Washington — U.S. Rep. Sander Levin of Royal Oak on Friday wrote to Republican Gov. Rick Snyder, pleading that he speak out about the potentially “devastating effect” of the GOP health care repeal bill under consideration in the U.S. Senate.
Levin, the ranking Democrat on the House Ways and Means Subcommittee on Health, highlighted independent projections that Michigan could lose as much as $8 billion in federal funding for health care through 2026, according to an analysis by the consulting firm Avalere Health.
Levin also warned that the bill sets up a “catastrophic” funding cliff in 2027 when lump-sum federal payments to states would end if not extended by Congress, costing Michigan an estimated $140 billion over the next two decades.
In addition, he worries that the transition from Medicaid from an open-ended commitment to the states to a per capita cap on funding would be at a level insufficient to keep pace with rising health costs.
“Protecting the health care of the people of our state should not be a partisan issue. Republican governors from Ohio, Massachusetts, Vermont, and Nevada have all spoken out against this dangerous legislation, which threatens the well-being and in many cases the lives of their citizens,” wrote Levin, who chaired the tax-writing Ways and Means panel when lawmakers approved the Affordable Care Act in 2010.
“I urge you to stand up for the people of Michigan and speak out about this bill.”
Snyder’s office has said he is still reviewing the legislation and has not commented on it. Senate Republicans are rushing to take up the bill, sponsored by GOP Sens. Bill Cassidy of Louisiana and Lindsey Graham of South Carolina, next week, starting with a hearing in the Senate Finance Committee on Monday.
“The governor will speak out once the analysis is complete,” Snyder spokeswoman Anna Heaton said.
The Graham-Cassidy proposal would end the Affordable Care Act’s subsidies for private insurance and eliminate the Medicaid expansion for low-income Americans adopted by 31 states, including Michigan, in 2020, converting some of the funding to lump-sum payments to states. But those block grants would end in 2027 without further appropriations from Congress.
States would be required to provide “adequate and affordable health care” for patients with preexisting conditions, Graham and Cassidy have said. But states could apply for waivers that allow insurers to charge sick patients higher premiums and not cover certain benefits required under the federal health care law, such as prescription drugs and maternity care.
Brian Peters, CEO of the Michigan Health and Hospital Association, said Graham-Cassidy would “most certainly spell the end” of coverage for nearly 1 million Michigan residents, including those enrolled in the Medicaid expansion known as Healthy Michigan and the federal insurance exchanges.
“Our member hospitals and health systems cannot support legislation that eviscerates healthcare coverage and access to care on such a large scale,” Peters said in a statement.
Snyder has previously said the state likely couldn’t afford to continue its Healthy Michigan program without a replacement for the Medicaid expansion funding.
Levin pointed Snyder to a March letter the governor sent to members of the congressional delegation about the House GOP’s repeal plan, which called for major cuts to Medicaid that would “adversely impact” thousands of “vulnerable” Michigan residents, Snyder said at the time.
Levin said the cuts to Medicaid in Graham-Cassidy are in some ways worse than the House bill, in that they would “undermine our ability to provide care to seniors in nursing homes and carry out other basic functions of the Medicaid program.”
While Snyder hasn’t weighed in yet, his Medicaid director has. Chris Priest, who overseas the Healthy Michigan program, sits on the board of the National Association of Medicaid Directors.
The board on Thursday warned Congress of the significant burden the legislation would place on states in order to comply with its proposed deadlines for implementation.
“Taken together, the per-capita caps and the envisioned block grant would constitute the largest intergovernmental transfer of financial risk from the federal government to the states in our country’s history,” the group’s board of directors wrote in a statement Thursday.
The bill requires states craft their own health-care programs by 2020, but the directors say the “vast majority of states will not be able to do so within the two-year timeframe envisioned here, especially considering the apparent lack of federal funding in the bill to support these critical activities.”
It’s unclear whether Senate Republicans will muster the 50 votes they need to approve the Graham-Cassidy proposal.
The last GOP effort to repeal the Affordable Care Act failed in July by a single vote.