Trump of­fi­cials push­ing gov­er­nors

Ne­vada’s San­doval could be key to fate of GOP leg­is­la­tion

The Denver Post - - NEWS - By Sean Sul­li­van and Dan Balz

PROVIDENCE, R.I.» Brian San­doval spent his Satur­day morning 3,000 miles from home tucked away in a con­ven­tion cen­ter ball­room where two top Trump ad­min­is­tra­tion of­fi­cials tried to per­suade him that ev­ery­thing would be OK un­der their plan to dra­mat­i­cally al­ter the na­tion’s health care sys­tem. They couldn’t.

As a re­sult, the Repub­li­can Party’s seven-year quest to over­haul the Af­ford­able Care Act re­mains at se­ri­ous risk of hit­ting another wall.

More than any other Repub­li­can in the coun­try right now, San­doval, the cen­trist gov­er­nor of Ne­vada, could hold the power to sink or salvage the health care bill Se­nate GOP lead­ers are hop­ing to pass.

San­doval’s voice is more in­flu­en­tial than per­haps any other Repub­li­can gov­er­nor here — largely be­cause what he de­cides is widely ex­pected to de­ter­mine the vote of his home­s­tate col­league, Sen. Dean Heller. Se­nate Ma­jor­ity Leader Mitch Mccon­nell, R-KY., has al­ready lost two Repub­li­can votes. A third would be game over.

Among the 32 state ex­ec­u­tives who at­tended the Na­tional Gov­er­nors As­so­ci­a­tion sum­mer meet­ing here this weekend, no one drew more at­ten- tion and in­ter­est than San­doval, a square-jawed, 53-year-old with neatly parted dark hair, a made-for-tv smile and a po­lit­i­cal dis­po­si­tion that is the an­tithe­sis of Pres­i­dent Don­ald Trump.

All weekend, he has been be­sieged — by re­porters tak­ing his tem­per­a­ture and by ad­min­is­tra­tion of­fi­cials, in­clud­ing Vice Pres­i­dent Mike Pence, try­ing to per­suade him that the Se­nate bill would not hurt his Ne­vada con­stituents de­spite its deep fed­eral spend­ing cuts to Med­i­caid.

So far, he isn’t buy­ing what the ad­min­is­tra­tion is sell­ing. “I’m no dif­fer­ent than I was,” San­doval told re­porters af­ter a gov­er­nors-only meet­ing Satur­day morning with Health and Hu­man Ser­vices Sec­re­tary Tom Price and Seema Verma, ad­min­is­tra­tor of the Cen­ter for Medi­care and Med­i­caid Ser­vices. He said he is likely to come to a fi­nal de­ci­sion “early next week.”

The Trump ad­min­is­tra­tion mounted a full-court ef­fort in Providence, rec­og­niz­ing the re­sis­tance not only by San­doval but other Repub­li­can gov­er­nors who are po­ten­tially in­flu­en­tial with their state’s sen­a­tors. De­spite a heavy pub­lic and pri­vate ef­fort, how­ever, the ad­min­is­tra­tion ap­peared to have changed no minds — and may even have hard­ened some of the op­po­si­tion.

One mo­ment in par­tic­u­lar drew pri­vate crit­i­cism from gov­er­nors of both par­ties — when Pence openly tar­geted Ohio Gov. John Ka­sich, a Repub­li­can who is a vo­cif­er­ous op­po­nent of the GOP health care pro­posal, with in­ac­cu­rate facts about Med­i­caid wait­ing lists for the dis­abled in Ohio.

At a meet­ing Satur­day morning with gov­er­nors, Price and Verma sought to dis­credit other analy­ses show­ing po­ten­tially dev­as­tat­ing con­se­quences for states un­der the Se­nate bill, in­clud­ing a yet-to-be re­leased analysis by the non­par­ti­san Con­gres­sional Bud­get Of­fice and an in­de­pen­dent analysis by the health care firm Avalere, which was pre­sented at the meet­ing.

Other key Repub­li­can gov­er­nors also ex­pressed skep­ti­cism about the bill af­ter the closed­door gath­er­ing, high­light­ing the Trump ad­min­is­tra­tion’s strug­gles.

“There’s still work to be done,” said Ari­zona Gov. Doug Ducey. Arkansas Gov. Asa Hutchin­son the­o­rized that the Se­nate bill “is prob­a­bly not the bill that’s ac­tu­ally go­ing to be voted on.”

Heller cited San­doval when he an­nounced his op­po­si­tion to an ear­lier ver­sion of the Se­nate bill. The two men and their staffs are in close con­tact an­a­lyz­ing the newer ver­sion.

San­doval, first elected in 2010, was the first Repub­li­can gov­er­nor in the na­tion to de­cide to ex­pand Med­i­caid un­der the Af­ford­able Care Act. He sees some strong sim­i­lar­i­ties be­tween his current predica­ment and that one.

“We did a tremen­dous amount of due dili­gence lead­ing up to that de­ci­sion,” he said. “This is the iden­ti­cal process that I used lead­ing up to mak­ing that de­ci­sion.”

San­doval well rec­og­nizes the po­si­tion he holds in the freighted de­bate over the fu­ture of Oba­macare. “Of course I am,” he replied when a re­porter asked him whether he is feel­ing the weight of his po­si­tion. “That’s part of what be­ing a gov­er­nor is all about.”

“A lot of peo­ple’s lives and health and health care and qual­ity of life is in the bal­ance,” he added. “I’m a for­mer judge. I take in all the in­for­ma­tion and then I make a de­ci­sion and that’s what I’m do­ing now.”

The Se­nate Repub­li­can pro­posal would cut $772 bil­lion from Med­i­caid over the next decade and re­sult in 22 mil­lion fewer Amer­i­cans with in­sur­ance com­pared with current law, ac­cord­ing to a CBO as­sess­ment of an ear­lier ver­sion. An up­dated score is ex­pected as soon as Mon­day.

The Avalere study pre­sented Satur­day morning pro­jected fed­eral Med­i­caid fund­ing re­duc­tions in all 50 states rang­ing from 27 per­cent to 39 per­cent by 2036. In Ne­vada, the study pro­jected a 37 per­cent re­duc­tion.

Stephan Savoia, The As­so­ci­ated Press

Ne­vada Repub­li­can Gov. Brian San­doval, left, and Vir­ginia Demo­cratic Gov. Ter­ence Mcauliffe chat be­fore Tesla and Spacex CEO Elon Musk ad­dresses the Na­tional Gov­er­nors As­so­ci­a­tion meet­ing Satur­day.

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