Arizona Sens. John McCain and Jeff Flake on Thursday said they were studying a new Senate health care proposal repealing much of Barack Obama's health care law and imposing big cuts to Medicaid, but the proposal was slammed by many who have been lobbying for it to retain coverage for millions of Medicaid patients.
McCain said he's closely reviewing the draft legislation and will be speaking with Republican Gov. Doug Ducey and other Arizonans before making a decision. Flake tweeted that he'd just gotten his copy of the bill and "I'm going to take time to thoroughly read and review it." He previously said he'd take the weekend to look it over before deciding whether to back it.
Both have expressed dismay over how the bill was written behind closed doors, with no public hearing before an expected vote next week.
Ducey spokesman Daniel Scarpinato said the governor's staff was "reviewing the bill and its impacts on Arizona."
The governor's office also released a letter he sent to McCain on Wednesday that urges a slower phase-out of higher Medicaid expansion matches to give the state time to adjust, explicit flexibility and elimination of a penalty for states that expanded parts of Medicaid early, as Arizona did in the 2000s.
The proposal was slammed by the state hospital association and former Gov. Jan Brewer, a Republican who surprised many in her own party by embracing Medicaid expansion, a key part of Obama's law that now covers about 400,000 Arizonans.
Brewer said the Senate plan would harm the state's most vulnerable citizens, including children, seniors and the disabled. And she said cutting Medicaid will cost health care jobs, could force rural hospitals to close and eventually cause private insurance premiums to rise. That's because those losing coverage will still seek treatment in hospital emergency rooms that has to be paid for somehow.
"Where are they going to go? They're going to end up in our hospitals," Brewer said. "We're going to pay for it one way or another, there are no free lunches. And it's going to be much more expensive having them show up in our emergency rooms then it would be to have a program where they would have a primary care provider."
The Senate bill essentially ends Obama's expansion of Medicaid that covers about 14 million Americans, with bigger payment to cover existing expansion patients going away within about six years. Ducey has been pressuring the senators for more flexibility on Medicaid but hasn't said how he might avoid dropping those people from coverage.
The proposal also cuts the taxes that paid for expansion and ends the insurance mandate for individuals and businesses. But it maintains the health insurance marketplaces and tax subsidies that help people pay premiums.
The association representing Arizona's hospitals said the Senate bill repealing much of the Affordable Care Act would be devastating to millions of Americans who rely on Medicaid for their care.
The Arizona Hospital and Healthcare Association issued a statement saying it has been calling on leaders in Washington for months to find a workable replacement. It called the version passed by the House last month "a categorical failure" and said the Senate version is "equally troubling."
The group says the more gradual phase-out of Medicaid expansion now covering 400,000 Arizonans gives states more time to adjust. But the cuts would eventually be deeper.
"Regardless, this bill is the wrong approach," association president Greg Vigdor said. "Reduced Medicaid enrollment means more people without health coverage. This inevitably will result in a massive shift of financial risk and burden from the federal government to states, local healthcare providers and Arizona patients and families."
The Senate proposal also was panned by Arizona Rep. Andy Biggs, for another reason. Biggs said he's disappointed by what he calls "the lack of resolve" to repeal the Affordable Care Act.
Biggs is among the few Republicans who voted against the House health care bill last month, saying then that it also failed to fully repeal "Obamacare."