Washington — Gov. Dannel P. Malloy on Sunday said a GOP plan to replace and repeal the Affordable Care Act is a “moving disaster” that could force governors to dramatically shrink the number of Medicaid patients in their states just so the federal government could “pay for a tax cut for the wealthy.”
Malloy said the GOP plan to curb federal Medicaid money would be likely to force governors to make painful decisions, including shrinking the pool of those eligible for the joint federal-state health program for low-income people to only those who earn 100 percent or less of poverty-level wages.
The ACA expanded eligibility in states willing to participate to 138 percent of the poverty level, making about 12 million additional Americans eligible for Medicaid, more than 120,000 of whom are in Connecticut, where the program is known as HUSKY.
“That takes a lot of people out of Medicaid,” said the governor, who heads the Democratic Governors Association, of the GOP plan. “There’s just no justification for what they want to do…it’s all being done to pay for a tax cut for the wealthy.”
Malloy and many of the 46 governors at the National Governors Association winter meeting attended a briefing by consulting firms McKinsey & Co. and Avalere Health on Saturday that showed that many people would not be able to afford coverage under a House GOP draft bill to repeal and replace the Affordable Care Act.
A study by Avalere Health said the GOP plan’s tax credits based on age, which would replace the ACA’s subsidies to consumers, would not be large enough for many to purchase insurance. According to the draft bill, the tax credits would run from $2,000 a year for people under 30 to $4,000 a year to those 60 and older.
More troubling to Democratic governors like Malloy, and some of his Republican counterparts, are the plan’s proposals for Medicaid.
The heath consultants estimated the number of people covered by the ACA through the individual insurance market could be slashed by as much as 51 percent in states that chose not to expand Medicaid coverage under Obamacare and by 30 percent in those like Connecticut that did expand the health program for the poor.
Under the ACA, the federal government paid 100 percent of the cost of the expansion from 2014 to 2016. The federal share fell to 95 percent this year and was scheduled to fall to 90 percent by 2020.
Under the GOP’s plans to replace the ACA, the federal share of expanded Medicaid coverage would fall back in 2020 to the level it is for traditional Medicaid recipients. In Connecticut that is only 50 percent.
In addition, GOP lawmakers are considering placing a per-capita cap on federal spending on Medicare or using block grants to pay for the federal share of those in the expanded Medicaid program.
“Medicaid caps are likely to result in state funding gaps,’’ according to the Avalere study. “Because states must balance their budgets annually, reductions in federal funding may lead to cuts in eligibility, benefits or payment rates.’’
Although the changes being proposed for Medicaid would not be implemented until 2020, Malloy said the GOP plan “does present a challenge” to much of the nation’s health services sector, especially hospitals that would suffer an uptick in uninsured patients.
“It’s a moving disaster in the making,” Malloy said.
Ohio Gov. John Kasich was among the GOP governors expressing concern.
“There’s going to be a problem in the House of getting anything out of there that still provides coverage to people,’’ Kasich said on CBS News’s “Face the Nation” Sunday. “There are some very conservative Republicans in the House who are going to say, ‘just get rid of the whole thing.’ And that’s not acceptable when you have 20 million people, or 700,000 people in my state, because where do the mentally ill go? Where do the drug-addicted go?”
During their weekend meeting, the governors also discussed the hot-button issue of immigration, education and their hopes President Donald Trump follows through on a $1 trillion infrastructure plan.
“But most of the talk and most of the fear is about what House Republicans will do with the ACA,” Malloy said.
He and his colleagues will attend a dinner and ball at the White House Sunday evening, then visit with Trump again on Monday morning for a policy session.
“Big dinner with Governors tonight at White House,” Trump tweeted Sunday afternoon. “Much to be discussed, including healthcare.”