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We Need A Clear Replacement To Obamacare, Sen. Braun Says

STEVE INSKEEP, HOST:

And I'm Steve Inskeep in Washington, D.C. The Affordable Care Act is close to a decade old, and the fight over it is not done. The Trump administration made that clear this week. The Justice Department formally supported a move to have the entirety of Obamacare thrown out in the courts. An appeals court is considering a lower court's ruling to do just that.

The lawsuit comes after repeated efforts to repeal Obamacare failed in Congress, which is also still debating health care. So we have brought in Senator Mike Braun of Indiana, newly elected Republican, who campaigned on repealing Obamacare among many other things. Senator, welcome.

MIKE BRAUN: Good to be here.

INSKEEP: Do you support the court throwing out the entire law?

BRAUN: I think it's almost a moot point because when I did campaign, I always was clear that unlike most Republicans running, that the repeal effort had to be there with a clear replacement. I actually - because I did it in my own company - built an insurance plan that covered pre-existing conditions, no cap on coverage, kids can stay on the plan until they're 26. And I thought that was a good part of Obamacare.

INSKEEP: OK, so you liked that part.

BRAUN: Yeah.

INSKEEP: You were not in favor of repealing without a replacement...

BRAUN: Definitely not.

INSKEEP: ...Which would suggest you're not in favor of this court ruling...

BRAUN: Well...

INSKEEP: ...Because that's what a court would do, right?

BRAUN: I think it's a distraction at this point because it was confusing when I said that on the campaign trail because they tied me with most other Republicans that said repeal it. But we never had a replacement. The ship has sailed. We've got to cover those three pillars. But Obamacare was doomed to fail because it was big government. They got in cahoots with big health care, especially health insurance. When has that ever worked out to where it's cheaper and more effective?

INSKEEP: Although you are underlining that there are key parts of Obamacare that are very popular, that it sounds like you would like to keep in some form. We had Rick Wilson, Republican strategist...

BRAUN: Yeah.

INSKEEP: ...On the program earlier this week, and he described the political reality of the situation that Republicans find themselves in. Let's listen to a little bit of that.

(SOUNDBITE OF ARCHIVED BROADCAST)

RICK WILSON: The Affordable Care Act has led to a lot of people becoming accustomed to particularly having the pre-existing coverage. How do you get people who are up for re-election in 18 months to jump on that grenade?

INSKEEP: Sounds like you agree with that, Senator. Let's not be messing around with pre-existing conditions is what he's saying.

BRAUN: No, I think it's confusing. And I liked the other day, when President Trump came over to the luncheon and said Republicans are going to lead on health care. I just think it's kind of a wrong way to do it when you're talking about repeal without a clear replacement. If they were hand in hand, that would be different. But it's never been hand in hand, so I say, quit worrying about the repeal part of it. Get a plan that's going to be consumer-driven, that tasks the industry with getting with it.

I blame the industry. They're the ones in the business of giving us health care. It's a broken system. So that's why the Democrats own the issue. But you can't solve it by doing Medicare for All before you start addressing the costs involved. And I think when we go there, we sacrifice the best of what's there for the sake of getting government involved. And I think that's a failure that's going to happen again.

INSKEEP: I think you're pointing toward a new phase in the debate here, Senator. You're saying, Obamacare is, let's not worry about that. Let's talk about what comes next. You've noted that some Democrats want to go for Medicare for All. That's where they want to go.

BRAUN: Yeah.

INSKEEP: There are various other bills and proposals. You want Republicans to have some specific proposals on the table. What's one that you would favor?

BRAUN: Number one, transparency throughout the industry. There is no other business than it is so cloaked and shrouded because it's evolved, mostly through insurance companies, to make it paternalistic. Nobody that uses the system has any skin in the game. There's nothing where you spend that much money and you never ask, how much does it cost?

INSKEEP: Because the insurance company ends up paying the bill, and I may not understand who gets paid what, who's profiting...

BRAUN: And they get their margin, and they've cloaked the whole process. The providers don't mind it, the drug companies, the hospitals, the caregivers because it's all evolved to where they've all done well. But it's 18 percent of our GDP. It should be closer to 12 to 13 percent. And if the industry doesn't get with it - that's unusual out of a Republican.

Most of us have been apologists for the industry. I blame them. They will have one business partner, the federal government, and it'd be a shame because we'll sacrifice some stuff when that happens.

INSKEEP: If we just talk about the price of prescription drugs, would you use the power of the federal government to push harder, to push down prescription drug prices?

BRAUN: Yes, in the sense of making it transparent. Let consumers do the heavy lifting. You should not, on a generic prescription, have a 3 to 400 percent difference in your - I - you know, I renewed one the other day. It was 10 bucks one place, $34.50 another, on a common prescription. No other markets work that way.

INSKEEP: And if I'm a consumer and I know that in advance, I might be able to save money.

BRAUN: You can shop around, and you'll get the best value.

INSKEEP: Senator Mike Braun of Indiana, thanks for coming by.

BRAUN: You bet. Transcript provided by NPR, Copyright NPR.