Ex-Gov. Beshear opposes Medicaid block grants at U.S. Senate hearing, says any changes should be 'deliberate and thoughtful'

Former Gov. Steve Beshear

Former Gov. Steve Beshear urged lawmakers at a Feb. 1 U.S. Senate hearing to not turn Medicaid into a block-grant program and to move forward in a "deliberate and thoughtful manner" as they work toward repealing and replacing the Patient Protection and Affordable Care Act, Lesley Clark reports for McClatchy Newspapers.

“The Affordable Care Act isn’t perfect. There are things you can do to improve it,” said the Democrat who embraced the ACA in his second four-year term. “But it needs to be done in a deliberate and thoughtful manner. The one thing we can’t do is go backward.”

Beshear "delivered a full-throated defense" of the ACA, Clark writes, telling lawmakers that Kentucky had the "sharpest decline in the country of residents without health insurance," from 20 percent to 7.5 percent. He also cited studies that show an increase in preventive care and substance-abuse treatment by the state's Medicaid enrollees and a drop in uncompensated care at hospitals.

“As a result of the ACA, all evidence indicates that Kentuckians are seeing improved health and beginning to reverse decades of poor health statistics,” Beshear told the senators, adding that he “can’t go out of my house or office without someone grabbing and thanking me for having affordable health care, mostly for the first time in their lives.”

Most who gained coverage are on Medicaid, which Beshear expanded to people with incomes up to 138 percent of the federal poverty line. Beshear said a block-granting Medicaid "sounds great," but it would not give states the funds they need. Congress would be “pulling a “Pontius Pilate routine, washing their hands” and placing the blame on governors, he said.

Republican Gov. Matt Bevin supports block grants, but in the meantime says the state can't afford to have almost one-third of its population on Medicaid and has asked the federal government to let him make beneficiaries pay monthly premiums and require non-disabled recipients to work or to do community service, among other things.

A spokeswoman for Bevin told Clark that the state had seen “unsustainable growth” of 68 percent in its Medicaid program, which “consumes every new dollar of revenue during this time of economic growth – and then some.”

The Senate Committee on Health, Education, Labor, and Pensions meeting was part of hearings being held by congressional committees this week about repealing and replacing Obamacare. Panelists at the Senate hearing told Republicans they need to make a decision about how they want to replace the ACA by the end of March so that insurance companies can develop their 2018 plans, Clark reports.

“Insurance markets do not respond well to uncertainty,” said Tennessee Insurance Commissioner Julie Mix McPeak, who along with Janet Trautwein of the National Association of Health Underwriters told lawmakers they need a plan by the end of March "to avoid creating more turmoil in individual insurance markets already unnerved by political uncertainty in Washington," Clark writes.

Senate Health Committee Chair Lamar Alexander of Tennessee said they "must move deliberately so they don't tilt the national health care system out of balance," Clark reports.

Marilyn Tavenner, an Obama administration official who helped with the ACA rollout and now leads the insurers' lobby, told the committee that the market needs to be stabilized, and urged Congress to keep the taxpayer-funded subsidies for people earning between 138 and 400 percent of the poverty line.