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Republican governors outline health care plan, Medicaid changes

AP PHOTO Ohio Gov. John Kasich walks out of the White House in Washington, Friday, to speak with reporters following a meeting with President Donald Trump.

DES MOINES — Republican governors from seven states are calling for dramatic changes to Medicaid, which provides insurance to more than 70 million low-income Americans, as they nervously watch President Donald Trump and GOP congressional leaders move to repeal and replace the Obama-era health law.

At the same time, they’re telling Washington: Don’t scrap the Affordable Care Act without a viable alternative.

According to a draft of the proposal obtained by The Associated Press, the governors are urging Congress to adopt an alternative that would change Medicaid from an open-ended federal entitlement to a program designed by each state within a financial limit. Led by Ohio Gov. John Kasich, a frequent critic of some GOP proposals on health care, the governors plan to present their proposal at their annual meeting in Washington on Saturday.

In addition to Kasich, the governors are Arizona Gov. Doug Ducey, Tennessee Gov. Bill Haslam, Utah Gov. Gary Herbert, Michigan Gov. Rick Snyder, Nevada Gov. Brian Sandoval and Wisconsin Gov. Scott Walker.

At the heart of the document is concern among Republican governors they would bear the consequences if Congress scraps the health care law, shifting costs to the states, and jeopardizing coverage for millions of people who gained it under Obamacare’s expansion.

“We must ensure that people do not have the rug pulled out from under them and are not left without access to care, especially during the transition,” the draft says.

The proposal, if adopted by the Republican Governors Association on Saturday, would be submitted to leaders in the GOP-controlled Congress as House Republicans prepare to unveil their plan. Kasich met in Washington on Friday with Trump to discuss the plan, and described the president as having “listened very carefully to what I had to say about it.”

The governors represent states that expanded Medicaid despite strong GOP opposition and others that did not. Arizona, Michigan, Nevada and Ohio all agreed to expand Medicaid coverage under the federal law, in return for federal reimbursement to cover uninsured lower-income residents who would not have otherwise qualified. Tennessee, Utah and Wisconsin did not.

According to the Kaiser Family Foundation, Medicaid consumed an average 19 percent of state budgets in 2015, the most current year available, ranging from 7 percent in Utah to 41 percent in New Hampshire.

The governors’ proposal calls for putting states in charge of the program, but the federal government would continue to pay for most of it.

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