass in two weeks and they will try to get to 50 to pass it. i think this bill is in trouble but i think it's very much alive. i think mcconnell pulled the bill because he knew he couldn't pass it this week, and he thinks he might be able to pass it in a couple weeks. >> adam, he will no doubt try to follow in paul ryan's footsteps. he will try to repair this, he will try to put it together. but you know in the senate it's very different from the house. the second you hand something to one side of a party, the individuals on the other side know immediately that you're taking it away from them. so you have to take from susan collins to give to rand paul, and that transaction is very, very hard to pull off in the senate and hold onto both of them.
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>> that's absolutely right. i think what you're seeing from republican senators is not just a rebellion against the content of the bill which is horrible, but also a rebellion of the process through which mcconnell put the bill together. he essentially crafted this massive bill that covers one-sixth of our economy and affects millions and millions of americans in secret with a small handful of his closest aides. and i think what is very different about the senate and the house is all senators feel like they have a right to be a part of the process and have their voices heard and be accomplished. the bill did not achieve what they wanted to achieve, and the bill is a process, they want to be included. you can't restart the committee process now. it's too late to restart the drafting of the bill from scratch, so i'm not really sure how he puts that together in two weeks and how he mollifies his process concerns. but i do think his ultimate goal is to get the bill passed. it is a bill in the sense that it will not go away for mr. mcconnell. it's an extension of the
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republican party, and if it fails, it will not go away, which is why those who oppose it must keep their feet on the gas. >> he comes up with his own promise to his party in the senate which is, i will move on. he told them from the outset that he was willing to lose. he will move on no matter what the vote was. he now has a pressure he created for himself, which is the pressure to move on. >> right. and also, at some point, he has to move on. they have to pass a bill to raise the debt limit, they have to pass spending bills for the next fiscal year. there are other things that really are must pass that the senator has to do. at some point they will at least have to set health care aside. the other thing is insurers are going through the process of setting premiums for next year. they're spooked by health care in the market. the longer that goes on, the uglier the insurance situation gets for them and the republicans have to take care of that.
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>> thank you for being here. coming up, can president trump convince republicans to do anything? does he have any real power of persuasion with the congress? and later, the trump administration's chaotic foreign policy got even more confusing when the white house surprised much of the rest of the government with a very peculiar statement about syria. it's ok that everybody ignores me when i drive. it's fine. because i get a safe driving bonus check every six months i'm accident free. because i don't use my cellphone when i'm driving. even though my family does, and leaves me all alone. here's something else... i don't share it with mom. i don't. right, mom? i have a brand new putter you don't even know about! it's awesome. safe driving bonus checks, only from allstate. sometimes i leave the seat up on purpose.
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what should the president be doing at this point to get this bill passed? >> the president has been very involved over the last week, talking to members individually. he wanted to talk to all of us together today. i think that's helpful. and, look, legislation of this complexity almost always takes longer than anybody else would hope. >> here is president trump trying to be helpful. >> mean. that was my term, because i want to see -- and i speak from the heart. that's what i want to see, i want to see a bill with heart. >> i've been talking about a plan with heart. i said, add some money to it. a plan with heart. >> joining us now, george f. will, pulitzer prize winning journalist for the "washington post" and analyst.
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everything has come down to a plan with heart, and a plan with heart for him is throw more money at it. >> i'm going to take care of everybody, he said during the campaign, and replace obamacare with some huge and terrific. the devil is in the details. in 1993, the clintons, mr. and mrs., come into the office and say, we're going to start with health care reform. the senator from new york, pat moynihan, your friend and my friend, said don't do this, it's complicated, it will bog you down. it never even came to a vote in a congress controlled by the democratic party. george w. bush makes a big entitlement change, a big health care change with medicare part d which was popular because no one paid for it. it was an entitlement program without a funding stream. barack obama comes in, and he knows he's talking to a country where 85% of the republican
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people have health insurance and 85% were pretty happy with it. he said, still, this is a moral imperative, i want to do it. i think he exaggerated his ability to make it popular with his rhetorical powers, it certainly didn't work, but i think he said, i'll do it, anyway. in fact, in 2012 and 2014, democrats suffered a huge wave of defeats. but at least obamacare was congruent with basic democratic beliefs and values about the redistributive nature of the federal government and its emeloriative powers and all the rest. republicans don't believe in that, therefore, they're being asked now to walk the plank on something they don't believe in other than a promise that never had had much content. >> george, i'm wondering if the dialogue of this since the clinton crusade of the early '90s has changed republican thinking on it.
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remember the clinton period began with a republican bill that senator chafey was pushing and senator dole was thinking about. during that few months, republicans all walked away from that, and then they all opposed what president obama was trying to do. it turns out apparently not on principle, because they're using some of the obama principles in what they're holding onto, so i don't get anymore what the congressional republican claimed to principle would be in the health care field. >> i think first of all the country has changed in two particulars. in 2009 when work on the affordable care act began, there was not a national consensus that the metric by which we were judged, the success of our health care system as universal coverage. there was not yet a consensus as there now is that there should not be the ability of insurance companies to deny coverage to people with preexisting conditions, which is a fancy way
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of saying people were already sick. those two consensuses have now emerged and it has changed the landscape. second, i think if you took republicans in a room, turned out the light and said speak your hearts, they would say the following. the big problem is that 180 million americans are covered by employer-provided health insurance that is not taxed, is what is manifestly compensation. what we ought to do is undo that system, tell people they can shop across state lines, they can buy any kind of health insurance that any insurance provider wants to sell them, and to those who can't afford it, we will do premium support. that is, we will do the one thing the federal government does magnificently as with social security. it identifies an eligible cohort and sends them a check, and checks would be sent to those who needed premium support, that is, support paying their premiums. that is a real market system.
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but no one is going to go there. no one is going to be radical enough to challenge this original sin of our health care system, which is not taxing as compensation employers-provided health insurance. given that, the choice is now clear, despite all the rhetoric we're not going to have a government-centered system. the choice is between a democratic system of regulations and subsiies or mandates, and that's not a good choice. >> and it's simply generosity from one to the other? >> precisely. republicans get in a bidding war, they cannot win. in their heart of hearts, the republicans say that's not a choice, that's an echo. >> george will, thank you very much for joining us tonight. i really appreciate it. >> glad to be with you. up next, "washington post" reveals that donald trump has actually produced some of his own fake news and put it on the
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here is the "washington post's" david farenthold. >> there are two covers that look like covers of time magazine and the one cover is donald trump. it's a big photo and it says, the "apprentice" is a smash. then another headline says, "trump is hitting on all fronts,
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including tv." it's hung up on the wall, it's very impressive looking, it's fake. it's totally fake. >> at least five trump properties, including mar-a-lago, are displaying a fake cover of time magazine. the fake cover has the same bar code and an on-line image tutorial of how to create a fake time magazine cover. trump is asking the time magazine organization to take the covers down. he tweeted again about fake news. he lies to his supporters about what he calls fake news are absolutely essential lies for the trump style of governing, which is simply to lie. this week, as the president was trying to help mitch mcconnell take health insurance coverage away from 22 million people, including millions of people on medicaid, the white house sent their spokespeople to the microphones to simply lie and say no one would lose medicaid coverage.
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they actually tried to tell the lie that there are no medicaid cuts in a bill that was the most massive cut to medicaid in history. knowing that newspapers and news programs like this one would be saying that the president was violating his promise to not cut medicaid, the white house strategy was simply to lie and say that the president was not cutting medicaid. for the line of work, trump supporters would have to believe that the "new york times" is lying when the president says they're not cutting medicaid, and the "washington post" is lying, and nbc is lying, thus the trump magnifications about fake news. up next, rick stengel, standing editor of time magazine on how lying about fake news advances the trump agenda.
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>> it's very easy. there is a whole thing on line that you can do that. it's pretty easy to spot. the color was wrong, the logo was wrong, it's not professional. it would never be a kind of gushy cover. >> it has exclamation marks and you guys don't do that. here's a white house that was determined to come out and deliver the message that the bill does not cut medicaid. that was their defense to these indefensible -- politically indefensible cuts to medicaid. so this idea that it's all fake news out there is crucial to pushing a lie like that. >> the problem is most journalists evaluate him according to previous politicians who tried to vaguely adhere to the truth.
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he is the authoritarian ruler who says accept my reality. that is the way he governed. we had to cover him in a different way which you're doing by exposing those things which are absolutely untrue. >> jay, as we watched the health care issue during the president's campaign, he promised everything. and he promised basically that republicans were going to love it. it was going to be universal coverage, no one was going to lose anything, it was going to cost less. all of these things were impossible. we knew it when we were hearing it. so you can sort of imagine forward, okay, so if he's president, when he doesn't do these things, what is he going to say? we now know he's just going to lie and say i did what i said i would do. >> yeah. picking up on what rick said, we're used to candidates who, when they win the nomination, try to broaden their appeal to the entire party. and we're used to nominees who, when they win the presidency, try to broaden their appeal to the entire nation.
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trump is taking a very different line in which he's trying to deepen the attachment to a core group of people who are, in a sense, accomplices in the lies and propaganda that burst his presidency. so the implication of that is that trying to be plausible at all, trying to persuade doubters, trying to make the case with the available facts are simply not things that are important to his presidency. that's why his communication style seems, from the outside, to be so ineffective and sort of dead on arrival, because he's not trying to persuade anybody. >> and this goes to what happened in week in the senate. if the presidency, if the president has given up on persuading people, given up on trying to change people's minds which he apparently did as of election day. he hasn't tried to change anyone's mind since then. that comes back to haunt you on a week like this in the united states senate where you have to change a lot of people's minds in ohio and other states so that those senators could support your bill. >> there is a lot of social
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science now, lawrence, that shows that it's very hard to change anybody's mind. there's such a thing called the backfire effect. if you had a strongly held belief and someone tries to change your mind with facts, what it does is try to make you double down your belief. that's where he's operating from, that his supporters are acting on emotion, not facts. he doesn't try to persuade people, he tries to double down with the people who already believe he's saying the right thing. >> and jay, this could work if he had won 52% of the vote, and he just never tried to change anybody's mind, and he could come back and get his 52% again. >> uh-huh. but i think if there is a strategy, it's that he has enough to threaten the primary challenge for republican congressmen, and he has the three branches of government in the hands of the same party, and those three things together will get him through. part of what's going on here, lawrence, presidents in the past always tried to assure us they were in the grip of facts, that they were aware of what was
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happening in the world, that they had good advisers, that they were calm, rational, sane people, partly because we knew they had the means to blow up the world. and trump doesn't try and give us that reassurance. he has a different idea, which is that he might just be crazy enough to blow up the world or the government, and you better listen to what he says for that reason. >> what jay just said made me think about president george h.w. bush when he was running for reelection, and somewhere in a supermarket in new hampshire somewhere there came the question of how much does a quart of milk cost. and he did not know. and this was played by the media as the biggest presidential failure of the year. we don't know exactly how it landed on the public, but it was considered something to be shocked about, that the president was out of touch and didn't know this basic fact. >> you know, the thing that depresses me, i think, more than anything else is the coarsening of our public dialogues.
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things that were considered scandals before for a president now doesn't even pale compared to what he's done by 10:00 in the morning. i think post trump we will never have a situation where there will be that kind of rational die log that jay was talking about. coming up, president trump has a new problem, and that is the way people around the world see him. except in one country where he is very popular. take your time. guess which one. rick stengel will have the answer when we come back. ♪ at johnson's we care about safety as much as you do. that's why we meet or exceed
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president trump is more popular than president obama, way more popular. in russia. a pugh research center poll of nations around the world asked, who do you have confidence will do the right thing regarding world affairs? 53% of russians chose president trump while only 11% chose president obama. around the world 64% had confidence in president obama at the end of his administration, only 22% are confident that president trump will do the right thing in global affairs. joining us now, ned price, former senior director and spokesperson for the national security council and a former cia analyst.
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and back with us, richard stengel, also an nbc political analyst. rick, so russia sees donald trump the way he wishes the united states would. >> what a surprise. in fact, donald trump has achieved, after a hundred-some-odd days where george bush took eight years to get to the end of his administration after invading iraq when their popularity was so low. the thing that's disturbing about this is not his personal popularity but the fact it undermines the world base order that we tried to establish since world war ii. it makes people question our values, it makes them question when we talk about those kinds of things, and that, i think, will take years and years to get back. >> ned, i want to bring into this frame this story that broke last night at 10:00 p.m. when the white house press secretary issued a statement saying that the united states has identified potential preparations for another chemical weapons attack by the assad regime, and they ended it by saying that if mr.
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assad conducts another mass murder attack using chemical weapons, he and his military will pay a heavy price. everyone agrees it was kind of unprecedented kind of press release, but there is a question about the president's credibility, there is a question about the white house communications team's credibility and their credibility around the world when a statement like this is made. >> that's right, lawrence, and the fact there is a question is, in and of itself, significant. this is a question that has been asked a question frankly you won expect to ask of other presidents, be democrats or republicans, the main stream presidents, the 44 who have preceded president trump. but by his own actions and his own words, including in the national security are realm by routinely offering mistruths, half truths and lies he himself has engendered this question. it's another self-inflicted wound to his own credibility. >> what do you make of the
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controversy involving how many people in the administration and who in the administration knew about this white house statement before it went out last night? >> well, look, certainly there were key people who did not know it was come. people at the department of defense. department of state and right behind me at the capitol here. key senators including those on the senate intelligence committee were caught off guard. that is important not just for professional courtesy that these people be brought into the process. but when it comes to the kpt of defense and state they need to around the table formulating the strategy, a stand alone statement does not a strategy make. and it leads to serious questions the fact that so many people were in the dark about whether this is nested within a broader strategy. it also undermines the credibility of a statement like this. a statement like this will have maximumle impact when officials pr the executive and legislative branch are speaking with one resolute voice warning the assad
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greem and moscow andtairn that any action will have profound consequences. instead for several hours we had profound confusion in this yes. >> ned price aband rick thank you for joining us appreciate it. >> coming up a surgeon gets tonight's last word on the republican health care bill. ♪ music
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those protestors greeted republican senators today when they headed to the white house to meet with president trump about the republican senate health care bill. joining us now, dr. gwanda a harvard staff writer for the new yorker." i know you have studied the effects of having health coverage on long-term health what do we know. >> what we've learned is a few things. almost immediately upon getting coverage people start to get access to primary care, preventative care, also needed medicines, more likely to get a regular source of care abneeded smgss and chronic illness treatment. the result is they have improved health pretty quickly. overall health and get better outcomes. then four or five years into it.
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we see substantial and growing reductions in mortality. about a 6% reduction in mortality at five years. and that's a big deal. >> it's easy to talk about elements of the republican bill that are the maef losses of coverage, just people going from being well covered in effect under obamacare to nothing. there is 22 million of those. but, even the people who would manage to hang on would be hanging on to something that would be much, much more expensive for them if any can hang on. >> yeah, i think this is really important to understand. it's not just the 22 million uninsured. it's the vision of a health system where the average insured person has a $6,000 ductable and no primary or chronic care coverage. and that's what we see in the exchanges under the senate proposal. >> and talk about what happens at the -- in the higher age brackets.
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you've written about the example of a 60-year-old man, one version of it it in alaska one version in another state where they end up paying in alaska the premiums would be $36,000 on such a policy. >> that's right. 60 years old, $50,000 of income, my hometown is agentever athens ohio three three the premium is triple what they are currently paying under obamacare. so it goes to $15,000. in some parts of the country it gets to 36,000, $38,000. the shift of the cost. here is the challenge. you can't take a trillion dollars out of the health care coverage system tax revenues brought into the system for coverage, take it away and expect you're not hurting people's care and hurting coverage. and then the results look like these kinds of large costs that even the insured people have to
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pay. they're paying more for less coverage with very high ductables and not rfrl the good care, the primary and chronic care where the reductions in mortality and improvement in health come from. it seems the one number the republicans have concentrated on is the actual are premium. that's the number most health care consumers are aware of, how much they write in that check every month to pay for their insurance policy. and what's less visible are the deductables and the other aspects the noncovered care for which deductionables and preemious don't matter, out of pocket. all of that. when you look at the overall cost of what would be left of health care policies under this new system, that has gone up enormously even in the cases where some of the premiums have gone down.
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>> yeah, the crucial thing to understand is that when the premiums go down it's only because there is poorer coverage. so if you had a silver plan under obamacare in picking up from health care.gov that 70% of the costs. the proposal would make it so the standard plan available with coverage would be just over half of your cost coverage. that's a big amount that's really left for you to have to deal with. and that's what hurts people's health. >> and i think this is what mitch mcconnell knew was going to come out in any debate this week. and if the bill comes back to life we'll be hearing a lot more about all the other numbers beyond just the premiums. doctor, thank you for joining us tonight. i really appreciate it. >> thank you. >> "the 11th hour" with brian williams starts now.
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>> the president promised the, republicans promised to repeal and replace obamacare faded today. the senate majority leader mitch mcconnell i

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