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* From Governing Magazine on Friday…
In the early morning hours on Thursday, U.S. Senate Republicans jammed a provision through that will speed up the process of repealing the Affordable Care Act (ACA), President Obama’s signature health reform law.
Congressional Republicans voted to repeal Obamacare dozens of times throughout the last few years, but the threat of a presidential veto always stood in their way. With Donald Trump’s election giving Republicans full control of Congress and the White House, though, the debate has largely become not whether Obamacare will be repealed — but how quickly the law will be replaced and what will appear in its place.
Of the 31 states that adopted one of Obamacare’s biggest provisions, Medicaid expansion, 16 of them have Republican governors. If that provision isn’t part of the replacement plan, states would likely lose millions of dollars in federal funding for health care. Even if Medicaid expansion is carried over into the new plan, millions of low-income people could lose health insurance if there’s a gap between repealing and replacing the law.
That puts many Republican governors, some of whom have long criticized the ACA, in a tough spot and for many, up against their Republican counterparts in Congress. On Thursday, GOP governors will discuss Medicaid with members of the U.S. Senate Finance Committee.
They go on to list where various governors stand, but Illinois isn’t on the list. I asked the governor’s press office for a response the other day and haven’t heard back.
* That meeting between GOP governors and members of the Finance Committee is in two days, so Gov. Rauner was asked about what he wants for Illinois out of the ACA repeal/replace actions…
There are a lot of changes being proposed. I think it’s too early to say. We’re having conversations [with] the federal administration. There’s disagreement within Congress, there’s disagreement between the Trump administration and congressional leaders about what to do. This is going to take some sorting out.
Rauner was asked whether it wasn’t important for him and other governors “to say ‘This is what will hurt us, this is what will not,’ and speak out about it?”
* Rauner’s response…
Well, we’re having conversations. And I am working with other governors around the country. We’ll speak louder if we have a joint voice. One governor’s voice isn’t as much in a federal administration as many governors. So we’re talking with other governors and administrations, we’re talking with the federal government directly. These are conversations that would be inappropriate for me to, you know, talk too much about specific ideas through the press. That’s not the way to have a negotiation or discussion. They want to be able to talk with us in confidence. Because, frankly when there’s disagreements people are very sensitive about whose opinions are getting put out there, so we just gotta be thoughtful and we’ll pursue it. I’m just gonna be a strong advocate for the people of Illinois in these discussions.
Oh, so now he understands that it’s best not to negotiate through the media?
And now he understands that in times of disagreement people might be a bit sensitive about what is “put out there”?
And now he understands the benefits of being “thoughtful” about an approach to negotiations?
Ah, how things change when an unpredictable and vengeful president-elect has millions of Twitter followers and our governor only has 15.7 thousand.
* Raw audio…
* Related…
* 18M would lose insurance year after Obamacare repeal: study
posted by Rich Miller
Tuesday, Jan 17, 17 @ 12:22 pm
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Newsflash: Rauner is a hypocrite. Story at 10.
Comment by PublicServant Tuesday, Jan 17, 17 @ 12:27 pm
this switch is straight up terrifying to some people. I’ve experienced first hand the confusion and fear and anger from a person I know well who had a deeply serious diagnosis and it complicates another care issue. She is terrified about what will happen to her insurance. Plan, plan, plan. take a stand. lives literally depend on this.
Comment by Amalia Tuesday, Jan 17, 17 @ 12:31 pm
===Ah, how things change when an unpredictable and vengeful president-elect has millions of Twitter followers and our governor only has 15.7 thousand.===
Once Rauner took over the Editorial Boards, “State House Chick”, Kass… had the IPI/INN connection cemented… had Proft with newspapers, radio, and ads…
… once Rauner completely and absolutely took over messaging, including documentaries, and a website targeting enemies…
… the only fear Rauner has is a Trump-like messaging machine that could take Rauner to task, on items like ACA or state issues like Higher Ed, Social Services, and Labor.
Rauner knows and fears Trump. Trump can get his message to target Rauner.
Democrats are still using Blackberry devices and beepers, using flip phones to respond to either.
Very telling bit, Rich.
Comment by Oswego Willy Tuesday, Jan 17, 17 @ 12:32 pm
Rauner outsourced jobs to Canada with the MyBenefits site. He may be getting a midnight tweet from the new President.
Comment by A Jack Tuesday, Jan 17, 17 @ 12:33 pm
Our governor is very good at not taking a position when it suits his purposes – such as not getting pinned down to either side during a particularly contentious argument where he can’t control the narrative
Comment by Archiesmom Tuesday, Jan 17, 17 @ 12:35 pm
Now that his party actually controls government at the federal level, Brucey is gonna have to get used to takin’ positions on all da governin’ happenin’.
Comment by LeonDespres Tuesday, Jan 17, 17 @ 12:38 pm
What other govenor are you talking to Kasich? What is your federal communication? Don’t call us will call you, you turned your back now it’s your turn to cry
Comment by Rabid Tuesday, Jan 17, 17 @ 12:41 pm
The GOP are like the dog that car the car they have been chasing. A lot of nervous members of congress on the GOP side right who are coming to understand they will own and where the collar for people losing healthcare.
Maybe they are counting on people like the guy in Kentucky over the weekend who told the press is all for Trump getting reading of Obama Care because Trump will keep the ACA.
Comment by Give Me A Break Tuesday, Jan 17, 17 @ 12:44 pm
1.4% and his uber wealthy pals are trying to figure out how to personally benefit from the coming change to Obamacare. So why would he ever tell the unwashed any of his plans?
Comment by Huh? Tuesday, Jan 17, 17 @ 12:44 pm
Non-answer if ever I saw one.
Comment by Sir Reel Tuesday, Jan 17, 17 @ 12:46 pm
Rauner needs to man up and say what needs to be said. Stop beating around the bush. The left is going to be kicking and screaming and moaning no matter what (and especially for the next 8 years) so just ignore them. Or laugh at them. It’s what I do.
Comment by Hohum Tuesday, Jan 17, 17 @ 12:47 pm
Remember Diana Rauner telling us that Bruce has no social agenda? Perhaps she should have said, he has no social agenda so you can’t expect him to fight to help poor people keep their health insurance.
Comment by slow down Tuesday, Jan 17, 17 @ 12:50 pm
The fact that Rauner has no position on Obamacare, one way or the other, is not socking to me. We were all told during his election campaign that “Bruce has NO social agenda.”
Comment by Hit or Miss Tuesday, Jan 17, 17 @ 12:51 pm
What’s to worry? The president-elect promised over the weekend he’s about ready with his “insurance for everybody” plan with lower deductibles, plus he’s going to break the Big Pharma stranglehold on price gouging. And he says he’ll make the Congressional GOP caucuses like it.
I’m all for it.
But just in case Trump’s blowing smoke out of his wherever, it should be noted that 850,000 previously uninsured Illinoisans gained health-care coverage through ACA.
Hopefully, the interests of those Illinois citizens are on the governor’s radar, not like the one million the United Way identified as losing state services due to the broken service contracts of squeeze-the-beast.
https://www.hhs.gov/healthcare/facts-and-features/state-by-state/how-aca-is-working-for-illinois/index.html
Comment by wordslinger Tuesday, Jan 17, 17 @ 12:52 pm
Rauner seems to be a man of many secrets and no conviction.
Comment by AlfondoGonz Tuesday, Jan 17, 17 @ 12:53 pm
I don’t know why, but when I read what the governor says and does I always think of Pinky and the Brain.
Comment by Flynn's mom Tuesday, Jan 17, 17 @ 12:59 pm
Probably for the best, right? The Senate’s Grand Bargain, AFSCME negotiations…clearly, things go a lot smoother when he’s *not* involved.
In fact, maybe he should just leave the Governor’s Office altogether!
Comment by Arsenal Tuesday, Jan 17, 17 @ 1:06 pm
Many of the formerly uninsured in Illinois are getting coverage now thanks to expanded Medicaid, for which the feds are paying full freight. How does Governor Rauner expect to keep those people insured without that federal cash?
Discuss.
Comment by 47th Ward Tuesday, Jan 17, 17 @ 1:11 pm
Hit or Miss:
This isn’t a social issue. It has major and direct economic and health consequences for Illinois residents. He can’t hide behind a cowardly “no social issues” stance on this.
By the way, if he really didn’t have a social agenda, we’d have legal and taxable marijuana here. It’s clearly an economic benefit, but he won’t sign it. Because like every other human on earth, he has opinions on things beyond the economy.
Comment by Anonymous Tuesday, Jan 17, 17 @ 1:14 pm
What I can’t figure out is how can he not have a position at this point in the discussion. If 1 out of 6 people in Illinois are covered under Medicaid, he has to have a position and he needs to make it known. You could hardly pick a more impactful topic that effects those he is to serve than Medicaid expansion.
Comment by Mod Dem Tuesday, Jan 17, 17 @ 1:26 pm
Not a single R voted for the Medicaid expansion the Illinois House or Senate. Dems own that mess.
Comment by Single Tuesday, Jan 17, 17 @ 1:40 pm
Rich -
As i recall, many of the cuts Rauner proposed to the budget were based on the argument that specified services were now covered by. Obamacare. Seems it would be useful to revisit those numbers.
Comment by Juvenal Tuesday, Jan 17, 17 @ 1:47 pm
Also, I don’t think it has much to do with how many twitter followers Trump has.
Rauner wants his discussions with the Feds to succeed. He wants the budget negotiations to fail.
Comment by Juvenal Tuesday, Jan 17, 17 @ 1:49 pm
- Dems own that mess. -
Dems will own the mess caused by repealing ACA? Or are the words in the post just hard for you to understand?
Comment by Daniel Plainview Tuesday, Jan 17, 17 @ 1:53 pm
Well I guess that rambling non-answer is better than what we usually get out of Gov. Gaslight, something like, “I’m not commenting on that because I’m focused on structural reforms in Illinois,” or whatever this week’s word salad is.
In the end, though, on an important national issue that affects 20 million-30 million people nationwide (and 850,000 Illinois citizens), and could literally put lives at risk, Rauner is once again hiding under his desk.
“Brave, brave Sir Robin…”
Comment by Nick Name Tuesday, Jan 17, 17 @ 1:56 pm
And it is not just the Medicaid expansion or the subsidized marketplace which are affected by the repeal of ACA. Also affected is the coverage gap or “donut hole” for Medicare prescriptions. With a repeal it would return to its original, larger coverage gap.
Comment by retiree Tuesday, Jan 17, 17 @ 2:01 pm
And now he understands…that he’s negotiating with fellow Republicans, so he eschews demands in the media, name-calling, and threats.
Comment by Anon Tuesday, Jan 17, 17 @ 2:07 pm
Remember when Quinn expanded Medicaid under the ACA claiming the 2018 state expense would only be like 300 million. The real number is closer to 1.5 Billion. So where will that $$ come from. Giving people at 4 times the poverty rate Medicaid was always an extravagant use of tax dollars. Rand Paul has it right. If states want to expand Medicaid- let them find a way to pay for it
Comment by Sue Tuesday, Jan 17, 17 @ 2:37 pm
–Remember when Quinn expanded Medicaid under the ACA claiming the 2018 state expense would only be like 300 million. The real number is closer to 1.5 Billion.–
Sue, could you show your work on any of that?
Under current law, the federal share is 94% for any new Medicaid enrollees under ACA in 2018.
You claim that the state will be paying $1.5 billion for new enrollees in 2018. Since the state’s share is 6%, that would mean the federales would be ponying up $25 billion for new ACA Medicaid enrollees.
Your math is whack.
Meanwhile, a report on the subject last week from the Civic Federation.
https://www.civicfed.org/iifs/blog/review-medicaid-expansion-illinois-under-affordable-care-act
Comment by wordslinger Tuesday, Jan 17, 17 @ 3:10 pm
I hope we learn that being a politician has nothing directly to do with government experience. When someone without government experience tells us to vote for her or him because s/he’s not a politician, we should not just not fall for it.
Rauner is very much a politician, being evasive and talkin’ out of both sides of his mouth, tellin’ people what they want to hear. Rauner was against ACA Medicaid expansion.
No matter, Rauner should consider supporting health insurance expansion, especially Medicaid for single/married adults. So many Illinoisans have been helped by ACA Medicaid expansion.
This weekend I hung out with someone from the old neighborhood. This person is a multiple organ transplant survivor and patient advocate. This person said people who desperately need medical insurance are very frightened of losing coverage. This should move people who care into action.
Comment by Grandson of Man Tuesday, Jan 17, 17 @ 3:14 pm
Word- its 90/10 fed State on the cost sharing
Comment by Sue Tuesday, Jan 17, 17 @ 4:03 pm
So it’s ok for the Gov to play politics on issues but not anybody else. Gotcha. Really shakin’ things up.
Comment by Boone's is Back Tuesday, Jan 17, 17 @ 4:07 pm
**Word- its 90/10 fed State on the cost sharing**
Wrong. It doesn’t go down to 90% until 2020. http://kff.org/medicaid/issue-brief/medicaid-financing-how-does-it-work-and-what-are-the-implications/
And even if it were, your math would STILL be way off.
Comment by JoeMaddon Tuesday, Jan 17, 17 @ 4:08 pm
Sue, you don’t have to keep guessing or trying not to misremember. You can read the Civic Federation link I posted.
–The federal reimbursement rate declined to 95% on January 1, 2017 and is scheduled to drop to 94% in 2018, 93% in 2019 and 90% thereafter. The Illinois portion of the cost for newly eligible individuals is estimated at about $60 million in FY2017.–
$60 million is a wee bit less than the $1.5 billion you posted.
For the record, putting up $6 for a sure-bet $94 return is a sweet deal.
Here’s the link, again.
https://www.civicfed.org/iifs/blog/review-medicaid-expansion-illinois-under-affordable-care-act
Comment by wordslinger Tuesday, Jan 17, 17 @ 4:13 pm
So Gov. Rauner stands for nothing?! Not surprised.
Comment by GetOverIt Tuesday, Jan 17, 17 @ 5:40 pm