GOP Governors Pitch Medicaid Reforms as Cornyn Pledges No Coverage Losses

Republican governors told members of a key Senate panel on Thursday that they want more flexibility when it comes to Medicaid.

That was the focus of a roughly two-hour, closed-door meeting among several GOP governors and Republicans on the Senate Finance Committee, which is set to play a key role in crafting legislation that would repeal and replace the Affordable Care Act. Officials inside the meeting described it as a listening session, during which Finance Committee members spoke little and governors made presentations about what they’d like to see.

Sen. John Cornyn (R-Texas), the Senate’s No. 2 Republican, said concerns about people losing coverage were raised, but he said that wouldn’t happen under a Republican plan.

“We’re all concerned, but it ain’t gonna happen. Will you write that down?” he told reporters leaving the meeting. “Nobody is going to lose coverage.”

Governors attending the meeting included Florida Gov. Rick Scott, Utah Gov. Gary Herbert, Ohio Gov. John Kasich and Iowa Gov. Terry Branstad, among others. House Energy and Commerce Chair Rep. Greg Walden (R-Ore.) and Health Subcommittee Chair Michael Burgess (R-Texas) also attended.

Keeping the ACA’s expanded Medicaid coverage is one of the big decisions Republican lawmakers are faced with as they craft legislation to repeal and replace Obamacare. A 2012 Supreme Court ruling gave states the flexibility to decide to expand eligibility for Medicaid to low-income adults, or not. Thirty-one states and D.C. have expanded the program, including several states with Republican governors. Some of those states, such as Indiana and Arkansas, got federal permission to expand the program with their own twist, requiring enrollees to do things including invest in a health savings account or pay premiums.

While no decisions were made during the meeting, Cornyn said governors suggested the federal government currently ties their hands with Medicaid dollars that are given to states. He pointed to Kasich, a former House member who sought the GOP nomination for president last year, as someone who offered ideas about steps that could be taken.

Kasich told reporters he suggested people within 100 percent of the federal poverty line be eligible for Medicaid, and anyone above that purchase insurance on the exchange. He also suggested reducing the benefits that are required and making changes to how much plans can charge based on age.

“The question is, as we move to offer, to make sure you can have coverage … are there some things in that package that if we had flexibility we wouldn’t have to provide? I think the answer to that is yes,” he said.

Hutchinson, the Arkansas governor who also previously served in the House, said block grants could be one way to give states more flexibility over the Medicaid program. Republicans have long advocated reforming Medicaid through a block grants or per capita caps.

Thursday’s meeting took place after Republicans on the Finance Committee wrote to GOP governors last month seeking feedback on the Medicaid program.

Morning Consult