U.S. Sen. Shelley Moore Capito, R-W.Va., said Friday she wouldn’t support an amendment to the GOP’s health care overhaul pushed by far-right Senate conservatives, pouring cold water on prospects of unifying the party around any legislation.
Following Senate Majority Leader Mitch McConnell’s decision to delay a vote on the Better Care Reconciliation Act of 2017, a rewrite of the House-passed American Health Care Act, Capito came out against the bill as written, citing deep Medicaid cuts, the potential to worsen the growing opioid epidemic and how it could harm rural health care providers.
Since then, Republican senators such as Ted Cruz, R-Texas, and Mike Lee, R-Utah, have called for an amendment, “The Consumer Freedom Option,” that would allow insurance providers to offer coverage that does not comply with key aspects of the Affordable Care Act, so long as they also offer plans that do. However, Capito said she’s not ready to vote for a plan that takes away from some of the ACA’s most popular provisions.
“I think that reopens an issue that I can’t support, that it would make it too difficult for people with pre-existing conditions to get coverage,” she said.
Capito, who often is mentioned as one of the more critical votes Republicans would need to pass the bill, said she is still wary of the issues that turned her off of it in the first place. She said she would need to see more money added to the legislation used to combat the heroin and prescription pill epidemic that has ravaged West Virginia before she can support the bill.
“The opioid crisis needs a bigger and more robust investment,” Capito said.
Though she said they aren’t working as a bloc necessarily, she and Sen. Rob Portman, R-Ohio, are trying to add language into the bill that would earmark $45 billion to combat the opioid crisis, and she thinks they’re close. The two first came out in opposition of the bill via a joint statement last week.
Along with opioid issues, Capito said she’s concerned about the BCRA’s cuts to Medicaid and its less-generous subsidies to help citizens cover their premiums and deductibles.
On Medicaid, she said she’s worried about how the reductions would affect those on the program’s rolls from accessing care for substance abuse disorders, such as medication-assisted treatment programs.
According to an analysis from the Congressional Budget Office, the latest version of the BCRA would slash Medicaid funding by $772 billion by 2026. According to data from the West Virginia Department of Health and Human Resources, more than 550,000 West Virginians are covered through Medicaid, and 170,000 through the ACA’s Medicaid expansion alone.
Additionally, Capito said she’s wary of stingier subsidies under the BCRA than those under current law. She said given the state’s aging, rural and poor population, the CBO analysis worried her regarding how some of these people would pay for their coverage.
Across the aisle, U.S. Sen. Joe Manchin, D-W.Va., said Thursday he continues to oppose the bill. He said he’s repeatedly offered help in fixing issues with the Affordable Care Act or taking part in any new aspect of the legislative overhaul, but he’s been shut out.
As for the proposal at hand, he said the bill would endanger thousands of West Virginians reliant on federal funds to share health care costs. He said he hopes it doesn’t come to a vote, although it’s looking that way.
“I think they’re determined to have a vote one way or another, and I pray to God they don’t repeal it,” he said. “I think that would have a devastating effect on West Virginians. I don’t how anyone in their right — I don’t know how our three congressmen voted for it knowing it’s such a flawed piece of legislation that will hurt so many West Virginians.”
All three of West Virginia’s members in the House of Representatives voted in favor of the bill.
Despite its shortfalls, Capito said there are some aspects of the bill she can get behind. For one, she said she supports the waiver provisions that would allow states to exempt insurers from requirements under current law that they cover certain essential health benefits and do not beef up coverage costs on people with pre-existing conditions.
While she said she does not think West Virginia should seize the exemptions, a state like Alaska will have wildly different health care needs than a mainland state and should have the flexibility to serve its citizens accordingly.
West Virginia’s senators are hardly the only two against the bill. Along with all 48 Senate Democrats, a growing list of Republicans are withholding full-blown support for the bill. While some of them said the cuts go too far, others said the cuts aren’t going far enough to repeal the ACA, and leadership is vexed on how to round up the 50 votes needed for passage, assuming Vice President Mike Pence steps in to break the tie.
McConnell called the task of rewriting the bill a Rubik’s cube and said he needs to twist and spin things just right to placate everyone.
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