Saturday, January 7, 2017

Ducey on affordable care: replace before repeal

Gov. Doug Ducey has a message for Congress: Ducey to Congress: Don’t rush Obamacare’s repeal. So reports Howard Fischer at Arizona Capitol Times (subscription required) - reprinted in this morning’s Daily Star. Essential snippets from the Times follow.

Saying he fears harm to Arizonans, Gov. Doug Ducey today urged Congress to not to rush repeal of the Affordable Care Act.

“I don’t want to see any Arizonan have the rug pulled out from underneath them in terms of changing this law,” the governor told an audience of business executives, lobbyists and lawmakers.

“We can take a little time to get there,” he explained. “There’s no rush, although we should have sense of urgency because it’s topical now.”

Right. The Republicans have had six years to figure out a replacement plan (not counting the decades of inaction and obstruction before that).

Ducey is obliged to echo the Republican mantras: "monumental failure … failing under its own weight”.

But the governor sought to dampen the enthusiasm of Republican members of Congress, who already are moving to make outright repeal of the program their first order of business.

“The skill is in the replacement of what everyone wanted to see, which was a better health care market,” he said.

… the governor said this time, Congress should have broad input, including from patients, doctors, advocates, insurers and the pharmaceutical industry.

That statement, however, ignores what did occur.

Obama convened a “health summit” shortly after taking office and brought in all of the interests that Ducey said now need to be part of what comes next. And it took months before the final plan was approved by Congress.

Approved, I might add, without any Republican support because “Obama” was the president and in spite of the summit.

There’s a potentially more immediate – and more direct – concern for Ducey, if lawmakers repeal the federal law and the funding that goes with it.

Ducey’s predecessor, Jan Brewer, took advantage of one provision of the Affordable Care Act that said the federal government would pick up pretty much the entire cost if states expanded eligibility for their Medicaid programs.

Medicaid already paid about two-thirds of the cost for what Arizona had, which was free care for persons below the federal poverty level. But in 2013, Brewer got lawmakers to extend the program to those up to 138 percent of the federal poverty level on the governor’s promise that it would bring in $1.6 billion a year.

Ducey inherited that program. But if the Affordable Care Act goes away, so does the federal money.

The governor sidestepped questions of what his backup plan is.

“These are all hypotheticals and I’m not going to deal with them,” he quipped.

Translation: “I have no clue.”

[Former Governor Jan Brewer] told Capitol Media Services at the time that, once it was clear the law would take effect, she sought ways to have Arizona take advantage of the provision that rewards states that expand their Medicaid program. And she said that made it worthwhile to fight with legislators from her own Republican Party and even form an alliance with Democrats to push the plan through.

“The bottom line is we need that money in our economy to save rural hospitals and jobs in rural areas,” Brewer said at the time.

Will Ducey and the Phouls in Phoenix throw all that - hospitals and jobs - under Paul Ryan’s bus?

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