The Washington PostDemocracy Dies in Darkness

Senate health-care bill panned by Republicans in Maryland and Virginia

June 23, 2017 at 4:04 p.m. EDT
Republican Ed Gillespie, left, and Democratic Lt. Gov. Ralph Northam are vying to be Virginia’s next governor. (Bill O’Leary/The Washington Post)

Democratic and Republican officials in the Washington region are panning the draft Senate legislation to overhaul the U.S. health-care system.

A spokeswoman for Maryland Gov. Larry Hogan (R), who is up for reelection next year, said the Senate proposal does not work for Maryland and that Congress should start over. Virginia GOP lawmakers object to provisions they say would penalize states such as Virginia that chose not to expand Medicaid under the Affordable Care Act, also known as Obamacare.

Meanwhile, federal health-care politics are seeping into gubernatorial contests. In Virginia, the Democrat and Republican running for governor have been sparring over the issue. In Maryland, all five Democrats competing for the chance to run against Hogan denounced the legislation, and some proposed a state-run alternative.

Senate Republicans want to reach yes on health-care bill

As one of just two gubernatorial campaigns this year, the Virginia governor’s race offers the earliest look at how health care may affect state-level politics.

Lt. Gov. Ralph Northam, the Democratic nominee, is a physician who is opposed to the GOP plans. He blasted his Republican opponent Ed Gillespie, a former lobbyist and Republican National Committee chairman, for what he called silence in the face of an “irresponsible effort” that would put thousands of Virginians’ health care “at risk.”

“Mr. Gillespie is the biggest ­gator in Trump’s swamp, so he must feel right at home keeping his positions this murky, but Virginians deserve honesty and clarity from their leaders,” Northam said in a statement.

Gillespie called the draft Senate bill an “important step forward” in repealing the Affordable Care Act, but he declined to take a position, saying he was reviewing the legislation. He did say Virginians are suffering under the status quo.

“Unfortunately Ralph Northam continues to proudly champion Obamacare, despite the indisputable facts that it has driven up premiums, caused Virginians to lose their choice in doctors, and forced major insurance carriers like Aetna out of the Virginia market,” Gillespie said in a statement.

A recent poll by Quinnipiac University found 30 percent of Virginia voters listed health care as their top priority in the governor’s race, on par with the economy. And voters trusted Northam over Gillespie on health-care issues by a 13-point margin.

Northam has early lead over Gillespie in governor’s race poll

The same survey also found a cool reception to the Republican health-care plan — before details of the Senate version were released — with a quarter of Virginians approving and 57 percent disapproving.

The Senate bill, largely crafted in secret and unveiled by Majority Leader Mitch McConnell (R-Ky.), would end the mandate for individuals to buy insurance and for large employers to provide coverage, and it would enact deep, long-term cuts to the federal Medicaid program.

Here’s what’s in the Senate health-care bill

Both the House and Senate versions allow states to seek waivers from requirements that insurance plans cover certain “essential health benefits,” including preventive and maternity care, as well as substance-abuse and mental-health treatment. Such a waiver could allow residents to buy plans that provide less coverage for lower premiums but higher out-of-pocket costs.

Democrats have demanded that incumbent and aspiring GOP governors say whether they would seek such waivers from consumer protections. Northam would not seek a waiver, a spokesman said. Through aides, Gillespie did not respond when asked whether he would seek such a waiver.

Another major issue in Virginia has been the expansion of Medicaid. Gov. Terry McAuliffe (D) has unsuccessfully tried to persuade the GOP legislature to expand Medicaid, which would allow 400,000 low-income individuals to access health insurance, but Republicans have repeatedly rejected the idea as financially unsound.

Now, GOP lawmakers say the Senate bill would punish them for their fiscal prudence by providing states that did expand Medicaid a softer landing for long-term federal cuts than those that rejected expansion.

“Virginia has been a prudent steward of Medicaid funding and should not be penalized for making a policy decision to not expand Medicaid eligibility,” Sens. Emmett W. Hanger Jr. and S. Chris Jones wrote in a letter to Senate leaders asking for parity between expansion and non-expansion states.

On the other side of the Potomac River, the Senate health-care bill drew a rare rebuke from Hogan, who typically adopts a wait-and-see approach to policies coming out of Washington.

“We know the current system needs to be fixed, but the proposals that are being considered in Congress do not work for Maryland,” said Hogan spokeswoman Amelia Chasse. “Congress should go back to the drawing board in an open, transparent and bipartisan fashion to craft a bill that works for all Americans.”

The four men who launched campaigns for next year’s Democratic gubernatorial primary — former NAACP president Benjamin Jealous, Prince George’s County Executive Rushern L. Baker III, attorney James L. Shea and Baltimore tech entrepreneur Alec Ross — all took to social media on Thursday to blast the Senate health-overhaul proposal.

Maryland gubernatorial candidate backs single-payer health system

Jealous, a progressive and top surrogate during the presidential run of Sen. Bernie Sanders (I-Vt.), said this week that he would push for a state-run, single-payer health-care system. No state has a single-payer health system, and bills to establish them in California and New York have appeared to stall amid concerns over costs.

“We have to make sure every Marylander who currently lacks health care gets it,” Jealous said.

Ross and state Sen. Richard S. Madaleno Jr. (D-Montgomery), who said he plans to run for governor but has not formally announced, said they support a state-run public option for health insurance that would compete with private insurers.