Bloomberg BNA: Blue States Blast House Obamacare Repeal Vote

Politicians and other leaders in blue states such as California and New York blasted House Republicans for passing the American Health Care Act (AHCA).

The bill (H.R. 1628) to repeal the Affordable Care Act would cost New York almost $7 billion annually by 2021, according to a statement from New York Gov. Andrew M. Cuomo (D). He said 2.7 million New Yorkers will be left without health coverage.

The House voted 217-213 to approve the ACA repeal measure May 4, sending it to the Senate, which is expected to fashion its own version of health-care legislation. The House Republicans’ measure would repeal the ACA’s requirement that individuals get health insurance and that most employers provide it to their workers. The legislation also would wind down an expansion of Medicaid insurance for the poor and eliminate taxes on the wealthy, insurers and drugmakers used to fund the law.

Cuomo said the federal share of his state’s $65 billion Medicaid program would be cut by $4.7 billion under the bill. An additional $2.3 billion would be shifted to the state from the so-called Collins-Faso Amendment, named after two upstate New York Republicans, he said.

“This bill is a targeted assault against our values, punishing New Yorkers because we support women’s reproductive rights and including the Collins/Faso amendment which would devastate the state’s health care industry, put millions of New Yorkers at risk, and increase the total cost of this bill on New York to $6.9 billion,” Cuomo said in a statement,

Cuomo said 8.4 million New Yorkers under 65 years-old have pre-existing conditions. New York, under a 1992 law, requires community rating for all health policies. In addition, a law enacted earlier this year requires that insurance cover contraceptives, as well as abortion.

And New York Attorney General Eric T. Schneiderman (D) said in a statement that “if this disastrous and unconstitutional healthcare bill is ultimately signed into law, I will challenge it in court.”

Cuomo Takes Aim

Cuomo took particular aim at three parts of the bill: the Collins-Faso amendment, provisions on reproductive rights and provisions on pre-existing conditions. He said the federal Medicaid cuts, particularly resulting from Collins-Faso, would force the state to either raise taxes, reduce coverage or “devastate health care providers.”

The Collins-Faso amendment, authored by Reps. Chris Collins (R-N.Y.) and John J. Faso (R-N.Y.), who both voted yes on the final bill, would prohibit New York state from requiring that upstate counties share the cost of the Medicaid program.

Defenders of the amendment said it is designed to provide relief from state mandates that force upstate counties to impose unusually high property taxes. Collins’s office said in a statement May 4 that for Western New Yorkers, the House bill includes “the largest property tax reduction ever to be enacted” by barring federal reimbursements for New York State Medicaid funds raised from local governments.


California’s public hospitals would lose $2 billion a year if Congress repeals the ACA Medicaid expansion and billions more over time under changes to the system in the American Health Care Act, according to the California Association of Public Hospitals and Health Systems.

“The AHCA’s drastic cuts to the Medicaid program would return us to overcrowded emergency rooms and exorbitant uninsured rates, all while doing nothing to address the underlying cost of health care,” CAPH President and Chief Executive Officer Erica Murray said in a May 4 news release.

Twenty-one public health-care systems in California, together with hospitals in the University of California system, provide care to 35 percent of the state’s Medicaid enrollees but make up only 6 percent of the state’s hospitals.

State officials have said the measure will cut $24 billion from the state Medicaid program with its cap, cut premium subsidies for enrollees in the state health benefits exchange by 50 percent and undermine basic coverage. More than 4 million Californians are covered under the Medicaid expansion, and another 1.5 million buy insurance on the exchange, called Covered California.

“This bill is scary for not just for the 5 million Californians who now get help under the ACA, but anyone who may need to rely on Medi-Cal or the ACA’s patient protections in the future,” said Anthony Wright, executive director of consumer advocacy coalition Health Access California.

Democratic leaders in the Legislature faulted California Republicans in Congress for approving the bill. “Representatives from the Central Valley and the Inland Empire—regions of California that had among the highest rates of uninsured prior to the ACA, and were among its biggest beneficiaries—should be ashamed of themselves for this vote,” Senate Health Committee Chair Ed Hernandez (D) said in a news release. “They will have more constituents lose coverage under this bill than almost anyone in the country.”


The Colorado Health Institute in Denver said it projects that under the previous version of the Republican repeal bill, 600,000 Coloradans would have lost their Medicaid eligibility by 2030, with most becoming uninsured.

“The latest amendments don’t change that projection,” Joe Hanel, manager of public policy outreach for the institute, told Bloomberg BNA. The institute is a health-policy think tank.

In the private market, the latest Republican bill would lower insurance premiums for younger, healthier people and raise them for older, sicker people and those who live in rural Colorado, he said. “The latest amendments allow states to waive essential health benefits and the ban on charging more for customers with pre-existing conditions, but we don’t expect Colorado would do this under our current political leadership,” he said.

Rep. Jared Polis (D-Colo.) said the Republican health-care plan “is a tax cut for the wealthy at the expense of middle-class families, small businesses, and the destitute. With the passage of this bill, it’s clear that Republicans value special interests over people, the wealthy over the middle class, and ideology over economics.”

New Jersey

The AHCA is “a horrible deal” for New Jersey, according to New Jersey Policy Perspective, a liberal-leaning think tank.

The so-called Upton amendment on pre-existing conditions falls short of meeting the needs of 3.3 million New Jersey residents with pre-existing conditions, according to a statement from Ray Castro, director of health policy at the organization. He said it would take up to $790 million each year to assist New Jerseyans with pre-existing conditions who would apply for health coverage. The bill would only allocate about $353 million on average, leaving a $437 million gap in New Jersey, he said.

Castro said insurance plans for up to 3.6 million New Jerseyans could come with annual and lifetime limits on coverage under the House bill.

The AHCA, he said, would cause up to 500,000 New Jersey residents to lose their health insurance and make “permanent structural changes to Medicaid” that would reduce funding to New Jersey by 20 percent.