Report warns of state money fallout from health law repeal

RGA map represents the 33 governorships - a 95-year high not seen since 1922 - held by the Republican Party in 2017 | Background by Backyard Production / iStock / Getty Images Plus; Map courtesy of the Republican Governors Association; composite image, St. George News

DISTRICT OF COLUMBIA (AP) — A report to governors about the potential consequences of repealing the Obama-era health care law warns that federal spending cuts probably would create funding gaps for states and threaten many people with the loss of insurance coverage.

The Affordable Care Act has two main components for expanding coverage: subsidized private health insurance available in all 50 states, and an optional Medicaid expansion that has been accepted by 31 states and the District of Columbia. Those two components of the health law cover more than 20 million people.

A report by the consulting firm Avalere Health, delivered Saturday at a meeting of the Republican Governors Association in Washington, concluded that the changes under consideration by the GOP-led House would reduce significantly federal dollars for Medicaid and subsidized private insurance.

The effect on Medicaid would be far-reaching. The federal-state program for low-income people covers more than 70 million Americans, many of whom have high health-care needs.

The Associated Press obtained a copy of the slide presentation made by Avalere to the governors meeting. The report said the combination of phasing out Medicaid expansion money from the U.S. government, plus transforming the overall program from an open-ended federal entitlement to one that operates under a cap would likely result in state funding gaps. States that expanded Medicaid would face the deepest cuts.

States would get more flexibility to design their programs, but the money crunch could lead to cuts in eligibility, benefits, or payments to hospitals and other service providers. The impact of federal spending reductions would compound over time.

The private insurance subsidies provided under Obama’s law would also be scaled back, according to the report.

Although states would get some additional safety-net funding, reductions in federal insurance subsidies would expose some consumers to new costs for their coverage. That would probably result in fewer people covered, as some consumers drop their plans.

According to the Kaiser Family Foundation, Medicaid consumed an average 19 percent of state budgets in 2015, the most current year available, ranging from 7 percent in Utah to 41 percent in New Hampshire.

Budget hawks including House Speaker Paul Ryan, R-Wisconsin, support the kind of program flexibility GOP governors are seeking, but chiefly want to spend less on Medicaid.

Health and Human Services Secretary Tom Price is followed by reporters as he leaves a health care meeting during the National Governors Association Winter Meeting Saturday in the District of Columbia, Feb. 25, 2017 | AP Photo/Cliff Owen, St. George News

Ohio Gov. John Kasich said he thinks “there’s going to be a problem in the House of getting anything out of there that still provides coverage to people. That’s why the Republicans have to reach out to some of the Democrats. I don’t know whether this is going to happen,” he told CBS’ “Face the Nation.”

Governors on Saturday met privately with Health and Human Services Secretary Tom Price, who according to several of the state leaders said the Trump administration wanted to work with states to overhaul health care, but he did not provide specifics.

A Medicaid proposal by GOP governors, a draft of which was obtained by the AP, urges Congress to change Medicaid from an open-ended federal entitlement to a program designed by each state within a financial limit.

Utah Gov. Gary Herbert joined six other governors in the draft proposal along with Ohio’s Kasich, Arizona Gov. Doug Ducey, Tennessee Gov. Bill Haslam, Michigan Gov. Rick Snyder, Nevada Gov. Brian Sandoval and Wisconsin Gov. Scott Walker.

Some of the governors behind the proposal, including Kasich, opted to expand Medicaid in their states despite pressure from conservatives.

I think there are some very conservative Republicans in the House who are going to say just get rid of the whole thing. And that’s not acceptable,” he said.

He added: “Republicans can go and do what they want, and I’m going to talk to them. But at the end of the day I’m going to stand up for the people that wouldn’t have the coverage if they don’t get this thing right. And I happen to believe that the best way to get this right over time is for actually both parties to work together. I know that’s considered an impossibility now, but what’s at stake is not some political thing. What’s at stake here are 20 million Americans.”

Written by: BEN NUCKOLS and RICARDO ALONZO-ZALDIVAR, Associated Press

Email: [email protected]

Twitter: @STGnews

Copyright 2017 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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  • ladybugavenger February 26, 2017 at 11:27 am

    Mumbai jumbo….hey, why don’t you increase tax on gov’t employees they just stand around and collect their pension anyways. Nothing ever gets accomplished in the government it just there to blackball civilians.

  • ladybugavenger February 26, 2017 at 11:28 am

    Mumbo not Mumbai

  • CaliGirl February 26, 2017 at 2:34 pm

    Why not remove the Earned Income Tax Credit and give a credit for those who do carry health insurance? Reward employers who offer health insurance coverage with tax credits too. If you don’t have coverage, your stuck with the medical bills you incur. Its all in our choices. Choose wisely or suffer the consequences.

  • hiker75 February 26, 2017 at 2:41 pm

    I think a good number of voters wanted ACA repealed.

  • comments February 26, 2017 at 7:05 pm

    even if it’s repealed Nolan will continue to get his free socialist healthcare, paid for 100% by us the taxpayers. But Nolan hates socialism so he should refuse to use his socialist healthcare on principle. Nolan, will u pledge to stop using socialism or not?

    • .... February 26, 2017 at 11:05 pm

      Hey Bob write a letter to your reelected Republican Governor I’m sure he cares what you think !

  • ladybugavenger February 26, 2017 at 9:13 pm

    I was jobless for 6 months. I had no insurance for 6 months. I got a notice from IRS for about a $900 fine. I have not seen a doctor, I have received no medical care and I’m not on gov’t assistance. Thank you for nothing Obamacare.

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