Signaling a possible rift among congressional Republicans, U.S. Sen. Cory Gardner and three GOP colleagues told Senate leadership Monday that they were “concerned” about a House plan to roll back expansion of Medicaid as part of an effort to repeal and replace the Affordable Care Act.
Gardner joined fellow U.S. Sens. Rob Portman of Ohio, Shelley Moore Capito of West Virginia and Lisa Murkowski of Alaska — along with Colorado, all states that expanded Medicaid under Obamacare — writing a letter to Senate Majority Leader Mitch McConnell expressing reservations about details of legislation released by House Republicans, calling Medicaid the “core of the health care safety net for individuals across the country.”
“We are concerned that any poorly implemented or poorly timed change in the current funding structure in Medicaid could result in a reduction in access to life-saving health care services,” the four senators wrote. “While we support efforts to repeal and replace the Affordable Care Act and make structural reforms to the Medicaid program, we are concerned that the February 10th draft proposal from the House of Representatives does not provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states.”
While the GOP majority is wide in the House, Republicans can only afford the defection of two senators so long as Democrats hold their ranks in opposition to overturning one of former President Obama’s signature legislative achievements.
The House measure — hatched behind closed doors until Monday, when a draft was released — is called the “American Health Care Act” and contains provisions to halt expansion of Medicaid coverage in 2020 and gradually phase out federal funding for the program after that.
The four senators wrote that they want more flexibility and more time for states to take over funding for Medicaid, which is covering more than 11 million additional people under the Obamacare in states that embraced the expansion.
“As the largest payer of mental health and substance use services in the United States,” the senators wrote, “it is critical that any healthcare replacement provide states with a stable transition period and the opportunity to gradually phase-in their populations to any new Medicaid financing structure.”
The senators assert that the Affordable Care Act “is not working for states or the federal government and must be repealed and replaced with a plan that reforms Medicaid and protects individuals and their families over the long term,” but they contend that the draft House proposal “does not meet the test of stability for individuals currently enrolled in the program,” and conclude: “[W]e will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states.”
It’s a delicate balancing act for Republicans, who have made repeal of the 2010 legislation a centerpiece of their campaigns for the last three election cycles. More conservative House members have also recently balked at suggestions to delay repealing some Obamacare taxes and have taken issue with proposals to help Americans buy insurance with refundable health care tax credits, preferring tax deductions instead.
White House Spokesman Sean Spicer hailed the release of the initial draft of the legislation. “Today marks an important step toward restoring healthcare choices and affordability back to the American people,” he said in a statement. “President Trump looks forward to working with both Chambers of Congress to repeal and replace Obamacare