White House launches aggressive push to flip GOP governors opposed to Senate health bill – Washington Post
Despite the administration’s sales pitch, however, four influential governors reiterated their concerns about the bill’s impact on their states’ most vulnerable individuals — underscoring the challenge facing the White House and Senate Republicans as they seek to fulfill a seven-year GOP promise to undo the Affordable Care Act (ACA).
“I’ve still got to come back to my concerns with regard to the Medicaid population,” said Gov. Brian Sandoval (R-Nev.) on his way to a private session with Vice President Pence here at the summer meeting of the National Governors Association. Pence had earlier delivered a detailed speech to the entire group defending the bill.
Sandoval’s views, along with those of three other governors whose states expanded Medicaid under the ACA — John Kasich of Ohio, Doug Ducey of Arizona and Asa Hutchinson of Arkansas — could prove decisive in determining whether the Senate passes legislation next week. Republican senators from those states are closely watching how their governors respond to the newly revamped legislation as they decide whether to support it.
Kasich, who did not attend, issued a statement calling the revised Senate plan “still unacceptable” because of its Medicaid cuts and possible impact on the private ACA insurance market.
Pence joined Tom Price, President Trump’s health and human services secretary, and Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, to work governors in front of cameras and behind the scenes Friday in this waterfront city.
They offered a detailed pitch contrasting with the more general and sometimes contradictory rhetoric Trump has delivered on health care — but one that contained inaccuracies and quickly met with rebukes from health advocates. They claimed, for instance, that the bill would not throw millions off insurance and that disabled Americans have been denied care because of the expansion of Medicaid under the ACA, which is also known as Obamacare.
In his speech, Pence also said Obamacare’s expansion of Medicaid put “far too many able-bodied adults” on the program.
“I know Governor Kasich isn’t with us, but I suspect that he’s very troubled to know that in Ohio alone, nearly 60,000 disabled citizens are stuck on waiting lists, leaving them without the care they need for months or even years,” said Pence.
The waiting lists Pence referred to apply to Medicaid’s home and community-based services, and have not been affected by the program’s expansion under the ACA. States have long had waiting lists for these services, and the Henry J. Kaiser Family Foundation’s executive vice president, Diane Rowland, noted that waiting lists in non-expansion states are often longer than in expansion states, which currently receive a 95 percent federal match for their newly covered beneficiaries.
Kasich spokesman Jon Keeling said in an interview that Pence’s suggestion that 60,000 disabled Ohioans remain on waiting lists “is not accurate,” adding that to suggest Medicaid expansion hurt the state’s developmentally disabled “system is false, as it is just the opposite of what actually happened.”
“That waiting list is nothing new, and to attribute it to expansion is absurd,” said Families USA’s senior director of health policy, Eliot Fishman.
Moreover, the expansion population is not solely composed of able-bodied beneficiaries: It includes low-income parents and childless adults, some of whom have chronic illnesses.
The Senate Republican proposal would cut $772 billion from Medicaid over the next decade by phasing out the expansion population, and it make even deeper cuts starting in 2025. By 2036, according to the Congressional Budget Office (CBO), the governmentwould spend 35 percent less on Medicaid than under the current law.
Among the GOP senators who have questioned aspects of the Senate proposal, at least half a dozen hail from Medicaid-expansion states. Pence, a former governor of Indiana, expanded Medicaid in his state.
Under the Senate bill, roughly 15 million Medicaid recipients would lose coverage within a decade, according to the CBO, which is expected to provide an updated score on the revised legislation next week. But Trump officials are arguing that the administration can cushion the bill’s financial blow to the states through a combination of legislative provisions and administrative measures.
In a departure from the president, who often has seemed to have little grasp of health policy details and the effect of them on everyday people, Pence delivered a speech in which he recounted stories of individuals he has met across the country who he said have been harmed by Obamacare.
He named a Kentucky small-business owner who he said was struggling under increasing premiums, a disabled Ohio woman who he said lost her plan, and doctor and a Wisconsin grandmother who he claimed had to choose between paying for coverage and buying Christmas presents.
At least one Republican governor may have been swayed by the pitch: Tennessee Gov. Bill Haslam.
Haslam, whose state did not enter into the expanded Medicaid program, nonetheless had some concerns about the Senate legislation’s impact on Tennessee, but he said he came away feeling better about the bill after hearing from administration officials.