8 to 10 Repub­li­cans have con­cerns on bill

Mon­tana’s dou­ble quandary

Arab Times - - INTERNATIONAL -

WASH­ING­TON, July 17, (Agen­cies): Eight to 10 Repub­li­can US sen­a­tors have se­ri­ous con­cerns about Repub­li­can healthcare leg­is­la­tion to roll back Oba­macare, mod­er­ate Repub­li­can Sen­a­tor Su­san Collins, who op­poses the bill, said on Sun­day.

The Se­nate, which is de­lay­ing its con­sid­er­a­tion of the bill while Ari­zona Repub­li­can Sen­a­tor re­cu­per­ates from surgery to re­move a blood clot, will take it up as soon as all sen­a­tors are avail­able, Sen­a­tor John Cornyn, the sec­ond-rank­ing Repub­li­can sen­a­tor, said.

McCain’s ab­sence casts doubt on whether the Se­nate would be able to pass leg­is­la­tion to re­peal parts of the Af­ford­able Care Act, Demo­cratic for­mer pres­i­dent Barack Obama’s sig­na­ture leg­isla­tive achieve­ment, com­monly known as Oba­macare.

Collins is one of two Repub­li­can sen­a­tors who have al­ready said that they would not even vote to open de­bate on the lat­est ver­sion of the bill re­leased on Thurs­day, mean­ing one more de­fec­tion from the Repub­li­can ranks could kill it..

Repub­li­cans con­trol the Se­nate by a 52-48 mar­gin. With the Democrats solidly op­posed to the leg­is­la­tion, the Repub­li­cans can only pass the bill if all their other mem­bers back it and if Repub­li­can Vice Pres­i­dent Mike Pence casts his tie-break­ing vote in fa­vor.

A Wash­ing­ton Post-ABC News poll pub­lished on Sun­day showed Amer­i­cans pre­ferred Oba­macare by a 2-1 mar­gin. Ap­proach­ing six months in of­fice, Trump’s over­all ap­proval rat­ing has dropped to 36 per­cent from 42 per­cent in April.



While Collins said that she did not know if the leg­is­la­tion would ul­ti­mately pass, she said as many as 10 Repub­li­cans have doubts about it.

“There are about eight to 10 Repub­li­can sen­a­tors who have se­ri­ous con­cerns about this bill,” Collins told CNN’s “State of the Union” pro­gram, fault­ing the bill for its ma­jor cuts to the Med­i­caid gov­ern­ment health in­sur­ance pro­gram for the poor, which she said would harm ru­ral hos­pi­tals and nurs­ing homes.

“I don’t know whether it will pass, but I do know this, we should not be mak­ing fun­da­men­tal changes in a vi­tal safety net pro­gram that’s been on the books for 50 years — the Med­i­caid pro­gram — without hav­ing a sin­gle hear­ing to eval­u­ate what the con­se­quences are go­ing to be,” she added.

Repub­li­can Sen­a­tor Rand Paul also re­it­er­ated his op­po­si­tion to the bill, which he de­scribed as “ter­ri­ble” be­cause it re­tained many of the Oba­macare taxes and sub­si­dies.

“The cur­rent sys­tem is ter­ri­ble,” Paul said on Fox News Sun­day. “I don’t think Repub­li­cans should put their name on this. It is a bad po­lit­i­cal strat­egy and it will not fix the prob­lem.”

The bill un­winds Oba­macare’s Med­i­caid ex­pan­sion over three years, from 2021 to 2024. But it goes be­yond re­peal­ing Oba­macare by im­pos­ing dras­tic cuts to Med­i­caid that deepen in 2025.

For all the un­cer­tainty over the fate of a healthcare over­haul in Wash­ing­ton, tens of thou­sands of Mon­tana’s work­ing poor are al­ready in a dou­ble quandary: Even if Congress leaves Med­i­caid ex­pan­sion mostly in­tact, the fu­ture of the state’s pro­gram re­mains un­cer­tain.

Gov who counts Med­i­caid ex­pan­sion as a key achieve­ment in his first term, has less than two years to jus­tify its con­tin­u­a­tion. The pro­gram is sched­uled to end in 2019 if state law­mak­ers de­cline to re­new it dur­ing the leg­isla­tive ses­sion that starts in Jan­uary of that year.

Among the 31 states with ex­panded Med­i­caid, Mon­tana’s pro­gram is unique. As part of a grand bargain to pla­cate mod­er­ate Repub­li­cans in the con­ser­va­tive-lean­ing state, Bul­lock and his fel­low Democrats agreed to charge most en­rollees pre­mi­ums and co-pays, es­tab­lish a jobs pro­gram in­tended to help able-bod­ied Med­i­caid re­cip­i­ents find good-pay­ing work, and seek reau­tho­riza­tion.

While Mon­tana Democrats tout their state’s plum­met­ing num­ber of med­i­cally unin­sured — from 20 per­cent of the pop­u­la­tion in 2013 to 7 per­cent last year — the num­ber of Med­i­caid en­rollees has far ex­ceeded ex­pec­ta­tions, and some worry the pro­gram can­not be sus­tained.

Since it took ef­fect in Jan­uary of last year, nearly 80,000 of Mon­tana’s 1 mil­lion res­i­dents have en­rolled. The state had pro­jected only 33,000 by this time.

A US Se­nate bill to re­place the ad­min­is­tra­tion’s health care law would phase out, over sev­eral years, the fed­eral money given to states to ex­pand Med­i­caid. That might not be soon enough for con­ser­va­tive Mon­tana law­mak­ers who are eager to re­visit the ex­pan­sion pro­gram when the ses­sion re­con­venes in 2019.

“So, is this thing re­ally work­ing?” said state Sen a Repub­li­can from the west­ern Mon­tana town of Big­fork. “I’m from the state of Mis­souri at this point in time — show me.”

Keenan and other crit­ics are skep­ti­cal the state is do­ing enough to get peo­ple into jobs — and off Med­i­caid — in the pro­gram’s sec­ond year.

“The spin right now is that con­ser­va­tive Repub­li­cans are go­ing to take some­thing away,” Keenan said. “That’s not me. For now, I’m just sit­ting back and wait­ing to see if they can jus­tify the pro­gram.”

Even the lead spon­sor of the bill that au­tho­rized ex­pan­sion is rais­ing con­cern that the higher-than-ex­pected num­ber of en­rollees could be un­sus­tain­able and that state of­fi­cials need to be more ag­gres­sive with the pro­gram’s job train­ing com­po­nent.

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