The following is the transcript of the interview with Sen. Bill Cassidy, Republican of Louisiana, that aired on “Face the Nation with Margaret Brennan” on Nov. 16, 2025.
MARGARET BRENNAN: Welcome back to Face the Nation. On Friday, we spoke with the Chairman of one of the Senate committees responsible for crafting health care legislation, Louisiana’s Bill Cassidy, who is also a doctor. We began by showing him what the President is thinking of for a healthcare fix.
VOSOT, PRESIDENT DONALD TRUMP: I’m calling today for insurance companies not to be paid, but for the money, this massive amount of money to be paid directly to the people of our country so that they can buy their own health care, which will be far better and far less expensive than the disaster known as Obamacare.
MARGARET BRENNAN: So are you, Senator, coordinating with the White House on this proposal?
SEN. BILL CASSIDY: So we’re absolutely in communication with the White House and with the administration, because there’s a lot of stuff that you have to work out to do that. But let me give a little meat on the bones of what the President’s speaking about. If you look at an Obamacare policy now, there’s a $6,000 deductible. Democrats are fighting to lower the premiums. You lower a premium on something which has $6,000 deductible, it’s basically a catastrophic policy. Now, I like to speak of the cost of being insured, not just the cost of the health insurance. The President is proposing that we take the $26 billion that would be going to insurance companies if we just do a straight out extension, and by the way, 20 percent of that $26 billion, 20 percent will go for profit and administrative overhead, give it directly to the American people in an account in which 100 percent of the money is used for them to purchase health care on their own terms. Now- now, that makes them an informed consumer. It also helps address the need to have coverage for that deductible, and if they get that policy with a higher deductible, they can actually lower their premium. It’s a sweet spot, lower premiums, help with the deductible, making the patient the informed consumer, the President and I are united. We should all be united about that.
MARGARET BRENNAN: Well, the President’s economic adviser, Kevin Hassett, was on this program last Sunday. He said the president was just brainstorming, things aren’t formally put together among Republican senators yet, but I just want to clarify what you are coordinating with the President on here, because, is it to buy your own insurance policy, which is kind of complicated, or is it to use this flexible spending account you’ve talked about for related health care needs? Like, are there restrictions on how you can use that money?
SEN. CASSIDY: So first, there’s two types of premium tax credits. There’s the baseline premium tax credit, which was part of Obamacare, that would stay in effect, and people would still buy a policy. For example, they get in a car wreck, something disastrous. They need somebody negotiating on their behalf with all the providers. That stays the same. What we’re talking about the shutdown was over the enhanced premium tax credits. Policies have become so expensive under Obamacare that under Joe Biden, Democrats passed another subsidy on top of the first subsidy. That’s what we’re fighting about and what Republicans are saying, and I like to hope Democrats will too. Hey, wait a second, if we can have lower premiums and help people with their deductible by giving the money directly to the patient. By the way, 20 percent doesn’t go for insurance company profit and overhead. 100percent goes for health care. Why don’t we unite Republican and Democrats in doing that? That’s where the President is. You got to figure some things out. But we’re a lot further along than you might imagine.
MARGARET BRENNAN: So do you want to fix Obamacare, or do you want to eliminate Obamacare?
SEN. CASSIDY: First, you have to, like, we’re going into 2026. That’s like a month and a half from now.
MARGARET BRENNAN: Right.
SEN. CASSIDY: And so you’ve got to work with what you have. But on the other hand, Obamacare was a top heavy, administratively heavy type system in which a lot of money is a lot of money, and responsibility is taken from individuals and given to insurance companies. As one example, I’m a doctor. I work for 20 years in a hospital for the uninsured. I found that if you give the patient the power, good things happen that’s supported, by the way, by the medical literature, if the patient is engaged in her health care and the health care of her family. She’s going to be a wise shopper, wise for her health and wise for her pocketbook. We need to have a new model, and that model is to engage the patient in her own health care. Doing so is good for her, good for us all.
MARGARET BRENNAN: Okay, but you said we need to work with what we have. That is, as you just said, you have a short amount of time before the end of the year. Do you think you need to extend the health care tax subsidies that are currently in place until you figure out all the rest of this complicated policy making?
SEN. CASSIDY: Let me back you up just a little bit, Margaret. I’ll just say, everybody assumes it’s easy just to extend the premium tax credits, the enhanced premium tax credits. It’s not that easy. 50 percent of the states did not plan on them being extended, and they don’t have rates as if they were to be extended. So that means if we pass this mid December, they’ve got to recalculate rates in time for, wait a second, by that time, we’re already into 2026 it’s not an easy matter. And by the way, did I mention the policies that people want to lower the premiums for have $6,000 deductibles. It is basically something for insurance companies to make money off of and for the individual to wade through $6,000 of debt before they can finally access it. Now, the kind of proposal I am proposing Republicans are, and I hope Democrats will join, is, let’s take that money, and we have a mechanism to do so. We give it to the patient. By giving her that money, she could choose a bronze level plan, which is to say lower premiums. So now her premiums are down, but she has money in an account to help with the deductible, and I think we can figure that out about as easily as we can figure out what we would do if we just did a straight out extension.
MARGARET BRENNAN: So you want to do all this, though, by the second week of December, when the Democrats have been promised they’ll have a vote on an ACA bill of their choice.
SEN. CASSIDY: Yes, and I tell my Democratic colleagues first, let’s not be Democrats and Republicans. Let’s be Americans, representing all of Americans. Let’s recognize what you’re doing just gives money to insurance companies, but we can do it better with lower premiums and with money and accounts to pay deductibles. And then why don’t we come together? There can be a Democratic bill and a Republican bill, and both fail. Let’s do an American bill where the American people benefit and this work together, collaborate to lower those premiums and help them with that first dollar coverage in the- in the deductible.
MARGARET BRENNAN: So we looked and there are about 293,000 Louisianans, your state, enrolled in Obamacare currently, six weeks from now, those extent expanded tax credits that you’ve been talking about will go away for individuals making $62,000 or above. Individuals making less than that amount will see their tax credit shrink. So are you telling those hundreds of thousands of Louisianans that that tax credit is going away no matter what, that- that they should make plans–
SEN. CASSIDY: No.
MARGARET BRENNAN: – for higher prices?
SEN. CASSIDY: I’m telling them that we’re I’m telling them that we are working to make it work better for them. And they would tell you, by the way, wait a second, I got a $6,000 deductible that does not work for me. Margaret, I’m a doctor. I would talk to people when they’d come to see me, and they would tell me, I can’t afford that. My deductible is too high. That’s reality, and that reality is being lost in this discussion. We’ve got to do something about sky high deductibles. Maybe you can afford the premium. You can’t afford the policy. Let’s lower the cost of having health insurance, focusing by not just on the premium, but the deductible. And I think we can do both.
MARGARET BRENNAN: Well, even in the private market, health care costs have gone up up six to 9 percent when you look at the projections. But I want to ask you about your oversight role. Secretary Kennedy has this hand picked panel of vaccine advisors. You know them at ACIP. They’re going to meet in a few days and potentially vote on changing the hepatitis B vaccine schedule for infants. That same vaccine advisory group is also considering the safety of vaccine ingredients like aluminum, which would impact a number of childhood shots. This should matter for American parents. Are you comfortable with what they are about to put to a vote?
SEN. CASSIDY: I’m very concerned about this. As it turns out, my medical practice focused on hepatitis B, and so we know that because of a recommended dose at birth of hepatitis B vaccine, recommended, not mandated, the number of children born contracting hepatitis B at birth, or shortly thereafter, has decreased from about 20,000, 20 years ago to like 200 now. That’s 20- effectively a clerical error. We have decreased incidence of chronic hepatitis B by 20,000 people over the last two decades with this kind of recommendation. And by the way, if you’re infected at birth, you’re more likely- you’re 95 percent likely to become a chronic carrier. The vaccine is safe. It has been established, and these ingredients they’re speaking of have been shown to be safe. This is policy by people who don’t understand the epidemiology of hepatitis B, or who have grown comfortable with the fact that we’ve been so successful with our recommendation that now the incidence of hepatitis B is so low, they feel like we can rest on our laurels. I’m a doctor. I have seen people die from vaccine-preventable disease. I want people to be healthy. I want to make America healthy, and you don’t start by stopping recommendations that have made us substantially healthier.
MARGARET BRENNAN: Well, the president of the United States also told American women not to take Tylenol. Or give it to their kids. This is based on a theory that it causes autism somehow. And he also in a social media post, the same one, called for the measles, mumps and rubella shot to be broken up into three different shots. That was then endorsed by the acting CDC director. Are you concerned by this kind of suggestive linkage at the top of the CDC and from the White House?
SEN. CASSIDY: Again, I’m a doctor, and so I’m going to go where the evidence takes me. And the best evidence is a study out of Sweden with 2 million children that found no- no causality, no association, if you will, between taking Tylenol in pregnancy and getting autism. And of course, that concerns me, because there’s going to be a mom out there —again, I’m a doctor, I talk to I talk to patients— in a room, and her child has autism. She took Tylenol for a high fever during pregnancy and now she blames herself. That’s just the way mamas think, and that’s wrong. We don’t want her to think that. The best evidence is that there is no relationship, by the way, if you have a high fever during pregnancy, that may be a risk for autism. Now, of course, if you’re pregnant, talk to your physician before you take anything, but point being, the best evidence is that there is no relationship between the two. And I don’t want women putting themselves on a guilt trip when the best evidence shows not. By the way, the President has spoken out strongly in favor of immunizations in other cases, and I noted, when he got his physical, he got the flu and COVID shots. So the President has demonstrated that he believes in immunization.
MARGARET BRENNAN: But that’s why clarifying the statements, I think, is important, since you interpret them differently. I wonder, do you regret your confirmation vote for Secretary Kennedy?
SEN. CASSIDY: I smile because every reporter asks me that–
MARGARET BRENNAN: Well, because these questions run right into a pledge that you extracted from him not to tinker with some of the structures that were set in place to have oversight of these vaccines and this process.
SEN. CASSIDY: So you live life forward, again, you just do, let the day’s own troubles be sufficient for the day. And I’ll credit the secretary. He’s brought attention to things like ultra-processed food that has, frankly, never received this sort of attention before, and people praise him for that. So he and I have publicly disagreed on some matters, but I strongly agree with him on others, and so, so that’s how I’ll answer your question.
if this is your final year in office, sir, will you make overhauling health care your top priority?
SEN. CASSIDY: Well, I sure hope it’s not my final year in office, but, but I’ve been thinking about healthcare for 30 years, because when I worked in a public hospital for the uninsured, I saw the burden it could be on middle-income families who had middle income but couldn’t afford the insurance or couldn’t assure afford the healthcare. And so it’s been my priority for 30 years, and I will continue to do that. And if there is a silver lining, if there is a silver lining in the shutdown, we just had, the silver lining is now we are focused on how do we make health care more affordable for the American people. That should be our goal, not to be partisan one way or the other. How do we make it more affordable for fellow Americans? If we can accomplish that, I will feel like I’ve done my job.
MARGARET BRENNAN: Senator, thank you for your time.
SEN. CASSIDY: Thank you Margaret.