How Governors From Both Parties Plotted to Derail the Senate Health Bill

Gov. John R. Kasich of Ohio, a Republican, at the White House in November. He denounced his party’s health legislation in biting terms, saying that it would victimize the poor and those with mental illnesses, and redirect tax money “to people who are already very wealthy.” Credit Kevin Lamarque/Reuters
WASHINGTON — A once-quiet effort by governors to block the full repeal of the Affordable Care Act reached its climax in Washington on Tuesday, as state executives from both parties — who have conspired privately for months — mounted an all-out attack on the Senate’s embattled health care legislation hours before Republicans postponed a vote.

At the center of the effort has been a pair of low-key moderates: Gov. John R. Kasich, Republican of Ohio, and Gov. John W. Hickenlooper, Democrat of Colorado, who on Tuesday morning called on the Senate to reject the Republican bill and to negotiate a bipartisan alternative.

Just before Senate Republicans delayed a vote on the bill, Mr. Kasich denounced his own party’s legislation in biting terms, saying it would victimize the poor and mentally ill, and redirect tax money “to people who are already very wealthy.”

“This bill,” Mr. Kasich said, “is unacceptable.”

The mounting criticism from governors, including sharp denunciations from within President Trump’s party, helped stymie Republican efforts to marshal support in the Senate, and may have led, in a roundabout way, to the stalling of the measure this week.

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More than half a dozen Republican governors, including several from states with Republican senators, expressed either grave reservations or outright opposition to the bill, while Democrats have been unanimous in their disapproval. Though their preferences on health policy diverge in many ways, state leaders from both parties were alarmed at the potential for harm to their constituents, state budgets and insurance markets.

Gov. Brian Sandoval, Republican of Nevada, rejected the Senate proposal so forcefully that he helped sway his state’s Republican senator, Dean Heller, to oppose the measure. Mr. Heller’s unrestrained attack on the bill on Friday helped set off a chain of events that forced Senate Republicans to delay the vote.

On Monday, a second bipartisan pair of governors, Terry McAuliffe of Virginia, a Democrat, and Charlie Baker of Massachusetts, a Republican, issued a joint letter asking the Senate to halt its dash toward a vote.

In an indication of the stakes involved for the states, Mr. McAuliffe and Mr. Baker wrote explicitly in their capacity as chairman of the National Governors Association and vice chairman of its health and human services committee — a striking gesture given the nonpartisan organization’s reputation for caution in politically sensitive matters.

The doggedness of the governor-led efforts reflects the expansive implications of a federal health care overhaul for state governments. In states that accepted expanded Medicaid funding under the Affordable Care Act, including Ohio and Nevada, the sharp restrictions on the program imposed under the Senate bill would batter state budgets and threaten the health coverage of millions of people.

The current Senate bill, which could be revised extensively, would wind down support for expanded Medicaid coverage and recalculate federal funding for longstanding Medicaid programs on a more restrictive basis. The Congressional Budget Office projected on Monday that the Senate’s plan would lead to 15 million fewer people receiving Medicaid coverage by 2026.