{"id":539,"date":"2014-11-16T14:35:00","date_gmt":"2014-11-16T19:35:00","guid":{"rendered":"http:\/\/press.nbcnews.com\/?p=539"},"modified":"2014-11-16T14:35:00","modified_gmt":"2014-11-16T19:35:00","slug":"539","status":"publish","type":"post","link":"https:\/\/nbcuniversalnewsgroup.com\/nbcnews\/2014\/11\/16\/539\/","title":{"rendered":"\u201cMeet the Press\u201d 11\/16 — Burwell: 100k New Healthcare Applications On Day 1"},"content":{"rendered":"
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Burwell: \u201cfocused on transparency\u201d Jindal: \u201cRepublicans should do everything they can\u201d to stop Obama on immigration<\/div>\n<\/blockquote>\n
<\/div>\n<\/div>\n
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NOVEMBER 16, 2014 — Today\u2019s \u201cMeet the Press with Chuck Todd\u201d<\/strong> featured exclusive interviews with Health and Human Services Secretary Sylvia Matthews Burwell<\/strong> and Louisiana Governor Bobby Jindal<\/strong> (R), as well as a discussion on healthcare with Dr. Toby Cosgrove<\/strong> of the Cleveland Clinic, Neera Tanden<\/strong> of the Center for American Progress and Forbes<\/em>‘ Avik Roy<\/strong>.<\/p>\n

Today\u2019s political panel included MSNBC’s Chris Matthews<\/strong>, Helene Cooper<\/strong> of The New York Times<\/em>, former Hewlett Packard CEO Carly Fiorina<\/strong>, and Reid Wilson<\/strong> of The Washington Post<\/em>.\u00a0 Also: Richard Engel<\/strong> provided the latest details on the new ISIS video and Anne Thompson<\/strong>compared the effects of the healthcare law in Texas and Illinois.<\/p>\n

Below are highlights and a rush transcript of today\u2019s program. Video will be available online at http:\/\/www.MeetThePressNBC.com.<\/p>\n

# # #<\/strong><\/p>\n

Sec. Burwell: 100,000 new applications submitted on first day of open enrollment<\/strong>
\nVIDEO: http:\/\/nbcnews.to\/1wJz84y<\/a><\/strong><\/p>\n

SYLVIA BURWELL:\u00a0 Yesterday, we had 100,000 folks submit applications.<\/p>\n

CHUCK TODD: New applications?<\/p>\n

SYLVIA BURWELL: Submit applications. \u2026 And there were over 500,000 people who logged in effectively yesterday as well.\u00a0 So I think the vast majority of people coming to the site were able to get on and do what they were intending to do.<\/p>\n

Burwell responds to Gruber comments: says she is \u201cfocused on transparency\u201d<\/strong>
\nVIDEO: http:\/\/nbcnews.to\/1ENtL8T<\/a><\/strong><\/p>\n

SYLVIA BURWELL: I have to start with how fundamentally I disagree with his comments about the bill and about the American people.\u00a0 Since I’ve been at the department, one of the things that I’ve focused on is transparency, making sure that all our numbers coming out, whether they’re good or bad.\u00a0 And the other thing is that the law is based on the issues of transparency and belief in the American people and choices in the marketplace. \u2026 When you give the American people the tools to make the right choices for themselves, they’re going to do that.\u00a0 And that’s what this is about.<\/p>\n

Burwell: \u201cwe fundamentally disagree\u201d with Gruber<\/strong>
\nVIDEO: http:\/\/nbcnews.to\/1vfhlaB<\/a><\/strong><\/p>\n

CHUCK TODD: Is Mr. Gruber going to be welcomed back as a consultant?<\/p>\n

SYLVIA BURWELL: Certainly right now in terms of the work that we’re doing at HHS, we are doing our work and focusing on what we are doing and our modeling.<\/p>\n

CHUCK TODD: So he’s not welcome back?<\/p>\n

SYLVIA BURWELL: With regard to Mr. Gruber and his comments, I think I’ve been clear.\u00a0 That’s something we fundamentally disagree with.<\/p>\n

Jindal: expanding Medicaid in Louisiana would be \u201ca huge mistake\u201d<\/strong>
\nVIDEO: http:\/\/nbcnews.to\/1H5ut5p<\/a><\/strong><\/p>\n

CHUCK TODD: Expanding Medicaid coverage — you’d have more people off of the uninsured roles in Louisiana if you did it.\u00a0 Why aren’t you doing it?<\/p>\n

GOV. BOBBY JINDAL: Chuck, look.\u00a0 Democrats and Republicans both want to help the vulnerable, want to help people get affordable, high-quality healthcare.\u00a0 Medicaid is not the right way to do it. \u2026 It was a program designed to take care of the disabled, of vulnerable children.\u00a0 It was never designed to be there for able-bodied adults. \u2026 In Louisiana, if we were to expand Medicaid, it would cost my taxpayers $1.7 billion over ten years.\u00a0 For every uninsured person we’d cover, oh, we’d have to kick more than one person out of private insurance.\u00a0 Now, think about that.\u00a0 I know that this president likes to define success as more people dependent on the government.\u00a0 I would have to take over 200,000 out of private insurance and put them into Medicaid.\u00a0 To me, that’s a huge mistake.<\/p>\n

Jindal: Pres. Obama is threatening to shut down the government with executive action on immigration and \u201cRepublicans should do everything they can\u201d to stop him<\/strong><\/p>\n

CHUCK TODD: Very quickly on immigration.\u00a0 If the president goes through with his executive action, do you think Republicans and Capitol Hill ought to use even the power of shutting down the government to stop him from doing it?<\/p>\n

GOV. BOBBY JINDAL: Two things.\u00a0 I don’t think the president should shut down the government to try to break the Constitution.\u00a0 The reality is this.\u00a0 I do think the–<\/p>\n

CHUCK TODD: You think the president would be shutting down the government?<\/p>\n

GOV. BOBBY JINDAL: Oh, absolutely.<\/p>\n

CHUCK TODD: So you do want Republicans to fight him on this to the point that it could shut down the government?<\/p>\n

GOV. BOBBY JINDAL: Absolute– I don’t think the president should shut down the government. \u2026 I would expect even Democrats who may agree with him on substance, to say the right way to do this is to follow the Constitution, follow the law.\u00a0 No, we shouldn’t shut down the government, but absolutely Republicans should do everything they can to force the president to follow the law.\u00a0 Let’s secure the border.\u00a0 No, the president shouldn’t shut down the government so that he can break the law.<\/p>\n

Jindal: \u201cwe are praying\u201d about whether to run for President <\/strong>
\nVIDEO: http:\/\/nbcnews.to\/1wJzhF9<\/a><\/strong><\/p>\n

CHUCK TODD:\u00a0 You’re going to decide when, by the 1st of the year?<\/p>\n

GOV. BOBBY JINDAL: First half of next year.\u00a0 We are praying about this.\u00a0 But bottom line is let’s restore the American dream for our children and grandchildren.<\/p>\n

Carly Fiorina: \u201cthis president has taken advantage\u201d of Hispanics<\/strong>
\nVIDEO: http:\/\/nbcnews.to\/1vfhH15<\/a><\/strong><\/p>\n

CARLY FIORINA: What they should do is systematically and soberly pass a series of bills to solve a decades-old problem.\u00a0 And they should point out to Hispanics all over this nation that this president has taken advantage of them.\u00a0 He sunk comprehensive immigration reform in 2007.\u00a0 He did nothing to push forward immigration reform when he had the Senate, the House, and the White House.\u00a0 He said in ’11 and ’12 he couldn’t do anything.\u00a0 And then he delayed his action for the elections.\u00a0 Unbelievable cynicism.<\/p>\n

# # # <\/strong><\/p>\n

Additional video clips from today\u2019s program:<\/strong><\/p>\n

Richard Engel on Latest ISIS Video
\nhttp:\/\/nbcnews.to\/1qMNU8t<\/a><\/p>\n

Chuck Todd on Obama\u2019s Legacy
\nhttp:\/\/nbcnews.to\/11fXKcf<\/a><\/p>\n

#NerdScreen: How 2014\u2019s Turnout Could Define 2016
\nhttp:\/\/nbcnews.to\/1BDVbS9<\/a><\/p>\n

Anne Thompson on Healthcare Reform: A Tale of Two States
\nhttp:\/\/nbcnews.to\/11btnEg<\/a><\/p>\n

Deep Dive into the Affordable Care Act
\nhttp:\/\/nbcnews.to\/1uijcI7<\/a><\/p>\n

Chris Matthews: Tea Party is the Problem
\nhttp:\/\/nbcnews.to\/1A3HHxj<\/a><\/p>\n

World Leaders Embrace Koalas
\nhttp:\/\/nbcnews.to\/1vfi2AN<\/a><\/p>\n

Panel: Obama vs. Republicans
\nhttp:\/\/nbcnews.to\/1A3HPgv<\/a><\/p>\n

# # # \u00a0<\/strong><\/p>\n

Below is a RUSH transcript of the 10AM feed of this morning\u2019s broadcast — mandatory attribution to NBC News\u2019 \u201cMeet the Press.\u201d A final transcript of the program will be available at www.MeetThePressNBC.com.<\/strong><\/p>\n

\u201cMEET THE PRESS WITH CHUCK TODD\u201d<\/strong>
\nNovember 16, 2014<\/strong><\/p>\n

CHUCK TODD (V\/O):
\nThis Sunday, what appears to be another beheading of an American by the radical Islamic group ISIS.\u00a0 The victim is apparently hostage Peter Kassig, a former aid worker.\u00a0 We’ll have a full report.\u00a0 Here at home, the gloves are off again.<\/p>\n

PRESIDENT OBAMA:
\nWhat I’m not going to do is just wait.<\/p>\n

CHUCK TODD (V\/O):
\nOn one side, a president, no longer constrained by another election.\u00a0 On the other side, triumphant Republicans.\u00a0 At stake, two huge issues:\u00a0 immigration and healthcare.<\/p>\n

JOHN BOEHNER:
\nWe’re going to fight the president tooth and nail.<\/p>\n

CHUCK TODD (V\/O):
\nPresident Obama prepares to bypass Congress with executive action on immigration reform.<\/p>\n

PRESIDENT OBAMA:
\nAnd it’s way overdue.\u00a0 And we’ve been talking about it for ten years now.<\/p>\n

CHUCK TODD (V\/O):
\nHow will Republicans respond?\u00a0 Also, will Republicans follow through on their goal to dismantle the Affordable Care Act? Where you stand on the issue…<\/p>\n

ROBERT MAYFIELD:
\nIt’s going to be more taxes on all the Texas people.<\/p>\n

CHUCK TODD (V\/O):
\n…may depend on where you sit.<\/p>\n

KEITH MOON:
\nIf you don’t want to repeal this law, you go without insurance for two years and tell me how you feel.<\/p>\n

CHUCK TODD:
\nPlus, following the Republican midterm wave, can Democrats reassemble their winning coalition in 2016 without President Obama on the ballot?\u00a0 I’m Chuck Todd.\u00a0 And joining me to provide insight and analysis are MSNBC’s Chris Matthews, Helene Cooper of The New York Times, former CEO Hewlett Packard, of Carly Fiorina, and Reid Wilson of The Washington Post.\u00a0 Also Louisiana Governor Bobby Jindal, a possible Republican presidential candidate.\u00a0 And Health and Human Services Secretary, Sylvia Burwell are here exclusively.\u00a0 Welcome to Sunday.\u00a0 It’s Meet the Press.<\/p>\n

ANNOUNCER:
\nFrom NBC News in Washington, this is Meet the Press with Chuck Todd.<\/p>\n

CHUCK TODD:
\nGood morning.\u00a0 We begin with some grim news from Syria.\u00a0 Intelligence officials are investigating a video that was posted online purportedly by ISIS that claims to show that captured U.S. aid worker, Peter Kassig, has been killed.\u00a0 The video also shows the killing of several Syrian soldiers.\u00a0 Kassig, 26, from Indiana, was working as a humanitarian aid worker in Syria when he was captured by ISIS in October of 2013.<\/p>\n

He was born Peter Kassig, but changed his name to Abdul Rahman after converting to Islam while in captivity.\u00a0 Now, the National Security Council has released a statement this morning.\u00a0 It reads in part:\u00a0 “We are aware of a video that claims to show the murder of U.S. citizen Peter Kassig.\u00a0 The intelligence community is working as quickly as possible to determine its authenticity.\u00a0 If confirmed, we are appalled by the brutal murder of an innocent American aid worker, and we express our deepest condolences to his family and friends.”<\/p>\n

I’m joined now by our chief foreign correspondent, Richard Engel.\u00a0 He is in Istanbul where he has been based to cover this war.\u00a0 Richard, it seems as if the government is assuming this video is authentic.\u00a0 What do you know?<\/p>\n

RICHARD ENGEL:
\nWell, I’ve seen the video and unfortunately, it does appear to be authentic.\u00a0 We see the same, now familiar, militant dressed in all black with a distinctive London accent, saying that Peter Kassig has been killed.\u00a0 You don’t actually see the beheading.\u00a0 You just see the militant and then what looks to be Peter Kassig’s head at his feet.<\/p>\n

It was a long video.\u00a0 It shows the beheadings of other hostages, a group that are allegedly Syrian soldiers.\u00a0 If, in fact, it is confirmed that Kassig was murdered, he would be the fifth Western hostage killed by ISIS.\u00a0 And the reason ISIS said it killed Kassig is because he was a former soldier who served in Iraq before he changed his life and went to Syria to help provide some humanitarian and medical relief to Syrian victims of war.<\/p>\n

CHUCK TODD:
\nNow Richard, speaking of Iraq, General Martin Dempsey, of course, the chairman of the Joint Chiefs, he made a surprise visit to Iraq yesterday.\u00a0 I think he’s still there.\u00a0 Where he’s supposed to get a firsthand look at the Iraqi military.\u00a0 We’ve got advisors on the ground.\u00a0 There’s some talk that maybe more have the go.\u00a0 What is the state of the Iraqi military, and how are they doing on the fight against ISIS?<\/p>\n

RICHARD ENGEL:
\nI think it’s very mixed, frankly.\u00a0 There are some units of the Iraqi military that are making some progress.\u00a0 They made some advances north of Baghdad in the last several days.\u00a0 But the military is infiltrated.\u00a0 It’s infiltrated by Shiite militias, it’s infiltrated by the Iranian\u00a0 Revolutionary Guard.\u00a0 Just a few weeks ago, in fact, a unit from the Iraqi military, backed up by militias, went into a town, they killed some ISIS.<\/p>\n

But then they also went back and butchered Sunni civilians who were living in the town.\u00a0 And this was an act according to officials that I’ve spoken to, directly carried out by an Iranian-backed group within the Iraqi Security Services.\u00a0 So I think it is a very mixed record of success so far.<\/p>\n

The Kurds are making advances.\u00a0 Some units of the Iraqi army are making advances.\u00a0 But others are Iranian-backed death squads.\u00a0 And this is the Iraqi army, this patchwork that we are supposed to be guiding, advising, and leading in a fight against ISIS.<\/p>\n

CHUCK TODD:
\nLooks like it’s going to be a longer slog than anybody wants to deal with.\u00a0 Richard Engel, in Istanbul for us this morning, Richard, thanks very much.\u00a0 Now I want to switch gears here, get to domestic politics.\u00a0 The new third rails of American politics these days; one, immigration reform.<\/p>\n

Democrats now on it.\u00a0 Republicans not for what the president wants.\u00a0 And then President Obama now says he’s going to go ahead with or without the GOP.\u00a0 The other, of course, is healthcare reform.\u00a0 It’s President Obama’s signature achievement, his legislative place in history.\u00a0 And here come the Republicans.\u00a0 They want to take it apart brick by brick.<\/p>\n

There are two intractable issues so important to each side that neither is willing to give any quarter.\u00a0 Defy the other side, and you’re declaring political war.\u00a0 And that’s just what’s happening.\u00a0 To quote Bette Davis, fasten your seatbelts.\u00a0 It’s going to be a bumpy night.<\/p>\n

(BEGIN TAPE)<\/p>\n

CHUCK TODD (V\/O):
\nIf Republicans thought a wave election would humble the president, he didn’t show it.\u00a0 Promising executive action that would stop deportations for millions of undocumented immigrants, a lightning rod for the GOP, the president doubled down.<\/p>\n

PRESIDENT OBAMA:
\nAnd that’s going to happen.\u00a0 That’s going to happen before the end of the year.<\/p>\n

JOHN BOEHNER:
\nWe’re going to fight the president tooth and nail if he continues down this path.<\/p>\n

CHUCK TODD (V\/O):
\nSo much for that kumbaya lunch at the White House last week.\u00a0 And there’s healthcare.\u00a0 Yesterday marked the premier of season two of Obamacare.\u00a0 The president now playing salesman in chief.<\/p>\n

PRESIDENT OBAMA:
\nYou can go online or call 1-800-318-2596 and get covered for 2015.<\/p>\n

CHUCK TODD (V\/O):
\nNew website, new cast, and this time, administration officials hope a new story line after a disastrous debut last year.<\/p>\n

PRESIDENT OBAMA:
\nNobody’s madder than me about the fact that the website isn’t working as well as it should.<\/p>\n

CHUCK TODD (V\/O):
\n7.1 million Americans signed up and paid by the end of the first enrollment period, hitting projections.\u00a0 This time around, the government expects a total of between nine and ten million for 2015.\u00a0 But that’s over three million less than the government’s original projection of 13 million signups.\u00a0 And yes, the future of the law remains somewhat cloudy.<\/p>\n

Thirteen states, plus D.C., run their own health insurance exchanges.\u00a0 Thirty-seven states, mostly with Republican governors, haven’t set up their own exchange, and rely on the federal government.\u00a0 But what the Affordable Care Act is doing for the cost of healthcare, this map shows the change in premiums from the largest cities in each state, and it’s a mixed bag.\u00a0 Premiums up in some states, and down in others.\u00a0 And in January, the new Republican majority in Congress takes office, promising to dismember the law.<\/p>\n

MITCH MCCONNELL:
\nI want to pull this law out root and branch.<\/p>\n

CHUCK TODD (V\/O):<\/p>\n

And to top it all off, the Supreme Court will hear another case this term about those exchanges, which could cripple the law.<\/p>\n

(END TAPE)<\/p>\n

CHUCK TODD:
\nI’m joined now by Sylvia Mathews Burwell, secretary of Health and Human Services, welcome to Meet the Press.<\/p>\n

SYLVIA BURWELL:
\nThank you.<\/p>\n

CHUCK TODD:
\nMadam Secretary, I want to start with, we heard the President earlier this morning, or yesterday or tomorrow, however you want to talk about Australian time.\u00a0 He said 23,000 new applications is what he reported.\u00a0 Do you have any up-to-date numbers?\u00a0 And I guess I would ask, it seems as if new applications went well on the website.\u00a0 People trying to get to their old accounts struggled.<\/p>\n

SYLVIA BURWELL:
\nSo with regard to that, yes I do.\u00a0 Yesterday, we had 100,000 folks submit applications.<\/p>\n

CHUCK TODD:
\nNew applications?<\/p>\n

SYLVIA BURWELL:
\nSubmit applications.<\/p>\n

CHUCK TODD:
\nOkay.<\/p>\n

SYLVIA BURWELL:
\nAnd there were over 500,000 people who logged in effectively yesterday as well.\u00a0 So I think the vast majority of people coming to the site were able to get on and do what they were intending to do.<\/p>\n

CHUCK TODD:
\nDo you have an issue with people getting onto their old accounts?\u00a0 Is that an issue that you’ve identified or is this just user error?<\/p>\n

SYLVIA BURWELL:
\nSo with regard to that, we think the vast majority were able to.\u00a0 That’s what we see in that 500,000.\u00a0 In some of those examples, we’re tracking them down.\u00a0 That’s part of what I said we were going to do and what we want to do.\u00a0 Some people forget their user names.\u00a0 Some people are renewing their passwords and other things, if there were any other technical problems.\u00a0 Our customer service folks are ready and able to help people.\u00a0 There were over 100,000 calls yesterday.<\/p>\n

CHUCK TODD:
\nAll right.\u00a0 Let me ask if you if you guys have, the uninsured right has dropped by 25%.\u00a0 The average premium has gone down for 2015.\u00a0 There’s Medicare solvency has increased.\u00a0 So a bunch of good news.\u00a0 And yet the public’s opinion about the healthcare law hasn’t changed one bit.\u00a0 Still more people think it’s a bad idea than a good idea.\u00a0 Why is that?\u00a0 Why hasn’t success translated?<\/p>\n

SYLVIA BURWELL:
\nI think one of the things we need to do is translate that success because I think when you ask the American people about those things individually, or when you ask the American people about the importance of no longer being held off healthcare because of preexisting conditions, or the fact that their children up to the age 26 can be on their plans, that’s three million.\u00a0 When you ask them about the substance of the issue, the American people respond positively.\u00a0 And that’s what I think we need to more about.<\/p>\n

CHUCK TODD:
\nSo whose fault is this?<\/p>\n

SYLVIA BURWELL:
\nI think what we need to do is make sure that we’re communicating clearly and that we talk about what is the substance instead of something that is one-word descriptions but actually what this is.\u00a0 This is about three things:\u00a0\u00a0 Affordability, quality, and access.\u00a0 And when you talk about, as you just did, the measures against those things, that’s what we need to do more of.<\/p>\n

CHUCK TODD:
\nSo why is it that you had to downgrade the expectations of how many people would sign up?\u00a0 You’re looking at less than ten million.\u00a0 The original projection was try to get to 13 million after year two.\u00a0 That’s a steep expectation decline.\u00a0 Why?<\/p>\n

SYLVIA BURWELL:
\nSo the 13 million was a number that was set as CBO scored the initial bill.\u00a0 And scoring, as we know, is something that is done to determine–<\/p>\n

CHUCK TODD:
\nThey were accurate about year one.<\/p>\n

SYLVIA BURWELL:
\nSo with regard to that though, what we have done is when I got to HHS, I asked the team to actually look at the numbers and let’s figure out what we think that target should be.\u00a0 It has two basic pieces to it:\u00a0 reenrollment and new enrollees.\u00a0 With regard to the reenrollment, what we did was went actually out to the marketplace, asked people, “What is the general reenrollment of this type of thing?”<\/p>\n

They created a range that was 70% to 90%.\u00a0 Many of the people were in the 80% to 85%.\u00a0 We chose 83%.\u00a0 And then what we did was build the number that way.\u00a0 So in setting our target, what we did was take the information from last year, including the fact that when CBO did its estimates, and others did estimates, they actually thought more people would switch from employer-based care than did.<\/p>\n

CHUCK TODD:
\nSo you think that’s one of the reasons that this, employers have to dropped people.\u00a0 But this is the first year the employer mandate.\u00a0 Do you expect to see employers drop people now?<\/p>\n

SYLVIA BURWELL:
\nSo with regard to the number, we think it’s a number of elements.\u00a0 And as we made the number that we chose, that 9.1, we said there’d be 28% growth.\u00a0 And we believe in the second year of a new marketplace, 28% growth is strong and healthy growth.<\/p>\n

CHUCK TODD:
\nAll right.\u00a0 I’ve got to ask you about these comments from Jonathan Gruber.\u00a0 He’s of course, a lot of opponents of the Affordable Care Act have been pointing to these comments all week long.\u00a0 He’s an MIT professor.\u00a0 He helped write the healthcare law both in Massachusetts, an advisor to the healthcare law and to people that wrote it back when the Obama administration was working on it.<\/p>\n

I understand you didn’t necessarily work with him very closely.\u00a0 But I do want to have you take a listen and get you to respond.\u00a0 This is how Gruber explained taxing high-end Cadillac health insurance plans and sort of doing a little “okey-doke” on the American public.\u00a0 Take a listen.<\/p>\n

(BEGIN TAPE)<\/p>\n

JONATHAN GRUBER:
\nWe just tax the insurance companies.\u00a0 They pass on higher prices, that offsets the tax break we get it, it ends up being the same thing.\u00a0 It’s a very clever, you know, basic exploitation of the lack of economic understanding of the American voter.\u00a0 And they proposed it and it passed, because the American voter is too stupid to understand the difference.<\/p>\n

Lack of transparency is a huge political advantage.\u00a0 And basically, you know, call it the stupidity of the American voter, or whatever.\u00a0 But basically, that was really, really critical to getting this thing to pass.\u00a0 So what does this bill do?\u00a0 This bill takes, what I call, the spaghetti approach.\u00a0 Which is it takes a bunch of ideas that might work and throws them against the wall, we’ll see what sticks.<\/p>\n

(END TAPE)<\/p>\n

CHUCK TODD:
\nHe’s playing into every fear that many conservatives had about this bill, that it’s not transparent, that there are things in it that people don’t know.\u00a0 This certainly can’t help a credibility gap.<\/p>\n

SYLVIA BURWELL:
\nI have to start with how fundamentally I disagree with his comments about the bill and about the American people.\u00a0 Since I’ve been at the department, one of the things that I’ve focused on is transparency, making sure that all our numbers coming out, whether they’re good or bad.\u00a0 And the other thing is that the law is based on the issues of transparency and belief in the American people and choices in the marketplace.<\/p>\n

This past week, since we’ve had window shopping on, over a million people have come to the site and done window shopping.\u00a0 Because what they’re doing is they’re comparing.\u00a0 They’re comparing based on premiums, they’re comparing based on deductibility.\u00a0 When you give the American people the tools to make the right choices for themselves, they’re going to do that.\u00a0 And that’s what this is about.\u00a0 From the issue of actually the consumer to the fact that we have put out information so that people can see what providers are receiving from pharmaceuticals.<\/p>\n

CHUCK TODD:
\nHe said, “Spaghetti at the wall.”\u00a0 And he said that the week the health care law passed.\u00a0 Is that what this bill is?\u00a0 To see what works and what doesn’t?<\/p>\n

SYLVIA BURWELL:
\nThis law is a piece of legislation that is about three fundamental things.\u00a0 And these are things that have bipartisan agreement.\u00a0 Affordability, access, and quality.\u00a0 That’s what the American people want.\u00a0 And actually, there’s bipartisan agreement.\u00a0 The bill has a lot of different pieces.\u00a0 You touched on many of them, and people know about them, whether it’s closing the Medicare donut hole.\u00a0 And there are eight million American seniors that benefited from that $11 billion.\u00a0 There are so many parts of this law that target those three fundamental things.<\/p>\n

CHUCK TODD:
\nIs Mr. Gruber going to be welcomed back as a consultant?<\/p>\n

SYLVIA BURWELL:
\nCertainly right now in terms of the work that we’re doing at HHS, we are doing our work and focusing on what we are doing and our modeling.<\/p>\n

CHUCK TODD:
\nSo he’s not welcome back?<\/p>\n

SYLVIA BURWELL:
\nWith regard to Mr. Gruber and his comments, I think I’ve been clear.\u00a0 That’s something we fundamentally disagree with.<\/p>\n

CHUCK TODD:
\nMadam Secretary, thanks for coming on Meet the Press.<\/p>\n

SYLVIA BURWELL:
\nThank you.<\/p>\n

CHUCK TODD:
\nAll right.<\/p>\n

CHUCK TODD:
\nAnd now joining me since the Affordable Care Act was implemented, 23 states have not expanded Medicaid to help cover low-income individuals, leaving 3.8 million in a so-called coverage gap where their income is above Medicaid eligibility limits, but below the threshold for marketplace premium tax credit.\u00a0 Why does it matter?\u00a0 Let me show you an example in two states.<\/p>\n

Arkansas did expand Medicaid coverage.\u00a0 They saw their uninsured rate decrease by 46%.\u00a0 Next door in Louisiana, which did not expand Medicaid coverage, the uninsured rate was only reduced by 15%.\u00a0 So to talk about this and some other things, I’m joined now by the governor of Louisiana, Republican Bobby Jindal.\u00a0 Governor, welcome back to Meet the Press.<\/p>\n

GOV. BOBBY JINDAL:
\nChuck, thank you for having me.<\/p>\n

CHUCK TODD:
\nLet’s go right there to that number.\u00a0 You look at Arkansas, your neighbor to the north.\u00a0 I know you don’t want to talk about Arkansas right now.<\/p>\n

(OVERTALK)<\/p>\n

CHUCK TODD:
\n–that issue last night.\u00a0 But obviously, expanding Medicaid coverage, you’d have more people off of the uninsured roles in Louisiana if you did it.\u00a0 Why aren’t you doing it?<\/p>\n

GOV. BOBBY JINDAL:
\nChuck, look.\u00a0 Democrats and Republicans both want to help the vulnerable, want to help people get affordable, high-quality healthcare.\u00a0 Medicaid is not the right way to do it.\u00a0 The problem with expanding Medicaid, the problem with the Affordable Care Act, the problem with ObamaCare, is that it chooses a top-down, closed approach, where the government is running your healthcare.<\/p>\n

Medicaid’s already a program with bad healthcare outcomes.\u00a0 You look at the Oregon study, they showed by expanding Medicaid, there was no improvement in physical outcomes.\u00a0 It was a program designed to take care of the disabled, of vulnerable children.\u00a0 It was never designed to be there for able-bodied adults.<\/p>\n

By expanding and creating a new entitlement when we can’t afford the ones we’ve already got, the Affordable Care Act, the president basically is doubling down on a failed approach for providing healthcare.\u00a0 There’s a better way to help those uninsured.<\/p>\n

CHUCK TODD:
\nHere’s the thing though.\u00a0 It would cost your state nothing.\u00a0 In fact, look, you’ve got your own fiscal problems right now with the deficit issue.\u00a0 You’d have more money from the federal government.\u00a0 They’re paying for it.\u00a0 It’s not going to cost Louisiana taxpayers any extra state money.\u00a0 Why not do it while the law is enacted?<\/p>\n

GOV. BOBBY JINDAL:
\nSo, look, two things.\u00a0 Chuck, I’m glad you asked that.\u00a0 One of the things I love is when Democrats say, “Oh, this is free money.”\u00a0 This is not free money.\u00a0 Every dollar we don’t spend on Medicaid is another dollar we don’t have to borrow from China.\u00a0 This is the reason we’ve gotten nearly $18 trillion in debt.<\/p>\n

Louisiana taxpayers are federal taxpayer.\u00a0 These are federal tax dollars.\u00a0 Why waste these tax dollars?\u00a0 We’ve got to stop acting in this city like all of this money is free money.\u00a0 Secondly, secondly, when you look at the best way to help folks, it is to decrease the cost of healthcare.\u00a0 I propose a detailed plan to repeal and replace ObamaCare.\u00a0 If the president were really serious, why not give states more flexibility?\u00a0 Why not go to states and say–<\/p>\n

CHUCK TODD:
\nBut he has.\u00a0 I mean, you look at in Indiana.\u00a0 So why is, I guess, John Kasich wrong?\u00a0 Why is Mike Pence of Indiana wrong?\u00a0 Mike Pence did get the federal government to approve a much different plan.\u00a0 Why not negotiate with the government and do something that you want to do?<\/p>\n

GOV. BOBBY JINDAL:
\nIn Louisiana, if we were to expand Medicaid, it would cost my taxpayers $1.7 billion over ten years.\u00a0 For every uninsured person we’d cover, oh, we’d have to kick more than one person out of private insurance.\u00a0 Now, think about that.\u00a0 I know that this president likes to define success as more people dependent on the government.\u00a0 I would have to take over 200,000 out of private insurance and put them into Medicaid.\u00a0 To me, that’s a huge mistake.<\/p>\n

CHUCK TODD:
\nYeah, but you have 200,000 not insured at all, though.<\/p>\n

GOV. BOBBY JINDAL:
\nWell, but no, I’m saying for every uninsured person you’re covering, you’re taking more than another person out of private insurance.\u00a0 In Louisiana in particular, we inherited a decades-old public hospital system, unlike other states.\u00a0 We’re the only state, we had ten state-operated hospitals.\u00a0 The private sector, public\/private partnerships, we’ve actually improved healthcare access and outcomes.<\/p>\n

For one example, it used to take ten days to get a prescription filled, now you can get it done in ten minutes.\u00a0 Through Bayou health, we reformed our program, we had before 5% of our adults were getting preventive care screenings, now over 80% of our– Chuck, my point is This.\u00a0 There are better ways to provide healthcare to the vulnerable, to the uninsured.\u00a0 The answer’s not for the government to be running healthcare.\u00a0 The answer is not to expand a failed program, a one-size-fits-all approach like Medicaid.<\/p>\n

CHUCK TODD:
\nYou think Medicaid’s a total failure?<\/p>\n

GOV. BOBBY JINDAL:
\nNo, I think Medicaid–<\/p>\n

CHUCK TODD:
\nBut why do you implement any of it?<\/p>\n

GOV. BOBBY JINDAL:
\nI think Medicaid, when it was targeted for the disabled, for children, in Louisiana, over 95% of our children have coverage.\u00a0 I think that it can be improved and more flexibility.\u00a0 Oregon, the Harvard– now, this wasn’t a conservative study.\u00a0 The Harvard study showed when you expanded Medicaid after two years in Oregon, there was no improvement of physical healthcare outcomes.\u00a0 Simply giving people a card without giving them access to healthcare, to doctors, to hospitals doesn’t improve anything.<\/p>\n

CHUCK TODD:
\nVery quickly on immigration.\u00a0 If the president goes through with his executive action, do you think Republicans and Capitol Hill ought to use even the power of shutting down the government to stop him from doing it?<\/p>\n

GOV. BOBBY JINDAL:
\nTwo things.\u00a0 I don’t think the president should shut down the government to try to break the Constitution.\u00a0 The reality is this.\u00a0 I do think the–<\/p>\n

CHUCK TODD:
\nYou think the president would be shutting down the government?<\/p>\n

GOV. BOBBY JINDAL:
\nOh, absolutely.<\/p>\n

CHUCK TODD:
\nSo you do want Republicans to fight him on this to the point that it could shut down the government?<\/p>\n

GOV. BOBBY JINDAL:
\nAbsolute– I don’t think the president should shut down the government.<\/p>\n

CHUCK TODD:
\nBut you’re twisting my question.<\/p>\n

GOV. BOBBY JINDAL:
\nBut wait, wait.<\/p>\n

CHUCK TODD:
\nThat means you want that kind of showdown?<\/p>\n

GOV. BOBBY JINDAL:
\nLet’s step back and understand what we’re talking about.\u00a0 So the president said, “I want to break the law.”\u00a0 He purposely said I\u2019m going to wait till after the election, because I know it’s not going to be popular to grant amnesty to millions of folks here that are here illegally.\u00a0 We had an election.\u00a0 He said his policies were on the ballot.<\/p>\n

He lost in red states, purple states, blue states.\u00a0 The American people overwhelmingly rejected and rejected his policies.\u00a0 Now he’s saying, “I’m still going to break the law.”\u00a0 Talk about arrogance.\u00a0 This president used to say, “Elections have consequences.”\u00a0 We’re talking about how can the Congress force the president to follow the law?<\/p>\n

I would expect even Democrats who may agree with him on substance, to say the right way to do this is to follow the Constitution, follow the law.\u00a0 No, we shouldn’t shut down the government, but absolutely Republicans should do everything they can to force the president to follow the law.\u00a0 Let’s secure the border.\u00a0 No, the president shouldn’t shut down the government so that he can break the law.<\/p>\n

CHUCK TODD:
\nAll right.\u00a0 I’m going to ask you about your own presidential ambitions.\u00a0 A majority in Louisiana disapprove of your job as governor.\u00a0 Why is that a launching pad to Iowa and New Hampshire?<\/p>\n

GOV. BOBBY JINDAL:
\nChuck, I don’t care at all about poll numbers.\u00a0 I never have.\u00a0 The reality is, I was elected in Louisiana to make generational changes.\u00a0 Look at what we’ve done in Louisiana.\u00a0 So now, we’ve cut our state budget 26%, cut the number of state employees 34%.<\/p>\n

We’ve got the best private-sector economy in a generation.\u00a0 Our economy has grown twice as fast as the national economy.\u00a0 More people working than ever before at a higher income than ever before.\u00a0 We transformed the charity house.\u00a0 That’s, like, the third rail in Louisiana politics.<\/p>\n

Statewide school of choice, so our children have the opportunity to get a great education.\u00a0 If I were to run, and I haven’t made that decision, if I were to run for president, it’s because I believe in our country.\u00a0 The American dream is at jeopardy.\u00a0 This president has defined the American dream as more dependence on the government.\u00a0 We need to restore the American dream.\u00a0 So it’s more about opportunity and growth and not redistribution.<\/p>\n

CHUCK TODD:
\nBut very quickly, one part of your record, you now have nearly a billion dollar hole in your budget.\u00a0 Every midyear review, your deficit has grown.\u00a0 You did a big tax cut at the beginning of your term as governor.\u00a0 Revenues haven’t followed.<\/p>\n

GOV. BOBBY JINDAL:
\nThat’s not actually true, Chuck.\u00a0 The billion dollars is if you assume we grow government next year.\u00a0 Our budget’s been balanced every year.\u00a0 We’ve never raised taxes.\u00a0 I’ve had eight credit upgrades in three of the major credit rating agencies.\u00a0 Best credit ratings in decades in our state.\u00a0 We’ve actually balanced our budget every single year without running deficits, without raising taxes.<\/p>\n

CHUCK TODD:
\nWell, you constitutionally have to balance your budget.<\/p>\n

GOV. BOBBY JINDAL:
\nAnd we need to do that in D.C. as well.\u00a0 But my point is, we’ve actually made the tough choices.\u00a0 Unlike D.C., we cut our spending $9 billion.\u00a0 I’m not talking about cutting growth.\u00a0 We cut our budget by $9 billion.\u00a0 So we’ve actually balanced our budget and we’ve done it by growing the private sector.<\/p>\n

We’ve got, right now in Louisiana, we’ve got more than 80,000 jobs, more than $50 billion in private investment coming into our state.\u00a0 We actually, our economy’s doing so well, when I was elected, our worry was we were losing our sons and daughters.\u00a0 Today, our biggest challenge is filling all these great jobs.<\/p>\n

CHUCK TODD:
\nGovernor Bobby Jindal, I will have to leave it there.\u00a0 You’re going to decide when, by the 1st of the year?<\/p>\n

GOV. BOBBY JINDAL:
\nFirst half of next year.\u00a0 We are praying about this.\u00a0 But bottom line is let’s restore the American dream for our children and grandchildren.<\/p>\n

CHUCK TODD:
\nGovernor, thanks for coming back to Meet the Press.\u00a0 Coming up, President Obama says, “Election?\u00a0 What election?”\u00a0 The Democrats’ midterm losses not only haven’t stopped him, they seemed to have energized him.\u00a0 How will Republicans respond?<\/p>\n

***Commercial Break***<\/p>\n

CHUCK TODD:
\nThe controversial Keystone XL Pipeline, which would transport oil from Canada down to the Gulf of Mexico is back in the news.\u00a0 The senate is expected to take up a bill this week that could allow the project to go forward.\u00a0 So we asked two experts to argue for and against the pipeline being built in our weekly web series, Make the Case.\u00a0 That and more can be found on our website at MeetThePressNBC.com.\u00a0 Up next, President Obama and Republicans get ready for another series of partisan showdowns.<\/p>\n

***Commercial Break***<\/p>\n

CHUCK TODD:
\nAnd welcome back.\u00a0 This month’s midterm results were miserable for the Democratic party.\u00a0 They lost the Senate, and of course, a lot more seats in the House.\u00a0 So with two years of his tenure left, President Obama has two options: Eke out some areas of compromise with the new Republican majority, or try to be bold and push his agenda by using his executive authority.\u00a0 Well, this week, it became clear that the president has opted to favor the latter approach.\u00a0 As they say, he may believe the best form of a defense is a good offense.<\/p>\n

(BEGIN TAPE)<\/p>\n

PRESIDENT OBAMA:
\nWithout any Republican support on anything then it’s going to be hard to get things done.<\/p>\n

CHUCK TODD (V\/O)
\nThat was four years ago.\u00a0 This is now.<\/p>\n

PRESIDENT OBAMA:
\nThere are going to be actions I take that they don’t like, and there are going to be bills they pass that I don’t like.<\/p>\n

CHUCK TODD (V\/O)
\nIn 2010, President Obama, realizing he himself would be facing voters in two years, walked away from the shellacking with a pledge to build consensus.\u00a0 The effort and accommodation failed.\u00a0 A grand bargain on taxes and entitlements broke down.\u00a0 And clashes over spending paved the way for a government shutdown.\u00a0 This time around, without the burden of a re-election campaign, the president is learning a different lesson from defeat.\u00a0 With time running out to secure a legacy, this week, the president put his fists up, telling supporters, “Let’s go.”<\/p>\n

PRESIDENT OBAMA:
\nI’m laying out a plan to keep the internet free and open.<\/p>\n

CHUCK TODD (V\/O)
\nOn Monday, the president pushed the FCC to issue the strongest possible rules for internet service providers like Verizon and NBC parent company, Comcast, saying the internet should be regulated like a public utility so broadband companies can’t charge for better access.\u00a0 Republican Senator Ted Cruz called it, “ObamaCare for the internet.”\u00a0 On Tuesday, Mr. Obama announced an historic climate deal with China, designed to cut carbon emissions from both countries.<\/p>\n

PRESIDENT OBAMA:
\nFor the first time, we got China to make a very serious commitment to constrain its greenhouse gasses.\u00a0 Why would anybody be against that?<\/p>\n

CHUCK TODD (V\/O)
\nRepublicans were.<\/p>\n

MITCH MCCONNELL:
\nI had maybe na\u00efvely hoped the president would look at the results of the election and decide to come to this political center.\u00a0 But the early signs are not good.<\/p>\n

CHUCK TODD (V\/O)
\nAs early as next week, President Obama will give Republicans another target when he acts alone to extend protections to as many as five million undocumented immigrants.<\/p>\n

JOHN BOEHNER:
\nWe’re going to fight the president tooth and nail.<\/p>\n

MITCH MCCONNELL:
\nIt’s like waving a red flag in front of a bull.<\/p>\n

REP. BRAD WENSTRUP (R-OH):
\nThe president may have said, “I hear you,” but by the looks of things, it’s just the opposite.<\/p>\n

CHUCK TODD (V\/O)
\nRepublican leaders, hoping to prevent a government shutdown, and to avoid upsetting conservatives, are now considering another option:\u00a0 the courts.<\/p>\n

PRESIDENT OBAMA
\nI would advise rather than devote a lot of time trying to constrain my lawful actions, as the chief executive of the U.S. government in charge of enforcing our immigration laws, that they spend some time passing a bill.<\/p>\n

CHUCK TODD (V\/O)
\nNow instead of worrying about shoring up red state incumbents, the president is working on firing up base Democrats who stayed home on Election Day, contributing to the lowest overall midterm turnout in more than seven decades.\u00a0 That may mean picking a fight with members of his own party, as Democratic soul searching revives a rift between moderates and progressives.\u00a0 The first skirmish in the battle to define the party’s future, a Senate vote next week on the Keystone Pipeline.<\/p>\n

MARY LANDRIEU:
\nI’d like to vote on Keystone now.<\/p>\n

PRESIDENT OBAMA:
\nUnderstand what this project is.\u00a0 It is providing the ability of Canada to pump their oil, send it through our land, down to the Gulf, where it will be sold everywhere else.\u00a0 It doesn’t have an impact on U.S. gas prices.<\/p>\n

(END TAPE)<\/p>\n

CHUCK TODD:
\nWell, the panel is here.\u00a0 I want to start with Keystone.\u00a0 Chris Matthews, the president, is he going to veto it?\u00a0 And is that a death knell for Mary Landrieu?<\/p>\n

CHRIS MATTHEWS:
\nI think this time around, he’ll veto.\u00a0 But it’s going to come back again and again.\u00a0 And it’s one of things that will end up being negotiated.<\/p>\n

CHUCK TODD:
\nIs it a mistake to veto it?<\/p>\n

CHRIS MATTHEWS:
\nWell, he may feel he has to do it for his environmental supporters.\u00a0 But it’s not going to stop it.\u00a0 It’s going to happen.\u00a0 It will happen.\u00a0 It’ll happen now or next year or the year after.\u00a0 Because the country wants jobs and energy is always a primary concern of the American people.\u00a0 And look who are the swing electorate?\u00a0 Working-class whites.<\/p>\n

These are the people that Hillary Clinton will want, the Republicans will want.\u00a0 These people are going to be for jobs like this.\u00a0 He said, “There’s nothing in it for us.”\u00a0 There are jobs in it.\u00a0 And that’s the way the American people look at it.\u00a0 Not energy, jobs.<\/p>\n

CHUCK TODD:
\nHelene Cooper, are you surprised at this more energized President Obama?<\/p>\n

HELENE COOPER:
\nI’m not.\u00a0 I think it’s really interesting though because somebody clearly didn’t tell him that his party got whipped.<\/p>\n

CHUCK TODD:
\nYeah.\u00a0 It wasn’t close.<\/p>\n

HELENE COOPER:
\nYeah.\u00a0 So it’s really interesting seeing just how he’s come out.\u00a0 He’s clearly now shooting for the fences.\u00a0 He’s thinking about his legacy.\u00a0 He wants to get things done.\u00a0 I think that’s why you’re going to see him doing much more things on the international stage, where he has more ability.\u00a0 And I think, you know, for all of the nice talk that you heard, you know, the day after the election about trying to get along, that’s not going to happen.\u00a0 I think we’re in for two years of complete gridlock.<\/p>\n

CHUCK TODD:
\nSo Carly Fiorina, what should Republicans do if the president, you know, wants to basically still enact his agenda and not let the midterms interrupt that?\u00a0 How should Republicans respond?<\/p>\n

CARLY FIORINA:
\nWell, first, just on Keystone Pipeline, perhaps the president will veto this.\u00a0 But on what basis would he do so?\u00a0 The American people support it by wide majorities.\u00a0 What we are doing today is actually worse for global greenhouse gas emissions than the Keystone Pipeline would be.\u00a0 It would create jobs despite his bizarre statement that it wouldn’t.\u00a0 And finally, two and a half years–<\/p>\n

CHUCK TODD:
\nThere have been some mixed studies on this.\u00a0 I mean, there’s temporary jobs and then there’s full-time jobs.<\/p>\n

CARLY FIORINA:
\nTwo and a half years of a process, that’s either purposeful foot dragging or it’s incompetence.\u00a0 And the American people know that.\u00a0 I think what the Republicans should do is soberly and systematically pass bills that make sense, that have bipartisan support.\u00a0 And Keystone XL Pipeline is one of them.\u00a0 They should pass it.\u00a0 If he jumps in and does this executive action on immigration, I think Republicans should not be goaded into–<\/p>\n

CHUCK TODD:
\nShowdown?<\/p>\n

CARLY FIORINA:
\nShowdown.\u00a0 Because it only help Obama and hurts the American people.\u00a0 But what they should do is systematically and soberly pass a series of bills to solve a decades-old problem.\u00a0 And they should point out to Hispanics all over this nation that this president has taken advantage of them.\u00a0 He sunk comprehensive immigration reform in 2007.\u00a0 He did nothing to push forward immigration reform when he had the Senate, the House, and the White House.\u00a0 He said in ’11 and ’12 he couldn’t do anything.\u00a0 And then he delayed his action for the elections.\u00a0 Unbelievable cynicism.<\/p>\n

CHUCK TODD:
\nReid, it does appear as if the president is looking at different Democratic constituency groups.\u00a0 And when in doubt, going to the base.<\/p>\n

REID WILSON:
\nAnd your point earlier that this is the beginning of a feud between the two factions of the Democratic party, he’s absolutely correct.<\/p>\n

CHUCK TODD:
\nYou think there is?\u00a0 Yeah.<\/p>\n

REID WILSON:
\nI mean, I think it’s more valuable for Mary Landrieu to be against President Obama and have him veto the Keystone Pipeline than it is for her to actually be able to deliver it.\u00a0 I mean, here we are fully–<\/p>\n

CHUCK TODD:
\nDo you think that’s better politics for Mary Landrieu?<\/p>\n

REID WILSON:
\nIt certainly is.\u00a0 In a state where President Obama–<\/p>\n

(OVERTALK)<\/p>\n

CHUCK TODD:
\nIf she can’t get something that she wants to get done done, that’s good for her?<\/p>\n

REID WILSON:
\nShe’s not going to be able to convince voters that she’s not President Obama’s vote.\u00a0 You know, another vote for President Obama.\u00a0 This is the constant problem that Democrats across the country had.\u00a0 They were too closely tied to him.\u00a0 Why not do everything possible to distance yourself from the White House?<\/p>\n

CHUCK TODD:
\nSo a veto might help her?\u00a0 No?<\/p>\n

REID WILSON:
\nLook, she doesn’t have great chances either way.<\/p>\n

CHUCK TODD:
\nAll right, all right.\u00a0 Either way.\u00a0 Yeah.<\/p>\n

HELENE COOPER:
\nBut that’s–<\/p>\n

CHRIS MATTHEWS:
\nIt all happens before December 12th, too.\u00a0 In ten days, they’re going to have the veto one way or the other.\u00a0 It’s going to happen.\u00a0 We’ll have the verdict.<\/p>\n

CHUCK TODD:
\nAll right.\u00a0 You guys are coming back.\u00a0 We’re going to talk a little bit more about this coming up.\u00a0 Democrats stayed home on election day.\u00a0 Can they reassemble that coalition that elected President Obama twice if he’s not on the ballot?\u00a0 On Meet the Press, our Nerd Screen segment is next.<\/p>\n

***Commercial Break***<\/p>\n

CHUCK TODD:
\nWell, the Democratic party’s prospects for 2016 are all about who shows up to vote.\u00a0 One reason President Obama did so well in 2012 was due to minority and youth turnout.\u00a0 In fact, let’s take a look at 2012.\u00a0 72% of that vote was white, 13% black, 10% Hispanic.\u00a0 And 19% of the overall electorate was between the ages of 18 and 29.<\/p>\n

Now, here’s what we know.\u00a0 Whites voted for Mitt Romney by nearly 20 points, 59-39.\u00a0 But if you look at everybody else, blacks, Hispanics, Asians, the president won that share of the vote 80 to 19.\u00a0 Now, let’s take a look at what happened last Tuesday.\u00a0 We all know turnout was pretty low.\u00a0 But the percentage of white voters actually was up compared to 2012, 75%.<\/p>\n

Black and Hispanic numbers dropped, and perhaps most significantly, that 18 to 29 year old vote, dropped all the way down to 13% of those who voted.\u00a0 And guess what that did?\u00a0 It helped produce the GOP wave that we saw.\u00a0 In fact, here are two states where a turnout that looked more like 2012 likely would’ve changed the outcome of the election.<\/p>\n

Colorado and North Carolina.\u00a0 In Colorado, Republican Cory Gardner beat the Democratic incumbent Mark Udall by roughly 42,000 votes.\u00a0 Now look at this.\u00a0 Between 2012 and 2014, the youth turnout in Colorado, mostly Democratic voters, dropped from being 20% of the electorate, one in five voters, to 14%.\u00a0 The youth turnout it held steady, guess what?\u00a0 Probably would’ve produced enough votes to put Udall over the top.\u00a0 Let’s take a look at another example, North Carolina.<\/p>\n

Republican Thom Tillis beat the Democratic incumbent Kay Hagan by a little more than 45,000 votes.\u00a0 Had the African American turnout been the same percentage of the electorate as it was in 2012, Senator Hagan easily may have won.\u00a0 In fact, it would’ve produced 56,000 more votes, would’ve led to a different outcome.<\/p>\n

So what does all this mean for 2016?\u00a0 Many have argued that you need someone like Barack Obama at the top of the ballot to get the kind of turnout that favors the Democrats, or at least favored them in ’08 and ’12.\u00a0 Well, if that’s true, the Democrats could have a problem.\u00a0 Barack Obama’s not going to be at the top of the ticket.<\/p>\n

But the long-term shift in demographics in the United States as a whole probably will help the Democratic party in the next presidential election when turnout will be higher.\u00a0 Experts expect the white vote turnout to be about 69%.\u00a0 And that alone could help almost any Democrat no matter who’s at the top of the ticket, even if his name or her name is not Barack Obama.<\/p>\n

***Commercial Break***<\/p>\n

CHUCK TODD:
\nAnd welcome back, a little earlier I discussed the politics of healthcare with Secretary Burwell and Governor Jindal.\u00a0 But what difference has the Affordable Care Act made to the millions of Americans who have signed up for coverage?\u00a0 I asked my colleague Anne Thompson to take a look at two states, Texas and Illinois.\u00a0 They took very different approaches to the law.<\/p>\n

(BEGIN TAPE)<\/p>\n

ANNE THOMPSON (ON TAPE):
\nEverything is bigger in Texas.\u00a0 Including the opposition to the Affordable Care Act.<\/p>\n

ROBERT MAYFIELD:
\nAnd it’s going to be more taxes on all the Texas people.\u00a0 I mean, that’s a trap if it was one, it seems to me.<\/p>\n

ANNE THOMPSON (ON TAPE):
\n1,000 miles away in the land of Lincoln and the current president, it’s also called the ACA and embraced.<\/p>\n

KEITH MOON:
\nThe ACA saved us.<\/p>\n

ANNE THOMPSON (ON TAPE):
\nOne year later, two states with very different assessments.\u00a0 Robert Mayfield has a sizzling business in Austin, Texas.\u00a0 He owns a burger joint and six Dairy Queens, employing just under 100 people at above minimum wage.<\/p>\n

ROBERT MAYFIELD:
\nWe pay $10 an hour to start.\u00a0 We don’t have to.\u00a0 We don’t do that because we’re nice guys.\u00a0 We do that because we get the best people.<\/p>\n

ANNE THOMPSON (ON TAPE):
\nMayfield wants to expand the business started by his father in 1949.\u00a0 But going over that 100 employee mark means he would have to offer healthcare to most of his full-time workers or pay penalties under the law’s employer mandate.<\/p>\n

ROBERT MAYFIELD:
\nThese costs the government imposes on a business, they don’t come out of the air.\u00a0 You know, if we have to pay them, we’ve got to pass them on, or we don’t stay in business.<\/p>\n

ANNE THOMPSON (ON TAPE):
\nAnd if 30 hours a week is how the law defines a full-time worker, forget expansion.\u00a0 Mayfield says he may have to cut hours or jobs.<\/p>\n

ROBERT MAYFIELD:
\nWe’ve got some people that I care very much about that have worked for us ten, 12 years.\u00a0 You know, what do I do with them?<\/p>\n

ANNE THOMPSON (ON TAPE):
\nTexas has the highest percentage of uninsured in the nation,\u00a0 some six million people.\u00a0 Only 733,000 signed up for the ACA.<\/p>\n

REP. JOHN ZERWAS:
\nIt was just characterized that this is going to be the panacea to our uninsured issues out there.\u00a0 Well, it’s not and it never was.<\/p>\n

ANNE THOMPSON (ON TAPE):
\nState Representative John Zerwas says he hears complaints from people who paid more for less coverage.\u00a0 And though Texas rejected the Medicaid expansion, this Republican doctor is open to other ways.<\/p>\n

REP. JOHN ZERWAS:
\nThere is the possibility to look at ways of how we provide insurance for some kind of program available to this million, million and a half people.\u00a0 For which there’s not an option for right now.<\/p>\n

ANNE THOMPSON (ON TAPE):
\nIn Washington, the incoming Republican majority vows to repeal the law.\u00a0 Fighting words in Keith Moon’s house outside Chicago.<\/p>\n

KEITH MOON:
\nIf you don’t want to repeal this law and the people that won’t extend Medicaid, they sit there with insurance, you go without insurance for two years and tell me how you feel.<\/p>\n

ANNE THOMPSON (ON TAPE):
\nMoon’s family did after he and his wife Joyce lost their jobs.\u00a0 Joyce’s pre-existing thyroid condition pushed the price tag for insurance to an unaffordable $1,750 a month.<\/p>\n

ANNE THOMPSON:
\nAs a husband, your wife isn’t getting the attention she needs.<\/p>\n

KEITH MOON:
\nIt was terrible.\u00a0 You felt awful about that.<\/p>\n

ANNE THOMPSON (ON TAPE):
\nNow with the ACA, they pay $300 a month.\u00a0 And Joyce gets the care she needs.<\/p>\n

ANNE THOMPSON:
\nOne year later, what’s the emotional difference?<\/p>\n

KEITH MOON:
\nYou don’t have that overhanging stress and risk of medical bankruptcy.\u00a0 So you have that burden lift from your shoulders is just, I don’t even know how to put it in words.<\/p>\n

ANNE THOMPSON (ON TAPE):
\nIn Illinois, of the 1.2 million people eligible, more than 700,000 signed up.<\/p>\n

BRIAN GORMAN:
\nBecause of the coverage in the Affordable Care Act, a lot of people are more likely to live.\u00a0 Families are less likely to go bankrupt.<\/p>\n

ANNE THOMPSON (ON TAPE):
\nEntering year two, the Affordable Care Act has not healed the divide it created.\u00a0 For Meet the Press, Anne Thompson.<\/p>\n

(END TAPE)<\/p>\n

CHUCK TODD:
\nNow for a deep dive on the policy, I’m joined by Dr. Toby Cosgrove, head of the Cleveland Clinic, Neera Tanden, President of the Center for American Progress.\u00a0 She worked with the White House and in the White House to developed President Obama healthcare law, and Avik Roy, he’s a senior fellow at the Manhattan Institute for Policy Research and opinion editor for Forbes, who advised Mitt Romney on healthcare.\u00a0 Welcome to all of you.\u00a0 Dr. Cosgrove, let me start with you.\u00a0 Affordable Care Act, is it working?<\/p>\n

DR. TOBY COSGROVE:
\nWell, we’ve seen several good things happen.\u00a0 It’s really started out to decrease the cost.\u00a0 And the jury’s not in on that yet.\u00a0 And you have to understand that costs are not just about the individual.\u00a0 They’re also about the cost for healthcare across the nation.\u00a0 It certainly has improved.<\/p>\n

CHUCK TODD:
\nAnd you, as the head of the Cleveland Clinic, you would know.<\/p>\n

DR. TOBY COSGROVE:
\nWell, we certainly have seen that, yes.<\/p>\n

CHUCK TODD:
\nAnd so you feel like costs have come down?<\/p>\n

DR. TOBY COSGROVE:
\nWe are working very hard to bring costs down.\u00a0 We realize that the pressure is on healthcare providers across the country to try and make care more affordable and greater efficiency, and at the same time, bring up quality.\u00a0 And we’ve seen the national quality indicators go up and we certainly have seen access increased across the country.\u00a0 So there are the main thing that we’re seeing is the jury is not in yet on how we’re doing as far as costs across the country is concerned.<\/p>\n

CHUCK TODD:
\nAvik?<\/p>\n

AVIK ROY:
\nHospital costs are going up.<\/p>\n

CHUCK TODD:
\nBut I was just going to say, first year, is it not the doom and gloom that was predicted?<\/p>\n

AVIK ROY:
\nWell, so hospital costs and the underlying cost of insurance for people to buy coverage on their own did go up in year one for ObamaCare.\u00a0 It’s stable this year from those higher levels.\u00a0 But a big part of what’s happening that a lot of people haven’t been paying attention to is as more people are on Medicaid and Medicare, the big government insurance plans, hospitals across the country are merging in order to have higher market power to raise prices on people with private insurance.<\/p>\n

And thereby increase premiums for people with private insurance.\u00a0 We’re seeing that actually in Northeastern Ohio, the Cleveland Clinic recently merged with the hospital system in Akron.\u00a0 Now, Toby’s situation might be an exception.\u00a0 But in general, these mergers have led not so much to increased quality, but to higher prices.\u00a0 On average, 44% higher prices for things like knee replacements and angioplasty and heart surgery compared to what they were like in competitive markets in the old days.<\/p>\n

CHUCK TODD:
\nNeera, you’re shaking your head.<\/p>\n

NEERA TANDEN:
\nJust to clarify, we actually have data on these things.\u00a0 And premiums, national premiums, are coming down.\u00a0 Premiums that people are paying, your out-of-pocket costs are actually coming down.\u00a0 We used to have double-digit increases over the last couple years, those come down.\u00a0 So it’s true that the healthcare system is transforming itself, because there is a lot of pressure to bring costs down.<\/p>\n

There is greater concentration in some areas.\u00a0 Sometimes, and in most of those cases, the world we’re seeing is that there’s better value for the patient.\u00a0 So I’m happy to discuss the ins and outs of particular areas, but as a national plan, we have national numbers and medical inflation is down.\u00a0 And it’s translating into lower premium increases.<\/p>\n

CHUCK TODD:
\nDr. Cosgrove, what’s the next metric?<\/p>\n

DR. TOBY COSGROVE:
\nWell, the metrics are going to be around quality transparency and the transparency around costs.\u00a0 And we’re going to see both of those happen over time.\u00a0 And that will bring the marketplace to a real marketplace.\u00a0 We need to have people understand and have a part in how much they are paying for their health care.\u00a0 And we really need to move from sick care to well care.<\/p>\n

And that’s going to require that people get involved in their care and understand what they’re doing.\u00a0 And at the end of the day, you have to understand that the health of the country is only as good as the health of its citizens.\u00a0 And we need to work on that hard.<\/p>\n

CHUCK TODD:
\nAvik, what would you be advising Republicans to do right now?\u00a0 Do you try to dismantle the law, or do you try to improve it?<\/p>\n

AVIK ROY:
\nI think you try to make changes to the law based on things that you think the president can sign, whether it’s bipartisan support.<\/p>\n

CHUCK TODD:
\nSo you wouldn’t be going for the kill on this?<\/p>\n

AVIK ROY:
\nNo, I mean, they’re going to have a vote on repeal, because the base really wants it.\u00a0 They’ve made that promise to the voters, and that’s fine.\u00a0 But Republicans in the next two years really have to start thinking constructively about how to make the healthcare system better.\u00a0 One of those is to increase access to coverage, access to care.<\/p>\n

But a big part of how you increase access to care is to make it less expensive.\u00a0 The average day spent in a hospital in the United States costs five times what it does in the typical industrial country.\u00a0 That’s way too high.\u00a0 And it’s not enough to just say, “Okay, we’re increasing hospital costs by 2% or 3% next year.”\u00a0 We’ve got to bring it down.<\/p>\n

CHUCK TODD:
\nAnd Neera, that’s one part of this law that didn’t, you know, it really focused on insurance coverage.\u00a0 It was having a harder time to go after the cost.<\/p>\n

NEERA TANDEN:
\nWell, we do have national health expenditures that have been lowering.\u00a0 And I think that’s in part because of the ACA, but a lot of other factors as well.<\/p>\n

CHUCK TODD:
\nSure, economics.<\/p>\n

NEERA TANDEN:
\nYou know, the economic downturn has had some pressure as well.\u00a0 I think the thing that we have to distinguish is that out-of-pocket costs have been going up for consumers.\u00a0 That’s a ten-year trend.\u00a0 Those employers have been shifting.\u00a0 So I think that’s the next area for Democrats, I hope Republicans, the next area to really concentrate on.\u00a0 How much consumers are paying.\u00a0 The law has actually had a big benefit here because premiums are coming down.\u00a0 But people have to, you know, that’s a huge issue for all people.<\/p>\n

CHUCK TODD:
\nVery quickly.<\/p>\n

DR. TOBY COSGROVE:
\nWe have to understand also we’re going to have a shortage of doctors and nurses.\u00a0 800,000 nurses in a decade and another 130,000 doctor shortage.\u00a0 And we have to address that before it gets to be a real crisis.<\/p>\n

CHUCK TODD:
\nAll right, Dr. Cosgrove, Avik Roy, Neera Tanden, a little substance with people’s Sunday morning breakfast we thought would be good–
\n(OVERTALK)<\/p>\n

CHUCK TODD:
\n–a little policy-wonkish.\u00a0 Thank you all for this.\u00a0 We’ll be back in 15 seconds with more from the political panel.<\/p>\n

***Commercial Break***<\/p>\n

CHUCK TODD:
\nAnd welcome back.\u00a0 The panel is still here.\u00a0 And I want to pick up on quickly on the healthcare conversation.\u00a0 Carly Fiorina, would you be advising for repeal at this point in time?\u00a0 And do you think at some point, you’ve got to almost stop talking about repeal, or no?<\/p>\n

CARLY FIORINA:
\nI think that the Republican House will pass the bill that repeals it.\u00a0 I think ultimately this bill does need to be repealed.<\/p>\n

CHUCK TODD:
\nAnd you don’t think the Senate will?<\/p>\n

CARLY FIORINA:
\nNo, I don’t think the Senate will.\u00a0 Let me tell you why I think it needs to be repealed utilities.\u00a0 You know, what happens when you have vast legislative overreach is you don’t particularly fix the problem you started out to fix and you create problems for everyone else.\u00a0 And that’s what we’ve done.<\/p>\n

The number of uninsured isn’t coming down fast enough.\u00a0 Preexisting conditions, I’m a cancer survivor.\u00a0 Of course that should not be a reason not to get health insurance, but they keep talking about premiums.\u00a0 What they don’t talk about is everyone’s deductibles have gone up.\u00a0 What they don’t talk about is not enough people are getting insured.\u00a0 And very created so many other problems.\u00a0 You referenced Jonathan Gruber before.\u00a0 This law is longer than a Harry Potter novel.\u00a0 It’s been accompanied of tens of thousands of paper regulation.<\/p>\n

CHUCK TODD:
\nBut shouldn’t have–<\/p>\n

(OVERTALK)<\/p>\n

CHUCK TODD:
\nI never understood the–<\/p>\n

CARLY FIORINA:
\nOf course nobody understands it.<\/p>\n

CHUCK TODD:
\nBut in the health–<\/p>\n

CARLY FIORINA:
\nIt created problems for everyone.<\/p>\n

CHUCK TODD:
\nBut of course, the healthcare, you’re going to write a big, long law.\u00a0 Or you don’t?<\/p>\n

CARLY FIORINA:
\nWell, or, you can go to the one force that we know reliably improves quality and lowers costs and it’s called competition.\u00a0 The health insurance market has never been competitive.\u00a0 It was crony capitalism, the way this bill was written between the health insurance companies trying to protect their franchises and big government.<\/p>\n

CHUCK TODD:
\nWell, Reid Wilson, you helped me a lot on my book, Stranger.\u00a0 And when went through the healthcare thing, clearly passing the bill became more important than sometimes the words in the bill.<\/p>\n

REID WILSON:
\nIt did.\u00a0 And within the White House, there was a lot sort of overcorrection for the mistakes that the Clintons had made.\u00a0 They ceded a lot of power, a lot of writing authority to Capitol Hill.\u00a0 That didn’t work because of some internal dynamics within the Democratic Conference up there especially in the Senate.\u00a0 So this is, you know, a political problem for the president.\u00a0 From the first day of his administration, it has plagued him.\u00a0 And it will continue to do so in the last two years of his serve.<\/p>\n

CHUCK TODD:
\nYou know, Chris Matthews, if you’re the administration, you know, Sylvia Burwell admitted, they still haven’t marketed health care very well.<\/p>\n

CHRIS MATTHEWS:
\nI agree with that.\u00a0 But I want to go back to the basis, the genesis of this bill.\u00a0 And it’s the same as the fight over immigration.\u00a0 As long as you have an intractable opposition, I mean, I was hoping we could get Orrin Hatch on this health care bill.\u00a0 I was hoping that Mike Enzi, these are all good people, they were negotiating.\u00a0 They all fell off because of fear of the tea party people.\u00a0 Same with immigration.\u00a0 Please God have a meeting between the president and the speaker in the House this week before this–<\/p>\n

(OVERTALK)<\/p>\n

CHUCK TODD:
\nYou think they need to meet before?<\/p>\n

CHRIS MATTHEWS:
\nMeeting in public.\u00a0 I’d like it on television.\u00a0 What is your opposition to this immigration bill?\u00a0 Is it we don’t have enough enforcement?\u00a0 I’ll give you more enforcement.\u00a0 Is it hiring rules?\u00a0 We’re going to enforce them.\u00a0 I promise you we’re going to enforce them.\u00a0 What do you want?\u00a0 So you’re absolutely against any kind of amnesty for people who have been here 20, 30 years, absolutely against it?<\/p>\n

So what then when the president issues the executive order, people will understand he really tried to negotiate.\u00a0 Let me tell you something, we’re negotiating with Tehran right now.\u00a0 We’re desperately trying to cut a deal over nuclear weapons to the last moment.\u00a0 Why don’t we have negotiations going on right now between the two sides?<\/p>\n

CHUCK TODD:
\nYou know, he brings up a point, and I can hear Republicans now echoing, he’ll negotiate with the Iranians, he won’t negotiate with us on immigration.<\/p>\n

HELENE COOPER:
\nI think though for the Republicans, though, there’s also–<\/p>\n

CHRIS MATTHEWS:
\nThat’s not the way I said it.<\/p>\n

CHUCK TODD:
\nNo, I’m telling you how you’re going to get requoted.<\/p>\n

CHRIS MATTHEWS:
\nRight.<\/p>\n

CHUCK TODD:
\nNo, you and I both know that.<\/p>\n

HELENE COOPER:
\nYou’re right.\u00a0 You’re absolutely right.<\/p>\n

CHUCK TODD:
\nNo, that’s how he’s going to get requoted.<\/p>\n

(OVERTALK)<\/p>\n

CHRIS MATTHEWS:
\nBut they want to negotiate though, Chuck.<\/p>\n

(OVERTALK)<\/p>\n

CHRIS MATTHEWS:
\nWell, they need to tape more television shows.\u00a0 What’s their opposition to immigration?\u00a0 I’m sorry, Helene.<\/p>\n

CHUCK TODD:
\nVery quick.<\/p>\n

HELENE COOPER:
\nI think that for the Republicans, there’s going to be a danger of overreach as well.\u00a0 Because they right now control the Senate and if they’re going to go and shut down the government over an immigration bill, they’re going to go after repealing healthcare, what are they going to be for?<\/p>\n

CHUCK TODD:
\nWell, that’s what they have to figure out.\u00a0 Alright, before I let you go, we thought we’d end on a happy note.\u00a0 The president of course is on his way home from the G20 summit in Australia.\u00a0 Reportedly, there were some edgy exchanges of course and some meetings between the leaders, Russian President Putin.<\/p>\n

But being Australia, the host brought out some cuddly koalas to relieve any tension as the summit ended.\u00a0 Well, look at that.\u00a0 Putin and a koala.\u00a0 This is like him posing with an animal that wasn’t faked, by the way.\u00a0 There’s the president, almost getting tickled by a koala.\u00a0 Is this just a reminder that just everything goes better with animals?\u00a0 Right?\u00a0 Everybody’s in a happier mood when–<\/p>\n

CHRIS MATTHEWS:
\nYou want an Irish joke?<\/p>\n

CHUCK TODD:
\nYeah, go quick.<\/p>\n

CHRIS MATTHEWS:
\nOkay.<\/p>\n

CHUCK TODD:
\nUh-oh.<\/p>\n

CHRIS MATTHEWS:
\nAn Irishman is trying to get through immigration.\u00a0 The guy says, “Do you have a criminal record?”\u00a0 He said, “No, is it still required?”<\/p>\n

CHUCK TODD:
\nOh, ouch.\u00a0 Ouch.\u00a0 Carly Fiorina, before I let you go, how serious are you about running for president?<\/p>\n

CARLY FIORINA:
\nThat’ll be something I consider at the right time.<\/p>\n

CHUCK TODD:
\nSo are you considering?<\/p>\n

CARLY FIORINA:
\nWell, when people ask you over and over again, you have to pause and reflect.\u00a0 So I’ll pause and reflect at the right time.<\/p>\n

CHUCK TODD:
\nSo that means it’s something you’re pondering?\u00a0 You’re going to go Iowa soon?<\/p>\n

CARLY FIORINA:
\nYou have to ponder when people keep asking.\u00a0 And I’ve been to Iowa plenty to help women engage and isn’t it fantastic that Joni Ernst won?<\/p>\n

REID WILSON:
\nThere’s a direct flight out of DCA now.<\/p>\n

CHUCK TODD:
\nAll right.\u00a0 That’s all for today.\u00a0 We’ll be back next week because if it’s Sunday, it’s Meet the Press.<\/p>\n

* * *END OF TRANSCRIPT* * *<\/strong><\/p>\n

# # #<\/strong><\/p>\n<\/div>\n

Media contacts<\/h4>\n

For more information contact:
\nErika Masonhall
\nNBC News
\no: (212) 664-3230
\nc: (917) 628-8943
\ne: erika.masonhall@nbcuni.com<\/a><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Burwell: \u201cfocused on transparency\u201d Jindal: \u201cRepublicans should do everything they can\u201d to stop Obama on immigration NOVEMBER 16, 2014 — Today\u2019s \u201cMeet the Press with Chuck Todd\u201d featured exclusive interviews with Health and Human Services Secretary Sylvia Matthews Burwell and Louisiana Governor Bobby Jindal (R), as well as a discussion on healthcare with Dr. Toby […]<\/p>\n

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