Republican governors from Medicaid expansion states oppose a bill to repeal and partially replace Obamacare, saying it would make them pay more for Medicaid.
The letter from the governors of Arkansas, Michigan, Nevada and Ohio puts more pressure on GOP leadership as it tries to advance the bill to the House floor next week. Conservative House and Senate members want Obamacare’s Medicaid expansion to end next year instead of in 2020, but any attempts to change it could create a backlash.
The letter sent Friday to GOP House and Senate leadership said the American Health Care Act’s Medicaid reforms wouldn’t work. After the expansion ends in 2020, Medicaid would move to a per-capita system that would cap federal spending per beneficiary.
“It provides almost no new flexibility for states, does not ensure the resources necessary to make sure no one is left out, and shifts significant new costs to states,” the letter said.
The letter also calls on Congress to first work on stabilizing the private insurance market, “where the greatest disruption from Obamacare has occurred.”
The governors in the letter suggest a series of reforms they believe Congress should adopt.
The key one is that states can choose between two options. They could keep the current pay structure with some reduced federal funds or convert to a per capita cap or block grant for one or more population groups.
The letter comes at a critical time for the healthcare fight. The bill advanced out of the House Budget Committee Thursday and now goes to House Rules Committee and after that to the House floor.
But conservatives and some moderate Republicans have balked at the Medicaid portion of the bill, with the House Freedom Caucus and conservative senators calling for the expansion to end in 2018 instead of 2020.
But any attempt to roll back the Medicaid expansion sooner could create more opposition from GOP moderates, especially those in the Senate from expansion states.
House Speaker Paul Ryan has conceded changes need to be made to the bill for it to pass the House, but no changes have been made so far.
GOP leadership hoped to get the bill to the Senate and passed before the two-week Easter recess in early April.
