Press Briefing by Press Secretary Sean Spicer, 3/14/2017, #23
James S. Brady Briefing Room
2:13 P.M. EDT
MR. SPICER: Looks like the snow didn’t keep anyone away. Good afternoon. I hope -- I'm glad to see everyone made it safely in.
As you may have seen last night, the President met with D.C. Mayor Bowser and Metro general manager Wiedefeld about the preparations for the storm. The President continues to closely monitor the impact of the storm throughout the Northeast. The White House Office of Intergovernmental Affairs has been in touch with state and local officials in the path of the storm to provide them guidance and support. As the storm continues to track the East Coast, heavy to intense snow, sleet, and strong winds could result in significant travel impacts and possible coastal flooding.
Again, the President encourages everyone to listen to their state and local leaders and public safety officers, and follow their warnings and closure notices. They are working around the clock to ensure the safety of our citizens and their families.
In light of the storm, the schedule for today changed a bit. Obviously, German Chancellor Merkel's visit was moved to Friday. We'll continue to provide you updates on the schedule as we grow closer to Friday.
Today, the President had lunch with the Deputy Crown Prince and Minister of Defense of the Kingdom of Saudi Arabia. This afternoon, the President will swear in Seema Verma as the Administrator of Centers for Medicare and Medicaid Services. The President looks forward to having the spectacularly qualified and experienced Administrator Verma finally onboard, especially as we continue to lay the groundwork for historic reform of our healthcare system.
Later this afternoon, the President and Secretary of Health and Human Services, Dr. Tom Price, will have a call with the CEO of Anthem Healthcare, Mr. Joseph Swedish. He will then have a phone call with Speaker Ryan and Majority Leader McCarthy to further discuss the Republican plan to repeal and replace Obamacare with the American Health Care Act and a series of much-needed regulatory reforms to accompany that.
The President was glad to see the National Federation of Independent Businesses announce their support for the American Health Care Act, and FIB has previously identified healthcare along with small business taxes as their two biggest priorities, and the President's healthcare agenda will address many of their concerns for small businesses.
Yesterday, of course, the Congressional Budget Office released their report on the American Health Care Act. I know that there have been significant concerns about the CBO report, and I want to give a little bit of context to the numbers that have been going around.
In 2013, the CBO estimated that 24 million people would have coverage under Obamacare in 2016. They were way off. They were off by 13 million people -- over 50 percent. In fact, only 10.4 million people were actually covered. Reports now suggest that that number has dwindled down to 9 million. CBO coverage estimates are consistently wrong and, more importantly, did not take into consideration the comprehensive nature of the three-pronged plan to repeal and replace Obamacare with the American Health Care Act.
We're working to bring real relief and better choices to the American family. The two other prongs of our plan contain several additional reforms that will further drive down cost and increase coverage. When you get down to it, the Congressional Budget Office is there to measure the potential impact of programs on the federal budget. Its attempts to estimate coverage have been historically faulty. But in the portion of its analysis that focuses on what the office is really about, the CBO concedes that the American Health Care Act would actually reduce the deficit by over $330 billion and bring health insurance premiums down 10 percent, even before many of the significant reforms in prongs two and three have taken effect.
And as I've mentioned before, some of these include expanding healthcare savings accounts, streamlining the process at FDA so that innovative and lower-cost medicines can get to patients faster, allowing health insurance to be sold across state lines, which increases competition and decreases cost, permitting small businesses to band together to negotiate healthcare rates for all of their employees, and reforming the medical malpractice system so that doctors aren’t spending their time and patients' money on unnecessary procedures.
Beyond the numbers, let's talk about some real-life examples of the cost of Obamacare for some actual Americans who the President heard from during his listening session yesterday. Kim Sertich, a small-business owner in Arizona, had her healthcare cost skyrocket from $389.79 a month to $809.15. Carrie Couey from Colorado, a mother of six whose youngest son is autistic, saw her family's yearly insurance go from $1,700* [$17,000] to $52,000 for a lower-quality plan. And Joel Brown, a farmer from Tennessee, saw his catastrophic coverage cost spike in the wake of Obamacare from $119 a month to more than $500 per month.
These are the stories that really matter to millions of Americans who are suffering under Obamacare, and these are the stories that are at the top of the President's mind as he works towards reforming our healthcare system. The President is committed to working together with Speaker Ryan, Majority Leader McCarthy, and Majority Leader McConnell to create a system that's affordable and accessible to all Americans.
Let me walk through the rest of the schedule for the week. Tomorrow, the President is headed to Michigan to meet with auto executives and workers, and will discuss how his plans for rolling back federal red tape will lead to more American jobs and higher wages, specifically in the automobile sector. It's a great opportunity for the President to showcase moves he's already made towards these ambitious "Buy American, Hire American" agenda, like encouraging investment and workforce training and developments so that Americans are ready for the jobs of the future, and removing the roadblocks that prevent American businesses from staying and expanding here in the United States.
The President hopes to build on the great optimism that he's built within the business community in anticipation of the renewed opportunities the President's economic agenda has already created. He and his team are hard at work to produce the results that the American people deserve and voted for last year.
He will also travel to Nashville, Tennessee, where he will lay a wreath at President Andrew Jackson's tomb on his 250th birthday.
Thursday, the Taoiseach of Ireland Kenny will come to the White House for the traditional St. Patrick's Day visit, including a reception in honor of the Taoiseach and Mrs. Kenny. And as I mentioned, German Chancellor Merkel's visit will resume on Friday, and we will have an update on that schedule.
With that, I'm glad to take a few questions.
Q Sean, President Trump has said that under his plan there will be insurance for everybody. How do you square that with the CBO numbers? And is that a promise he can really keep?
MR. SPICER: Well, I think there's two issues that are important to note on that, Katherine. Number one, more and more Americans have no choices, so they don't have insurance. I've mentioned this before. Having a card and having coverage that when you walk into a doctor’s office has a deductible of $15,000, $20,000 a year isn't coverage. That's a card. That doesn’t get you the care you need. That doesn’t allow you to get the procedure or the referral that you need from a doctor that's telling you what you need to have happen.
That's vastly different than what we hope to exist, which is giving people who don't have it -- and let’s kind of -- I think it's important to add some context to this. If you think about the individual market that exists right now, the individual insurance market, you’ve got roughly 30 million people that exist right now -- 9 million people now are on the exchange. That number has gone down; 6.5 million people have said they don't want any insurance and they’re going to pay a penalty, and then just under 14 million people have said that they have applied for a hardship. So you’ve got almost 20 million people in America who have said that they don't want Obamacare and they’ll either pay a penalty or will apply for a hardship.
Those are people who don't have it to begin with. The exchanges sought out to cover these people, and we're finding out that you’ve got 9 million-plus who are getting it right now. They have no coverage. And for more and more Americans, they’re losing their coverage, their choices are gone. Tax credits in competition that will come in phases two and three in the prongs that we talked about will further drop prices down, will further increase competition.
The CBO score didn’t take into consideration in that. And again, if you look at their numbers, you’ve got roughly just over 9 million people on the exchanges. The CBO number says that 14 million people in the first year alone will lose coverage. It doesn’t take a ton of analysis to recognize that that doesn’t make any sense logically. You can't only have 9-plus million people on the exchange and say in the first year alone, when there’s no touch to Medicaid or anything else, you're just removing the individual mandate that forced people to buy something that they didn’t want in the first place, that is going to lead to 14 million people -- that people are going to drop off Medicare, they’re not going to take their employer -- that just doesn’t add up.
In fact, I would argue that if you look at the other part of the equation, the 20 million-plus people who have either chosen to pay a penalty -- you think about that -- the 6.5 million people are saying either the plan is too costly, the plan doesn’t provide coverage. I think a lot of those people, especially when we continue to instill additional coverage, they have more choices, they can pick a plan that actually fits their needs or fits their budget, you're going to see more people want coverage who are going to choose coverage.
So I think that the CBO number, A, they have a record that doesn’t match up with the ability to count people. They’re pretty good at dollars, not as good at people. And I think that when you look at the additional phases or prongs of this whole comprehensive approach, that actually changes the equation a lot. It’s looking at one piece of a three-part plan, and that's not the entirety of the plan that we're looking at. So that doesn’t --
Q So what does the White House think the change will be next year?
MR. SPICER: Well, again, I don't think that we -- we don't do those projections. But I think that there’s no question, when you look at the cost, they’re already saying just this alone, just doing the first prong of this will take costs down 10 percent in the individual market. If you think about it, they’re up 25 percent in the individual market on average already. This year alone, on just people who are on the exchanges, up 25 percent. The CBO is saying, just with what we're doing on the first prong alone, 10 percent decline in the individual market. That's a significant reduction.
That's what we're talking about. Bringing costs down, it increases choices. That's a big deal right now. The problem that you have currently is that these subsidies that people get get them a card that doesn’t get them care. And that's what we need to start focusing on, is how many people are actually getting the care they need to deal with the medical concerns of them or their family. And that's not what’s happening.
Q Sean, stating as you did that the primary objection of this White House is that the CBO report doesn’t take into account phase two and phase three, are there specifics either in terms of the specific regulatory reforms that the White House is considering and the specific terms of the legislation that you would offer that are out there for people to study as part of this? Because as you surely know, Tom Cotton among others are skeptical of whether these phases can actually --
MR. SPICER: Look, the things that I mentioned earlier -- allowing people to buy across state lines, to pool their insurance, to expand HSAs, to reform the FDA -- all of those things I think unquestionably add competition and choice. There’s no question about it. If one plan can sell that was in Maryland, into Virginia, where they can seek additional customers, that competition alone invariably brings down costs. And we've seen this in market after market where once you allow competition, by itself, that will bring down costs. It will bring in choice.
Right now these insurance who have been mandated by the government to create certain packages that people don't need, you’ve got young people that are being told to buy packages that have end-of-life care that they don't necessarily need. You’ve got people who are in their older phases having to buy stuff for maternity that may not be a service that they need at their stage of life. But the problem is that the government got involved in health care and started dictating what needed to happen instead of allowing the choice and allow people to buy a plan that actually was tailored to the needs that they want.
Those reforms in themselves unquestionably bring down cost. There’s no question. But I think one of the issues that has to go back to overriding this issue -- and the President has stated this on numerous occasions -- if we do nothing, if we just allow this to continue, it will collapse on its own. The cost of it is unsustainable. The premiums are going sky-high in state after state. And the choices keep going further and further down.
And so this idea of comparing it to Obamacare is a false choice because they have no choice. The choice is going away and the cost continues to get higher through every phase. And so to assume that the comparison is apples to apples is a false choice.
Q I'm not making that. But you’ve been critical from this podium of the Obama administration, of Democrats, in the way they went about passing the Affordable Care Act. In the interest of transparency that you accused them of not following, of shoving it down people’s throat, shouldn’t the White House, should HHS put those details out now? Should they put the legislative details out and the subsequent steps in phase three?
MR. SPICER: I think the House is working on that in a lot of cases. And as that legislation gets done --
Q -- put the cards on the table now, because there's a lot of skepticism --
MR. SPICER: I think that's a great question for Speaker Ryan, and I know that he’s been working with a team in getting it done. And I think the sooner that we can get all those prongs out there, the better. I agree with you. But I think the big difference, just so we're clear, is that we posted this bill online, the Speaker had it out there, the President tweeted it out. Anyone in the country and anyone in the world, could read it. That's a vastly different approach than after it's being done, told, after we pass it you can read it, which is what Speaker Pelosi said.
Q Does the White House encourage Republicans to put details of the phase three legislation out there now?
MR. SPICER: I mean, sure. The more that can get out there on those phases, absolutely. And I know the Speaker is working with his members to do that. But I think that's an appropriate question for the Speaker to answer, not for me. I know that we are trying to work with them. I know that there’s a lot of members that are working with Speaker Ryan and Leader McCarthy and, frankly, on the other chamber as well. But I think that we continue -- and that's why I think we're talking about all of those prongs and all the pieces of them so that we can start making sure that people understand the comprehensive nature of this.
Q Will that happen before there’s a vote on the --
MR. SPICER: I think that's a question for Speaker Ryan to answer. I think the more we can get out there the better, though.
Q Can I follow up on what Mike was asking about Senator Cotton? Why is the White House giving Senator Cotton full running room to go again and again in the media and to denigrate the House plan without bringing him in, discussing with him what Mike was just bringing up -- alternatives that he’s suggesting? Why does he have special dispensation to go out?
MR. SPICER: I don't think he has special dispensation. It's a free country; he can say what he wants.
Q But if you brought him in here --
MR. SPICER: No, I think our team has been working with his team as they are with Senator Paul’s team and anyone else who has ideas. We've been engaged in a very, very robust discussion with members in both chambers who have ideas to move this thing forward. I don't think we are able to tell people what they can and cannot engage in a free society. And Senator Cotton is obviously able to make any comments that he’d like. We’d obviously continue to like to work with him. And I think the team will continue to reach out to both he and his team to try to get his ideas on this.
Q But the President spent time talking to him about his ideas on immigration. Has he called him? Has the Vice President called Senator Cotton?
MR. SPICER: I know that we've had a very, very robust discussion with members of the House and Senate. I would have to get specific details of what we've done with specifically Senator Cotton.
Q Is Senator Cruz coming today?
MR. SPICER: I believe he -- I'd have to check on that. I know that there was a group of individuals. I don't have that list in front of me.
MR. SPICER: I will get back to you on that, Alexis, I promise. The snowstorm kind of shifted a bunch of stuff up, so I don't want to start getting in front of who actually can be here and who can't. But I will make sure that we get those details out and we have --
Q Can you get it to the pool?
MR. SPICER: I'd be glad to get it to the entire pool.
Q Thank you.
MR. SPICER: Margaret.
Q Thank you. So still on the same subject. Does the White House support the House bill as it is, or amending it? And there’s been reporting that the White House is involved, or some White House officials are involved in shaping what's being described as like a major or significant manager’s amendment in conjunction with conservatives. Can you tell --
MR. SPICER: I would -- I'm sorry, please finish.
Q No, we can go back and forth. But I'm just wondering, can you -- is the White House writing this amendment or just considering backing the amendment? And does Paul Ryan know about it? We can tell him about it right now, I guess.
MR. SPICER: I think Speaker Ryan is well aware of the manager’s amendment. I think as we've noted multiple times from the podium, when people have ideas that are constructive or supportive, or ones that we have heard about from different members that we have engaged with, and, frankly, ones that the House and Senate has engaged with who shared ideas, we’ve always stated a willingness. Director Mulvaney has talked about it, Secretary Price, the President himself, the Vice President.
Part of the reason we're engaging with these individuals is to hear their ideas, to talk to them about not just the content but the approach -- what can go in, what can go out, how we deal with the different phases, as Mike was asking, and when we go.
But all of that is part of a comprehensive strategy to engage with members who support us, who have ideas and want to be onboard, who want to be constructive in the process and achieve the President’s goal of having a patient-centric healthcare system.
So we are obviously in talks with House leadership about the contents. But as I mentioned, the President will be on the phone with Speaker Ryan and Leader McCarthy later this afternoon to talk to them about some of these ideas and some of the path forward. But that's part of the legislative process.
Q So all this -- actually, I have a second question. But just to clarify this, so this involves -- the White House is working to help shape that manager's amendment?
MR. SPICER: Yes.
Q Okay. And on the visit of the Deputy Saudi Crown Prince today, can you talk us through a little bit more detail? Does that involve the resumption of arms sales? Is that about oil?
MR. SPICER: It literally was wrapping up as we were walking over here, so I want to make sure that I get a readout. We’ll provide that to the pool, as we do with all the leader visits. So I will have more details from that once -- they were concluding that visit as we were coming here, and so I’ll make sure I get it.
Q Thanks, Sean. In the middle of all this, there is also the debt ceiling.
MR. SPICER: Yeah.
Q How urgent of a priority is this? And how concerned is the administration in tackling this, given the letter that Secretary Mnuchin sent out last week?
MR. SPICER: Yeah, so Secretary Mnuchin sent a letter noting that, under the Budget Reconciliation Act, the Congress’s debt authority had until March 15th. He notified them of that. We continue to work with Congress. As you know, we’ll be releasing a budget later this week. That's part and parcel of our approach to fiscal responsibility, to making sure that we talk about the path forward, how we address both the ending of fiscal year ’17 -- it goes until September 30th this year -- and then the budget, which would be fiscal year ’18. But how we address our budget deficits, our debt, and our spending going forward is something that is a holistic conversation that the Secretary and Director Mulvaney and others, and the President and the Vice President are engaging with Congress on.
So this isn’t -- our job under the law was to notify them of the authority that they passed when it expired, and I think the Secretary will work with Congress on a path forward as far as our debt situation.
Q Secondly, let me get your reaction to Jonathan Gruber, one of the architects of Obamacare. He called essentially the plan that you've put forward, if it’s implemented, a “scam.” Your reaction to that would be what?
MR. SPICER: I think that the plan that he helped create hasn’t done so well for Americans seeking health insurance. Again, I have to go to the numbers. But just think about what he sought out to do. There was a pool of people that needed healthcare; they got about 9 million of them. You got 14.4-plus-or-minus million of people who claimed a hardship exemption -- so they have no insurance; that are not receiving Medicaid; that don't qualify for any other assistance, who can't afford Obamacare. And then you've got another 6 million-plus that have chosen to pay the penalty. So I would argue that just on what he sought to achieve in the plan that he helped craft didn't achieve too many great results. Of the people that did get it, their premiums have gone sky high, their choices have gone down, and singlehandedly had a tremendous effect through the rest of the healthcare system.
So people who weren’t even affected by Obamacare initially have now paid higher premiums and get less choices. So even for 175 million people who get employer-based healthcare, they felt the impact of what he sought out to do through higher prices, few choices. So, respectfully, I think that he should just hang out more time at MIT and focus -- and allow good ideas to continue to come forward so that we can focus on achieving the President's goal of doing what he sought out in the first place.
Q Thanks, Sean. The President several times recently has said that he would like his healthcare plan to have healthcare for everybody.
MR. SPICER: Right.
Q The CBO score yesterday seems to indicate that that's not the case. Will the White House commit that after these phases two and three, if they are implemented, if they're ever offered publicly, that there will be healthcare for everybody? And if you can define that phrase, please.
MR. SPICER: Yeah, I mean, I think everybody who wants -- look at what Obamacare did. Again, I just ran through the numbers. You've got 30-plus million people of an Obamacare-mandated -- under penalty of law that you had to have health insurance, 9 million of the 30-plus million -- 30 plus-or-minus people got it; 4 million -- 4.5 [million] said, no, we'll pay the penalty; and then another 14 or so million said that we'll claim a hardship. So that was a government-mandated system, and they chose not to do it.
I think that in many of these cases, that if people were given the choice and the option to get a plan that sought their needs, was tailored to what they wanted, it wasn’t forced down their throat, that didn’t give them services they didn’t want, and brought down costs -- I read you some of the stories of the individuals -- and we've seen tremendous growth from people who got a reasonably priced plan on the individual market -- $119, $150 bucks a month, which I think for people who aren’t getting their services through Medicaid because of their financial situation, for many middle-class families, while that's still a struggle, it's an attainable goal in many cases.
When you're talking about $350, $500 on the individual market, that's a huge chunk of someone's individual take-home pay. And I think that getting a process that we have down that levels the playing field, allows people who aren’t getting it through an employer-based system to get a tax credit, that at the same time lowers cost and creates more competition and choices, is actually going to give more people the option to have healthcare and to give more Americans that ability. I mean, right now, they're choosing not to do it.
Q (Inaudible) you more people. That's still not everybody.
MR. SPICER: No, no, no, but everybody has a choice to get it. And that's what I think we want to do, is give everyone who wants to get healthcare the financial ability to get it is what the President is trying to achieve through this. And I think this is the system that will get them there. Right now, they're being forced to get it by a government-run system and in huge margins choosing not to. I think that's the system. And, by the way, they're getting a system that's failing and that is collapsing on its own and is only going in the wrong direction with higher prices, higher premiums, higher deductibles, and lower choice.
I mean, that's what you've got now: If you're American citizen on the Obamacare exchange, you're paying more, you have a higher deductible, and your choice is going down. And so that is an unsustainable, unacceptable outcome for Americans who need care.
Q Thanks, Sean. On immigration, a group that tracks the number of sanctuary cities in the U.S. came out with a report today saying there's now nearly 500 sanctuary cities across the country, and that number has grown by about three dozen just this year. Does that concern the White House? And does it suggest that your warnings about withholding federal funds is not getting through to people?
MR. SPICER: I think the last poll I saw on this issue, on sanctuary cities, was somewhere in the 80 percent that American people don’t support sanctuary cities, they don’t want their tax dollars used to finance people who are in this country illegally. I think if you're a mayor or a councilman or a state representative or a governor in a state, you need to answer to the people that elected you, whether or not you're going to support this. From a federal perspective, I think the President has been very clear that we're not going to use federal taxpayer dollars to support cities that support services to people who are here in this country illegally. But I think at the end of the day, this is a question for mayors and councilmembers at the local level who have to answer to the people that elected them with clearly a position that is not in keeping with what most Americans believe.
Q Thanks, Sean. You mentioned the call with the CEO of Anthem Health. Can you tell me what this proposal of the President means for health insurance companies? Will their profits go up or down under the President's proposal?
MR. SPICER: Well, I don’t think that's been the focus of the President's proposal. It's not about them, it's about patients. But I think what it means for them is that they finally get to create more choice and more plans and allow people to choose a plan that fits them. Right now, they don’t have that choice. And, frankly, in more and more markets, companies like Anthem, UnitedHealth, Signa are pulling out -- Aetna -- because they don’t have the choice and because of the government mandate. I think what we want to do is allow competition and choice to exist so that they can offer more options for the American people.
Q But will those companies make more money under the President's plan or less?
MR. SPICER: I don’t know the answer to that. That's not been the focus of what we're doing now. And at the end of the day, right now they're pulling out of market after market, leaving the American people with fewer and fewer choices. So right now it's not a question of -- from the last I checked, I think many of them were doing pretty well, but it's the American people and its patients that are losing under the current system. So I think that there's a way you can do a little of both.
Q Yes. We've seen the White House and Secretary Price push back on calling this healthcare bill "Trumpcare." Does anything need to change for the President to be comfortable putting his name on the bill?
MR. SPICER: Well, I mean, I don’t think -- the Obama administration didn’t label it Obamacare, they called it the ACA. I mean, this is the American Health Care Act. The President is proud of it. The President is proud of the fact that we're working with Congress. But this is a bill that is not his, it's a joint effort that we've worked with the House and the Senate on. He's proud of it. He's proud of the impact that it's going to have on American patients. So I don’t think this is about labels and names, this is about getting a job done.
Q You keep pointing out that the CBO did not take into consideration phases two or three. Some people might say that the White House has been criticizing the CBO for not taking into account phases two and three in their scoring of the first phase of this. How are they supposed to take into account something that doesn’t yet exist?
MR. SPICER: Well, I think that that's a question for the House offer. There are constraints that are put on the CBO in terms of what they can't consider. But I think that the point that we want to make is that -- and it came up yesterday at the briefing -- if members are going to base their vote off a score, they need to understand the totality and comprehensive nature of the entire program. And so to base your score off of one piece of information is literally looking --
Q But --
MR. SPICER: Hold on, let me answer the question.
Q That's all they had.
MR. SPICER: I understand that. But what I’m saying is, is that the question that keeps being asked is to see all the reports on this about how it’s going to impact and not note -- I mean, I don't recall too many packages that read on the evening news last night, or too many of the stories noting that it was one piece of a comprehensive package, noting that it was prong one of three prongs.
So, respectfully, I think that when we've gone out here and tried to make sure that people understand the comprehensive nature of what’s happening and why it has to happen -- it wasn’t by choice that we had to do this. There are certain ways that it had to be conducted because of how it was constructed in the first place in terms of how it gets repealed and replaced. The reconciliation piece of this, which is inside-baseball Senate talk may not make sense to a lot of people, but it’s the way that we have to go -- the process by which we have to achieve this because of the Senate rules, which is how it was constructed in the first place when Democrats enacted it in 2009.
That being said, when we talk about this -- again, you guys, when there’s a report that comes out on the evening news, or on cable news, or in the paper, and it doesn't explain the comprehensive nature of this, and it just said, "the CBO says this is the impact, full stop," it is incumbent upon to make sure that people who are trying to understand what we're doing understand that there are two more pieces to come of this.
And like anything else, it’s like building a puzzle. If you only put a third of it on the table and said, hey, look, this puzzle is incomplete, we hid the other two-thirds pieces, is not explaining to people how the whole thing comes together.
I think that is a very, very important piece of explaining how this whole thing is going to matter and impact the American people.
Q The other thing I’m curious about, too, is can this thing -- the President called it a big, beautiful negotiation. People like Jim Jordan say it’s a big, beautiful dud. Is there a way to hammer this thing into shape where you can satisfy conservatives?
MR. SPICER: I hope so.
Q Or do you have to -- as has been suggested by a number of people -- rip it up and start all over again? Because Jim Jordan just this morning was saying that the fundamental aspects of what was promised the American people by House members when they ran for election back in the fall, and by the President when he ran for election, is not in this bill.
MR. SPICER: Well, respectfully, I would suggest that it’s gone through two House committees that consisted of over 50 Republican members -- when you look at both committees -- with unanimous support. So I get that we can't --
Q (Inaudible) not a Freedom Caucus member on either one of those?
MR. SPICER: Okay. I don't know that that's actually true.
Q Well, that's what they said.
MR. SPICER: I understand that, but -- I’m going to use Major Garrett to fact-check you. (Laughter.)
Q Well, that's just what they're saying. They're saying they didn’t get a chance --
MR. SPICER: Four Pinocchios -- John Roberts.
Q I did not say that. (Laughter.)
MR. SPICER: But my point is, I think that we've got tremendous support. The President, as I’ve stated, wants to work with them. There will be a manager's amendment. And I hope that ultimately -- yeah, I’d love to have every member support this on both sides of the aisle. I think the President’s principles and goals are going to benefit every American. And obviously, the more support we get, the better.
And as we continue to meet with members and talk to them and get their ideas, I think we're going to have a phenomenal outcome of this bill. There’s a lot of ways we continue to gather input and ideas. And the more that we can get that will achieve that goal, great.
And so I hope that he continues to provide us with constructive ideas, and we look forward to getting as many as possible.
Q Sure, let’s continue that conversation, because the manager’s amendment --
MR. SPICER: Now it’s John’s chance to fact check. (Laughter.)
Q The manager’s amendment is a tacit admission that the bill, as written, can't pass. You wouldn’t --
MR. SPICER: No, that's not entirely true --
Q You wouldn’t put together a manager’s amendment if you had the votes, correct?
MR. SPICER: Well, no, I think it’s an admission of what we stated at the beginning of this entire process, which is the President was going to engage with members to hear their ideas. He welcomed them. Director Mulvaney stated it multiple times, and Secretary Price, the Vice President. We're not -- this has never been a “take it or leave it.” And I’ve said it from this podium; the President has talked about it, as you mentioned just a second ago. This is an opportunity to hear from individuals and groups and insurance -- and victims of Obamacare, doctors --
Q So is the goal of the manager's amendment to win more Freedom Caucus support --
MR. SPICER: Hold on. It’s not a question of just -- it’s not about --
Q -- by dealing with Medicaid or the tax credits or some other alterations?
MR. SPICER: It’s not about one caucus or one member.
Q It’s not?
MR. SPICER: No. I think this is about bringing people together. And if we have great ideas that will achieve a better outcome for the American people, then we're going to listen to them and we're going to incorporate them. I don't think that this is -- we have been very clear from the get-go: If you can come with a good idea that will strengthen this bill, that will benefit American patients, we’ll do it.
And so the manager’s amendment is --
Q Passing a bill is about getting votes, right? You can't have a strong bill that can't pass, right?
MR. SPICER: No, no, you can -- absolutely. But you can jam through a bill and get it out, and get 218 and send it over to the Senate. But I think that we want to get the strongest bill through the House with as many ideas and opinions and facts that will help strengthen this as possible.
So I’d rather -- instead of getting a bill through with 218, 219 -- work on a process as the Speaker and the Majority Leader have done that brings in additional ideas. And if we can get the bill higher and higher, we will.
Q To Tom Cotton’s point -- because you talked about it just a second ago, prongs two and three -- he went out of his way to describe that process, process two and three -- because at least the third part of that is going to require 60 votes because it’s outside of reconciliation -- by definition “as mythical, imaginary, and just spin.” And he’s telling House Republicans, don't buy into this third- or second-prong argument because a practical, legislative matter don't exist. Because you need 60 votes to get them. And so if you “walk the plank” -- his words, not mine -- on this first initiative, you're not going to get second and third phase of this process because it can't get through the Senate.
MR. SPICER: So there’s a couple things. First, this is the only vehicle that seeks to achieve what people on our side of the aisle have been talking about since 2010. This is it. If we don't get this through, the goal of repealing Obamacare and instituting a system that will be patient-centered is going to be unbelievably difficult. This is the vehicle to do that. And so we welcome Senator Cotton’s ideas.
But the second prong of this is administrative in nature. It is something that was delegated to Kathleen Sebelius, who was then the Secretary of Health and Human Services, to do. So prong two is actually fairly easy to do, because the same authority that was granted to Secretary Sebelius now is in the auspices of Dr. Price. And he has the ability to implement and work on that, and I think he noted it yesterday that his office has already been going through and doing that. So that phase is easy to do.
The third prong, which is all of these things that conservatives have been championing for a long time, and, frankly, many Democrats agree with us on, is this ability to bring down costs through selling over state lines and allowing small businesses to group together is something that we've been talking about for over a decade.
Q And you can get 60 votes?
MR. SPICER: And I think that we can not just get 60 -- I think this is something that should bring people together. I think there is bipartisan, bicameral support for almost every one of these things because they benefit -- there is no one that doesn't benefit. Who could be against allowing insurance to be sold over state lines? It’s something that you can do your car insurance -- so many -- there is no other product that I can think of -- I’m sure someone will fact-check me on this -- but for the most part, the American consumer, when you want a product, you can go online, you can go to a store. You have choice. You could go to a store across state lines. If you live in Virginia, you can drive to Maryland or the District and shop around. With our insurance, we don't have that ability. There’s no question that increased competition drives down cost. It is just an economic certainty. And allowing greater choice will do the same. And so I think, respectfully, I would say to any senator that has that concern, there is no other entity that I can think of that greater choice and greater competition doesn’t drive down cost significantly.
And all we have to do is look no farther than Obamacare. I read off three of the individuals the President met with yesterday who were victims of Obamacare. In every one of those cases, the insurance premium went skyrocketing when what? When choice and competition went away.
Most any person that was in the individual market eight or nine years ago will tell you that depending on the plan, you could get a plan for as low as 100 bucks and change. Now the cheapest plan you can get is easily in the $300 range. And so the question that you have to ask yourself is, what changed? Competition went down and choice went down. And I think allowing both of those to reenter the marketplace will achieve in itself that goal. And going through the additional pieces of the reform will also do the same thing.
There’s so many ways that we can achieve greater choice and competition that unquestionably bring down the cost of health care that benefits every American, whether or not you're in the exchanges or you're on an employer-based plan.
And again, we have to have this conversation in the context of what’s going on now. Talk to somebody that's on Medicare or Medicaid. Ask them if the doctor and services that they used to be getting are available to them. I know so many times now when you walk into the doctor they have a sign that says, “We no longer accept Medicaid.” That used to be a given almost. And now, for older Americans, for Americans at the lower end of the income scale, it's becoming harder and harder to find a place that even takes your insurance.
And I think that to find that an acceptable income -- the question has to be asked of people who oppose this, no matter what side of the aisle they’re on, is, what is your alternative? Because the ideas that they propose we can incorporate, we can make this better and better. But to sit back and act as though there’s a choice. Doing nothing is not a choice. And that's something the President had done.
Q Thanks, Sean. As you know, the DOJ now has an additional week to produce evidence that President Trump was wiretapped by the Obama administration. How confident is President Trump that any evidence will arise to support his claim?
MR. SPICER: I think he’s extremely confident. There’s been -- I mean, I mentioned this before -- I'll let them do their job. I'll let the House and Senate and I'll let the DOJ report this. But as I commented in the past, I think there’s significant reporting about surveillance techniques that have existed throughout the 2016 election. I'll leave it to them to issue their report. But I think he feels very confident it that will ultimately come to this -- will vindicate him.
Q And a quick follow-up. When a decision is announced, whatever evidence or potentially no evidence is released, will he make a statement about the evidence or lack of evidence?
MR. SPICER: I've been asked this I think at least three times, and I don't want to prejudge what’s going to come. I'm sure you will do a fine job of asking me the question when there’s a report to be asked and I will not be able to escape it. But I don't want to get ahead of what the President may or may not do.
Q Evidence will be presented?
MR. SPICER: I don't want to get ahead of -- as I mentioned, I'm not going to --
Q Because the House Intelligence Committee has given the administration until Monday --
MR. SPICER: I understand -- no, it's given the DOJ, and the Department of Justice. Again, we covered this yesterday. But I'm not going to get ahead of what they may or may not submit.
Q It's possible there may be nothing.
MR. SPICER: No, that's not -- I think there is -- at least from where we stand, we know that there’s significant reporting on the subject that --
Q Something will be presented.
MR. SPICER: Yeah, I feel very confident of that.
Q Okay. And a follow-up on coverage. You were saying that people -- if they can't get access to insurance, they don't have coverage. But if you remove the individual mandate, you are going to have people who are not going to buy coverage, they’re not going to buy insurance. And so getting back to the Congressional Budget Office score, would you concede that there will be some coverage losses, perhaps in the millions? That there will be millions of people who will not have health insurance as a result of what you're doing?
MR. SPICER: Well, again -- sure, except you have to look at the current situation. You are mandated by law to buy insurance right now under Obamacare; 13-plus million people have asked for a hardship exemption, and 6.5-plus million people have determined to pay the penalty. So, currently, if we look at the universe and say it's roughly 30 million people, only 9 million people engaged in the exchanges when required by law. The majority, almost two-thirds, if my back-of-the-envelope math is right -- about two-thirds have chosen to either apply for a hardship exemption or pay a penalty.
Q The mandate forces people to buy insurance, and if they don't have insurance then you have the free rider problem in the system --
MR. SPICER: Right. But look at what’s happening now --
Q -- which was a problem in the Obama administration. You have free riders and those folks --
MR. SPICER: No, no, no, because the current --
Q -- in a car accident, they show up at the emergency room, and then the health care is much more expensive.
MR. SPICER: But my point, Jim, is that the way the system was constructed under Obamacare, they created a system to force people to buy plans that they did not like. They were mandated by the government in terms of what was part of the plan, what it had to cover, the deductible, et cetera, et cetera, and yet, roughly two-thirds of the people either paid a penalty or asked for a hardship exemption. They didn’t do it.
And so the idea is, actually, if you could bring down cost and choices and allow people to find a plan that fit their budget, that was tailored to their needs, there is actually a higher likelihood that they will find something that they want at a price that they can afford -- as to right now, which is I get a plan that I'm forced to buy that has a deductible that I can't afford, but I've got a cute little plastic card that I can wave around.
Q But it will get you coverage.
MR. SPICER: No, no, that's not true.
Q If you show up at the emergency room, if you’ve been hit by a bus, you're not going to need to pay out of pocket to the hospital until you die. You're going to have some sort of catastrophic coverage that will make sure you have insurance. That is the point.
MR. SPICER: Thank you, that's a great advertisement for --
Q You're welcome.
MR. SPICER: Thank you. That's exactly what the President is trying to do. Because right now you’ve got -- of the attempt to get 30 million people covered, 14.4 or 14.5 million people applied for a hardship exemption. They’re exactly the people that you're talking about. Another 6.5 million people have paid the penalty and don't have it. So we have roughly 20 million people in this country who were supposed to be paying -- required to buy health care that have chosen not to do it who fall in exactly the category that you're talking about. The question --
Q But that number is massive by the year 2026 -- more than 20 million Americans --
MR. SPICER: But if they actually had choices and had a plan option that was down near a budget that they could afford, there is a higher likelihood that they would buy a plan that was, A, tailored to them, and B, actually that they could afford.
So to your question about catastrophic, right now that's in most cases not even an option. In a third of all the counties in the United States, they only have one choice. In five states, they have one choice. Can you imagine if they could actually buy a plan --
Q You're saying a talking point, but at least --
MR. SPICER: It's not a talking point.
Q -- there’s coverage in those states. There's an option of coverage.
MR. SPICER: No, no, it means -- right, and in a lot of --
Q If you pull this away then you're going to have people in a lot of states who aren't going to have access to any coverage --
MR. SPICER: No, no, totally false.
Q -- because they can't afford it with these tax credits that you're providing.
MR. SPICER: No, no --
Q There’s an argument to the other side --
MR. SPICER: No, there’s not. No, actually --
Q The subsidies are more generous --
MR. SPICER: You’ve got 175 million Americans that get their insurance through their employer. And frankly, right now they’re the ones who keep paying higher and higher premiums because a system that was only supposed to help people get access and require them -- get a government-mandated, government-run healthcare has actually gone amuck. And so right now --
Q You say government-run health care. Medicare is government run.
MR. SPICER: Right, and what’s happening --
Q You don't have senior citizens screaming that they want you to get rid of their Medicare.
MR. SPICER: Yes, they are. I think you need to maybe get outside and talk to some of them, because more and more Medicaid recipients -- in fact, more and more Medicare recipients -- aren't actually able to get coverage. Again, it's one thing to have a card. It's another thing to walk into a doctor’s office and them to tell you, we no longer accept Medicaid anymore. That's not care.
Q But the President is okay with there are going to be millions of people who aren't going to have coverage?
MR. SPICER: No, no, the President’s goal is to provide healthcare coverage to every American. And right now they’re not getting that. And by giving them more choices at a lower cost, more Americans can either buy healthcare for their family or themselves, or, in a lot of cases, for their business, without paying the penalty, which is what a lot of them are doing, or forcing people into exchanges that have fewer and fewer choices.
The system now is not working. The costs are going up, the choices are going down, and deductibles are going up. That is not an option. And for every American -- and I mentioned this earlier -- to make this look like a choice, there isn’t really a choice. The system that we have now is failing. The choice is whether we give them an opportunity to have real care and in a way that is tailored to them in their budget.
Q Sean, on a different subject. The Intelligence Committee yesterday, when responding to the Department of Justice's request for more time, basically issued a subpoena threat. Does the White House have a reaction to that? Do you think it will come that far?
MR. SPICER: I hope not. And as I said, as has been noted, the Department asked for additional time, and that will be up to the Intelligence Committee to grant that time. But they're working on that.
Q And on a separate note, you mentioned the President's call with the CEO of Anthem today. Does he have a position on Anthem's effort to merge with Signa, which was challenged by the Justice Department under President Obama?
MR. SPICER: I don’t -- I'm not aware of that. I don’t know that that would -- that the President has ever expressed any personal view. I think that would come under the FTC, if I'm correct, and so I'd refer you to them.
Q Just one last follow-up on Margaret's question about Saudi. I know that that meeting was just finishing up when you came out here, but can you give us a sense of what was on the agenda before they sat down?
MR. SPICER: I think the President had a call earlier with the King, a couple weeks back. I think they talked about safe havens in Syria, they talked about the threat of ISIS. I would expect all of those came up. But again, I think -- I will provide a readout to you all, to everyone in the pool, about what happened that will more clearly define that.
Q Thank you, Sean. Coming up in the rest of the year are four special elections for the U.S. House of Representatives, all of which are sure to draw national attention as venues for debate on the American Health Care Act. Does the President plan to be involved on behalf of the Republican candidates and perhaps appear on their behalf of the districts as this may well be a barometer of where people feel about the American Health Care Act?
MR. SPICER: You're also going to have elections in Virginia and New Jersey, as far as I'm aware. And I think that as we get further into the schedule and get closer to elections, we'll obviously entertain requests from candidates at a variety of -- level to gauge the President's support. So he's been very supportive of candidates in the last cycle. I don’t see him not being -- continued support of people that want to fight hard for the agenda. We're not at that point yet, so I can probably give you more at some point as we move closer to the elections. But in a lot of those cases it's going to be dependent on whether or not there's a request from the candidate or not.
Q Thanks, Sean. You said earlier that the White House doesn’t have projections on how many people will lose coverage. Is that a projection that hasn’t been made yet? Are you saying that the White House is not going to come out with those numbers?
MR. SPICER: That's not something that OMB does.
Q But if you're advocating for a plan that you say the President wants to cover everyone, how are you going to be able to assess whether you've been successful if you're not going to project that yourself and CBO's projections, you're saying, are invalid?
MR. SPICER: Well, I think that if you look at what the goal is, which is to make healthcare available to every American -- as I said, I mean, you have a choice right now that's either we support a failing system that there is no choice and that the premiums are going up, or you provide them with a system that we're looking at, which does address the 30 million people -- it gives them a tax credit, it gives them great choice. And one of the issues that I have with a lot of the models that I see around is they're very static; they talk about this prong only. I think when you look at the subsidy and the cost of a current plan right now, without looking at prong two and three and how those will additionally drive down cost, that it's not a fair analysis of where the plan is going.
But there's no question that right now there is -- I detailed it to Jim -- I mean, we have a system that mandates that people buy health insurance under penalty of law, and it's not working. And so the question is, what can we do instead and what can we replace that with that gives people greater choice and lowers cost. I think in most cases, of course some people are always going to choose in a free society to not purchase something -- I mean, we live in a country of 320 million people -- at some point, you can't force a product or a good down people in a free society. But I think if you can give them a quality product that serves their needs, that they have the time, at a price that they can afford, there's a greater likelihood under every economic model that that suggests that that will work.
So I think it's, frankly, economics 101 and basic common sense that dictate that the more competition and the more choice that we institute in the system, the greater likelihood of more and more Americans getting healthcare is something that is easy.
Q Thanks a lot, Sean. I want to ask you about the American Health Care Act, but I want to first see if you have an answer to a question that I asked you yesterday, and that was one that you did not know the full answer to, about whether there are repercussions for violations of that five-year lobbying ban.
MR. SPICER: I'm sorry, I do owe you an explanation on that. I will check with Counsel and get back to you.
Q Okay. And then on the American Health Care Act, you use language very similar to language that House Speaker Paul Ryan used about why Republicans should support this legislation. You talked about this binary choice -- it's either this particular legislation or it's Obamacare. You have Republicans in control of the House and the Senate, you have President Trump in the White House. Why do they have to vote on this particular bill? Why can't they negotiate for something that, for instance, the Freedom Caucus thinks may be a better piece of legislation?
MR. SPICER: Well, to get back to a question that Major asked -- I mean, at the end of the day, whatever it is has to at least get 218 votes. You obviously want the greatest number of votes as possible, but you need to get 218, and in the case of the Senate under reconciliation, only 50 votes. But that's your floor. And I think that what you need to do is to get enough members coalescing around key principles to get you to that floor. Now, you can obviously go as high as 435 in terms of the ceiling. I'm not sure we'll hit that. But the floor is what's going to coalesce the greatest number of members around a bill that gets you at 218.
So we will continue to work with them, provide ideas and input. And regardless of what caucus or faction you're a part of, if you have an idea that can enhance this bill and make it more patient-centric and achieve the goals, then we're all for it. So that's a process. And I think Speaker Ryan has been talking about this since 2010. There have been a lot of ideas, a lot of debate, and a lot of issues put forward into how to craft this.
So this has been something that's been in the works for seven-plus years in terms of getting members, at least in the Republican conference, to coalesce around principles and ideas and solutions to make this a more patient-centric thing.
Q Two quick clarifications and then one other thing. It sounded like you were telling Mike to ask Paul Ryan about phases two and three. Phase two would be regulatory measures that the President and Secretary Price would be in charge of. When can we expect to see a list of those from the White House?
MR. SPICER: I will ask Secretary Price. I know that he mentioned yesterday when he came out to talk to folks after the score, that his office was working on that. I'll be glad to see if we have a timeline on that, and then follow up with you on that.
Q And also, it sounded like you were saying that the White House is confident that you'll get to 60 votes on those things in phase three, those measures that conservatives have been asking for. Is the White House confident about the 60 votes?
MR. SPICER: Yes.
Q Okay. And then the final thing is, it's also on healthcare as well. Yesterday, Secretary Price said that he wasn’t saying to disregard the CBO report completely. But that sounds like what the administration is arguing and what you're arguing as well from the podium. You said that the CBO coverage estimates are consistently wrong --
MR. SPICER: Yeah.
Q -- and you've questioned their credibility from here.
MR. SPICER: No, no, no, just to be clear, CBO is a budget office. They look at impacts on the federal budget. That is why they were created, and that's what they do. And I think to look at them in terms of their budget numbers is one thing; that's their job. And I think on the aspect of budget impact, it talked about how while we currently see a 25 percent increase in premiums this year under Obamacare and the individual market, it markedly shows that under the current American Health Care Act, there will be a 10 percent decline in premium.
Where I think the CBO has gotten it wrong -- and it's not a question of what we characterize it as; it's a fact -- the CBO, when it tried to project people and coverage, was over 50 percent wrong the last time. And the point that I think we're trying to make is that when you look at their record and you say the last time they did this they were off by more than 50 percent -- they projected 24 million who would be covered by Obamacare in the exchanges in 2016; in fact, that number was initially 10.4 and it's dropping.
And so the question that you have to ask yourself is, if you're using that as a gauge to determine our vote, you need to question whether or not they do counting people like they do counting numbers. I think on the budget thing, that's what their wheelhouse is for, that's what they do -- they count budget -- they look at budgetary impact on things. When they have come to counting people, they've been wrong and vastly so. And I think it's important for people to understand that context in which those numbers are given to you. And I think that's something that I just want to make sure of.
Q Thanks, Sean. I asked you yesterday about the President's response to Steve King. Do you have anything on that?
MR. SPICER: I think the President believes that this is not a point of view that he shares. He believes he's the President for all Americans, and so I'll leave it at that.
Q Reports surfaced Friday that the President will support primary challengers to conservative lawmakers who don’t support the final version of the American Health Care Act. Can you confirm that report? And if it's true, can you offer us insight into what the President is looking for in congressional candidates in 2018?
MR. SPICER: I'm not going to -- I don’t have anything for you on that.
Q Sean, it's Ronica.
MR. SPICER: Ronica.
Q I'm sorry.
MR. SPICER: No, I'm sorry.
Q If we fix it now, we get it done. Okay, two questions. The first one: Does the President believe that he was surveilled through microwaves and televisions?
MR. SPICER: I'm not going to -- I will just say the President has tweeted about this. He's pretty clear that he believes that there was surveillance that was conducted during the 2016 election, and we're going to wait for the conclusion of that. I think there's pretty sound evidence that has been -- that the microwave is not a sound way of surveilling someone. And I think that has been cleaned up. It was made in jest. So I think we can put that to rest.
Q Okay. Second question. Newt Gingrich said that the COB [sic] should be abolished. You're saying some pretty harsh words against parts, aspects of the COB. Would the President agree with that?
MR. SPICER: CBO.
Q Oh, excuse me.
MR. SPICER: No, I got it wrong with you. So now we're even. (Laughter.)
But look, that's -- Speaker Gingrich obviously -- I'll let him comment on the House. CBO was established I think in the Budget Act from 1974. It's up to members to decide on the House and Senate whether or not they want to go through this. We've got OMB, they've got CBO. I'm not going to get in the business of telling the House who their scorekeeper should be in the House.
Q Sean, just quickly, I wanted to circle back on something. You started to answer it, but apologies if you did. I want to clarify, though. Can you stand here today and say that the President will keep his promise of insurance for everybody?
MR. SPICER: I think the President's goal is to provide insurance -- to make insurance available to everybody, yes. That's what he intends to do. I think that is -- the goal of this is to make sure that every American has the choice and a plan that they can afford and that they have the choice to buy. And that's not what they have now.
Q Sean, thanks very much. I wonder if the White House has a view on reports from Bloomberg that Jared Kushner's family stands to gain around half a billion dollars from a real estate deal with Anbang Corporation, which is linked to the Chinese government, or has been linked to the Chinese government in the past.
MR. SPICER: I don’t. I mean, I'd leave that -- I'd refer you back to the Kushner companies to talk about their entities. Jared went through extraordinary lengths, as you all know, and we provided a lot of documentation on this, to make sure that he -- although he's not taking a salary here -- that he complied as if he was an employee, and went through extraordinary lengths to make sure that he de-conflicted himself and worked through the Office of Government Ethics.
Q Is Jared currently working on preparations for Xi Jinping's visit to Mar-a-Lago?
MR. SPICER: I'm sure he's involved in a lot of stuff. I don’t know specifically who's involved in that visit.
Q Sean, you did just say that the President still stands by making sure that insurance can be afforded by everyone. What's your specific response to the CBO's estimate that for someone who's 64 years old, making $26,000, that right now, under current law, they would shell out $1,700 in a premium, but under this change, the premium would go up from $1,700 to $14,600? What's the message to a 54-year-old, who, 10 years from now, faces that?
MR. SPICER: I think that, again, I would go back to the fact that I don’t think that that analysis takes into consideration the choice that they have. Part of the problem right now, Steve, is a 54-year-old doesn’t need certain things. They don’t need maternity care, they don’t need certain medical services that are being provided to them by this government product that is being forced on them right now.
So, number one, you have a product that is being served up to older Americans, middle-aged Americans, or younger Americans that doesn’t fit where they are in life and the services that they need. And so, number one, having more choice and the ability to tailor a plan towards the needs that an individual has depending on their stage of life, whether it's an individual or a family, number one. Number two, that they don’t have any competition. So when you combine both of those things together, I think that number goes way down. And then the third is that they can have whatever subsidy they want now, but on the exchange, in many cases, again, they're getting a subsidy to a plan that has a very high deductible so that they have a card but not care. And that is, again, not an apples-to-apples way to examine the current plans. And that's what this really all comes down to.
Q So the message then is, wait until phases two and three come in, and then we'll have something better?
MR. SPICER: Yeah, I mean, I think -- it's not just wait, it's that you have to look at the totality of what we're doing to understand how this is going to impact the plan. But right now, in the scenario that you're giving, a 54-year-old doesn’t have choice, is buying a plan that they don’t want or need for the most part, and has a subsidy that's probably not giving them the ability to go see the doctors that they need to because their deductible is off the chart. And that's one thing that's missing in a lot of these discussions, is that you can have a premium for month, but if your deductible is skyrocketing, then, again, you might be able to get an appointment, but you're not getting care.
Q Oh, Cheryl. Thanks.
MR. SPICER: Cheryl. I'm not good on this side. (Laughter.)
Q The budget is coming out Thursday, and I'm just trying to find out how detailed is that going to be. Are you going to be giving agency levels, program levels? Or are we going to see what programs are going to be eliminated in the budget?
MR. SPICER: I'll let Director Mulvaney -- he's going to have an entire presentation. I know they'll start background briefings tomorrow for you all. They'll walk through different aspects of the budget. I don’t want to get ahead of him on this. So let's figure out where we go first on this with what he has, and then we'll have a full presentation on Thursday.
Q Can you just say if the infrastructure plan is going to be part of that, or is that going to be later?
MR. SPICER: No, that's separate. That is separate.
Q Thanks. I have two questions. The first one: The President, one of his signature campaign promises on immigration was to pursue HB-1 visa reform. And on April 1st, the United States will begin accepting new HB-1 visa applications. Can we expect to see any movement on that before then?
MR. SPICER: That's a good question. I don’t -- I think -- we've talked about immigration in the past. I think there is an entire comprehensive process that's being looked at in terms of how we're preventing illegal immigration and then what we're doing about legal immigration, whether it's H1-Bs or K1 or other visas that exist within the system. There is an entire look that is being taken with respect to the visa program. And we will have more for you as we get through the system.
Thank you, guys, very much. We're headed off to Detroit and Nashville tomorrow. If you're not on the trip, we look forward to -- I hope everyone wears their green on Thursday and Friday. You got a double shot at it this year because of the visit. So thank you. Stay safe on the roads.
Q How are you all going to do the background briefings?
MR. SPICER: Right here.
3:14 P.M. EDT