As U.S. Senate Republicans’ latest plan to repeal and replace “Obamacare” crashed and burned, two of the state’s top GOP officeholders said Tuesday they support a straight repeal of the health-care law – with a delayed effective date.
Both U.S. Sen. Steve Daines and state Auditor Matt Rosendale, whose office regulates insurance, told MTN News that the Affordable Care Act now should simply be repealed, without a replacement.
The repeal then can be delayed for two years while Congress works on a replacement, they said.
“I think ultimately we have got to have (health) insurance regulation turned back over to the states,” Rosendale said in an interview. “The federal government is finally starting to recognize that providing oversight at that level … doesn’t function properly, because each of the states are so dramatically different.”
Daines also said he’s concerned about the cost of the ACA’s Medicaid expansion, which he said is “blowing the (state) budget.”
“It’s a fiscal train-wreck,” he said. “We are on an unsustainable fiscal path in Montana.”
Yet while Daines and Rosendale called for a straight repeal of the ACA, or “Obamacare,” that approach could be a political dead-end as well.
Three Republican U.S. senators said Tuesday they oppose a repeal without a replacement, leaving Republicans without the needed 50 votes to pass a bill.
Montana’s newest member of Congress, Republican U.S. Rep. Greg Gianforte, said in a statement Tuesday that he wants the Senate to “move swiftly to provide Montanans with relief by repealing and replacing Obamacare,” but didn’t indicate whether he favors repeal now, replace later.
The state’s top two Democratic officeholders – U.S. Sen. Jon Tester and Gov. Steve Bullock – said Tuesday that repealing the ACA is a bad idea, and called for bipartisan cooperation to fix the law’s flaws.
Tester, in a statement, called repeal “a disgusting attempt by Washington politicians to play politics with Montanans’ lives by jacking up health-care costs, kicking folks off their plans and shutting down rural hospitals, with no plan to increase access to health care or lower costs.”
Bullock said lawmakers in Washington, D.C., should “step back, take a breath and move forward together” to shore up the private health-insurance market.
He also said that he’s happy to work on improving Medicaid, the state-federal program that pays medical bills for the poor, but that “gutting Medicaid” is not the answer – and that all of the previous GOP proposals did just that.
Under the ACA, Montana has expanded Medicaid to cover nearly 80,000 additional low-income Montanans with virtually free health care, on top of some 150,000 poor and disabled Montanans already covered by the program.
The federal government pays at least 90 percent of the costs of the expansion, but the state picks up the rest. The amount of signups for the program is more than double the amount initially predicted in 2015.
Daines has never said publicly whether he would have supported the GOP proposal that was pulled Monday night, after two additional Republican senators came out against it.
On Tuesday, however, he said it’s time to vote to get rid of “Obamacare,” delay the effective date, and figure out the replacement before that date kicks in.
Rosendale agreed, and said two years should be enough time to come up with a replacement.
Rosendale said states should be allowed to let health insurers offer less-expensive plans that cover fewer things, instead of the minimum benefits mandated by the ACA.
Those products could be priced lower for younger, healthier customers, he said – or people could use non-insurance products for their health coverage, such as agreements with primary-care providers.
“If you give the consumer the ability to find something that fits their budget, that fits their health-care needs and meets their personal choices, then that will help us start bending the cost curve down,” Rosendale said.
Health insurers and others have said this approach would end up pricing certain people out of the market, such as older, sicker customers.
However, Rosendale said the state and federal government can solve that problem by financing a high-risk insurance pool that would offer coverage to these more costly patients.
“I truly believe that it’s a good thing to have the repeal, to have this turned back over to the states,” he said.
Tester said there are plenty of possible solutions for problems in health-care markets, but that repealing the ACA is “dismantling the current health-care system” and would drive up costs, rather than reduce them.