Governors urge Senate leaders to rethink Medicaid cuts

Pennsylvania Gov. Tom Wolf joined three other Democratic governors and three Republican governors in signing a letter to Senate leaders that outlines their vision for healthcare reform. (Governor Tom Wolf / CC BY 2.0)

A group of Democratic and Republican governors is urging the Senate to adopt a more moderate stance on Medicaid than what's outlined in the House's healthcare bill—even amid reports that the chamber's Republicans are doing just the opposite.

In a letter sent Friday to Senate Majority Leader Mitch McConnell, R-Ky., and Minority Leader Chuck Schumer, D-N.Y., the seven governors say Congress’ first goal should be to reform the private health insurance system. The governors included: Republicans Brian Sandoval of Nevada, John Kasich of Ohio and Charlie Baker of Massachusetts, and Democrats Tom Wolf of Pennsylvania, Steve Bullock of Montana, John Bel Edwards of Louisiana and John Hickenlooper of Colorado.

Instead, the House version of the American Health Care Act “calls into question coverage for the vulnerable and fails to provide the necessary resources to ensure that no one is left out, while shifting significant costs to the states,” the governors write.

The Medicaid provisions in the bill, they add, are “particularly problematic.”

Starting in 2020, the House bill would roll back Medicaid expansion and replace the program’s current funding structure with a per capita cap arrangement. A new report from the Urban Institute estimates that the legislation could cut federal Medicaid spending by $938.3 billion from 2019 to 2028. 

However, one leading proposal as the Senate crafts its own version of a healthcare overhaul would cut Medicaid even more, The Hill reports. That proposal would start out with the growth rate for a new cap on Medicaid spending at the same levels as the House bill, but then drop to a lower growth rate.

In addition to criticizing the House bill’s approach to Medicaid, the seven governors who sent Friday’s letter laid out “guiding principles” for how to reform the private insurance markets. They call for improving affordability by addressing rising healthcare costs across the system while increasing access to coverage, as well as restoring stability to the individual markets.  

Predictably, the governors also want states to have more control over healthcare policy. Thus, they call for more flexibility to “implement reforms in a manner that is responsive to local and regional market conditions,” and relief from “duplicative or burdensome” federal regulations.

The concept of more state control already has the support of the Trump administration, which has encouraged states to apply for waivers to remake their Medicaid programs and institute reinsurance programs or high-risk pools in their individual insurance markets.