The Columbus Dispatch

Kasich goes to Hill to pitch health plan

- By Jessica Wehrman

WASHINGTON — As Ohio Gov. John Kasich canvassed Capitol Hill Thursday to weigh in on Obamacare to Republican lawmakers, he had to walk a fine line.

Like a handful of other GOP governors, he is a supporter of the Medicaid expansion that, in Ohio, helped cover 700,000. And there are elements of the controvers­ial 2010 Affordable Care Act — the exchanges, for example — that he likes.

But ask Kasich whether he’d be satisfied just tweaking the existing health-care law, and he’ll have none of it.

“Don’t put me in a trap where I say, ‘Oh, no, we don’t need to repeal it,’” he told reporters Thursday after the first of two meetings with congressio­nal Republican­s on the

Affordable Care Act. “Yeah, repeal it and replace it and take some things in the law that are good.”

Kasich, who was one of the most vocal of Donald Trump’s GOP detractors during campaign season, now finds himself among a group of Republican governors who stand to lose the most if the 2010 Affordable Care Act is repealed without an effective replacemen­t: Ten, including Kasich, expanded Medicaid in their states and don’t want to risk losing it.

“We don’t want to lose coverage for 700,000 people in our state,” he said. “I think there’s a dramatic way to improve the quality of care while reducing the cost.”

In Ohio, 700,000 people have gained access to health care through Medicaid; 1 million gained coverage through Medicaid or the Obamacare exchange. That figure includes 500,000 with mental-health needs and 37,000 veterans or their family members.

Republican senators, all members of the Senate Finance Committee, which organized the closed-door meeting, vowed that no one would lose insurance even

as they offered few concrete suggestion­s on what would replace the 2010 law.

“It ain’t going to happen,” said Sen. John Cornyn, a Republican from Texas. “Nobody’s going to lose coverage.”

Sen. Bill Cassidy, R-La., made a similar vow.

“If President-elect Trump has said that at least as many people will be insured under his plan as under Obamacare, and those with pre-existing conditions will be cared for, those are kind of marching orders.”

But those senators were noncommitt­al on the Medicaid expansion. Republican Sen. Rob Portman of Ohio, meanwhile, said he’s “open” to keeping the expansion, but, “what I think my colleagues will be for is reforming Medicaid so it works better.”

“The current system is not working for families, for small businesses, for the economy,” he said, saying it has made it unaffordab­le to have healthcare coverage even for those in private, non-Obamacare plans.

Among those who also attended the roundtable were Michigan Gov. Rick Snyder, who has spoken in defense of the Medicaid expansion, Iowa Gov. Terry Branstad, who also oversaw an expansion, and Arkansas Gov. Asa Hutchinson, who inherited an expanded Medicaid system when he replaced a Democratic governor.

Even as congressio­nal Republican­s face criticism that they have no real plan to replace the controvers­ial 2010 law, Kasich, in a six-page letter to Senate Republican­s, offered suggestion­s, publishing many of them in an editorial in Time magazine. In it, Kasich said he wants:

Any reform to retain Medicaid expansion, but said if it must change, Congress should roll back rather than repeal the expansion all together. For example, Congress could reduce the eligibilit­y requiremen­t level to 100 percent of the federal poverty level, rather than 138 percent.

Congress to confront the rising cost of health care. Though access to health insurance is important, he said, market dynamics are creating “unsustaina­ble” cost increases.

Congress to pass a repeal and replacemen­t at the same time. If Congress repeals now and replaces later, he said, he worries that the individual market could deteriorat­e and the uncertaint­y could hurt the system as it transition­s.

Kasich also said that the current benefits package is “very expensive” and has “kept people who are younger from buying insurance.” Stripping down that package, he said, might encourage younger Americans to buy coverage rather than pay a tax penalty.

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