AUDIE CORNISH, HOST:
From NPR News, this is ALL THINGS CONSIDERED. I'm Audie Cornish.
MELISSA BLOCK, HOST:
And I'm Melissa Block. Two years ago, a backlash against the Obama administration's health care law helped propel Republicans to a House majority and today's Supreme Court ruling upholding the law prompted more Republican calls for repeal. Here's the speaker of the House, John Boehner.
REPRESENTATIVE JOHN BOEHNER: Today's ruling underscores the urgency of repealing this harmful law in its entirety.
BLOCK: Democrats, on the other hand, are thrilled with the ruling.
CORNISH: One of the key architects behind the design and passage of the Affordable Care Act was House Democratic leader Nancy Pelosi. She joins us now to respond to the ruling by the high court.
Welcome to the program.
REPRESENTATIVE NANCY PELOSI: Thank you, Audie. I'm really absolutely delighted with the decision of the court. It was a victory for America's families, for our children, for anybody with a preexisting medical condition or anyone who wants to be healthy.
CORNISH: For months, Democrats had expressly argued that the penalty charge under the new law was not a tax and it seems as though the court has described it as a tax, so what do you consider this?
PELOSI: What I call this is the free rider provision. Call it what you will, but the fact is that some people who will not, even though they're younger and healthier and have some resources, decide they're invincible and they're not going to pay into a system. So, when they get sick, then they think they can just dip into it and that makes it more expensive for other people. And so, in order to eliminate the free rider piece of this, there's a penalty to be paid if you don't want to participate. Call it what you will. What it does is lower cost for the American people and it's a fair way to go.
CORNISH: There's hardly any support for taxes of any kind on Capitol Hill. New taxes are generally a toxic idea in election campaigns, so does the court ruling make this more vulnerable to political challenge and to a repeal effort?
PELOSI: No. American people will now see through the confusion of it as they reap the benefits of the bill. I think that will be more eloquent than anything the Republicans can say.
CORNISH: At the same time, we heard House Speaker John Boehner today saying that they plan to repeal the health care law. They've already set a date for another vote on this.
PELOSI: Yeah. Well, you know what? That's going no place, but if they want to take a vote, we welcome the discussion. But they are just another example of the Republicans in Congress being hand maidens of the insurance companies. I don't paint all Republicans with that brush. I'm just talking about the ones in the House of Representatives and they will do anything to enhance the profits of the industry at the cost of the consumers and that's what their repeal is about.
CORNISH: And, on the issue of Medicaid, essentially, the court ruling has allowed for states to say if they don't want to participate, they don't have to and they can still continue with their Medicaid program?
PELOSI: Yes. That's right. And that's consistent with what we had in our House bill.
CORNISH: But does this create a patchwork of coverage? If you live in a state that...
PELOSI: No, it doesn't.
CORNISH: ...isn't going to participate, then you won't get to enjoy the expanded care.
PELOSI: I think that the consideration that states will get 100 percent Medicaid coverage, as provided for in the bill, for the first three years of the bill, begs the question, is a governor going to turn down 100 percent coverage without any matching funds from the state? This is policy and it's always choices to be made, but this is consistent with what we wrote in our House bill, so we feel comfortable with the Supreme Court decision.
CORNISH: And, lastly, does this essentially roll back the political atmosphere to 2010? I mean, it seems like the conservative activists who are speaking out today say that this is only pushing them to fight more.
PELOSI: The 2010 election was about nine and a half percent unemployment and that was something that was a shield that was very hard to penetrate with any message about health care. The other side was spending $200 million misrepresenting it, but I think this election in 2012 is going to be as was intend - about jobs, jobs, jobs, jobs. This bill creates four million jobs and the more people know about this act of Congress that has now been upheld by the court, the more popular it will be.
CORNISH: House minority leader Nancy Pelosi, thank you for speaking with me.
PELOSI: Thank you. Transcript provided by NPR, Copyright NPR.