GOP Wins Unlikely To Affect Medicaid, Could Alter ACA’s Future
The status of states' Medicaid expansion under the Affordable Care Act is unlikely to change substantially following the midterm elections on Tuesday, particularly given Republican victories in several gubernatorial elections, the New York Times' "The Upshot" reports.
For example, GOP governors who were re-elected in Kansas, Maine and Wisconsin all oppose Medicaid expansion, meaning their state programs are unlikely to change. Similarly, Florida Gov. Rick Scott (R) -- also re-elected on Tuesday -- said he supported expansion, but he never pushed forcefully for it, suggesting the program is unlikely to expand in his state over the next few years. Further, Arkansas' Republican Gov.-Elect Asa Hutchinson has been tepid in his support for the state's alternative expansion of its Medicaid program, and expansion opponents picked up two key state Senate seats, which might make it more difficult to reauthorize the program.
By contrast, Bill Walker (I) -- who holds a slight lead over Republican incumbent Sean Parnell in the Alaska gubernatorial race -- has previously voiced support for expansion and could move to extend the state's Medicaid coverage. Meanwhile, Pennsylvania Gov. Tom Corbett (R) lost to Democratic Governor-Elect Tom Wolf (D), which means that the state's alternative Medicaid expansion plan -- adopted under Corbett -- could change when Wolf is in charge (Barro/Sanger-Katz, "The Upshot," New York Times, 11/4).
HHS Secretary Looks Forward To Expanding Medicaid With New Govs.
Meanwhile, HHS Secretary Sylvia Mathews Burwell on Tuesday said Medicaid expansion would remain among her "top priorities" and urged newly elected governors to contact her if they are interested in expanding their states' Medicaid programs, The Hill reports.
During a speech to the National Association of Medicaid Directors, Burwell said HHS is "eager and willing to work with states that have yet to expand." She added, "My message to governors is that, 'If you're interested in expanding, call me.' And to those governors who are about to get elected or re-elected today, my message is that 'I'm happy to meet with you before your inauguration'" (Viebeck, The Hill, 11/4).
Republican Gains in U.S. Senate, House Could Bring Health Policy Changes
In related news, Republicans' gains in the U.S. House and Senate could increase the chances of a vote to repeal the ACA in 2015, the Wall Street Journal's "Capital Journal" reports (Peterson/Hughes, "Capital Journal," Wall Street Journal, 11/4).
According to Politico, Senate Republicans likely will use a legislative process known as budget reconciliation, which allows budget bills to be passed by a simple majority of 51 votes, to alter the ACA (Sherman/Everett, Politico, 11/5). Doing so would avoid Democratic hurdles that Republicans would typically need 60 votes to bypass.
Sen. John Cornyn (R-Texas) said, "That's the best way for Republicans to get a 'repeal Obamacare' bill to the president's desk because we can do it with less than 60 votes." However, Cornyn added that it is unlikely President Obama would sign such a measure, but said, "I do think we have a certain responsibility to the people who are going to put us in the majority to have that vote and to present that choice to the president" ("Capital Journal," Wall Street Journal, 11/4).
However, Senate Republicans might need to seek a more compromised path on altering the ACA, National Journal reports. Although many GOP candidates were elected in part by promising to repeal the health reform law, too much focus on attempting to repeal the ACA could hurt the party's chances of a presidential victory in 2016. Instead, Republicans might try to pass measures targeting specific, unpopular parts of the law, such as its medical device tax or portions of the employer mandate (Baker, National Journal, 11/5).
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