Snyder meets with U.S. senators on Obamacare, Medicaid plans

Jan. 20--WASHINGTON -- Gov. Rick Snyder and other governors met with Republican U.S. senators on Thursday to voice concerns about a proposed repeal of the Affordable Care Act -- with Medicaid coverage for about 600,000 low-income Michiganders in the balance.

Following the meeting Thursday, Snyder declined to talk about specifics, only saying that he thought it was "a very healthy discussion" and that he appreciated senators showing "interest in hearing from the governors." About 10 governors -- including Ohio Gov. John Kasich and Florida Gov. Rick Scott -- took part in the discussion with members of the Senate Finance Committee.

Snyder and other governors have said Medicaid expansion made possible under the Affordable Care Act -- otherwise known as Obamacare -- could be threatened by Republican promises to repeal it, though it is unclear what sort of replacement President-elect Donald Trump, who will take the oath of office on Friday, and congressional leaders have in mind.

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In his State of the State speech on Tuesday, Snyder, a Republican, called on Michigan residents to speak out on behalf of the state's Medicaid expansion program, which is known as Healthy Michigan. Under a plan approved by the Obama administration, Healthy Michigan requires beneficiaries to make monthly contributions based on their income, with payments being reduced for specified healthy behaviors.

Under Obamacare, which was passed in 2010, the federal government was expected to pick up the cost of expanding Medicaid to people making up to 138% of the federal poverty limit beginning in 2014. The federal share was expected to phase down to 90% by 2020 with states picking up the difference.

Snyder said he "appreciates" the national challenges involved in keeping Obamacare or Medicaid expansion, but added, "We have over 600,000 Michiganders (on the Healthy Michigan program) and we have a lot of positive data showing some good things going on in our state."

"There's a variety of concerns. ... They're concerned about how it all works out," Senate Finance Chairman Orrin Hatch, R-Utah, said of the governors who came to the meeting. "It's a serious set of problems."

Republicans -- having long promised to get rid of the Affordable Care Act and now having control of the White House as well as Congress -- are now wrestling with how best to rescind and replace it without a significant number of Americans losing coverage.

This week, the Congressional Budget Office estimated that a repeal of the health care law -- leaving in place market reforms guaranteeing certain coverage, but eliminating government premium subsidies and a mandate that all Americans have insurance -- would result in 18 million more uninsured individuals in the first year after elimination, growing to 27 million as Medicaid eligibility was restricted.

Republicans downplayed the report, saying it doesn't take into account a replacement plan -- as yet unspecified -- which they expect to pass in Obamacare's place. Trump, in recent remarks to the Washington Post, said he expected to propose a plan that would provide coverage for every American, though it was unclear what such a proposal would include or how it would differ from President Barack Obama's signature legislation.

U.S. Sen. Bill Cassidy, R-La., said he takes Trump at his word -- if his word means to provide at least as much access to coverage as Obamacare does now -- though he doesn't know how Republican leaders plan to keep such a promise.

"Those are kind of marching orders," said Cassidy.

Contact Todd Spangler: 703-854-8947 or at [email protected]. Follow him on Twitter at @tsspangler.

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