Obamacare repeal power brokers: GOP governors – Health Care News

on May17

17 May 2017 | 6:00 pm

(Reuters) – A group of about a dozen Republican governors is pushing for its own set of national healthcare reforms, flexing its considerable muscle in the national debate over the future of Obamacare as the U.S. Senate begins writing its bill.

Led by Governor John Kasich of Ohio, the governors are using a nine-page proposal they crafted in February as the platform to shape what they think a critical portion of an Obamacare replacement law should look like, according to a half dozen people who helped write the plan.

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Amongthegroup’srecommendationsfortheSenateincludemaintainingtheexpansionofMedicaid,thegovernmenthealthinsuranceprogramforthepooranddisabled,whilealsolimitingfederalspendingforcertainpopulations,accordingtoacopyoftheproposal.

Membersofthegroup,whichincludegovernorsfromUtah,TennesseeandMichigan,arealsonowlookingtoformabipartisancoalitionofstatestoproposereformsfortheindividualinsurancemarket,accordingtoonesource,thattheyhopetheSenatewillalsouse.

ISSUESOFFOCUS

Theyhavenotyetmetordecidedonspecificreformsabouttheindividualinsurancemarket,butthegoalistoaddressissuessuchashowtomakeinsurancemoreaffordableandstabilizethemarkets.

TheHouseofRepresentativesnarrowlypasseditsnationalhealthcarebillearlierthismonth,calledtheAmericanHealthCareAct,whichwouldslashfederalMedicaidfundingbymorethan$800billionoverthenextdecade.

IthaspromptedfiercecriticismfrombothRepublicanandDemocraticgovernors.

Kasichrecentlycalledthebill“inadequate,”andsaiditwouldleavemillionsofpeoplewithoutaffordablecoverageand“livingintheemergencyroomsagain.”

BUILDINGPRESSURE

Pressureisbuildingfromtheirconstituents.

TheReuters/Ipsospoll,whichhasbeentrackingpublicopiniononhealthcareissuesforthepastseveralyears,hasfoundthatRepublicansaremoresupportivethantheywerein2013ofbenefitsincludingexpandedMedicaidandinsurancesubsidiesforlow-incomefamiliesandagovernmentrequirementthatsmallbusinessesprovideinsurancefortheiremployees.

ThelatestReuters/IpsospollwasconductedonlineinEnglishacrosstheUnitedStatesandgatheredresponsesfrom2,126adults,including887Republicans.Ithasacredibilityinterval,ameasureofaccuracy,of2percentagepointsfortheentiregroupand4percentagepointsforRepublicans.

ThegovernorsgroupislookingtotheSenateformassivechangesastheybeginwritingtheirownbill.

INFLUENCING THE PROCESS

Severalgroups,frominsurersandhospitalstomedicalgroupsandpatientadvocates,aretryingtoinfluencetheSenate.Butthegovernorscarryextraweightbecausetheywillultimatelyberesponsibleforimplementingwhateverhealthcareoverhaulissignedintolaw,andRepublicansinCongresshaverepeatedlyspokenabouttheneedtohavefewerfederalregulationsapplytoMedicaidandcommercialinsurance.

UnderObamacare,morethan30states,includingaboutadozenRepublican-ledstates,expandedMedicaid.OneofthethorniestissuesRepublicanshavegrappledwithistreatingbothexpansionandnon-expansionstatesequally.GovernorsfrombothtypesofstatesunitedtocraftMedicaidproposalsinthehopethattheirvoicewouldcarryaddedweightandprovideasurerpathforlawmakers.

ThegovernorsarealsointhesameboatpoliticallyasU.S.senatorsbecausebothareelectedstatewide,ratherthaninsmallerdistrictsasHouserepresentativesare.Somanygovernorsandtheirsenatorshavebeenbetteralignedonwhathealthcarereformshouldlooklike,severalofthesourcessaid.

REGULAR CONTACT

Severalgovernorsandtheirstaffsaidtheyhavebeeninregularcontactwiththeirsenators,andwillbepushingfortheSenatetousethegovernors’setofreformsasaframeworkinwritingitsbill.

SenatorRobPortmanofOhiowroteinanop-edMondaythatheandothersenatorstaskedwithwritingahealthcarebillhavecontinuedtoengagewithgovernors,“manyofwhosharemyconcernsaboutMedicaidbutwhoalsowantmoreflexibilitytoensuretheycandesignhealthcareprogramsthatmeettheindividualneedsoftheirstates.”

HeaddedthattheSenatewillcontinuetoworkwithgovernorsonhealthcarereform.

“Theyaredefinitelyhearingourconcernsandquestions.Theyhavebeenveryattentivetoourinterests,”saidNathanChecketts,deputydirectoroftheUtahDepartmentofHealth.

UNIFIEDVOICE

ThegroupofRepublicangovernorshasworkedtohaveaunifiedvoicetoreconcileneedsamongadiversesetofstates,includingArizona,Illinois,Wisconsin,ArkansasandNevada.Itsleaders,whichalsoincludeGovernorRickSnyderofMichiganandGovernorDougDuceyofArizona,deliberatelychosesomeparticipantsfromstateswithinfluentialRepublicansenatorswhowouldbecomekeyplayersinafederalhealthcareoverhaul.

A13-memberSenatepanelhasbeentaskedwithwritingahealthcarebill,andatleastfiveofitssenatorsarefromstatesfromtheRepublicangovernors’group,includingPortman,OrrinHatchofUtah,MikeLeeofUtahandLamarAlexanderofTennessee.

OtherRepublicansenatorswithgovernorsinthegroupincludingDeanHellerofNevadaandJeffFlakeofArizonaareupforreelectionin2018.

AsSenateRepublicanstakeupthebill,oneofthemostcomplicatedpolicyandpoliticalissuestheymustgrapplewithisMedicaidreform.

CALLFORPROTECTION

StatesthatexpandedMedicaid,suchasOhioandMichigan,havesaidahealthcareoverhaulmustprotectthosewhogainedcoverageunderObamacare.Non-expansionstates,meanwhile,havesaidtheydonotwanttobepenalizedwithlessfederalfundingbecausetheydidnotexpandandthereforecoverfewerpeople.

Thegovernors’proposalrecommendsmaintainingObamacare’sMedicaidexpansionandgivingotherstatestheopportunitytoexpand,butcappingfederalspendingoncertainpopulationsthrougheitherblockgrantsorpercapitacaps.

Itwouldprovidestatestheoptiontophaseinothergroups,suchasparentsandchildren,topercapitacapsorblockgrants,anditrecommendsreducingfederalregulationsonstatesandtheirMedicaidprograms.



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