and do your thing. starting right now on "this week" with george stephanopoulos. >> we don't have to talk about this unbelievable victory. wasn't it unbelievable? >> high stakes over health care. donald trump declaring victory. >> how am i doing? am i doing okay? i'm president. hey, i'm president. can you believe it? >> as the gop's bill passes with one vote to spare. >> the bill is passed. the motion is laid upon the table. >> now, republicans under fire. for backing the bill. >> these are human beings! >> does every aspect of this bill apply to members of congress? >> no. >> what does it mean for your health care? will this bill cost the gop in the next election? we ask house speaker paul ryan in our exclusive, live interview, his first since the big vote. and, as the battle over the bill

continues -- [ chanting ] >> all: shame, shame, shame. >> will it stall in the senate? we talked to one senator who could block the bill. from abc news. it's "this week." here now, chief anchor george stephanopoulos. >> good morning. back in march, the gop effort to repeal obamacare seemed to end with more whimper than bang. after seven years of debate, dozens of symbolic votes, republicans couldn't rally behind a bill that actually could become law. obamacare appeared too popular to kill. the benefits too meaningful for too many. it's almost an iron law in politics. once the government provides a benefit, it's almost impossible to take it back. we have seen it with social security and medicare. now the law is being put to the biggest test in generations. cut to the rose garden this week. president trump and speaker ryan savoring a victory. backed by dozens of cheering house members who cobbled together a compromise that passed with a single vote to

spare. >> and this is a great plan. i actually think it will get even better. and this is -- make no mistake. this is a repeal and a replace of obamacare. make no mistake about it. make no mistake. >> here's the surprising thing. back in the house, democrats appear just as pleased. leader nancy pelosi closed the debate by warning republicans they were making the mistake of their careers. >> you have every provision of this bill tattooed on your forehead. you will glow in the dark on this one. you will glow in the dark. >> and as the final votes were counted, her troops broke out in song -- ♪ hey, hey, hey, good-bye >> all of this sparked a rare bipartisan scolding from "the new york post." children, they're all children. point taken. the stakes in the debate too high for silly games. both sides may also be right. the gop needed a win now. needed to show their base they could deliver on a big promise. but if history holds, they could

pay a big price later. democrats lost control of congress in 2010. after passing obamacare in 2009. and in town meetings this weekend, members of congress are facing tough questions and raw feelings. >> you're mandating people on medicaid accept dying. you are making americans -- >> no one wants anybody to die. but you know, that line is so indefensible. nobody dies because they don't have access to health care. [ crowd reacts ] >> that emotion is fueled by a simple fact. what happens to health care matters to everyone. everyone has a stake. everyone has a story. everyone wants the health care they need at a price they can afford. rarely does official washington touch so many lives so directly and so deeply. this morning, three big questions on the table. how would repeal legislation passed by the house affect all of us and america's health care system overall? can legislation that looks anything like that bill actually pass the senate?

leaders there are saying they're going to start from scratch. and what will be the political fallout? when this debate ends, which party will own health care? at what cost? we begin with a personal impact. from one of america's premier health professionals. from dr. atul gawande. a surgeon and author. a professor at harvard. an author of four "new york times" best sellers. thank you for joining us. speak to us from the perspective as a doctor first. what is your biggest concern with this bill? >> i read the bill. there are three big concerns. one is the weakening for protections of people with pre-existing conditions. another is the major cuts in the number of people who are on medicaid coverage. and the third is the increased cost for people who buy insurance on their own, especially if they're over 50. >> let's take those one at a time. starting with the pre-existing conditions. got so much attention this week, particularly after that monologue from jimmy kimmel. want to show a bit of that. >> if your baby is going to die and it doesn't have to, it

shouldn't matter how much money you make. i think that's something whether you're a republican or democrat or something else, we all agree on that, right? i mean, we do. [ cheers and applause ] >> now, we know what happened with the house bill. they were basically giving the states the option to waive the requirements so people could be charged higher premiums who had pre-existing conditions. they also added some money to pay for that. the president says the coverage for pre-existing conditions will be the same now as it was under obamacare. your response? >> it's hard to watch that jimmy kimmel clip. my own son who is in his 20s, and has almost the same heart condition. when he turns 27, he goes out on the market. most of the jobs he has had are freelance jobs with no benefits. he's like 1 in 4 americans that are, with histories of cancers, diabetes, heart conditions. and my worry, as a father, as a cancer surgeon is that, when we say we're going to put people into high-risk pools, we have seen what that is. high-risk pools are separate

insurance plans for people with pre-existing conditions. they've historically had very low coverage. waiting lists. poorer coverage. and high costs. it's -- it's chilling to imagine my telling my son those are where he would end up going or my own patients. >> and the medicaid savings. about $880 billion in savings according to the congressional budget office. >> right. it cuts the 70 million people on medicaid by about a quarter. for the rest of the people, there's a cap, whether it's the elderly in nursing homes. people who are working poor. the cap means the coverage becomes limited. >> and then, finally, because of the way they affect the subsidies, some older and sicker americans will be paying more. >> yes. people who are over 50 can be charged under this new bill up to five times more than younger people. >> but how about if you take the flipside? it's very clear right now for a lot of younger and healthier

americans, their premiums have gone up under obamacare. we have seen insurance companies facing losses. a lot of insurance companies facing losses in states like virginia and iowa most recently. big insurance companies pulling out of those states. that fuels the president's argument and speaker's argument that obamacare is collapsing. >> so the core thing that's happening is that there's uncertainty in the market about will there be subsidies? will there be mandates? the insurers don't know how to price and are pulling out. here's the thing to understand. is that -- this is not -- this is a bill that makes each measure of health and health care worse. rather than better than under obamacare. it's not a proposal that anybody would put forward as a credible or sane proposal for solving the problems in obamacare. >> why not? >> the core reasons are, number one, it doesn't have the -- the subsidies. by cutting the subsidies, we're taking $1 trillion away from support for people's health care

in the bottom 40%. and returning it as a tax cut to the top 2%. so you take $1 trillion out of health care with it's ending income-based subsidies, turning them into age-based subsidies. it hurts people across the board. >> given the fact that there are problems with obamacare, what would you do to fix it? >> the aim is to guarantee that it's good for the patient. the biggest way to fix that is ensure that you have the average person out there with a $2500 deductible under obamacare. we want to open up the subsidies so people have better coverage. that will mean that we continue the plan that secures the insurers to be able to offer coverage under it. the best way to put it. last year, insurers had made actually a profit by participating in the exchanges. if they have certainty and know that the rules allow them to

protect pre-existing conditions and offer a minimum benefit coverage, including maternity care and mental health, they're in a place where the market can be restabilized. and keep medicaid coverage going. 19 states have not expanded medicaid coverage allowing a republican president to offer medicaid coverage to the rest of the country would actually make conditions better for us all. >> dr. gawande, thank you for your time. >> thank you. let's bring this to the speaker of the house. paul ryan. mr. speaker, thank you for joining us this morning. a lot to talk about this morning. i want to start out with the big bottom line question. you heard dr. gawande. he said this will make health care worse off on almost every level. can you guarantee if the house bill were to become law that no americans would be worse off than they are today? >> i fundamentally does agree with his analysis on so many levels. but first of all, good morning, george. it's good to be with you. let's remember what is happening

right now. obamacare is collapsing. it's not working. what good is it for anybody, let alone for a person with pre-existing conditions if you don't have a health insurance plan that you can even get? this is a rescue mission. we want to achieve the goals we all want. getting the cost of coverage down and making sure everyone has access to affordable health care. especially and including people with pre-existing conditions. that is what our bill does. >> well let's take -- >> let me just say a couple things. you have all these health insurers. if they're doing so well, why would they be pulling out of the marketplace. over 1,000 counties in america have one plan to choose from. this week in iowa, the last state-wide insurer says they have to pull out. that means people in 99 of their counties will have zero choices. aetna just pulled out of virginia. the law is collapsing. it's not working. you can't get health insurance in these places, whether you have a pre-existing condition or not. we're trying to step in front of this collapsing law and make

sure we can have a system that works. a system with choice and competition and affordable premiums. and we have multiple layers of protections for people with pre-existing conditions. so -- >> let's talk about that, first. >> so they, too, can have the peace of mind -- so they, too, can have the peace of mind to get affordable coverage. >> let's talk about that first. under the amendments you have, states will have the option to charge people with pre-existing conditions more. you heard dr. gawande and others say where they have had high-risk pools they have been underfunded. if you used all the money you all put in for high-rirvsk pool, that would still cover only a fraction of those with pre-existing conditions. >> can i get you there for a second? under this bill, no matter what, you cannot be denied coverage if you have a pre-existing condition. >> but you can charge people more. >> let me finish my point. you can't charge people more if they keep continuous coverage. the key to having

coverage provision is to make sure people stay covered and move from plan to plan if they want to. it's like waiting until your house is on fire to then buy home owner's insurance. you want to make sure people stay covered. >> sometimes people lose coverage through no fault of their own. that is one point. >> that's right. soy was getting there until you just cut me off. the point of this bill in those states that get a waiver to do what they need to do to make it work better in their particular states has support for exactly that very person who, if, in the course between a year, get extra aid for support for pre-existing conditions. on the state waivers, on the condition that a state has a working high-risk pool to help specifically that person with pre-existing conditions. an example. in wisconsin, we had a really successful high-risk pool. 10% of people in the individual market in wisconsin were in the state high-risk pool. they had eight or nine plans to choose from. they could go to any doctor or hospital they wanted. and their premiums and co-pays

were cheaper than they are under obamacare today. and the other 90% of wiscons wisconsinites had cheaper health insurance. better choices. that's what we want to get to. you can't say one size fits all. one rule for the entire country. our states are different. in maine, they had an invisible risk program. that's the model we used for this bill. you didn't have a different plan. if you became catastrophically ill, subsidies kicked in and helped your health insurance and premiums. it lowered the cost of premiums for everyone. because if a person gets a catastrophic illness and state and federal subsidies kick in to help that person, it means all the other insurance plans don't have to cover those costs. you stabilize the marketplace. our goal is this, george, get everyone access to affordable care including people with pre-existing conditions. that is not happening under obamacare.

obamacare, the premiums are going up double digits. the deductibles are sky high. choices are evaporating to the point where 1 in 3 counties have one insurer left. and now we're learning, those last insurers in many states are pulling out. this is a crisis. we're trying to prevent this crisis. we think we have better ideas. in wisconsin, we had a good system. in maine, they had a good system. different states are different. let the states perfect this. while making sure we have multiple levels of protection for people with pre-existing conditions. we're proud of this. we're proud of the effort. it's us keeping our promises. >> there's a lot of uncertainty over what exactly it will do, including in the senate. senator lindsey graham said a bill finalized yesterday has not been scored, amendments not allowed, and three hours of final debate should be viewed with caution. i want to go back to something you said in 2009 when obamacare was being debated. here you were on msnbc. >> i don't think we should pass bills that we haven't read and

don't know what they cost. if you rush this thing through before anybody even knows what it is, that's not good democracy. >> a lot of your members have conceded they didn't read the bill. there wasn't a single hearing or markup on the finalized version of the bill. there wasn't a cbo analysis of this bill. so have you met your own standard here? >> yeah, i think this is kind of a bogus attack from the left. the bill has been online for two months. the bill has been -- >> not the final version. >> the final version was an amendment that was three pages long. takes 30 seconds to read. by the way. obamacare was over 2,000 pages. this bill, under 200 pages. it doesn't take long to get through the bill. the final amendment three pages long. but more importantly, we got two cbo scores. the most recent cbo score says we're perfectly compliant. with the sthat budget rules. which is what matters here. the last amendment is not going to dramatically alter that score. it was narrow changes to the

bill. that has been online for quite some time. >> the members who changed their vote said there were quite significant changes to the bill. essential benefits. it changed how you dealt with pre-existing conditions. it added money, as well. >> the last one, yeah. it's called the upton law. and several other members wanted this 'mehmet. amendment. is there a situation under any situation where the state getting a waiver if there is a person that could get charged higher health care costs because of their health status? we looked and decided there might be a situation where, within the course of one year, a person could conceivably get higher health care costs. this amendment affects that. we have multiple layers of protection to make sure that these families, that these people. look, these are our friends and our constituents. we want to make sure people get affordable coverage. that's not happening in obamacare. you have to remember. if you can't get a health insurance plan, what good is it? you don't have health insurance.

what we're trying to do here is have a system where we have more choices, more competition, and lower prices. and yes, this cbo score does say it lowers premiums. the goal here is two things. get premiums down and get people choices. and make sure that people with pre-existing conditions get coverage. we have multiple layers of this. a one-size-fits-all, federal government-run system does not do that. >> the cbo analysis says over ten years, 24 million people will lose coverage. for most americans, deductibles will go up. it says that for a lot of americans in that age range just short of medicare, 55-64 years old, particularly in rural areas, they're going to be paying thousands more in premiums every single year. the aarp calls that an age tax. if you accept one part of the cbo analysis, do you accept all of them? >> what the cbo is saying, if the government is not going to

force somebody to buy something they don't want to buy, then they're not going to buy it. so they're basically saying, people, through their own free choice, if they're not mandated to buy something unaffordable, they're not going to do it. under this bill, everybody will get a refundable tax credit to buy a plan of their choosing. on the age point, you make a good point. obamacare said we'll have younger, healthier people subsidize older people. that didn't happen. those young healthy people said, i'm not paying for this unaffordable insurance. i'll just pay the penalty. that's one of the big reasons the situation is collapsing. we're fixing that. we're adding money. it's been out there for a month. we're going to add more money to the tax credit for those people you just mentioned people 50 and 60 years old. that's what the senate is going to do. i think that's what lindsey graham is talking about. we added money to the bill, which the senate will complete the job of making sure that the tax credits for those people in their older cohorts, 50s and of

60s, will have a much larger tax credit to reflect those changes. the fact that their health care costs more. what we learned with obamacare is making younger people buy unaffordable insurance that they can't afford, they're not going to do it. that's one of the reasons it's collapsing. >> sounds like you wouldn't be comfortable with this bill being signed into law. >> no, this bill takes $85 billion and adds to it the tax credits. what the senate is going to do is the specific adding to the tax credits. the senate is going to say, let's figure out exactly how much more of a tax credit a 50-year-old gets and how much more a 60-year-old gets. so what the house bill did is it took this bill and said, we need to add more money to those refundable advanceable tax credits for older people. the senate is going to complete the job of saying just how much more money. this is one stage in a multistage legislative process. you know how this works. they pass a bill through the house. pass a bill through the senate. go to conference and iron out the differences. and we have already acknowledged

we think we need to do even more support for people who are older and more support for people with pre-existing conditions. but gives states the ability to craft and customize. i know the wisconsin health insurance market really well. it's a lot different than the new york health insurance market or the texas health insurance market. we have this one-size-fits-all rule from obamacare that is crashing. it's why insurers are pulling out. people are getting no choices. premiums are skyrocketing. they went up 116% in arizona this year alone. so it's not working. we need to fix this problem. for the sake of just our constituents, or the american people. people want the peace of mind knowing they can get affordable coverage. especially for people with pre-existing conditions. quite frankly, george, that's what we're achieving. >> a lot of people think it will be worse. i want to get to another point, though. this bill does cut taxes by about $900 billion. cuts medicaid and other subsidies by about $1 trillion. i want to show a chart.

the chart shows the distribut n distributions of the benefits. under $50,000 is going to be cut back. small benefits for the middle class above that. but a huge, huge benefit for those making over $200,000 a year. warren buffett said he'll get a 17% tax cut. critics say this is a huge transfer of wealth from the poor and middle class to the wealthy. how do you respond? >> a couple of things. we're keeping our word. which is we're repealing and replacing the entirety of this law. all the obamacare taxes. the obamacare taxes are job-killing taxes that hurt economic growth and make health insurance more expensive. these taxes, most of them are aimed at the health care system, which makes the premiums higher. it pushes medical device companies overseas. it makes it more expensive to buy health care. that's point number one. point number two -- >> most of the benefits go to millionaires. >> medicaid -- it's -- we're repealing all of the obamacare

taxes. medicaid, we're giving the states the ability to customize medicaid to meet the particular needs of their vulnerable populations. you have to remember that medicaid is done by the states by micromanaged by the federal government. but not very well. more and more doctors are refusing to accept people with medicaid. we want to give the states the ability to customize the medicaid program to work for their states. >> you're saying they can do that with $880 billion less. you're saying they can do it with $880 billion less. >> we're -- we're giving states the ability to run their own medicaid program. it's increasing for medical inflation. and by the way, we recognize that for certain people in medicaid, the disabled, the aged, the people in nursing homes, we're giving them an even bigger increase so that their funds are even more than everybody else. so by giving states the right to run medicaid, and giving them a bloc grant. a per capita grant, increasing the spending by medicare inflation, i hardly think that

is draconian. >> you don't think anyone will be hurt when you're taking $880 billion out of the system? >> no, no, i don't. i think the micro management of health care is a problem. hospitals can't survive with medicaid alone. doctors are not taking medicaid. whenever we have had a waiver given to a state so they can customize, it works better. we want to give every state the ability to work for the unique needs of their populations. again, george, here is the fatal conceit of obamacare. it says we're going to mike r micromanage this in washington. telling every state and community how it will work. it's failing. medicaid is not working. obamacare is collapsing. people are not getting choices. we have to fix this. this is a rescue operation. you have to acknowledge, every state is a little different. what we're trying to achieve here, and what this bill does achieve, gives states the ability to meet the needs of their populations. put the resources in there so everyone can have affordable

health insurance coverage. including people with pre-existing conditions. >> you talk about state -- >> in micro managing this -- >> you're talking about the state flexibility. senator susan collins is coming up next. she has a bill that says, if a state wants to keep obamacare, they can. if a state wants to experiment, they can. that's state flexibility. what about that bill? >> i think susan collins has made a tremendous contribution to this debate. again, we want to make sure that we get rid of these obamacare rules, regulations, taxes, that are make it impossible. so if maine, by the way, she comes from a great state, which has an invisible risk insurance system that says, we're going to pay for the catastrophic illnesses for the people that are catastrophically ill.

what that's done in maine is lower the premiums for people with pre-existing conditions. we target the support for people with a pre-existing condition. that is the model we're copying in this bill. 1% of the people in the individual market drive 23% of the costs in health care in the individual market. 5% drive up almost 50% of the costs. we're saying let's target our support for that population so they get the peace of mind and get lower health insurance costs. that stabilizes the market for everybody else. maine has proven how this can work successfully. we're looking at that maine model saying let's do that nationwide. so then if a state like wisconsin wants to do something different because they're slightly different and unique, let them do that. so long as we maintain coverage for people with pre-existing conditioning and give everyone equal access. >> it doesn't sound like -- >> these are important rules that we think are going to be maintained. and the goal here, i'll say it one more time. lower prices. expand access and coverage. >> it doesn't sound like a full endorsement of senator collins. one final question. we're just about out of time. i want to ask you a question on the politics. as you know, the democrats got

wiped out in 2010 after voting on obamacare. it's one of the reasons you're speaker today. they smell real blood now. you saw leader pelosi. on friday, the cook political report, well respected, shifted 20 seats away from the gop. dave wasserman said, house republicans willingness to spend political capital on a proposal that garnered the support of just 17% of the public in a march quinnipiac poll is consistent with past scenarios that have generated a midterm wave. how worried are you about a midterm wave? what are you telling your members? >> i'm not. number one. health care is a complicated, emotional issue. we completely understand that. the system is failing. we're stepping in front of it and rescuing people from a collapsed system. more importantly, we're keeping our word. that's really important here, george. people expect the elected leaders if they run and campaign on doing something, they expect them to do that. that's what we're doing. we're keeping our word. i would argue we would spell disaster for ourselves, politically, if that's your question, if we go back on our

word. this is us keeping our word. most importantly, it's us trying to fix a real problem that real people are experiencing in this country. >> mr. speaker, thank you for your time this morning. >> thank you, george. when we come back, she could be the make-or-break vote in the senate. senator susan collins joins us live. later, our "roundtable" weighs in. we're back in just two minutes. later, our "roundtable" weighs in. we're back in just two minutes. in 12 weeks. yeah. ♪ ♪ the world of fast food is being changed by faster networks. ♪ ♪ data, applications, customer experience. ♪ ♪ which is why comcast business delivers consistent network performance and speed across all your locations. fast connections everywhere. that's how you outmaneuver. come on! dogs just won't quit. neither does frontline gold. its triple action formula

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susan collins, joins us next. president trump is up and tweeting this morning. just out a few moments ago, he said republican senators will not let the american people down. obamacare premiums and deductibles are way up. it was a lie. and it is dead. we're joined now but one of those republican senators. senator susan collins from maine. thank you for joining us this morning. we just heard the president right there. you heard speaker ryan as well. but you had serious concerns. you were against the original house bill. is it fair to say you're against the amended one? >> i have a lot of concerns. it's difficult to assess the new house bill. because we still don't have a cbo analysis of the impact of coverage and costs. and those are key questions. >> those are the key questions. i mean, we heard dr. gawande weigh in on that, as well.

you heard speaker ryan right there. he says he's going to take care of those older, rural americans who don't have the tax credits and will lose subsidies. under obamacare. he cited your state of maine several times. >> well, first of all, one of the problems with the house bill is that the tax credits are not adjusted for income or geographic region. that really hurts a state like maine, where we have an older population living in largely more expensive, rural areas, as far as health care is concerned. i have heard a lot of talk about the maine high-risk pool. indeed, it was a success in maine for the 18 months or so in which it operated before the passage of the aca. and it can be part of the solution. but in maine, we had definite revenue streams supporting the high-risk pool.

and that is why it worked. in the house bill, it's really up to the states to come up with whatever option they wish. so that could work. it could be part of a solution. but the devil really is in the details. >> so do you agree with the speaker ryan and president trump saying people with pre-existing conditions are going to have the same coverage right now, even better, speaker ryan said, in some cases than under obamacare? >> i think that's unlikely. but -- so much discretion is given to the states without any guardrails. the different between that approach and the approach in the bill that senator cassidy and i have introduced is we keep the aca safeguards, the consumer protections, for people with pre-existing conditions. it's true that under the house bill that a state that gets a waiver would still have to

provide coverage to people with pre-existing conditions. but that coverage might well be unaffordable. and if the coverage is unaffordable, that doesn't do any good for a child who has juvenile diabetes and is going to have that her entire life. and once she's no longer on her parents' policy, that's going to create problems in some states. >> if the house bill were before you today, would you be a yes? >> well, first of all, the house bill is not going to come before us. the senate is starting from scratch. we're going to draft our own bill. i'm convinced that we're going to take the time to do it right. speaker ryan today said that he hoped that the senate would improve the house bill. i think we will do so and that we will come up with a whole new fresh approach that solves the legitimate flaws that do exist with the aca. where we have seen in some markets, insurers fleeing.

so people won't be able to buy subsidized insurance. but it will also keep some of the benefits of the aca. my goal is to actually expand coverage for those 28 million americans who still lack coverage today despite the aca. >> a lot of people are struck by the working group put together in the senate to deal with health care. i'll put the picture up right there. there you see it right there. 13 men. not a single woman. cecile richards said when women are not at the table, we're on the menu. senator patty murray, democratic senator, of course. it matters to have women at the table. and it matters when they aren't. why aren't you in that working group? >> well, the leaders obviously chose the people they want. i'm working hard with senator cassidy, with our co-sponsors. senator mike rems. shelley moore capito, johnny isakson. we're reaching out to moderate democrats. i would like to see us put together a bipartisan group to

solve this problem. democrats who acknowledge that there are problems with the current law. that it is not working well in several states. and republicans who also want to make sure that we're not reducing coverage and we're giving flexibility. there's an issue that no one is talking about in washington that is so critical. and that is if we're going to reduce the cost of health insurance, we have to take steps to reduce the costs of health care. and no one's talking about that. senator cassidy and i have in our bill a transparency section so that you would actually know what you're paying. and i think that would help consumers make better choices. >> final question. can you support a final bill that denies medicaid funding to planned parenthood? >> that is an important issue to me because i don't think that

low-income women should be denied their choice of health care providers. forfamily planning, cancer screenings, and well women care. it's not the only issue in this huge bill. but i certainly think that it's not fair and it is a mistake to defund planned parenthood. it's one of many issues. >> senator collins, thank you for your time this morning. >> thank you, george. up next, the "roundtable" takes on the politics of health care. will this week's victory for health care cost the gop control of congress next year? we'll be right back. the average family's hectic home: its raised 1 dare devil, 2 dynamic diy duos, and an entrepreneur named sharon. its witnessed 31 crashes, 4 food fights, and the flood of '09. it's your paradise perfected with behr premium plus low odor paint.

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matthew dowd. i want to start with that going in political question. big victory for the white house and the republicans this week. will it look like a victory in 2018? >> well, i think there's a difference between passing a bill and a victory. i think those are two separate things in this. i'll give donald trump -- i'll say he's right about something. donald trump is right that our health care system is broken. and he's right that something needs to be done. but something needs to be done both on affordability and access. all of us have personal stories. i have a brother and a sister who are doctors. i was on the board of a charity hospital. a catholic charity hospital. i had two daughters in the hospital for nine months. cost $2 million in their care in this. and i think until we fundamentally address, this bill doesn't do it. it actually makes affordability worse and access worse in this. until we address those concerns, the american public is going to keep crying about this. >> the question of a victory. i was struck by paul ryan saying i'm proud of this. that could be an ad against him.

yes, they feel very good that they kept their promise, as he kept saying. and their campaign chairman says, we need to keep our base excited in an offyear election. keeping your base excited at the expense of people losing health care i don't think works well politically. >> this fires up both bases. no doubt. one of the things that has not gotten much coverage is that the republican base demanded this. they demanded it for very good reasons. paul ryan pointed them out. obamacare was failing. we can talk all we want about people with pre-existing conditions. or access to health care. if there's no health care system in entire states, essentially, these are all mute arguments because it doesn't exist. something has to get done. i heard very little between senator collins and speaker ryan that was incompatible. >> are you kidding? >> no, no. >> oh. >> you go back and read the

transcripts of those interviews. there was only one disagreement. >> hold on a second. i'll take that they were both careful. if you read between the lines and senator collins is going for a bipartisan health care plan and more tax credits and no defunding of planned parenthood, that's a pretty big difference. >> i think there's a couple things here. i think first of all, from the standpoint of the republicans, this could be tough electorally. if you look at the polls. obamacare, in part, thanks to this debate, now polls at a 54% approval rating. this bill polls at 17% approval. so i think americans do have concerns. this thing about pre-existing conditions is important but not the most important negative change they're making in this bill. it's caught a national wave. i did one tweet that got 29,000 retweets about pre-existing conditions. i have never had a response like that. the democrats have to worry about, however, is that there are problems with the aca. there are insurance companies dropping out. some of those are the doings of this administration. they've pulled advertisements and done other things to

discourage people from signing up. and discouraged insurance companies. some of it is stuff that should and can be fixed. it's something the republicans and democrats have to worry about. >> forget the bases. the affordable care act -- bankruptcies down 50% largely because of the affordable care act. if i'm the aarp and american lung association, cancer association, march of dimes, you know what i'm doing? i'm holding town halls in those congressional districts saying we're going to tell you actually what is in this bill, how it impacts you. the top ten states trump won are going to be hurt the most by this house gop bill. tell that to the base. >> when you really dig down into it, it gets worse and worse. because the fact is is is that paul ryan says, yes, we're going to cover these pre-existing conditions. if you don't lose your coverage. and this bill says there's no penalty for employers dropping their coverage. so they can drop coverage of people. you lose your coverage. >> everybody needs to take a deep breath on this.

which is we're through one part of the process. >> yeah, but they voted for it. >> they voted for it. it's not the final vote they're going to take. what you heard out of speaker ryan is that he's looking for the senate to make improvements. what you heard out of senator collins is that the senate is going to make improvements. >> the problem with this is, take the pottery barn rule, if you voted for it, you own it. the problem for the house, a bill now that the majority -- vast majority of the american public does not want. if they had -- >> republicans need to lock arms with what speaker ryan said today. which is that if you don't have a health care system that's functioning, having one that is functioning, even if imperfect, is far better than one -- >> please. >> sara, please, tell somebody with a pre-existing condition to take a breath when they're fighting for their last breath. no, no, no, no, no. when you say -- when you say leave it -- >> this does not get rid of people with pre-existing

conditions. >> you say leave it up to the states. we saw what happened when the states did not expand medicaid. the rural hospitals shut down in rural north carolina, louisiana, mississippi. whether you're white and broke, black and broke, you live in rural america, you should be scared to death of this bill. >> the one thing we know about this bill is $880 million is coming out of medicaid. something like $600 billion is coming out of the subsidies. the cbo has scored this costing 24 million people their insurance. that number won't be right. maybe it's 22 million. may be it's 18 million. 26 million. whatever the number is it's huge. i don't see how speaker ryan can say his bill is fixing a problem. >> they're overstating the business that the health care system is broke. it's not so broke. and the fact is is that the medicaid expansion has helped health care in the country. >> hold on. in the meantime, though, it wasn't broke before. we do have insurance companies now saying they're seeing increases losses with all the uncertainty. >> some are. others like anthem say they're doing quite well.

>> the longer the debate goes on, the more uncertainty there is. >> the health care is system has been broken for more than 20 years. it was broke before aca. it's broken after aca. this is like going to a sick patient and giving them experimental treatments. many experimental treatments hurt the patient. a ahca is going to hurt the patient. to me, no side is fundamentally addressing, we need to ask the question, should we go to a single payer system? affordability hasn't been fixed by this or aca. and accessibility. >> that is a huge, huge question. it's not on the table. you have a republican house, a republican senate. and the white house. i want to bring a question to sara fagen. it seemed from what you were saying there that now that the house has passed something, it's imperative that the senate pass something that the house can pass again and the president can sign. >> on that, we absolutely agree. i don't disagree on the politics of this. with my colleagues up here. the politics of this for republicans are pretty dicey. something needs to get through the senate that improves on what

the house did. i think ted cruz will play a critical role. the freedom caucus members in the house will watch what he does and how he interacts. in this legislative fight. if they can come together and get something done that improves health care in this country. >> how do you improve terrible? how do you improve terrible? >> we don't know that this is terrible. >> this -- this -- this bill is terrible. >> one at a time. >> if you do something that makes ted cruz happy, improves it in his direction, you're going the lose susan collins. lisa murkowski. rob portman. >> not necessarily true. >> let me pick up on roland's point. you're saying you can't improve terrible. let's say you're right. they come together with something that adds money back to medicaid. puts more money into the subsidies. still, cbo comes back and says, okay, it's 18 million people, 20 million that lose insurance. is that something that is defensible?

>> cbo, first of all, has been very good on the math. thai not been so good in history on reporting the numbers of people who do or do not have coverage. but, politically, you know, they're going to have to do something. whether it's a grandfather or something -- that does make sure that people who have coverage now continue to have coverage and have good coverage. >> that is the ultimate question. the question that hurts president obama. >> if i were a democratic strategist, i would focus all my attention on governors. because the house is dicey in terms of the district. and the states are going to have to enact this stuff. >> you saw the oregon governor earlier this week say this is going to leave a $2.8 billion hole in their budgets. to your point, cokie. when the governors realize if this bill becomes law how it's going to impact them, they might have to raise taxes. trust me, the base won't be so happy. >> george, to me, substantively the bill is bad. politically, it's really bad. so if you take a combination of this bad bill, which we have all

seen what happened in 2010, with donald tru'sl ratings, the odds of the democrats taking back the house are more than 50-50 today, which nobody thought that was possible. >> that is very far away. >> we're just about out of time. i want to ask you all quickly. a yes or no question. does president trump sign a health care bill this year? >> no. >> yes. >> no. >> yes. >> no. >> i think i'm a no, too. we'll see. when we come back, the presidential election in france today. did the russians interfere there as well? we're live in paris with the latest.

voters going to the polls today in france. big presidential election. our chief foreign correspondent terry moran is on the scene in paris. that election, as well, roiled by the last-minute charges of hacking, probably by russia. >> reporter: it seems that way. but i have to tell you, george. talking to voters here, they're indifferent. they're dismissive. some suspicious and angry. if this was intended to change the outcome of the election, it came too late. and i think because it came after the hacking of hillary clinton, people are very, very suspicious. i don't think it will have an impact. >> let's talk about where the race stands right now. emmanuel macron endorsed by former president obama. marine le pen has said nice things about trump. right now, macron has a huge lead. we have seen surprises before. >> reporter: it's a giant lead.

the london bookies have him as an odds-on favorite. turnout is important. and so far today, while turnout is not as robust as it usually is in this country, where french people go to the polls, it is tracking with the expectations of pollsters. a higher turnout is good for macron. it is high enough right now, so far, for things to look good for him. there's no question he's the odds-on favorite today. >> let's talk about what that would mean for the united states. marine le pen riding the nationalist wave. if she were to win, she would pull back from nato and pull out of the european union. we know a lot less about what macron would mean. >> reporter: well, he's very much pro europe. he wants more european integration. if macron should win, you'll have an interesting situation where angela merkel in germany and perhaps macron in france are really the leaders of that liberal free world that american presidents used to lead. but with donald trump essentially backing away from

free trade and from other climate agreements and things like that, the internationalist party in the world will be led probably by germany and france. >> you have been covering elections all across europe. you think this nationalist wave has hit a wall? >> reporter: it does seem as if the chaos of the early days of the donald trump administration has cooled the nationalist populist fervor here and in other countries. >> thank you, terry. we'll be right back.

and now we honor our fellow americans who serve and sacrifice. in the month of april, four service members were killed in iraq and afghanistan. ♪ and that is all for us today. thanks for sharing part of your sunday with us. check out "world news" tonight. i'll see you tomorrow on "gma."

coming up, voters at the polls choosing a new president in france. what bay residents think may happen. an uber driver saying he was kidnapped at gunpoint and how he was able to escape. >> looking outside, look at all of that sun. mid 50s here in the city. a high in the upper 60s today, we're in for a bit of a warm up, stay tuned and i'll have