Moran undecided on new health bill

Amid a last-ditch attempt by Senate Republicans to repeal and replace the Affordable Care Act, an unpredictable senator has yet to take a side: Kansas' Jerry Moran.

Moran, a Republican, helped sink two unpopular repeal-and-replace bills this summer, though he later voted for repeal-only versions. His office said Wednesday he still was undecided on Senate Republicans' latest efforts to repeal the Affordable Care Act, also known as Obamacare.

"Sen. Moran continues to have conversations with Kansans and his colleagues regarding Graham-Cassidy and reconciliation," his office said.

The vote is a politically difficult one, said Washburn University political science professor Bob Beatty. He said he thought Moran and some other Republicans saw the value in fixing the problems with Obamacare -- rather than repealing it -- because of the popularity of some key provisions, such as protections for those with pre-existing conditions, Medicaid expansion and the ability for people to stay on their parents' insurance until age 26. The problem, Beatty said, is that Republicans have been talking about repealing Obamacare since it began in 2010.

"They painted themselves a bit into a corner for years, saying they were going to get rid of it," Beatty said.

Moran has been a key figure in the struggle to repeal Obamacare since he came out in opposition to the Better Care Reconciliation Act in July, one of the first repeal-and-replace attempts. At a closely-watched town hall in Palco, he laid out criteria for his repeal vote. He said he would evaluate proposals based on whether they made premiums more affordable, protected those with pre-existing conditions, protected rural health care and paid Medicaid providers enough without inhibiting job creation or punishing Kansas for not expanding Medicaid.

"I would say this bill would flunk the Moran test," said David Jordan, executive director of the Alliance for a Healthy Kansas, a pro-Medicaid expansion advocacy group.

Jordan said he thought the newest repeal and replace bill -- called Graham-Cassidy for Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La. -- was the worst yet.

The Congressional Budget Office has yet to evaluate the bill's effects and won't be able to fully evaluate it for several weeks -- likely past the Sept. 30 deadline -- but the left-leaning Center for Budget and Policy Priorities predicts even more people would be uninsured than if senators simply repealed Obamacare. According to CBPP, the bill would replace both the Obamacare marketplace and Medicaid with block grants, do away with Medicaid expansion and weaken protections for those with pre-existing conditions. A formula for marketplace block grant funding would also direct more toward non-expansion states, like Kansas.

The bill's supporters contend it gives states more flexibility to administer their health care systems.

Sheldon Weisgrau, director of the Health Reform Resource Project, said Kansas would come out ahead by about $800 million between 2020 and 2026 between the Obamacare block grants and reduction in Medicaid funding through per-capita caps, but after that, funding would drop. He said the state would be better off under the existing Obamacare system if it expanded Medicaid.

"With Medicaid expansion, we'd get nearly that much funding every year," Weisgrau said.

Jordan also expressed concerns over the leeway states would get in spending the money, citing complaints against Kansas' Medicaid program, KanCare.

"It really creates a number of red flags," he said. "How could Kansas possibly be trusted to administer this money?"

Jordan said he appreciated Moran's willingness to listen to Kansans' concerns about the bill. He said his group's members planned to rally outside Moran's Olathe office on Tuesday and call Moran and his fellow Republican U.S. Senator from Kansas, Pat Roberts, who has steadfastly supported any effort to repeal Obamacare.

Roberts' office did not immediately return a request for comment, but he told Vox the new bill was Republicans' last chance. He said they would feel the effects in the 2018 election if they did nothing and compared Obamacare to being driven by Thelma and Louise, a reference he has made several times while talking about Obamacare.

"It's clear that he's not concerned how this bill impacts Kansans, and he's looking to score political points with donors," Jordan said.

Credit: By Allison Kite [email protected]