Congressman Peter Welch told state lawmakers Wednesday that a repeal of the Affordable Care Act could result in the state of Vermont losing tens of millions of dollars in Medicaid funds.
But Welch says the situation is in flux because he thinks opposition to these Medicaid cuts will grow as Congress addresses the health care issue.
Welch's remarks came in an unusual setting. It was standing room only in the largest hearing room at the Statehouse as he met with members of the House and the Senate.
While he covered a number of topics, the future of the Affordable Care Act was his primary concern. Welch said his main job in Washington these days is to assess the impact of every change that House Republican leaders propose to this health care law.
"We have to be defending the progress that we've made,” said Welch. “Every time there is a proposal, I'm going to ask the question, 'Will this increase costs or lower costs? Will it increase access or diminish access? Will it increase benefits or will it reduce benefits?' And that will be the basis upon which I evaluate proposals that are made."
A key part of the Affordable Care Act expanded Medicaid by allowing states to increase their income-eligibility levels with matching federal funds. Welch says many states, including Vermont, would face tough policy and financial questions if this provision is repealed.
“It will mean that the state legislature will have to decide how to respond to that, and we all know you can cut services, you can cut eligibility or you can raise taxes,” said Welch. “Those are the choices that a federal action to repeal the Affordable care Act would impose on this General Assembly."
Welch says his biggest concern is that GOP leaders will try to dismantle the ACA one section at a time.
“This is the aspect of it that really worries me, because it'll be step by step,” said Welch. “Each step will appear to be easy to take and to be somewhat without enormous consequence, but it begins the unraveling of the structure."
House Speaker Mitzi Johnson says the uncertainty of many federal programs in Washington makes it very difficult for the Vermont Legislature to draft its budget. But she says she wants lawmakers to work on these issues as best as they can.
"We obviously can't freeze our work and just wait for something to happen so we will continue moving forward to the best of our knowledge and ability,” said Johnson.
A group of five Republican governors is urging Congress not to repeal the expansion of Medicaid. Although he's not formally part of this group, Gov. Phil Scott says it's critical to retain this program and several other key parts of the Affordable Care Act.
"If they want to replace it, that's fine,” said Scott. “Let's have the discussion about that, have something meaningful in place. But just for the sake of repealing it, that doesn't make any sense to me ... have another option in place for us to move towards."
Scott will outline his budget priorities to lawmakers next week. The governor says the proposal will include a plan to replace Vermont's Health Care exchange with a different system that will provide individuals with access to health care coverage.