A proposal by U.S. Republican state governors to overhaul Medicaid, the federal program that provides insurance to more than 70 million low-income Americans, triggered tensions at a national gathering of state leaders in Washington on Saturday.

The National Governors Association (NGA) was in the second day of its annual winter meeting, with policy discussions so far focusing on health care reform, education and cybersecurity.


In addition to their talks on domestic issues, a number of state executives spoke to VOA about immigration controversies that have gained widespread attention nationwide in recent weeks.

Governors from both major political parties said they want to see immigrants and refugees newly arrived in America succeed in making new lives for themselves; they also stressed that everyone should be treated with compassion and in a reasonable manner as laws are enforced.

Medicaid proposal

The Republican governors’ Medicaid proposal, a draft of which was obtained by The Associated Press, urges Congress to change Medicaid from an open-ended federal entitlement to a program designed by each state to stay within financial limits. Medicaid provides insurance to more than 70 million low-income Americans, and states had the option of making it available to more people under former president Barack Obama’s health care overhaul.

The Republicans say their plan would give states more flexibility to administer health coverage for poorer residents while also protecting them from absorbing the costs of repealing the Affordable Care Act, signed into law by Obama.

Democratic governors accused their Republican counterparts Saturday of being dishonest about the effects of their plan, which they said would take away people’s health care coverage to finance tax cuts for the wealthy.

“They want to spend less money on people’s health care so they can do tax cuts for the rich. They’ve tried to put this camouflage on it that somehow they’re giving governors flexibility. We’ve got plenty of flexibility,” the Democratic governor of Washington state, Jay Inslee, told the AP. “This is not what we are asking for.”

Republican Governor Matt Bevin of Kentucky, however, said, “The kind of conversation that’s being had now — sobering, shocking, surprising as it might be to some — is the conversation that we must have, because the piper has to get paid at some point.

“People are looking at reality, and that’s good,” Bevin added.

Republicans in control

With Republicans controlling the White House and both houses of Congress, major changes to Obama’s signature health care law appear inevitable. However, public-opinion surveys indicate a broad majority of Americans oppose repealing the health care law unless lawmakers can come up with an acceptable substitute.

The governors met Saturday with recently confirmed Health Secretary Tom Price. As a senator, Price was a vocal critic of the Affordable Care Act and led efforts to repeal the law and replace it with alternative legislation.

Several governors said they were told the Trump administration wanted to partner with states to reform health care, but there were no specifics. Price told the governors the administration would release its plan soon, The Washington Post reported.

Meanwhile, President Donald Trump met at the White House with two of the Republican governors, Scott Walker of Wisconsin and Rick Scott of Florida, to discuss the health care law. They discussed “how best to solve the problems” of the law, with “special emphasis” on states’ role in health care, according to a statement released by Trump’s press secretary.

Details from draft proposal

U.S. media outlets reported details Friday of potential replacements for the health care law, frequently referred to as Obamacare. The details were obtained from draft legislation circulating among lobbyists and congressional staff.

One proposal would cap the amount of money the federal government gives to states for Medicaid. Another idea said to be under discussion would allow those who had become eligible for Medicaid when the program was expanded under Obama to keep their benefits, while additional enrollees would be excluded.

Democrats passed the Affordable Care Act in 2010 when they had majority control of both houses of Congress, as well as the White House. Republicans have opposed the law since its passage, and they tried more than 50 times unsuccessfully to repeal it during the Obama administration.

The Republican Party argues that prices are too high for Affordable Care Act insurance coverage, and that individual states should have more control than the federal government over the issue.

The health care law has enabled 20 million previously uninsured Americans to obtain coverage, but it has been plagued by difficulties, including rising premiums and some large private insurers’ decisions to leave the system.


The annual governors meeting comes on the heels of the president’s recent orders to get tougher on the estimated 11 million illegal immigrants in the U.S., in part by cutting off billions of dollars in federal funds to so-called sanctuary cities that limit cooperation with federal immigration authorities.

Washington state’s Inslee, who backed a successful legal challenge against Trump’s earlier ban on travelers from seven Muslim-majority countries, ordered state workers and agencies Thursday not to assist the enforcement of federal immigration laws.

“This executive order makes clear that Washington will not be a willing participant in promoting or carrying out mean-spirited policies that break up families and compromise our national security and, importantly, our community safety,” Inslee announced before flying to the nation’s capital, according to the Seattle Times.

Virginia Governor Terry McAuliffe, who heads the NGA, said immigrants and refugees are “safe in Virginia. … We want people to come, we want you to start a business and raise your family and have a great quality of life.”

“In Virginia, we’re going to protect all the basic and fundamental civil liberties and civil rights,” McAuliffe told VOA’s Persian service.

Oregon Governor Kate Brown told VOA her state is inclusive, and added: “We want to make sure Oregon is a place where everyone can thrive; that includes our immigrant and refugee populations.”

Arkansas Governor Asa Hutchinson told VOA’s Somali service his state has a large number of immigrants from Vietnam as well as Mexico and Central America.

“Immigrants and refugees are what make up the United States of America,” Hutchinson told VOA. “It just has to be done in a legal process. What you see is not just in the United States, but really globally, a tightening of immigration enforcement.

“Europe has a border policy they’re struggling with. … The United States is in the same position,” Hutchinson added. “Let’s start by enforcing the laws. Obviously we need to do it in a compassionate and reasonable way, but we have to protect our borders and enforce the law.”

Asked about Trump’s immigration travel ban, Kentucky Governor Bevin told VOA’s Somali service that state issues vary throughout the nation and that “immigration policy is less significant in Kentucky.” He said he wants to “focus on economic development … job creation” in his state.

Infrastructure on agenda

On Sunday, the governors will discuss child hunger and infrastructure efforts.

“Everyone likes planning infrastructure” development, Bevin told VOA. “The time has come for us to address this. We have spent an inordinate amount of money globally, building and rebuilding infrastructure in places where we, frankly, were not exactly welcomed or appreciated.

“I think there’s a lot of folks who think, ‘Let’s deploy those dollars in our own nation,’” the Kentucky governor said.

The governors will attend a ball at the White House Sunday night hosted by President Trump and first lady Melania Trump, and on Monday, all the state executives will meet with both the president and congressional leaders.

On Tuesday evening, Trump will speak to both houses of Congress, laying out his vision for the coming year. Such an address, the equivalent of the State of the Union address, traditionally is delivered by a new president shortly after his inauguration.

VOA’s Persian and Somali services contributed to this report. Some information for this article came from AP.

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