MSNBC host Ali Vitali sits down for an exclusive one-on-one discussion with Senate Majority Leader Sen. John Thune (R-SD) about the continued government shutdown. Thune said that he has privately told Democratic leaders that, if they need a vote on extending Obamacare subsidies in exchange for opening the government, he’s willing to make that deal. Thune said he was turned down by Democratic leadership. “We can guarantee you get a vote by a date certain,” Thune said. “At some point, Democrats have to take ‘yes’ for an answer.”

ALI VITALI, HOST:  Leader Thune, I’m so thankful that you came and sat down with us, your first time on MSNBC as leader. So we’re thankful that you’ve given us the time.     I spoke with your colleague, Mike Johnson, about two weeks ago.  And the first thing that I asked him was Americans are starting their open enrollment process in — in October and November.  At the time, he maintained that these negotiations could wait because that date was pretty far off.  But we’re two weeks deeper in now to the calendar.     So I’ll ask you the same question, for folks who are making their open enrollment decision now, shouldn’t they have the ability to know what they’re dealing with?  And shouldn’t you do negotiations on Affordable Care Act subsidies?     SEN. JOHN THUNE (R-SD), SENATE MAJORITY LEADER:  Right.  And if we can just open up the government, we could do that.  And I think that’s the — that’s really the order, Ali, that it needs to happen in.  I mean, I don’t think taking the federal government hostage to try and get this negotiation started is the right approach.  I mean, honestly, I think we — we have made it very plain.  We want to fund the government.  We want to have a normal appropriations process.  And, yes, we are happy to sit down and talk about a solution on the ACA tax credits.     But that needs to happen in a separate context on — you know, away from having the government open up.     VITALI:  But how can you tell families that they might be paying more without knowing what they’re signing up for at this point?     THUNE:  Well, and I think the — when the enrollment period starts, which is November the 1st, yeah, people are going to start looking.  And the insurance companies are putting rates out there, quotes out there.  And they’re going to have to make some decisions about that.  I don’t think you can do a — if you do a straight up extension of the ACA tax credits, premium tax credits, they are enhanced subsidies.  So they are over and above the base Obamacare program, which was available to people up to 400 percent of poverty.     What the Democrats did a couple of years ago is they took the income cap off.  So now you’ve got people that are making 500,000 or $ 600,000 year that are eligible for, qualifying for, and getting subsidies under this program.  You’ve also got insurance companies that are benefiting enormously because they get — they’re incentivized to sign people up, because the federal government is making direct payments to the insurance companies.  They go out, auto-enroll people.  There are tons of people out there who have these policies who don’t even know they’re covered.     So this — this is a program that’s desperately in need of reform.  And that’s — and that’s…   VITALI:  But can you guarantee that you guys will work to reform it?     THUNE:  Well, and I — that’s what I’m saying.  I mean, I think that there’s an interest in the White House.  I think the House, the Senate, there is an interest in making the health care that people buy in this country through the exchanges or any other place, for that matter, more affordable.  And one of the ways you have to do that is you’ve got to change that incentive structure that’s currently baked into these enhanced COVID credits which, by the way, the Democrats created the expiration date when they did this.  They could’ve done this permanently and they didn’t.   VITALI:  I hear that.  But at the same time, when you see estimates from the Kaiser Family Foundation, for example, that says on average, a 60-year-old couple making $ 85,000 would see premiums in 2026 rise by over $ 22,000.  Are you sympathetic to families like that who say, OK, I hear the policy, but I actually just don’t want to pay more for health care next year?  Can you guarantee that?     THUNE:  Well, and I — and I would say, and, again, I don’t want to see anybody’s premiums go up by that amount.  And that’s not going to be attributable exclusively to these enhanced credits.  The insurance companies are raising rates everywhere every year anyway.  And part of the reason for that is the basic — the basic program is flawed.  People ought to be able to buy the insurance that they want.  And, you know, they — they are in the exchanges and every year these premiums keep going up.  And that’s not the way this ought to work.     I mean, these — these premiums are going up a little bit because of — if the expiration of the enhanced premium tax credits, but…    VITALI:  I think people hearing it doubling don’t feel that it’s a little bit.     THUNE:  But — no, but I’m just saying, but only a small part of that is attributable to the expiration of the enhanced premium tax credits.  A lot of it is the base program doesn’t work for the reasons I mentioned.     (CROSSTALK)    VITALI:  So then what assurances can you offer Democrats that they will get a negotiation on this?     (CROSSTALK)    THUNE:  Well, I mean, I think — yeah, well, I’ve told them.  I’ve said — and I’ve said, we are willing to have the conversation.  I’ve said, if you need a vote, we can — we can guarantee you get a vote by a date certain.  At some point Democrats have to take yes for an answer.     But I’m — I agree totally, we are all about getting health insurance down, making it affordable to more people.  Premiums shouldn’t be going up by that amount.  And one of the reasons they are is because there is waste, fraud, and abuse in this program and the incentive structure is skewed to the insurance companies.  So the insurance companies have no incentive to lower costs.  All they go out is auto-enroll people and they’re making — they’re making bank doing it.     VITALI:  So I hear you saying about the program that needs to reform, it sounds like you’re guaranteeing that there will be a negotiation on this.     THUNE:  Well, what I’m saying is there is a — there’s a path forward, I believe.  But it has to…   VITALI:  But yes or no?     THUNE:  But it has to include — it has to include reforms.  And, you know, can I guarantee an outcome?  No.  I mean, and that’s what — and that’s what people want to see, guarantee us that this is going to pass.  I can’t guarantee it’s going to pass.  I can guarantee you that there will be a process and you will get a vote.     VITALI:  So if Democrats came to you and said, OK, let’s do a one-year extension at $ 35 billion for that one year, would you personally vote for that?  Would you say yes?     THUNE:  Well, I think you’d have to do something to reform it.  I think it’s really hard to extend the program…   VITALI:  With those — with reforms, or with income caps…   THUNE:  Well, let’s reform — so it’s reforms and if you did reforms, it probably doesn’t cost you $ 35 billion a year.     VITALI:  So you’d say yes to that.     THUNE:  Well, I think you’d have to — if you — if you structure it in a way that did away with — you know, took — at least put some income cap in there, like the program used to have prior to these enhanced — and these — these were COVID subsidies.  You know, this was in response to COVID.  COVID is no longer with us.  And so the program — the people who were designed to take advantage of this program that are people of 400 percent of poverty and under.  Now you’ve got people making half a million, 600,000 grand a year that are benefiting from the subsidies.     So I’m saying that it’s a program that needs to be reformed and give us — you know, get the government open again and let’s have that conversation about how to fix it.  

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