Transcript: Reps. Altmire, Adler on 'FNS'

The following is a rush transcript of the March 7, 2010, edition of "Fox News Sunday With Chris Wallace." This copy may not be in its final form and may be updated.

CHRIS WALLACE, ANCHOR: It's no exaggeration to say our next guests will be among the most powerful people in Washington the next few weeks. They are House Democrats who voted "no" on health care reform the first time around, and the president needs a number of them to switch their votes to "yes" if his plan is to have any chance for passage.

Jason Altmire is a second-term congressman from Pennsylvania. John Adler is a first-term member from New Jersey.

And, Congressmen, welcome to "Fox News Sunday."

Both of you, as we say, voted against health care reform in the House in November because you both said that you felt that it failed to contain costs.

Are you satisfied — and we'll start with you, Congressman Altmire. Are you satisfied with the Senate bill? Will you vote for it?

REP. JASON ALTMIRE, D-PA.: I need to see the recreation package. That's the key component — the amendment to the Senate bill. But there's no question in my mind the Senate bill was much stronger than the House bill on cost containment, and it did away with some of the things in the House bill that I was concerned about, the income tax increase and the employer mandate.

So I think we have a much better product to work with, but I need to see the CBO score on the finished package and the revisions.

WALLACE: All right. We're going to talk about the revisions in a minute. But I get the sense, Congressman, that you are leaning towards switching your vote.

REP. JOHN ALTMIRE, D-N.J.: Well, I wouldn't say that. I have an open mind. I'm considering the bill. I am talking to my constituents in this process, too. They're a big part of this. But in the end, I have to make a decision between passing this bill — this is the finish line — or doing nothing. And I'm weighing the balance between the two.

WALLACE: Congressman Adler?

ADLER: Well, I think we actually have to know what the bill says. I'm one of these guys that believes I should read the bill first before I make up my mind.

Having said that, I think there were some pieces in the Senate bill that were missing. The House bill also, I think, failed to address cost containment. So I'm worried about my businesses in my district, around the country, and whether they can afford to pay for insurance for their employers or whether it'll go up 20 percent a year as they have for the last several years.

If the House and the Senate can't work out cost containment, I don't see how I could support a bill that doesn't help our business community and create more jobs.

WALLACE: I get the impression — I failed with Congressman Altmire. I get the impression you're leaning no.

ADLER: Well, we need health care reform. I'm not sure the bills coming through the House and Senate really address health care reform, delivery reform, and that involves cost containment and changing the way we reimburse for fee-for-service system.

I think we don't have a good system in some ways, even though health care is good for a lot of Americans. And I'm not sure we've gone far enough in terms of fixing the underlying system to make it affordable for businesses and for taxpayers.

WALLACE: All right. Let's talk about fixes. For health care reform to pass, first of all, you in the House would have to pass the Senate bill as-is. Then you would have to pass what you're calling the fixed bill, the reconciliation bill, which would have a number of changes in it to the Senate bill.

Let me ask you first of all, Congressman Altmire, because we've seen this happen before, where the House passes something and it dies in the Senate, do you trust the Senate to pass the reconciliation bill?

ALTMIRE: The Senate has given us a lot of reason not to trust them. Certainly, that's a key component of the dynamic of getting the votes — is there has to be some certainty that the Senate is going to follow through on their part.

WALLACE: So that would give you some concern, then, about just passing the Senate bill and wondering whether the fix will ever go through the Senate.

ALTMIRE: It gives me concern, but look. My constituents put me in Washington to cast tough votes on their behalf. I'm not afraid to take the vote. But certainly, for it to pass, the Senate's going to have to follow through.

WALLACE: Specifically, Congressman Altmire, what fixes, two or three key fixes, do you need to see in this, quote, "reconciliation" bill for you to go along with this whole package?

ALTMIRE: I need to see a much clearer picture of the cost containment, bringing down the cost of health care for people who have it now.

The bill does a good job on insurance reforms, making sure that you can't do preexisting conditions exclusions and the rest.

It does a good job on coverage, getting the young and healthy people into the system and improving access.

The House bill didn't do such a good job on bringing down the cost for people who have it now.

WALLACE: So tell me one specific thing you would like to see in the fixes.

ALTMIRE: Value-based purchasing, bundling.

WALLACE: All right, which means what?

ALTMIRE: Quality, reimbursing based on the quality of care, not quantity of care. Right now, the doctor gets reimbursed every time you come to see them. Every test they run, every procedure they order, they make more money. I think they should be reimbursed based on the quality of care, not quantity.

WALLACE: But, Congressman Adler — and I get the sense that's the kind of thing — you nodded — that you would like to see. I mean, there was talk about that for a year and they never got it done. I think the chances that they're going to do that kind of wholesale addition or change to the Senate bill is very unlikely in the — in the reconciliation process.

ADLER: Well, you've got people like Jason and me that are raising that issue in a very clear way. I think we have some leverage to try to make a better bill that actually really meets the needs of America's taxpayers, America's patients and America's business community as insurance purchases for years to come.

There are a bunch of pilot projects in the bill. If instead of having them be pilot projects we actually mandated that the good pilot projects were implemented to save money, to improve outcomes for patients, and to save money for people buying insurance, that would be something that would really serve America's economy well for years to come.

WALLACE: Congressman Altmire, you are pro-life, but you voted against the House bill even with the Stupak amendment, which really very sharply limited — some would say banned — any use of federal funds for anything that would approach subsidizing abortion.

How big an issue do you think abortion is going to be in deciding whether or not this passes the House?

ALTMIRE: Well, I think given the vote dynamic, abortion may be the decisive issue. There is a block of voters who voted for the Stupak amendment — I voted for the Stupak amendment — who say that they're not going to vote for the finished product unless they tighten the abortion language that's in the Senate bill. So we may see some vote holdouts based on that issue.

WALLACE: Let's talk — as I mentioned at the beginning, only half kidding, you are going to be two of the most important people in Washington over the next few weeks.

Let me start with you, Congressman Adler. What kind of attention slash pressure are you getting from the White House and from the House to go along and switch your vote?

ADLER: I will tell you I've had a very respectful conversation with the president some weeks ago about cost containment. He seemed to understand what I was talking about and really wanted to try to fix things that — as I was laying out.

I've spoken with the speaker. She had been very gracious in considering my comments. I think she's looking elsewhere for votes right now.

But we have to find a way to solve America's real problems. Health care costs are one of those problems. I'm not sure that's adequately addressed yet in the bill that's being talked about.

WALLACE: Have they given you any specific commitment that they're going to do something that you asked for?

ADLER: Frankly, I'm not feeling pressure from the people in the Washington. I'm feeling pressure from people in my district to try to meet needs for business people, to try to create a stronger economy, get people back to work. That's what I'm about.

WALLACE: Congressman Altmire, what kind of pressure are you getting? And are you getting any offers of, "Gee, maybe we could do something for your district?"

ALTMIRE: I haven't gotten any offers unrelated to health care policy. I've been involved in this from the start. I'm on one of the committees of jurisdiction. Health care is my professional background. So for me, it's a continuing conversation.

And I have spoken with the president about it very recently. And again, it's all on policy. It's what my concerns are in the bill. And in the end, again, this is going to come down to whether or not we do nothing or whether or not we pass the bill.

I think the worst possible thing we could do is pass a bill that makes the system worse. But a very close second is to do nothing, because if we do nothing, business owners are going to continue to see double-digit rate increases. Seniors are going to continue to see Medicare increases.

WALLACE: All right. We've got a couple of minutes left. I want to talk some politics. Some would say we've been talking it all along.

Congressman Adler, you come from a district that had not, prior to you, had a Democratic congressman — I think it was for more than 100 years. So question: If you switch from a "no" vote on health care reform — you know, because a lot of people aren't going to get all the nuances — to a "yes" vote, don't you put a big target on your back come November?

ADLER: Chris, I think the politics of all this will work itself out. I think I was elected to do what was right, to represent my district and help our country for a two-year term. That's what I'm focused on.

So I'm not worried about election stuff. I'm worried about trying to help the business community, taxpayers, and our future as a society.

WALLACE: Congressman Altmire, you're one of the Democrats who won in 2008 in a district that John McCain also carried. Wouldn't switching your vote from "no" to "yes" give Republicans a big argument to use against you?

ALTMIRE: Using the word "switch" implies that this is the same bill. As I outlined, this is a very different finished product than where we were the first time we voted on this in November.

Number one for me is where my constituents are. I'm not going to cast a vote that my constituents aren't comfortable with. I feel like they want health care reform. There is a level of unease with this package. And it's my job to talk with them about it and cast a vote on their behalf.

WALLACE: And finally, quickly, the president has staked enormous prestige — some people say he's all in — on this issue.

Starting can with you, Congressman Altmire, are you prepared to hand the president a huge defeat by defeating health care?

ALTMIRE: I was sent here to represent my constituents. And what I'm doing is trying to impact the debate so that we can have a bill that I can vote for. I've told the president what my concerns are. If the finished product is something I can pass, I'll vote for it. If it's not, then I'm not going to be able to support it.

WALLACE: And no way you're leaning at this point?

ALTMIRE: No, I want to see the finished product. I need to see the CBO score.

WALLACE: And, Congressman Adler, are you prepared to give the president a defeat that would substantially weaken his standing?

ADLER: I think this should be about trying to create jobs for the unemployed in our country, helping our business community, making sure that the soldiers and Marines overseas finish their job in Afghanistan and Iraq.

I wouldn't say this is the only issue facing America. I'm supposed to do what I think is right for my district and my country.

WALLACE: Congressman Altmire, Congressman Adler, thank you both so much for coming in. We and a lot of other people will be watching to see how you vote.

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