Washington — Michigan Gov. Rick Snyder backed President Donald Trump’s warning on Monday that the nation’s health care system is in danger of imploding as he argued for replacing the Affordable Care Act while keeping an expanded health program for the poor.
Trump said at a White House meeting with dozens of governors including Snyder that he hoped to reform the American tax system, but that was a “tiny little ant” compared with what the effort needed to overhaul the law also known as Obamacare. He said Congress must make fundamental changes to former President Barack Obama’s law.
Snyder agreed with the GOP president that the health care system is in crisis.
“The Affordable Care Act’s goal was … was mainly about access, about coverage,” he said after the White House meeting. “And it’s a situation when in principle it was a good cause but it hasn’t worked, particularly in the insurance marketplace. It’s collapsing.”
This marked Snyder’s first official meeting with Trump since he took office, albeit with other governors. Snyder attended the same inaugural ball as Trump.
Snyder touted Michigan’s approach to Medicaid expansion for low-income earners as rifts emerged with other Republican governors that rejected to expand Medicaid under the 2010 health care law.
“We took Medicaid expansion but we did it better,” he said, arguing Michigan has kept Medicaid cost increases lower than health inflation. “We added a front end about responsibility and wellness, and it’s working. People are getting opportunities now because they’re taking more responsibility for their health care, and they have a medical home.”
The second-term governor praised the “unprecedented” effort by Congress and the White House to work together and reach out to the governors -- the first time he has experienced it during his seven years in office. Since Snyder took office in 2011, neither party has controlled the White House and Congress until Trump’s victory in November.
The president’s first major meeting with governors came as Congress prepares to fulfill a main Trump campaign promise by repealing and replacing the health care law. Governors like Snyder have raised concerns that the changes could undermine their Medicaid expansion efforts and stick them with a bigger share of the health care tab.
“It’s an unbelievably complex subject. Nobody knew that health care could be so complicated,” Trump told the governors.
Trump met later Monday morning with health insurance executives, some of whom are worried that the uncertainty over the health care law’s future is spilling into the marketplace.
The Affordable Care Act has subsidized private health insurance available in all 50 states while an optional Medicaid expansion has been accepted by 31 states including Michigan.
The nation’s governors don’t want people in their states to lose health coverage under a repeal of the Obama-era health care law. But even after a weekend of bipartisan meetings, they still don’t agree on the best approach to replace it.
While the Trump administration pledged cooperation with the states, some House Republicans are pushing to limit future federal funding to provide care for low-income people in exchange for giving states more flexibility to run their programs.
Medicaid insures more than 70 million low-income Americans, and budget hawks in Congress, including House Speaker Paul Ryan, want to curtail federal spending on the program.
Michigan has added more than 600,000 low-income earners under Medicaid expansion, hundreds of thousands more than anticipated. The federal government so far has fully funded the program, minus some administrative costs, spending around $4 billion a year in Michigan.
But the funding rates for expanded Medicaid eligibility will drop to 95 percent this year and 90 percent by 2020 and beyond under the current year. Michigan must make up the difference, a cost that will eventually approach an estimated $400 million at the least.
If the Affordable Care Act is scrapped without an immediate replacement for Medicaid expansion funding, the state likely couldn’t afford to continue the Healthy Michigan program, Snyder told The News last year.
“We’re contributing part of the cost, but the bulk of it is coming from the federal government,” he said in a December interview. “You’re talking billions of dollars.”
Republican Gov. Gary Herbert of Utah, which did not expand Medicaid, said Monday after the meeting at the White House that he supports a proposal to cap funding in exchange for flexibility.
“We need to find a formula that’s fair for everyone. Maybe that’s going to be an impossibility, but we need to get as close to fairness as we can and give flexibility to the respective states,” Herbert said.
Gov. Matt Bevin of Kentucky, a critic of Medicaid expansion in his state, argued the Affordable Care Act has been hurting health care affordability overall.
“The net result has been a remarkable decline in access to health care coverage. More people covered, but covered by what? Fewer people able to actually even see a doctor,” Bevin said.