For over seven years, Republicans criticized Obamacare.  The words “repeal and replace” were part of the conservative mantra, and one that contributed to their election successes.  But like the barking dog that caught the car, the GOP’s next step is uncertain.

That became painfully evident this week when Senate Majority Leader Mitch McConnell delayed the vote on the Republican replacement for Obamacare until after the July 4th recess. McConnell risked a defeat if he had gone ahead now with the Senate plan as an increasing number of Republican Senators came out in opposition.

Among the “no” votes is Senator Shelley Moore Capito of West Virginia.  While a member of the House, Capito voted multiple times to repeal Obamacare, but when given the opportunity in the Senate to actually vote for a replacement she couldn’t do it.

U.S. Senator Shelley Moore Capito

During an appearance on Talkline Wednesday, Capito said she found the Senate bill lacking. “Repeal and replace and fixing Obamacare is important, but it’s got to be done the right way,” she said. Capito added that she was never even close to supporting the bill.

Capito, like several of her fellow Republicans, has issues with how the Senate bill changes Medicaid.  The expansion program, which is funded by a 90-10 federal match, would phase out and by 2024 the match would revert to the current state rate for traditional Medicaid, which is 72-28.

West Virginia has nearly 173,000 people in the expansion.  It’s estimated that the state will have to pay $50 million under the 90-10 match, so a 72-28 split could push the state share to nearly $150 million just for the expansion.

If the state could not afford the additional cost the expanded coverage would be at risk. Supporters of the Senate plan believe those individuals could be shifted to private insurance, but there’s a question whether they could afford it, even with the proposed tax credits.

Capito, along with Republican Senator Rob Portman of Ohio, also object to how the Senate plan would impact drug treatment programs, since both come from states battling the opioid epidemic. Phasing out Medicaid expansion would make it harder for addicts to get treatment and the $2 billion included in the Senate plan for drug treatment would be woefully short when spread among all 50 states.

West Virginia has the trifecta of health care problems; we are older, sicker and poorer than most states. Our costs are higher, while a large share of our population can barely pay for day-to-day needs, much less an unexpected medical bill or long-term care.

These are complicated issues.  Obamacare’s overreach triggered the “repeal and replace” movement. That still plays with many, especially those who have seen their premiums and out-of-pocket costs skyrocket.

But the question now is “replace it with what?”  Kentucky Republican Senator Rand Paul said, “It’s worse to pass a bad bill than to pass no bill.”  That should be the new mantra until lawmakers figure out how to make the Affordable Care Act better.

 

 

 

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