Daines to decide on GOP health care bill after hearing from Montanans

BILLINGS - U.S. Sen. Steve Daines, R-Mont., will decide whether to support his party’s health care bill after hearing from Montanans next week, the lawmaker said Friday.

The senator said he will spend the weekend reading the 142-page bill and then hear from Montanans at Wednesday's telephone town hall meeting. Daines expects 30,000 people to participate in Wednesday’s call, based on the 28,000 people who participated in a call a couple weeks ago.

“What Montanans have told me they want to see, first and foremost, is a reduction in premiums, the affordability question,” Daines said. “No. 2, taking care of those with pre-existing conditions, that they have access to care and affordable care. And No. 3, very important for Montana is, we are one of the Medicaid expansion states, is that we save Medicaid and protect Medicaid.”

Concerns about Medicaid cuts topped criticisms Thursday when Senate Republican leaders published the Better Care Reconciliation Act. The bill, crafted behind closed doors by 13 key Republican lawmakers, didn’t seem out of step with the House Republican American Health Care Act passed in May. The Congressional Budget Office had estimated 23 million people would lose health coverage under the House plan, mostly because of Medicaid cuts affecting the working poor.

The Montana Health Care Foundation put lost coverage in Montana at 70,000 or more people, basically by ending Medicaid coverage offered to working people earning 138 percent of the of federal poverty level, or $16,400 a year. The Affordable Care Act championed by Democratic congressional majorities and President Barack Obama in 2010, sought to cover working people who couldn’t afford insurance. Medicaid had previously not been offered to the working poor and instead primarily protected children and people with disabilities.

Republicans have argued since ACA’s conception that Medicaid needed to return to its original mission, which meant winding down federal Medicaid funding of coverage for the working poor. Daines said the Republican bill unveiled last week would continue through 2020 the current federal level of support for Medicaid expansion at more than 90 percent of the cost.

After 2020, federal support for Medicaid would begin declining. The federal government would step down support starting with an 85 percent match in 2021 and ultimately lowering support to about 68 percent or 70 percent, the normal Medicaid reimbursement rate, after 2024. States would continue to offer Medicaid to the working poor, but would have to either spend more to offset the lower federal support level, or scale down their Medicaid programs to levels not seen since before the ACA. Republicans consider Medicaid unsustainable at its current size.

“Medicaid is a very important safety net. The disabled, elderly pre-Medicare, pregnant moms, children. In fact, one of the highest percentage of Medicaid enrollees are children,” Daines said. “So, it’s very important for rural states, frankly it’s important for every state, and we want to make sure we got a Medicaid system that is sustainable and that we’ve allowed the state a greater voice in the way Medicaid is administered.”