Jan. 20, 2012 — On CNN last night, Republican presidential candidates Mitt Romney, Newt Gingrich, Rick Santorum and Rep. Ron Paul disputed each other’s positions on the health law and on abortion. The moderator was John King.
Here is a full transcript of the health care sections of the debate:
JOHN KING, DEBATE MODERATOR AND CNN CHIEF NATIONAL CORRESPONDENT: Let’s turn to our audience now.
Let’s turn now and take a question from down in our audience tonight. Go ahead, sir.
QUESTION: My name is Sonny Cohen. I’m from Sevier County, Tennessee. My question to any of the candidates is: Do any of you sincerely believe that Obamacare can either be repealed or reversed in its entirety?
KING: Let me go first to Governor Romney on that one.
Governor, you had said you would do it on day one with an executive order that would free the states up to opt out, waivers essentially to get out of that program. I know your friend, the South Carolina governor might like to have that option.
Help me understand as you do that how would it play out? And what happens to those, someone with a preexisting condition for example, who now has coverage under the president’s health care plan, or a young American, 22, 23, 24, who because of the changes in the law, can now stay a few extra years on their parents’ health care? What happens to them when you sign that executive order?
FORMER GOV. MITT ROMNEY (R-MA.), PRESIDENTIAL CANDIDATE: Well, first of all, the executive order is a beginning process. It’s one thing, but it doesn’t completely eliminate Obamacare. It’s one thing I want to get done to make sure that states could take action to pull out of Obamacare.
But number two, we have to go after a complete repeal and that’s going to have to happen…
… that — that’s going to have to happen with a House and a Senate, hopefully that are Republican. If we don’t have a Republican majority, I think we’re going to be able to convince some Democrats that when the American people stand up loud and clear and say, “We do not want Obamacare; we do not want the higher taxes; we do not want a $500 billion cut in Medicare to pay for Obamacare,” I think you’re going to see the American people stand with our president and say, “Let’s get rid of Obamacare.”
But we’ll replace it, and I’ve laid out what I’ll replace it with. First, it’s a bill that does care for people that have preexisting conditions. If they’ve got a preexisting condition and they’ve been previously insured, they won’t be denied insurance going forward.
Secondly, I’d allow people to own their own insurance, rather than just be able to get it from their employer. I want people to be able to take their insurance with them if they go from job to job.
So — so we’ll make it work in the way that’s designed to have health care act like a market, a consumer market, as opposed to have it run like Amtrak and the post office. That’s what’s at risk…
… at stake here. Do we — we — we go back to this. Ours is the party of free enterprise, freedom, markets, consumer choice. Theirs is the party of government knowledge, government — government domination, where Barack Obama believes that he knows better for the American people what’s best for them. He’s wrong. We’re right. That’s why we’re going to win.
KING: Mr. Speaker, you heard the skepticism. This is a southern Republican voter, but he’s skeptical. He knows how Washington works. He’s watched Washington work. He’s asking it be reversed in its entirety.
You — you were the speaker of the House. You understand how this works. How — how can it be repealed in this current political environment?
GINGRICH: Well, let me say first of all, if you’ve watched Washington and you’re not skeptical, you haven’t learned anything.
I mean, this — this system is a total mess right now. Second, can you get it repealed in total? Sure. You have to elect a House, a Senate and a president committed to that. It has to be major part of the fall campaign. And I think that, frankly, on our side with any of us, it’s going to be a major part of the fall campaign.
The American people are frightened of bureaucratic centralized medicine. They deeply distrust Washington and the pressure will be to repeal it. And a lot of what Governor Romney has said I think is actually a pretty good, sound step for part of the replacement.
I would always repeal all of it because I so deeply distrust the congressional staffs that I would not want them to be able to pick and choose which things they cut.
But let me make one observation. He raised a good example. Why is President Obama for young people being allowed to stay on their parents’ insurance until 26? Because he can’t get any jobs for them to go out and buy their own insurance.
I mean I have — I have an offer — I have an offer to the parents of America: Elect us and your kids will be able to move out because they’ll have work.
KING: Senator Santorum, you heard Governor Romney and you heard Speaker Gingrich. Do you trust them if one of them is the Republican party’s nominee and potentially the next president of the United States to repeal this?
FORMER SEN. RICK SANTORUM (R-PA.), PRESIDENTIAL CANDIDATE: The biggest — the biggest thing we have to do is elect a president. I think Newt’s right. The problem is that two of the people up here would be very difficult to elect on, I think, the most important issue that this country is dealing with right now, which is the robbing of our freedom because of Obamacare.
Governor Romney tells a very nice story about what his plan is now. It wasn’t his plan when he was in a position to do a plan. When he was governor of Massachusetts, he put forth Romneycare, which was not a bottom-up free market system. It was a government-run health care system that was the basis of Obamacare, and it has been an abject failure. And he has stood by it. He’s stood by the fact that it’s $8 billion more expensive…
… than under the current law. He stood by the fact that Massachusetts has the highest health insurance premiums of any state in the country. It is 27 percent more expensive than the average state in the country.
Doctors — if you’re in the Massachusetts health care system, over 50 percent of the doctors now are not seeing new patients — primary care doctors are not seeing new patients. Those who do get to see a patient are waiting 44 days on average for the care. It is an abject disaster. He’s standing by it. And he’s going to have to run against a president — he’s going to have to run against a president who’s going to say, well, look, look at what you did for Massachusetts, and you’re the one criticizing me for what I’ve done? I used your model for it. And then…
… then we have Speaker Gingrich, who has been — who has been for an individual mandate, not back when the time that just was — Heritage was floating around in the ’90s, but as late as comments since 2008, just a few years ago.
He stood up and said that you should have an individual mandate or post $150,000 bond. How many $150,000 bond holders do we have here who can post a bond for their health insurance?
These are two folks who don’t present the clear contrast that I do, who was the author of health savings accounts, which is the primary basis of every single conservative reform of health care.
I was the author of it back in 1991 and ’92, 20 years ago. I’ve been fighting for health reform, private sector, bottom up, the way America works best, for 20 years, while these two guys were playing (inaudible) with the left.
KING: I want to bring Congressman Paul — bring you into the discussion in just a moment. But Senator Santorum directly challenged the governor and then the speaker. Governor, you first.
ROMNEY: Well, so much of what the senator said was wrong. Let me mention a few of the things. First of all, the system and my state is not a government-run system. Ninety-two percent of the people had their own insurance before the system was put in place and nothing changed for them. They still had the same private insurance. And the 8 percent of the uninsured, they brought private insurance, not government insurance.
And the people in the state still favor the plan 3-1. And it certainly doesn’t work perfectly. Massachusetts, by the way, had the highest insurance costs before the plan was put in place and after. But fortunately, the rate of growth has slowed down a little less than the overall nation.
And one of the things I was proud of is that individuals who wanted to buy their own insurance saw their rates — when they were not part of a big group — saw their rates drop by some 40 percent with our plan.
Is it perfect? Absolutely not. But I do believe that having been there, having been in the front lines, showing that I have compassion for people that don’t have insurance but that the Obama plan is a 2,700-page massive tax increase, Medicare-cutting monster. I know how to cut it. I’ll eliminate it. I will repeal it. And I’ll return to the — I’ll return the power to the states, where the power for caring for the uninsured ought to reside constitutionally. Thank you.
KING: Senator Santorum, he says your facts are wrong.
SANTORUM: Well, they’re simply not wrong. The fact is that, yes, you’re right, Governor Romney. Ninety-two percent of people did have health insurance in — in Massachusetts. But that wasn’t private- sector health insurance. A lot of those people were, as you know, on Medicare and Medicaid. So they’re already on government insurance, and you just expanded.
In fact, over half the people that came on the rolls since you put Romneycare into effect are fully subsidized by the state of Massachusetts. And a lot of those are on the Medicaid program.
So the idea that you have created this marketplace in — with this government-run health care system, where you have very prescriptive programs about reimbursements rates. You have very prescriptive programs just like what President Obama is trying to put in place here.
You’re arguing for a plan; you’re defending a plan that is top-down. It is not a free-market health care system. It is not bottom-up. It is prescriptive and government. It was the basis for Obamacare.
And you do not draw a distinction that’s going to be effective for us just because it was the state level, not the federal level.
KING: If you want, Governor, quickly?
ROMNEY: Sure, absolutely. First of all, as you probably know, Medicaid is not a state program.
SANTORUM: Of course it is. It’s a state and federal program.
ROMNEY: Medicaid is as demanded by the federal government and it is — it’s a mandate by the federal government and it’s shared 50/50, state and federal.
The people of Massachusetts who are on Medicaid — I would like to end that program at the federal level, take the Medicaid dollars and return them to the states and allow states to craft their own plans. That would make the plan we had in Massachusetts a heck of a lot better.
My view is get the federal government out of Medicaid, get it out of health care. Return it to the states. And if you want to go be governor of Massachusetts, fine. But I want to be president and let states take responsibility for their own plans.
KING: Mr. Speaker — it may seem like a while ago, Mr. Speaker, but Senator Santorum made the point, in his view, you don’t have credibility on this issue.
GINGRICH: No, what he said, which I found mildly amazing, was that he thought I would have a hard time debating Barack Obama over health care. Now, in fact, I — as Republican whip, I led the charge against Hillarycare in the House. As Speaker of the House, I helped preside over the conference which wrote into law his idea on health savings accounts. So I was delighted to help him get it to be a law.
And the fact is, I helped found the Center for Health Transformation. I wrote a book called “Saving Lives and Saving Money” in 2002. You can go to healthtransformation.net and you’ll see hundreds of ideas, none of which resemble Barack Obama’s programs.
So I’d be quite happy to have a three-hour Lincoln/Douglas style debate with Barack Obama. I’d let him use a teleprompter. I’ll just rely on knowledge. We’ll do fine.
KING: Senator, I want to bring Congressman Paul in. You’re shaking your head. Quickly.
SANTORUM: The core of Obamacare is an individual mandate. It is what is being litigated in the Supreme Court right now. It is government, top-down, telling every business, every American what kind of health care you will have. That is the problem with Obamacare at the core of it, and the Speaker supported it repeatedly for a 10-year period.
So when he goes and says, I can, you know, run rings around President Obama in a Lincoln/Douglas debate, you can’t run rings around the fact, Newt, that you supported the primary, core basis of what President Obama’s put in place.
GINGRICH: Look, just one —
KING: Quickly, Mr. Speaker. The congressman’s getting lonely down here. Let’s go.
GINGRICH: Just one brief comment. Of course you can. I can say, you know, I was wrong and I figured it out. You were wrong and you didn’t.
SANTORUM: Newt, you held that position for over 10 years. And, you know, it’s not going to be the most attractive thing to go out there and say it took me 10 or 12 years to figure out I was wrong when guys like Rick Santorum knew it was wrong from the beginning.
KING: Congressman Paul, you have the floor. Do you trust these men to repeal Obamacare?
REP. RON PAUL (R-TX.), PRESIDENTIAL CANDIDATE: Thank you.
PAUL: I thought you were — I thought maybe you were prejudiced against doctors and a doctor that practiced medicine in the military or something.
No, I want to address the question. The gentleman asked whether he thinks we can repeal Obamacare.
Theoretically, we can. The likelihood isn’t all that good.
We can diminish some of the effect, but I’m more concerned about a bigger picture of what’s happening. And that is, government involvement in medicine.
I had the privilege of practicing medicine in the early ’60s before we had any government. It worked rather well and there was nobody out in the street suffering with no medical care.
But Medicare and Medicaid came in and it just expanded. But even when we had the chance to cut back on it, when we had a Republican Congress and a Republican president, we gave them prescription drug programs. Senator Santorum supported it. You know, that’s expanding the government.
PAUL: So — and most of them are bankrupt. Prescription drugs, they’re not going to be financed. Medicare’s not financed. Medicaid’s in trouble. But nobody talks about where the money’s going to come from.
Now, even in my budget proposal, which is very, very tough, because I’m going to cut $1 trillion the first year, but I try to really —
PAUL: Even though these programs should have never started but a lot of people depend on it, I want to try to protect the people who are dependent on medical care.
Now, where does the money come? My suggestion is, look at some of the overseas spending that we don’t need to be doing.
PAUL: We have troops in Korea since the Korean War, in Japan since World War II, in Germany since — those are subsidies to these countries. And we keep fighting these wars that don’t need to be fought. They’re undeclared. They never end. Newt pointed out that World War II was won in less than four years. Afghanistan, we’re there for 10 years. Nobody says where’s the money coming from?
We could work our way out of here and take care of these people with these medical needs. But we can’t do it with the current philosophy of the government taking care of everybody forever on medical care, cradle to grave, and being the policeman of the world.
We will get rid of all this government program, unfortunately because we’re going bankrupt and you’re going to have runaway inflation, and our checks are going to bounce. And that’s going to be a lot worse problem than we’re facing tonight.
And here’s what the candidates had to say on abortion:
KING: I think we have nodding heads. I assume we have agreement on that. But let’s move on to another issue that came up in the campaign right here in South Carolina this week, and that’s the life issue.
Mr. Speaker, your campaign sent out a mailing to South Carolina Republicans across this state essentially questioning Governor Romney’s commitment on this issue, saying that he has changed his position on the abortion issue.
If you’ll recall, I moderated a debate back in New Hampshire in June. There were seven candidates then. We have four tonight. But when this came up, we talked about it briefly, and then I asked, is this fair game, an issue in this campaign, or is it case closed?
Mr. Cain, who was with us at the time, said case closed, and I paused. No one else took the opportunity to speak up.
If it was case closed then, why is a legitimate issue now?
GINGRICH: You just said nobody else spoke. So nobody else said, yes, it’s case closed. I mean, Herman Cain said it was case closed, the rest of us, it wasn’t a particular issue we wanted to fight that night.
I mean, we are allowed to run our own campaigns, John. It’s not an automatic requirement that we fit in your debate schedule.
This is — look, this is a very straightforward question. Governor Romney — and I — and I accept this — I mean, Governor Romney has said that he had a experience in a lab and became pro-life, and I accept that.
After he became pro-life, Romneycare does pay for tax-paid abortions. Romneycare has written into it Planned Parenthood, the largest abortion provider in the country, by name. Does not have any right to life group written into it.
He did appoint pro-abortion judges. And a branch of the government which included his appointees did agree to fund an abortion clinic for Planned Parenthood. All that occurred after he had become pro-life.
Now, those are all facts which we validated, and it seems to me that’s a legitimate part of the campaign, is to say, “OK, if you’re genuinely pro-life, how come these things are occurring?”
KING: Governor Romney, he questions whether you’re genuinely pro- life.
ROMNEY: I’m not questioned on character or integrity very often. And I don’t feel like standing here for that. But let me clarify the things which are wrong in what the speaker just said. And — and he can get a scintilla of truth in there to make it seem like this is a significant issue. But let’s go through one by one.
First, in Romneycare there’s no mention of abortion whatsoever. The courts in Massachusetts, the supreme court was the body that decided that all times if there was any subsidy of health care in Massachusetts that one received abortion care. That was not done by the legislature. Would not be done by me either. I would have vetoed such a thing. That was done by the courts, not by the legislature or by me.
Number two, it’s true, somewhere in that bill of ours, 70 pages, there’s the mention of the word Planned Parenthood, but it describes a person at a technical advisory board about payment structures. There’s no requirement or no participation of Planned Parenthood in our health care plan.
With regards to judges, I appointed probably 50 or 60 judges, at the trial court level mostly, the great majority. These were former prosecutors, 80 percent of them former prosecutors. We don’t have a litmus test for appointing judges, asking them if they’re pro-life or not pro-life. These are people going after crimes and — and — and the like. I didn’t get to appoint any supreme court justices.
I am pro-life. And the Massachusetts Citizens for Life and several other family-oriented groups wrote a letter two weeks ago and said they’d watched my record, that I was an avidly pro-life governor. I’m a pro-life governor. I am a pro-life individual.
And — and I — I have to be honest here. It is — this is not the time to be doubting people’s words or questioning their integrity. I’m pro-life.
By the way, is there any possibility that I’ve ever made a mistake in that regard, I didn’t see something that I should have seen? Possibly. But you can count on me as president of the United States to pursue a policy that protects the life of the unborn, whether here in this country or overseas. And I’ll reverse the policies of this president.
KING: Mr. Speaker, he says you’re questioning his integrity.
GINGRICH: I’ll yield to Senator Santorum.
SANTORUM: I just want to make one point. And a lot of legislatures here — legislators here in the room and they — and they know this to be the truth, that if you write a piece of legislation and you — and you say medical care and you do not specifically mention that abortion is not covered, we know from every court decision at the state and federal levels that the federal courts and state courts will require it.
That is someone (sic) every governor knows, every state legislator knows. And so when Governor Romney did not put that in the bill, you can’t say, “Oh, gee, surprise, the court made us cover abortions.” He knew very well that the court would make them cover abortions. That’s number one.
Number — number two, what we’re talking about here is someone who’s not going to just check the boxes and say, “Yes, I’m pro-life.”
We’ve got a lot of folks who just whisper into the microphone that they’re pro-life, and then you have other people who go out and fight the battle and defend life and come out of the trenches and actually work to make sure that the dignity of every human life, innocent human life in this country is protected.
And I’ve done that.
And I — and I would say to you in — in contrast with Speaker Gingrich, who on the social issues, in particular when he was speaker and even afterwards, they were pushed on the back bench. There was a pledge to America that the Congress tried to put together in 2010. I got phone calls ringing off the hook that Speaker Gingrich went in and told them, “Keep social issues out of the pledge to America for the 2010 elections, and we need you to come in and help to try to convince these folks to put that back into the pledge.”
We don’t need someone who in the back rooms is going to say social issues in the front — are in the back of the bus, and then come out here and try to prevent they’re pro-life.
KING: Governor Romney and then Speaker Gingrich, he mentioned (inaudible). Very quickly.
ROMNEY: Senator, I — I admire the fact that you’ve been a stalwart defender of — of pro-life and in a state where that’s not easy. I was also a governor in a state where being pro-life was not easy. And I — and I battled hard. What came to my desk was a piece of legislation that said “We’re going to redefine when life begins.” In our state, we said life began at conception. The legislature wanted to change that to say, “No, we’re going to do it an implantation.” I vetoed that.
The legislature also said, “We want to allow cloning for purposes of — of creating new embryos for testing.” I vetoed that. The legislature did not want to abstinence education. I pushed and pursued abstinence education. There was an effort to also have a morning-after pill provided to, as I recall, young women in their teens. I can’t remember the exact age. I vetoed that.
I stood as a pro-life governor and that’s why the Massachusetts Pro- Life Family Association supported my record as governor, endorsed my record as governor. I — I did my very best to be a pro-life governor. I will be a pro-life president. I’m proud of that. I wrote about it in my book. My record is — is solid.
I appreciate your record. I hope you’ll appreciate mine.
KING: Mr. Speaker, he — he mentioned you specifically, and then we want to move on, but please respond.
GINGRICH: Well, the fact is that I voted with Henry Hyde, who was the leading pro-life advocate in the House for a generation. I had a 98.6 percent pro-life voting record. The only one we disagreed on was welfare reform, which they scored for reasons we never understood. Otherwise, it was a perfect record on — on pro-life.
When I was speaker, we twice passed a bill that actually Rick was — was very active in, to end partial-birth abortion. Twice, it was vetoed by Clinton, but twice we passed it.
In the 2010 election, the freshman class has the highest percentage of pro-life members ever in history, and my job was to maximize their winning. And the fact is, we won a huge victory in 2010 with the largest number of pro-life members ever elected in a freshman class.
KING: All right, let’s move on. Let’s take another question.
Congressman, I’ll (inaudible) on this one. Let’s — let’s take a question now from social media. Question — (inaudible), before we move on, do you want in on this issue? They want you in on this issue. Would you like in on this issue?
PAUL: John, once again, it’s a medical subject and I’m a doctor.
No, I do want to make a couple of comments because I can remember the very early years studying obstetrics and I was told — and it was before the age of abortion. And I was told taking care of a woman that’s pregnant, you have two patients. And I think that’s — that solves a lot of the problems of life — you know, when life begins and all.
And I also experienced a time later on in my training, in the 1960s when the culture was changing. The Vietnam War was going on. The drugs were there and pornography and everything came in. And abortion became prevalent, even though it was illegal. So the morality of the country changed, but then the law followed up. When the morality changed, it will — reflects on the laws.
The law is very important. We shouldn’t have these laws, but law will not correct the basic problem, and that’s the morality of the people that we must do.
Now, just very, very briefly, I want to talk a little bit about that funding because the flaw there is if you — if you send funding out and you say, “Well, you can have it for birth control, but not for abortion,” all funds are fungible. Even funds that go to any hospital if you say, “Well, it’s not for birth control and it’s not for Planned Parenthood and it’s not for abortion,” if you send it to the hospital, they can still use that money.
This is an indictment of government-run medicine because you never can sort that all out. You need the government out of that business or you will always argue over who’s paying what bills.
KING: Very quickly, Senator.
SANTORUM: I think that was directed at me, and so I would just say this. Congressman Paul has a national right-to-life voting record of 50 percent, which is pretty much what Harry Reid’s national right to life voting record is.
So for — to go out and say that you’re someone who stands up for the right to life, you repeatedly vote against bills on a federal level to promote the right to life. And you say that this is an individual, a personal decision, or state decision. Life should be protected, and you should have the willingness to stand up on a federal law and every level of government and protect what our Declaration protects, which is the right of our creator to life, and that is a federal issue, not a state issue.
KING: Quickly, sir.
PAUL: Just for the record, I wasn’t even thinking about you when I was giving my statement, so you are overly sensitive.
PAUL: But it is true that we have a disagreement on how we approach it. I follow what my understanding is of the Constitution. And it does allow for the states to deal with difficult problems.
A matter of fact, it allows the states to deal with almost all the problems if you look at it. It is not given — these powers aren’t given to the Congress.
I see abortion as a violent act. All other violence is handled by the states — murder, burglary, violence. That’s a state issue.
So don’t try to say that I’m less pro-life because I want to be particular about the way we do it and allow the states the prerogative. This is the solution. This is the solution. Because if we would allow the states to write their laws, take away the jurisdiction by a majority vote in the Congress, you repeal Roe versus Wade overnight, instead of waiting year after year to change the court system.KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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