January 23, 2017

Meet the Republican governors who want to save Medicaid expansion

Daily Briefing

    A group of Republican governors on Thursday met with Republican members of the Senate Finance Committee to discuss the future of Medicaid as lawmakers look to repeal the Affordable Care Act (ACA).

    Thirty-one states and Washington, D.C., have expanded Medicaid under the ACA, providing insurance to about 11 million new enrollees. Of the 31 states that have expanded the program, 16 have Republican governors.

    GOP govs. tout benefits of Medicaid expansion

    Some governors on Thursday urged federal lawmakers to continue funding Medicaid expansion, even as Republicans work to repeal the ACA.

    Michigan Gov. Rick Snyder (R) on Thursday praised the effects of Medicaid expansion in Michigan, saying the program "has had a lot of success, both in terms of healthier behaviors and better outcomes helping people."

    Ohio Gov. John Kasich (R) in a letter sent to Congress ahead of the meeting urged Republicans to continue Medicaid expansion. "We strongly recommend states be granted the flexibility to retain the adult Medicaid coverage expansion," he wrote. Kasich has voiced concerns about what would happen to the 700,000 Ohio residents who gained coverage under the state's Medicaid expansion if the ACA is repealed.

    After the meeting, Senate Minority Whip John Cornyn (R-Texas) refuted concerns that individuals covered through the ACA's Medicaid expansion will lose coverage, saying, "It ain't going to happen." However, a Cornyn aide later clarified that the senator meant no one would lose "access" to coverage, The Hill reports. 

    GOP govs. discuss ACA replacement options

    During Thursday's meeting, Republican governors and senators discussed ways to address Medicaid in the GOP's plan to replace the ACA.

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    Kasich proposed changing the Medicaid eligibility threshold from individuals with annual incomes equaling 138 percent of the federal poverty level (FPL) to individuals with incomes equaling 100 percent FPL. Under such a proposal, individuals with annual incomes between 100 and 138 percent FPL would be moved into exchange plans and could receive financial assistance from the federal government.

    Iowa Gov. Terry Branstad (R), whose state has expanded Medicaid, suggested that Seema Verma, President Trump's nominee for CMS administrator, could help states experiment with their Medicaid programs.

    Utah Gov. Gary Herbert (R), whose state has expanded Medicaid, said states need to reduce Medicaid spending. He suggested states could achieve this in part by "restricting benefits and limiting" benefit packages. He said, "The same is true with restricting the number of people [who] get on the system."

    Texas Gov. Greg Abbott (R), whose state has not expanded Medicaid under the ACA, proposed the federal government provide funding to all states through a per capita cap and give states the flexibility to set eligibility standards. Abbott said such a proposal would be " very fair to all states," not just those who already have received federal funding to expand Medicaid.

    Sen. Rob Portman (R-Ohio) said panel members intend to hold more meetings with governors in the future.

    Study links Medicaid expansion to improved hospital finances

    According to CQ News, Democrats on the Senate Finance Committee were not invited to Thursday's meeting. In response, Democrats have reached out to governors about how to prevent anticipated Medicaid cuts (Levitz/Kamp, Wall Street Journal, 1/19; Sullivan, The Hill, 1/19; Cornwell, Reuters, 1/19; Shesgreen, USA Today, 1/19; Siddons, CQ HealthBeat, 1/19 [subscription required]; Owens, Axios, 1/19).

    5 must-have upgrades for the consumer-focused health system (with or without the ACA)

    5 must-have upgrades for the consumer-focused health system

    Failure to prepare for today's consumer-driven reality is a risky strategy in any market. Increased out-of-pocket costs, the improvement of price transparency tools, the emergence of meaningful alternatives to traditional care sites, and the weakening of the traditional patient-physician relationship have accelerated the growth of a consumer market.

    Health systems that do not build real consumer loyalty are in danger of losing substantial share to new competitors. If they hope to grow, organizations must build long-term durable relationships with their customers. Check out this infographic to see five upgrades health systems should make to succeed in this new era of health care.

    Download the infographic

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