Conservatives in the House said Tuesday that the GOP needs to move faster in repealing Obamacare, saying governors who counted on the health law to expand Medicaid are out of luck unless Congress crafts a fairer deal for everyone.
Some 31 states, including many run by Republican governors, expanded their health programs under Obamacare, counting on federal money to cover their increased caseloads. Gov. John Kasich, Ohio Republican, and others have begged Congress to let them keep the money or at least give them a soft landing as the GOP in Washington plots its repeal efforts.
Members of the conservative House Freedom Caucus, though, said Obamacare needs to be rooted out entirely, and that means putting all states on equal footing — including those that had foresight to avoid the Obama administration’s deal for broader Medicaid coverage.
“I would have a hard time telling voters in my district that they have to fund the Medicaid expansion for California, for another state,” said Raul Labrador, Idaho Republican.
While conservatives said they may be open to a compromise later, for now they want their leaders to revive a 2015 repeal bill that cleared Congress but was vetoed by President Obama.
The Affordable Care Act tried to entice states to expand Medicaid, the federal-state health program for the poor, by offering to pay most of the costs. While a majority of states signed up, 19 others — chiefly GOP-led states — balked, saying their budgets would explode and they’d rather hold out for a Republican president to undo Mr. Obama’s designs.
Conservatives say that moment has arrived, and if the 2015 bill was good enough for GOP lawmakers under Mr. Obama, they should have the courage to push ahead under President Trump, who will endorse their plans.
“It’s hard to see them supporting an argument that, now with a Republican president, they aren’t going to do the same thing that they did when they had a Democratic president,” Rep. Warren Davidson, Ohio Republican, said at a “Conversations with Conservatives” event hosted by the Heritage Foundation.
The Freedom Caucus took an official stand late Monday to reject any repeal bill that does not go as far as the 2015 effort, which repealed the Medicaid expansion, phased out government subsidies and scrapped Obamacare’s “individual mandate” requiring people to hold insurance.
On Medicaid, GOP leaders are looking at ways to rein in federal funding for the program by converting it to a fixed grant based on the number of enrollees in each state.
Republicans say that will allow governors to tailor their programs to their needs, making the program more efficient.
Democratic are already crying foul, saying it will force states to cut back on benefits.
House conservatives will also have to convince Senate Republicans whose states have benefited from Obamacare’s generosity.
“I think it is far too early to say who is out of luck on health care reform,” said Timothy Jost, a law professor at Washington and Lee University who closely tracks the health reform debate. “Whatever the House passes will have to get through the Senate, where expansion state senators are likely to balk.”
Sen. Bill Cassidy, Louisiana Republican whose state expanded Medicaid last year, says the best fix is to let each state decide whether to stick with Obamacare, abandon it completely or use federal money on an alternative that automatically enrolls people in a high-deductible, catastrophic plan.
“Whether my bill or a similar bill passes probably depends as much upon you as it does me,” Mr. Cassidy told a National Association of Health Underwriters conference Monday at a D.C. hotel. “We are elected to represent.”
But conservatives say voters didn’t elect GOP majorities to let states keep their Obamacare if they like it.
“If we’re just going to replace Obamacare with Obamacare light, then it begs the question — were we just against Obamacare because it was proposed by Democrats?” Mr. Labrador said. “And if that’s our position, then we’re very hypocritical.”