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Rep. John Katko on healthcare, Trump's budget, his own future, and more

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Rep. John Katko (R-Camillus)

Rep. John Katko (R-Camillus) joined Grant Reeher for this week's edition of the Campbell Conversations. Topics included his recent public forum in Oswego, the healthcare debate in Washington, President Trump's proposed federal budget, his own political future, and much more. 

Note: Transcript has been edited for style and clarity

Grant Reeher (GR): Welcome to the Campbell Conversations I'm Grant Reeher and my guest today is Congressman John Katko. He represents New York's 24th Congressional District which includes all of Cayuga, Onondaga and Wayne Counties and the western portion of Oswego County. Congressman Katko was last on the program a couple of days prior to President Trump's inauguration. But a lot has changed since then. Congressman Katko, welcome back to the program.

John Katko (JK): Thanks for having me back, and I think it's a colossal understatement to say that few things have changed since a couple of days before the inauguration.

GR: Let me start with something about you and your office and then we'll get to some of those issues. You held the first public forum of your second term last week. It was in Oswego and it was focused on the theme of opioid addiction and the opioid epidemic. First of all just generally, how did the forum go did you have fewer protesters than you expected at that?

JK: Yeah we did and actually we had a great substantive conversation and we took questions on both the heroin itself and the whole epidemic, which dominated a lot of the conversation. But as more we discuss things, more we wove in many other topics. Affordable Care Act, you know, the border issue, the wall, many many issues that weren't to the heroin as well, So, it was a good substantive conversation all around and it went very well.

GR: Do you have any specific plans to hold a similar forum in Syracuse that you can share with us?

JK: Oh absolutely. We just we haven't scheduled it yet because I've been in Congress the last six weeks. I'm going down today for the sixth straight week actually, and things are going to start loosening up on our schedule and as they do we're going to continue to have these theme-based forums and we're going to open up the discussion at times to other topics as well. So yeah, we're going to have plenty of these and we've done that before. We did about eight of them last term and are going to continue to do the same thing.

GR: OK let me ask you a question about the opioid problem. I think first of all to put this problem in perspective it's worth noting that drug overdoses kill almost four times as many people as homicide with a gun. It's really quite an epidemic. I wanted to get your sense drawing on your background as a prosecutor who worked on drug crime, among other things, of how you see the source of this problem breaking down in terms of supply versus demand. Is one of those two things driving the problem more than the other, you think?

JK: Well, I think once you create the demand the supply will follow obviously. When I was on the southwest border as a federal prosecutor for a couple of years in the mid 90s, back then we were seizing large quantities of cocaine, of course. But mixed in with cocaine was large quantities of methamphetamine. What they would do is they would just put it, give it as part of the load for free to create the demand. And then of course subsequently it was dealing with a meth epidemic in other areas. So they did the same thing with heroin. And the heroin, the biggest difference with heroin compared to the others, is that heroin is killing people at a much greater pace than any drug I've ever seen before. And it's because it's more lethal, more pure, but also the mixing with major synthetic drugs like fentanyl, which are killing people. That forum we had in Oswego last week, the night before there was seven heroin overdose deaths Buffalo in one night. And that's kind of something that you don't see with any other drug, so it's really a difficult thing. And now there is enforcement, there is prevention, and there's treatment. You need to have all three. And they're just addressing one is not going to do it well.

GR: On that point, tell me if you can a little bit more specifically what you think are the most effective things that we can do through government to address the problem, and then also as a society what can we do to address the problem?

JK: Well first of all, the treatment centers and the availability of treatment is woefully inadequate in this country, and I'll give an example here in Syracuse. Crouse Chemical Dependency, which loses money doing this, but they do it because they're morally sound. They have a dependency treatment center that treats about 500 people at a time for heroin addiction. They have upwards of 500 people at any one time on a waiting list. Many of those people never get to treatment because they die before they get there. And having enough treatment facilities is really critical and having enough long term treatment facilities are critical and they're lacking in both of those. And you know the other thing we have to do is obviously we have to try and tamp down the supply, and securing the borders is really going to help with that, because it's all coming across the southwest border. So, it's a major problem but you need all three things, treatment, prevention and enforcement. And we've done several things in the House. We had a Comprehensive Addiction Recovery Act. We've had, this Congress, I've been really advocating for more of that and more coverage and also a 21st century cure addresses part of the addiction issue. And I'm working on synthetic drug legislation again this term like I did last term.

GR: I had somebody on the program about a year ago that had done an in-depth investigation of synthetic marijuana and it was really striking to me just how dangerous that drug was. Can you speak a little bit about your perception of how that's playing out here in this district, the synthetic drugs?

JK: Theresa Woolson, I met her. The mother of a young man who died just smoking synthetic marijuana and she's in Oswego and I met her when I was first running for office and we're very good friends now. And she was at the forum the other night as well. The thing about synthetic drugs is technically not illegal, because unless they're listed on the chemical compositions listed on the DEA list, then you know technically they can sell them right over-the-counter. They do it at gas stations, bodegas, and what have you. And they come from China and what you have to do is basically get the chemical composition identified and get it listed. It's about a two year process. And the legislation I'm trying to pass is going to speed up that process so we can keep up more with that. But the problem is every time you identify a chemical composition, the bad guys in China just change it a little bit and it becomes legal again. So it's a really difficult thing to encounter.

GR: I'm Grant Reeher and I'm speaking with Congressman John Katko who represents New York's 24th Congressional District. You mentioned the importance of treatment centers in this particular problem, and that kind of is a segue into what's happened with the consideration of the repeal and replacement of Obamacare. Because I know that was one of your concerns that you expressed when you said you weren't going to support that. Let me start with a more general question about Obamacare. And first if I could tease you a little bit on this. You really came out smelling like a rose on this one, because you were against it publicly but you never had to vote for it. So, the big full page ad from the Health Education Project in the Post-Standard last Sunday thanking you for that. But let me ask you a question about what's likely going forward. Paul Ryan's bill got squeezed between the right wing of his party, who wanted more dismantling, even less government commitment, to ensuring access to health insurance. And then folks like you, who thought the bill went too far in certain respects. And in the conversation that you and I had earlier this year, you've voiced concerns in particular about the Medicaid expansion piece being cut and the effects that it would have on New York State for instance. So, I wanted to get your sense here. What do you see as the most likely scenario for round two of this effort. The president is now making some noises that when he first said 'you know I'm moving on' now it seems like he may not be moving on, he may be looking at this again. How do you think this is going to play out in the next year or so? Are we going to see a series of individual changes done separately, maybe eliminating the individual mandate, something bigger? Where are we going?

JK: Lord only knows, is the answer. I'm not trying to be smug by saying that, but one thing's for sure. We're going to have to do something, because everybody on every side of this equation, analysts to the market makers and insurance companies, everybody says the same thing and that is that this is absolutely positively going to collapse under its own weight if we don't do something about it. So absolutely we got to do something. And what we do is going to be up in the air. I can see them taking another stab at a major piece of legislation. I think they're going to try and use somewhat of the same framework they have now and try and tweak it a bit. But my concern is that they seem to be punishing Medicaid expansion states like New York, and that's a huge concern for me because the current iteration that they were trying to pass last week, or two weeks ago, called for about 7 billion with a 'B', $7 billion in cuts to Medicaid in New York State. And that's pretty much unsustainable. So they didn't have enough replacement there for me. And unless they have more of a replacement ready to go in the next bill that's not going to get my support either and I have made it perfectly clear to them. You juxtapose my position with a lot of the more conservative elements of the Republican Party, they simply want a straight repeal and a strict repeal without having replacement would send the markets into complete chaos, and of course, it would displace probably tens of millions of Americans who now have insurance. To me that's a nonstarter. So I think we've got to try and find a good market based solution that gets government out of the way, but still ensures that people have coverage and that's going to come in the form of some sort of a subsidy or something and we're going to have to do that going forward.

GR: One of the data points that got cited quite a bit in this debate was the Congressional Budget Office's estimate that 24 million people would lose coverage compared with what would have been the case if the law were to have continued and it's going to continue at least for now. Did you take that number and trust it? How did you view that because that was a linchpin of a lot of the discussion.

JK: Well it is the linchpin. It was like 12 to 24 million is the figure I saw from CBO. But the bottom line was, the question is would they be able to get insurance, would they be displaced from insurance initially? Absolutely. But would they be able to have the ability through these tax credits to go out and get insurance? Technically yes. Whether that's practically yes, I'm not I'm not so sure.

GR: And what about the Medicare piece of this. I mean Paul Ryan has long been an advocate of changing that program and pretty substantial ways. Is that something that concerns you in this discussion?

JK: It does, but quite frankly the Medicaid portion dominated my concerns more than anything. Medicare under Obamacare, they took $700 billion out of Medicare over a 10 year term. So Medicare was already taken a pretty good hit as it was. So I thought that some of the things they should do is maybe restore some of those Medicare dollars to Medicare instead of taking  it from Medicare to put it over into the Affordable Care Act.

GR: Let me ask you a question about the budget. There seems to be a consensus that the president's proposed budget is going to be heavily altered.

JK: It's dead on arrival.

GR: Yeah, that's the phrase. But nonetheless, the proposed budget does contain a lot of cuts that could affect this area from Lake Ontario on down. So looking at it at least as it sits now, are there budgetary deal breakers for you that you're going to be watching as the negotiations proceed.

JK: Yeah I mean first I got to take a step back and remember the president doesn't create the budget, Congress does. We control the purse strings. We've done a pretty terrible job of doing that the last several years at least, because with a lot of continuing resolutions and we're not really exercising our power of the purse the way we should. The president's budgets now become have more of a conceptual framework for the president, but certainly not for us. And so I can see us tweaking and nipping and tucking like we've been doing. And quite frankly we're spending levels back I think at 2011 when Republicans first took over Congress and we continuously cut since that time, and we're going to continue to try to maintain fiscal responsibility and any budget is going to reflect that. But are we going to take a hatchet to problems? No. We should be taking a scalpel. And so these concerns that are out there based on the president's budget, I understand people are worried and I understand people are concerned but like, for example, the Great Lakes Restoration Initiative and Meals on Wheels and all these great programs and I support them all and I'll be advocating to make sure that they get adequate funding. All of them. But I do think that you know, all the agencies need to be as fiscally responsible they possibly can be and under this age of sequestration we really don't have a choice.

GR: You're listening to the Campbell Conversations on WRVO. I'm Grant Reeher and I'm talking with John Katko, a member of Congress from New York's 24th Congressional District. Well, another big issue coming up. It does seem likely that some kind of significant federal tax cuts are going to be passed. I mean that that looks like to be the case. And I wanted to link this to something that you talked about as a candidate when you first ran but also when you ran for reelection. You've talked about the problem of poverty in this district, particularly in Syracuse. The tax cuts that are being discussed are going to exacerbate economic inequality. I had the tax expert Len Berman on the program a few weeks ago, and he detailed that. I don't think that really is a controversial statement. So how are you going to fit those two things together when you're thinking about voting on those tax cuts? Are you going to be thinking about that issue of economic inequality?

JK: Yeah of course. But I am also trying to think of some of the practical fallout of the tax reform and that is that job creation. And I'll give you a quick example. I brought someone down, and I don't want to name the name because the projects project's not public yet, but he came down to Washington and we talked about tax reform. And he went to an event and he actually got to see the president there and he was so inspired when he came back he said "You know I bring in X amount of shipping containers a year from China' and he goes 'I'm not going to do it anymore because I want to build a plant here in the city of Syracuse. And I want to create hundreds and hundreds of jobs and I want to hire people from the city of Syracuse to do it'. So, theoretically you can look on paper and say 'you know the tax cuts are going to advantage this person or that person'. But if we don't incentivize manufacturers to bring the jobs back here, then we're never going to be able to tackle the poverty issue. So, people in poverty don't want a handout they want a hand up, they want an opportunity and we've got to maintain their basic standard of living. We've got to make sure we take care of the less fortunate as a country but we've also got to give them opportunities. And if you don't have economic opportunity, you're done. And by doing this tax reform, I'm confident we're going to have economic opportunity and economic revitalization which critically is needed in this area.

GR: Now one area where the president does have a lot of latitude to act on his own is the environment, and he's already taken some of those actions and he's also signaled that there's going to be some other big changes there and that has a lot of people concerned. I wanted to press you on this issue a little bit, because I think this is an area where there's some evidence that suggests you may be a little bit more to the right. The League of Conservation Voters, it's a mainstream liberal environmental group, provides a yearly score on 100 point scale of voting for members of Congress. And for 2016 their average score for all members was 43. Yours was 26. Your score for the entire term was 21. For comparison Richard Hanna was 37. Elise Stefanik was 29. You recently voted for repeal of a rule, existing federal rule that was aimed at preventing coal mining waste from being dumped into streams and rivers. So I wanted to push you on those things and ask you is there anything you're seeing from the Trump administration in this area on the environment that you are particularly concerned about and you would consider joining an effort in Congress to provide some counterpoint.

JK: Of course there is. But you know I do want to correct the record a little bit. I mean when you make generalizations like saying 'well I voted for a rule that allows coal companies to dump waste into wastewater and streams' and that's not true. There's a thing called a Buffer Rule and it was just an artificial rule that kind of buffer from the stream to where the waste was. The thing is, they got to make sure waste doesn't go into the stream. But the way they set the rule up was designed to gut the coal industry. So, my mind is, of course the rules are already there they already exist. They should be robustly enforced. So it's not like I'm advocating for coal companies to dump waste in streams. I'm very much against that and they should be hammered when they do it. I grew up watching Onondaga Lake and it profoundly affected me and that's why I one of a few Republicans to join onto something called the Gibson Climate Resolution last term, and we're going to have another one this term. I think Ms. Stefanik is going to be the signatory on that. Just a small handful of Republicans who are acknowledging that man contributes to the climate change issue and that carbon emissions are part of the issue and we should we should do something about it and that's why I've been such a strong advocate of nuclear power, because to me, it's absolutely emission free, carbon free emissions for large amounts of energy that is going to serve as a bridge as far as I'm concerned, unless until such time that renewables are where they should be and I strongly support renewable energy tax credits for renewable energy, shifting funding from coal based tax credits to renewable energy. So these scorings are done in a different way. One is called the Citizens Climate Lobby, one of those that is a strong supporter of what I'm doing. So I have a pretty good environmental record and I stand behind it no problem.

GR: If you just joined us you're listening to the Campbell Conversations on WRVO Public Media and my guest is Congressman John Katko. I wanted to end with a couple of political questions for you. When I spoke to you last time we talked about the possibility that you might face some payback from the White House for publicly rejecting Trump as a candidate. And I wanted to know have you had any experience of that so far in the dealings with him or with the White House?

JK: No they haven't been calling me to come down there for lunch, but I didn't expect that to happen either. But you know I think that quite frankly, this guy just wants to get things done. And so he was really taken aback when he invited people down to the White House for example during the Affordable Care Act negotiations. And someone told him to his face they weren't going to support it. They invited my group down, the Tuesday Group, and I didn't think there was any reason for me to go and tell the wizard himself that I was going to vote against it so I didn't go. That was prudent for me to do so I think. But the bottom line is, I haven't seen any major repercussions of it. And moving forward I think he's all about trying to get things done and we should try and get things done. And I want to do the best I can to try and get things done and serve my constituents the best I can.

GR: And how do you think your speaker Paul Ryan is doing trying to ride this three-headed horse of the right wing of his caucus, the president on his own agenda?

JK: I think it's like trying to herd cats that drink a lot of caffeine. Everybody's running every which way and he's trying to herd them all together and I think he's having...it's a tough time. But you know things can be done and I think everyone's doing a little self-examination right now. And quite frankly, I think that the Freedom Caucus is really kind of been the far right wing of the party. They're really more about saying NO than they are about coming up with ideas. And I think that even they are doing some self-examination. So I'm cautiously optimistic going forward that perhaps everyone is going to try and do what's best for the country and I hope they do. I hope their heart's in the right place. And but there's no question about he's got a very tough job. Very tough job.

GR: Well let's, let's imagine that they keep saying, as you say they keep saying, 'no' and you know their view and their strategy is that there is some political integrity in that and also some kind of political payoff I think down the line. How do you see that playing out for Congress and how it functions but also what happens in the midterm elections?

JK: Well I think all that's in play right now. There is no question about it that there is a backlash. We've also seen from the Democratic side, to be fair. Is there some dysfunction in the Republican side? For sure. But I think the Democrats have got to decide to do something more than just simply say no to everything, and be obstructionists in hopes that will get things moving. That's part of the problem in Washington and I'm part of a group called No Labels and it's called the problem solvers. A group of serious Democrats and serious Republicans who want to try to reach across the aisle to get things done and lead by example. And we're becoming more and more strong as a coalition and we're actually going to start having some more structure to what we're doing. And that coupled with the Tuesday Group and I think we're really trying to set an example that, you have to, if you want to get anything done in Washington, you have to work with the other side at least to some extent, try and get some people on the other side to buy into what you're doing. I've done that since I got here. That's why I've had more bills passed than anybody in Congress. I've had 18 pass now, I had three more this term. So every single one of them I have Democratic co-sponsors on and I want to continue to do that. And that type of idea has to break through, because both parties right now are dominated by the far left and the far right. And that's why we have such gridlock and we got to break through it.

GR: So another political question, but this one is about you and your district and your future. If there is a political mid-term storm coming, some people have suggested there is one coming. It does seem like you've done a pretty good job boarding up the windows, to extend the metaphor. Do you politically, do you worry more about a challenge from the left. Or do you worry about the right?

JK: Honestly, I don't care. Because, and I don't mean to be flippant about it. But the bottom line is I'm always going have a challenge in a district like this, and quite frankly, if I had one wish and if I could wave a wand and do one thing I'd make every district in the country between a D-5 and an R-5, meaning anywhere on the spectrum between 5 percent more Republican and 5 percent more Democrat. If you had that, you would have everybody forcing to make tough decisions like I do every single vote. If you do that I think you did much easier to build consensus. I've been told since I've been in office that 'oh my god you're never going to beat the incumbent' and we beat him by 20 points. And they said 'oh my god you're a top target in the country you're going to get crushed' and we won by 22. So I'm not saying I'm going to win. I'm not saying I'm going to lose. I'm just saying that I'm going to do what's best for my constituents no matter what and whatever happens happens. I'll accept it.

GR: That was Congressman John Katko. Congressman, thanks so much for talking with me again.

JK: I'm always amazed how quickly as time goes by. Thanks for having me.

Grant Reeher is Director of the Campbell Public Affairs Institute and a professor of political science at Syracuse University’s Maxwell School of Citizenship and Public Affairs. He is also creator, host and program director of “The Campbell Conversations” on WRVO, a weekly regional public affairs program featuring extended in-depth interviews with regional and national writers, politicians, activists, public officials, and business professionals.