Given the Republican Party's extreme difficulty in passing replacement legislation for Obamacare, and health care's close connection to tax policy, "Face the Nation" spoke with White House Legislative Affairs Director Marc Short about Congress' future endeavors and how the administration is looking to spend any political influence left for Capitol Hill.
What follows is a transcript of the interview, which aired Sunday, Sept, 24, 2017, on "Face the Nation."
JOHN DICKERSON: We turn now to the White House Director of Legislative Affairs, Marc Short. He is the liaison between the administration and Capitol Hill. Marc, welcome to the broadcast.
MARC SHORT: John, thanks for having me.
JOHN DICKERSON: I'm going to pick up with something that Senator Collins said about preexisting conditions. She says they are not guaranteed in this legislation. The president, when we spoke to him in April, said, "This healthcare bill that passes will have a guarantee." But this one doesn't. So the president's okay with that?
MARC SHORT: This one does, John. In fact, the Obamacare legislation required coverage of preexisting conditions. This legislation does not change that. So preexisting conditions continue to be covered.
JOHN DICKERSON: So the critics of the bill say that's not the case. While the Obamacare protections may exist, states can opt out. So they can apply for a waiver. And then when they get that waiver, the terms that they have to meet are really fuzzy. And people who are involved in healthcare know that, because it's really hard, and they're going to have to squeeze out a lot of money, they'll take the path of least resistance, which means people will preexisting conditions will see less coverage and higher costs.
MARC SHORT: John, look, this system's not working. Everybody knows that having Washington, D.C., as a central hub for this has failed. It's failed American people. And prices are going out the roof. In Arizona, prices increased by 190% over four years, in Alaska, by 203% over the last four years.
To your question, we guarantee preexisting conditions continue to be covered. You're right that there is also an ability for states to apply for a waiver. But in that, it's conditional upon them showing how they will continue to make preexisting conditions covered on an affordable basis. There's also federal dollars that are provided to help states to do that. But nobody can deny that the costs right now are going through the roof.
JOHN DICKERSON: But leaving aside -- there are plenty of problems with the bill, as people on both sides say. But on this question of preexisting conditions, the analysis from the AMA, from the AARP, from the Medicaid directors, they look at it, and they say, "What's going to happen is the vagueness of this language, which says that a state can opt out if it offers an adequate and affordable alternative, that that is a huge hole through which states will increase costs, lower coverage for the most, we're talking here about the most vulnerable, people with preexisting conditions."
So if I'm out there with a preexisting condition, and this is, of course, what Senator Collins was talking about, there's no backstop here. There's no guarantee. Someday down the road, it's going to get worse. And people would like some kind of surety. And all they hear is vague words about affordable and adequate.
MARC SHORT: John, the current system is unsustainable. The Medicaid dollars are going to go bankrupt. They continued to predict a 6% increase annually that this country cannot afford. So it's no surprise that the special interests are opposed to it. The same special interests and those trade associations you mentioned went to bed with the Obama administration to force Obamacare on all Americans.
Because why? Because it forced all Americans to have to have insurance, whether you want it or not, and an individual mandate and all employers to force coverage on all their employees. This is something that they like the current system. And they want the government to continue to give more dollars. Now they're asking for bailouts on the CSR payments. That's what they want. That's not what's working for the American people. We need to change the system.
JOHN DICKERSON: But anybody with a preexisting condition is not wrong to think that their costs might go up, and their coverage might decrease.
MARC SHORT: They will continued to be guaranteed coverage, John. That's what we've said. The law does not change that.
JOHN DICKERSON: But it might be quite different from the coverage they have now, because of this opt-out.
MARC SHORT: Likely, the coverage they have now is not working. The system is not working. Coverage for millions of Americans is not working. That's why, last year, 7 million people chose to pay the penalty instead of get the terrible insurance that's offered on the Obamacare exchanges. They don't want it.
JOHN DICKERSON: Well, those weren't people with preexisting conditions. Those are healthy people.
MARC SHORT: There's a mix of people who are saying they'd rather pay the penalty than have to pay the taxes.
JOHN DICKERSON: Let me ask you about the president's push for this. He spent 90 minutes in Alabama this week. He talked about a wide variety of issues. Why does the president, who's a marketer, who has some skills in that regard, not go 90 minutes on the benefits and beauties and wonders of this plan? He talked about how hard he was working. He has a list of people he's jawboning. But why is he not out there selling this plan for all of its great merits? Is it because there are not merits that he can sell to his voters?
MARC SHORT: Oh, no. I think he actually is selling it, John. I think that he's had many calls with those senators who are on the fence. He's continuing to make calls through the weekend. And you saw his activity in the first go around. So he's continued to stay active. In reality, the whole Graham-Cassidy effort, it came to be, because the first effort failed. And a lot of our voters are saying, "Look, this isn't good enough. You promised us, for years, you would repeal this."
JOHN DICKERSON: But here's a president who's got, I mean, on the phone, I'm sure he's got talent. But he's the rally guy. He's the 90 minutes whipping people up. He's talking about the NFL. Today, the owners and teams and everybody's responding to the president who says something on the NFL. Isn't that totally getting in the way of your effort to fix this healthcare issue and get all the Republicans onboard?
MARC SHORT: No. The president's a huge asset to our efforts on Capitol Hill. He's not getting in the way.
JOHN DICKERSON: But the NFL issue is a useful one in terms of healthcare?
MARC SHORT: Look, I think the NFL is an issue where the president has made a case that, as we've talked about, there are coaches across this country, at high-school level, who are penalized and disciplined for leading their players in prayer. And yet, you see an issue in the NFL where the media champions those who are taking a knee to disrespect the American flag. That is a dichotomy that most Americans can't understand and for good reason. And the president's raising attention to that.
JOHN DICKERSON: But he raised attention to not the prayer issue, but pointed out to players. I mean, you mentioned the prayer. But he didn't mention the prayer.
MARC SHORT: Well, he's making the case that, in many cases, there are generations of Americans who have fought and died to protect our freedoms and fought and died for the red on that flag that represents the blood that's been sacrificed by so many Americans.
And what the president is doing is saying, "This is not the appropriate place to raise your social activism." And I think he's made the case that you have a First-Amendment right, if you wish, to protest the flag. But owners have a First-Amendment right, as well. They have the First-Amendment right to fire those players, if they so choose.
JOHN DICKERSON: All right. Marc Short, we're going to have to leave it there. We're out of time. Thanks so much for being with us.
MARC SHORT: John, thanks for having me.