Legislative budget analysts say a possibly doomed Republican health care bill would mean a first-year loss of $1.7 billion of funding for Arizona for the Medicaid eligibility expansion and the health exchange created under President Barack Obama's health law.
The Joint Legislative Budget Committee analysts released their preliminary estimate of the bill's impact late Thursday, before its chances for passage diminished greatly with Arizona Sen. John McCain's announcement Friday that he would not vote for the legislation sponsored by two fellow Senate Republicans.
Arizona Gov. Doug Ducey reacted to McCain's announcement by expressing hope that the bill can still pass, as the governor's chief spokesman downplayed the committee's estimate.
McCain, whose decisive vote scuttled a July repeal bill, said he opposed the latest proposal because Republicans and Democrats need to work together on replacement legislation. He also said too little was known about the bill's impacts.
"I cannot in good conscience vote for the Graham-Cassidy proposal," McCain said in a statement.
Ducey, who had come out for the bill Monday, tweeted Friday that he still supports it, encouraged others "to do the same" and asserted that "51 votes are still possible," a reference to the number of "yes" votes needed for Senate approval.
It would end Obama's Medicaid expansion and subsidies for people buying private insurance and combine the money into new block grants for states.
Ducey reiterated Friday that he likes the flexibility that the bill would give states.
The budget committee's estimate said current law would provide Arizona with $4.9 billion in 2020 for Arizona's Medicaid expansion population of 400,000 and the health exchange but only $3.2 billion under the bill. About 196,000 people get coverage through the exchange.
The total budget of the state's Medicaid program for the current fiscal year is about $12 billion, including both federal and state funding.
The budget committee's analysis says its projections are preliminary and subject to change. The analysis noted that projections doesn't include potential effects on changes in several areas, including additional federal funding for the state for health care for Native Americans and new limits on spending for Medicaid enrollees who weren't part of the expansion.
A 10-year timeline included in the budget committee's estimate has the net change in federal funding to the state dropping to $1.2 billion in 2026, but the estimate said multiyear estimates were "highly speculative.
Ducey spokesman Daniel Scarpinato said officials with Arizona's Medicaid program are still working on an analysis of the bill's impact, but he said Ducey believes the bill is clearly superior to the existing law.
The budget committee's analysis is narrowly focused, and the administration's own review will provide a more comprehensive "holistic understanding of the bill," Scarpinato said.
He stressed that Ducey believes that additional work by Congress on health care will be needed even if the bill becomes law. "What the governor doesn't want to see is Congress just check the box and move on from the health care issue," Scarpinato said.
The Congressional Budget Office announced Monday that it needs several weeks to do an analysis of the proposal's effect on premiums and insurance coverage