Democrats, GOP spar over Medicaid reform at govs’ meeting

WASHINGTON (AP) — Tensions emerged Saturday between Democratic and Republican U.S. governors over a GOP-led proposal for a major overhaul to Medicaid, with Democrats saying the changes would take away people's health coverage to finance tax cuts for the wealthy.

GOP governors intend to present Congress with a plan that they say would give states more flexibility to administer health coverage for poorer residents while protecting states from absorbing the costs of repealing the Affordable Care Act. Democratic governors said Saturday that their Republican counterparts were being dishonest about the effects of their plan.

"They want to spend less money on people's health care so they can do tax cuts for the rich. They've tried to put this camouflage on it that somehow they're giving governors flexibility. We've got plenty of flexibility," Democratic Washington Gov. Jay Inslee said. "This is not what we are asking for."

While major changes to former president Barack Obama's signature health care law appear inevitable with Republicans controlling the White House and both houses of Congress, Inslee said there's still a chance that Democrats can win over GOP lawmakers who've been facing angry constituents at town hall meetings.

"People are madder than hops about this. Look, there's four Republican members of the House in the state of Washington, and they're now in the witness-protection program," Inslee said. "We think churches are going to offer them sanctuary at some point, given how mad people are about this."

Inslee, whose national profile is rising as Democrats look for new leaders following Hillary Clinton's loss in November, led a successful legal challenge against President Donald Trump's ban on travel from seven predominantly Muslim countries.

The angry rhetoric about health care reform brought a dose of political reality to the nonpartisan National Governors' Association's winter meeting, where governors otherwise spend time praising each other and participating in panels on noncontroversial topics, such as early childhood education, a cause that got a boost from actress Jennifer Garner.

On Saturday afternoon, the governors met behind closed doors with Health Secretary Tom Price, who according to several governors said the Trump administration wanted to partner with states to reform health care but did not provide specifics.

Meanwhile, at the White House, Trump met with two Republican governors, Wisconsin's Scott Walker and Florida's Rick Scott, and discussed "how best to solve the problems" of the Obama-era health law, with "special emphasis" on states' role in health care, according to a statement by his press secretary.

The entire governors' group will meet with Trump and congressional leaders on Monday.

The governors also listened to a consultant's report about the fiscal impact of a Medicaid overhaul on states. The report, a copy of which was obtained by The Associated Press, predicted that Medicaid reforms being proposed by House Republicans would result in tens of thousands of people losing their insurance coverage in an average-size state.

Inslee and Democratic Gov. Terry McAuliffe of Virginia called the report "disturbing." Republican Gov. Matt Bevin of Kentucky said if Democrats were disturbed, they haven't been paying attention.

"The kind of conversation that's being had now — sobering, shocking, surprising as it might be to some — is the conversation that we must have because the piper has to get paid at some point," Bevin said. "People are looking at reality, and that's good."

The GOP governors' Medicaid proposal, 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. Medicaid provides insurance to more than 70 million low-income Americans, and states had the option of making it available to more people under Obama's health care overhaul.

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

Another GOP governor in a Medicaid expansion state, Doug Ducey of Arizona, said Democrats are failing to acknowledge the shortcomings of Obama's health law and the need for urgent reforms.

"We don't want to see any citizen have the rug pulled out from underneath them, yet we know Obamacare is failing," Ducey said. "We're working hard to put together a plan that will replace Obamacare and actually be an improvement for health care, be a real reform of the Medicaid system."

It's not clear whether House Republicans will accept the GOP governors' proposal. Many congressional Republicans want to rewrite the basic financial contract for Medicaid, offering flexibility to states in exchange for limits on future federal funding. Budget hawks including House Speaker Paul Ryan, R-Wis., support the kind of program flexibility Republican governors are seeking, but chiefly want to spend less on Medicaid.

A recent Kaiser Family Foundation poll shows that 8 in 10 people nationally say lawmakers should preserve federal funding that has allowed states to add coverage for roughly 11 million low-income people. Almost 7 in 10 Republicans agreed, according to the survey by the nonpartisan group.

Follow Ben Nuckols on Twitter at https://twitter.com/APBenNuckols.