Arizona Gov. Doug Ducey heads to Washington this week to attend the Conservative Political Action Conference. The Washington Examiner asked him to preview his main priorities regarding Obamacare replacement and what they should know about Arizona's healthcare challenges.
Washington Examiner: How should Congress go about replacing the Affordable Care Act?
Ducey: The answer is a) as expeditiously as possible, as long as b) it's well-conceived. The damage from Obamacare is clear: Insurance markets have been wrecked; premiums have soared; and promises, such as "you can keep your doctor," have been broken. That's what happens when one party imposes a one-size-fits-all solution on one-sixth of the country's economy without even bothering to read the bill. Congress should do the opposite of what occurred in 2010: It should seek to expand choices for consumers, not limit them; it should encourage innovation in the states, not stifle it; and it should read the bill and understand the implications of what it's passing instead of simply hoping for the best despite ample evidence to the contrary.
Washington Examiner: You and other governors are coming to Washington to talk about your work on this. How are you working together and what do you need Congress and the administration to understand about the process and the results you're trying to achieve?
Ducey: Earlier this year, House Majority Leader Kevin McCarthy asked governors across the country to weigh in on the effort to replace Obamacare, and we've done so. We want flexibility to adapt healthcare regulations that reflect what our states' citizens need. We want to ensure that the rug isn't pulled out from under people who need help and access to healthcare. And we want to get it right the first time without inflicting all the trauma that came along with Obamacare. Congressional leadership and [Health and Human Services] Secretary [Tom] Price are listening, and that alone is a vast improvement. We have a good framework to continue the conversation and move forward.
Washington Examiner: Do you support maintaining provisions that prohibit insurance companies from denying coverage based on pre-existing conditions?
Ducey: Yes. We all know individuals who were unable to find coverage due to a pre-existing condition. These individuals need access to health insurance and for them, the thought of repeal and returning to a time when they could not buy coverage is scary. I think there's broad consensus on this point, and I'm confident we won't go back on it.
Washington Examiner: How quickly would you like to see Republicans in Congress, and President Trump, move in repealing and replacing Obamacare? Would you like to see the effort move as quickly as possible, or would you prefer they take a step-by-step approach that phases out Obamacare over a couple of years, and phases in the new law over the same period?
Ducey: We've had six years of poor implementation of bad policy. As a result, in 2017, most Arizonans shopping for healthcare coverage on the federal marketplace will have a single choice for coverage and some people will see a premium increase of over 100 percent. Fixing this won't happen overnight, and I think most people understand that. But there should be no ambiguity — the taxes, mandates and federal control that comprise Obamacare should be repealed as quickly as possible, and the necessary elements of a healthcare plan that puts patients first and ensures the broadest possible access to quality healthcare should replace them.
Washington Examiner: You opposed Arizona adopting the Medicaid expansion portion of Obamacare (your predecessor, Republican Jan Brewer, supported and implemented the expansion.) Now that there are Arizonans covered under the expansion, how would you like to see the Medicaid expansion maintained in any Obamacare replacement? Are you concerned if it isn't maintained as a part of any replacement that Congress passes, and that the federal government will stick the states with the bill?
Ducey: Whenever you deal with the federal government, that's always the concern, namely that they'll change the rules and stick you with the bill. With states contributing a portion of the financing, serving as the operational arm and acting as equity partners, Medicaid is a unique federal-state partnership. We're fortunate that, in Arizona, we have one of the best-run state healthcare programs [AHCCCS] in the country. Our job going forward — with the help of our congressional delegation — is to ensure that we're rewarded for the quality of our program and not punished for it. The Obamacare replacement needs to ensure that states are treated on their population, not on their existing costs, and it especially needs to take into account the impact on rural communities. As I mentioned earlier, we don't want to have the rug pulled out from under people, so the details of how Obamacare is replaced is critically important to us, especially as a state that did expand Medicaid.
Washington Examiner: What is Arizona's biggest pressing problem when it comes to healthcare policy that you would like the replacement bill to address?
Ducey: There are a few factors that contribute to Arizona's challenges when it comes to healthcare policy. We have a significant rural population that relies on community hospitals which are counting on the restoration of Medicare cuts, and we have a dwindling marketplace of insurance providers available to our state. But at the end of the day, Arizona's most pressing healthcare question is no different than the rest of the country's. How do we protect access to affordable coverage and high-quality care today while ensuring the viability of our care providers, and truly creating a patient-centered healthcare infrastructure every American can rely on in the future? This challenge is also the greatest opportunity with the repeal and replacement of Obamacare and why we must get it right.