PROVIDENCE, R.I. — With billions of federal dollars for their states on the line, the nation’s governors are watching closely as the Senate GOP bill to repeal and replace the Affordable Care Act stumbles toward a conclusion in Washington.
“It’s on everyone’s mind. It’s in every private conversation. There’s a high degree of anxiety,” said Rhode Island Democratic Gov. Gina Raimondo, the host of the summer meeting Friday and Saturday of the National Governors Association here. “They see it as an unfair shift of financial burden from the federal government to the states.”
Vice President Mike Pence, who has been leading the White House’ lobbying efforts while President Donald Trump is in France, addressed the governors Friday to sell the health care plan and meet privately with some of his party’s more skeptical state leaders.
Trump has made it clear he’s watching closely, tweeting early Friday morning that he’s waiting, “at my desk, pen in hand” to sign a health care bill.
Republicans Senators are working hard to get their failed ObamaCare replacement approved. I will be at my desk, pen in hand!
At the top Pence’s list for courting is Republican Gov. Brian Sandoval of Nevada, the NGA co-chairman and a political moderate who is an outspoken opponent of the bill.
Both in public and in back rooms, seemingly everyone here is trying to buttonhole Sandoval into influencing —one way or the other — his fellow Nevada Republican, Sen. Dean Heller, who is seen as the one of the decisive vote on the Senate bill.
“Senator Heller and I are in constant conversation, and obviously he’s going to vote and make up his own mind,” Sandoval said. “But I’ve told him all along that I’m very worried.”
Heller is the most endangered Republican senator up for reelection in 2018 and has not yet said how he plans to vote on the Senate bill. Two GOP senators are already opposed to measure and Senate Majority Leader Mitch McConnell cannot afford to lose even one more vote.
Of particular interest to the governors is the Medicaid expansion. Obamacare incentivized states to dramatically expand access to the public health care program with the promise that federal government would foot much of the cost.
A majority of states took the deal and are now worried about losing the federal money they relied on to provide healthcare to millions of their residents. While most of those states are controlled by Democrats, some Republicans like Sandoval opted into the program as well.
Sandoval joined two other moderate GOP governors, John Kasich of Ohio and Charlie Baker of Massachusetts, in drafting a letter to McConnell last month criticizing the Republican approach to health care and calling for a bipartisan one instead.
In his speech, Pence did not beat around the bush about why he had come to Providence, devoting most of his remarks to a hard sales pitch for the GOP health care plan.
“President Trump and I believe the Senate bill is the right bill at the right time to begin the end of Obamacare and rescue the American people from this failed policy,” Pence said to fairly muted applause.
As the governors sat in white leather desk chairs arranged in diamond formation in front of the podium, Pence went on for 20 minutes, mixing statistics with personal anecdotes, leaning on his experience as a former governor vouch for the bill.
Pence expanded Medicaid as governor of Indiana, as Virginia Democratic Gov. Terry Mcauliffe, the chairman of the NGA, reminded the audience in a backhanded compliment during his introduction of the vice president.
But Pence used that to his advantage.
“As a former governor who expanded Medicaid in our state, I understand and appreciate, as the president does, the concerns that many of you have,” Pence said. “The truth is, for a long time Medicaid’s been a broken system that’s been fundamentally unsustainable…This just can’t continue. That’s why the Senate health care bill for the first time in its history puts Medicaid over budget.”
Pence specifically addressed the concerns of Kasich, who was not present, and extended thanks Sandoval for his leadership in the NGA, but mentioned no other governors by name.
Meanwhile, even Democrats from conservative states felt comfortable slamming the latest version of the repeal plan.
The Senate health care bill is “trying to put lipstick on a pig, guess what, it’s still a pig,” said Montana Gov. Steve Bullock.
John Bel Edwards, the Democratic governor of Louisiana, called for a bipartisan approach to healthcare that leaves the Affordable Care Act largely in place.
“It is literally saving lives, it is saving money, it is making a real difference for working people in our state,” he said.
Republican Gov. Doug Ducey of Arizona said this week that the Senate bill “needs a lot of work.”
“I am talking with [Arizona GOP] Senators [Jeff] Flake and [John] McCain and I’m telling them what my opinion is, and I’m letting them know that I don’t want to see any Arizonan have the rug pulled out from underneath them,” he said in a radio interview.
Even some GOP governors from red states that have not expanded Medicaid are expressing concern.
“We can’t just have a significant cost shift to the states because that’s something we cannot shoulder,” Arkansas Gov. Asa Hutchinson said on MSNBC. “The new Senate bill made significant progress in a number of areas that we’ve requested, but there’s still a challenge in terms of cost-sharing with the states.”
However, other conservatives, like Kentucky GOP Gov. Matt Bevin, backed the Republican plan to repeal Obamacare.
“Something has to be done. I’m a big proponent above all else of having control given back to the states,” Bevin told reporters. “The reality is this was supposed to create more opportunity for people, but it’s had the exact opposite effect. We were very close to having half our counties with no provider.”
Grandparents and other extended relatives are exempt from President Trump’s travel ban, a federal judge in Hawaii declared late Thursday, again stopping the administration from implementing the president’s controversial executive order in the way that it wants.
U.S. District Judge Derrick K. Watson wrote that the government’s “narrowly defined list” of who might be exempt was not supported by either the Supreme Court decision partially unfreezing the ban or by the law.
“Common sense, for instance, dictates that close family members be defined to include grandparents,” Watson wrote. “Indeed, grandparents are the epitome of close family members. The Government’s definition excludes them. That simply cannot be.”
Watson wrote that refugees with an assurance from a resettlement agency could also be exempt from the ban.
Attorney General Jeff Sessions said in a statement that Justice Department would “reluctantly return directly to the Supreme Court to again vindicate the rule of law and the Executive Branch’s duty to protect the nation.”
“Once again, we are faced with a situation in which a single federal district court has undertaken by a nationwide injunction to micromanage decisions of the co-equal Executive Branch related to our national security,” Sessions said. “By this decision, the district court has improperly substituted its policy preferences for the national security judgments of the Executive branch in a time of grave threats, defying both the lawful prerogatives of the Executive Branch and the directive of the Supreme Court.”
As of Friday afternoon, the Justice Department already had filed a “notice of appeal” — which lawyers view as a procedural step to help move the matter straight to the Supreme Court.
Justice Department lawyers believe that federal law allows as much and that the Supreme Court still has jurisdiction in the case to clarify the order it issued. There is also a Supreme Court rule that allows the justices to get involved before an appeals court rules if a case is “of such imperative public importance as to justify deviation from normal appellate practice and to require immediate determination in this Court.”
Department of Homeland Security and State Department spokesmen said their agencies were reviewing the decision with the Justice Department to work on implementation.
At issue is how far the administration can go in keeping relatives of U.S. residents out under the president’s travel ban, which temporarily bars entry for all refugees and the issuance of new visas to residents of six Muslim-majority countries.
The Supreme Court ruled late last month that the government could begin enforcing the measure, but not against those with “a credible claim of a bona fide relationship” with a person or entity in the United States.
The court offered only limited guidance on what type of relationship would qualify. “Close familial” relationships would count, the court said, as would ties such as a job offer or school acceptance letter that were “formal, documented, and formed in the ordinary course.”
The administration said it would let into the United States from the six affected countries parents, parents-in-law, siblings, spouses, children, sons and daughters, fiances, and sons-in-law and daughters-in-law of those already here.
Still banned, however, were grandparents, grandchildren, aunts, uncles, nieces, nephews, cousins, brothers-in-law and sisters-in-law. And the administration also said it would keep out refugees who had a formal assurance from a resettlement agency.
The state of Hawaii, which has been suing over the travel ban, soon asked Watson to intervene.
The district judge had initially ruled against Hawaii in the case, telling it to go straight to the Supreme Court. The U.S. Court of Appeals for the 9th Circuit also rebuffed the state’s request, although it offered a way forward: Watson, the appeals court said, would have jurisdiction over a reframed request. Hawaii then filed such a request, setting up Watson’s ruling Thursday — which allows the entry of those the government had wanted to keep out.
Hawaii Attorney General Douglas S. Chin said in a statement: “The federal court today makes clear that the U.S. Government may not ignore the scope of the partial travel ban as it sees fit. Family members have been separated and real people have suffered enough. Courts have found that this Executive Order has no basis in stopping terrorism and is just a pretext for illegal and unconstitutional discrimination. We will continue preparing for arguments before the U.S. Supreme Court in October.”
The government had argued that it drew its definition of who counted as a close family member from immigration law. The ruling was a blow to the administration, although not the last word on the case.
Both those suing over the ban and the government lawyers defending it indicated earlier they thought the question of who could properly be kept out after the Supreme Court unfroze the ban was a matter destined for higher courts.
While the Supreme Court partially unfroze Trump’s travel ban, it did so only temporarily, indicating it would truly take up the case in the fall. By that time, the bans might have expired. The barring of new visas to those from six countries is supposed to last 90 days, and the barring of refugees is supposed to last 120 days.
Which family members could visit under the travel ban