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McKenna still clarifying stance on health-law repeal

Post by Brad Shannon / The Olympian on July 12, 2012 at 5:04 pm |
July 13, 2012 9:03 am

Republicans’ leading candidate for governor, Rob McKenna, does not support repealing the Affordable Care Act, his top spokesman Charles McCray said today. That squares with remarks McKenna made to reporters two weeks ago – the day the Supreme Court upheld the Affordable Care Act (a.k.a Obamacare) from a lawsuit that McKenna had joined with other attorneys general.

Rob McKenna

The suit – if fully successful – would have overturned the act, which is further than McKenna has always said he really wanted to happen. After the ruling McKenna said it was time to move on and improve what the act doesn’t address.

That earlier position – see it here on TVW, starting at the 9:45 minute mark – put McKenna under fire from some conservatives like Republican gubernatorial candidate Shahram Hadian.

The result is that McKenna on Monday told a Yakima chamber of commerce audience that his initial remarks at the June 28 press conference were miscast by Seattle reporters. Go here for the Yakima Herald-Republic’s report, and The Times’ Jim Brunner posted this wrap-up of McKenna’s shifting claims.

Meanwhile, Democratic gubernatorial candidate Jay Inslee’s campaign has accused McKenna of flip-flopping with his Yakima remarks.

In response to the hubbub, McKenna wrote an opinion piece for a conservative blog that published today. In it, McKenna he lays out more of his thoughts on the Affordable Care Act – including his statement that the U.S. House efforts to repeal the law is “a largely symbolic vote” that is blocked in the Senate. You can read McKenna’s column here.

McKenna doesn’t address his apparent double-switch in positions, but McCray said in a telephone interview: “Rob is not advocating for full repeal.” He also said the campaign is waiting to review footage from the Yakima event. In his blog column, McKenna does say the U.S. healthcare system is “unsustainable financially” and that “Obamacare is likely to make it worse.” He also faults Congress for not doing more to contain costs, arguing that Democrats chose higher taxes and higher deficits instead of making hard decisions. And, he says, Washington state can continue as a health-care leader by addressing that cost issue:

At the federal level, then, Congress is driving federally-mandated health insurance reform. The act changes the way people think about coverage, but not the cost of care itself. The states will have to address what Washington, D.C. refuses to confront. Indeed, the states are the best place to implement market-friendly policies that give consumers choices and increase competition among insurers. From Olympia to Albany, we need a serious discussion regarding how each state will provide for itself needed reforms that address cost, access and quality of care in a way that works for each state.

After all that, McKenna does not spell out whether, as governor, he would seek to fully expand the shared state-federal Medicaid program that pays for healthcare for the poor, or if he intends to do less.

Gov. Chris Gregoire, a Democrat, favors the expansion, and Inslee has not stated he intends anything other than that. Gregoire has painted the Medicaid expansion as an opportunity that would be hard for policy makers to turn down.

Under the reform law, which Inslee voted for and helped write in Congress, the federal government is paying 100 percent of the cost for newly eligible Medicaid enrollees through 2016, and states would see their share rise to 5 percent and then 10 percent by 2020.

But McKenna is hesitant. Cost is one reason, as his column outlines here:

Legislators and the next governor must take a comprehensive look at the short and long-term budget impacts of any Medicaid expansion as they shape the safety net for our most vulnerable citizens. The Supreme Court’s decision on Medicaid provides new state leverage for a dialogue with the federal government about Medicaid’s cost trajectory and our pressing need for regulatory flexibility, meaningful consumer engagement and delivery-system reform. .

There are two pieces to the state’s potential costs. One is the state’s potential 10 percent share of expanding coverage to childless adults who meet higher income eligibility standards. The other, as McKenna explained in his press conference, is that the law creates a “welcome mat” effect that will draw new people into Medicaid who have always been eligible but haven’t signed up.

He said at his press conference he’s heard costs could be $250 million a year. That is because the state and federal government will split costs 50-50 for those people who could have signed up before but didn’t.

McKenna’s campaign team says it can’t put a finger on how large of a hit the state might face, because the candidate doesn’t have a full budget office like Gregoire or the Legislature does.

But for McKenna, McCray said: “It’s going to be an ongoing debate between the state and federal government about what the state can afford in terms of Medicaid expansion.” McCray said Washington needs a governor “willing to stand up for what is right for the state” in dealings with the federal government.

The Washington Post reported today that some Democratic governors around the country also have been noncommittal about expanding Medicaid, including Montana Gov. Brian Schweitzer.

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