Governor battling his own party on health care
BOSTON — Charlie Baker's relationship with GOP leaders in Washington just keeps getting stickier.
Republican attempts to repeal former President Barack Obama's health care law have become something of a recurring nightmare for the Republican Massachusetts governor, who pushed back against earlier efforts, all of which failed.
Now Baker, who spent the early part of the week in meetings at a Republican Governors Association gathering in Chicago, finds himself taking again to the health policy ramparts to inveigh against the latest bid by leaders in his own party to undo the 2010 law.
Baker, a former health care executive and health and human services secretary under GOP Gov. William Weld, is hoping this latest effort also fizzles.
This week he and a group of other Republican and Democratic governors outlined their fears about the proposed replacement to the Obama law.
For Baker, the biggest worry is that the law will cut the legs out from under the state's efforts to expand health care to nearly every resident — an effort that traces back to a 2006 state law signed by former Republican Gov. Mitt Romney.
That law provided a blueprint for Obama's law. The state and federal laws signed by Romney and Obama have helped Massachusetts claim the title of the most insured state, with about 96 percent of residents enrolled in health care plans.
In a letter sent Tuesday to Republican Majority Leader Mitch McConnell of Kentucky and Democratic Senate Minority Leader Chuck Schumer of New York, Baker joined a group of 10 governors — including five Democrats, four Republicans and an independent — arguing against the GOP bill.
In the letter the group asked Senate leaders not to consider the proposal and instead renew efforts for a bipartisan effort "to make health care more available and affordable for all Americans."
The group pointed to recent hearings in the Senate's Health, Education, Labor and Pensions Committee aimed at finding ways to steady the individual insurance market.
"Improvements insurance markets should control costs, stabilize the market, and positively impact coverage and care of millions of Americans, including many who are dealing with mental illness, chronic health problems, and drug addiction," the governors wrote. Baker isn't alone. The state's allDemocratic congressional delegation also opposes the GOP proposal.
U.S. Sen. Elizabeth Warren sent an email to supporters on Monday warning that the plan would gut funding for Medicaid, roll back protections for people with pre-existing conditions and eliminate help for families to buy health insurance. "Make no mistake: This CassidyGraham ' health care' bill is Trumpcare on steroids - and millions of Americans will lose their health care if the Republicans pass this piece of garbage," Warren wrote, referencing the Republican authors of the bill.
Supporters of the bill say it will give states more control by rolling up funding into block grants that states can decide how to spend.
For Baker, the most troubling part of the bill for comes down to money.
The bill could end up costing Massachusetts billions of dollars — billions the state would be hardpressed to replenish on its own, given its ongoing struggles to balance the annual budget.
Ironically, it's the success that Massachusetts has had in signing up its residents for health care that would make it a loser under the GOP bill.
Generally, the measure would shift money from states that expanded their Medicaid programs for the poor under Obama's statute, which tend to be run by Democrats, to the largely Republican-run states that shunned that expansion.
After 2019, the Graham-Cassidy proposal would eliminate federal funding for Medicaid expansion. From 2020 to 2026, states would instead receive a block grant, which could be used for coverage, payments to providers, or other purposes.
Over the 2020 to 2026 period, 29 states would receive less in federal funding than under current law with an average reduction of 19 percent, according to a report by health care consultants Manatt Health.
Massachusetts could see losses running in the billions over that time period, according to the report.