Four Republican governors have written to House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell to register their opposition to Trumpcare, as written in the current House bill. Michigan Gov. Rick Snyder, Ohio Gov. John Kasich, Arkansas Gov. Asa Hutchinson and Nevada Gov. Brian Sandoval argue that the bill as-is "shifts significant new costs to states" and should focus on "stabilizing the private insurance market" rather than Medicaid cuts, even though they're Republicans and really do think Medicaid needs "fundamental reform."
We were encouraged by the President’s Joint Address to Congress when he established his principle that “we should give our great state governors the resources and flexibility they need with Medicaid to make sure no one is left out.” We also appreciate the outreach from the Administration, and Secretary Price’s commitment to a partnership between federal and state governments to “design programs that meet the spectrum of diverse needs of their Medicaid population.”
We agree and share in these important objectives.
Unfortunately, the current version of the House bill does not meet this test. 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.
We support fundamental reform of the Medicaid entitlement. We have worked to develop a proposal (attached) that accomplishes this and addresses issues of equity for expansion and non-expansion states. Additionally, we believe Congress should focus first on stabilizing the private insurance market, where the greatest disruption from Obamacare has occurred.
That proposal includes some ideas that might be included in the new version of the bill Trump worked out with House conservatives. The governors want a choice between per-capita caps or block grants, not just per-capita caps in the Medicaid reforms, the option to keep the current structure of Medicaid, but with less money, and more flexibility to run their programs differently.
Note that when Rick "let them drink lead" Snyder has a problem with the current Medicaid cuts, Republicans have a big problem. Not with the conservatives, but with the moderates. The fact that Nevada Gov. Brian Sandoval has registered his opposition gives the most vulnerable Republican in the Senate in 2018 room to oppose as well. And that's just what Dean Heller is doing, as the bill stands now, that is.
Trumpcare is a travesty: It cuts taxes for the rich, kills Medicaid expansion for the poor and defunds Planned Parenthood. We can defeat it in the Senate, if you call the Capitol Hill switchboard at (202) 224-3121 and contact your senators.