
Sen. Cassidy Has a Plan to Lower Healthcare Costs. Can It Work?
Clip: 12/3/2025 | 18m 1sVideo has Closed Captions
Sen. Bill Cassidy (R-LA) discusses his proposal to lower healthcare premiums.
Next week Congress will decide on proposed plans to save pandemic-era enhanced tax credits, which are due to expire in less than 30 days. Without these credits, tens of millions of Americans could see their insurance premiums increase by 114% on average. Sen. Bill Cassidy (R-LA), a doctor and the chairman of the Senate’s health committee, joins Walter Isaacson to share his proposal.
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Sen. Cassidy Has a Plan to Lower Healthcare Costs. Can It Work?
Clip: 12/3/2025 | 18m 1sVideo has Closed Captions
Next week Congress will decide on proposed plans to save pandemic-era enhanced tax credits, which are due to expire in less than 30 days. Without these credits, tens of millions of Americans could see their insurance premiums increase by 114% on average. Sen. Bill Cassidy (R-LA), a doctor and the chairman of the Senate’s health committee, joins Walter Isaacson to share his proposal.
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Learn Moreabout PBS online sponsorshipTO U.S HEALTHCARE, WHERE CONGRESS WILL MEET NEXT WEEK TO DECIDE ON TO WHETHER TO SAVE OBAMACARE WITHOUT IT TENS OF MILLIONS OF AMERICANS COULD SEE PREMIUMS INCREASING BY AN AVERAGE OF 114%.
BILL CASSIDY WAS A DOCTOR WHO BELIEVES HE MIGHT HAVE A SOLUTION AND ADDRESSES CONTROVERSIAL MEDICAL MOVES BY RFK JR.
>> THANK YOU.
SENATOR BILL CASSIDY, WELCOME BACK TO THE SHOW.
>> VERY NICE TO BE WITH YOU.
THANK YOU FOR HAVING ME WALTER.
>> YOU WERE A DOCTOR.
ONE OF THE THINGS THAT YOU DID AS A DOCTOR IS THAT YOU HAD A CAREER IN PUBLIC HOSPITALS WHERE YOU WERE SERVING PATIENTS AND WERE NOT INSURED AND YOU WERE POOR.
TELL ME WHAT DREW YOU TO THAT.
>> I DID MY RESIDENCY AND FELLOWSHIP AT LOS ANGELES COUNTY HOSPITAL.
AT THE TIME THE LARGEST IN THE UNITED STATES.
I REALLY ENJOYED THE PATIENT POPULATION.
I ENJOYED TEACHING.
I ENJOYED TO BE INVOLVED WITH THE RESEARCH THING.
I CAME BACK TO LOUISIANA WITH MY WIFE.
AT THE TIME SHE WAS PRACTICING IN TRAUMA SURGERY AND WE BOTH STARTED IN LSU.
I WORKED IN A PUBLIC HOSPITAL IN BATON ROUGE TAKING CARE OF THE UNINSURED AND POORLY INSURED, TEACHING MEDICAL STUDENTS AND DOING CLINICAL RESEARCH.
>> WHEN YOU TALK ABOUT THE UNINSURED WE ARE HAVING A BIG ISSUE NOW.
HOW DOES IT INFORM THE FACT THAT YOU WANT TO MAKE SURE THAT THERE ARE EXTENSIONS OF SOME SORT FOR HEALTH CARE BENEFITS WE ARE FACING TO VOTE ON SOON.
>> MY LIFE IS DEDICATED TO MAKING SURE ALL-AMERICANS HAVE ACCESS TO ADEQUATE HEALTH CARE AND SOMETIMES THAT PUTS ME AT ODDS WITH PEOPLE THINKING BECAUSE YOU MAKE INSURANCE CHEAPER IT ACTUALLY WORKS FOR THE PATIENT.
IF SOMEBODY HAS GOT A $6,000 DEDUCTIBLE IT WOULD BE LIKE THEY DO NOT HAVE INSURANCE AT ALL.
THE PREMIUM MAY BE CHEAPER.
IF THEY GET IN A CAR WRECK THEY ARE PROTECTED FROM FINANCIAL RUIN, BUT THEY DON'T HAVE $5,000 TO PAY FOR HEALTH CARE.
THEY WOULD TELL ME, DOC, I CAN'T AFFORD THAT.
I HAVE A DEDUCTIBLE.
>> TELL ME HOW THAT WOULD PUT MONEY TO HELP PEOPLE PAY DEDUCTIBLES.
AND A LOT OF PEOPLE INCLUDING THE KAISER FAMILY FOUNDATION SAY IT COULD HURT PEOPLE.
>> KAISER FAMILY FOUNDATION IS NOT FAMILIAR WITH THE DETAILS OF MY PLAN.
I KNOW THAT FROM MY COMMENTS.
WE ARE SPEAKING ABOUT THE PATIENTS OR THE PEOPLE OR OUR FELLOW AMERICANS THAT ARE ON THE OBAMACARE EXCHANGES.
IT IS ABOUT 6% OF THE POPULATION.
THERE HAS BEEN A RAPID INCREASE IN THE COST OF HEALTH CARE AND OF THE HEALTH CARE AND HEALTH INSURANCE PREMIUMS.
A RAPID INCREASE.
THE ORIGINAL OBAMACARE HAD A TAX CREDIT HELPING EVERYBODY BELOW 400% OF POVERTY.
COSTS ARE EXPLODING SO MUCH UNDER THE BIDEN ADMINISTRATION THEY ADDED SOMETHING CALLED THE ENHANCED PREMIUM TAX CREDIT BENEFITTING THOSE OVER 400% OF FEDERAL POVERTY.
THAT IS THE CONTEXT.
I AM SORRY FOR THE DETAIL.
KAISER FAMILY FOUNDATION THOUGHT I WAS SPEAKING OF THE ADVANCED PREMIUM, THE BASELINE TAX CREDITS AND THE ENHANCED.
I AM NOT.
I AM ONLY SPEAKING ABOUT THE ENHANCED PREMIUM TAX CREDITS.
WHAT IF WE DID THIS.
INSTEAD OF 100% OF IT TO INSURANCE COMPANIES AND TAKE 20% OF WHAT WE GET THEM AS OVERHEAD AND PROFIT.
20% OF THE $26 BILLION WE WOULD SPEND GIVEN TO INSURANCE COMPANIES, 20% OF THAT IS USED FOR OVERHEAD AND PROFIT.
WHAT INSTEAD, IF WE SAID WE WERE GOING TO TAKE THE SAME MONEY AND MAKE SURE NOBODY SPENDS MORE THAN 8.5 OR 9% ON HEALTH INSURANCE PREMIUMS THAT ONLY AFFECTS CERTAIN OLDER PEOPLE, BASICALLY.
50s AND THE 60s.
IT ONLY AFFECTS THEM.
WE ARE GOING TO GIVE 100% OF THE MONEY TO THE PATIENTS IN THE FORM OF A HEALTH SAVINGS ACCOUNT.
THE PATIENT WOULD CHOOSE A LOWER PREMIUM AS A CHEAPER POLICY.
THEY ARE SPENDING LESS ON PREMIUMS THAN THEY WOULD UNDER THE TYPICAL UPON OBAMACARE POLICY.
BUT THEY ARE ALSO GETTING MONEY INTO A HEALTH SAVINGS ACCOUNT FOR FIRST DOLLAR COVERAGE OF THEIR DEDUCTIBLE.
THEIR DEDUCTIBLE ON NET COULD BE LOWER THAN THE POLICY THEY ARE CURRENTLY GETTING, AND NOT ONLY THAT THEY HAVE FIRST DOLLAR COVERAGE.
WHAT DOES THAT MEAN?
PRACTICALLY MY DAUGHTER SPRAINED HER ANKLE.
I BRING HER TO THE URGENT CARE CENTER.
INSTEAD OF A $5,000 DEDUCTIBLE AND I HAVE TO SPEND $5,000 BEFORE INSURANCE PAYS, THEY HAVE $2,000 IN THE HEALTH SAVINGS ACCOUNT AND THEY PAY FOR THE VISIT OUT OF THE $2,000 AND NOT OUT OF THEIR POCKET.
THAT IS A SWEET SPOT.
CHEAPER PREMIUMS, LOWER DEDUCTIBLES AND FIRST DOLLAR COVERAGE.
THAT IS THE PLAN I AM PROPOSING, WALTER.
>> IT TAKES ALL OF THE MONEY IN OBAMACARE AND SORT OF JUST TRANSFERS IT THIS WAY SO THEY ARE IN HEALTH SAVINGS ACCOUNTS, RIGHT?
>> BASICALLY.
THERE ARE OTHER THINGS YOU CAN DO WITH IT.
ONE THOUGHT I HAD IS WHAT IF WE SET UP A REINSURANCE FUND FOR MATERNITY.
WHAT CAN SOMETIMES HAPPEN IF A COUPLE HAS A HEALTH SAVINGS ACCOUNT WITH A COUPLE THOUSAND.
AND THE WOMAN HAS GOT A PROBLEM PREGNANCY.
THEY USE ALL OF THE HSA.
THEY BLOW THROUGH THE DEDUCTIBLE AND IT IS SO EXPENSIVE THAT IT INCREASES THE RATES FOR EVERYBODY.
IF WE DID A REINSURANCE FOR THAT, IT IS PRO-FAMILY.
IT IS PRO-EVERYBODY.
NOT ONLY IS SHE CARED FOR FINANCIALLY AND PHYSICALLY, ABOUT YOU IT KEEPS PREMIUMS DOWN FOR EVERYBODY.
YOU MAY TAKE A PORTION AND SET UP A PROGRAM LIKE THAT.
>> IT SEEMS LIKE IT IS AS MUCH MONEY YOU WOULD HAVE TROUBLE GETTING YOUR FELLOW REPUBLICANS ON BOARD.
IN THE SENATE AND IN THE HOUSE, ARE THEY SUPPORTIVE OF THE CONTINUED SPENDING?
>> YOU CAN ACTUALLY SAVE SOME MONEY.
DID I MENTION, INSTEAD OF GIVING 100% TO INSURANCE COMPANIES AND TAKE 20% FROM PROFIT AND OVERHEAD, 100% AND PUT OVER HERE.
YOU ARE STILL SAVING 20%.
THERE IS STILL OPPORTUNITY TO MAKE IT LESS EXPENSIVE FOR THE TAXPAYER.
NUMBER ONE.
NUMBER TWO, THIS FITS EXACTLY WHERE PRESIDENT TRUMP IS, EXACTLY WHERE.
HE HAS SAID, AND I AM QUOTING, DO NOT GIVE MONEY TO THE MONEY SUCKING BLOOD SUCKING INSURANCE COMPANIES, GIVE IT TO THE PATIENT.
MIKE JOHNSON, I THINK, WOULD BE SENSITIVE TO WHAT THE PRESIDENT WAS INTERESTED IN.
IF WE COME UP WITH A POLICY THAT WORKS FOR REPUBLICANS AND WORKS FOR DEMOCRATS AND PRESIDENT TRUMP EMBRACES I THINK WE GET A VOTE IN THE HOUSE OF REPRESENTATIVES.
>> HAVE YOU TALKED TO THE WHITE HOUSE ON THIS?
>> WE HAVE SPOKEN TO THE WHITE HOUSE.
THEY HEARD MY IDEAS AND INCORPORATED SOME OF THEM.
I CONTINUE TO SPEAK WITH REPUBLICANS AND DEMOCRATS IN THE HOUSE.
>> HOW MANY DEMOCRATS HAVE YOU SPOKEN TO AND HOW MANY DO YOU THINK MIGHT COME ALONG WITH YOU?
>> PROBABLY FOUR OR FIVE.
OF COURSE I AM SPEAKING TODAY, WE ARE RECORDING THIS, AND LATER TODAY I WILL BE SPEAKING TO ALL OF MY REPUBLICAN SENATORS.
I WILL BE SPEAKING LATER THIS WEEK TO DEMOCRATIC AND REPUBLICAN HOUSE MEMBERS.
WE CONTINUE TO WORK IT.
THANK YOU FOR HAVING ME ON.
I NEED THE AMERICAN PEOPLE TO KNOW THIS IS NOT A REPUBLICAN PLAN.
THIS IS NOT A DEMOCRATIC PLAN.
THIS IS AN AMERICAN PLAN.
IT GIVES POWER TO THE PATIENT AND NOT PROFIT TO THE INSURANCE COMPANY.
>> IF THIS DOES NOT COME TO PASS, THERE IS GOING TO BE AN UP AND DOWN VOTE THAT SENATOR JOHN THUNE SAID HE WOULD HAVE IN THE SENATE ON EXTENDING THE OBAMACARE AND THE BIDEN ENHANCED SUBSIDIES.
IF YOUR PLAN DOES NOT GO THROUGH WOULD YOU VOTE FOR THAT?
>> NO.
WHY?
IT STILL LEAVES THE PATIENT WITH A $6,000 DEDUCTIBLE.
IT IS MORE ABOUT PROFIT FOR THE INSURANCE COMPANY THAN IT IS ABOUT POWER TO THE PATIENT.
THE ABILITY TO GIVE THE PATIENT THE ABILITY TO AFFORD THE HEALTH CARE THEY NEED.
IF I GET IN A CAR WRECK, THAT IS IMPORTANT, BUT WHAT ABOUT YOUR DAUGHTER'S SPRAINED ANKLE.
I AM WORKING NOT TO HAVE AN UP AND DOWN PLAN ON A REPUBLICAN PLAN AND FAIL AND RATHER WE HAVE AN AMERICAN PLAN THAT WE CAN ALL VOTE FOR AND PASS AND TURN IN TO LAW.
BY THE WAY, YOU RARELY LOSE MONEY BETTING AGAINST THE ABILITY OF CONGRESS TO GET SOMETHING DONE.
THIS IS SO IMPORTANT THAT I AM HOPING THAT IF PEOPLE CAN PUT ASIDE THE I AM NOT GOING TO WORK WITH PRESIDENT TRUMP BECAUSE IT IS PRESIDENT TRUMP OR WHATEVER AND SAY WAIT A SECOND.
IT BALANCES THE LOWER PREMIUMS, FIRST DOLLAR COVERAGE, LOWER DEDUCTIBLES.
THIS IS THE WAY THAT WE SHOULD GO.
>> WHAT WOULD HAPPEN TO OUR STATE IN LOUISIANA, PEOPLE THERE, IF NONE OF IT PASSES AND THE EXTENSION DOESN'T PASS?
>> THERE WILL BE A SUBSET OF PEOPLE IN LOUISIANA AND ACROSS THE NATION NOT DOING AS WELL.
THAT IS WHY I AM SO COMMITTED TO MAKING IT WORK.
MY EXPERIENCE PRACTICING IN LOUISIANA, AND I CAN SAY IN CALIFORNIA BECAUSE I DID LONG AGO, IS WHEN YOU GET SOMEONE WHO HAS A DEDUCTIBLE OF $6,000, THAT POLICY DOES NOT WORK FOR THEM.
MOST PEOPLE DO NOT HAVE $6,000 IN THE BACK POCKET TO PAY FOR THE DEDUCTIBLE.
IF WE CAN GIVE THEM A POLICY LOWERING THE PREMIUM, LOWERS THE DEDUCTIBLE AND GIVES THEM FIRST DOLLAR COVERAGE TO PAY FOR THE SPRAINED ANKLE THAT THEIR CHILD HAS, THAT DOES WORK FOR THEM.
AND I SAY AGAIN, THAT IS AN AMERICAN PLAN GETTING POWER TO THE PATIENT AND NOT PROFIT TO THE INSURANCE COMPANY.
>> WHEN YOU WERE HERE IN LOUISIANA AND WHEN YOU WERE PRACTICING YOU ENDED UP DEVELOPING A PUBLIC-PRIVATE PARTNERSHIP TO VACCINATE 36,000 CHILDREN AGAINST HEPATITIS B. NO COST TO THE PARENTS.
I THINK THE CDC ADVISORY COMMITTEE, THE VACCINE ADVISORY COMMITTEE IS EXPECTED TO VOTE ON WHETHER TO UNDO ALL OF THAT.
WHAT WOULD YOU DO IF THAT HAPPENS, AND HOW CAN YOU MAKE SURE THAT THE SECRETARY ROBERT F. KENNEDY JR.
DOES NOT PUSH THAT THROUGH?
>> THE RULE VOTE WILL BE ON WHETHER TO RECOMMEND A BIRTH DOSE OF HEPATITIS B. I AM STRONGLY IN FAVOR OF THAT.
IT IS NOT A MANDATE.
IT IS A RECOMMENDATION TO THE MOTHER THAT THE CHILD BE VACCINATED ON BIRTH.
FOLKS SAY WHY.
WHY WOULD YOU GIVE A VACCINE TO A CHILD FOR A SEXUALLY TRANSMITTED DISEASE?
WHY?
WHEN A CHILD PASSES THROUGH THE BIRTH CANAL IT IS EXPOSED TO THE SAME SECRETIONS AS IF APPROXIMATE IT WAS INTERCOURSE.
IF THE MOTHER IS HEPATITIS B POSITIVE, THE CHILD IF INFECTED THROUGH THE SECRETIONS HAS A 95% CHANCE OF BECOMING PERMANENTLY INFECTED WITH HEPATITIS B. INSTEAD IF YOU GIVE THE CHILD A BIRTH DOSE OF HEPATITIS B VACCINE, THE CHILD HAS A 95% CHANCE OF NOT BECOMING INFECTED.
THE NUMBER OF CHILDREN ACQUIRING HEPATITIS B AT BIRTH OR AFTER BIRTH DECREASED FROM 20,000 A YEAR TO 200 A YEAR.
FOLKS SAY WAIT A SECOND.
WE SHOULD KNOW THE MOTHER'S HEPATITIS B STATUS, BUT SOMETIMES IT IS JUST MISSED.
IT IS NOT THERE.
THE MOM IS OUT OF TOWN.
GOES TO A DIFFERENT HOSPITAL.
THEY DON'T HAVE ACCESS TO THE RECORDS OR SHE SHOWS UP AND HASN'T HAD PRENATAL CARE.
THAT HAPPENS IN A COUNTRY AS BIG AS OURS.
THIS IS A WAY, AS MUCH AS POSSIBLE, MAKE SURE THAT WHEN THE CHILD IS BORN THAT THE CHILD, IF EXPOSED TO HEPATITIS B IS NOT CHRONICALLY INFECTED.
>> WHEN YOU VOTED TO CONFIRM ROBERT F. KENNEDY JR., AND RATHER RELUCTANTLY.
YOU EXTRACTED A FEW PROMISES INCLUDING THE FACT THEY WOULD KEEP A RECOMMENDATION ON THE CDC WEBSITE SAYING THAT VACCINES DO NOT CAUSE AUTISM.
>> IF CONFIRMED HE WILL MAINTAIN THE ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES AND RECOMMENDATIONS WITHOUT CHANGES.
CDC WILL NOT REMOVE STATEMENTS ON THE WEBSITE.
POINTING OUT VACCINES DO NOT CAUSE AUTISM.
>> HE BACKTRACKED ON THAT.
HOW YOU CAN HOLD HIM ACCOUNTABLE?
>> AS A PHYSICIAN I KNOW THIS IS WRONG.
IF YOU ARE SUING DRUG COMPANIES, I CAN SEE WHY YOU WANT IT OUT THERE.
IF YOU ARE TRYING TO REASSURE A MOTHER WHOSE CHILD AS AUTISM AND NOW MAY BLAME HERSELF BECAUSE HER CHILD WAS VACCINATED.
WHY PUT THE GUILT TRIP ON A MOM WHEN THAT HAS NOTHING TO DO WITH IT?
IT ALSO DISTRACTS ATTENTION FROM GOING AFTER REAL CAUSES.
IT APPEARS TO BE A COMPLEX MIXTURE OF A CHILD'S GENETIC PREDISPOSITION, THE AGE OF THE PARENTS, ENVIRONMENTAL STRESSORS.
ALL OF THAT IS A COMPLEX MIXTURE.
TO DISTRACT ON THE FALSITY, THE FALSEHOOD THAT IMMUNIZATIONS HAVE A ROLE OR EVEN TO IMPLY IS A TERRIBLE INJUSTICE.
THAT SET ONLY PARENTS THAT I KNOW READING CDC WEBSITES ON IMMUNIZATIONS ARE PROBABLY PEDIATRICIANS THAT ALSO ARE MOMS.
IT IS NOT COMMONLY READ.
I STRONGLY ENCOURAGE MOMS AND DADS TO TALK TO THE CHILD'S PEDIATRICIAN AND HAVE SOMETHING THAT IS LEARNED AND HAS GONE TO MEDICAL SCHOOL TO REVIEW IT WITH YOU.
THE RISK OF AUTISM IS ABSOLUTELY NOTHING.
>> IF IT IS ON THE CDC WEBSITE, IT DOES HAVE AN IMPACT.
>> I AM NOT DENYING THAT.
>> HAVE YOU TALKED TO SECRETARY KENNEDY?
>> WE HAVE SPOKEN IN A STRENUOUS.
I WILL LEAVE IT AT THAT.
NOW I HAVE TO GO TO THE NEXT FUNCTION.
>> ALL RIGHT.
LET ME ASK YOU ONE MORE GENERAL QUESTION.
YOU HAVE BEEN ABLE TO REACH ACROSS THE AISLE, SENATOR BERNIE SANDERS AND TIM KAINE AND ANOTHER ON VACCINES.
DO YOU THINK THAT IT IS POSSIBLE TO RESTORE THE ABILITY TO WORK ACROSS THE AISLES, ESPECIALLY ON THE HEALTH CARE ISSUES?
>> YES.
I WOULD NOT WORK AT THIS IF I DID NOT THINK IT WAS POSSIBLE.
THIS WOULDN'T PASS WITHOUT REPUBLICANS AND DEMOCRATS VOTING FOR IT.
PUT ASIDE YOUR PREJUDICE.
THINK ABOUT THAT COUPLE.
THEY ARE ACTUALLY STRUGGLING TO MAKE THEIR ENDS MEET AND THEY NEED THAT HEALTH INSURANCE AND HEALTH CARE.
THEY CAN'T HANDLE A 6,000 DEDUCTIBLE.
IF WE DO BETTER FOR THAT FAMILY, WHY DON'T WE DO IT.
I SAY THAT MORE AS A DOCTOR AND MORE AS AN AMERICAN.
AMERICANS FIRST.
>> SENATOR BILL CASSIDY, THANK YOU SO MUCH FOR JOINING US.
>> THANK YOU WALTER.

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