Pres­sure mounts for GOP sen­a­tors to back health bill

Hutchin­son voices ob­jec­tion to ‘cost shift to states’

Northwest Arkansas Democrat-Gazette - - FRONT PAGE -

WASHINGTON — Pres­i­dent Don­ald Trump and other ad­min­is­tra­tion of­fi­cials lob­bied Repub­li­cans on Fri­day to sup­port the Se­nate GOP’s re­worked health care bill, with the pres­i­dent say­ing wa­ver­ing sen­a­tors “must come through” to keep the mea­sure from col­laps­ing.

But the bill, re­peal­ing much of the 2010 Pa­tient Pro­tec­tion and Af­ford­able Care Act, re­mained on ten­u­ous ground as Se­nate Ma­jor­ity Leader Mitch McCon­nell worked to keep more Repub­li­cans from de­sert­ing. Com­pli­cat­ing the ef­fort, Ohio GOP Gov. John Ka­sich called the re­vised mea­sure “still un­ac­cept­able,” largely be­cause of its cuts to Med­i­caid, the same con­cern that’s been voiced by hold­out Ohio Repub­li­can Sen. Rob Port­man.

“It also doesn’t do enough to sta­bi­lize the in­sur­ance mar­ket, where costs are ris­ing un­sus­tain­ably and com­pa­nies are sim­ply drop­ping cov­er­age,” Ka­sich added.

Ka­sich and other GOP gov­er­nors from states that ex­panded Med­i­caid cov­er­age un­der the Af­ford­able Care Act — such as Asa Hutchin­son of Arkansas, Brian San­doval of Ne­vada,

Doug Ducey of Ari­zona — have ex­pressed con­cern that the mea­sure’s pro­posed cuts could leave tens of thou­sands unin­sured. Sev­eral key sen­a­tors from these states, in turn, are cur­rently with­hold­ing their sup­port for the mea­sure.

McCon­nell, R-Ky., re­leased the mea­sure Thurs­day, a plan that caps seven years of his party’s prom­ises to re­move the health care law.

But two GOP sen­a­tors im­me­di­ately said they’d vote no on a cru­cial vote planned for next week. Fac­ing uni­form Demo­cratic op­po­si­tion, McCon­nell can’t af­ford to lose any more votes in the cham­ber, where Repub­li­cans have a 52- 48 ma­jor­ity and Vice Pres­i­dent Mike Pence has tie-break­ing power.

“Af­ter all of these years of suf­fer­ing thru Oba­maCare, Repub­li­can Sen­a­tors must come through as they have promised!” the pres­i­dent tweeted from Paris, where he was at­tend­ing Bastille Day cer­e­monies.

Hutchin­son, who was in Prov­i­dence, R.I., for a meet­ing of the Na­tional Gov­er­nors As­so­ci­a­tion, met with Pence on Fri­day af­ter­noon at the vice pres­i­dent’s re­quest.

In a phone in­ter­view af­ter­ward, Hutchin­son said he told the vice pres­i­dent that Arkansas’ sen­a­tors, John Booz­man and Tom Cot­ton, had been help­ful ad­vo­cat­ing for changes that Hutchin­son had re­quested and that were adopted in the re­vised ver­sion of the bill.

But Hutchin­son said he main­tained his ob­jec­tion that the bill rep­re­sents a “cost shift to the states.”

“It’s cer­tainly mov­ing in the right di­rec­tion, but I ex­pressed the ad­di­tional con­cerns that I had,” Hutchin­son said.

He said he is sched­uled to meet to­day with Tom Price, the health sec­re­tary, and Seema Verma, the ad­min­is­tra­tor of the Cen­ters for Medi­care and Med­i­caid Ser­vices, to con­tinue the dis­cus­sion.

Hutchin­son has ex­pressed

op­po­si­tion to the bill’s phase­out of the Af­ford­able Care Act’s en­hanced fund­ing for Med­i­caid ex­pan­sion, which cov­ers more than 316,000 Arkansans.

On Fri­day, he said the im­pact of that cut could be mit­i­gated by other fund­ing, in­clud­ing grants to states and sub­si­dies for pri­vate cov­er­age.

“It’s just go­ing to take a lot more study and anal­y­sis to be able to com­pare the changes that are be­ing pro­posed and its im­pact on Arkansas,” he said.

In an in­ter­view ear­lier Fri­day on CNBC, Hutchin­son cred­ited the ex­panded part of the state’s Med­i­caid pro­gram, known as Arkansas Works, with help­ing to hold down pre­mi­ums in the mar­ket for in­di­vid­ual in­sur­ance cov­er­age.

He said the state de­cided to ex­pand its Med­i­caid pro­gram in 2013 with the un­der­stand­ing that it would never have to pay more than 10 per­cent

of the cost.

Un­der the cur­rent ver­sion of the Se­nate bill, the state’s share would grad­u­ally rise af­ter 2020 un­til it’s the same as what the state pays for other Med­i­caid re­cip­i­ents’ care. Arkansas’ share would rise to 30 per­cent.

“I wish the fed­eral gov­ern­ment would keep its bar­gain,” Hutchin­son said. “That’s the frus­trat­ing part.”

Mean­while, Sen. Dean Heller, R-Nev., was tar­geted as top ad­min­is­tra­tion of­fi­cials were talk­ing to his state’s pop­u­lar GOP gover­nor, San­doval. Repub­li­cans con­sider win­ning over San­doval a key to gain­ing Heller’s vote.

In an in­ter­view Fri­day, San­doval said his ini­tial un­der­stand­ing of McCon­nell’s new bill was that it “re­ally doesn’t change the dy­namic” about its Med­i­caid cuts, and “that’s a big con­cern for me.” Ne­vada added 200,000 ben­e­fi­cia­ries un­der Obama’s ex­pan­sion of the health in­sur­ance pro­gram for the poor,

dis­abled and nurs­ing home pa­tients.

Heller, who faces a tough re-elec­tion con­test next year, has stood arm in arm with San­doval in crit­i­ciz­ing the pro­posed Med­i­caid cuts. Heller has said he would have op­posed McCon­nell’s orig­i­nal leg­is­la­tion, which the leader with­drew last month be­cause it faced cer­tain de­feat.

San­doval said he ex­pected to meet pri­vately with Pence and Price at the gov­er­nors’ meet­ing. He said he had al­ready heard from both men.

The na­tion’s largest doc­tors’ group dealt an­other blow to the mea­sure Fri­day, say­ing the plan falls short on cov­er­age and ac­cess, par­tic­u­larly for low-in­come peo­ple on Med­i­caid. The Amer­i­can Med­i­cal As­so­ci­a­tion said Med­i­caid cuts and “in­ad­e­quate sub­si­dies” will lead to “mil­lions of Amer­i­cans los­ing health in­sur­ance cov­er­age.”

The as­so­ci­a­tion said GOP

lead­ers took a “pos­i­tive step” by adding $ 45 bil­lion for treat­ment to help vic­tims of the opi­oid epi­demic. But it pointed out that peo­ple deal­ing with ad­dic­tion also need reg­u­lar health in­sur­ance and that many would lose it if Repub­li­cans suc­ceed in rolling back Med­i­caid fi­nanc­ing.

McCon­nell’s re­worked bill aims to win con­ser­va­tives’ sup­port by let­ting in­sur­ers sell low-cost poli­cies with min­i­mal cov­er­age. At the same time, he seeks to pla­cate hes­i­tant mod­er­ates by adding bil­lions to com­bat opi­oid abuse and help con­sumers with sky­rock­et­ing in­sur­ance costs.

Mod­er­ate Repub­li­can Sen. Su­san Collins of Maine told re­porters she had in­formed McCon­nell she would be vot­ing against be­gin­ning de­bate on the bill, cit­ing in part cuts in the Med­i­caid pro­gram. Sen. Rand Paul of Ken­tucky, who has re­peat­edly com­plained

that McCon­nell’s ef­forts don’t amount to a full-blown re­peal of Obama’s law, also an­nounced he was a “no.”

Sen. John Cornyn of Texas, the No. 2 Se­nate GOP leader, said in an in­ter­view he is hop­ing for the cli­mac­tic vote Tues­day or Wed­nes­day. “I’m op­ti­mistic we’ll get there,” he said of pre­vail­ing.

McCon­nell could can­cel next week’s vote if he’s short of sup­port. He and other GOP lead­ers are urg­ing sen­a­tors to at least vote in fa­vor of open­ing de­bate, which would open the mea­sure up to amend­ments.

In­for­ma­tion for this ar­ti­cle was con­trib­uted by Erica Werner, Alan Fram, Ri­cardo Alonso-Zaldivar, Mary Clare Jalonick, Julie Bykow­icz, Matthew Daly, Kevin Frek­ing, Jen­nifer McDer­mott, Julie Carr Smyth and Will Weis­sert of The As­so­ci­ated Press; by Juliet Eilperin and Sean Sul­li­van of The Washington

Post; and by Andy Davis of the Arkansas Demo­crat-Gazette.

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