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WASHINGTON (AP) — The nation's governors don't want people in their states to lose health coverage under a repeal of the Obama-era health care law, but even after a weekend of bipartisan meetings, they still don't agree on the best approach to replace it.
Governors attending the winter meeting of the National Governors' Association met Monday morning with President Donald Trump at the White House, where the president marveled about the intricacies of health policy.
"It's an unbelievably complex subject. Nobody knew that health care could be so complicated," Trump told the governors.
Discussion of health care dominated the governors' meeting. While the Trump administration pledged cooperation with the states, some House Republicans are pushing to limit future federal funding to provide care for low-income people in exchange for giving states more flexibility to run their programs.
Rifts emerged between Republican governors in states that opted to expand Medicaid under the 2010 health care law and those that did not. Medicaid insures more than 70 million low-income Americans, and budget hawks in Congress, including House Speaker Paul Ryan, want to curtail federal spending on the program.
Republican Gov. Gary Herbert of Utah, which did not expand Medicaid, said Monday after the meeting at the White House that he supports a proposal to cap funding in exchange for flexibility.
"We need to find a formula that's fair for everyone. Maybe that's going to be an impossibility, but we need to get as close to fairness as we can and give flexibility to the respective states," Herbert said.
But Gov. Brian Sandoval of Nevada, where more than 300,000 people joined the Medicaid rolls after expansion, said changes to the federal funding formula could be detrimental to his state.
"Nevada is one of the fastest-growing states in the country, so if you benchmark me three years ago, that's something that's going to punish Nevada," he said.
Later Monday, the governors met with congressional leaders who made clear that cutting Medicaid spending is a top priority. House Majority Leader Kevin McCarthy called the meeting constructive but suggested there would be no compromise on key GOP "principles."
"Medicaid is on track to transform into a $1 trillion annual entitlement program we simply cannot afford," McCarthy, R-California, said in a statement.
The divides among governors were evident even in the ways they interacted with reporters. The National Governors Association organized a news conference on Capitol Hill where Herbert and Sandoval spoke about the meeting with Trump alongside the group's chairman, Democratic Gov. Terry McAuliffe of Virginia. But the White House also arranged for seven Republican governors to address reporters in a gathering that the rest of the governors weren't invited to.
That group included Gov. Matt Bevin of Kentucky, a tea party conservative and a critic of Medicaid expansion in his state.
"The net result has been a remarkable decline in access to health care coverage. More people covered, but covered by what? Fewer people able to actually even see a doctor," Bevin said.
Health care wasn't the only issue on governors' minds. McAuliffe said he had frank discussions about immigration enforcement with the president and Homeland Security Secretary John Kelly. McAuliffe said Kelly assured him that federal authorities are only targeting immigrants for deportation if they've committed crimes since entering the country, and that people aren't being stopped randomly by Immigration and Customs Enforcement agents. He said he implored Trump to communicate that message more clearly.
"I told the president, 'People are confused about this policy and they are frightened about this policy, and you need to clarify it so that people are not scared in this country,'" McAuliffe said. "There is a sincere fear that they may be deported. I've been told that's not the case now. I'm going to watch very closely."
Associated Press writers Vivian Salama and Ken Thomas contributed to this report.
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