Gover­nors at odds on Med­i­caid

Republicans set with plan; Democrats say it will cut cov­er­age

Northwest Arkansas Democrat-Gazette - - NATIONAL - BEN NUCKOLS

WASH­ING­TON — Ten­sions emerged Satur­day be­tween Demo­cratic and Repub­li­can gover­nors over a GOP-led pro­posal for an over­haul of Med­i­caid, with Democrats say­ing the changes would take away peo­ple’s health cov­er­age to fi­nance tax cuts for the wealthy.

GOP gover­nors in­tend to present Congress with a plan that they say would give states more flex­i­bil­ity to ad­min­is­ter health cov­er­age for poorer res­i­dents while pro­tect­ing states from ab­sorb­ing the costs of re­peal­ing the Pa­tient Pro­tec­tion and Af­ford­able Care Act. Demo­cratic gover­nors said Satur­day that their Repub­li­can coun­ter­parts were be­ing dis­hon­est about the ef­fects of their plan.

“They want to spend less money on peo­ple’s health care so they can do tax cuts for the rich. They’ve tried to put this cam­ou­flage on it that some­how they’re giv­ing gover­nors flex­i­bil­ity. We’ve got plenty of flex­i­bil­ity,” Demo­cratic Wash­ing­ton Gov. Jay Inslee said. “This is not what we are ask­ing for.”

While ma­jor changes to for­mer Pres­i­dent Barack Obama’s sig­na­ture health care law ap­pear in­evitable with Republicans con­trol­ling the White House and both houses of Congress, Inslee said there’s still a chance that Democrats can win over GOP law­mak­ers who’ve been fac­ing an­gry con­stituents at town-hall-style meet­ings.

“Peo­ple are mad­der than hops about this. Look, there’s four Repub­li­can mem­bers of the House in the state of Wash­ing­ton, and they’re now in the wit­ness- pro­tec­tion pro­gram,” Inslee said. “We think churches are go­ing to of­fer them sanc­tu­ary at some point, given how mad peo­ple are about this.”

Inslee, whose na­tional pro­file is ris­ing as Democrats look for new lead­ers af­ter Hil­lary Clin­ton’s loss in Novem­ber, led a suc­cess­ful le­gal chal­lenge against Pres­i­dent Don­ald Trump’s ban on travel Mus­lim­from seven coun­tries. pre­dom­i­nantly

The an­gry rhetoric over health care changes brought a dose of po­lit­i­cal re­al­ity to the non­par­ti­san Na­tional Gover­nors As­so­ci­a­tion’s win­ter meet­ing, where gover­nors oth­er­wise spend time prais­ing one an­other and par­tic­i­pat­ing in pan­els on non­con­tro­ver­sial top­ics, such as early-child­hood ed­u­ca­tion, a cause that got a boost from ac­tress Jen­nifer Gar­ner.

On Satur­day af­ter­noon, the gover­nors met in pri­vate with Health and Hu­man Ser­vices Sec­re­tary Tom Price, who ac­cord­ing to sev­eral gover­nors said the Trump ad­min­is­tra­tion wanted to part­ner with states to over­haul health care but did not pro­vide specifics.

Mean­while, at the White House, Trump met with two Repub­li­can gover­nors, Wis­con­sin’s Scott Walker and Florida’s Rick Scott, and dis­cussed “how best to solve the prob­lems” of the Obama-era health law, with “spe­cial em­pha­sis” on states’ role in health care, ac­cord­ing to a state­ment by his spokesman. The gover­nors will meet with Trump and con­gres­sional lead­ers Mon­day. The gover­nors also lis­tened to a con­sul­tant’s re­port about the fis­cal ef­fect of a Med­i­caid over­haul on states. The re­port, a copy of which was ob­tained by The As­so­ci­ated Press, pre­dicted that Med­i­caid changes be­ing pro­posed by House Republicans would re­sult in tens of thou­sands of peo­ple los­ing their in­sur­ance cov­er­age in an av­er­age-size state. Inslee and Demo­cratic Gov. Terry McAuliffe of Vir­ginia called the re­port “dis­turb­ing.” Repub­li­can Gov. Matt Bevin of Ken­tucky said that if Democrats were dis­turbed, they haven’t been pay­ing at­ten­tion.

“The kind of con­ver­sa­tion that’s be­ing had now — sober­ing, shock­ing, sur­pris­ing as it might be to some — is the con­ver­sa­tion that we must have be­cause the piper has to get paid at some point,” Bevin said. “Peo­ple are look­ing at re­al­ity, and that’s good.”

The GOP gover­nors’ pro­posal, a draft of which was ob­tained by the AP, urges Congress to change Med­i­caid from an open-ended fed­eral en­ti­tle­ment to a pro­gram de­signed by each state within a fi­nan­cial limit. Med­i­caid pro­vides in­sur­ance to more than 70 mil­lion low-in­come Amer­i­cans, and states had the op­tion of mak­ing it avail­able to more peo­ple un­der Obama’s health care over­haul.

Some of the GOP gover­nors be­hind the pro­posal, in­clud­ing Ohio’s John Ka­sich, opted to ex­pand Med­i­caid in their states de­spite pres­sure from con­ser­va­tives.

An­other GOP gover­nor in a Med­i­caid ex­pan­sion state, Doug Ducey of Ari­zona, said Democrats were fail­ing to ac­knowl­edge the short­com­ings of Obama’s health law and the need for ur­gent changes.

“We don’t want to see any cit­i­zen have the rug pulled out from un­der­neath them, yet we know Oba­macare is fail­ing,” Ducey said, referring to the law. “We’re work­ing hard to put to­gether a plan that will re­place Oba­macare and ac­tu­ally be an im­prove­ment for health care, be a real re­form of the Med­i­caid sys­tem.”

It’s not clear whether House Republicans will ac­cept the GOP gover­nors’ pro­posal. Many con­gres­sional Republicans want to re­write the ba­sic fi­nan­cial con­tract for Med­i­caid, of­fer­ing flex­i­bil­ity to states in ex­change for lim­its on fu­ture fed­eral fund­ing. Bud­get hawks in­clud­ing House Speaker Paul Ryan, R-Wis., sup­port the kind of pro­gram flex­i­bil­ity Repub­li­can gover­nors are seek­ing, but chiefly want to spend less on Med­i­caid.

AP/CLIFF OWEN

Gov. Asa Hutchin­son speaks with a re­porter Satur­day dur­ing the Na­tional Gover­nors As­so­ci­a­tion Win­ter Meet­ing in Wash­ing­ton.

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