What’s a Republican governor to do when his own political party is the problem?
We’re hearing a lot about the divide among Republicans in D.C. over the “repeal and replacement” of Obamacare.
President Donald Trump and the House Republican leadership have a plan. But, conservatives don’t like it. Democrats don’t like it. Interest groups like the AARP are already piling on, and let’s add to the list: Republican governors like Ohio Governor John Kasich and Michigan’s own Rick Snyder.
This Republican proposal is exactly what they feared. That’s because the House GOP plan takes aim at the Obamacare Medicaid expansion. That’s the Healthy Michigan program that 650,000 people in Michigan have signed up for it. Many of whom live in rural, conservative districts represented by Republicans.
Snyder has made trips to D.C where it’s been reported he’s roaming receptions and the halls of Congress with sheets of paper showing the data - how many more people are covered, what it means in terms of savings to hospitals that don’t have to swallow the costs of uninsured emergency room visits, and the cost-benefits of incentives to adopt healthier lifestyles.
But, Snyder says, governors don’t seem to have the ear of Congress, at least not yet.
“The current plan doesn’t reflect a number of the comments we made, so I hope there’s opportunities to continue working this process. I think the governors need to be on the forefront of recommending what this program should look like,” Snyder said.
And that’s despite the fact that the governor has Michigan Republicans on both of the congressional committees that moved along this early version of the overhaul. These are powerful committees with folks from Michigan, some possible early opportunities to shape this new healthcare plan. But, they didn’t. At least not to Snyder’s liking.
And it’s not just the Medicaid expansion. This is really wonky. But really important: This plan would also change how states get money from the federal Medicaid program. Managing this program is a major headache for governors. No matter what party they’re from.
It’s a huge budget pressure and it affects a lot of people. Medicaid is not just healthcare for the poor. It also touches seniors and families with a loved one in a nursing home. Mental health services are part of it. People who suffer an injury or a medical crisis that requires long-term care are as well.
Republicans are in a bind. Congressional Republicans need to follow through on “repeal and replace” or risk infuriating Michigan voters who were part of the Trump wave.
But, at the same time, a lot of those same voters are benefiting from the Affordable Care Act and want to keep, at least, parts of it. Like in Michigan’s First Congressional District. That’s Trump country. The northern part of the state represented by freshman Republican Jack Bergman has more enrollees per capita in Healthy Michigan than any other part of the state.
Sometimes what looks like political algebra is more like political alchemy - what makes this so difficult is there’s so much room for so many people to get angry no matter what Washington comes up with.
