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Governors uneasy over Medicaid changes in GOP health care bill

Governors on both sides of the aisle are warily watching the Republican health care bill move through Congress, anxious over potentially significant cuts to Medicaid funding.

If enacted, the bill, which was narrowly passed by the House on Thursday and could face significant changes in the Senate, would significantly overhaul Medicaid. It would send the states a fixed amount of money for each Medicaid enrollee, known as a per-capita cap.

States could also opt to receive federal Medicaid funding as a block grant for the adults and children in their programs. That would mean states would get a fixed amount of federal funding each year regardless of how many participants are in the program.

Either of those options would limit federal funding, shifting that burden to the states. But many states don’t have the money to make up any shortfalls, so in such cases they would likely either curtail benefits, reduce eligibility or cut provider payments. The block grant would be more restrictive since the funding level would not adjust for increases in enrollment, which often happens in bad economic times.

“They are talking about slashing $800 billion, Chris, from Medicaid coverage. $800 billion,” Virginia Gov. Terry McAuliffe, a Democrat, told CNN’s Chris Cuomo Friday on “New Day.” “Who do you think is going to be affected by that?”

“What they are doing is, they put people’s lives in jeopardy,” he added. “People will die if this becomes law of the land.”

McAuliffe said the requirements to receive Medicaid were already “very lean” in Virginia prior to the House voting to repeal the Affordable Care Act, also known as Obamacare.

“In Virginia, we have a very lean Medicaid delivery system already,” he said. “If you are a single woman with two children in Virginia, you have to make less than $6,200 a year. What do you you want me to do, cut it to $5,000 a year?”

“I don’t have room to cut; that’s the problem with the per cap,” McAuliffe said. “I can’t go back and cut.”

Arkansas Republican Gov. Asa Hutchinson praised the House vote but said questions remain about covering his state’s residents, saying the bill needs to be “rectified” when it gets to the Senate.

“There needs to be change,” Hutchinson said. “It started in the House yesterday. It gives us more flexibility to manage our health care systems.”

Hutchinson said lawmakers need to better examine the impact of shifting costs to the state and provide more clarity about how former Medicaid recipients will get coverage.

“We are concerned that is more limited under what came from the House,” he said.

Another vocal opponent of the bill includes Republican Gov. John Kasich, who said the legislation “remains woefully short on the necessary resources to maintain health care for our nation’s most vulnerable citizens.”

Kasich cited the importance of coverage for individuals “dealing with mental illness, addiction and chronic illness” and said he was “hopeful” that the Senate would revise the bill.

Massachusetts Gov. Charlie Baker, a Republican, said Thursday that the health care plan would “significantly reduce critical funds for the commonwealth’s health care system.”

“Maintaining flexibility through the Medicaid program is critical to the commonwealth’s ability to provide coverage for the needy, and I urge Congress to reject this bill in its current form,” Baker said in a statement shared on Twitter.

Illinois Gov. Bruce Rauner, also a Republican, said the GOP plan fails to address how the new bill affects health care coverage for those depending on Medicaid.

“Recent changes did not address fundamental concerns about the bill’s impact on the 650,000 individuals that are part of our Medicaid expansion population, nor have those changes eased the concerns of the 350,000 people in the individual market who are dealing with skyrocketing premiums and fewer choices,” Rauner said Thursday in a statement. “We will continue to voice our concerns as the law moves to the Senate.”

Oregon Gov. Kate Brown said it was “irresponsible” for Congress to consider legislation that she she said will reduce federal funding for Medicaid.

“It is irresponsible for the US House of Representatives to consider this legislation before the Congressional Budget Office has analyzed its impacts on Americans,” the Democrat said Thursday in a statement. “In its current form, the (American Health Care Act) would roll back major provisions in the Affordable Care Act, jeopardizing the health care of 350,000 Oregonians, increasing prices for elderly Oregonians, reducing federal funding for Medicaid enrollment, and risking the loss of more than 23,000 jobs that were created in Oregon after the implementation of the ACA.”