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Michael Petruzzelli

, National Council for Mental Wellbeing

Leaked Draft GOP Health Plan Receives Mixed Reactions from Congress, Governors

March 2, 2017 | ACA | Medicaid | Comments
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Congress returned from recess this week and continued work on repealing and replacing the Affordable Care Act. This week focused on the leaked draft GOP health care plan which has received opposition from both the left and right. While Speaker of the House Paul Ryan (R-WI) promised party unity for the draft plan, factions have broken out in the GOP on both sides: some arguing tenants of the ACA – like Medicaid expansion – must remain in a replacement plan, while others say the plan does not go far enough to fully repeal the health care law. Congressional action on a “repeal and replace” bill is expected to begin next week.


A number of Republicans are voicing concerns over potential plans to repeal Medicaid expansion under the Affordable Care Act. Under the draft proposal, Congress would allow states to keep Medicaid expansion in full until 2020. After that, states that choose to maintain the expanded eligibility population would return to receiving traditional Medicaid reimbursements rates. By shrinking the federal investment for Medicaid expansion, Congress would put already cashed-strapped states on the hook for covering the expansion population.

A trio of Republican Senators – Senators Shelley Moore Capito (R-WV), Lisa Murkowksi (R-AL) and Susan Collins (R-ME) – spoke out this week expressing skepticism and outright opposition to repealing the expansion of Medicaid. “I’m very concerned about a bill that would repeal the Medicaid expansion,” Capito told Politico this week. “I don’t think we’re going to go in that direction. I hope not — from the House or here. That would be a major source of concern for me.” Senator Collins said plainly she would not vote for a bill that repealed Medicaid expansion.

Governor John Kasich (R-OH), who expanded Medicaid in Ohio in 2014, made his views clear on the draft plan, saying “It’s not acceptable. I’m not going to sit silent and just allow them to rip that [Medicaid expansion] out.” Governor Kasich joined the nation’s governors last weekend at their winter meeting in Washington, D.C., where health care was major focus of conversation. Read more on that convening here.


Another segment of the GOP caucus is a group looking to fulfill a longtime campaign promise and repeal and replace the Affordable Care Act in its entirety. Members of the House Freedom Caucus said before last week’s recess that they would not vote for legislation that does not fully repeal the ACA. This week, Senators Rand Paul (R-KY), Mike Lee (R-UT) and Ted Cruz (R-TX) declared their opposition to the draft measure with Senator Paul saying, “We were elected to fully repeal and replace Obamacare, and that’s the only thing I will vote for.”


Congressional leaders are reportedly moving quickly to get repeal and replace legislation through the House of Representatives over the next three weeks. Chief congressional ally to the Trump Administration, Rep. Chris Collins (R-NY) speculated on Thursday that a draft bill could be available to members by the end of the week. A subcommittee vote is expected to be held next week.

For more details on the draft GOP plan and its potential impact on mental health and substance abuse treatment, check out this week’s Unite for Behavioral Health Advocacy Webinar. The latest webinar provided an overview of the plan’s Medicaid provisions, forecasted possible congressional action in the near future, and provided opportunities for advocates to speak up and get involved. For the National Council’s latest call to action, visit the Unite4BH webpage here.