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ROBINSON: GOP cuts Medicaid for tax breaks

26 June 2017

On Friday a fifth GOP senator, Dean Heller of Nevada, said he does not support the bill.

The proposal released Thursday calls for a slower phase-out of the Medicaid expansion than a bill adopted earlier by the House.

ROVNER: Well, the piece of the Affordable Care Act that's most at stake is what we've just been talking about, the people who buy their own insurance in the individual market. Several of them felt his lash during last year's campaign or, like Portman and Susan Collins of ME, have kept their distance from Trump. Because it preserves more reasonable subsidies than the House bill and because its Medicaid drawdown happens in the distant 2020s - which is to say, perhaps never - it might not be an outright political catastrophe.

Nurses and administrators at the Samuel U. Rodgers Health Center on Euclid Avenue concerned about more uninsured patients joined Jackson County Sheriff Mike Sharp, who decried potential cuts to substance abuse treatment in the midst of an opioid crisis.

The heads of 10 Medicaid managed care companies sent a letter to McConnell and Senate Minority Leader Chuck Schumer asking them to rethink the proposed changes.

It "would have a profoundly negative impact on Americans", said John Meigs, president of the American Academy of Family Physicians.

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Instead of enrolling childless adults with incomes up to 133 percent of the poverty level, nearly entirely at federal expense, Walker and the Republican-controlled Legislature limited Medicaid coverage to adults at or below the poverty line.

House Minority Leader Nancy Pelosi, D-Calif., was urging Democrats to post stories on social media on constituents whose health care coverage would be threatened.

Democrats have blasted the Senate bill, with some calling it "meaner". It would also slap annual spending caps on the overall Medicaid program, which since its inception in 1965 has provided states with unlimited money to cover eligible costs.

Collins says another seven to eight senators including herself remain troubled about the possible Medicaid cuts. Now comes his next challenge - persuading enough Republicans to back the measure and avert a defeat that would be shattering for President Donald Trump and the GOP. If you are a 27-year-old who makes $70,000 a year and has no illness, this is a good bill for you.

I would still be willing to vote for it if it allowed states and/or individuals to opt-out of the Obamacare system free-and-clear to experiment with different forms of insurance, benefits packages, and care provision options. Those costs are rising there and elsewhere even with the federal government paying for most of the expansion, largely because more people signed up than originally expected. The problem we don't have is how to help 27-year-olds get cheaper insurance.

In Montana, 20 percent of residents didn't have medical insurance in 2013.

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"I believe that the bill that the Senate will vote on, assuming they get to that point, will have some sort of mechanism to cause participation in it", said former GOP Senate staffer Rodney Whitlock.

Charlie Baker, the Republican governor in heavily Democratic Massachusetts, and Tom Wolf, a Democratic governor in Pennsylvania, had similar concerns.

"Senator McConnell has said that he wants a vote next week, and that's up to him to run the chamber the way he sees fit".

Morrow explained that Medicaid now has structural problems and because it has been open-ended for years, there is fraud and abuse and gaming of the system by states.

There are a number of things that we can work on constructively to make insurance more affordable for people, to make insurance more competitive.

Twitter is not having it with the Obamacare repeal hashtag #HellerVoteYes
That would focus the aid more on people with lower incomes than the House legislation, which bases its subsidies on age. The bill could be amended to allow for a modified version of the deregulatory waivers included in the House.

Alaska Gov. Bill Walker, a Republican-turned-independent, said in a statement Thursday that he is still reviewing the Senate plan, but had some worries about how it might affect his vast and sparsely populated state, where health care costs are high.