Thread: Governors mull Medicaid expansion ahead of Trump meeting

Governors mull Medicaid expansion ahead of Trump meeting

By Tom LoBianco, David Wright and Tami Luhby, CNN
Updated 11:46 PM ET, Sat February 25, 2017

Story highlights

Governors are told millions could lose coverage under the GOP plan
They discuss turning Medicaid into a block-grant or per capita program

(CNN)A group of governors huddled Saturday with Health and Human Services Secretary Tom Price in Washington to air their concerns on Medicaid and the effort to repeal Obamacare.

The meeting comes two days before governors are set to meet with President Donald Trump at the White House, where worries about the Obamacare replacement are expected to dominate the discussion.

Price only briefly talked about his meeting Saturday as he dashed out of the room, surrounded by staffers, calling it "a good, candid exchange." The Health and Human Services Department later said in a release that "they discussed real, positive solutions."

Governors said afterward that much of the focus was on how to treat states that expanded Medicaid under the Affordable Care Act and those that didn't fairly.

Oklahoma Gov. Mary Fallin told reporters afterward that Price was in a "listening mode" and did not say which items Trump would support or oppose.

"He's in a listening mode right now, and certainly has talked about partnership with the states, listening to different challenges we face as governors," she said.

Governors also heard presentations from consulting firms McKinsey & Co. and Avalere Health that showed millions of residents could lose coverage under the Republican plan. The analyses, first reported by Vox, showed that many people would not be able to afford coverage if the GOP gave them tax credits based on age instead of Obamacare's subsidies based on income. Even more low-income residents would lose access to Medicaid coverage under the Republicans' plan to change federal funding levels.

Governors discussed whether Medicaid would be turned into a block-grant program or a per capita program, in which states would receive fixed funding based on the number of enrollees. They also discussed possibly compensating states that did not expand Medicaid.

Kentucky Gov. Matt Bevin, who has been in regular talks with the Trump White House about how to handle any Obamacare replacement, called the discussions of policy "gelatinous."

"That's your word of the day," said Bevin, who has a proposed overhaul to Kentucky's Medicaid expansion program pending before HHS. "It is this sort of amorphous thing that has yet to gel up, and until it does, we don't know what it will look like."

Republicans have convened a group of 10 governors (and their Medicaid directors) from five states that expanded Medicaid and five that did not to talk about how they should handle Medicaid, Fallin said.

Wisconsin Gov. Scott Walker, chairman of the Republican Governors Association, started the group a few weeks ago and said that they have been talking regularly by phone. Bevin and Arkansas Gov. Asa Hutchinson are also part of the group.

Congressional Republicans have also asked Walker, Ohio Gov. John Kasich, Nevada Gov. Brian Sandoval and Tennessee Gov. Bill Haslam to come up with a deal to resolve the expansion problem.

Changing Medicaid into a per-capita funding program and eliminating expansion could reduce federal spending by $1.4 trillion over 10 years, according to Avalere's analysis. Governors are wary of overhauling Medicaid because it's the largest source of federal funding for states.

Republican governors also have grown increasingly skittish about the fate of their low-income residents who gained coverage under Medicaid expansion -- as well as the future. Some 11 million adults are now insured in the 31 states, plus the District of Columbia, that expanded Medicaid. Sixteen of those states are run by Republicans.

"I think the concern of governors alike, not just Republican governors, but governors on either side of the aisle is: Give us a base, give us a foundation upon which we could help slow the curve. But you can't cut Medicaid. There's no way about it," Walker told The Washington Post on Friday.

Republicans have been feeling pressure across the country as Democratic protesters have flooded town halls hosted by Republican lawmakers -- yelling, screaming and chanting over the legislators and at times telling deeply personal stories about their health care.

Hutchinson, who expanded Medicaid, cited the surprising town hall hosted by Sen. Tom Cotton earlier this week in northwest Arkansas.

"Any time you have 2,000 Arkansans show up at a town hall meeting, that gets people's attention, and particularly politicians. And I think you have to understand that this is reflecting voter intensity. They are very concerned," Hutchinson told CNN Saturday.

"There's nothing more precious to you then health care, whether you have an individual policy or whether it's an employer policy or whether it's Medicaid."

http://www.cnn.com/2017/02/25/politi...nors-medicaid/

The problem unless people are too blind to see it is that we have too many "low income" people.

One solution is stop immigration of "low income" people, this is what Trump wants to do, because continuing to accept over 1,000,000 "low income" people every year as legal immigrants on green cards just adds low income people to the health insurance problem and increases the pressure for expansion of Medicaid and other welfare programs. So just stop that, altogether. JUST STOP IT.

Another solution is Trump's plan to create new good manufacturing jobs by bringing our jobs back home, expanding existing industry, building new manufacturing plants in the United States and hiring Americans at good jobs with sustainable wages and great benefits. This puts millions of unemployed, underemployed and "low income" people as a result of lack of good jobs, back to work at jobs with livelihoods that sustain them without government assistance of any kind. People who work in manufacturing do not need and do not use "welfare" or Medicaid, because they don't need it.

A third solution is deport every single illegal alien from the country along with their minor children, regardless of where they were born. There are millions of illegal aliens on Medicaid because of US born children when neither the illegal aliens or the children should be in the United States to begin with. There are also a lot of fraudulent schemes going on here with illegal aliens and Medicaid, just stop all that. Stop it all. No more benefits for illegal aliens, they must leave, families intact, no child left behind. PERIOD. Trump knows this and he will do everything within his power to make this happen. He knows the numbers, he's a numbers guy, and he knows the drain on jobs, wages and and public coffers for which illegal aliens are responsible. They all gotta go! Don't worry about the bad press from it, this administration is going to get bad press every day no matter what it does, so just disregard it altogether, push forward, do the right thing and the rewards for our citizens will be amazing.

Until that all happens, there is no option but to keep the expanded Medicaid coverage option, so it needs to have a time limit, 2 years, and then cut it off and return to just the basic Medicaid that we had before Obamacare. This will encourage STATES to develop industrial development programs that expand their industrial base instead of their health care business. This is what's at war here you know. It's the health care industry lining its pockets from all the new federal dollars through the expanded Medicaid that's pushing the debate on this issue, it's not really people. I'm in a non-Medicaid expansion state and I never hear anyone talking about it. My home state is a non-Medicaid expansion state and I never hear anyone talking about it there. Some of my family lives in another non-Medicaid expansion state and no one talks about it there either. So, it's an industry created issue. Put a time limit on it and move this mess forward to clean it up, clean it out and get health insurance on the right track.

I don't know if anyone saw the life-span report that came out the other day. It was easy to miss given the total preoccupation of the MSM with creating FAKE NEWS on Trump instead of reporting what's actually going on in the United States, but the life expectancy of Americans dropped last year.

So Obamacare has had the complete opposite effect of what it was supposed to do which is increase the life-span of Americans.

This should also give everyone a big clue about all that expensive "prevention" crap. It costs a fortune, annoys most people, and overall has done nothing to increase the life expectancy of Americans, all it did was fund health wellness companies that make you think you're "healthy" because you use their services, big business.

In the days before Obamacare, health insurance was for hospitalization, major events, not piddling doctor's appointments or ordinary short-term prescriptions. I was talking to my nephew the other night about Obamacare, repeal and replace, he'd been sick with a novovirus, terrible thing, he was sick for almost 10 days, so sick and contagious that he missed work and school for 10 days because of a virus and he was telling me about his health insurance plan that paid for his prescriptions except for $10, and I said that in the ole days, insurance would have only paid for his trip to urgent care for IV's, he was so dehydrated, and you would have paid for your prescriptions.

He's only 20, and he said "really?" I said, "really, today's health insurance is so expensive because it covers a lot more than what it used to cover. Maybe that's good on one level, but not on another." He thought about that for awhile and said "well, it would be better for most people to pay for the little stuff yourself, so you can afford health insurance for the big stuff like when you have to go to the hospital or have a cancer treatment or things like that." And I said, "exactly."

So we need some common sense interjected into this process which is what Trump is talking about when he says he wants to see all types of plans where you choose, yes, please, with some basic regulation and erasing the state lines with the repeal of McCarran-Ferguson, please let private insurance companies offer all those options.