Gov. Nathan Deal took a cautious stance on the embattled Senate health bill Thursday, urging lawmakers not to "punish" Georgia and other states that didn't expand their Medicaid program while stopping short of opposing the measure.
Deal said in an interview he was concerned about changes to the Medicaid program that could leave the states to pick up the tab. But he said he wanted to reserve final judgment until Senate GOP leaders hobbled by a wave of defections reveal a new draft of the measure.
The two-term Republican said he's expressed to home-state Sens. Johnny Isakson and David Perdue much of the same reservations he had about a version of the House health plan, which would have rewarded states with more generous Medicaid funding.
“From a state standpoint, our main concern is our Medicaid program. As I have said before, we want to make sure we are not punished because we did not expand our Medicaid population,” he said, adding: “We want to be treated fairly.”
The Congressional Budget Office projections released Monday concluded the Senate bill would cut $772 billion from Medicaid and lead to 15 million fewer people receiving coverage under the program by 2026.
Georgia decided not to expand the state's Medicaid program under the Affordable Care Act, saying enlarging the state's rolls would be too costly in the long run. Georgia lawmakers in 2014 approved a measure that gives the Legislature the final say over any expansion to the Medicaid program.
The governor said the Senate bill appears to treat non-expansion states like Georgia more favorably than the House plan, but stressed that it’s still early. And he applauded provisions in the Senate measure that preserve funding to hospitals that treat indigent patients that benefits Grady Memorial Hospital and other health systems.
The CBO analysis found that those payments to hospitals in Georgia and other non-expansion states would increase by $19 billion over 10 years.
“We’re a long way from knowing what the final product is going to look like,” said Deal. “But those are the areas that I’m looking at most intently.”
Republican governors opposed to the embattled Senate health measure have pressed their senators to buck the legislation over concerns that changes to Medicaid will leave cash-strapped states to foot the bill.
Ohio Gov. John Kasich and Nevada Gov. Brian Sandoval have been among the most outspoken critics, both rejecting the measure in forceful terms. The pressure Sandoval exerted on his state's GOP senator, Dean Heller, swayed him to oppose the bill and led to a cascading effect that postponed a vote until July.
The GOP critics express concerns that the measure would penalize the poor and mentally ill, leave more than 23 million people off the insurance rolls and give tax breaks to the wealthy.
Senate leaders are set to make significant changes to sway wavering lawmakers, including conservatives who say the measure doesn’t go far enough in nixing spending mandates and moderates worried it would penalize the poor and mentally ill and give tax incentives to the wealthy.
Senate Majority Leader Mitch McConnell said he would seek help from Democrats to rework the existing law if the GOP can't cobble together an agreement. Democrats won't negotiate unless Republicans abandon their plans to repeal the Affordable Care Act.
Deal, for his part, joined the chorus of Republican lawmakers who said sweeping changes were needed to fix the Affordable Care Act. He said a “death knell is being sounded” for the law as premiums increase and insurance providers pull out of health exchange programs.
“There is a sense of urgency to do something about it. And some states are in a more desperate state than we are,” he said. “It’s not a crisis that’s being created by the current administration or the current Congress. It’s an outgrowth of what happened when Obamacare was originally passed.”
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