WASHINGTON -- Republicans have said repeatedly that the landmark health care reform law, upheld as constitutional by the Supreme Court last week, must be repealed and replaced. But the GOP leader in the U.S. Senate gave a surprising answer on "Fox News Sunday" when asked how Republicans would provide health care coverage to 30 million uninsured Americans.
"That is not the issue," Sen. Mitch McConnell said. "The question is how to go step by step to improve the American health care system. It is already the finest health care system in the world."
"Fox News Sunday" host Chris Wallace interrupted, "You don't think 30 million uninsured is an issue?"
"We're not going to turn the American health care system into a western European system," McConnell said. "That's exactly what is at the heart of Obamacare. They want to ... have the federal government take over all American health care. The federal government can't handle Medicare or Medicaid."
Wallace pressed McConnell, noting that the Affordable Care Act will prohibit insurance companies from not offering plans to individuals with pre-existing health conditions. "If you repeal Obamacare, how will you protect those people with pre-existing conditions?"
"Over the half of the states have high-risk pools that deal with that issue," McConnell said, assuring Wallace that the state programs could cover the tens of millions of uninsured Americans who have pre-existing health conditions.
Thirty-five states now have high-risk pools, covering about 208,000 people. Those policies are open to individuals with pre-existing health issues but often come with high premiums, waiting periods and coverage exclusions for certain conditions.
The Affordable Care Act included a new federal high-risk pool (modeled on the state plans) called the Pre-Existing Condition Insurance Plan. So far, only 67,000 Americans have enrolled. The program will be phased out in 2014 when the law's broader provisions kick in.
Don Stewart, a spokesman for McConnell, offered some additional information about Senate Republican leader's position on health care insurance.
"If you watched the interview, it was clear that the Leader believes we need to focus on lowering costs, first and foremost," Stewart said in an email. "That is the best way to help the 250 million Americans who have insurance today, and to help the 47 million who do not. We need to make it affordable, but Obamacare -- in its rush to expand coverage to everyone -- actually drives up health care costs by $300 billion. If health care is more affordable, more of the uninsured can find coverage."
There are as many as 25 million Americans who lack insurance and have pre-existing conditions, and all together 50 million people are uninsured, according to government estimates. The White House expects 30 million Americans to gain insurance coverage as a result of the new law.
This story has been updated to include comment from Don Stewart, a spokesman for Senate Republican leader Mitch McConnell, and additional details about the number of people uninsured.