Capitol Alert

Ridiculing Trump, Brown says state would take a hit under GOP health plan

Gov. Jerry Brown stood on the steps of the U.S. Capitol on Wednesday and railed against the Republican plan to replace Obamacare, just moments after his administration issued an analysis that found billions of dollars in increased state costs.

Brown taunted President Donald Trump, urging the Republican to “come down from Trump Tower,” and called the GOP proposal a sham that will leave millions of Americans without health coverage. The administration’s analysis found it would constrain California with $6 billion in new costs annually by 2020, rising to $24 billion per year in 2027.

“This is not about health care reform, this is about disease, death and suffering,” Brown said at a news conference featuring former Vice President Joe Biden and House Democratic leader Nancy Pelosi. “Mr. Trump,” Brown challenged, “come down from Trump Tower and walk among the people and see the damage that this latest exercise in raw political power will wreck among the women, the men and the children of this country.”

“This is a dangerous bill,” Brown added. “It’s written by people who don’t know what the hell they’re talking about.”

Brown’s remarks came a day before House Republicans were set to vote on a repeal and replacement of the 2010 Affordable Care Act, also know as Obamacare. While the current version of the plan is likely to see broad revisions to make it palatable in the U.S. Senate, California’s analysis served as a stark warning for a state that dramatically swelled its health care rolls following passage of Obamacare.

In an interview later Wednesday, Brown said the state still has time to formulate a game plan to deal with the potential staggering hole in the budget.

“Our first idea is to do everything to prevent it from happening,” Brown said. “That story will be known in a few weeks, and we’ll go from there.”

Asked if he’s thought about the scenario, Brown said there are so many “iffys” out there that it makes the whole situation “highly speculative.”

“We’ll react, whatever it is, and whatever they enforce will be an element of the budget. We, or whenever it comes up, will have to deal with it. ... $6 billion is not chump change. And it’s not $6 billion. It’s $6 billion, and then $7 (billion), and $8 (billion) and then beyond.”

California’s review focused on the parts of the Republican plan dealing with Medicaid, the federal-state health care program for the poor.

Among the California Department of Health Care Services’ most pressing concerns is a proposed overhaul of the Medicaid funding formula. If a state exceeded a Washington-imposed per capita spending cap, it would have to repay the federal share of the excess spending, under the GOP plan. That would cost California an estimated $679.2 million in 2020, growing to $5.3 billion by 2027.

Also undergoing major changes would be the generous federal assistance to pay for Obamacare’s optional expansion of Medicaid.

California embraced the optional expansion, which will cover an estimated 4.1 million people in the coming budget year. The federal government will pick up about 94 percent of the cost, with its share scheduled to decline to 90 percent by 2020.

The Republican bill would maintain that split, but only for Medi-Cal patients who keep their coverage without interruption. Participants, though, would have to re-enroll every six months, which state officials and the Congressional Budget Office say will cause many to drop off the rolls.

If they re-enroll, the federal government would pay for only one-half of the coverage. That would increase California’s cost by an estimated $4.8 billion in 2020, up to $18.5 billion in 2027, state officials said.

There also is an expected drop in funding tied to the state’s in-home care program for the blind, elderly and disabled. California’s program, the largest in the country, would take an initial $400 million federal hit in 2020, with that amount growing annually, state officials said.

Brown, in his brief address outside the Capitol, said the Republican effort was so expansive and complicated that he doubted the GOP members had read it, recalling criticisms leveled against Democrats about Obamacare. “I know the people at Trump Tower have not read it,” Brown said.

“We care,” he added, directing his ire again at Trump. “We ask you do what you said: Cover every American with real health care.”

Jim Miller of The Bee Capitol Bureau contributed to this report.

Christopher Cadelago: 916-326-5538, @ccadelago

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