GOP gov­er­nors to sen­a­tors: Do no harm to health care

The Denver Post - - NEWS - By Ali­son Noon and Bill Bar­row

CARSON CITY, NEV.» The pres­sure­se­n­a­tors — is fromon con­gres­sional Repub­li­can lead­ers, con­ser­va­tive groups and im­pa­tient GOP vot­ers — to ful­fill a 7-yearold prom­ise to scrap much of for­mer Pres­i­dent Barack Obama’s health care law. But back home, Repub­li­can gov­er­nors who have ex­pe­ri­enced some of the up­side of the law are warn­ing their GOP sen­a­tors to first, do no harm.

For these gov­er­nors, the is­sue is less about de­liv­er­ing a tri­umph to Pres­i­dent Don­ald Trump and more about not blow­ing a hole in state bud­gets and main­tain­ing health care cov­er­age for con­stituents. In the crit­i­cal next few weeks, some gov­er­nors are uniquely po­si­tioned to press home-state Repub­li­can sen­a­tors who could deny Ma­jor­ity Leader Mitch McCon­nell the votes he needs to pass a Repub­li­can health care bill. “We are the voice of re­al­ity,” Ne­vada GOP Gov. Brian San­doval told The As­so­ci­ated Press. San­doval said he has been in reg­u­lar con­tact with Ne­vada Repub­li­can Sen. Dean Heller to dis­cuss the ram­i­fi­ca­tions of the evolv­ing GOP plan. Heller, who faces a tough re-elec­tion next year, has joined San­doval in op­pos­ing the cur­rent mea­sure. For wary Repub­li­cans, the main con­cerns about the GOP plan are rolling back premium sub­si­dies that help peo­ple buy pri­vate in­sur­ance poli­cies and phas­ing out the ex­pan­sion of Med­i­caid, the fed­eral-state in­sur­ance pro­gram for the poor, dis­abled and many nurs­ing home pa­tients. In Ne­vada, more than 220,000 res­i­dents have gained cov­er­age through Med­i­caid ex­pan­sion, 13,000 of them chil­dren.

“They set pol­icy, but we’re the ones who have to de­vel­opthe the care, bud­gets, de­velop de­velop the plans, work di­rectly with the peo­ple,” San­doval said. He said if money is re­duced, gov­er­nors will be left to de­cide among un­pop­u­lar choices: “Raise a tax or limit cov­er­age or change el­i­gi­bil­ity re­quire­ments” for cov­er­age. Heller is lis­ten­ing. “I can­not sup­port a piece of leg­is­la­tion that takes in­sur­ance away from tens of mil­lions of Amer­i­cans and tens of thou­sands of Ne­vadans,” he said re­cently. Ohio’s John Ka­sich has out­spo­ken been GOPone of gov­er­nors­the most in crit­i­ciz­ing GOP pro­pos­als. That has in­creased pres­sure on Ohio GOP Sen. Rob Port­man, who an­nounced his op­po­si­tion to the bill af­ter McCon­nell abruptly post­poned a vote. “My con­cern all along has been, could low-in­come Ohioans get ac­cess to the health care they need and more specif­i­cally, the treat­ment for the opi­oid epi­demic?” he told re­porters this past week. Port­man said he has dis­cussed with Ka­sich var­i­ous fi­nanc­ing op­tions that would ease any changes to Med­i­caid while not gut­ting drug treat­ment pro­grams. One McCon­nell pro­posal would be to pro­vide an ad­di­tional $45 bil­lion over a decade for states’ drug abuse pro­grams. In Ari­zona, GOP Gov. Doug Ducey has called Obama’s law “a dis­as­ter” and stopped short of out­right op­po­si­tion to McCon­nell’s ver­sion. But he has urged Repub­li­can Sens. Jeff Flake and John McCain to shield states from ex­ten­sive Med­i­caid cuts. The pro­gram cov­ers 1.9 mil­lion Ari­zo­nans, nearly 28 per­cent of all res­i­dents. The ex­pan­sion alone cov­ers 400,000. Both sen­a­tors have yet to in­di­cate how they’d vote on a GOP bill. Alaska’s Bill Walker, an in­de­pen­dent who iden­ti­fies as a con­ser­va­tive, has had reg­u­lar con­tacts with the state’s two Repub­li­can sen­a­tors — Lisa Murkowski and Dan Sul­li­van — over what the Repub­li­can health care over­haul will mean for his state. Alaska has some of the high­est health care costs and great­est med­i­cal needs in the coun­try. Tra­di­tional Med­i­caid cov­ers about a quar­ter of Alaska’s 740,000 res­i­dents, while the ex­pan­sion ben­e­fits 34,000 more. Murkowski has said she doesn’t have enough in­for­ma­tion to vote for the GOP plan. She has op­posed the elim­i­na­tion of fed­eral money for Planned Par­ent­hood, a pro­vi­sion of the bill. McCon­nell has lit­tle wig­gle room. With 52 Repub­li­can sen­a­tors, just three de­fec­tions leave him short of a ma­jor­ity. Democrats are uni­fied in op­po­si­tion. The Repub­li­can leader has said he plans to in­tro­duce an­other ver­sion Mon­day. But McCon­nell also said that if he is un­able to get 50 votes for the GOP plan, he would try to shore up in­sur­ance mar­kets, a leg­isla­tive step that would in­volve Democrats.

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