Ohio lawmakers air concerns about GOP health proposal

June 26--Ohio's top political leaders from both parties united in their concern over Senate Republicans' plan to repeal and replace the Affordable Care Act, also known as Obamacare.

Gov. John Kasich and U.S. Sens. Rob Portman and Sherrod Brown all issued statements voicing major worries about the bill, which was unveiled Thursday after weeks of closed-door deliberations by top Senate Republicans.

The 142-page bill -- known as the Better Care Reconciliation Act -- would make sharp cuts in Medicaid and eliminate Obamacare's individual mandate, under which Americans pay a fine if they do not purchase health insurance. Medicaid would operate on a fixed budget rather than as an open-ended program.

The Republican plan would also institute a new system of federal tax credits to help people pay for coverage, and would allow states to roll back a number of benefits required under the Affordable Care Act, including maternity care, emergency services, and mental health treatment.

Mr. Portman, a Republican, was one of the senators who served on a group designed to address health-care legislation.

He said he has problems with the provisions of the bill relating to Medicaid, but he stopped short of saying he opposed it in its current form.

"There are some promising changes to reduce premiums in the individual insurance market, but I continue to have real concerns about the Medicaid policies in this bill, especially those that impact drug treatment at a time when Ohio is facing an opioid epidemic," he said.

Mr. Portman's press secretary, Emily Benavides, said the senator is reviewing the bill and awaiting the analysis by the Congressional Budget Office, which could arrive as soon as Monday.

Mr. Brown, a Democrat, was harsher in his criticism.

"This bill takes away the No. 1 tool we have in the fight against opioids -- Medicaid treatment," he said. "We cannot allow Washington to rip the rug out from under Ohio communities."

He also criticized the bill for raising premiums for low-income Americans and people older than 50, who could pay as much five times more than younger people. Under the Affordable Care Act, people older than 50 could be charged up to three times more than younger people.

Mr. Kasich, a Republican, said he has "deep concerns" with the bill and condemned its secret drafting process. He said Congress will never reform the American health-care system "with a one-party approach that's developed behind closed doors, without public discussion and input."

Senate Majority Leader Mitch McConnell of Kentucky hopes to put the Better Care Reconciliation Act to a vote this week, just before the July 4 recess. But five conservative senators have come out in opposition. Several others, like Mr. Portman, have expressed serious concerns. Senate Democrats unanimously oppose the plan.

Ohio Democratic Party Chairman David Pepper hopes a combination of intra-party strife and grassroots opposition will derail the bill. In Ohio, he said, the strategy is to mobilize constituents in an effort to sway Mr. Portman with a flood of calls and emails.

And with the razor-thin margins at play in the Senate, Mr. Portman's vote could have an impact.

"The activity on the ground and in the grassroots does matter," Mr. Pepper said.

Ultimately, though, the ball is in Republicans' court, said Mark Caleb Smith, director of the Center for Political Studies at Cedarville University. Despite initial opposition from staunch conservatives, Mr. Smith believes Senate Republicans can find common ground.

"It's going to be difficult, but I think there's a good chance of getting it passed," Mr. Smith said. "I think right now they probably have pretty good odds to get something done because Republicans have sort of painted themselves into a corner over the last seven or eight years, essentially arguing that this was their first priority ... to repeal and replace Obamacare."

But that singular focus cuts both ways, Mr. Smith said. After years of rallying its base against the Affordable Care Act, the pressure to deliver is high for the Republican Party. And that pressure was only compounded by the initial withdrawal of the American Health Care Act in the House three months ago. The House later passed the measure in a close vote.

Failure to pass the senate bill next week would be a "setback," Mr. Smith said. If Republicans' campaign to repeal the Affordable Care Act stalls longer, though, the consequences could prove more severe.

"I think if they could get nothing done before the midterm elections in 2018 it would be devastating for Republicans," he said. "It would be devastating toward their fund-raising.It would be devastating toward the enthusiasm of their electorate, and I think they would certainly struggle because of it."

Contact Jacob Stern at: jstern@theblade.com or 419-724-6050.

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